Cost of Parasitism Incurred by Two Songbird Species and Their Quality As Cowbird Hosts1

Science.gov (United States)

Dirk Burhans; Frank R. Thompson III

2000-01-01

We measured the costs of Brown-headed Cowbird (Molothrus ater) parasitism incurred by Field Sparrows (Spizella pusilla) and Indigo Buntings (Passerina cyanea). We predicted that the frequent occurrence of nest desertion as a response to cowbird parasitism in Field Sparrows would be reflected by a higher cost of...

Delivery of antiretroviral treatment services in India: Estimated costs incurred under the National AIDS Control Programme.

Science.gov (United States)

Agarwal, Reshu; Rewari, Bharat Bhushan; Shastri, Suresh; Nagaraja, Sharath Burugina; Rathore, Abhilakh Singh

2017-04-01

Competing domestic health priorities and shrinking financial support from external agencies necessitates that India's National AIDS Control Programme (NACP) brings in cost efficiencies to sustain the programme. In addition, current plans to expand the criteria for eligibility for antiretroviral therapy (ART) in India will have significant financial implications in the near future. ART centres in India provide comprehensive services to people living with HIV (PLHIV): those fulfilling national eligibility criteria and receiving ART and those on pre-ART care, i.e. not on ART. ART centres are financially supported (i) directly by the NACP; and (ii) indirectly by general health systems. This study was conducted to determine (i) the cost incurred per patient per year of pre-ART and ART services at ART centres; and (ii) the proportion of this cost incurred by the NACP and by general health systems. The study used national data from April 2013 to March 2014, on ART costs and non-ART costs (human resources, laboratory tests, training, prophylaxis and management of opportunistic infections, hospitalization, operational, and programme management). Data were extracted from procurement records and reports, statements of expenditure at national and state level, records and reports from ART centres, databases of the National AIDS Control Organisation, and reports on use of antiretroviral drugs. The analysis estimates the cost for ART services as US$ 133.89 (?8032) per patient per year, of which 66% (US$ 88.66, ?5320) is for antiretroviral drugs and 34% (US$ 45.23, ?2712) is for non-ART recurrent expenditure, while the cost for pre-ART care is US$ 33.05 (?1983) per patient per year. The low costs incurred for patients in ART and pre-ART care services can be attributed mainly to the low costs of generic drugs. However, further integration with general health systems may facilitate additional cost saving, such as in human resources.

Outside opportunities and costs incurred by others.

Science.gov (United States)

Roes, Frans L

2007-07-21

Descriptions of interactions between ants and their 'guests' serve to illustrate the thesis that Ewald's theory of the 'evolution of virulence' not only applies to interactions between micro-organisms causing infectious diseases and their hosts, but also to interactions between individuals belonging to differing species. For instance, the prediction is put forward and discussed that guests of army ants are, relative to guests of other species of ants, more often parasitic. A key variable in Ewald's theory is 'transmissibility'. It shows some resemblance to similar variables used in micro-economic theory and in Emerson's sociological Power-Dependence Relations theory. In this article, this variable is called 'outside opportunities'. In an A-B relation, an outside opportunity for A is anything which constitutes an alternative to what B can provide. It is concluded that in A-B interactions, the more outside opportunities are available to A, the more costs are incurred by B. Differences and similarities between this idea and Game Theory are discussed.

24 CFR 1000.420 - May grants made by HUD under section 603 of NAHASDA be used to pay net interest costs incurred...

Science.gov (United States)

2010-04-01

... section 603 of NAHASDA be used to pay net interest costs incurred when issuing notes or other obligations... Activities § 1000.420 May grants made by HUD under section 603 of NAHASDA be used to pay net interest costs incurred when issuing notes or other obligations? Yes. Other costs that can be paid using grant funds...

The burden of pediatric diarrhea: a cross-sectional study of incurred costs and perceptions of cost among Bolivian families.

Science.gov (United States)

Burke, Rachel M; Rebolledo, Paulina A; Embrey, Sally R; Wagner, Laura Danielle; Cowden, Carter L; Kelly, Fiona M; Smith, Emily R; Iñiguez, Volga; Leon, Juan S

2013-08-02

Worldwide, acute gastroenteritis represents an enormous public health threat to children under five years of age, causing one billion episodes and 1.9 to 3.2 million deaths per year. In Bolivia, which has one of the lower GDPs in South America, an estimated 15% of under-five deaths are caused by diarrhea. Bolivian caregiver expenses related to diarrhea are believed to be minimal, as citizens benefit from universal health insurance for children under five. The goals of this report were to describe total incurred costs and cost burden associated with caregivers seeking treatment for pediatric gastroenteritis, and to quantify relationships among costs, cost burden, treatment setting, and perceptions of costs. From 2007 to 2009, researchers interviewed caregivers (n=1,107) of pediatric patients (costs (e.g. medication, consult fees) and indirect costs (e.g. lost wages). Patient populations were similar across cities in terms of gender, duration of illness, and age, but familial income varied significantly (pcosts to families were significantly higher for inpatients as compared to outpatients of urban (pcosts made up a large proportion of total costs. Forty-five percent of patients' families paid ≥1% of their annual household income for this single diarrheal episode. The perception that cost was affecting family finances was more frequent among those with higher actual cost burden. This study demonstrated that indirect costs due to acute pediatric diarrhea were a large component of total incurred familial costs. Additionally, familial costs associated with a single diarrheal episode affected the actual and perceived financial situation of a large number of caregivers. These data serve as a baseline for societal diarrheal costs before and immediately following the implementation of the rotavirus vaccine and highlight the serious economic importance of a diarrheal episode to Bolivian caregivers.

42 CFR 412.105 - Special treatment: Hospitals that incur indirect costs for graduate medical education programs.

Science.gov (United States)

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Special treatment: Hospitals that incur indirect costs for graduate medical education programs. 412.105 Section 412.105 Public Health CENTERS FOR... SYSTEMS FOR INPATIENT HOSPITAL SERVICES Special Treatment of Certain Facilities Under the Prospective...

The role of mental health and addiction among high-cost patients: a population-based study.

Science.gov (United States)

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.

Predonation Direct and Indirect Costs Incurred by Adults Who Donated a Kidney: Findings From the KDOC Study.

Science.gov (United States)

Rodrigue, J R; Schold, J D; Morrissey, P; Whiting, J; Vella, J; Kayler, L K; Katz, D; Jones, J; Kaplan, B; Fleishman, A; Pavlakis, M; Mandelbrot, D A

2015-09-01

Limited information exists on the predonation costs incurred by eventual living kidney donors (LKDs). Expenses related to completion of the donation evaluation were collected from 194 LKDs participating in the multi-center, prospective Kidney Donor Outcomes Cohort (KDOC) Study. Most LKDs (n = 187, 96%) reported one or more direct costs, including ground transportation (80%), healthcare (24%), lodging (17%) and air transportation (14%), totaling $101 484 (USD; mean = $523 ± 942). Excluding paid vacation or sick leave, donor and companion lost wages totaled $35 918 (mean = $187 ± 556) and $14 378 (mean = $76 ± 311), respectively. One-third of LKDs used paid vacation or sick leave to avoid incurring lost wages. Few LKDs reported receiving financial support from the transplant candidate (6%), transplant candidate's family (3%), a nonprofit organization (3%), the National Living Donor Assistance Center (7%), or transplant center (3%). Higher total costs were significantly associated with longer distance traveled to the transplant center (p costs were not associated with age, sex, race/ethnicity, household income, marital status, insurance status, or transplant center. Moderate predonation direct and indirect costs are common for adults who complete the donation evaluation. Potential LKDs should be advised of these possible costs, and the transplant community should examine additional strategies to reimburse donors for them. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.

Relationship Between Severity of Illness and Length of Stay on Costs Incurred During a Pediatric Critical Care Hospitalization.

Science.gov (United States)

Hsu, Benson S; Lakhani, Saquib; Brazelton, Thomas B

2015-08-01

To estimate the impact of severity of illness and length of stay on costs incurred during a pediatric intensive care unit (PICU) hospitalization. This is a retrospective cohort study at an academic PICU located in the U.S. that examined 850 patients admitted to the PICU from Jan. 1 to Dec. 31, 2009. The study population was segmented into three severity levels based on pediatric risk of mortality (PRISM) III scores: low (PRISM score 0), medium (PRISM score 1-5), and high (PRISM score greater than 5). Outcome measures were total and daily PICU costs (2009 U.S. dollars). Eight hundred and fifty patients were admitted to the PICU during the study period. Forty-eight patients (5.6 percent) had incomplete financial data and were excluded from further analysis. Mean total PICU costs for low (n = 429), medium (n = 211), and high (n = 162) severity populations were $21,043, $37,980, and $55,620 (p costs for the low, medium, and high severity groups were $5,138, $5,903, and $5,595 (p = 0.02). Higher severity of illness resulted in higher total PICU costs. Interestingly, although daily PICU costs across severity of illness showed a statistically significant difference, the practical economic difference was minimal, emphasizing the importance of length of stay to total PICU costs. Thus, the study suggested that reducing length of stay independent of illness severity may be a practical cost control measure within the pediatric intensive care setting.

Alcohol drinking behaviour and economic cost incurred by users in Khon Kaen.

Science.gov (United States)

Paileeklee, Suchada; Kanato, Manop; Kaenmanee, Sumeth; McGhee, Sarah M

2010-03-01

Alcohol consumption increases health risks and social consequences. It also lowers productivity resulting in economic losses for drinkers and the rest of society. To investigate alcohol drinking behavior and to estimate economic cost incurred by alcohol users in Khon Kaen province in 2007. A cross-sectional survey targeting the population aged 12-65 years old was conducted in 20 communities. Data were collected using full-structured questionnaires through interviews. Among 1,053 respondents, 53.0% drank alcohol sometime in their lives (95% CI: 46.1, 59.9). The percentage of individuals drinking in the past 12 months was 43.3% (95% CI: 37.1, 49.5). The average number of drinking days in past 12 months was 36.8 days. Most respondents drank for social activities, mainly with friends and relatives. Individual costs of alcohol consumption varied greatly. The weighted average cost in 2007 was 975.5 Baht per drinker. The estimated overall cost of alcohol consumption in Khon Kaen, in 2007, was 691.2 million Baht (95% CI: 280.0, 1,102.3 million), or 502.9 Baht per capita. More than half of the Khon Kaen population drank alcohol sometime in their lives and 43.3% were current drinkers. The average number of drinking days in past 12 months was 36.8 days. The estimated cost of alcohol consumption in Khon Kaen province was enormous.

The price of 'free'. Quantifying the costs incurred by rural residents attending publically funded outpatient clinics in rural and base hospitals.

Science.gov (United States)

Fearnley, David; Kerse, Ngaire; Nixon, Garry

2016-09-01

INTRODUCTION Rural living is associated with increased costs in many areas, including health care. However, there is very little local data to quantify these costs, and their unknown quantity means that costs are not always taken into account in health service planning and delivery. AIM The aim of this study was to calculate the average time and travel costs of attending rural and base hospital outpatient clinics for rural Central Otago residents. METHODS A survey of 51 people attending rural hospital outpatient clinics. Individual costs in terms of travel and time were quantified and an average cost of both rural and base hospital attendance was calculated. RESULTS The average travel and lost time cost of attending a rural outpatient clinic was NZ$182 and 61% of respondents reported this cost had a significant effect on their weekly budget. The average cost incurred by residents associated with a base hospital attendance in Dunedin was NZ$732. DISCUSSION This study data show that costs are substantial and probably higher than most people might expect for both rural and base hospital attendances. It seems likely that these costs are a potential barrier to service access. However, the full implications of the personal costs incurred by rural residents in accessing health services are largely unstudied and therefore remain unknown in New Zealand.

Social cost of heavy drinking and alcohol dependence in high-income countries.

Science.gov (United States)

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.

Maintenance of buildings: Italian examples of deviations between planned and incurred costs

Science.gov (United States)

Rebaudengo, Manuela; Piantanida, Paolo

2018-05-01

In recent years, drawing up the maintenance plan for a building has proved to be a theoretical practice, which has been expressed in the indication of a multiplicity of interventions more for caution reasons than for real needs. In this way, the document (mandatory by the Italian law both for public and private works) has been interpreted as a formal requirement: it must be part of the project, without any particular operational interest. So, the maintenance plans are more often "standard plans", not directing the user towards a specific maintenance strategy and thus consolidating the common thesis that reality is different. The paper compares, with reference to two xxx of study (offices and residence), the planned maintenance actions and those carried out, with an indication of the difference between expected and incurred costs.

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

Hearing-impaired children in the United Kingdom, III : cochlear implantation and the economic costs incurred by families

OpenAIRE

Barton, GR; Fortnum, HM; Stacey, PC; Summerfield, AQ

2006-01-01

Objectives: This article addresses two questions. First, are there differences in the economic costs incurred by families of hearing-impaired children depending on whether or not children have cochlear implants? Second, are these differences important when assessed from the perspective of society? Methods: In a cross-sectional survey, parents of a representative sample of hearing-impaired children provided data about annual resources used by the family because of their child’s hearing impairm...

Preschool hyperactivity is associated with long-term economic burden: evidence from a longitudinal health economic analysis of costs incurred across childhood, adolescence and young adulthood.

Science.gov (United States)

Chorozoglou, Maria; Smith, Elizabeth; Koerting, Johanna; Thompson, Margaret J; Sayal, Kapil; Sonuga-Barke, Edmund J S

2015-09-01

Preschool hyperactivity is an early risk factor for adult mental health problems and criminality. Little is known about; (a) the patterns of long-term service costs associated with this behavioural marker in the general population and (b) the specific factors predicting hyperactivity-related costs. We undertook a prospective study investigating associations between preschool hyperactivity and average individual annual service costs up to late adolescent and young adulthood. One-hundred and seventy individuals rated as hyperactive by their parents and 88 nonhyperactive controls were identified from a community sample of 4,215 three years olds. Baseline information about behaviour/emotional problems and background characteristics were collected. At follow-up (when individuals were aged between 14 and 25 years) information was obtained on service use, and associated costs since the age of three. Based on this information we calculated the average cost per annum incurred by each individual. Compared to controls, preschoolers with hyperactivity had 17.6 times higher average costs per annum across domains (apart from nonmental health costs). These were £562 for each hyperactive individual compared with £30 for controls. Average annual costs decreased as a function of age, with higher costs incurred at younger ages. The effects of hyperactivity remained significant when other baseline factors were added to the model. Effects were fully mediated by later psychiatric morbidity. When the hyperactive group were examined separately, costs were consistently predicted by male gender and, for some cost codes, by conduct problems. Preventative approaches targeting early hyperactivity may be of value. Services should be targeted towards high-risk individuals with careful consideration given to the cost-to-benefit trade-off of early intervention strategies. © 2015 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association

42 CFR 137.265 - May a Tribe be reimbursed for actual and reasonable close out costs incurred after the effective...

Science.gov (United States)

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false May a Tribe be reimbursed for actual and reasonable... HEALTH AND HUMAN SERVICES TRIBAL SELF-GOVERNANCE Reassumption § 137.265 May a Tribe be reimbursed for... be reimbursed for actual and reasonable close out costs incurred after the effective date of...

Estimating time and travel costs incurred in clinic based screening: flexible sigmoidoscopy screening for colorectal cancer.

Science.gov (United States)

Frew, E; Wolstenholme, J L; Atkin, W; Whynes, D K

1999-01-01

To identify the characteristics of mode of travel to screening clinics; to estimate the time and travel costs incurred in attending; to investigate whether such costs are likely to bias screening compliance. Twelve centres in the trial of flexible sigmoidoscopy screening for colorectal cancer, drawn from across Great Britain. Analysis of 3525 questionnaires completed by screening subjects while attending clinics. Information supplied included sociodemographic characteristics, modes of travel, expenses, activities foregone owing to attendance, and details of companions. More than 80% of subjects arrived at the clinics by car, and about two thirds were accompanied. On average, the clinic visit involved a 14.4 mile (22.8 km) round trip, requiring 130 minutes. Mean travel costs amounted to 6.10 Pounds per subject. The mean gross direct non-medical and indirect cost per subject amounted to 16.90 Pounds, and the mean overall gross cost per attendance was 22.40 Pounds. Compared with the Great Britain population as a whole, non-manual classes were more strongly represented, and the self employed less strongly represented, among the attendees. In relation to direct medical costs, the time and travel costs of clinic based screening can be substantial, may influence the overall cost effectiveness of a screening programme, and may deter potential subjects from attending.

A survey of costs incurred in U.K. X-ray diffraction research laboratories as a consequence of proposed regulations for radiological safety

International Nuclear Information System (INIS)

Blow, D.M.

1981-01-01

A small survey of British X-ray diffraction laboratories was undertaken, with the aim of discovering the effects of the Health and Safety at Work Act (1974) and the draft regulations on radiological protection and ionising radiations (1978) on the practice of X-ray crystallography. The responses lead to the conclusion that the average cost incurred in bringing X-ray diffraction equipment to a safety standard compatible with the draft regulations (as judged by the respondents) will exceed Pound2,000 per X-ray generator. The safety costs will represent an overhead charge of at least 15-18% on the purchase of an X-ray generator, requiring additional capital outlay of over Pound5m to maintain the current level of X-ray diffraction activity in the U.K. There seems to be no evidence of a high accident rate with diffraction equipment, and the cost of the safety precautions bears no relation to the risks involved. (author)

Low cost high performance uncertainty quantification

KAUST Repository

Bekas, C.; Curioni, A.; Fedulova, I.

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

Costs associated with wheeling

International Nuclear Information System (INIS)

Anon.

1991-01-01

Wheeling costs are incurred by all companies that experience a change in power flows over their transmission lines during a specific transaction, whether or not the lines of that company are part of the contract path. The costs of providing wheeling service differ from one system to another and from one kind of wheeling transaction to another. While most transactions may be completed using existing capacity, others may require an increase in line. Depending on the situation, some cost components may be high, low, negative, or not incurred at all. This article discusses two general categories of costs; transactional and capital. The former are all operation, maintenance and opportunity costs incurred in completing a specific transaction assuming the existence of adequate capacity. Capital costs are the costs of major new equipment purchases and lines necessary to provide any increased level of transmission services

Costs incurred by applying computer-aided design/computer-aided manufacturing techniques for the reconstruction of maxillofacial defects.

Science.gov (United States)

Rustemeyer, Jan; Melenberg, Alex; Sari-Rieger, Aynur

2014-12-01

This study aims to evaluate the additional costs incurred by using a computer-aided design/computer-aided manufacturing (CAD/CAM) technique for reconstructing maxillofacial defects by analyzing typical cases. The medical charts of 11 consecutive patients who were subjected to the CAD/CAM technique were considered, and invoices from the companies providing the CAD/CAM devices were reviewed for every case. The number of devices used was significantly correlated with cost (r = 0.880; p costs were found between cases in which prebent reconstruction plates were used (€3346.00 ± €29.00) and cases in which they were not (€2534.22 ± €264.48; p costs of two, three and four devices, even when ignoring the cost of reconstruction plates. Additional fees provided by statutory health insurance covered a mean of 171.5% ± 25.6% of the cost of the CAD/CAM devices. Since the additional fees provide financial compensation, we believe that the CAD/CAM technique is suited for wide application and not restricted to complex cases. Where additional fees/funds are not available, the CAD/CAM technique might be unprofitable, so the decision whether or not to use it remains a case-to-case decision with respect to cost versus benefit. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Cost that is Directly Incurred as a Result of Operating the Train Service on the 1520 mm Rail with Primarily Freight Transportation

OpenAIRE

Hudenko, J; Ribakova, N; Počs, R

2016-01-01

Under the Directive 2012/34/EU (21 November 2012) "the charges for … [rail] infrastructure … shall be set at the cost that is directly incurred as a result of operating the train service". This charging rule is new for Baltic States’ railways, where due to the favorable geographic position a full cost application without detalization was possible. Although, a big number of relevant studies on the issue was made in EU, all of them covered only 1435mm railways with primarily passenger transport...

29 CFR 95.27 - Allowable costs.

Science.gov (United States)

2010-07-01

... cost principles applicable to the entity incurring the costs. Thus, allowability of costs incurred by... Governments.” The allowability of costs incurred by non-profit organizations is determined in accordance with... Organizations.” The allowability of costs incurred by institutions of higher education is determined in...

24 CFR 84.27 - Allowable costs.

Science.gov (United States)

2010-04-01

... to the entity incurring the costs. Thus, allowability of costs incurred by State, local or federally..., “Cost Principles for State and Local Governments.” The allowability of costs incurred by non-profit...-Profit Organizations.” The allowability of costs incurred by institutions of higher education is...

7 CFR 550.25 - Allowable costs.

Science.gov (United States)

2010-01-01

... cost principles applicable to the entity incurring the costs. Thus, allowability of costs incurred by... at 2 CFR part 225. The allowability of costs incurred by non-profit organizations is determined in... at 2 CFR part 230. The allowability of costs incurred by institutions of higher education is...

49 CFR 19.27 - Allowable costs.

Science.gov (United States)

2010-10-01

... applicable to the entity incurring the costs. Thus, allowability of costs incurred by State, local or... Circular A-87, “Cost Principles for State and Local Governments.” The allowability of costs incurred by non... Principles for Non-Profit Organizations.” The allowability of costs incurred by institutions of higher...

36 CFR 1210.27 - Allowable costs.

Science.gov (United States)

2010-07-01

... applicable to the entity incurring the costs. Thus, allowability of costs incurred by State, local or... Circular A-87, “Cost Principles for State and Local Governments.” The allowability of costs incurred by non... Principles for Non-Profit Organizations.” The allowability of costs incurred by institutions of higher...

7 CFR 3019.27 - Allowable costs.

Science.gov (United States)

2010-01-01

... applicable to the entity incurring the costs. Thus, allowability of costs incurred by State, local or... Circular A-87, “Cost Principles for State and Local Governments.” The allowability of costs incurred by non... Principles for Non-Profit Organizations.” The allowability of costs incurred by institutions of higher...

Diagnostic pathways and direct medical costs incurred by new adult pulmonary tuberculosis patients prior to anti-tuberculosis treatment - Tamil Nadu, India.

Science.gov (United States)

Veesa, Karun Sandeep; John, Kamalabhai Russell; Moonan, Patrick K; Kaliappan, Saravanakumar Puthupalayam; Manjunath, Krishna; Sagili, Karuna D; Ravichandra, Chinnappareddy; Menon, Pradeep Aravindan; Dolla, Chandrakumar; Luke, Nancy; Munshi, Kaivan; George, Kuryan; Minz, Shantidani

2018-01-01

Tuberculosis (TB) patients face substantial delays prior to treatment initiation, and out of pocket (OOP) expenditures often surpass the economic productivity of the household. We evaluated the pre-diagnostic cost and health seeking behaviour of new adult pulmonary TB patients registered at Primary Health Centres (PHCs) in Vellore district, Tamil Nadu, India. This descriptive study, part of a randomised controlled trial conducted in three rural Tuberculosis Units from Dec 2012 to Dec 2015, collected data on number of health facilities, dates of visits prior to the initiation of anti-tuberculosis treatment, and direct OOP medical costs associated with TB diagnosis. Logistic regression analysis examined the factors associated with delays in treatment initiation and OOP expenditures. Of 880 TB patients interviewed, 34.7% presented to public health facilities and 65% patients sought private health facilities as their first point of care. The average monthly individual income was $77.79 (SD 57.14). About 69% incurred some pre-treatment costs at an average of $39.74. Overall, patients experienced a median of 6 days (3-11 IQR) of time to treatment initiation and 21 days (10-30 IQR) of health systems delay. Age ≤ 40 years (aOR: 1.73; CI: 1.22-2.44), diabetes (aOR: 1.63; CI: 1.08-2.44) and first visit to a private health facility (aOR: 17.2; CI: 11.1-26.4) were associated with higher direct OOP medical costs, while age ≤ 40 years (aOR: 0.64; CI: 0.48-0.85) and first visit to private health facility (aOR: 1.79, CI: 1.34-2.39) were associated with health systems delay. The majority of rural TB patients registering at PHCs visited private health facilities first and incurred substantial direct OOP medical costs and delays prior to diagnosis and anti-tuberculosis treatment initiation. This study highlights the need for PHCs to be made as the preferred choice for first point of contact, to combat TB more efficiently.

Medical care costs incurred by patients with smoking-related non-small cell lung cancer treated at the National Cancer Institute of Mexico.

Science.gov (United States)

Arrieta, Oscar; Quintana-Carrillo, Roger Humberto; Ahumada-Curiel, Gabriel; Corona-Cruz, Jose Francisco; Correa-Acevedo, Elma; Zinser-Sierra, Juan; de la Mata-Moya, Dolores; Mohar-Betancourt, Alejandro; Morales-Oyarvide, Vicente; Reynales-Shigematsu, Luz Myriam

2014-01-01

Smoking is a public health problem in Mexico and worldwide; its economic impact on developing countries has not been well documented. The aim of this study was to assess the direct medical costs attributable to smoking incurred by lung cancer patients treated at the National Cancer Institute of Mexico (INCan). The study was conducted at INCan in 2009. We carried out a cost of illness (COI) methodology, using data derived from an expert panel consensus and from medical chart review. A panel of experts developed a diagnostic-therapeutic guide that combined the hospital patient pathways and the infrastructure, human resources, technology, and services provided by the medical units at INCan. Cost estimates in Mexican pesos were adjusted by inflation and converted into US Dollars using the 2013 FIX exchange rate for foreign transactions (1 USD = 13.06 Mexican pesos). A 297 incident cases diagnosed with any type of lung cancer were analyzed. According to clinical stage, the costs per patient were 13,456; 35,648; 106,186; and 144,555 USD, for lung cancer stages I, II, III, and IV respectively. The weighted average annual cost/patient was and 139,801 USD and the average annual cost/patient that was attributable to smoking was 92,269 USD. This cost was independent of the clinical stage, with stage IV representing 96% of the annual cost. The total annual cost of smoking-related lung cancer at INCan was 19,969,781 USD. The medical care costs of lung cancer attributable to smoking represent a high cost both for INCan and the Mexican health sector. These costs could be reduced if all provisions established in the Framework Convention of Tobacco Control of the World Health Organization were implemented in Mexico.

10 CFR 600.317 - Allowable costs.

Science.gov (United States)

2010-01-01

... to the type of entity incurring the cost as follows: (1) For-profit organizations. Allowability of costs incurred by for-profit organizations and those nonprofit organizations listed in Attachment C to... specifically authorized in the award document. (2) Other types of organizations. Allowability of costs incurred...

Diagnostic pathways and direct medical costs incurred by new adult pulmonary tuberculosis patients prior to anti-tuberculosis treatment – Tamil Nadu, India

Science.gov (United States)

Veesa, Karun Sandeep; John, Kamalabhai Russell; Moonan, Patrick K.; Kaliappan, Saravanakumar Puthupalayam; Manjunath, Krishna; Sagili, Karuna D.; Ravichandra, Chinnappareddy; Menon, Pradeep Aravindan; Dolla, Chandrakumar; Luke, Nancy; Munshi, Kaivan; George, Kuryan; Minz, Shantidani

2018-01-01

Background Tuberculosis (TB) patients face substantial delays prior to treatment initiation, and out of pocket (OOP) expenditures often surpass the economic productivity of the household. We evaluated the pre-diagnostic cost and health seeking behaviour of new adult pulmonary TB patients registered at Primary Health Centres (PHCs) in Vellore district, Tamil Nadu, India. Methods This descriptive study, part of a randomised controlled trial conducted in three rural Tuberculosis Units from Dec 2012 to Dec 2015, collected data on number of health facilities, dates of visits prior to the initiation of anti-tuberculosis treatment, and direct OOP medical costs associated with TB diagnosis. Logistic regression analysis examined the factors associated with delays in treatment initiation and OOP expenditures. Results Of 880 TB patients interviewed, 34.7% presented to public health facilities and 65% patients sought private health facilities as their first point of care. The average monthly individual income was $77.79 (SD 57.14). About 69% incurred some pre-treatment costs at an average of $39.74. Overall, patients experienced a median of 6 days (3–11 IQR) of time to treatment initiation and 21 days (10–30 IQR) of health systems delay. Age ≤ 40 years (aOR: 1.73; CI: 1.22–2.44), diabetes (aOR: 1.63; CI: 1.08–2.44) and first visit to a private health facility (aOR: 17.2; CI: 11.1–26.4) were associated with higher direct OOP medical costs, while age ≤ 40 years (aOR: 0.64; CI: 0.48–0.85) and first visit to private health facility (aOR: 1.79, CI: 1.34–2.39) were associated with health systems delay. Conclusion The majority of rural TB patients registering at PHCs visited private health facilities first and incurred substantial direct OOP medical costs and delays prior to diagnosis and anti-tuberculosis treatment initiation. This study highlights the need for PHCs to be made as the preferred choice for first point of contact, to combat TB more efficiently. PMID

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.

Economic consequences incurred by living kidney donors: a Canadian multi-center prospective study.

Science.gov (United States)

Klarenbach, S; Gill, J S; Knoll, G; Caulfield, T; Boudville, N; Prasad, G V R; Karpinski, M; Storsley, L; Treleaven, D; Arnold, J; Cuerden, M; Jacobs, P; Garg, A X

2014-04-01

Some living kidney donors incur economic consequences as a result of donation; however, these costs are poorly quantified. We developed a framework to comprehensively assess economic consequences from the donor perspective including out-of-pocket cost, lost wages and home productivity loss. We prospectively enrolled 100 living kidney donors from seven Canadian centers between 2004 and 2008 and collected and valued economic consequences ($CAD 2008) at 3 months and 1 year after donation. Almost all (96%) donors experienced economic consequences, with 94% reporting travel costs and 47% reporting lost pay. The average and median costs of lost pay were $2144 (SD 4167) and $0 (25th-75th percentile 0, 2794), respectively. For other expenses (travel, accommodation, medication and medical), mean and median costs were $1780 (SD 2504) and $821 (25th-75th percentile 242, 2271), respectively. From the donor perspective, mean cost was $3268 (SD 4704); one-third of donors incurred cost >$3000, and 15% >$8000. The majority of donors (83%) reported inability to perform usual household activities for an average duration of 33 days; 8% reported out-of-pocket costs for assistance with these activities. The economic impact of living kidney donation for some individuals is large. We advocate for programs to reimburse living donors for their legitimate costs. © 2014 The Authors. American Journal of Transplantation Published by Wiley Periodicals, Inc. on behalf of American Society of Transplant Surgeons.

Hidden costs of low-cost screening mammography

International Nuclear Information System (INIS)

Cyrlak, D.

1987-01-01

Twenty-two hundred women in Orange County, California, took part in a low-cost mammography screening project sponsored by the American Cancer Society and the KCBS-TV. Patients were followed up by telephone and questioned about actual costs incurred as a result of screening mammography, including costs of repeated and follow-up mammograms, US examinations and surgical consultations. The total number of biopsies, cancers found, and the costs involved were investigated. The authors' results suggest that particularly in centers with a high positive call rate, the cost of screening mammograms accounts for only a small proportion of the medical costs

25 CFR 900.254 - May the contractor be reimbursed for actual and reasonable “wind up costs” incurred after the...

Science.gov (United States)

2010-04-01

... up costs” incurred after the effective date of rescission? Yes. ... 25 Indians 2 2010-04-01 2010-04-01 false May the contractor be reimbursed for actual and reasonable âwind up costsâ incurred after the effective date of rescission? 900.254 Section 900.254 Indians...

Quality of Security Service Costing Demonstration for the MSHN Project

National Research Council Canada - National Science Library

Spyropoulou, Evdoxia

2000-01-01

.... Each service has two costs: an initialization cost and a run-time cost. The demonstration illustrates the costs incurred as network modes and security levels are changed. High level and detailed specifications are provided.

7 CFR 786.106 - Determination of losses incurred.

Science.gov (United States)

2010-01-01

... 7 Agriculture 7 2010-01-01 2010-01-01 false Determination of losses incurred. 786.106 Section 786... Determination of losses incurred. (a) Eligible payable losses are calculated on a dairy operation by dairy..., dairy production losses incurred by producers under this part are determined on the established history...

25 CFR 1000.316 - May the Tribe/Consortium be reimbursed for actual and reasonable “wind up costs” incurred after...

Science.gov (United States)

2010-04-01

... reasonable âwind up costsâ incurred after the effective date of retrocession? 1000.316 Section 1000.316... Reassumption § 1000.316 May the Tribe/Consortium be reimbursed for actual and reasonable “wind up costs” incurred after the effective date of retrocession? Yes, the Tribe/Consortium may be reimbursed for actual...

Survey on the Assessment of the Current Actual Expenses Incurred by Students on the Meals and Accommodation within and around the Campuses: The Case of Tanzania Higher Education Students' Loans Beneficiaries

Science.gov (United States)

Nyahende, Veronica R.; Bangu, Asangye N.; Chakaza, Benedicto C.

2015-01-01

This Survey analyses the current actual expenses incurred by students on the meals and accommodation within and around the campuses. The study was geared towards achieving the following objectives: (i) to examine the current cost incurred by a students for meals In Campus, (ii) to examine the current cost incurred by a students for accommodation…

Northeast Commercial Fishing Vessel Cost Survey

Data.gov (United States)

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...

25 CFR 215.12 - Advertising costs.

Science.gov (United States)

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Advertising costs. 215.12 Section 215.12 Indians BUREAU... LEASES, QUAPAW AGENCY § 215.12 Advertising costs. All advertising costs, publication fees, expenses incurred for abstracts of lease title, and other expenses incurred in connection with the advertising and...

Time and travel costs incurred by women attending antenatal tests: A costing study.

Science.gov (United States)

Verhoef, Talitha I; Daley, Rebecca; Vallejo-Torres, Laura; Chitty, Lyn S; Morris, Stephen

2016-09-01

to estimate the costs to women, their friends and family for different antenatal tests in the Down's syndrome (DS) screening pathway. questionnaire-based costing study. eight maternity clinics across the UK. pregnant women (n=574) attending an appointment for DS screening, NIPT or invasive testing between December 2013 and September 2014. using data collected from the questionnaires we calculated the total costs to women by multiplying the time spent at the hospital and travelling to and from it by the opportunity costs of the women and accompanying person and adding travel and childcare costs. Assumptions about the value of opportunity costs were tested in one-way sensitivity analyses. The main outcome measure was the mean cost to the women and friends/family for each test (DS screening, NIPT, and invasive testing). mean costs to women and their family/friend were £33.96 per visit, of which £22.47 were time costs, £9.15 were travel costs and £2.34 were childcare costs. Costs were lowest for NIPT (£22), £32 for DS screening (£44 if combined with NIPT), and highest for invasive testing (£60). Sensitivity analysis revealed that variations around the value of leisure time opportunity costs had the largest influence on the results. there are considerable costs to women, their friends and family when attending different tests in the DS screening pathway. when assessing the cost-effectiveness of changes to this pathway, costs to women should be considered. Copyright © 2016 Elsevier Ltd. All rights reserved.

Living with incurable cancer: what are the rehabilitation needs in a palliative setting?

Science.gov (United States)

Loughran, Kirsti; Rice, Sarah; Robinson, Lisa

2017-11-29

Increasing numbers of people are living with incurable cancers. Symptoms, side effects, and treatment burdens impact on physical functioning, yet little is known about the impact on people's lives and how best to provide rehabilitation. A qualitative study employing a phenomenological approach explored the lived experience of incurable cancer. A purposive sample of six people participated in semi-structured interviews. The data were analysed thematically at a semantic level to identify the functional difficulties experienced by people living with incurable cancer, the meanings of those difficulties, and participants perceived rehabilitation needs. People living with incurable cancer described cancer-related issues spanning all five domains of the International Classification of Functioning, Disability and Health (ICF). Although highly valued amongst study participants, rehabilitation services were difficult to access, poorly utilised, and referrals were sporadic and consequential; indicative of poor awareness of rehabilitation for people with incurable cancer amongst potential referrers. Participants valued a change in terminology away from "palliative" towards more positive language in line with enhanced supportive care movements. Validated tools such as the Palliative Care Therapy Outcome Measure, which align with the ICF, would allow rehabilitation professionals to demonstrate maintenance or improvement in participation and wellbeing. Implications for Rehabilitation Incurable cancer leads to a fluctuating multifactorial disability. People living with incurable cancer can benefit from rehabilitation input throughout their illness. Offering flexible and varied rehabilitation options for people living with incurable cancer will increase physical and emotional well-being, function, and coping. Allied health professionals should take and create opportunities to promote rehabilitation for people living with incurable cancer and their services to other potentially

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.

Patients direct costs to undergo TB diagnosis.

Science.gov (United States)

de Cuevas, Rachel M Anderson; Lawson, Lovett; Al-Sonboli, Najla; Al-Aghbari, Nasher; Arbide, Isabel; Sherchand, Jeevan B; Nnamdi, Emenyonu E; Aseffa, Abraham; Yassin, Mohammed A; Abdurrahman, Saddiq T; Obasanya, Joshua; Olanrewaju, Oladimeji; Datiko, Daniel; Theobald, Sally J; Ramsay, Andrew; Squire, S Bertel; Cuevas, Luis E

2016-03-24

A major impediment to the treatment of TB is a diagnostic process that requires multiple visits. Descriptions of patient costs associated with diagnosis use different protocols and are not comparable. We aimed to describe the direct costs incurred by adults attending TB diagnostic centres in four countries and factors associated with expenditure for diagnosis. Surveys of 2225 adults attending smear-microscopy centres in Nigeria, Nepal, Ethiopia and Yemen. Adults >18 years with cough >2 weeks were enrolled prospectively. Direct costs were quantified using structured questionnaires. Patients with costs >75(th) quartile were considered to have high expenditure (cases) and compared with patients with costs <75(th) quartile to identify factors associated with high expenditure. The most significant expenses were due to clinic fees and transport. Most participants attended the centres with companions. High expenditure was associated with attending with company, residing in rural areas/other towns and illiteracy. The costs incurred by patients are substantial and share common patterns across countries. Removing user fees, transparent charging policies and reimbursing clinic expenses would reduce the poverty-inducing effects of direct diagnostic costs. In locations with limited resources, support could be prioritised for those most at risk of high expenditure; those who are illiterate, attend the service with company and rural residents.

Individual loss reserving using paid-incurred data

NARCIS (Netherlands)

Pigeon, M.; Antonio, K.; Denuit, M.

2014-01-01

This paper develops a stochastic model for individual claims reserving using observed data on claim payments as well as incurred losses. We extend the approach of Pigeon et al. (2013), designed for payments only, towards the inclusion of incurred losses. We call the new technique the individual Paid

Transaction cost of micro and small enterprises financing

Directory of Open Access Journals (Sweden)

Ghana Atma Sulistya

2016-10-01

Full Text Available High transaction costs become one of the obstacles for the micro and small enterprises (MSEs to access financial loans to the bank. In order to minimize the transaction costs, group lending scheme become  alternative, so that both sides are pay lower transaction costs, and MSEs are able to improve their welfare. This study aims to analyze the credit process and transaction costs incurred on the model of individuals and groups lending and to compare the magnitude of transaction costs on both models. Mixed Method Analysis is used to analyze the component of transaction costs and the magnitude of the transaction cost on both models.These results indicate there are differences in transaction costs incurred on both schemes. In the amount of the transaction costs, the overall group scheme still allows for greater compared to individual schemes and dominated by the cost of the disbursement. Even so, the transaction cost per member group is much smaller than the individual schemes.

27 CFR 70.302 - Fees and costs for witnesses.

Science.gov (United States)

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Fees and costs for... Collection of Excise and Special (Occupational) Tax Miscellaneous Provisions § 70.302 Fees and costs for... costs. Directly incurred costs are costs incurred solely, immediately, and necessarily as a consequence...

High-Cost Patients Had Substantial Rates Of Leaving Medicare Advantage And Joining Traditional Medicare.

Science.gov (United States)

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.

Endoscopically placed guide wire assisted nasogastric tube insertion for palliation of absolute dysphagia in patients with incurable esophageal cancer

Directory of Open Access Journals (Sweden)

Purkayastha Joydeep

2006-01-01

Full Text Available Carcinoma of the esophagus is a dreadful disease because it causes a lot of distress to the patient due to its adverse effects on swallowing. Many patients present with large incurable disease or undergo disease progression and become incurable. Such patients are advised palliative and symptomatic care. The most distressing symptom that requires palliation in such patients is dysphagia. Many procedures are available for relief of dysphagia, but these are not readily available or are costly. We describe a simple, safe, cost effective and easy to do procedure for palliation of malignant dysphagia by insertion of Ryle′s tube over a endoscopically placed guide wire especially suitable for patients of the poor socio-economic strata.

Low cost high performance uncertainty quantification

KAUST Repository

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.

48 CFR 49.109-4 - No-cost settlement.

Science.gov (United States)

2010-10-01

... incurred costs for the terminated portion of the contract or (b) the contractor is willing to waive the costs incurred and (c) no amounts are due the Government under the contract. ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false No-cost settlement. 49.109...

The high cost of low-acuity ICU outliers.

Science.gov (United States)

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.

How much does it cost to care for survivors of colorectal cancer? Caregiver's time, travel and out-of-pocket costs.

Science.gov (United States)

Hanly, Paul; Céilleachair, Alan Ó; Skally, Mairead; O'Leary, Eamonn; Kapur, Kanika; Fitzpatrick, Patricia; Staines, Anthony; Sharp, Linda

2013-09-01

Cancer treatment is increasingly delivered in an outpatient setting. This may entail a considerable economic burden for family members and friends who support patients/survivors. We estimated financial and time costs associated with informal care for colorectal cancer. Two hundred twenty-eight carers of colorectal cancer survivors diagnosed on October 2007-September 2009 were sent a questionnaire. Informal care costs included hospital- and domestic-based foregone caregiver time, travel expenses and out-of-pocket (OOP) costs during two phases: diagnosis and treatment and ongoing care (previous 30 days). Multiple regression was used to determine cost predictors. One hundred fifty-four completed questionnaires were received (response rate = 68%). In the diagnosis and treatment phase, weekly informal care costs per person were: hospital-based costs, incurred by 99% of carers, mean = €393 (interquartile range (IQR), €131-€541); domestic-based time costs, incurred by 85%, mean = €609 (IQR, €170-€976); and domestic-based OOP costs, incurred by 68%, mean = €69 (IQR, €0-€110). Ongoing costs included domestic-based time costs incurred by 66% (mean = €66; IQR, €0-€594) and domestic-based OOP costs incurred by 52% (mean = €52; IQR, €0-€64). The approximate average first year informal care cost was €29,842, of which 85 % was time costs, 13% OOP costs and 2% travel costs. Significant cost predictors included carer age, disease stage, and survivor age. Informal caregiving associated with colorectal cancer entails considerable time and OOP costs. This burden is largely unrecognised by policymakers, service providers and society in general. These types of studies may facilitate health decision-makers in better assessing the consequences of changes in cancer care organisation and delivery.

7 CFR 1430.306 - Determination of losses incurred.

Science.gov (United States)

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false Determination of losses incurred. 1430.306 Section... Disaster Assistance Payment Program § 1430.306 Determination of losses incurred. (a) Eligible payable losses are calculated on a dairy operation by dairy operation basis and are limited to those occurring in...

Estimating the costs of induced abortion in Uganda: A model-based analysis

Science.gov (United States)

2011-01-01

Background The demand for induced abortions in Uganda is high despite legal and moral proscriptions. Abortion seekers usually go to illegal, hidden clinics where procedures are performed in unhygienic environments by under-trained practitioners. These abortions, which are usually unsafe, lead to a high rate of severe complications and use of substantial, scarce healthcare resources. This study was performed to estimate the costs associated with induced abortions in Uganda. Methods A decision tree was developed to represent the consequences of induced abortion and estimate the costs of an average case. Data were obtained from a primary chart abstraction study, an on-going prospective study, and the published literature. Societal costs, direct medical costs, direct non-medical costs, indirect (productivity) costs, costs to patients, and costs to the government were estimated. Monte Carlo simulation was used to account for uncertainty. Results The average societal cost per induced abortion (95% credibility range) was $177 ($140-$223). This is equivalent to $64 million in annual national costs. Of this, the average direct medical cost was $65 ($49-86) and the average direct non-medical cost was $19 ($16-$23). The average indirect cost was $92 ($57-$139). Patients incurred $62 ($46-$83) on average while government incurred $14 ($10-$20) on average. Conclusion Induced abortions are associated with substantial costs in Uganda and patients incur the bulk of the healthcare costs. This reinforces the case made by other researchers--that efforts by the government to reduce unsafe abortions by increasing contraceptive coverage or providing safe, legal abortions are critical. PMID:22145859

7 CFR 3015.195 - Subgrants and cost-type contracts.

Science.gov (United States)

2010-01-01

...-21 would apply to the costs incurred by the institution of higher education even though OMB Circular A-87 would apply to the costs incurred by the State. ... 7 Agriculture 15 2010-01-01 2010-01-01 false Subgrants and cost-type contracts. 3015.195 Section...

7 CFR 1430.606 - Determination of losses incurred.

Science.gov (United States)

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false Determination of losses incurred. 1430.606 Section... Disaster Assistance Payment Program II (DDAP-II) § 1430.606 Determination of losses incurred. (a) Eligible payable losses are calculated on a dairy operation by dairy operation basis and are limited to those...

High cost of stage IV pressure ulcers.

Science.gov (United States)

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.

48 CFR 952.231-70 - Date of incurrence of cost.

Science.gov (United States)

2010-10-01

... have been negotiated regarding costs incurred prior to the contract effective date: Date of Incurrence of Cost (APR 1984) The Contractor shall be entitled to reimbursement for costs incurred in an amount... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Date of incurrence of cost...

Cure of incurable lymphoma

International Nuclear Information System (INIS)

De Nardo, Gerald L.; Sysko, Vladimir V.; De Nardo, Sally J.

2006-01-01

The most potent method for augmenting the cytocidal power of monoclonal antibody (MAb) treatment is to conjugate radionuclides to the MAb to deliver systemic radiotherapy (radioimmunotherapy; RIT). The antigen, MAb, and its epitope can make a difference in the performance of the drug. Additionally, the radionuclide, radiochemistry, chelator for radiometals and the linker between the MAb and chelator can have a major influence on the performance of drugs (radiopharmaceuticals) for RIT. Smaller radionuclide carriers, such as antibody fragments and mimics, and those used for pretargeting strategies, have been described and evaluated. All of these changes in the drugs and strategies for RIT have documented potential for improved performance and patient outcomes. RIT is a promising new therapy that should be incorporated into the management of patients with B-cell non-Hodgkin's lymphoma (NHL) soon after these patients have proven incurable. Predictable improvements using better drugs, strategies, and combinations with other drugs seem certain to make RIT integral to the management of patients with NHL, and likely lead to cure of currently incurable NHL

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

Science.gov (United States)

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

2010-05-01

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

Costs of employee turnover

Directory of Open Access Journals (Sweden)

Jiří Duda

2013-01-01

Full Text Available The aim of this paper is to establish a general methodology for calculating the costs incurred by employee turnover. This paper deals with identification of costs incurred by the departure of an employee, and does not deal with the cost of recruitment of a new employee. Economic calculations are adjusted to the tax policy in the Czech Republic. The costs of employee turnover (according to Bliss, 2012 include the costs of substitution of the unoccupied position, costs of conducting the exit interview and termination of the contract. The cost of an executive’s time to understand the causes of leaving and costs of the leaving employee’s training were also determined. Important factors in the costs of employee turnover also include the loss of knowledge and possibly also a loss of customers. Costs of lost employee and department productiveness represent an important part of the costs of employee turnover, as well. For all of these costs there have been proposed general calculations formulas.

Transaction costs and community-based natural resource management in Nepal.

Science.gov (United States)

Adhikari, Bhim; Lovett, Jon C

2006-01-01

Transaction costs in community-based resource management are incurred by households attempting to enforce property right rules over common resources similar to those inherent in private property rights. Despite their importance, transaction costs of community-based management of common pool resources (CPRs) are often not incorporated into the economic analysis of participatory resource management. This paper examines the transaction costs incurred by forest users in community forestry (CF) based on a survey of 309 households belonging to eight different forest user groups (FUGs) in the mid hills of Nepal. The analysis reveals that the average 'poor' household incurred Nepalese rupees (NRS) 1265 in transaction costs annually, while wealthier 'rich' households incurred an average of NRS 2312 per year. Although richer households bear higher proportions of such costs, transaction costs for CF management as a percentage of resource appropriation costs are higher for poorer households (26%) than those of middle-wealth (24%) or rich households (14%). There are also village differences in the level of transaction costs. The results show that transaction costs are a major component of resource management costs and vary according to socio-economic status of resource users and characteristics of the community.

Currency Integration under Labor Mobility: when Cost is incurred

OpenAIRE

Yoshimi, Taiyo

2014-01-01

We assess whether renouncing monetary policy autonomy becomes a cost of currency integration under labor mobility in the framework of the New Open Economy Macroeconomics. Assuming Nash equilibrium among central banks of candidate countries, we find that the forfeiture of monetary policy autonomy becomes a cost when country-specific total factor productivity shocks hit them, labor input weights differ between candidate countries, and country specific shocks on marginal disutility of labor occu...

Fees for Advertisements in Public Space Incurred by a Given Bank Brand in Poland

Directory of Open Access Journals (Sweden)

Płuciennik Monika

2017-03-01

Full Text Available This article aims to present significant changes in the rates of fees for advertisements on selected bank buildings located in public space, resulting from the implementation of the so-called "Act on Landscape Protection" (Act on amending certain acts in connection with the strengthening of landscape protection tools from 24 April 2015 (2015 Journal Of Laws, item 774. The Act on landscape protection aims to minimize the amount of signboards in city centers. It introduces significant changes regarding (a fees, (b the expanded definition of advertisements, and (c potential revisions and renewal of advertisements. The implementation of the Act causes significant inconveniences and challenges in the process advertising services. The objective of this research is to assess changes in the costs of advertising incurred by banks. More specifically, the research estimated (a fees incurred by a selected bank brand for signboards placed on all bank branches within the entire country. An altered definition of an advertisement placed in the right-of-way and in public space will cause an increase in the surface of signboards, and, therefore, an increase in fees. In addition, a new type of fee (i.e., advertising fee will increase the expenses incurred by the bank for the specified objects.

The pretreatment cost of a pyroprocess facility in Korea

International Nuclear Information System (INIS)

Kim, S. K.; Youn, S. R.; Lee, S. H.; Lee, H. J.; Ko, W. I.

2015-01-01

Shale gas still has many disadvantages such as significant technological difficulties and high costs even when the fracking technology is used to extract shale gas since shale gas is dispersed widely. Moreover, it is estimated that the shale gas can be used for about 60 years, which is comparable to the period estimated for oil deposits. Another concern is that the climate may change due to the discharge of harmful gas produced during the gas extraction process. PRIDE facility producing 10 ton/year uranium ingot was set as the cost object for the cost estimation, and it was possible to increase cost calculation's accuracy level since labor cost and expenses incurred in this facility were the costs incurred in actuality. In the end, First-In, First Out process costing method was used to calculate the pretreatment cost of pyroprocess. According to the cost calculation results, the pretreatment cost was estimated as $195/kgHM and the cost share of the pretreatment of pyroprocess was calculated as 20%. Accordingly, electrochemical reduction process is the process requires most cost, followed by the cost of electro-winning process

The pretreatment cost of a pyroprocess facility in Korea

Energy Technology Data Exchange (ETDEWEB)

Kim, S. K.; Youn, S. R.; Lee, S. H.; Lee, H. J.; Ko, W. I. [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

2015-05-15

Shale gas still has many disadvantages such as significant technological difficulties and high costs even when the fracking technology is used to extract shale gas since shale gas is dispersed widely. Moreover, it is estimated that the shale gas can be used for about 60 years, which is comparable to the period estimated for oil deposits. Another concern is that the climate may change due to the discharge of harmful gas produced during the gas extraction process. PRIDE facility producing 10 ton/year uranium ingot was set as the cost object for the cost estimation, and it was possible to increase cost calculation's accuracy level since labor cost and expenses incurred in this facility were the costs incurred in actuality. In the end, First-In, First Out process costing method was used to calculate the pretreatment cost of pyroprocess. According to the cost calculation results, the pretreatment cost was estimated as $195/kgHM and the cost share of the pretreatment of pyroprocess was calculated as 20%. Accordingly, electrochemical reduction process is the process requires most cost, followed by the cost of electro-winning process.

Fees For Advertisements In The Right-Of-Ways Of Public Roads Incurred By A Given Bank Brand In Poland

Directory of Open Access Journals (Sweden)

Płuciennik Monika

2015-12-01

Full Text Available This article aims to present the diversity in the rates of fees for advertisements on selected bank buildings located in the right-of-way, as well as the manner of calculating them. The research covered fees, incurred by a selected bank brand, for advertisements placed on all outlets of the bank in the area of the entire country in terms of the location of the buildings, means of establishing fees, rate of the basic fee, as well as costs incurred by the bank for placing advertisements in the right-of-way according to the state at the end of 2014.

The personal costs and convenience of screening mammography.

Science.gov (United States)

Suter, Lisa Gale; Nakano, Connie Y; Elmore, Joann G

2002-09-01

Few studies have examined the impact of women's personal costs on obtaining a screening mammogram in the United States. All women obtaining screening mammograms at nine Connecticut mammography facilities during a 2-week study period were asked to complete a questionnaire. Facilities included urban and rural fixed sites and mobile sites. The survey included questions about insurance coverage, mammogram payment, and personal costs in terms of transportation, family care, parking, and lost work time from the women's perspective. The response rate was 62% (731 of 1189). Thirty-two percent of respondents incurred some type of personal cost, including lost work time, family care, and parking. Women incurring personal costs were more likely than those without personal costs to attend an urban facility (46% vs. 23%, p convenience and 17% listed cost as a reason for choosing a mammography facility; 23% reported that cost might prevent them from obtaining a future mammogram. One third of women obtaining mammograms may be incurring personal costs. These personal costs should be considered in future cost-effectiveness analyses.

Covariates of depression and high utilizers of healthcare: Impact on resource use and costs.

Science.gov (United States)

Robinson, Rebecca L; Grabner, Michael; Palli, Swetha Rao; Faries, Douglas; Stephenson, Judith J

2016-06-01

To characterize healthcare costs, resource use, and treatment patterns of survey respondents with a history of depression who are high utilizers (HUds) of healthcare and to identify factors associated with high utilization. Adults with two or more depression diagnoses identified from the HealthCore Integrated Research Database were invited to participate in the CODE study, which links survey data with 12-month retrospective claims data. Patient surveys provided data on demographics, general health, and symptoms and/or comorbidities associated with depression. Similar clinical conditions also were identified from the medical claims. Factors associated with high utilization were identified using logistic regression models. Of 3132 survey respondents, 1921 were included, 193 of whom were HUds (defined as those who incurred the top 10% of total all-cause costs in the preceding 12months). Mean total annual healthcare costs were eightfold greater for HUds than for non-HUds ($US56,145 vs. $US6,954; pcosts/resource use. HUds were prescribed twice as many medications (total mean: 16.86 vs. 8.32; psychotropic mean: 4.11 vs. 2.61; both pcosts in patients with depression. Copyright © 2016 Eli Lilly and Company. Published by Elsevier Inc. All rights reserved.

Differential fitness costs of reproduction between the sexes

OpenAIRE

Penn, Dustin J.; Smith, Ken R.

2006-01-01

Natural selection does not necessarily favor maximal reproduction because reproduction imposes fitness costs, reducing parental survival, and offspring quality. Here, we show that parents in a preindustrial population in North America incurred fitness costs from reproduction, and women incurred greater costs than men. We examined the survivorship and reproductive success (Darwinian fitness) of 21,684 couples married between 1860 and 1895 identified in the Utah Population Database. We found th...

[Predicting individual risk of high healthcare cost to identify complex chronic patients].

Science.gov (United States)

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.

20 CFR 627.435 - Cost principles and allowable costs.

Science.gov (United States)

2010-04-01

... system, including the costs of hearings and appeals, and related expenses such as lawyers' fees. Legal...) Legal expenses for the prosecution of claims against the Federal Government, including appeals to an... incurred by the SJTCC, HRIC, PIC's, and other advisory councils or committees; (3) Advertising costs; (4...

Economic costs of diabetes in Saudi Arabia

Directory of Open Access Journals (Sweden)

Abdulkarim K Alhowaish

2013-01-01

Full Text Available Background: Diabetes imposes a large economic burden on the individual, national healthcare systems, and countries. Objective: To determine the economic impact of diabetes mellitus on Saudi healthcare system, both now and in the future. Materials and Methods: This research study uses a prevalence-based approach that combines the demographics of the population (classified by nationality, sex and age group with and without diagnosed diabetes in 1992 and 2010. The economic impact of diabetes is estimated in this study, using secondary sources of information provided by Ministry of Health, Ministry of Finance and Central Department of Statistics and Information databases. Results: People diagnosed with diabetes, on average, have medical healthcare expenditures that are ten times higher ($3,686 vs. $380 than what expenditures would be in the absence of diabetes. Over 96% of all medical healthcare expenditures attributed to diabetes are incurred by persons of Saudi nationality, with the remaining 4% incurred by persons of non-Saudi nationality. The population age 45-60 incurs 45% of diabetes-attributed costs, with the remaining population under age 15 incurs 3.8%, age 15-44 incurs 27.5%, and age 60 and above incurs 23.8%. Conclusion: The actual national healthcare burden because of diabetes is likely to exceed the $0.87 billion estimated in this study, because it omits the indirect costs associated with diabetes, such as absenteeism, lost productivity from disease-related absenteeism, unemployment from disease-related disability, lost productivity due to early mortality by disease. The social cost of intangibles such as pain and suffering and care provided by non-paid caregivers as well as healthcare system administrative costs, cost of medications, clinician training programs, and research and infrastructure development is also omitted from this research study. Further studies are needed to confirm the present findings and to improve our

Cost management of golf courses

OpenAIRE

Černický, Marek

2010-01-01

The thesis focuses on costs incurred during the golf course construction and also on operating costs. Types of these costs and options of cost cutting are described. The final part of the thesis analyzes and models usage yield and capacity of golf courses.

Research on perception of quality and interruption costs for customers of high and medium voltage; Pesquisa sobre percepcao da qualidade e custos de interrupcao em clientes de alta e media tensao

Energy Technology Data Exchange (ETDEWEB)

Pelegrini, Marcelo A.P.; Almeida, Carlos Frederico Mechini; Baldan, Silvio; Amasifen, Juan C. Cebrian; Cunha, Gabriel R.A.; Garcia, Valdomiro V.; Cyrillo, Ivo O.; Souza, Tiago P. de; Magalhaes, Cecilia H. Magalhaes; Silva, Fabiana A. Toledo [Sinapsis Inovacao em Energia S/S LTDA, Bela Vista, SP (Brazil)], E-mails: marcelo.pelegrini@sinapsienergia.com, carlos.almeida, juan.cebrian@sinapsienergia.com

2011-10-15

This paper presents partial results of an applied research on the perceived quality of energy by customers of AES Eletropaulo of high and medium voltage. In general, occurrences related to power interruption can cause serious consequences for industrial and commercial customers. This issue motivated the calculation, from the results obtained, of the cost of interruption incurred by customers individually, based on 12 categories of spending, and this result was validated by comparison with actual expenditures incurred during an intervention in a large industrial customer. (author)

48 CFR 9904.402 - Cost accounting standard-consistency in allocating costs incurred for the same purpose.

Science.gov (United States)

2010-10-01

... Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.402 Cost... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Cost accounting standard...

Cost function estimation

DEFF Research Database (Denmark)

Andersen, C K; Andersen, K; Kragh-Sørensen, P

2000-01-01

on these criteria, a two-part model was chosen. In this model, the probability of incurring any costs was estimated using a logistic regression, while the level of the costs was estimated in the second part of the model. The choice of model had a substantial impact on the predicted health care costs, e...

[Deinstitutionalization of long-stay psychiatric patients in upper Austria -- utilization of healthcare resources and costs of outpatient care].

Science.gov (United States)

Haberfellner, Egon Michael; Grausgruber, Alfred; Grausgruber-Berner, Rosemarie; Ortmair, Margarethe; Schöny, Werner

2006-03-01

The study was intended to evaluate the therapeutic and healthcare services utilized by 116 former long-stay patients after an average of 42.9 months of deinstitutionalization during a follow-up time of (1/2) year and to calculate the costs thus incurred. 116 patients and their caregivers were interviewed during a period of 6 months using the German version of the Client Sociodemographic and Service Receipt Inventory. On average, 3.3 institutions/facilities were contacted per patient, most often by younger patients living in group homes and least often by patients in psychiatric nursing homes. During the 6-month follow-up time costs of euro 14,665 were incurred per patient. Of these costs, 87.2 % were for the residential facilities. The costs of outpatient care accounted for 41.4 % of the costs that would have been incurred for inpatient care in a psychiatric hospital. Deinstitutionalization of psychiatric long-stay patients in Upper Austria provided for considerable reductions in costs while maintaining a high quality of care.

44 CFR 208.39 - Reimbursement for personnel costs incurred during Activation.

Science.gov (United States)

2010-10-01

...) Reimbursement of additional salary and overtime costs. DHS will reimburse any identified additional salary and...). (g) Reimbursement for Backfill costs upon Activation. DHS will reimburse the cost to Backfill System... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Reimbursement for personnel...

Cost of illness and determinants of costs among patients with gout.

Science.gov (United States)

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

2015-02-01

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

42 CFR 417.540 - Enrollment costs.

Science.gov (United States)

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Enrollment costs. 417.540 Section 417.540 Public... PLANS Medicare Payment: Cost Basis § 417.540 Enrollment costs. (a) Principle. Enrollment costs are... of costs included. Enrollment costs include, but are not limited to, reasonable costs incurred in...

76 FR 54223 - Notice of Proposed Administrative Cost Recovery Settlement Pursuant to the Comprehensive...

Science.gov (United States)

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...

The jurisdiction of administrative courts in disputes about the payment of costs incurred for investigating or supervisory tasks in compliance with section 21 AtG (Atomic Energy Act). Hess. VGH, decision of August 2, 1993 - 14 A 995/92

International Nuclear Information System (INIS)

Anon.

1994-01-01

Disputes about payment of costs incurred by investigating or supervisory tasks in compliance with section 21 AtG (Atomic Energy Act) are to be settled by a the first instance, the administrative courts. (Judgment of Higher Adm. Court of Hesse, as of August 2, 1993 - 14 A 995/92). (orig./HSCH) [de

Determinants of the property damage costs of tanker accidents

International Nuclear Information System (INIS)

Talley, W.K.

1999-01-01

This study investigates determinants of the vessel, oil cargo spillage, and other-property damage costs of tanker accidents. Tobit estimation of a three-equation recursive model suggests that, among types of tanker accidents, fire/explosion accidents incur the largest vessel damage costs, but the smallest oil cargo spillage costs. Alternatively, grounding accidents incur the smallest vessel damage costs, but the largest oil cargo spillage costs, reflecting the difficulty of controlling oil cargo spillage subsequent to such accidents. Also, oil cargo spillage costs are lower for US flag tanker accidents. A dollar of vessel damage cost increases other-property damage cost by 0.06 dollars, whereas a dollar of oil cargo spillage increases this cost by 1.55 dollars

33 CFR 214.11 - Costs.

Science.gov (United States)

2010-07-01

... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Costs. 214.11 Section 214.11... SUPPLIES OF DRINKING WATER § 214.11 Costs. Costs incurred by the Corps of Engineers in furnishing emergency... by the community generally will not be required. Costs of necessary measures for the decontamination...

7 CFR 330.107 - Costs.

Science.gov (United States)

2010-01-01

... 7 Agriculture 5 2010-01-01 2010-01-01 false Costs. 330.107 Section 330.107 Agriculture Regulations...; GARBAGE General Provisions § 330.107 Costs. All costs (including those incurred under § 330.106 of this... usual places of duty shall be furnished without cost to the person requesting the services, unless a...

The prognosis of incurable cachectic cancer patients on home parenteral nutrition

DEFF Research Database (Denmark)

Bozzetti, F; Santarpia, L; Pironi, L

2014-01-01

BACKGROUND: The role of home parenteral nutrition (HPN) in incurable cachectic cancer patients unable to eat is extremely controversial. The aim of this study is to analyse which factors can influence the outcome. PATIENTS AND METHODS: We studied prospectively 414 incurable cachectic (sub)obstruc...

23 CFR 140.505 - Reimbursable costs.

Science.gov (United States)

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...

45 CFR 602.22 - Allowable costs.

Science.gov (United States)

2010-10-01

... CFR part 31. Contract Cost Principles and Procedures, or uniform cost accounting standards that comply.... (b) Applicable cost principles. For each kind of organization, there is a set of Federal principles... principles applicable to the organization incurring the costs. The following chart lists the kinds of...

48 CFR 31.205-32 - Precontract costs.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Precontract costs. 31.205... CONTRACTING REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations 31.205-32 Precontract costs. Precontract costs means costs incurred before the effective date of the...

FACTORS INFLUENCING SMALLHOLDERS' TRANSACTION COST OF BORROWING FROM THE NIGERIAN AGRICULTURAL AND COOPERATIVE BANK

OpenAIRE

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 ...

New AICPA standards aid accounting for the costs of internal-use software.

Science.gov (United States)

Luecke, R W; Meeting, D T; Klingshirn, R G

1999-05-01

Statement of Position (SOP) No. 98-1, "Accounting for the Costs of Computer Software Developed or Obtained for Internal Use," issued by the American Institute of Certified Public Accountants in March 1998, provides financial managers with guidelines regarding which costs involved in developing or obtaining internal-use software should be expensed and which should be capitalized. The SOP identifies three stages in the development of internal-use software: the preliminary project stage, the application development stage, and the postimplementation-operation stage. The SOP provides that all costs incurred during the preliminary project stage should be expensed as incurred. During the application development stage, costs associated with developing or obtaining the software should be capitalized, while costs associated with preparing data for use within the new system should be expensed. Costs incurred during the postimplementation-operation stage, typically associated with training and application maintenance, should be expensed.

48 CFR 9905.502 - Cost accounting standard-consistency in allocating costs incurred for the same purpose by...

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Cost accounting standard... 9905.502 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...

48 CFR 1231.205-32 - Precontract costs.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Precontract costs. 1231... CONTRACTING REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations 1231.205-32 Precontract costs. (a) The decision to incur precontract costs is that of the contractor. No...

28 CFR 100.14 - Directly allocable costs.

Science.gov (United States)

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...

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

Directory of Open Access Journals (Sweden)

Dadan Soekardan

2015-08-01

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

Health care costs, work productivity and activity impairment in non-malignant chronic pain patients

DEFF Research Database (Denmark)

Kronborg, Christian; Handberg, Gitte; Axelsen, Flemming

2009-01-01

This study explores the costs of non-malignant chronic pain in patients awaiting treatment in a multidisciplinary pain clinic in a hospital setting. Health care costs due to chronic pain are particular high during the first year after pain onset, and remain high compared with health care costs be...... before pain onset. The majority of chronic pain patients incur the costs of alternative treatments. Chronic pain causes production losses at work, as well as impairment of non-work activities.......This study explores the costs of non-malignant chronic pain in patients awaiting treatment in a multidisciplinary pain clinic in a hospital setting. Health care costs due to chronic pain are particular high during the first year after pain onset, and remain high compared with health care costs...

Cost analysis of Healthcare in a Private sector Neonatal Intensive Care Unit in India.

Science.gov (United States)

Karambelkar, Geeta; Malwade, Sudhir; Karambelkar, Rajendra

2016-09-08

To study the actual cost of care per patient in private-sector level IIIa Neonatal Intensive Care Unit (NICU). Prospective cost-analysis study. Cost incurred by the family on the treatment of baby, separately for every newborn for entire length of hospitalization, was calculated. 126 newborns were enrolled; High level of intervention was needed for 25.4% babies. The mean cost of care was US $ 90.7 per patient per day. Bulk of the cost of care was the hospital bill.

The cost of poor working conditions

NARCIS (Netherlands)

Koningsveld, E.A.P.; Houtman, I.L.D.

2004-01-01

An estimate of the multiple costs incurred by workplace accidents, illnesses and long-term absence puts the amount at 3% of total GNP in the Netherlands. Musculoskeletal disorders and psychosocial diseases are responsible for 83% of the cost of work-related health issues.

28 CFR 70.27 - Allowable costs.

Science.gov (United States)

2010-07-01

... AND AGREEMENTS (INCLUDING SUBAWARDS) WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Financial and Program Management § 70.27 Allowable costs. (a... Organizations.” The allowability of costs incurred by institutions of higher education is determined in...

An economic and legal perspective on electric utility transition costs

Energy Technology Data Exchange (ETDEWEB)

Rose, K.

1996-07-01

The issue of possibly unrecoverable cost incurred by a utility, or `stranded costs,` has emerged as a major obstacle to developing a competitive generation market. Stranded or transition costs are defined as costs incurred by a utility to serve its customers that were being recovered in rates but are no longer due to availability of lower-priced alternative suppliers. The idea of `stranded cost,` and more importantly arguments for its recovery, is a concept with little basis in economic theory, legal precedence, or precedence in other deregulated industries. The main argument recovery is that the ``regulatory compact`` requires it. This is based on the misconception that the regulator compact is simply: the utility incurs costs on behalf of its customers because of the ``obligation to serve`` so, therefore, customers are obligated to pay. This is a mischaracterization of what the compact was and how it developed. Another argument is that recovery is required for economic efficiency. This presumes, however, a very narrow definition of efficiency based on preventing ``uneconomic`` bypass of the utility and that utilities minimize costs. A broader definition of efficiency and the likelihood of cost inefficiencies in the industry suggest that the cost imposed on customers from inhibiting competition could exceed the gains from preventing uneconomic bypass. Both these issues are examined in this paper.

45 CFR 2543.27 - Allowable costs.

Science.gov (United States)

2010-10-01

... GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Financial and Program Management § 2543.27 Allowable costs. For each kind... Organizations.” The allowability of costs incurred by institutions of higher education is determined in...

20 CFR 435.27 - Allowable costs.

Science.gov (United States)

2010-04-01

... AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, OTHER NON-PROFIT ORGANIZATIONS, AND COMMERCIAL ORGANIZATIONS Post-Award Requirements Financial and Program Management § 435.27 Allowable costs. For each kind... Organizations.” (c) Allowability of costs incurred by institutions of higher education is determined in...

US/FRG joint report on the pebble bed high temperature reactor resource conservation potential and associated fuel cycle costs

International Nuclear Information System (INIS)

Teuchert, E.; Ruetten, H.J.; Worley, B.A.; Vondy, D.R.

1979-11-01

Independent analyses at ORNL and KFA have led to the general conclusion that the flexibility in design and operation of a high-temperature gas-cooled pebble-bed reactor (PBR) can result in favorable ore utilization and fuel costs in comparison with other reactor types, in particular, with light-water reactors (LWRs). Fuel reprocessign and recycle show considerable promise for reducing ore consumption, and even the PBR throwaway cycle is competitive with fuel recycle in an LWR. The best performance results from the use of highly enriched fuel. Proliferation-resistant measures can be taken using medium-enriched fuel at a modest ore penalty, while use of low-enriched fuel would incur further ore penalty. Breeding is possible but net generation of fuel at a significant rate would be expensive, becoming more feasible as ore costs increase substantially. The 233 U inventory for a breeder could be produced by prebreeders using 235 U fuel

Acute costs and predictors of higher treatment costs of trauma in New South Wales, Australia.

Science.gov (United States)

Curtis, Kate; Lam, Mary; Mitchell, Rebecca; Black, Deborah; Taylor, Colman; Dickson, Cara; Jan, Stephen; Palmer, Cameron S; Langcake, Mary; Myburgh, John

2014-01-01

Accurate economic data are fundamental for improving current funding models and ultimately in promoting the efficient delivery of services. The financial burden of a high trauma casemix to designated trauma centres in Australia has not been previously determined, and there is some evidence that the episode funding model used in Australia results in the underfunding of trauma. To describe the costs of acute trauma admissions in trauma centres, identify predictors of higher treatment costs and cost variance in New South Wales (NSW), Australia. Data linkage of admitted trauma patient and financial data provided by 12 Level 1 NSW trauma centres for the 08/09 financial year was performed. Demographic, injury details and injury scores were obtained from trauma registries. Individual patient general ledger costs (actual trauma patient costs), Australian Refined Diagnostic Related Groups (AR-DRG) and state-wide average costs (which form the basis of funding) were obtained. The actual costs incurred by the hospital were then compared with the state-wide AR-DRG average costs. Multivariable multiple linear regression was used for identifying predictors of costs. There were 17,522 patients, the average per patient cost was $10,603 and the median was $4628 (interquartile range: $2179-10,148). The actual costs incurred by trauma centres were on average $134 per bed day above AR-DRG costs-determined costs. Falls, road trauma and violence were the highest causes of total cost. Motor cyclists and pedestrians had higher median costs than motor vehicle occupants. As a result of greater numbers, patients with minor injury had comparable total costs with those generated by patients with severe injury. However the median cost of severely injured patients was nearly four times greater. The count of body regions injured, sex, length of stay, serious traumatic brain injury and admission to the Intensive Care Unit were significantly associated with increased costs (p<0.001). This

48 CFR 31.205-42 - Termination costs.

Science.gov (United States)

2010-10-01

... nonrecurring labor, material, and related overhead costs incurred in the early part of production and result... the settlement proposal as a direct charge, such costs shall not also be included in overhead. Initial... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Termination costs. 31.205...

15 CFR 14.27 - Allowable costs.

Science.gov (United States)

2010-01-01

... GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, OTHER NON-PROFIT, AND COMMERCIAL ORGANIZATIONS Post-Award Requirements Financial and Program Management § 14.27 Allowable costs. For each kind of... Organizations.” The allowability of costs incurred by institutions of higher education is determined in...

49 CFR 594.9 - Fee for reimbursement of bond processing costs and costs for processing offers of cash deposits...

Science.gov (United States)

2010-10-01

... 49 Transportation 7 2010-10-01 2010-10-01 false Fee for reimbursement of bond processing costs and costs for processing offers of cash deposits or obligations of the United States in lieu of sureties on... indirect costs the agency incurs for receipt, processing, handling, and disbursement of cash deposits or...

Cost-benefit as weighed on genetic scales

International Nuclear Information System (INIS)

Grahn, D.

1976-01-01

The genetic cost that may be incurred by exposure to mutagenic agents in the coal and nuclear fuel cycles is assessed, using as a point of departure the presently estimated burden of spontaneously occurring genetic defects in human populations. Risk estimates are necessarily derived from radiation studies, but chemical mutagenic hazards can probably be evaluated relative to the known dose-response relationships of radiation exposure. Cost-benefit analyses for the coal and nuclear fuel cycles are discussed and translated into monetary terms. Coal-associated risks are almost entirely somatic while nuclear risks are somatic and genetic in equal proportions. Dollar costs per man-rem are concluded to be in the $100 range. Pollution abatement costs for the nuclear cycle lie in the range of several hundreds to many thousands of dollars per man-rem reduction. It is considered appropriate to incur such costs, because genetic risks to future generations involve primarily societal and ethical issues rather than economic considerations

23 CFR 140.907 - Overhead and indirect construction costs.

Science.gov (United States)

2010-04-01

... accounting principles; (2) The costs included in the distribution are limited to costs actually incurred by...), part 31, Contract Cost Principles and Procedures, relating to contracts with commercial organizations... 23 Highways 1 2010-04-01 2010-04-01 false Overhead and indirect construction costs. 140.907...

Biometric Screening and Future Employer Medical Costs: Is It Worth It to Know?

Science.gov (United States)

Vanichkachorn, Greg; Marchese, Maya; Roy, Brad; Opel, Gordon

2017-12-01

To study the relationship between a biometric wellness data and future/actual medical costs. A relationship between total cholesterol to high density lipoprotein ratio, blood pressure, and blood glucose and medical costs, based on analysis of claims data, was explored in 1834 employees that had both wellness program biometric and claims data in 2016. Increased total cholesterol to HDL ratio is strongly associated with increased average costs (P biometric screening of full cholesterol and glucose profiles, medium-sized employers can identify high-risk employees who are expected to incur significantly higher healthcare costs, as compared with low-risk level employees, and improve treatment outcomes.

42 CFR 417.538 - Enrollment and marketing costs.

Science.gov (United States)

2010-10-01

... PREPAYMENT PLANS Medicare Payment: Cost Basis § 417.538 Enrollment and marketing costs. (a) Principle. Costs incurred by an HMO or CMP in performing the enrollment and marketing activities described in subpart k of... 42 Public Health 3 2010-10-01 2010-10-01 false Enrollment and marketing costs. 417.538 Section 417...

48 CFR 31.205-30 - Patent costs.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Patent costs. 31.205-30....205-30 Patent costs. (a) The following patent costs are allowable to the extent that they are incurred... patent application where title or royalty-free license is to be conveyed to the Government. (b) General...

Cost-effectiveness of Intensive Blood Pressure Management

DEFF Research Database (Denmark)

Richman, Ilana B; Fairley, Michael; Jørgensen, Mads Emil

2016-01-01

Importance: Among high-risk patients with hypertension, targeting a systolic blood pressure of 120 mm Hg reduces cardiovascular morbidity and mortality compared with a higher target. However, intensive blood pressure management incurs additional costs from treatment and from adverse events......-effectiveness of intensive blood pressure management among 68-year-old high-risk adults with hypertension but not diabetes. We used the Systolic Blood Pressure Intervention Trial (SPRINT) to estimate treatment effects and adverse event rates. We used Centers for Disease Control and Prevention Life Tables to project age...... and accrued $155 261 in lifetime costs, while intensive management yielded 10.5 QALYs and accrued $176 584 in costs. Intensive blood pressure management cost $23 777 per QALY gained. In a sensitivity analysis, serious adverse events would need to occur at 3 times the rate observed in SPRINT and be 3 times...

Cost Optimization of Product Families using Analytic Cost Models

DEFF Research Database (Denmark)

Brunø, Thomas Ditlev; Nielsen, Peter

2012-01-01

This paper presents a new method for analysing the cost structure of a mass customized product family. The method uses linear regression and backwards selection to reduce the complexity of a data set describing a number of historical product configurations and incurred costs. By reducing the data...... set, the configuration variables which best describe the variation in product costs are identified. The method is tested using data from a Danish manufacturing company and the results indicate that the method is able to identify the most critical configuration variables. The method can be applied...... in product family redesign projects focusing on cost reduction to identify which modules contribute the most to cost variation and should thus be optimized....

25 CFR 117.26 - Expenses incurred pending qualification of an executor or administrator.

Science.gov (United States)

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Expenses incurred pending qualification of an executor or... HAVE CERTIFICATES OF COMPETENCY § 117.26 Expenses incurred pending qualification of an executor or administrator. Pending the qualification of the executor or administrator of the estate of a deceased Indian of...

Cost analysis of an integrated vaccine-preventable disease surveillance system in Costa Rica.

Science.gov (United States)

Toscano, C M; Vijayaraghavan, M; Salazar-Bolaños, H M; Bolaños-Acuña, H M; Ruiz-González, A I; Barrantes-Solis, T; Fernández-Vargas, I; Panero, M S; de Oliveira, L H; Hyde, T B

2013-07-02

Following World Health Organization recommendations set forth in the Global Framework for Immunization Monitoring and Surveillance, Costa Rica in 2009 became the first country to implement integrated vaccine-preventable disease (iVPD) surveillance, with support from the U.S. Centers for Disease Control and Prevention (CDC) and the Pan American Health Organization (PAHO). As surveillance for diseases prevented by new vaccines is integrated into existing surveillance systems, these systems could cost more than routine surveillance for VPDs targeted by the Expanded Program on Immunization. We estimate the costs associated with establishing and subsequently operating the iVPD surveillance system at a pilot site in Costa Rica. We retrospectively collected data on costs incurred by the institutions supporting iVPD surveillance during the preparatory (January 2007 through August 2009) and implementation (September 2009 through August 2010) phases of the iVPD surveillance project in Costa Rica. These data were used to estimate costs for personnel, meetings, infrastructure, office equipment and supplies, transportation, and laboratory facilities. Costs incurred by each of the collaborating institutions were also estimated. During the preparatory phase, the estimated total cost was 128,000 U.S. dollars (US$), including 64% for personnel costs. The preparatory phase was supported by CDC and PAHO. The estimated cost for 1 year of implementation was US$ 420,000, including 58% for personnel costs, 28% for laboratory costs, and 14% for meeting, infrastructure, office, and transportation costs combined. The national reference laboratory and the PAHO Costa Rica office incurred 64% of total costs, and other local institutions supporting iVPD surveillance incurred the remaining 36%. Countries planning to implement iVPD surveillance will require adequate investments in human resources, laboratories, data management, reporting, and investigation. Our findings will be valuable for

28 CFR 100.15 - Disallowed costs.

Science.gov (United States)

2010-07-01

... include, but are not limited to, any Marketing, Sales, Product Management, and Advertising expenses. (c...) costs are disallowed. G&A costs include, but are not limited to, any management, financial, and other expenditures which are incurred by or allocated to a business unit as a whole. These include, but are not...

48 CFR 2152.231-70 - Accounting and allowable cost.

Science.gov (United States)

2010-10-01

... allowable cost. As prescribed in 2131.270, insert the following clause: Accounting and Allowable Cost (OCT... cost; (ii) Incurred with proper justification and accounting support; (iii) Determined in accordance... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Accounting and allowable...

High-throughput determination of vancomycin in human plasma by a cost-effective system of two-dimensional liquid chromatography.

Science.gov (United States)

Sheng, Yanghao; Zhou, Boting

2017-05-26

Therapeutic drug monitoring (TDM) is one of the most important services of clinical laboratories. Two main techniques are commonly used: the immunoassay and chromatography method. We have developed a cost-effective system of two-dimensional liquid chromatography with ultraviolet detection (2D-LC-UV) for high-throughput determination of vancomycin in human plasma that combines the automation and low start-up costs of the immunoassay with the high selectivity and sensitivity of the liquid chromatography coupled with mass spectrometric detection without incurring their disadvantages, achieving high cost-effectiveness. This 2D-LC system offers a large volume injection to provide sufficient sensitivity and uses simulated gradient peak compression technology to control peak broadening and to improve peak shape. A middle column was added to reduce the analysis cycle time and make it suitable for high-throughput routine clinical assays. The analysis cycle time was 4min and the peak width was 0.8min. Compared with other chromatographic methods that have been developed, the analysis cycle time and peak width for vancomycin was reduced significantly. The lower limit of quantification was 0.20μg/mL for vancomycin, which is the same as certain LC-MS/MS methods that have been recently developed and validated. The method is rapid, automated, and low-cost and has high selectivity and sensitivity for the quantification of vancomycin in human plasma, thus making it well-suited for use in hospital clinical laboratories. Copyright © 2017 Elsevier B.V. All rights reserved.

The relationship between coping strategies, quality of life, and mood in patients with incurable cancer.

Science.gov (United States)

Nipp, Ryan D; El-Jawahri, Areej; Fishbein, Joel N; Eusebio, Justin; Stagl, Jamie M; Gallagher, Emily R; Park, Elyse R; Jackson, Vicki A; Pirl, William F; Greer, Joseph A; Temel, Jennifer S

2016-07-01

Patients with incurable cancer face many physical and emotional stressors, yet little is known about their coping strategies or the relationship between their coping strategies, quality of life (QOL), and mood. As part of a randomized trial of palliative care, this study assessed baseline QOL (Functional Assessment of Cancer Therapy-General), mood (Hospital Anxiety and Depression Scale), and coping (Brief COPE) in patients within 8 weeks of a diagnosis of incurable lung or gastrointestinal cancer and before randomization. To examine associations between coping strategies, QOL, and mood, we used linear regression, adjusting for patients' age, sex, marital status, and cancer type. There were 350 participants (mean age, 64.9 years), and the majority were male (54.0%), were married (70.0%), and had lung cancer (54.6%). Most reported high utilization of emotional support coping (77.0%), whereas fewer reported high utilization of acceptance (44.8%), self-blame (37.9%), and denial (28.2%). Emotional support (QOL: β = 2.65, P Patients with newly diagnosed, incurable cancer use a variety of coping strategies. The use of emotional support and acceptance coping strategies correlated with better QOL and mood, whereas the use of denial and self-blame negatively correlated with these outcomes. Interventions to improve patients' QOL and mood should seek to cultivate the use of adaptive coping strategies. Cancer 2016;122:2110-6. © 2016 American Cancer Society. © 2016 American Cancer Society.

44 CFR 208.44 - Reimbursement for other costs.

Science.gov (United States)

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Reimbursement for other costs... Cooperative Agreements § 208.44 Reimbursement for other costs. (a) Except as allowed under paragraph (b) of this section, DHS will not reimburse other costs incurred preceding, during or upon the conclusion of...

High resource utilization in liver transplantation-how strongly differ costs between the care sectors and what are the main cost drivers?: a retrospective study.

Science.gov (United States)

Harries, Lena; Schrem, Harald; Stahmeyer, Jona T; Krauth, Christian; Amelung, Volker E

2017-06-01

To control treatment pathways of transplant patients across healthcare sectors, a profound knowledge of the underlying cost structure is necessary. The aim of this study was to analyze the resource utilization of patients undergoing liver transplantation. Data on resource utilization for 182 liver-transplanted patients was investigated retrospectively. The observational period started with the entry on the waiting list and ended up to 3 years after transplantation. Median treatment cost was 144 424€. During waiting time, median costs amounted to 9466€; 72% of costs were attributed to inpatient care, 3% to outpatient care, and 26% to pharmaceuticals. During the first year after transplantation, median costs of 105 566€ were calculated; 83% were allocated for inpatient and 1% outpatient care, 14% for drugs, and 1% for rehabilitative care. During follow-up after the first year of transplantation, median costs amounted to 20 115€; 75% of these were caused by pharmaceuticals, 21% by inpatient, 4% by outpatient, and Costs incurred by inpatient care and pharmaceuticals are the dominating cost factors. These findings encourage a debate on challenges and improvements for cost-efficient clinical management between different healthcare sectors. © 2017 Steunstichting ESOT.

Societal and Family Lifetime Cost of Dementia: Implications for Policy.

Science.gov (United States)

Jutkowitz, Eric; Kane, Robert L; Gaugler, Joseph E; MacLehose, Richard F; Dowd, Bryan; Kuntz, Karen M

2017-10-01

To estimate the cost of dementia and the extra cost of caring for someone with dementia over the cost of caring for someone without dementia. We developed an evidence-based mathematical model to simulate disease progression for newly diagnosed individuals with dementia. Data-driven trajectories of cognition, function, and behavioral and psychological symptoms were used to model disease progression and predict costs. Using modeling, we evaluated lifetime and annual costs of individuals with dementia, compared costs of those with and without clinical features of dementia, and evaluated the effect of reducing functional decline or behavioral and psychological symptoms by 10% for 12 months (implemented when Mini-Mental State Examination score ≤21). Mathematical model. Representative simulated U.S. incident dementia cases. Value of informal care, out-of-pocket expenditures, Medicaid expenditures, and Medicare expenditures. From time of diagnosis (mean age 83), discounted total lifetime cost of care for a person with dementia was $321,780 (2015 dollars). Families incurred 70% of the total cost burden ($225,140), Medicaid accounted for 14% ($44,090), and Medicare accounted for 16% ($52,540). Costs for a person with dementia over a lifetime were $184,500 greater (86% incurred by families) than for someone without dementia. Total annual cost peaked at $89,000, and net cost peaked at $72,400. Reducing functional decline or behavioral and psychological symptoms by 10% resulted in $3,880 and $680 lower lifetime costs than natural disease progression. Dementia substantially increases lifetime costs of care. Long-lasting, effective interventions are needed to support families because they incur the most dementia cost. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Pre- and post-diagnosis costs of tuberculosis to patients on Directly Observed Treatment Short course in districts of southwestern Ethiopia: a longitudinal study.

Science.gov (United States)

Asres, Abyot; Jerene, Degu; Deressa, Wakgari

2018-05-21

Financial burden on tuberculosis (TB) patients results in delayed treatment and poor compliance. We assessed pre- and post-diagnosis costs to TB patients. A longitudinal study among 735 new TB cases was conducted from January 2015 through June 2016 in 10 woredas (districts) of southwestern Ethiopia. Direct out-of-pocket, payments, and lost income (indirect cost) were solicited from patients during the first 2 months and at the end of treatment. Thus, we ascertained direct medical, nonmedical, and indirect costs incurred by patients during pre- and post-diagnosis periods. We categorized costs incurred from onset of illness until TB diagnosis as pre-diagnosis and that incurred after diagnosis through treatment completion as post-diagnosis. Pre- and post-diagnosis costs constitute total cost incurred by the patients. We fitted linear regression model to identify predictors of cost. Between onset of illness and anti-TB treatment course, patients incurred a median (inter-quartile range (IQR)) of US$201.48 (136.7-318.94). Of the total cost, the indirect and direct costs respectively constituted 70.6 and 29.4%. TB patients incurred a median (IQR) of US$97.62 (6.43-184.22) and US$93.75 (56.91-141.54) during the pre- and post-diagnosis periods, respectively. Thus, patients incurred 53.6% of the total cost during the pre-diagnosis period. Direct out-of-pocket expenses during the pre- and post-diagnosis periods respectively amount to median (IQR) of US$21.64 (10.23-48.31) and US$35.02 (0-70.04). Patient delay days (p < 0.001), provider delay days (p < 0.001), number of healthcare facilities visited until TB diagnosis (p < 0.001), and TB diagnosis at private facilities (p = 0.02) independently predicted increased pre-diagnosis cost. Similarly, rural residence (p < 0.001), hospitalization during anti-TB treatment (p < 0.001), patient delay days (p < 0.001), and provider delay days (p < 0.001) predicted increased post-diagnosis costs. TB patients

The effect of business characteristics on tax compliance costs

Directory of Open Access Journals (Sweden)

Popi Fauziati

2018-05-01

Full Text Available Compliance fee is the cost incurred by the taxpayers in fulfilling the taxation requirements imposed on the taxpayers by the law and the authority of the country. The company expects to incur the minimum tax costs associated with fulfilling its tax obligations. Research on the influence of business characteristics to tax compliance cost is still scanty. This research examined the effect of business characteristics (age, size, sector and risk management on tax compliance costs. The research design adopted in this study is survey design. The questionnaires were distributed to the members of De-partment of Cooperatives and Micro Small-Medium Enterprises in Padang City. The non-probability sampling was used as the sampling method and 92 respondents participated in this re-search. The data obtained were analyzed using Statistical Package for Social Sciences (SPSS. The research findings indicate that age, size and sector have no effect on tax compliance costs while risk management has an effect on tax compliance costs.

24 CFR 4001.122 - Fees and closing costs.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 5 2010-04-01 2010-04-01 false Fees and closing costs. 4001.122... Requirements and Underwriting Procedures § 4001.122 Fees and closing costs. (a) The holder or servicer of the... delinquency and default fees. (b) Allowable closing costs incurred in connection with the refinancing and...

'No matter what the cost': A qualitative study of the financial costs faced by family and whānau caregivers within a palliative care context.

Science.gov (United States)

Gott, Merryn; Allen, Ruth; Moeke-Maxwell, Tess; Gardiner, Clare; Robinson, Jackie

2015-06-01

There has been significant attention paid in recent years to the economic costs of health service provision for people with palliative care needs. However, little is known about the costs incurred by family caregivers who typically provide the bulk of care for people at the end of life. To explore the nature and range of financial costs incurred by family caregiving within a palliative care context. In-depth qualitative interviews were conducted with 30 family/whānau caregivers who were currently caring for someone with a life-limiting illness or had done so within the preceding year. Narrative analysis was used to identify impacts and costs at the personal, interpersonal, sociocultural and structural levels. Auckland, New Zealand. Costs of caregiving were significant and, for participants, resulted in debt or even bankruptcy. A range of direct (transport, food and medication) and indirect costs (related to employment, cultural needs and own health) were reported. A multi-level qualitative analysis revealed how costs operated at a number of levels (personal, interpersonal, sociocultural and structural). The palliative care context increased costs, as meeting needs were prioritised over cost. In addition, support from statutory service providers to access sources of financial support was limited. Families incur significant financial costs when caring for someone at the end of life. Research is now needed to quantify the financial contribution of family and whānau caregiving within a palliative care context, particularly given attempts in many countries to shift more palliative care provision into community settings. © The Author(s) 2015.

26 CFR 1.934-1 - Limitation on reduction in income tax liability incurred to the Virgin Islands.

Science.gov (United States)

2010-04-01

... § 1.934-1 Limitation on reduction in income tax liability incurred to the Virgin Islands. (a) General... Islands will be computed as follows: (A) Add to the income tax liability incurred to the Virgin Islands... income from such sources. (ii) Limitation. Tax liability incurred to the Virgin Islands attributable to...

Tuberculosis and poverty: the contribution of patient costs in sub-Saharan Africa--a systematic review.

Science.gov (United States)

Barter, Devra M; Agboola, Stephen O; Murray, Megan B; Bärnighausen, Till

2012-11-14

Tuberculosis (TB) is known to disproportionately affect the most economically disadvantaged strata of society. Many studies have assessed the association between poverty and TB, but only a few have assessed the direct financial burden TB treatment and care can place on households. Patient costs can be particularly burdensome for TB-affected households in sub-Saharan Africa where poverty levels are high; these costs include the direct costs of medical and non-medical expenditures and the indirect costs of time utilizing healthcare or lost wages. In order to comprehensively assess the existing evidence on the costs that TB patients incur, we undertook a systematic review of the literature. PubMed, EMBASE, Science Citation Index, Social Science Citation Index, EconLit, Dissertation Abstracts, CINAHL, and Sociological Abstracts databases were searched, and 5,114 articles were identified. Articles were included in the final review if they contained a quantitative measure of direct or indirect patient costs for treatment or care for pulmonary TB in sub-Saharan Africa and were published from January 1, 1994 to Dec 31, 2010. Cost data were extracted from each study and converted to 2010 international dollars (I$). Thirty articles met all of the inclusion criteria. Twenty-one studies reported both direct and indirect costs; eight studies reported only direct costs; and one study reported only indirect costs. Depending on type of costs, costs varied from less than I$1 to almost I$600 or from a small fraction of mean monthly income for average annual income earners to over 10 times average annual income for income earners in the income-poorest 20% of the population. Out of the eleven types of TB patient costs identified in this review, the costs for hospitalization, medication, transportation, and care in the private sector were largest. TB patients and households in sub-Saharan Africa often incurred high costs when utilizing TB treatment and care, both within and outside of

The cost of myrmecophytism: insights from allometry of stem secondary growth.

Science.gov (United States)

Blatrix, Rumsaïs; Renard, Delphine; Djieto-Lordon, Champlain; McKey, Doyle

2012-10-01

Plant defence traits against herbivores incur production costs that are usually difficult to measure. However, estimating these costs is a prerequisite for characterizing the plant defence strategy as a whole. Myrmecophytes are plants that provide symbiotic ants with specialized nesting cavities, called domatia, in exchange for protection against herbivores. In the particular case of stem domatia, production of extra wood seems to be the only associated cost, making this indirect defence trait a particularly suitable model for estimating the cost of defence. Measurements were made of growth pattern and cumulative production cost of domatia over secondary growth in the myrmecophyte Leonardoxa africana subsp. africana, whose internodes display both a solid basal segment and a hollow distal part (the domatium), thus allowing paired comparison of investment in wood. Previous studies showed that 'overconstruction' of the hollow part of internodes during primary growth is needed for mechanical support. In this study, it is shown that the relationship between the woody cross-sectional area of the solid and hollow parts of internodes is negatively allometric at the beginning of secondary growth and nearly isometric later on. Thus, in hollow stems, the first phase of slow secondary growth compensates for the 'overconstruction' of the ring of wood during primary growth. Moreover, the cumulative production cost of a domatium (estimated as the additional volume of wood required for a hollow stem compared with a solid one) is very high at the beginning of secondary growth and then quickly tends to zero. Making domatia incurs high costs early in ontogeny, costs that are then amortized later in development of stems and of individual plants. Characterizing ontogenetic variation of the net cost of this peculiar defence mechanism will help us build more accurate theoretical models of resource allocation in myrmecophytes.

Self-centered social exchange: differential use of costs versus benefits in prosocial reciprocity.

Science.gov (United States)

Zhang, Yan; Epley, Nicholas

2009-11-01

Maintaining equitable social relations often requires reciprocating "in kind" for others' prosocial favors. Such in-kind reciprocity requires assessing the value of a prosocial action, an assessment that can lead to egocentric biases in perceived value between favor givers versus favor receivers. In any prosocial exchange, 1 person (the giver) incurs a cost to provide a benefit for another person (the receiver). Six experiments suggest that givers may attend more to the costs they incur in performing a prosocial act than do receivers, who tend to focus relatively more on the benefits they receive. Givers may therefore expect to be reciprocated on the basis of the costs they incur, whereas receivers actually reciprocate primarily on the basis of the benefit they receive. This research identifies 1 challenge to maintaining a sense of equity in social relations and predicts when people are likely to feel fairly versus unfairly valued in their relationships.

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...

Peroral endoscopic myotomy achieves similar clinical response but incurs lesser charges compared to robotic heller myotomy.

Science.gov (United States)

Khashab, Mouen A; Kumbhari, Vivek; Tieu, Alan H; El Zein, Mohamad H; Ismail, Amr; Ngamruengphong, Saowanee; Singh, Vikesh K; Kalloo, Anthony N; Clarke, John O; Stein, Ellen M

2017-01-01

Several uncontrolled studies comparing peroral endoscopic myotomy (POEM) and Heller myotomy have demonstrated equivalent short-term efficacy and safety. However, no data exists rergarding the cost of POEM and how it compares to that of robotic Heller myotomy (RHM). The primary aim of this study was to compare the inpatient charges incurred in patients who underwent POEM or RHM for the treatment of achalasia. A retrospective single center review was conducted among 52 consecutive POEM patients (2012-2014) and 52 consecutive RHM patients (2009-2014). All RHM procedures included a Toupet fundoplication and were performed via a transabdominal approach. All POEM procedures were performed by a gastroenterologist in the endoscopy unit. Clinical response was defined by improvement of symptoms and decrease in Eckardt stage to ≤I. All procedural and facility charges were obtained from review of the hospital finance records. There was no difference between POEM and RHM with regards to age, gender, symptom duration, achalasia subtype, manometry findings, or Eckardt symptom stage. There was no significant difference in the rate of adverse events (19.2% vs 9.6%, P = 0.26) or the length of stay (1.9 vs. 2.3, P = 0.18) between both groups. Clinical response rate of patients in the POEM groups was similar to that in the RHM group (94.3% vs. 88.5%, P = 0.48). POEM incurred significantly less total charges compared to LHM ($14481 vs. $17782, P = 0.02). POEM when performed in an endoscopy unit was similar in efficacy and safety to RHM. However, POEM was associated with significant cost savings ($3301/procedure).

Tuberculosis and poverty: the contribution of patient costs in sub-Saharan Africa – a systematic review

Science.gov (United States)

2012-01-01

Background Tuberculosis (TB) is known to disproportionately affect the most economically disadvantaged strata of society. Many studies have assessed the association between poverty and TB, but only a few have assessed the direct financial burden TB treatment and care can place on households. Patient costs can be particularly burdensome for TB-affected households in sub-Saharan Africa where poverty levels are high; these costs include the direct costs of medical and non-medical expenditures and the indirect costs of time utilizing healthcare or lost wages. In order to comprehensively assess the existing evidence on the costs that TB patients incur, we undertook a systematic review of the literature. Methods PubMed, EMBASE, Science Citation Index, Social Science Citation Index, EconLit, Dissertation Abstracts, CINAHL, and Sociological Abstracts databases were searched, and 5,114 articles were identified. Articles were included in the final review if they contained a quantitative measure of direct or indirect patient costs for treatment or care for pulmonary TB in sub-Saharan Africa and were published from January 1, 1994 to Dec 31, 2010. Cost data were extracted from each study and converted to 2010 international dollars (I$). Results Thirty articles met all of the inclusion criteria. Twenty-one studies reported both direct and indirect costs; eight studies reported only direct costs; and one study reported only indirect costs. Depending on type of costs, costs varied from less than I$1 to almost I$600 or from a small fraction of mean monthly income for average annual income earners to over 10 times average annual income for income earners in the income-poorest 20% of the population. Out of the eleven types of TB patient costs identified in this review, the costs for hospitalization, medication, transportation, and care in the private sector were largest. Conclusion TB patients and households in sub-Saharan Africa often incurred high costs when utilizing TB treatment

Tuberculosis and poverty: the contribution of patient costs in sub-Saharan Africa – a systematic review

Directory of Open Access Journals (Sweden)

Barter Devra M

2012-11-01

Full Text Available Abstract Background Tuberculosis (TB is known to disproportionately affect the most economically disadvantaged strata of society. Many studies have assessed the association between poverty and TB, but only a few have assessed the direct financial burden TB treatment and care can place on households. Patient costs can be particularly burdensome for TB-affected households in sub-Saharan Africa where poverty levels are high; these costs include the direct costs of medical and non-medical expenditures and the indirect costs of time utilizing healthcare or lost wages. In order to comprehensively assess the existing evidence on the costs that TB patients incur, we undertook a systematic review of the literature. Methods PubMed, EMBASE, Science Citation Index, Social Science Citation Index, EconLit, Dissertation Abstracts, CINAHL, and Sociological Abstracts databases were searched, and 5,114 articles were identified. Articles were included in the final review if they contained a quantitative measure of direct or indirect patient costs for treatment or care for pulmonary TB in sub-Saharan Africa and were published from January 1, 1994 to Dec 31, 2010. Cost data were extracted from each study and converted to 2010 international dollars (I$. Results Thirty articles met all of the inclusion criteria. Twenty-one studies reported both direct and indirect costs; eight studies reported only direct costs; and one study reported only indirect costs. Depending on type of costs, costs varied from less than I$1 to almost I$600 or from a small fraction of mean monthly income for average annual income earners to over 10 times average annual income for income earners in the income-poorest 20% of the population. Out of the eleven types of TB patient costs identified in this review, the costs for hospitalization, medication, transportation, and care in the private sector were largest. Conclusion TB patients and households in sub-Saharan Africa often incurred high costs

47 CFR 27.1166 - Reimbursement under the Cost-Sharing Plan.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Reimbursement under the Cost-Sharing Plan. 27... § 27.1166 Reimbursement under the Cost-Sharing Plan. (a) Registration of reimbursement rights. Claims for reimbursement under the cost-sharing plan are limited to relocation expenses incurred on or after...

Accounting for enforcement costs in the spatial allocation of marine zones.

Science.gov (United States)

Davis, Katrina; Kragt, Marit; Gelcich, Stefan; Schilizzi, Steven; Pannell, David

2015-02-01

Marine fish stocks are in many cases extracted above sustainable levels, but they may be protected through restricted-use zoning systems. The effectiveness of these systems typically depends on support from coastal fishing communities. High management costs including those of enforcement may, however, deter fishers from supporting marine management. We incorporated enforcement costs into a spatial optimization model that identified how conservation targets can be met while maximizing fishers' revenue. Our model identified the optimal allocation of the study area among different zones: no-take, territorial user rights for fisheries (TURFs), or open access. The analysis demonstrated that enforcing no-take and TURF zones incurs a cost, but results in higher species abundance by preventing poaching and overfishing. We analyzed how different enforcement scenarios affected fishers' revenue. Fisher revenue was approximately 50% higher when territorial user rights were enforced than when they were not. The model preferentially allocated area to the enforced-TURF zone over other zones, demonstrating that the financial benefits of enforcement (derived from higher species abundance) exceeded the costs. These findings were robust to increases in enforcement costs but sensitive to changes in species' market price. We also found that revenue under the existing zoning regime in the study area was 13-30% lower than under an optimal solution. Our results highlight the importance of accounting for both the benefits and costs of enforcement in marine conservation, particularly when incurred by fishers. © 2014 Society for Conservation Biology.

Counting the cost of housing

NARCIS (Netherlands)

Michiel Ras; Evelien Eggink; Edwin van Gameren; Ingrid Ooms

2006-01-01

Original title: Uitgerekend wonen. The Dutch government exerts a great influence on the housing costs incurred by households. Tenants can apply for housing subsidy, while owner-occupiers can set their mortgage interest against their income tax. These measures have existed for a long time, but

[Direct costs of medical care for patients with type 2 diabetes mellitus in Mexico micro-costing analysis].

Science.gov (United States)

Rodríguez Bolaños, Rosibel de Los Ángeles; Reynales Shigematsu, Luz Myriam; Jiménez Ruíz, Jorge Alberto; Juárez Márquezy, Sergio Arturo; Hernández Ávila, Mauricio

2010-12-01

Estimate the direct cost of medical care incurred by the Mexican Social Security Institute (IMSS, Instituto Mexicano del Seguro Social) for patients with type 2 diabetes mellitus (DM2). The clinical files of 497 patients who were treated in secondary and tertiary medical care units in 2002-2004 were reviewed. Costs were quantified using a disease costing approach (DCA) from the provider's perspective, a micro-costing technique, and a bottom-up methodology. Average annual costs by diagnosis, complication, and total cost were estimated. Total IMSS DM2 annual costs were US$452 064 988, or 3.1% of operating expenses. The annual average cost per patient was US$3 193.75, with US$2 740.34 per patient without complications and US$3 550.17 per patient with complications. Hospitalization and intensive care bed-days generated the greatest expenses. The high cost of providing medical care to patients with DM2 and its complications represents an economic burden that health institutions should consider in their budgets to enable them to offer quality service that is both adequate and timely. Using the micro-costing methodology allows an approximation to real data on utilization and management of the disease.

The Association between Charlson Comorbidity Index and the Medical Care Cost of Cancer: A Retrospective Study

Directory of Open Access Journals (Sweden)

Seok-Jun Yoon

2015-01-01

Full Text Available Background. This study compared comorbidity-related medical care cost associated with different types of cancer, by examining breast (N=287, colon (N=272, stomach (N=614, and lung (N=391 cancer patients undergoing surgery. Methods. Using medical benefits claims data, we calculated Charlson Comorbidity Index (CCI and total medical cost. The effect of comorbidity on the medical care cost was investigated using multiple regression and logistic regression models and controlling for demographic characteristics and cancer stage. Results. The treatment costs incurred by stomach and colon cancer patients were 1.05- and 1.01-fold higher, respectively, in patients with higher CCI determined. For breast cancer, the highest costs were seen in those with chronic obstructive pulmonary disease (COPD, but the increase in cost reduced as CCI increased. Colon cancer patients with diabetes mellitus and a CCI = 1 score had the highest medical costs. The lowest medical costs were incurred by lung cancer patients with COPD and a CCI = 2 score. Conclusion. The comorbidities had a major impact on the use of medical resources, with chronic comorbidities incurring the highest medical costs. The results indicate that comorbidities affect cancer outcomes and that they must be considered strategies mitigating cancer’s economic and social impact.

Change in the direct cost of treatment for children and adolescents with hyperkinetic disorder in Germany over a period of four years

Directory of Open Access Journals (Sweden)

Rothenberger Aribert

2009-01-01

Full Text Available Abstract Background In many developed countries, the treatment of hyperkinetic disorder (or ADHD consumes a considerable amount of resources. The primary aim of this study was to determine change in the direct cost of treatment for children and adolescents with hyperkinetic disorder in Germany over time, and compare the cost with the cost of treatment for two physical disorders: epilepsy and asthma. Methods The German Federal Statistical Office provided data on the direct cost of treating hyperkinetic disorder, epilepsy and asthma in Germany for 2002, 2004, and 2006. The direct costs of treatment incurred by hyperkinetic disorder in these years were compared with those incurred by epilepsy and asthma. Results The total direct cost of treatment for the hyperkinetic disorder was € 177 million in 2002, € 234 million in 2004, and € 341 million in 2006. The largest proportion of the cost was incurred by the age group Conclusion The direct cost of treatment for hyperkinetic disorder in the age group

The hand surgery fellowship application process: expectations, logistics, and costs.

Science.gov (United States)

Meals, Clifton; Osterman, Meredith

2015-04-01

To investigate expectations, logistics, and costs relevant to the hand surgery fellowship application process. We sought to discover (1) what both applicants and program directors are seeking, (2) what both parties have to offer, (3) how both parties collect information about each other, and (4) the costs incurred in arranging each match. We conducted on-line surveys of hand surgery fellowship applicants for appointment in 2015 and of current fellowship program directors. Sixty-two applicants and 41 program directors completed the survey. Results revealed applicants' demographic characteristics, qualifications, method of ranking hand fellowship programs, costs incurred (both monetary and opportunity) during the application process, ultimate match status, and suggestions for change. Results also revealed program directors' program demographics, rationale for offering interviews and favorably ranking applicants, application-related logistical details, costs incurred (both monetary and opportunity) during the application process, and suggestions for change. Applicants for hand surgery fellowship training are primarily interested in a potential program's academic reputation, emphasis on orthopedic surgery, and location. The typical, successfully matched applicant was a 30-year-old male orthopedic resident with 3 publications to his credit. Applicants rely on peers and Web sites for information about fellowships. Fellowship directors are primarily seeking applicants recommended by other experienced surgeons and with positive personality traits. The typical fellowship director offers a single year of orthopedic-based fellowship training to 2 fellows per year and relies on a common application and in-person interviews to collect information about applicants. Applicants appear to be more concerned than directors about the current state of the match process. Applicants and directors alike incur heavy costs, in both dollars and opportunity, to arrange each match. A nuanced

26 CFR 301.7610-1 - Fees and costs for witnesses.

Science.gov (United States)

2010-04-01

... 26 Internal Revenue 18 2010-04-01 2010-04-01 false Fees and costs for witnesses. 301.7610-1... Examination and Inspection § 301.7610-1 Fees and costs for witnesses. (a) Introduction. Section 7610 provides..., these fees are considered to be directly incurred by the summoned third party. (2) Reproduction cost...

Verifying different-modality properties for concepts produces switching costs.

Science.gov (United States)

Pecher, Diane; Zeelenberg, René; Barsalou, Lawrence W

2003-03-01

According to perceptual symbol systems, sensorimotor simulations underlie the representation of concepts. It follows that sensorimotor phenomena should arise in conceptual processing. Previous studies have shown that switching from one modality to another during perceptual processing incurs a processing cost. If perceptual simulation underlies conceptual processing, then verifying the properties of concepts should exhibit a switching cost as well. For example, verifying a property in the auditory modality (e.g., BLENDER-loud) should be slower after verifying a property in a different modality (e.g., CRANBERRIES-tart) than after verifying a property in the same modality (e.g., LEAVES-rustling). Only words were presented to subjects, and there were no instructions to use imagery. Nevertheless, switching modalities incurred a cost, analogous to the cost of switching modalities in perception. A second experiment showed that this effect was not due to associative priming between properties in the same modality. These results support the hypothesis that perceptual simulation underlies conceptual processing.

Economic costs of fever to households in the middle belt of Ghana.

Science.gov (United States)

Tawiah, Theresa; Asante, Kwaku Poku; Dwommoh, Rebecca Akua; Kwarteng, Anthony; Gyaase, Stephaney; Mahama, Emmanuel; Abokyi, Livesy; Amenga-Etego, Seeba; Hansen, Kristian; Akweongo, Patricia; Owusu-Agyei, Seth

2016-02-06

Malaria is one of the main health problems in the sub-Saharan Africa accounting for approximately 198 million morbidity and close to 600,000 mortality cases. Households incur out-of-pocket expenditure for treatment and lose income as a result of not being able to work or care for family members. The main objective of this survey was to assess the economic cost of treating malaria and/or fever with the new ACT to households in the Kintampo districts of Ghana where a health and demographic surveillance systems (KHDSS) are set up to document population dynamics. The study was a cross-sectional survey conducted from October 2009 to July 2011 using community members' accessed using KHDSS population in the Kintampo area. An estimated sample size of 4226 was randomly selected from the active members of the KHDSS. A structured questionnaire was administered to the selected populates who reported of fever within the last 2 weeks prior to the visit. Data was collected on treatment-seeking behaviour, direct and indirect costs of malaria from the patient perspective. Of the 4226 households selected, 947 households with 1222 household members had fever out of which 92 % sought treatment outside home; 55 % of these were females. 31.6 % of these patients sought care from chemical shops. A mean amount of GHS 4.2 (US$2.76) and GHS 18.0 (US$11.84) were incurred by households as direct and indirect cost respectively. On average a household incurred a total cost of GHS 22.2 (US$14.61) per patient per episode. Total economic cost was lowest for those in the highest quintile and highest for those in the middle quintile. The total cost of treating fever/malaria episode is relatively high in the study area considering the poverty levels in Ghana. The NHIS has positively influenced health-seeking behaviours and reduced the financial burden of seeking care for those that are insured.

ANALISIS PENENTUAN HARGA JUAL APARTEMEN BERDASARKAN TARGET COSTING PADA PT CIPUTRA VICTORY MITRA

Directory of Open Access Journals (Sweden)

ISLAMIYAH _

2017-05-01

The results showed that the ratio of total costs incurred by the company according to target costing, it can be said that with the implementation of target costing more efficient or more precisely if compared with the company said.

48 CFR 31.205-15 - Fines, penalties, and mischarging costs.

Science.gov (United States)

2010-10-01

... REGULATION GENERAL CONTRACTING REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial... violations of, or failure of the contractor to comply with, Federal, State, local, or foreign laws and... of the contract or written instructions from the contracting officer. (b) Costs incurred in...

31 CFR 101.5 - Payment of smelting costs.

Science.gov (United States)

2010-07-01

... FORFEITURE OF COUNTERFEIT GOLD COINS § 101.5 Payment of smelting costs. The petitioner shall be required to pay all reasonable costs incurred in extracting the bullion from the counterfeit coins, as shall be determined by the Assistant Secretary. Payment must be made prior to the return of the gold bullion to the...

The international inspection of a US excess fissile material storage facility with and without remote monitoring: A cost comparison

International Nuclear Information System (INIS)

Abrams, M.; Nilsen, C.; Tolk, K.M.; McGilvary, R.C. III

1996-01-01

This study estimates the DOE-incurred costs in preparing for and hosting potential IAEA inspections of an excess pit storage facility at the Pantex Site with and without the aid of remote monitoring. Focus was on whether an investment in remote monitoring is recoverable, ie, whether the costs for installing, operating, and maintaining a remote monitoring system (RMS) are overcome by the costs that would be incurred without its use. A baseline RMS incorporating demonstrated technologies is defined and its cost estimated. This estimate and several multiples of it, together with estimates of labor and operational costs incurred under a postulated inspection regime serve as the bases of this study. A key finding is that, for the range of parameters considered, the times for investment recovery are reached relatively quickly, ie, within a decade after the inspection regime's onset. Investment recovery times, expenditures in reaching them, and average annual cost accrual rates are provided as function of RMS initial cost. A guideline indicating when investment recovery is theoretically possible is also provided

The cost of electrocoagulation

Energy Technology Data Exchange (ETDEWEB)

Donini, J.C.; Kan, J.; Szynkarczuk, J.; Hassan, T.A.; Kar, K.L.

1993-01-01

Recent research has shown that electrocoagulation is suitable for separating solids from waste water. The purpose of this study is to determine whether the method is feasible economically. The cost incurred, namely energy costs and aluminum electrode consumed, during electrocoagulation experiments with kaolinite and bentonite are examined. Emphasis is placed on sodium chloride concentration, flow rate with and without recirculation, formation of passivation layers, how sodium chloride affects aluminum efficiency, and electrode efficiency. Further study is required. 8 refs., 25 figs., 9 tabs.

The economic costs of childhood disability.

Science.gov (United States)

Stabile, Mark; Allin, Sara

2012-01-01

Childhood disabilities entail a range of immediate and long-term economic costs that have important implications for the well-being of the child, the family, and society but that are difficult to measure. In an extensive research review, Mark Stabile and Sara Allin examine evidence about three kinds of costs-direct, out-of-pocket costs incurred as a result of the child's disability; indirect costs incurred by the family as it decides how best to cope with the disability; and long-term costs associated with the child's future economic performance. Not surprisingly, the evidence points to high direct costs for families with children with disabilities, though estimates vary considerably within these families. Out-of-pocket expenditures, particularly those for medical costs, for example, are higher among families with children with a special health care need. An important indirect cost for these families involves decisions about employment. Stabile and Allin examine several studies that, taken together, show that having a child with disabilities increases the likelihood that the mother (and less often the father) will either curtail hours of work or stop working altogether. Researchers also find that having a child with disabilities can affect a mother's own health and put substantial strains on the parents' relationship. In the longer term, disabilities also compromise a child's schooling and capacity to get and keep gainful employment as an adult, according to the studies Stabile and Allin review. Negative effects on future well-being appear to be much greater, on average, for children with mental health problems than for those with physical disabilities. Stabile and Allin calculate that the direct costs to families, indirect costs through reduced family labor supply, direct costs to disabled children as they age into the labor force, and the costs of safety net programs for children with disabilities average $30,500 a year per family with a disabled child. They note

Out-of-pocket costs, primary care frequent attendance and sample selection: Estimates from a longitudinal cohort design.

Science.gov (United States)

Pymont, Carly; McNamee, Paul; Butterworth, Peter

2018-03-20

This paper examines the effect of out-of-pocket costs on subsequent frequent attendance in primary care using data from the Personality and Total Health (PATH) Through Life Project, a representative community cohort study from Canberra, Australia. The analysis sample comprised 1197 respondents with two or more GP consultations, and uses survey data linked to administrative health service use (Medicare) data which provides data on the number of consultations and out-of-pocket costs. Respondents identified in the highest decile of GP use in a year were defined as Frequent Attenders (FAs). Logistic regression models that did not account for potential selection effects showed that out-of-pocket costs incurred during respondents' prior two consultations were significantly associated with subsequent FA status. Respondents who incurred higher costs ($15-$35; or >$35) were less likely to become FAs than those who incurred no or low (attenders. Copyright © 2018. Published by Elsevier B.V.

45 CFR 74.27 - Allowable costs.

Science.gov (United States)

2010-10-01

... FOR AWARDS AND SUBAWARDS TO INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, OTHER NONPROFIT ORGANIZATIONS, AND COMMERCIAL ORGANIZATIONS Post-Award Requirements Financial and Program Management § 74.27... Organizations” and paragraph (b) of this section. The allowability of costs incurred by institutions of higher...

22 CFR 145.27 - Allowable costs.

Science.gov (United States)

2010-04-01

... Relations DEPARTMENT OF STATE CIVIL RIGHTS GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Financial and Program Management § 145...-Profit Organizations.” The allowability of costs incurred by institutions of higher education is...

38 CFR 49.27 - Allowable costs.

Science.gov (United States)

2010-07-01

... ADMINISTRATIVE REQUIREMENTS FOR GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Financial and Program Management § 49.27 Allowable...-Profit Organizations.” The allowability of costs incurred by institutions of higher education is...

40 CFR 30.27 - Allowable costs.

Science.gov (United States)

2010-07-01

... ADMINISTRATIVE REQUIREMENTS FOR GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Financial and Program Management § 30.27 Allowable...-Profit Organizations.” The allowability of costs incurred by institutions of higher education is...

Proficiency test on incurred and spiked pesticide residues in cereals

DEFF Research Database (Denmark)

Poulsen, Mette Erecius; Christensen, Hanne Bjerre; Herrmann, Susan Strange

2009-01-01

A proficiency test on incurred and spiked pesticide residues in wheat was organised in 2008. The test material was grown in 2007 and treated in the field with 14 pesticides formulations containing the active substances, alpha-cypermethrin, bifentrin, carbendazim, chlormequat, chlorpyrifos...

37 CFR 251.73 - Deduction of costs of distribution proceedings.

Science.gov (United States)

2010-07-01

... OF CONGRESS COPYRIGHT ARBITRATION ROYALTY PANEL RULES AND PROCEDURES COPYRIGHT ARBITRATION ROYALTY PANEL RULES OF PROCEDURE Royalty Fee Distribution Proceedings § 251.73 Deduction of costs of... distributions of royalty fees are made, deduct the reasonable costs incurred by the Library of Congress and the...

Provision of an emergency theatre in tertiary hospitals is cost ...

African Journals Online (AJOL)

Background. Cancellations of planned elective surgical operations increase financial cost to the patient and the hospital. Objectives. To determine the rate and reasons for cancellations, estimate the cost incurred by such cancellations and recommend possible solutions. Methods. We did a prospective descriptive study of ...

Cost of high prevalence mental disorders: Findings from the 2007 Australian National Survey of Mental Health and Wellbeing.

Science.gov (United States)

Lee, Yu-Chen; Chatterton, Mary Lou; Magnus, Anne; Mohebbi, Mohammadreza; Le, Long Khanh-Dao; Mihalopoulos, Cathrine

2017-12-01

The aim of this project was to detail the costs associated with the high prevalence mental disorders (depression, anxiety-related and substance use) in Australia, using community-based, nationally representative survey data. Respondents diagnosed, within the preceding 12 months, with high prevalence mental disorders using the Confidentialised Unit Record Files of the 2007 National Survey of Mental Health and Wellbeing were analysed. The use of healthcare resources (hospitalisations, consultations and medications), productivity loss, income tax loss and welfare benefits were estimated. Unit costs of healthcare services were obtained from the Independent Hospital Pricing Authority, Medicare and Pharmaceutical Benefits Scheme. Labour participation rates and unemployment rates were determined from the National Survey of Mental Health and Wellbeing. Daily wage rates adjusted by age and sex were obtained from Australian Bureau of Statistics and used to estimate productivity losses. Income tax loss was estimated based on the Australian Taxation Office rates. The average cost of commonly received Government welfare benefits adjusted by age was used to estimate welfare payments. All estimates were expressed in 2013-2014 AUD and presented from multiple perspectives including public sector, individuals, private insurers, health sector and societal. The average annual treatment cost for people seeking treatment was AUD660 (public), AUD195 (individual), AUD1058 (private) and AUD845 from the health sector's perspective. The total annual healthcare cost was estimated at AUD974m, consisting of AUD700m to the public sector, AUD168m to individuals, and AUD107m to the private sector. The total annual productivity loss attributed to the population with high prevalence mental disorders was estimated at AUD11.8b, coupled with the yearly income tax loss at AUD1.23b and welfare payments at AUD12.9b. The population with high prevalence mental disorders not only incurs substantial cost to

Costs to build Fermilab in 1984 dollars

International Nuclear Information System (INIS)

Jordan, N.G.; Livdahl, P.V.

1984-02-01

It is of current interest to examine the costs incurred to date to build Fermi National Accelerator Laboratory and to determine what those costs are when stated in FY 1984 constant dollars. The appended tables are in support of this exercise and are based on all costs for Equipment items (reduced by obsolescence) and all Plant Projects which have been appropriated through FY 1984. Also included are non-plant costs which are required to complete the Energy Saver, Tevatron I and II projects (i.e., Equipment and R and D in support of Construction). This study makes the assumption that all funding through FY 1984 will have been costed by the end of FY 1986. Those costs incurred in FY 1985 and FY 1986 have been deflated to FY 1984 dollars. See Appendix A for the DOE inflation factors used in the conversion to FY 1984 dollars. The costs are identified in three categories. The Accelerator Facilities include all accelerator components, the buildings which enclose them and utilities which support them. The Experimental Facilities include all beam lines, enclosures, utilities and experimental equipment which are usable in current experimental programs. The Support Facilities include lab and office space, shops, assembly facilities, roads, grounds and the utilities which do not specifically support the Accelerator or Experimental Facilities, etc

The social cost of congestion games by imposing variable delays

Directory of Open Access Journals (Sweden)

Josep Díaz

2017-12-01

Full Text Available In this study, we describe a new coordination mechanism for non-atomic congestion games that leads to a (selfish social cost which is arbitrarily close to the non-selfish optimal. This mechanism incurs no additional cost, in contrast to tolls that typically differ from the social cost as expressed in terms of delays.

The social costs of alcohol misuse in Estonia.

Science.gov (United States)

Saar, Indrek

2009-01-01

The aim of this study was to estimate the social costs of alcohol misuse in Estonia in 2006. Using a prevalence-based cost-of-illness approach, both direct and indirect costs were considered, including tangible costs associated with health care, criminal justice, rescue services, damage to property, premature mortality, incarceration, incapability of working due to illnesses, and lower labor productivity. The results show that alcohol misuse cost Estonia more than EUR 200 million in 2006. The costs involved are estimated to represent 1.6% of the gross domestic product (GDP), which is relatively high in comparison with many other countries. In addition, the state receives less receipts from the alcohol excise tax than the costs that it incurs as a consequence of alcohol misuse, which points to the existence of economic inefficiency with respect to the alcohol market. The results of this study suggest that there is definitely a need for further cost-benefit analysis to reach a conclusion regarding the possible utility of government intervention. Copyright 2008 S. Karger AG, Basel.

Survey of life-cycle costs of glass-paper HEPA filters

International Nuclear Information System (INIS)

Moore, P.; Bergman, W.; Gilbert, H.

1992-08-01

We have conducted a survey of the major users of glass-paper HEPA filters in the DOE complex to ascertain the life cycle costs of these filters. Purchase price of the filters is only a minor portion of the costs; the major expenditures are incurred during the removal and disposal of contaminated filters. Through personal interviews, site visits and completion of questionnaires, we have determined the costs associated with the use of HEPA filters in the DOE complex. The total approximate life-cycle cost for a standard (2 in. x 2 in. x 1 in.) glass-paper HEPA filter is $3,000 for one considered low-level waste (LLW), $11,780 for transuranic (TRU) and $15,000 for high-level waste (HLW). The weighted-average cost for a standard HEPA filter in the complex is $4,753

Cost Decision Support in Product Design

NARCIS (Netherlands)

Liebers, A.; Kals, H.J.J.

1997-01-01

The constraints addressed in decision making during product design, process planning and production planning determine the admissible solution space for the manufacture of products. The solution space determines largely the costs that are incurred in the production process. In order to be able to

40 CFR 35.928-4 - Moratorium on industrial cost recovery payments.

Science.gov (United States)

2010-07-01

... industrial users defined in paragraphs (a) and (b) of the definition in § 35.905 pay industrial cost recovery... industrial cost recovery charges incurred for accounting periods or portions of periods ending before January... defined in paragraphs (a) and (b) of the definition in § 35.905 to pay industrial cost recovery payments...

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

International Nuclear Information System (INIS)

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

1993-01-01

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

39 CFR 551.8 - Cost offset policy.

Science.gov (United States)

2010-07-01

... associated with semipostal stamps will rest with the Office of Accounting, Finance, Controller. Individual organizational units incurring costs will provide supporting documentation to the Office of Accounting, Finance... Accounting, Finance, Controller, shall, based on judgment and available information, identify the comparable...

Costing the Australian National Hand Hygiene Initiative.

Science.gov (United States)

Page, K; Barnett, A G; Campbell, M; Brain, D; Martin, E; Fulop, N; Graves, N

2014-11-01

The Australian National Hand Hygiene Initiative (NHHI) is a major patient safety programme co-ordinated by Hand Hygiene Australia (HHA) and funded by the Australian Commission for Safety and Quality in Health Care. The annual costs of running this programme need to be understood to know the cost-effectiveness of a decision to sustain it as part of health services. To estimate the annual health services cost of running the NHHI; the set-up costs are excluded. A health services perspective was adopted for the costing and collected data from the 50 largest public hospitals in Australia that implemented the initiative, covering all states and territories. The costs of HHA, the costs to the state-level infection-prevention groups, the costs incurred by each acute hospital, and the costs for additional alcohol-based hand rub are all included. The programme cost AU$5.56 million each year (US$5.76, £3.63 million). Most of the cost is incurred at the hospital level (65%) and arose from the extra time taken for auditing hand hygiene compliance and doing education and training. On average, each infection control practitioner spent 5h per week on the NHHI, and the running cost per annum to their hospital was approximately AU$120,000 in 2012 (US$124,000, £78,000). Good estimates of the total costs of this programme are fundamental to understanding the cost-effectiveness of implementing the NHHI. This paper reports transparent costing methods, and the results include their uncertainty. Copyright © 2014 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Increasing expenditure on health care incurred by diabetic subjects in a developing country: a study from India.

Science.gov (United States)

Ramachandran, Ambady; Ramachandran, Shobhana; Snehalatha, Chamukuttan; Augustine, Christina; Murugesan, Narayanasamy; Viswanathan, Vijay; Kapur, Anil; Williams, Rhys

2007-02-01

This study aimed to assess the direct cost incurred by diabetic subjects who were in different income groups in urban and rural India, as well as to examine the changing trends of costs in the urban setting from 1998 to 2005. A total of 556 diabetic subjects from various urban and rural regions of seven Indian states were enrolled. A brief uniform coded questionnaire (24 items) on direct cost was used. Annual family income was higher in urban subjects (rupees [Rs] 100,000 or $2,273) than in the rural subjects (Rs 36,000 or $818) (P inflation, a secular increase of 113% was observed in the total expenses between 1998 and 2005 in the urban population. The highest increase in percentage of household income devoted to diabetes care was in the lowest economic group (34% of income in 1998 vs. 24.5% in 2005) (P < 0.01). There was a significant improvement in urban subjects in medical reimbursement from 2% (1998) to 21.3% (2005). Urban and rural diabetic subjects spend a large percentage of income on diabetes management. The economic burden on urban families in developing countries is rising, and the total direct cost has doubled from 1998 to 2005.

26 CFR 1.278-1 - Capital expenditures incurred in planting and developing citrus and almond groves.

Science.gov (United States)

2010-04-01

... developing citrus and almond groves. 1.278-1 Section 1.278-1 Internal Revenue INTERNAL REVENUE SERVICE... Capital expenditures incurred in planting and developing citrus and almond groves. (a) General rule. (1)(i... any citrus or almond grove (or part thereof), and which is incurred before the close of the fourth...

U.S. Solar Photovoltaic System Cost Benchmark: Q1 2016

Energy Technology Data Exchange (ETDEWEB)

Fu, Ran [National Renewable Energy Lab. (NREL), Golden, CO (United States); Chung, Donald [National Renewable Energy Lab. (NREL), Golden, CO (United States); Lowder, Travis [National Renewable Energy Lab. (NREL), Golden, CO (United States); Feldman, David [National Renewable Energy Lab. (NREL), Golden, CO (United States); Ardani, Kristen [National Renewable Energy Lab. (NREL), Golden, CO (United States); Margolis, Robert [National Renewable Energy Lab. (NREL), Golden, CO (United States)

2016-09-01

NREL has been modeling U.S. photovoltaic (PV) system costs since 2009. This report benchmarks costs of U.S. solar PV for residential, commercial, and utility-scale systems built in the first quarter of 2016 (Q1 2016). Our methodology includes bottom-up accounting for all system and project-development costs incurred when installing residential, commercial, and utility-scale systems, and it models the capital costs for such systems.

U.S. Solar Photovoltaic System Cost Benchmark: Q1 2016

Energy Technology Data Exchange (ETDEWEB)

Fu, Ran; Chung, Donald; Lowder, Travis; Feldman, David; Ardani, Kristen; Margolis, Robert

2016-07-19

NREL has been modeling U.S. photovoltaic (PV) system costs since 2009. This report benchmarks costs of U.S. solar PV for residential, commercial, and utility-scale systems built in the first quarter of 2016 (Q1 2016). Our methodology includes bottom-up accounting for all system and project-development costs incurred when installing residential, commercial, and utility-scale systems, and it models the capital costs for such systems.

Ventilation cost and air cleaning

Science.gov (United States)

Goodfellow, H. D.

The components associated with the costs of the purchase of pollution control equipment are discussed. These include the capital cost to purchase the equipment and installation, and the costs incurred to operate the control device on an annual basis. Although the capital costs can represent a significant outlay of money, typically these costs are spread out over the life of the equipment. In general, this amortized cost is combined with the operating cost and is referred to as an 'annualized cost'. The annualized cost is a commonly used indicator to demonstrate the actual year to year cost that the equipment and operation will represent. Values and methods used to estimate costs, typical cost indicators, and sources of computerized costing models are presented. A comparison of the capital cost expenditure required for a model case (a cement kiln operation), using three control device alternatives is made.

The costs and benefits of early action before Kyoto compliance

International Nuclear Information System (INIS)

Pan, Haoran; Regemorter, D. van

2004-01-01

Transaction costs have negative effects on emissions trading. Recent debates on the Kyoto Protocol have emphasized the potential threat of transaction costs to the implementation of emissions trading for the Protocol and consequently to the successful implementation of the Protocol. One way to suppress transaction costs is to use experience. In line with the EU Green Paper, we propose that an experimental early action before the Kyoto period could be helpful to reduce the transaction costs in emissions trading for the Kyoto compliance. However, because early action will incur additional costs, the final gain due to early action will be the cost-saving net of the costs of early action. This paper explores the relationship between the transaction costs in emissions trading and the early action effort to reduce transaction costs in the case of Kyoto Protocol. We find that in general early action can effectively offset transaction costs and thus are economically efficient. Only in the case of high transaction costs and constantly slow learning process, early action may become inefficient

El incurable luto en psicoanálisis

OpenAIRE

Marta Gerez Ambertín

2005-01-01

Se hace un breve recorrido de la teoría del duelo en Freud y Lacanque permite obtener un saldo clínico unívoco de ambas teorías: elduelo deja un enigma incurable en la subjetividad. Para Freud elduelo deja siempre en la subjetividad un hueco que puede tomar distintosdestinos. Lacan ubica al duelo en relación al objeto a y la privación;desde allí destacamos diferentes vicisitudes: pasaje al acto,movimiento donde el sujeto es arrastrado por el objeto hacia unacaída que puede terminar en suicidi...

Reimbursing live organ donors for incurred non-medical expenses: a global perspective on policies and programs.

Science.gov (United States)

Sickand, M; Cuerden, M S; Klarenbach, S W; Ojo, A O; Parikh, C R; Boudville, N; Garg, A X

2009-12-01

Methods to reimburse living organ donors for the non-medical expenses they incur have been implemented in some jurisdictions and are being considered in others. A global understanding of existing legislation and programs would help decision makers implement and optimize policies and programs. We searched for and collected data from countries that practice living organ donation. We examined legislation and programs that facilitate reimbursement, focusing on policy mechanisms, eligibility criteria, program duration and types of expenses reimbursed. Of 40 countries, reimbursement is expressly legal in 16, unclear in 18, unspecified in 6 and expressly prohibited in 1. Donor reimbursement programs exist in 21 countries; 6 have been enacted in the last 5 years. Lost income is reimbursed in 17 countries, while travel, accommodation, meal and childcare costs are reimbursed in 12 to 19 countries. Ten countries have comprehensive programs, where all major cost categories are reimbursed to some extent. Out-of-country donors are reimbursed in 10 jurisdictions. Reimbursement is conditional on donor income in 7 countries, and recipient income in 2 countries. Many nations have programs that help living donors with their financial costs. These programs differ in operation and scope. Donors in other regions of the world are without support.

Reimbursing Live Organ Donors for Incurred Non-Medical Expenses: A Global Perspective on Policies and Programs

Science.gov (United States)

Sickand, M.; Cuerden, M. S.; Klarenbach, S. W.; Ojo, A. O.; Parikh, C. R.; Boudville, N.; Garg, A. X.

2015-01-01

Methods to reimburse living organ donors for the non-medical expenses they incur have been implemented in some jurisdictions and are being considered in others. A global understanding of existing legislation and programs would help decision makers implement and optimize policies and programs. We searched for and collected data from countries that practice living organ donation. We examined legislation and programs that facilitate reimbursement, focusing on policy mechanisms, eligibility criteria, program duration and types of expenses reimbursed. Of 40 countries, reimbursement is expressly legal in 16, unclear in 18, unspecified in 6 and expressly prohibited in 1. Donor reimbursement programs exist in 21 countries; 6 have been enacted in the last 5 years. Lost income is reimbursed in 17 countries, while travel, accommodation, meal and childcare costs are reimbursed in 12 to 19 countries. Ten countries have comprehensive programs, where all major cost categories are reimbursed to some extent. Out-of-country donors are reimbursed in 10 jurisdictions. Reimbursement is conditional on donor income in 7 countries, and recipient income in 2 countries. Many nations have programs that help living donors with their financial costs. These programs differ in operation and scope. Donors in other regions of the world are without support. PMID:19788503

Distribution and drivers of costs in type 2 diabetes mellitus treated with oral hypoglycemic agents: a retrospective claims data analysis.

Science.gov (United States)

Bron, Morgan; Guerin, Annie; Latremouille-Viau, Dominick; Ionescu-Ittu, Raluca; Viswanathan, Prabhakar; Lopez, Claudia; Wu, Eric Q

2014-09-01

To describe the distribution of costs and to identify the drivers of high costs among adult patients with type 2 diabetes mellitus (T2DM) receiving oral hypoglycemic agents. T2DM patients using oral hypoglycemic agents and having HbA1c test data were identified from the Truven MarketScan databases of Commercial and Medicare Supplemental insurance claims (2004-2010). All-cause and diabetes-related annual direct healthcare costs were measured and reported by cost components. The 25% most costly patients in the study sample were defined as high-cost patients. Drivers of high costs were identified in multivariate logistic regressions. Total 1-year all-cause costs for the 4104 study patients were $55,599,311 (mean cost per patient = $13,548). Diabetes-related costs accounted for 33.8% of all-cause costs (mean cost per patient = $4583). Medical service costs accounted for the majority of all-cause and diabetes-related total costs (63.7% and 59.5%, respectively), with a minority of patients incurring >80% of these costs (23.5% and 14.7%, respectively). Within the medical claims, inpatient admission for diabetes-complications was the strongest cost driver for both all-cause (OR = 13.5, 95% CI = 8.1-23.6) and diabetes-related costs (OR = 9.7, 95% CI = 6.3-15.1), with macrovascular complications accounting for most inpatient admissions. Other cost drivers included heavier hypoglycemic agent use, diabetes complications, and chronic diseases. The study reports a conservative estimate for the relative share of diabetes-related costs relative to total cost. The findings of this study apply mainly to T2DM patients under 65 years of age. Among the T2DM patients receiving oral hypoglycemic agents, 23.5% of patients incurred 80% of the all-cause healthcare costs, with these costs being driven by inpatient admissions, complications of diabetes, and chronic diseases. Interventions targeting inpatient admissions and/or complications of diabetes may contribute to the decrease of the

Survey of Swiss nuclear's cost study 2016

International Nuclear Information System (INIS)

Alt, Stefan; Ustohalova, Veronika

2017-01-01

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

48 CFR 219.7104 - Developmental assistance costs eligible for reimbursement or credit.

Science.gov (United States)

2010-10-01

... costs eligible for reimbursement or credit. 219.7104 Section 219.7104 Federal Acquisition Regulations... reimbursement or credit. (a) Developmental assistance provided under an approved mentor-protege agreement is... eligible for reimbursement are set forth in appendix I. (b) Before incurring any costs under the Program...

Tracing contacts of TB patients in Malaysia: costs and practicality.

Science.gov (United States)

Atif, Muhammad; Sulaiman, Syed Azhar Syed; Shafie, Asrul Akmal; Ali, Irfhan; Asif, Muhammad

2012-01-01

Tuberculin skin testing (TST) and chest X-ray are the conventional methods used for tracing suspected tuberculosis (TB) patients. The purpose of the study was to calculate the cost incurred by Penang General Hospital on performing one contact tracing procedure using an activity based costing approach. Contact tracing records (including the demographic profile of contacts and outcome of the contact tracing procedure) from March 2010 until February 2011 were retrospectively obtained from the TB contact tracing record book. The human resource cost was calculated by multiplying the mean time spent (in minutes) by employees doing a specific activity by their per-minute salaries. The costs of consumables, Purified Protein Derivative vials and clinical equipment were obtained from the procurement section of the Pharmacy and Radiology Departments. The cost of the building was calculated by multiplying the area of space used by the facility with the unit cost of the public building department. Straight-line deprecation with a discount rate of 3% was assumed for the calculation of equivalent annual costs for the building and machines. Out of 1024 contact tracing procedures, TST was positive (≥10 mm) in 38 suspects. However, chemoprophylaxis was started in none. Yield of contact tracing (active tuberculosis) was as low as 0.5%. The total unit cost of chest X-ray and TST was MYR 9.23 (2.90 USD) & MYR 11.80 (USD 3.70), respectively. The total cost incurred on a single contact tracing procedure was MYR 21.03 (USD 6.60). Our findings suggest that the yield of contact tracing was very low which may be attributed to an inappropriate prioritization process. TST may be replaced with more accurate and specific methods (interferon gamma release assay) in highly prioritized contacts; or TST-positive contacts should be administered 6H therapy (provided that the chest radiography excludes TB) in accordance with standard protocols. The unit cost of contact tracing can be significantly

36 CFR 14.22 - Reimbursement of costs.

Science.gov (United States)

2010-07-01

... acceptable to the authorized officer, by bond, guaranty, cash, certificate of deposit, or other means... acceptable to the authorized officer, by bond, guaranty, cash, certificate of deposit or other means... shall reimburse the United States for costs incurred by the United States in monitoring the construction...

Methodology for Determining the Avoidable and Fully Allocated Costs of Amtrak Routes : Volume III, Appendix B-H

Science.gov (United States)

2009-08-01

The Federal Railroad Administration tasked the Volpe Center with developing a methodology for determining the avoidable and fully allocated costs of Amtrak routes. Avoidable costs are costs that would not be incurred if an Amtrak route were discontin...

75 FR 34336 - Reimbursement Transportation Cost Payment Program for Geographically Disadvantaged Farmers and...

Science.gov (United States)

2010-06-17

... DEPARTMENT OF AGRICULTURE Farm Service Agency 7 CFR Part 755 RIN 0560-AI08 Reimbursement... Reimbursement Transportation Cost Payment (RTCP) Program for geographically disadvantaged farmers and ranchers.... To be eligible for reimbursement, the transportation costs must have been incurred in the FY for...

48 CFR 31.205-47 - Costs related to legal and other proceedings.

Science.gov (United States)

2010-10-01

... ACQUISITION REGULATION GENERAL CONTRACTING REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With..., law or regulation by the contractor (including its agents or employees), or costs incurred in... or void a contract; or (iii) Terminate a contract for default by reason of a violation or failure to...

Cost analysis of in-patient cancer chemotherapy at a tertiary care hospital

Directory of Open Access Journals (Sweden)

Mohammad Ashraf Wani

2013-01-01

Materials and Methods: After permission from the Ethical Committee, a prospective study of 6 months duration was carried out to study the cost of treatment provided to in-patients in Medical Oncology. Direct costs that include the cost of material, labor and laboratory investigations, along with indirect costs were calculated, and data analyzed to compute unit cost of treatment. Results: The major cost components of in-patient cancer chemotherapy are cost of drugs and materials as 46.88% and labor as 48.45%. The average unit cost per patient per bed day for in-patient chemotherapy is Rs. 5725.12 ($125.96. This includes expenditure incurred both by the hospital and the patient (out of pocket. Conclusion: The economic burden of cancer treatment is quite high both for the patient and the healthcare provider. Modalities in the form of health insurance coverage need to be established and strengthened for pooling of resources for the treatment and transfer of risks of these patients.

Mental health services costs within the Alberta criminal justice system.

Science.gov (United States)

Jacobs, Philip; Moffatt, Jessica; Dewa, Carolyn S; Nguyen, Thanh; Zhang, Ting; Lesage, Alain

2016-01-01

Mental illness has been widely cited as a driver of costs in the criminal justice system. The objective of this paper is to estimate the additional mental health service costs incurred within the criminal justice system that are incurred because of people with mental illnesses who go through the system. Our focus is on costs in Alberta. We set up a model of the flow of all persons through the criminal justice system, including police, court, and corrections components, and for mental health diversion, review, and forensic services. We estimate the transitional probabilities and costs that accrue as persons who have been charged move through the system. Costs are estimated for the Alberta criminal justice system as a whole, and for the mental illness component. Public expenditures for each person diverted or charged in Alberta in the criminal justice system, including mental health costs, were $16,138. The 95% range of this estimate was from $14,530 to $19,580. Of these costs, 87% were for criminal justice services and 13% were for mental illness-related services. Hospitalization for people with mental illness who were reviewed represented the greatest additional cost associated with mental illnesses. Treatment costs stemming from mental illnesses directly add about 13% onto those in the criminal justice system. Copyright © 2016 Elsevier Ltd. All rights reserved.

Digital and conventional radiology techniques: comparison of dosage and costs

International Nuclear Information System (INIS)

Arranza, L.; Albornoz, C. de

1996-01-01

To compare the radiation dosage and costs in conventional and digital technologies. The study dealt with transverse sections. The dosage applied with conventional technology was measured in 254 patients who intertwined 402 explorations of 6 anatomic regions in 4 Radiodiagnostic Services. The dosage applied with digital technology was measured in 57 patients who underwent 95 explorations of the same anatomic region in one Radiodiagnostic Service. The costs of the 6 types of conventional and digital explorations performed were calculated for two Radiodiagnostic Service. The doses administered (mGy) using convectional/digital technology were as follows: chest PA 0.2/0.1; chest LAT 0.7/0.3; breast CC 7.0/8.4; breast LAT 7.0/7.8; breast OB 7.0/10.5; cervical spine AP 9.6/9.0; cervical spine LAT 21.9/29.6; pelvis AP 7.3/7.1; plain abdominal 6.5/2.2. The costs incurred (1992 pesetas) with the convectional/digital technologies: chest AP and LAT 1,393/2,973; portable chest 2,027/3,714; mammography 2,357/3,486; phlebography 12,718/14,023; hysterosalpingography 4,876/6,701; bone scientigraphy 1,633/2,839. Compared with conventional technology, digital imaging reduces the radiation doses received by the patients, except in the case of mammography. The costs associated with the use of digital technology are greater than those incurred with conventional technology, mainly due to the costs of amortization. the use of digital technology is more justified when: 1) it is very necessary to reduce the dosage; 2) studies of chest and abdomen predominant; 3) the volume of utilization is high; 4) staff management is flexible , and 5) the cost of purchasing the equipment is lower. (Author) 10 refs

The cost of home-based terminal care for people with AIDS in South ...

African Journals Online (AJOL)

Even with this level of HBC input, patients still incurred hospital costs of R2 522 and primary care clinic costs of R1 154 per patient per year. HBC costs are increased in rural areas where a vehicle is required for staff transport. HBC shows considerable potential to deal cost-effectively with growing palliative care needs in the ...

Drivers of imbalance cost of wind power

DEFF Research Database (Denmark)

Obersteiner, C.; Siewierski, T.; Andersen, Anders

2010-01-01

In Europe an increasing share of wind power is sold on the power market. Therefore more and more wind power generators become balancing responsible and face imbalance cost that reduce revenues from selling wind power. A comparison of literature illustrates that the imbalance cost of wind power...... varies in a wide range. To explain differences we indentify parameters influencing imbalance cost and compare them for case studies in Austria, Denmark and Poland. Besides the wind power forecast error also the correlation between imbalance and imbalance price influences imbalance cost significantly...... of imperfect forecast is better suited to reflect real cost incurred due to inaccurate wind power forecasts....

Supply chain cost improvement opportunities through streamlining cross-border operations

Directory of Open Access Journals (Sweden)

Jan Hendrik Havenga

2013-09-01

Full Text Available The Cross-Border Road Transport Agency (CBRTA in South Africa aims to encourage and facilitate trade between South Africa and its neighbouring countries. The CBRTA sponsored a study by Stellenbosch University (SU to determine the logistics cost impact of cross-border delays between South Africa and its major neighbouring trading partners, and prioritise opportunities for improvement. SU is the proprietor of both a comprehensive freight demand model and a logistics cost model for South Africa, which enable extractions and extensions of freight flows and related costs for specific purposes. Through the application of these models, the following information is identified and presented in this paper: South Africa’s most important border posts (based on traffic flows; a product profile for imports and exports through these border posts; the modal split (road and rail; the annual logistics costs incurred on the corridors feeding the border posts, as well as the additional costs incurred due to border delays. The research has proved that the streamlining of border-post operations that take a total supply chain view (i.e. of both border operations and those that could be moved from the border is beneficial.

The Cost-Effectiveness of Military Advertising: Evidence from 2002-2004

Science.gov (United States)

2009-01-01

real dollars, the budgets were adjusted for CPM (cost per 1,000 advertising impressions, or audience exposures) inflation. These costs for network...budgets have doubled. During the 1990s, real spending on advertising was signifi- cantly lower. 1 CPM actually incurred by the Services (computed by...TITLE AND SUBTITLE The Cost-Effectiveness of Military Advertising : Evidence from 2002?2004 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT

26 CFR 1.43-4 - Qualified enhanced oil recovery costs.

Science.gov (United States)

2010-04-01

... 26 Internal Revenue 1 2010-04-01 2010-04-01 true Qualified enhanced oil recovery costs. 1.43-4... TAXES Credits Against Tax § 1.43-4 Qualified enhanced oil recovery costs. (a) Qualifying costs—(1) In... “qualified enhanced oil recovery costs” if the amounts are paid or incurred with respect to an asset which is...

Insurance for replacement power costs

International Nuclear Information System (INIS)

Cleaver, A.

1980-01-01

Although careful consideration is given to insurance against physical damage to plant and equipment, little thought is given to the costs that will be incurred in replacing the power that is lost while a relatively efficient system is out of action. The results of an investigation carried out for a generating authority with an installed capacity of about 3000 MW is given. Replacement power costs for different cases of severity of damage range from Pound1.17m per month for damage to central services taking out all four units. (author)

Cost-effectiveness and resource implications of aggressive action on tuberculosis in China, India, and South Africa: a combined analysis of nine models.

Science.gov (United States)

Menzies, Nicolas A; Gomez, Gabriela B; Bozzani, Fiammetta; Chatterjee, Susmita; Foster, Nicola; Baena, Ines Garcia; Laurence, Yoko V; Qiang, Sun; Siroka, Andrew; Sweeney, Sedona; Verguet, Stéphane; Arinaminpathy, Nimalan; Azman, Andrew S; Bendavid, Eran; Chang, Stewart T; Cohen, Ted; Denholm, Justin T; Dowdy, David W; Eckhoff, Philip A; Goldhaber-Fiebert, Jeremy D; Handel, Andreas; Huynh, Grace H; Lalli, Marek; Lin, Hsien-Ho; Mandal, Sandip; McBryde, Emma S; Pandey, Surabhi; Salomon, Joshua A; Suen, Sze-Chuan; Sumner, Tom; Trauer, James M; Wagner, Bradley G; Whalen, Christopher C; Wu, Chieh-Yin; Boccia, Delia; Chadha, Vineet K; Charalambous, Salome; Chin, Daniel P; Churchyard, Gavin; Daniels, Colleen; Dewan, Puneet; Ditiu, Lucica; Eaton, Jeffrey W; Grant, Alison D; Hippner, Piotr; Hosseini, Mehran; Mametja, David; Pretorius, Carel; Pillay, Yogan; Rade, Kiran; Sahu, Suvanand; Wang, Lixia; Houben, Rein M G J; Kimerling, Michael E; White, Richard G; Vassall, Anna

2016-11-01

The post-2015 End TB Strategy sets global targets of reducing tuberculosis incidence by 50% and mortality by 75% by 2025. We aimed to assess resource requirements and cost-effectiveness of strategies to achieve these targets in China, India, and South Africa. We examined intervention scenarios developed in consultation with country stakeholders, which scaled up existing interventions to high but feasible coverage by 2025. Nine independent modelling groups collaborated to estimate policy outcomes, and we estimated the cost of each scenario by synthesising service use estimates, empirical cost data, and expert opinion on implementation strategies. We estimated health effects (ie, disability-adjusted life-years averted) and resource implications for 2016-35, including patient-incurred costs. To assess resource requirements and cost-effectiveness, we compared scenarios with a base case representing continued current practice. Incremental tuberculosis service costs differed by scenario and country, and in some cases they more than doubled existing funding needs. In general, expansion of tuberculosis services substantially reduced patient-incurred costs and, in India and China, produced net cost savings for most interventions under a societal perspective. In all three countries, expansion of access to care produced substantial health gains. Compared with current practice and conventional cost-effectiveness thresholds, most intervention approaches seemed highly cost-effective. Expansion of tuberculosis services seems cost-effective for high-burden countries and could generate substantial health and economic benefits for patients, although substantial new funding would be required. Further work to determine the optimal intervention mix for each country is necessary. Bill & Melinda Gates Foundation. Copyright © 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license. Published by Elsevier Ltd.. All rights reserved.

An analysis of potential costs of adverse events based on Drug Programs in Poland. Pulmonology focus

Directory of Open Access Journals (Sweden)

Szkultecka-Debek Monika

2014-06-01

Full Text Available The project was performed within the Polish Society for Pharmacoeconomics (PTFE. The objective was to estimate the potential costs of treatment of side effects, which theoretically may occur as a result of treatment of selected diseases. We analyzed the Drug Programs financed by National Health Fund in Poland in 2012 and for the first analysis we selected those Programs where the same medicinal products were used. We based the adverse events selection on the Summary of Product Characteristics of the chosen products. We extracted all the potential adverse events defined as frequent and very frequent, grouping them according to therapeutic areas. This paper is related to the results in the pulmonology area. The events described as very common had an incidence of ≥ 1/10, and the common ones ≥ 1/100, <1/10. In order to identify the resources used, we performed a survey with the engagement of clinical experts. On the basis of the collected data we allocated direct costs incurred by the public payer. We used the costs valid in December 2013. The paper presents the estimated costs of treatment of side effects related to the pulmonology disease area. Taking into account the costs incurred by the NHF and the patient separately e calculated the total spending and the percentage of each component cost in detail. The treatment of adverse drug reactions generates a significant cost incurred by both the public payer and the patient.

Talking about death with children with incurable cancer: perspectives from parents.

NARCIS (Netherlands)

Geest, I.M.M. van der; Heuvel-Eibrink, M.M. van den; Vliet, L.M. van; Pluijm, S.M.F.; Streng, I.C.; Michiels, E.M.C.; Pieters, R.; Darlington A.S.E.

2015-01-01

Objective: To investigate the rationale and consequences associated with a parent's decision to discuss death with a child with incurable cancer. Study design: We present data from a larger retrospective study involving bereaved parents of a child who died of cancer. Parents were asked whether they

Cost studies concerning decontamination and dismantling. The interim store for spent fuel at Studsvik

International Nuclear Information System (INIS)

Sjoeblom, Rolf; Sjoeoe, Cecilia; Lindskog, Staffan; Cato, Anna

2006-04-01

The interim store for spent fuel at Studsvik was designed and constructed in 1962-64. It has been used for wet storage of fuel from the Aagesta Nuclear Power Plant as well as the R2 reactor at Studsvik. The interim store comprises three cylindrical pools for fuel storage as well as equipment for handling and decontamination. The purpose of the present work is to develop methodology for calculation of future costs for decontamination and dismantling of nuclear research facilities. The analysis is based on information from Studsvik as well as results from information searches. The requirements on precision of cost calculations is high, also at early stages. The reason for this is that the funds are to be collected now but are to be used some time in the future. At the same time they should neither be insufficient nor superfluous. It is apparent from the compilation and analysis that when methodology that has been developed for the purpose of cost calculations for power reactors is applied to research facilities certain drawbacks become apparent, e.g. difficulties to carry out variation analyses. Generally, feedback of data on incurred costs for the purpose of cost calculations can be achieved by using one or more scaling factors together with weighing factors which are established based on e.g. expert judgement. For development and utilisation of such tools it is necessary to have access to estimated costs together with incurred ones. In the report, the following combination of aspects is identified as being of primary significance for achieving a high precision: Calculations with the possibility to calibrate against incurred costs; Radiological surveying tailored to the needs for calculations; Technical planning including selection of techniques to be used; Identification of potential sources for systematic deviations. In the case of the interim store, some of the sources of uncertainty are as follows: Damaged surface layers in the pools; Maintenance status for the

Improving health care costing with resource consumption accounting.

Science.gov (United States)

Ozyapici, Hasan; Tanis, Veyis Naci

2016-07-11

Purpose - The purpose of this paper is to explore the differences between a traditional costing system (TCS) and resource consumption accounting (RCA) based on a case study carried out in a hospital. Design/methodology/approach - A descriptive case study was first carried out to identify the current costing system of the case hospital. An exploratory case study was then conducted to reveal how implementing RCA within the case hospital assigns costs differently to gallbladder surgeries than the current costing system (i.e. a TCS). Findings - The study showed that, in contrast to a TCS, RCA considers the unused capacity, which is the difference between the work that can be performed based on current resources and the work that is actually being performed. Therefore, it assigns lower total costs to open and laparoscopic gallbladder surgeries. The study also showed that by separating costs into fixed and variable RCA allows managers to benefit from a pricing strategy based on the difference between the service's selling price and variable costs incurred in providing that service. Research limitations/implications - The limitation of this study is that, because of time constraints, the implementation was performed in the general surgery department only. However, since RCA is an advanced system that has the same application procedures for any department inside in a hospital, managers need only time gaps to implement this system to all parts of the hospital. Practical implications - This study concluded that RCA is better than a TCS for use in health care settings that have high overhead costs because it accurately assigns overhead costs to services by considering unused capacities incurred by a hospital. Consequently, this study provides insight into both measuring and managing unused capacities within the health care sector. This study also concluded that RCA helps health care administrators increase their competitive advantage by allowing them to determine the lowest

Use of health plan data to estimate cost and outcomes of a breast cancer population

International Nuclear Information System (INIS)

Konski, Andre

1997-01-01

recurred. A statistical difference was noted between cost of overall care compared to the cost billed as breast cancer care cost, p=0.0014, and between the cost identified as breast cancer care cost compared to the cost billed as breast cancer care cost, p=0.0113. For pts. in the health plan during the entire interval had 87.5% of cost incurred during the first year compared to 77.1% of cost incurred in the first year for patients not in the plan for the entire duration. Pts. having lumpectomy and radiation had 92.5% of cost incurred in the first year compared to 72.5% of cost incurred in the first year for pts. having mastectomy and reconstruction. Conclusion: Insurance claim data gives an accurate estimate of the date of diagnosis but are not accurate in providing information of dates of recurrence or death, unless the patient dies while in the plan. Cost of care can be overestimated if based upon the entire cost data as provided by insurance claims or underestimated if only cost identified as being from breast cancer is counted. Additional data are required to accurately estimate costs based upon the first year of incurred cost

Efficacy, safety and costs of intermittent presumptive treatment for malaria in Tanzania

DEFF Research Database (Denmark)

Mubyazi, Godfrey Martin; Bloch, Paul; Magnussen, Pascal

2011-01-01

users and partly HWs who are forced to pay out of their pockets; (iv) HFbased IPTp services forcing pregnant women who reside far away to incur additional costs on re-visiting HFs, including the costs on transport, foods and/or drinks, besides purchasing SP elsewhere when the HFs concerned are out...

Cost to patients of obtaining treatment for HIV/AIDS in South Africa ...

African Journals Online (AJOL)

Background. South Africa is providing antiretroviral (ARV) drugs for HIV I AIDS free of charge in order to increase access for poorer patients and promote adherence. However, non-drug costs of obtaining treatment may limit access. We estimated the costs that South African patients incur in obtaining antiretroviral therapy ...

Ensuring the adequacy of cost share provisions in superfund state contracts. Directive

International Nuclear Information System (INIS)

1993-01-01

The memorandum requests regional offices to re-examine existing Superfund State Contracts (SSCs) for Fund-financed remedial actions to verify that they adequately reflect incurred and projected remedial action costs

Can E-Filing Reduce Tax Compliance Costs in Developing Countries?

OpenAIRE

Yilmaz, Fatih; Coolidge, Jacqueline

2013-01-01

The purpose of this study is to investigate the association between electronic filing (e-filing) and the total tax compliance costs incurred by small and medium size businesses in developing countries, based on survey data from South Africa, Ukraine, and Nepal. A priori, most observers expect that use of e-filing should reduce tax compliance costs, but this analysis suggests that the assum...

An Evaluation of Shipyard Practices and Their Correlation to Ship Costs

Science.gov (United States)

2017-12-01

shareholders. This increases public investment into the company allowing it to flourish. 36 h. Ingalls Shipyard Employees Improved processes and cost ...some of the detriment of such a bottleneck could benefit the shipbuilding process by mitigating the adverse cost and quality impact of the...done to the best of the Navy’s ability, the benefit will be more efficient shipbuilding processes that incur cost and schedule savings and possible

Long term warranty and after sales service concept, policies and cost models

CERN Document Server

Rahman, Anisur

2015-01-01

This volume presents concepts, policies and cost models for various long-term warranty and maintenance contracts. It offers several numerical examples for estimating costs to both the manufacturer and consumer. Long-term warranties and maintenance contracts are becoming increasingly popular, as these types of aftersales services provide assurance to consumers that they can enjoy long, reliable service, and protect them from defects and the potentially high costs of repairs. Studying long-term warranty and service contracts is important to manufacturers and consumers alike, as offering long-term warranty and maintenance contracts produce additional costs for manufacturers / service providers over the product’s service life. These costs must be factored into the price, or the manufacturer / dealer will incur losses instead of making a profit. On the other hand, the buyer / consumer needs to weigh the cost of maintaining it over its service life and to decide whether or not these policies are worth purchasing....

Traditional growing rod versus magnetically controlled growing rod for treatment of early onset scoliosis: Cost analysis from implantation till skeletal maturity.

Science.gov (United States)

Wong, Carlos King Ho; Cheung, Jason Pui Yin; Cheung, Prudence Wing Hang; Lam, Cindy Lo Kuen; Cheung, Kenneth Man Chee

2017-01-01

To compare the yearly cost involved per patient in the use of magnetically controlled growing rod (MCGR) and traditional growing rods (TGRs) in the treatment of early onset scoliosis (EOS) and to assess the overall cost burden of MCGR with reference to patient and health-care infrastructure. For a hypothetical case of a 5-year-old girl with a diagnosis of EOS, a decision-tree model using TreeAge Software was developed to simulate annual health state transitions and compare the 8-year accumulative direct, indirect, and total cost among the four groups: (1) dual MCGRs with exchange every 2 years, (2) dual MCGRs with exchange every 3 years, (3) TGR with surgical distraction every year, and (4) TGR with surgical distraction every 6 months. Base-case values and ranges of clinical parameters reflecting complication rate after each type of surgical distraction were determined from a review of literature and expert opinion. Government gazette and expert opinion provided cost estimation of growing rods, surgeries, surgical complications, and routine follow-up. Microsimulation of 1000 individuals was conducted to test the variation in total direct costs (in 2016 Hong Kong dollars (HKD)) between individuals, and estimated the standard deviations of total direct costs for each group. Over the projected treatment period, indirect costs incurred by patients and family were higher for the MCGR as compared to the TGR. However, the total costs incurred by MCGR groups (group 1: HKD164k; group 2: HKD138k) were lower than those incurred by TGR groups (group 3: HKD191k; group 4: HKD290k). Although the accumulative costs of three groups (TGR with distraction every year and MCGR replacing every 2 and 3 years) were approaching each other in the first 2 years after initial implantation, at year 3 the accumulative cost of MCGR exchange every 2 years was HKD36k more than the yearly TGR surgery due to the cost of implant exchange. The cost incurred by both the MCGR groups was less than that

A cost-benefit analysis of spent fuel management

International Nuclear Information System (INIS)

Lamorlette, G.

2001-01-01

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

Nuclear cost studies for decontamination and dismantling. The interim storage for spent fuels at Studsvik

International Nuclear Information System (INIS)

Sjoeblom, Rolf; Sjoeoe, Cecilia; Lindskog, Staffan; Cato, Anna

2005-05-01

The interim store for spent fuel (FA) at Studsvik was designed and constructed in 1962-64. It has been used for wet storage of fuel from the Aagesta Nuclear Power Plant as well as the R2 reactor at Studsvik. FA comprises three cylindrical pools for fuel storage as well as equipment for handling and decontamination. The purpose of the present work is to develop methodology for calculation of future costs for decontamination and dismantling of nuclear research facilities. The analysis is based on information from Studsvik as well as results from information searches. The requirements on precision of cost calculations is high, also at early stages. The reason for this is that the funds are to be collected now but are to be used some time in the future. At the same time they should neither be insufficient nor superfluous. It is apparent from the compilation and analysis that when methodology that has been developed for the purpose of cost calculations for power reactors is applied to research facilities certain drawbacks become apparent, e.g. difficulties to carry out variation analyses. Generally, feedback of data on incurred costs for the purpose of cost calculations can be achieved by using one or more scaling factors together with weighing factors which are established based on e g expert judgement. For development and utilisation of such tools it is necessary to have access to estimated costs together with incurred ones. In the report, the following combination of aspects is identified as being of primary significance for achieving a high precision: Calculations with the possibility to 'calibrate' against incurred costs; Radiological surveying tailored to the needs for calculations; Technical planning including selection of techniques to be used; Identification of potential sources for systematic deviations. In the case of FA, some of the sources of uncertainty are as follows: Damaged surface layers in the pools; Maintenance status for the drains; Radiological

Efficacy, safety and costs of intermittent presumptive treatment for malaria in tanzania

DEFF Research Database (Denmark)

Mubyazi, Godfrey Martin; Bloch, Paul; Magnussen, Pascal

2010-01-01

users and partly HWs who are forced to pay out of their pockets; (iv) HF-based IPTp services forcing pregnant women who reside far away to incur additional costs on re-visiting HFs, including the costs on transport, foods and/or drinks, besides purchasing SP elsewhere when the HFs concerned are out...

What can dissaving tell us about catastrophic costs? Linear and logistic regression analysis of the relationship between patient costs and financial coping strategies adopted by tuberculosis patients in Bangladesh, Tanzania and Bangalore, India.

Science.gov (United States)

Madan, Jason; Lönnroth, Knut; Laokri, Samia; Squire, Stephen Bertel

2015-10-22

Tuberculosis (TB) is a major global public health problem which affects poorest individuals the worst. A high proportion of patients incur 'catastrophic costs' which have been shown to result in severe financial hardship and adverse health outcomes. Data on catastrophic cost incidence is not routinely collected, and current definitions of this indicator involve several practical and conceptual barriers to doing so. We analysed data from TB programmes in India (Bangalore), Bangladesh and Tanzania to determine whether dissaving (the sale of assets or uptake of loans) is a useful indicator of financial hardship. Data were obtained from prior studies of TB patient costs in Bangladesh (N = 96), Tanzania (N = 94) and Bangalore (N = 891). These data were analysed using logistic and linear multivariate regression to determine the association between costs (absolute and relative to income) and both the presence of dissaving and the amounts dissaved. After adjusting for covariates such as age, sex and rural/urban location, we found a significant positive association between the occurrence of dissaving and total costs incurred in Tanzania and Bangalore. We further found that, for patients in Bangalore an increase in dissaving of $10 USD was associated with an increase in the cost-income ratio of 0.10 (p costs of $7 USD (p costs that does not require usage of complex patient cost questionnaires. It also offers an informative indicator of financial hardship in its own right, and could therefore play an important role as an indicator to monitor and evaluate the impact of financial protection and service delivery interventions in reducing hardship and facilitating universal health coverage. Further research is required to understand the patterns and types of dissaving that have the strongest relationship with financial hardship and clinical outcomes in order to move toward evidence-based policy making.

26 CFR 1.181-1T - Deduction for qualified film and television production costs (temporary).

Science.gov (United States)

2010-04-01

... incurred to distribute or exploit a production (including advertising and print costs). (iii) Production costs do not include the costs to prepare a new release or new broadcast of an existing film or video after the initial release or initial broadcast of the film or video (for instance, the preparation of a...

Quantifying Queensland patients with cancer health service usage and costs: study protocol.

Science.gov (United States)

Callander, Emily; Topp, Stephanie M; Larkins, Sarah; Sabesan, Sabe; Bates, Nicole

2017-01-24

The overall mortality rate for cancer has declined in Australia. However, socioeconomic inequalities exist and the out-of-pocket costs incurred by patients in Australia are high compared with some European countries. There is currently no readily available data set to provide a systematic means of measuring the out-of-pocket costs incurred by patients with cancer within Australia. The primary aim of the project is to quantify the direct out-of-pocket healthcare expenditure of individuals in the state of Queensland, who are diagnosed with cancer. This project will build Australia's first model (called CancerCostMod) of out-of-pocket healthcare expenditure of patients with cancer using administrative data from Queensland Cancer Registry, for all individuals diagnosed with any cancer in Queensland between 1 July 2011 and 30 June 2012, linked to their Admitted Patient Data Collection, Emergency Department Information System, Medicare Benefits Schedule and Pharmaceutical Benefits Scheme records from 1 July 2011 to 30 June 2015. No identifiable information will be provided to the authors. The project will use a combination of linear and logistic regression modelling, Cox proportional hazards modelling and machine learning to identify differences in survival, total health system expenditure, total out-of-pocket expenditure and high out-of-pocket cost patients, adjusting for demographic and clinical confounders, and income group, Indigenous status and geographic location. Results will be analysed separately for different types of cancer. Human Research Ethics approval has been obtained from the Townsville Hospital and Health Service Human Research Ethics Committee (HREC/16/QTHS/110) and James Cook University Human Research Ethics Committee (H6678). Permission to waive consent has been sought from Queensland Health under the Public Health Act 2005. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

Food irradiation : estimates of cost of processing

International Nuclear Information System (INIS)

Krishnamurthy, K.; Bongirwar, D.R.

1987-01-01

For estimating the cost of food irradiation, three factors have to be taken into consideration. These are : (1) capital cost incurred on irradiation device and its installation, (2) recurring or running cost which includes maintenance cost and operational expenditure, and (3) product specific cost dependent on the factors specific to the food item to be processed, its storage, handling and distribution. A simple method is proposed to provide estimates of capital costs and running costs and it is applied to prepare a detailed estimate of costs for irradiation processing of onions and fish in India. The cost of processing onions worked out to be between Rs. 40 to 120 per 1000 Kg and for fish Rs 354 per 1000 Kg. These estimates do not take into account transparation costs and fluctuations in marketing procedures. (M.G.B.). 7 tables

Substantiating the Incurred but not Reported Reserve

Directory of Open Access Journals (Sweden)

Georgeta Vintilã

2009-12-01

Full Text Available In order to handle past and future liability taken by insurance contracts concluded, any insurance company must constitute and maintain technical reserves. Substantiating technical reserves is done through actuarial methods and its over-evaluation or under-evaluation influence solvency and financial performance of the insurance companies, in the sense of reducing solvency through over-evaluating reserves and, respectively, influencing profit (hence of outstanding tax through under-evaluating reserves. An important reserve for insurance companies is represented by the incurred but not reported reserve, as it allows the estimation of the liability the company may confront in the future, generated by events occurred in the past, which are not currently known in the present but will be reported in the future.

IFRS and US GAAP convergence in the area of borrowing costs

Directory of Open Access Journals (Sweden)

Hana Bohušová

2009-01-01

Full Text Available An agreement from Norwalk was issued in September 2002 on the basis of negotiations of Financial Accounting Standards Board (FASB a International Accounting Standards Board (IASB for the elimination of restrictions in the form of two different systems of financial reporting. The aim is to ensure absolute compatibility of existing U.S. GAAP and IFRS and the coordination of work programs in the future. Document Memorandum of Understanding was issued in 2006 in the frame of ongoing process of convergence, in which the FASB and IASB confirm their intention to create high-quality and global financial reporting standards. In this document there are specified areas, which would lead to convergence of procedures.Borrowing costs have been one from the fields, which was the subject of convergence works. U.S. GAAP dictated capitalization of borrowing costs incurred in connection with the acquisition of qualifying assets, while the IAS/IFRS leaved the decision on accounting entities, how it recognize and record borrowing costs incurred in connection with the acquisition of the assets.In the beginning, the method of analysis and description is used to identify and describe the basic difference of both systems, which had existed before the initiation of convergence within the frame of “Borrowing Costs” project. The above mentioned primary analysis has served as the basis for the further comparative analysis and synthesis.The paper further presents comparative analysis of two basic methodical approaches towards the borrowing costs reporting incurred in relation to the acquisition of the qualifying assets, which was possible to apply until 31st Dec 2008 under IFRS system.The comparative analysis is based on empirical company data. The subjects are mainly the differences in the indicators, which are used for the evaluation of the company financial situation. According (Suvova, 1999, mainly the indicators of vertical analysis of property and capital structure

Audit fees and IFRS accounting - Is information costly?

OpenAIRE

Friis, Ole; Nielsen, Mogens

2010-01-01

Since 2005 companies with equity instruments traded on regulated markets in the European Economic Area have prepared their financial reports in accordance with accounting standards issued by the IASB. A survey conducted in 2007 indicated that most of the EU companies that changed from local to IFRS rules incurred additional costs in connection with the transition. Also, companies expected additional future costs from using IFRS. Although the main part of these stemmed from the companies’ inte...

Resource consumption and costs in Dutch patients with Type 2 diabetes mellitus. Results from 29 general practices

NARCIS (Netherlands)

Redekop, WK; Koopmanschap, MA; Rutten, GEHM; Wolffenbuttel, BHR; Stolk, RP; Niessen, LW

Aims The aims of this study were to estimate the costs incurred by Dutch patients with Type 2 diabetes, examine which patient and/or treatment characteristics are associated with costs, and estimate the medical and non-medical costs of patients with Type 2 diabetes in The Netherlands. Methods

77 FR 16319 - Amtrak's Petition for Determination of PRIIA Section 209 Cost Methodology

Science.gov (United States)

2012-03-20

... Rail Investment and Improvement Act of 2008 (PRIIA). Following consultations, the affected states... reflect relative use, of costs incurred for the common benefit of more than one route. The decision will...

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

Science.gov (United States)

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

2016-07-01

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

Depreciation cost for the capital investment of a pyroprocess facility

Energy Technology Data Exchange (ETDEWEB)

Kim, S. K.; Lee, S. H.; Ko, W. I. [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

2015-10-15

The pyroprocess produces U/TRU metal ingots using four important processes, pretreatment, electrochemical reduction, electrorefining and electrowinning, in order to recycle spent fuel. KAPF+'s capacity is shown the cost that is injected into the KAPF+. The pyroprocess unit cost is data that are essential for inputting to calculate the pyroprocess-Sodiumcooled Fast Reactor (SFR) nuclear fuel cycle cost. Moreover, since the pyroprocess facility's depreciation cost is included in the manufacturing indirect cost of the pyroprocess cost, it can become an important element for judging the pyroprocess' economic viability. Since the pyroprocess unit cost calculates the sum of the costs that are incurred each year by dividing with the total amount of U/TRU ingot produced, the pyroprocess unit cost uncertainty increases as well when the uncertainty of the costs incurred by each year increases. KAPF+, which is a commercialization facility, was set as the cost object, and the existing methods (straightline method and fixed percentage of declining-balance method) used today and the depreciation cost of the ADDM were subjected to a comparative analysis. The results are as follows. First, in case of the straight-line method that calculated the durable period as 40 years, and in case of ADDM that factored in a 5% deceleration rate, the difference in the depreciation costs of $65.26/kgHM and $119.05/kgHM resulted during the first and last years, respectively. Accordingly, it was analyzed that there is a significant difference in terms of the cost of the capital investment every year depending on the depreciation method. Secondly, since the depreciation cost is a component of the manufacturing indirect cost, it is necessary to maintain a trend that is similar to that of the direct labor cost in addition to the direct material cost.

Depreciation cost for the capital investment of a pyroprocess facility

International Nuclear Information System (INIS)

Kim, S. K.; Lee, S. H.; Ko, W. I.

2015-01-01

The pyroprocess produces U/TRU metal ingots using four important processes, pretreatment, electrochemical reduction, electrorefining and electrowinning, in order to recycle spent fuel. KAPF+'s capacity is shown the cost that is injected into the KAPF+. The pyroprocess unit cost is data that are essential for inputting to calculate the pyroprocess-Sodiumcooled Fast Reactor (SFR) nuclear fuel cycle cost. Moreover, since the pyroprocess facility's depreciation cost is included in the manufacturing indirect cost of the pyroprocess cost, it can become an important element for judging the pyroprocess' economic viability. Since the pyroprocess unit cost calculates the sum of the costs that are incurred each year by dividing with the total amount of U/TRU ingot produced, the pyroprocess unit cost uncertainty increases as well when the uncertainty of the costs incurred by each year increases. KAPF+, which is a commercialization facility, was set as the cost object, and the existing methods (straightline method and fixed percentage of declining-balance method) used today and the depreciation cost of the ADDM were subjected to a comparative analysis. The results are as follows. First, in case of the straight-line method that calculated the durable period as 40 years, and in case of ADDM that factored in a 5% deceleration rate, the difference in the depreciation costs of $65.26/kgHM and $119.05/kgHM resulted during the first and last years, respectively. Accordingly, it was analyzed that there is a significant difference in terms of the cost of the capital investment every year depending on the depreciation method. Secondly, since the depreciation cost is a component of the manufacturing indirect cost, it is necessary to maintain a trend that is similar to that of the direct labor cost in addition to the direct material cost

Costs of climate change impacts on output of cassava among ...

African Journals Online (AJOL)

The result of the cost and returns analysis on per state basis indicated that farmers in Enugu ... while their counterparts in Abia State incurred the loss as a result of climate change. Farmers in Imo State, however, posted the highest net profit.

A Cost Analysis of the Decision to Cannibalize Major Components of the Navy's H-60 Helicopters at the Operational Level

National Research Council Canada - National Science Library

Kowalski, Danny

2000-01-01

... often make a decision to cannibalize without considering the total cost of their decision This thesis examines the costs incurred by an operational H-6O helicopter squadron to cannibalize major...

Life values of elderly people suffering from incurable cancer: A literature review

NARCIS (Netherlands)

Ebenau, A.F.; Gurp, J.L.P. van; Hasselaar, J.G.

2017-01-01

OBJECTIVE: Due to aging Western societies, older patients suffering from incurable cancer will present themselves more often to health care professionals. To be of service to these severely ill elderly patients, more knowledge is needed on which life values are guiding them through their last phases

The Real Cost of "Cosmetic Tourism" Cost Analysis Study of "Cosmetic Tourism" Complications Presenting to a Public Hospital.

Science.gov (United States)

Livingston, Ryan; Berlund, Paul; Eccles-Smith, Jade; Sawhney, Raja

2015-01-01

"Cosmetic Tourism," the process of traveling overseas for cosmetic procedures, is an expanding global phenomenon. The model of care by which these services are delivered can limit perioperative assessment and postoperative follow-up. Our aim was to establish the number and type of complications being treated by a secondary referral hospital resulting from "cosmetic tourism" and the cost that has been incurred by the hospital in a 1-year period. Retrospective cost analysis and chart review of patients admitted to the hospital between the financial year of 2012 and 2013 were performed. Twelve "cosmetic tourism" patients presented to the hospital, requiring admission during the study period. Breast augmentation was the most common procedure and infected prosthesis was the most common complication (n = 4). Complications ranged from infection, pulmonary embolism to penile necrosis. The average cost of treating these patients was $AUD 12 597.71. The overall financial burden of the complication to the hospital was AUD$151 172.52. The "cosmetic tourism" model of care appears to be, in some cases, suboptimal for patients and their regional hospitals. In the cases presented in this study, it appears that care falls on the patient local hospital and home country to deal with the complications from their surgery abroad. This incurs a financial cost to that hospital in addition to redirecting medical resources that would otherwise be utilized for treating noncosmetic complications, without any remuneration to the local provider.

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

Science.gov (United States)

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

2018-03-01

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

Absenteeism and Employer Costs Associated With Chronic Diseases and Health Risk Factors in the US Workforce

Science.gov (United States)

Roy, Kakoli; Lang, Jason E.; Payne, Rebecca L.; Howard, David H.

2016-01-01

Introduction Employers may incur costs related to absenteeism among employees who have chronic diseases or unhealthy behaviors. We examined the association between employee absenteeism and 5 conditions: 3 risk factors (smoking, physical inactivity, and obesity) and 2 chronic diseases (hypertension and diabetes). Methods We identified 5 chronic diseases or risk factors from 2 data sources: MarketScan Health Risk Assessment and the Medical Expenditure Panel Survey (MEPS). Absenteeism was measured as the number of workdays missed because of sickness or injury. We used zero-inflated Poisson regression to estimate excess absenteeism as the difference in the number of days missed from work by those who reported having a risk factor or chronic disease and those who did not. Covariates included demographics (eg, age, education, sex) and employment variables (eg, industry, union membership). We quantified absenteeism costs in 2011 and adjusted them to reflect growth in employment costs to 2015 dollars. Finally, we estimated absenteeism costs for a hypothetical small employer (100 employees) and a hypothetical large employer (1,000 employees). Results Absenteeism estimates ranged from 1 to 2 days per individual per year depending on the risk factor or chronic disease. Except for the physical inactivity and obesity estimates, disease- and risk-factor–specific estimates were similar in MEPS and MarketScan. Absenteeism increased with the number of risk factors or diseases reported. Nationally, each risk factor or disease was associated with annual absenteeism costs greater than $2 billion. Absenteeism costs ranged from $16 to $81 (small employer) and $17 to $286 (large employer) per employee per year. Conclusion Absenteeism costs associated with chronic diseases and health risk factors can be substantial. Employers may incur these costs through lower productivity, and employees could incur costs through lower wages. PMID:27710764

Absenteeism and Employer Costs Associated With Chronic Diseases and Health Risk Factors in the US Workforce.

Science.gov (United States)

Asay, Garrett R Beeler; Roy, Kakoli; Lang, Jason E; Payne, Rebecca L; Howard, David H

2016-10-06

Employers may incur costs related to absenteeism among employees who have chronic diseases or unhealthy behaviors. We examined the association between employee absenteeism and 5 conditions: 3 risk factors (smoking, physical inactivity, and obesity) and 2 chronic diseases (hypertension and diabetes). We identified 5 chronic diseases or risk factors from 2 data sources: MarketScan Health Risk Assessment and the Medical Expenditure Panel Survey (MEPS). Absenteeism was measured as the number of workdays missed because of sickness or injury. We used zero-inflated Poisson regression to estimate excess absenteeism as the difference in the number of days missed from work by those who reported having a risk factor or chronic disease and those who did not. Covariates included demographics (eg, age, education, sex) and employment variables (eg, industry, union membership). We quantified absenteeism costs in 2011 and adjusted them to reflect growth in employment costs to 2015 dollars. Finally, we estimated absenteeism costs for a hypothetical small employer (100 employees) and a hypothetical large employer (1,000 employees). Absenteeism estimates ranged from 1 to 2 days per individual per year depending on the risk factor or chronic disease. Except for the physical inactivity and obesity estimates, disease- and risk-factor-specific estimates were similar in MEPS and MarketScan. Absenteeism increased with the number of risk factors or diseases reported. Nationally, each risk factor or disease was associated with annual absenteeism costs greater than $2 billion. Absenteeism costs ranged from $16 to $81 (small employer) and $17 to $286 (large employer) per employee per year. Absenteeism costs associated with chronic diseases and health risk factors can be substantial. Employers may incur these costs through lower productivity, and employees could incur costs through lower wages.

analysis of cost efficiency in food crop production among small-scale

African Journals Online (AJOL)

PROF. BARTH EKWEME

Food crop production in Nigeria is dominated by small-scale farmers ... influenced by farm-specific factors, which delineate their ..... vii). Cost of seed: This is the total expenses on seed incurred by the farmer during the last cropping season. It.

No apparent costs for facultative antibiotic production by the soil bacterium Pseudomonas fluorescens Pf0-1

NARCIS (Netherlands)

Garbeva, P.V.; Tyc, O.; Remus-Emsermann, M.N.P.; Van der Wal, A.; Vos, M.; Silby, M.W.; De Boer, W.

2011-01-01

Background: Many soil-inhabiting bacteria are known to produce secondary metabolites that can suppress microorganisms competing for the same resources. The production of antimicrobial compounds is expected to incur fitness costs for the producing bacteria. Such costs form the basis for models on the

Transaction costs of access to health care: Implications of the care-seeking pathways of tuberculosis patients for health system governance in Nigeria.

Science.gov (United States)

Abimbola, Seye; Ukwaja, Kingsley N; Onyedum, Cajetan C; Negin, Joel; Jan, Stephen; Martiniuk, Alexandra L C

2015-10-01

Health care costs incurred prior to the appropriate patient-provider transaction (i.e., transaction costs of access to health care) are potential barriers to accessing health care in low- and middle-income countries. This paper explores these transaction costs and their implications for health system governance through a cross-sectional survey of adult patients who received their first diagnosis of pulmonary tuberculosis (TB) at the three designated secondary health centres for TB care in Ebonyi State, Nigeria. The patients provided information on their care-seeking pathways and the associated costs prior to reaching the appropriate provider. Of the 452 patients, 84% first consulted an inappropriate provider. Only 33% of inappropriate consultations were with qualified providers (QP); the rest were with informal providers such as pharmacy providers (PPs; 57%) and traditional providers (TP; 10%). Notably, 62% of total transaction costs were incurred during the first visit to an inappropriate provider and the mean transaction costs incurred was highest with QPs (US$30.20) compared with PPs (US$14.40) and TPs (US$15.70). These suggest that interventions for reducing transaction costs should include effective decentralisation to integrate TB care with services at the primary health care level, community engagement to address information asymmetry, enforcing regulations to keep informal providers within legal limits and facilitating referral linkages among formal and informal providers to increase early contact with appropriate providers.

Decision support systems for incurable non-small cell lung cancer: A systematic review

NARCIS (Netherlands)

Révész, D. (D.); Engelhardt, E.G. (E. G.); Tamminga, J.J. (J. J.); F.M.N.H. Schramel (Franz); B.D. Onwuteaka-Philipsen (Bregje); E.M.W. van de Garde (Ewoudt); E.W. Steyerberg (Ewout); Jansma, E.P. (E. P.); H.C. de Vet (Henrica C); V.M.H. Coupé (Veerle)

2017-01-01

textabstractBackground: Individually tailored cancer treatment is essential to ensure optimal treatment and resource use. Treatments for incurable metastatic non-small cell lung cancer (NSCLC) are evolving rapidly, and decision support systems (DSS) for this patient population have been developed to

Decision support systems for incurable non-small cell lung cancer : a systematic review

NARCIS (Netherlands)

Révész, D; Engelhardt, E G; Tamminga, J J; Schramel, Franz M N H; Onwuteaka-Philipsen, B.D.; van de Garde, E M W; Steyerberg, E.W.; Jansma, E P; de Vet, Henrica C W; Coupé, V.M.H.

2017-01-01

BACKGROUND: Individually tailored cancer treatment is essential to ensure optimal treatment and resource use. Treatments for incurable metastatic non-small cell lung cancer (NSCLC) are evolving rapidly, and decision support systems (DSS) for this patient population have been developed to balance

Delivery cost analysis of a reactive mass cholera vaccination campaign: a case study of Shanchol™ vaccine use in Lake Chilwa, Malawi.

Science.gov (United States)

Ilboudo, Patrick G; Le Gargasson, Jean-Bernard

2017-12-19

Cholera is a diarrheal disease that produces rapid dehydration. The infection is a significant cause of mortality and morbidity. Oral cholera vaccine (OCV) has been propagated for the prevention of cholera. Evidence on OCV delivery cost is insufficient in the African context. This study aims to analyze Shanchol vaccine delivery costs, focusing on the vaccination campaign in response of a cholera outbreak in Lake Chilwa, Malawi. The vaccination campaign was implemented in two rounds in February and March 2016. Structured questionnaires were used to collect costs incurred for each vaccination related activity, including vaccine procurement and shipment, training, microplanning, sensitization, social mobilization and vaccination rounds. Costs collected, including financial and economic costs were analyzed using Choltool, a standardized cholera cost calculator. In total, 67,240 persons received two complete doses of the vaccine. Vaccine coverage was higher in the first round than in the second. The two-dose coverage measured with the immunization card was estimated at 58%. The total financial cost incurred in implementing the campaign was US$480275 while the economic cost was US$588637. The total financial and economic costs per fully vaccinated person were US$7.14 and US$8.75, respectively, with delivery costs amounting to US$1.94 and US$3.55, respectively. Vaccine procurement and shipment accounted respectively for 73% and 59% of total financial and economic costs of the total vaccination campaign costs while the incurred personnel cost accounted for 13% and 29% of total financial and economic costs. Cost for delivering a single dose of Shanchol was estimated at US$0.97. This study provides new evidence on economic and financial costs of a reactive campaign implemented by international partners in collaboration with MoH. It shows that involvement of international partners' personnel may represent a substantial share of campaign's costs, affecting unit and vaccine

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

Science.gov (United States)

Hu, Teh-wei; And Others

1986-01-01

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

Asynchronous hatching provides females with a means for increasing male care but incurs a cost by reducing offspring fitness.

Science.gov (United States)

Ford, L E; Smiseth, P T

2016-02-01

In species with biparental care, sexual conflict occurs because the benefit of care depends on the total amount of care provided by the two parents while the cost of care depends on each parent's own contribution. Asynchronous hatching may play a role in mediating the resolution of this conflict over parental care. The sexual conflict hypothesis for the evolution of asynchronous hatching suggests that females adjust hatching patterns in order to increase male parental effort relative to female effort. We tested this hypothesis in the burying beetle Nicrophorus vespilloides by setting up experimental broods with three different hatching patterns: synchronous, asynchronous and highly asynchronous broods. As predicted, we found that males provided care for longer in asynchronous broods whereas the opposite was true of females. However, we did not find any benefit to females of reducing their duration of care in terms of increased lifespan or reduced mass loss during breeding. We found substantial negative effects of hatching asynchrony on offspring fitness as larval mass was lower and fewer larvae survived to dispersal in highly asynchronous broods compared to synchronous or asynchronous broods. Our results suggest that, even though females can increase male parental effort by hatching their broods more asynchronously, females pay a substantial cost from doing so in terms of reducing offspring growth and survival. Thus, females should be under selection to produce a hatching pattern that provides the best possible trade-off between the benefits of increased male parental effort and the costs due to reduced offspring fitness. © 2015 European Society For Evolutionary Biology. Journal of Evolutionary Biology © 2015 European Society For Evolutionary Biology.

Transaction costs in milk marketing: a comparison between Canada and Great Britain

NARCIS (Netherlands)

Royer, A.

2011-01-01

This study measures the magnitude of transaction costs incurred by milk producers in their contractual relations with dairy processors in two different coordination mechanisms: centralized contracting through a marketing board and decentralized bilateral contracting. Interviews and surveys were

Cost-effective control policies for multi-echelon distribution systems

NARCIS (Netherlands)

Diks, E.B.; Kok, de A.G.

1996-01-01

In this paper we consider a divergent multi-echelon inventory system, e.g., a distribution system or a production system. At every stockpoint orders are placed periodically. The order arrives after a fixed lead time. At the end of each period linear costs may be incurred at each stockpoint for

Low-cost high purity production

Science.gov (United States)

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.

Measuring the economic cost of malaria to households in Sri Lanka

DEFF Research Database (Denmark)

Konradsen, F; Hoek, Wim van der; Amerasinghe, P H

1997-01-01

. In estimating the socioeconomic impact of malaria and in measuring cost-benefits of malaria control interventions, these costs have to be considered together with direct expenditures incurred by households such as on treatment and travel and with costs for the service providers.......The economic cost at the household level of labor days lost due to malaria and other illnesses was estimated in a rural community in Sri Lanka. Over a one-year period, 223 episodes of malaria were recorded from the 298 inhabitants of the village. Based on daily activity records, the economically...

Sensory Load Incurs Conceptual Processing Costs

Science.gov (United States)

Vermeulen, Nicolas; Corneille, Olivier; Niedenthal, Paula M.

2008-01-01

Theories of grounded cognition propose that modal simulations underlie cognitive representation of concepts [Barsalou, L. W. (1999). "Perceptual symbol systems." "Behavioral and Brain Sciences, 22"(4), 577-660; Barsalou, L. W. (2008). "Grounded cognition." "Annual Review of Psychology, 59", 617-645]. Based…

Basic factors to forecast maintenance cost and failure processes for nuclear power plants

International Nuclear Information System (INIS)

Popova, Elmira; Yu, Wei; Kee, Ernie; Sun, Alice; Richards, Drew; Grantom, Rick

2006-01-01

Two types of maintenance interventions are usually administered at nuclear power plants: planned and corrective. The cost incurred includes the labor (manpower) cost, cost for new parts, or emergency order of expensive items. At the plant management level there is a budgeted amount of money to be spent every year for such operations. It is very important to have a good forecast for this cost since unexpected events can trigger it to a very high level. In this research we present a statistical factor model to forecast the maintenance cost for the incoming month. One of the factors is the expected number of unplanned (due to failure) maintenance interventions. We introduce a Bayesian model for the failure rate of the equipment, which is input to the cost forecasting model. The importance of equipment reliability and prediction in the commercial nuclear power plant is presented along with applicable governmental and industry organization requirements. A detailed statistical analysis is performed on a set of maintenance cost and failure data gathered at the South Texas Project Nuclear Operating Company (STPNOC) in Bay City, Texas, USA

Electric infrastructure failures in Nigeria: a survey-based analysis of the costs and adjustment responses

International Nuclear Information System (INIS)

Adenikinju, A.F.

2003-01-01

This paper examines the cost of electricity shortages on the Nigerian manufacturing sector. Utilizing the data obtained from a 1998 nationwide survey, the paper details the various costs from power outages and examines the response of manufacturers to the infrastructure problem. The findings of the study confirm that the cost of electricity failures on the Nigerian manufacturing sector is quite high. Firms incur huge costs on the provision of expensive back-up to minimise the expected outage costs. The average costs of this back-up are on the average 3 times the cost of publicly supplied electricity. The marginal cost estimates also indicate that the cost of kWh of unserved electricity in Nigeria is very high. Small-scale firms bear the greater proportion of the cost of the power failure. A situation where firms spend as much as 20-30% of initial investment on the acquisition of facilities to enhance electricity supply reliability has a significant negative impact on costs competitiveness of the manufacturing sector. Thus, the study supports current government efforts to privatise the public monopoly and liberalizes the electricity market. These hopefully will mitigate the burden of poor power supply as well as introduce the needed competition into the electricity market in the country

The cost of decommissioning uranium mill tailings

International Nuclear Information System (INIS)

Lush, D.L.; Lendrum, C.; Hostovsky, C.; Eedy, W.; Ashbrook, A.

1986-04-01

This report identifies several key operations that are commonly carried out during decommissioning of tailings areas in the Canadian environment. These operations are unit costed for a generic site to provide a base reference case. The unit costs have also been scaled to the quantities required for the decommissioning of four Canadian sites and these scaled quantities compared with site-specific engineering cost estimates and actual costs incurred in carrying out the decommissioning activities. Variances in costing are discussed. The report also recommends a generic monitoring regime upon which both short- and longer-term environmental monitoring costs are calculated. Although every site must be addressed as a site-specific case, and monitoring programs must be tailored to fit a specific site, it would appear that for the conventional decommissioning and monitoring practices that have been employed to date, costs can be reasonably estimated when site-specific conditions are taken into account

APPLICATION OF ACTIVITY BASED COSTING IN MANUFACTURING COMPANIES IN BANGLADESH: A SURVEY BASED STUDY

OpenAIRE

Nikhil Chandra SHIL; Alok Kumar PRAMANIK

2012-01-01

The widespread environmental change has forced many organizations to change and re-think their business and competitive strategies, particularly cost management system, in order to achieve the competitive edge in the marketplace. Successful organizations are those that are able to improve quality, lower costs and efficiency of operations and eliminate products and services that incur losses. This explains why some organizations are successful while others fail. An organization costing system ...

Cost-Effectiveness and Cost Thresholds of Generic and Brand Drugs in a National Chronic Hepatitis B Treatment Program in China.

Directory of Open Access Journals (Sweden)

Mehlika Toy

Full Text Available Chronic liver disease and liver cancer associated with chronic hepatitis B (CHB are leading causes of death among adults in China. Although newborn hepatitis B immunization has successfully reduced the prevalence of CHB in children, about 100 million Chinese adults remain chronically infected. If left unmanaged, 15-25% will die from liver cancer or liver cirrhosis. Antiviral treatment is not necessary for all patients with CHB, but when it is indicated, good response to treatment would prevent disease progression and reduce disease mortality and morbidity, and costly complications. The aim of this study is to analyze the cost-effectiveness of generic and brand antiviral drugs for CHB treatment in China, and assessing various thresholds at which a highly potent, low resistance antiviral drug would be cost-saving and/or cost-effective to introduce in a national treatment program. We developed a Markov simulation model of disease progression using effectiveness and cost data from the medical literature. We measured life-time costs, quality adjusted life years (QALYs, incremental cost-effectiveness ratios (ICERs, and clinical outcomes. The no treatment strategy incurred the highest health care costs ($12,932-$25,293 per patient, and the worst health outcomes, compared to the antiviral treatment strategies. Monotherapy with either entecavir or tenofovir yielded the most QALYs (14.10-19.02 for both HBeAg-positive and negative patients, with or without cirrhosis. Threshold analysis showed entercavir or tenofovir treatment would be cost saving if the drug price is $32-75 (195-460 RMB per month, highly cost-effective at $62-110 (379-670 RMB per month and cost-effective at $63-120 (384-734 RMB per month. This study can support policy decisions regarding the implementation of a national health program for chronic hepatitis B treatment in China at the population level.

Switching benefits and costs in the Irish health insurance market: an analysis of consumer surveys

OpenAIRE

KEEGAN, CONOR; Teljeur, Conor; Turner, Brian; THomas, Steve

2018-01-01

PUBLISHED Relatively little analysis has taken place internationally on the consumer-reported benefits and costs to switching insurer in multi-payer health insurance markets. Ideally, consumers should be willing to switch out of consideration for price and quality and switching should be able to take place without incurring significant switching costs. Costs to switching come in many forms and understanding the nature of these costs is necessary if policy interventions to improve market co...

Methodological issues in assessing changes in costs pre- and post-medication switch: a schizophrenia study example

Directory of Open Access Journals (Sweden)

Nyhuis Allen W

2009-05-01

Full Text Available Abstract Background Schizophrenia is a severe, chronic, and costly illness that adversely impacts patients' lives and health care payer budgets. Cost comparisons of treatment regimens are, therefore, important to health care payers and researchers. Pre-Post analyses ("mirror-image", where outcomes prior to a medication switch are compared to outcomes post-switch, are commonly used in such research. However, medication changes often occur during a costly crisis event. Patients may relapse, be hospitalized, have a medication change, and then spend a period of time with intense use of costly resources (post-medication switch. While many advantages and disadvantages of Pre-Post methodology have been discussed, issues regarding the attributability of costs incurred around the time of medication switching have not been fully investigated. Methods Medical resource use data, including medications and acute-care services (hospitalizations, partial hospitalizations, emergency department were collected for patients with schizophrenia who switched antipsychotics (n = 105 during a 1-year randomized, naturalistic, antipsychotic cost-effectiveness schizophrenia trial. Within-patient changes in total costs per day were computed during the pre- and post-medication change periods. In addition to the standard Pre-Post analysis comparing costs pre- and post-medication change, we investigated the sensitivity of results to varying assumptions regarding the attributability of acute care service costs occurring just after a medication switch that were likely due to initial medication failure. Results Fifty-six percent of all costs incurred during the first week on the newly initiated antipsychotic were likely due to treatment failure with the previous antipsychotic. Standard analyses suggested an average increase in cost-per-day for each patient of $2.40 after switching medications. However, sensitivity analyses removing costs incurred post-switch that were potentially

Freshwater Aquatic Nuisance Species Impacts and Management Costs and Benefits at Federal Water Resources Projects

National Research Council Canada - National Science Library

Cole, Richard A

2006-01-01

...) when they significantly degrade services provided by water resources. Government agencies, utilities, and other water resource managers incur substantial costs controlling ANS and repairing damage to restore service performance to desired levels...

Waste Dump Closure and Cost Estimates at AngloGold Ashanti ...

African Journals Online (AJOL)

Michael

2017-12-02

Dec 2, 2017 ... 2University of Mines and Technology, P.O. Box 237, Tarkwa, Ghana ... The mine has closure plans for the waste dumps and the closure activity ... incur additional cost, it was advised that the mine should execute the closure and reclamation plan without delay. .... Progressively rehabilitate the project area.

Influence of building costs on rents of residential property in Owerri ...

African Journals Online (AJOL)

Residential building accommodation projects undertaken by individuals and organizations are investment whose returns and rewards should be adequate to offset the costs incurred and give good level of profit for entrepreneurial risks. In the recent times there existed unprecedented rise in rental values of newly completed ...

The full financial costs of irrigation services: A discussion on existing ...

African Journals Online (AJOL)

Considering water as an economic good entails, among other requisites, properly assessing the cost incurred by supplying and managing the resource, and the required infrastructure thereof. Regarding irrigation, the International Commission for Irrigation and Drainage (ICID) set up a method for assessing the full financial ...

The Costs and Benefits of Development: The Transition From Crawling to Walking.

Science.gov (United States)

Adolph, Karen E; Tamis-LeMonda, Catherine S

2014-12-02

The transition from crawling to walking requires infants to relinquish their status as experienced, highly skilled crawlers in favor of being inexperienced, lowskilled walkers. Yet infants willingly undergo this developmental transition, despite incurring costs of shaky steps, frequent falls, and inability to gauge affordances for action in their new upright posture. Why do infants persist with walking when crawling serves the purpose of independent mobility? In this article, we present an integrative analysis of the costs and benefits associated with crawling and walking that challenges prior assumptions, and reveals deficits of crawling and benefits of upright locomotion that were previously overlooked. Inquiry into multiple domains of development reveals that the benefits of persisting with walking outweigh the costs: Compared to crawlers, walking infants cover more space more quickly, experience richer visual input, access and play more with distant objects, and interact in qualitatively new ways with caregivers.

Costs of the 'Hartslag Limburg' community heart health intervention

Directory of Open Access Journals (Sweden)

Ruland Erik

2006-03-01

Full Text Available Abstract Background Little is known about the costs of community programmes to prevent cardiovascular diseases. The present study calculated the economic costs of all interventions within a Dutch community programme called Hartslag Limburg, in such a way as to facilitate generalisation to other countries. It also calculated the difference between the economic costs and the costs incurred by the coordinating institution. Methods Hartslag Limburg was a large-scale community programme that consisted of many interventions to prevent cardiovascular diseases. The target population consisted of all inhabitants of the region (n = 180.000. Special attention was paid to reach persons with a low socio-economic status. Costs were calculated using the guidelines for economic evaluation in health care. An overview of the material and staffing input involved was drawn up for every single intervention, and volume components were attached to each intervention component. These data were gathered during to the implementation of the intervention. Finally, the input was valued, using Dutch price levels for 2004. Results The economic costs of the interventions that were implemented within the five-year community programme (n = 180,000 were calculated to be about €900,000. €555,000 was spent on interventions to change people's exercise patterns, €250,000 on improving nutrition, €50,000 on smoking cessation, and €45,000 on lifestyle in general. The coordinating agency contributed about 10% to the costs of the interventions. Other institutions that were part of the programme's network and external subsidy providers contributed the other 90% of the costs. Conclusion The current study calculated the costs of a community programme in a detailed and systematic way, allowing the costs to be easily adapted to other countries and regions. The study further showed that the difference between economic costs and the costs incurred by the coordinating agency can be very

Symptoms in Bangladeshi patients with incurable cancers: Implications for interventions

Directory of Open Access Journals (Sweden)

Richard R Love

2018-01-01

Full Text Available Aims: The poor state of palliative care in low- and middle-income countries has been termed a global crisis by the Lancet Commission on Palliative Care. The investigators previously reported on a cross-sectional study of symptoms in 640 Bangladeshi adults with incurable cancers. Usual levels of pain were high. The not-reported details of pain and other symptoms offered an opportunity to consider explanations and implications for interventions to lessen these symptoms.Methods: At one visit, 640 Bangladeshi patients completed a symptom questionnaire. The distributions of 12 symptom level scores and the correlations between pain and different symptom scores were determined.Results: The population had significantly high and functionally compromising average usual pain scores, but low percentages of patients with very high and low pain scores. The distributions of scores for multiple symptoms were all skewed to higher mid-scale levels and modestly high (≥0.6 correlations of pain with nausea, anxiety, lack of appetite, constipation, and sleep quality were seen.Conclusions: While the types and direct effects of the cancers, the young age distribution, and the true symptomatic status of this Bangladeshi population studied may explain the described characteristics, the observations deserve exploration of other causes with specific therapeutic implications. These patients appear to have been partially treated for pain, and in particular, environmental factors such as extreme heat and its consequences appear more likely causes of moderate levels of multiple symptoms, which collectively magnified patients' suffering. Greater attention to gastrointestinal symptoms and sleep disturbance, in particular, seems indicated.

Symptoms In Bangladeshi Patients with Incurable Cancers: Implications for Interventions.

Science.gov (United States)

Love, Richard R; Tanimul Ahsan, G M; Ferdousy, Tahmina; Nahar, Shamsun; Ahamed, Sheikh Iqbal

2018-01-01

The poor state of palliative care in low- and middle-income countries has been termed a global crisis by the Lancet Commission on Palliative Care. The investigators previously reported on a cross-sectional study of symptoms in 640 Bangladeshi adults with incurable cancers. Usual levels of pain were high. The not-reported details of pain and other symptoms offered an opportunity to consider explanations and implications for interventions to lessen these symptoms. At one visit, 640 Bangladeshi patients completed a symptom questionnaire. The distributions of 12 symptom level scores and the correlations between pain and different symptom scores were determined. The population had significantly high and functionally compromising average usual pain scores, but low percentages of patients with very high and low pain scores. The distributions of scores for multiple symptoms were all skewed to higher mid-scale levels and modestly high (≥0.6) correlations of pain with nausea, anxiety, lack of appetite, constipation, and sleep quality were seen. While the types and direct effects of the cancers, the young age distribution, and the true symptomatic status of this Bangladeshi population studied may explain the described characteristics, the observations deserve exploration of other causes with specific therapeutic implications. These patients appear to have been partially treated for pain, and in particular, environmental factors such as extreme heat and its consequences appear more likely causes of moderate levels of multiple symptoms, which collectively magnified patients' suffering. Greater attention to gastrointestinal symptoms and sleep disturbance, in particular, seems indicated.

Nuclear energy: the cost of opting-out

International Nuclear Information System (INIS)

Mueller, U.

2003-01-01

This article discusses the results of a study made on the financial and ecological costs that would be incurred if Switzerland opted out of the use of nuclear energy. Figures are quoted for the costs if two Swiss popular initiatives on the subject of opting out of nuclear energy were accepted in voting. The disadvantages offered by the alternatives such as combined gas and steam-turbine power plant, photovoltaics and wind power are quoted. Possible negative effects of opting out on the Swiss economy are looked at and the political aspects of renewing operational permits for nuclear power stations are discussed

The household costs of health care in rural South Africa with free public primary care and hospital exemptions for the poor.

Science.gov (United States)

Goudge, Jane; Gilson, Lucy; Russell, Steve; Gumede, Tebogo; Mills, Anne

2009-04-01

To measure the direct cost burdens (health care expenditure as a percent of total household expenditure) for households in rural South Africa, and examine the expenditure and use patterns driving those burdens, in a setting with free public primary health care and hospital exemptions for the poor. Data on illness events, treatment patterns and health expenditure in the previous month were assessed from a cross-sectional survey of 280 households conducted in the Agincourt Health and Demographic Surveillance site, South Africa. On average, a household experiencing illness incurred a direct cost burden of 4.5% of total household expenditure. A visit to a public clinic generated a mean burden of 1.3%. Complex sequences of treatments led 20% of households to incur a burden over 10%, with transport costs generating 42% of this burden. An outpatient public hospital visit generated a burden of 8.2%, as only 58% of those eligible obtained an exemption; inpatient stays incurred a burden of 45%. Consultations with private providers incurred a mean burden of 9.5%. About 38% of individuals who reported illness did not take any treatment action, 55% of whom identified financial and perceived supply-side barriers as reasons. The low overall mean cost burden of 4.5% suggests that free primary care and hospital exemptions provided financial protection. However, transport costs, the difficulty of obtaining hospital exemptions, use of private providers, and complex treatment patterns meant state-provided protection had limitations. The significant non-use of care shows the need for other measures such as more outreach services and more exemptions in rural areas. The findings also imply that fee removal anywhere must be accompanied by wider measures to ensure improved access.

Energetic Cost of Ichthyophonus Infection in Juvenile Pacific Herring (Clupea pallasii)

OpenAIRE

Johanna J. Vollenweider; Jake L. Gregg; Ron A. Heintz; Paul K. Hershberger

2011-01-01

The energetic costs of fasting and Ichthyophonus infection were measured in juvenile Pacific herring (Clupea pallasii) in a lab setting at three temperatures. Infected herring incurred significant energetic costs, the magnitude of which depended on fish condition at the time of infection (fat versus lean). Herring that were fed continually and were in relatively good condition at the time of infection (fat) never stored lipid despite ad libitum feeding. In feeding herrin...

The emotional costs of caring incurred by men and women in the British labour market.

Science.gov (United States)

Barron, David Nicholas; West, Elizabeth

2007-11-01

This study investigates whether men and women in caring occupations experience more negative job-related feelings at the end of the day compared to the rest of the working population. The data are from Wave Nine of the British Household Panel Survey (1999) where respondents were asked whether, at the end of the working day, they tended to keep worrying or have trouble unwinding, and the extent to which work left them feeling exhausted or "used up." Their responses to these questions were used to develop ordinal dependent variables. Control variables in the models include: number of children, age, hours worked per week, managerial responsibilities and job satisfaction, all of which have been shown in previous research to be significantly related to "job burnout." The results are that those in caring occupations are more likely to feel worried, tense, drained and exhausted at the end of the working day. Women in particular appear to pay a high emotional cost for working in caring occupations. Men do not emerge unscathed, but report significantly lower levels of worry and exhaustion at the end of the day than do women.

Direct costs associated with a nosocomial outbreak of Salmonella infection: an ounce of prevention is worth a pound of cure.

Science.gov (United States)

Spearing, N M; Jensen, A; McCall, B J; Neill, A S; McCormack, J G

2000-02-01

Nosocomial outbreaks of Salmonella infections in Australia are an infrequent but significant source of morbidity and mortality. Such an outbreak results in direct, measurable expenses for acute care management, as well as numerous indirect (and less quantifiable) costs to those affected, the hospital, and the wider community. This article describes the significant direct costs incurred as a result of a nosocomial outbreak of Salmonella infection involving patients and staff. Information on costs incurred by the hospital was gathered from a number of sources. The data were grouped into 4 sections (medical costs, investigative costs, lost productivity costs, and miscellaneous) with use of an existing tool for calculating the economic impact of foodborne illness. The outbreak cost the hospital more than AU $120, 000. (US $95,000). This amount is independent of more substantial indirect costs. Salmonella infections are preventable. Measures to aid the prevention of costly outbreaks of nosocomial salmonellosis, although available, require an investment of both time and money. We suggest that dedication of limited resources toward such preventive strategies as education is a practical and cost-effective option for health care facilities.

Patients' costs and cost-effectiveness of tuberculosis treatment in DOTS and non-DOTS facilities in Rio de Janeiro, Brazil.

Directory of Open Access Journals (Sweden)

Ricardo Steffen

2010-11-01

Full Text Available Costs of tuberculosis diagnosis and treatment may represent a significant burden for the poor and for the health system in resource-poor countries.The aim of this study was to analyze patients' costs of tuberculosis care and to estimate the incremental cost-effectiveness ratio (ICER of the directly observed treatment (DOT strategy per completed treatment in Rio de Janeiro, Brazil.We interviewed 218 adult patients with bacteriologically confirmed pulmonary tuberculosis. Information on direct (out-of-pocket expenses and indirect (hours lost costs, loss in income and costs with extra help were gathered through a questionnaire. Healthcare system additional costs due to supervision of pill-intake were calculated considering staff salaries. Effectiveness was measured by treatment completion rate. The ICER of DOT compared to self-administered therapy (SAT was calculated.DOT increased costs during the treatment phase, while SAT increased costs in the pre-diagnostic phase, for both the patient and the health system. Treatment completion rates were 71% in SAT facilities and 79% in DOT facilities. Costs per completed treatment were US$ 194 for patients and U$ 189 for the health system in SAT facilities, compared to US$ 336 and US$ 726 in DOT facilities. The ICER was US$ 6,616 per completed DOT treatment compared to SAT.Costs incurred by TB patients are high in Rio de Janeiro, especially for those under DOT. The DOT strategy doubles patients' costs and increases by fourfold the health system costs per completed treatment. The additional costs for DOT may be one of the contributing factors to the completion rates below the targeted 85% recommended by WHO.

Should large Spanish municipalities be financially compensated? Costs and benefits of being a capital/central municipality

OpenAIRE

Bosch Roca, Núria; Espasa Queralt, Marta; Montolio, Daniel

2014-01-01

We determine the costs and benefits of being a capital or central municipality, where central costs are understood to be incurred specifically as a result of the problems large municipalities located at the centre of an urban agglomeration face (including costs associated with social issues, immigration, commuting and diseconomies of scale) and capital costs result from the presence of regional and/or central government institutions in the municipality (loss of revenue or increase in expendit...

Possibility of reducing costs of mining operations - economic aspects of workplace accidents

Science.gov (United States)

Duda, Adam

2017-11-01

The article presents methods of calculating costs of workplace accidents incurred by an employer, and the influence of the number and severity of accidents on changes in the amount of accident insurance contribution paid by an employer within the framework of the social security system.

The Costs and Benefits of Undertaking Adult Education Courses from the Perspective of the Individual

Science.gov (United States)

AONTAS The National Adult Learning Organisation, 2009

2009-01-01

The aim of this study is to examine the costs and benefits of undertaking adult education courses from the perspective of the individual, using three different case studies. This will give a snapshot of the benefits and the types of costs incurred by three adult learners. Three individuals were contacted by Aontas and were asked if they would be…

Should developing countries take on binding commitments in a climate agreement? A cost-benefit analysis

International Nuclear Information System (INIS)

Kallbekken, Steffen; Westskog, Hege

2003-01-01

This paper explores the costs and benefits for all parties to a future climate agreement of developing countries taking on binding commitments. Such commitments would allow developing countries to participate in emissions trading, which has significantly lower transaction costs than the present Clean Development Mechanism (CDM). Thus we analyse whether the efficiency gains obtained by participating in emissions trading can offset the economic risk (due to the fact that future emissions cannot be known) incurred by taking on binding commitments. We use a dynamic computable general equilibrium model to carry out the analysis. We find that the efficiency gains that can be obtained by developing countries might not be very large compared to the risks they incur. Developing countries might therefore have good reasons not to embrace ''cap and trade'' emissions trading. (author)

Cost of illness for cholera in a high risk urban area in Bangladesh: an analysis from household perspective

Science.gov (United States)

2013-01-01

Background Cholera poses a substantial health burden to developing countries such as Bangladesh. In this study, the objective is to estimate the economic burden of cholera treatments incurred by households. The study was carried out in the context of a large vaccine trial in an urban area of Bangladesh. Methods The study used a combination of prospective and retrospective incidence-based cost analyses of cholera illness per episode per household. A total of 394 confirmed cholera hospitalized cases were identified and treated in the study area during June–October 2011. Households with cholera patients were interviewed within 15 days after discharge from hospitals or clinics. To estimate the total cost of cholera illness a structured questionnaire was used, which included questions on direct medical costs, non-medical costs, and the indirect costs of patients and caregivers. Results The average total household cost of treatment for an episode of cholera was US$30.40. Total direct and indirect costs constituted 24.6% (US$7.40) and 75.4% (US$23.00) of the average total cost, respectively. The cost for children under 5 years of age (US$21.50) was higher than that of children aged 5–14 years (US$17.50). The direct cost of treatment was similar for male and female patients, but the indirect cost was higher for males. Conclusion Our study suggests that by preventing one cholera episode (3 days on an average), we can avert a total cost of 2,278.50 BDT (US$30.40) per household. Among medical components, medicines are the largest cost driver. No clear socioeconomic gradient emerged from our study, but limited demographic patterns were observed in the cost of illness. By preventing cholera cases, large production losses can be reduced. PMID:24188717

Problems and needs in patients with incurable esophageal and pancreaticobiliary cancer: a descriptive study

NARCIS (Netherlands)

Uitdehaag, M.J.; Verschuur, E.M.I.; Eijck, C.H. van; Gaast, A. van der; Rijt, C.C. van der; Man, R.A. de; Steyerberg, E.W.; Kuipers, E.J.; Siersema, P.D.

2015-01-01

Patients with incurable esophageal cancer (EC) or pancreaticobiliary cancer (PBC) often have multiple symptoms and their quality of life is poor. We investigated which problems these patients experience and how often care is expected for these problems to provide optimal professional care.

The Emergence of the ‘Incurred-Loss’ Model for Credit Losses in IAS 39

NARCIS (Netherlands)

Camfferman, C.

2015-01-01

Abstract: Following the financial crisis, the view became widespread that International Financial Reporting Standards (IFRS), because it is based on a so-called incurred-loss approach, led to significant overstatements of financial assets by placing tight restrictions on the recognition of loan

Marginal pricing of transmission services. An analysis of cost recovery

Energy Technology Data Exchange (ETDEWEB)

Perez-Arriaga, I.J.., Rubio, F.J. [Instituto de Investigacion Technologica, Universidad Pontificia Comillas, Madrid (Spain); Puerta, J.F.; Arceluz, J.; Marin, J. [Unidad de Planificacion Estrategica, Iberdrola, Madrid (Spain)

1996-12-31

The authors present an in-depth analysis of network revenues that are computed with marginal pricing, and investigate the reasons why marginal prices in actual power systems fail to recover total incurred network costs. The major causes of the failure are identified and illustrated with numerical examples. The paper analyzes the regulatory implications of marginal network pricing in the context of competitive electricity markets and provides suggestions for the meaningful allocation of network costs among users. 5 figs., 9 tabs., 8 refs.

Marginal pricing of transmission services. An analysis of cost recovery

International Nuclear Information System (INIS)

Perez-Arriaga, I.J.., Rubio, F.J.; Puerta, J.F.; Arceluz, J.; Marin, J.

1996-01-01

The authors present an in-depth analysis of network revenues that are computed with marginal pricing, and investigate the reasons why marginal prices in actual power systems fail to recover total incurred network costs. The major causes of the failure are identified and illustrated with numerical examples. The paper analyzes the regulatory implications of marginal network pricing in the context of competitive electricity markets and provides suggestions for the meaningful allocation of network costs among users. 5 figs., 9 tabs., 8 refs

Increasing the cost-constrained availability of WDM Networks with Degree-3 Structured Topologies

DEFF Research Database (Denmark)

Gutierrez Lopez, Jose Manuel; Georgakilas, Kostas; Katrinis, Kostas

2010-01-01

based on genetic algorithms, we evaluate the performance of structured topologies and compare it against a practical topology (NSFNET). The results manifest that nodal degree fairness leads to increased availability compared to conventional topologies, while not incurring higher capital and deployment...... cost....

Marginal pricing of transmission services: An analysis of cost recovery

Energy Technology Data Exchange (ETDEWEB)

Perez-Arriaga, I.J.; Rubio, F.J. [Univ. Pontificia Comillas, Madrid (Spain); Puerta, J.F.; Arceluz, J.; Marin, J. [IBERDROLA, Bilbao (Spain). Unidad de Planificacion Estrategica

1995-02-01

This paper presents an in-depth analysis of network revenues computed with marginal pricing, and in particular it investigates the reasons why marginal prices fail to recover the total incurred network costs in actual power systems. The basic theoretical results are presented and the major causes of the mismatch between network costs and marginal revenues are identified and illustrated with numerical examples, some tutorial and others of realistic size. The regulatory implications of marginal network pricing in the context of competitive electricity markets are analyzed, and suggestions are provided for the meaningful allocation of the costs of the network among its users.

Marginal pricing of transmission services: An analysis of cost recovery

International Nuclear Information System (INIS)

Perez-Arriaga, I.J.; Rubio, F.J.; Puerta, J.F.; Arceluz, J.; Marin, J.

1995-01-01

This paper presents an in-depth analysis of network revenues computed with marginal pricing, and in particular it investigates the reasons why marginal prices fail to recover the total incurred network costs in actual power systems. The basic theoretical results are presented and the major causes of the mismatch between network costs and marginal revenues are identified and illustrated with numerical examples, some tutorial and others of realistic size. The regulatory implications of marginal network pricing in the context of competitive electricity markets are analyzed, and suggestions are provided for the meaningful allocation of the costs of the network among its users

Nuclear power costs

International Nuclear Information System (INIS)

1963-01-01

A report prepared by the IAEA Secretariat and presented to the seventh session of the Agency's General Conference says that information on nuclear power costs is now rapidly moving from the domain of uncertain estimates to that of tested factual data. As more and more nuclear power stations are being built and put into operation, more information on the actual costs incurred is becoming available. This is the fourth report on nuclear power costs to be submitted to the IAEA General Conference. The report last year gave cost information on 38 nuclear power projects, 17 of which have already gone into operation. Certain significant changes in the data given last year are included-in the present report; besides, information is given on seven new plants. The report is divided into two parts, the first on recent developments and current trends in nuclear power costs and the second on the use of the cost data for economic comparisons. Both stress the fact that the margin of uncertainty in the basic data has lately been drastically reduced. At the same time, it is pointed out, some degree of uncertainty is inherent in the assumptions made in arriving at over-all generating cost figures, especially when - as is usually the case - a nuclear plant is part of an integrated power system

Benefits of extra begging fail to compensate for immunological costs in southern shrike (Lanius meridionalis nestlings.

Directory of Open Access Journals (Sweden)

Gregorio Moreno-Rueda

Full Text Available Theoretical models aimed at explaining the evolution of honest, informative begging signals employed by nestling birds to solicit food from their parents, require that dishonest signalers incur a net viability cost in order to prevent runaway escalation of signal intensity over evolutionary time. Previous attempts to determine such a cost empirically have identified two candidate physiological costs associated with exaggerated begging: a growth and an immunological cost. However, they failed to take into account the fact that those costs are potentially offset by the fact that nestlings that invest more in begging are also likely to obtain more food. In this study, we test experimentally whether a 25% increase in ingested food compensates for growth and immunological costs of extra begging in southern shrike (Lanius meridionalis nestlings. Three nestmates matched by size were given three treatments: low begging, high begging-same food intake, and high begging-extra food intake. We found that, while a higher food intake did effectively compensate for the growth cost, it failed to compensate for the immunological cost, measured as T-cell mediated immune response against an innocuous mitogen. Thus, we show for the first time that escalated begging has an associated physiological net cost likely to affect nestling survival negatively.

Analysis of costs to dispense prescriptions in independently owned, closed-door long-term care pharmacies.

Science.gov (United States)

Carroll, Norman V; Rupp, Michael T; Holdford, David A

2014-03-01

The need for accurate calculation of long-term care (LTC) pharmacies' costs to dispense (CTD) has become more important as payers have moved toward reimbursement models based on pharmacies' actual acquisition cost for drug products and the Centers for Medicare Medicaid Services (CMS) has implemented requirements that LTC pharmacies must dispense prescriptions for certain branded drugs in 14-day-or-less quantities. To (a) calculate the average cost that the typical independently owned, closed-door LTC pharmacy currently incurs to dispense and deliver a prescription to the resident of a client LTC facility and (b) estimate how CMS-mandated changes to a 14-day-or-less dispensing cycle would affect the typical LTC pharmacy's average CTD. The data requirements and measurement model were developed by academic researchers in consultation with an industry advisory committee of independent LTC pharmacy owners. A survey instrument was constructed to collect financial and operating data required to calculate the CTD. Surveys were distributed via 3 dissemination channels to approximately 1,000 independently owned, closed-door LTC pharmacies. The National Community Pharmacists Association mailed surveys to their LTC members; 3 major national wholesalers distributed surveys to their LTC customers through their newsletters; and 3 LTC group purchasing organizations distributed the surveys to their members through emails, newsletters, mailings, and/or regional meetings. Each pharmacy's CTD was calculated by dividing total LTC dispensing-related 
costs by the total number of prescriptions dispensed. Dispensing-related costs included costs incurred to physically dispense and deliver prescriptions (e.g., dispensing pharmacists' and technicians' salaries and costs of medication containers) and costs incurred to support the dispensing function (e.g., salaries of delivery and medical records personnel). A model based on dispensing-related fixed, variable, and semivariable costs was

La palabra más brutal: definiciones de la enfermedad incurable en la medicina francesa del siglo XIX

Directory of Open Access Journals (Sweden)

Zaragoza, Juan Manuel

2012-12-01

Full Text Available This paper offers and analysis of the complex definition of the medical category «incurable disease» in the 19^th century French medicine. After a detailed examination of several definitions of «disease» used in the period, I will focus on three intimately related categories: old age’s diseases, chronic diseases, and incurable diseases. A complex scene is presented, where these three categories worked in an institutional frame where we cannot distinguish one from another, and both the theoretical discourse and the medical practice show how they shared spaces, practices, and even representations.

En el presente artículo se ofrece un análisis de la compleja definición del concepto de «enfermedad incurable» en la medicina francesa durante el siglo XIX. Tras un examen detenido de las distintas definiciones de «enfermedad» manejadas durante ese siglo, el texto se centra en el estudio de tres categorías íntimamente relacionadas: las enfermedades de la vejez, las enfermedades crónicas y las enfermedades incurables. Se presenta un panorama, tanto teórico como práctico, en el que estas tres categorías funcionan dentro de un marco institucional en el que, a todos los efectos, es prácticamente imposible diferenciar una de otras, al compartir tanto los espacios, como las prácticas e incluso las representaciones.

Computational cost for detecting inspiralling binaries using a network of laser interferometric detectors

International Nuclear Information System (INIS)

Pai, Archana; Bose, Sukanta; Dhurandhar, Sanjeev

2002-01-01

We extend a coherent network data-analysis strategy developed earlier for detecting Newtonian waveforms to the case of post-Newtonian (PN) waveforms. Since the PN waveform depends on the individual masses of the inspiralling binary, the parameter-space dimension increases by one from that of the Newtonian case. We obtain the number of templates and estimate the computational costs for PN waveforms: for a lower mass limit of 1M o-dot , for LIGO-I noise and with 3% maximum mismatch, the online computational speed requirement for single detector is a few Gflops; for a two-detector network it is hundreds of Gflops and for a three-detector network it is tens of Tflops. Apart from idealistic networks, we obtain results for realistic networks comprising of LIGO and VIRGO. Finally, we compare costs incurred in a coincidence detection strategy with those incurred in the coherent strategy detailed above

The cost of poor land use practices in Lake Nakivale Wetland in ...

African Journals Online (AJOL)

GREG

2006-09-15

Sep 15, 2006 ... land degradation, wetland encroachment, loss of wildlife habitats and crucial wetland resources. Based on a research ... species of birds, two of the endangered cichlid fish species ... rectly reflect the conservation cost the rural people incur ..... adjacent land use on wetland species richness and community.

76 FR 60721 - Deduction for Qualified Film and Television Production Costs

Science.gov (United States)

2011-09-30

... which the costs are paid (for an owner who uses the cash receipts and disbursements method of accounting) or incurred (for an owner who uses an accrual method of accounting). The deduction under section 181... Bernard P. Harvey, Office of Associate Chief Counsel (Income Tax and Accounting). However, other personnel...

Alternative measures of the Federal Reserve Banks' cost of equity capital

OpenAIRE

Barnes, Michelle L.; Lopez, Jose A.

2005-01-01

The Monetary Control Act of 1980 requires the Federal Reserve System to provide payment services to depository institutions through the twelve Federal Reserve Banks at prices that fully reflect the costs a private-sector provider would incur, including a cost of equity capital (COE). Although Fama and French (1997) conclude that COE estimates are “woefully” and “unavoidably” imprecise, the Reserve Banks require such an estimate every year. We examine several COE estimates based on the Capital...

Use of spikants in HTGR fuel and their effect on costs

International Nuclear Information System (INIS)

Brooks, L.H.

1979-05-01

The costs of fresh fuel fabrication have been estimated for flowsheets that have spikant added (Co-60) at various points. The costs are compared with refabricated and fresh fuel fabrication costs. It is shown that the costs increase as the spikant is added nearer to the plant feed point. The least cost is achieved by adding a detachable spikant to the finished fuel element. The highest cost is incurred when the spikant is fed in with the plant feed. This cost is greater than that for refabricated fuel because extra process cells are necessary to prepare the spikant and, in addition, the gamma flux from the Co-60 is much greater than from U-232 and greater precautions have to be taken

If You Stay, It Might Be Easier: Switch Costs from Comprehension to Production in a Joint Switching Task

Science.gov (United States)

Gambi, Chiara; Hartsuiker, Robert J.

2016-01-01

Switching language is costly for bilingual speakers and listeners, suggesting that language control is effortful in both modalities. But are the mechanisms underlying language control similar across modalities? In this study, we attempted to answer this question by testing whether bilingual speakers incur a cost when switching to a different…

The cost of molecular-guided therapy in oncology: a prospective cost study alongside the MOSCATO trial.

Science.gov (United States)

Pagès, Arnaud; Foulon, Stéphanie; Zou, Zhaomin; Lacroix, Ludovic; Lemare, François; de Baère, Thierry; Massard, Christophe; Soria, Jean-Charles; Bonastre, Julia

2017-06-01

There is increasing use of molecular technologies to guide cancer treatments, but few cost data are available. Our objective was to assess the costs of molecular-guided therapy for patients with advanced solid tumors alongside the Molecular Screening for Cancer Treatment and Optimization (MOSCATO) trial. The study population consisted of 529 patients. The molecular diagnosis included seven steps from tumor biopsy to the multidisciplinary molecular tumor board. The cost of a complete molecular diagnosis was assessed by micro-costing. Direct costs incurred from enrollment until progression were assessed from the French National Health Insurance perspective. The patients' mean age was 54 years (range: 3-82) and the mean follow-up period was 145 days (range: 1-707 days). A complete molecular diagnosis cost [euro ]2,396. There were 220 patients with an actionable target (42%), among whom 105 (20%) actually received a targeted therapy. The cost of molecular-guided therapy per patient was [euro ]31,269. The main cost drivers were anticancer drugs (54%) and hospitalizations (35%). This prospective cost analysis showed that molecular diagnosis accounts for only 6% of the cost of molecular-guided therapy per patient. The costs of drugs and hospitalizations are the main cost drivers.Genet Med advance online publication 01 December 2016.

U.S. Solar Photovoltaic System Cost Benchmark: Q1 2017

Energy Technology Data Exchange (ETDEWEB)

Fu, Ran [National Renewable Energy Lab. (NREL), Golden, CO (United States); Feldman, David [National Renewable Energy Lab. (NREL), Golden, CO (United States); Margolis, Robert [National Renewable Energy Lab. (NREL), Golden, CO (United States); Woodhouse, Mike [National Renewable Energy Lab. (NREL), Golden, CO (United States); Ardani, Kristen [National Renewable Energy Lab. (NREL), Golden, CO (United States)

2017-09-01

This report benchmarks U.S. solar photovoltaic (PV) system installed costs as of the first quarter of 2017 (Q1 2017). We use a bottom-up methodology, accounting for all system and projectdevelopment costs incurred during the installation to model the costs for residential, commercial, and utility-scale systems. In general, we attempt to model the typical installation techniques and business operations from an installed-cost perspective. Costs are represented from the perspective of the developer/installer; thus, all hardware costs represent the price at which components are purchased by the developer/installer, not accounting for preexisting supply agreements or other contracts. Importantly, the benchmark also represents the sales price paid to the installer; therefore, it includes profit in the cost of the hardware, 1 along with the profit the installer/developer receives, as a separate cost category. However, it does not include any additional net profit, such as a developer fee or price gross-up, which is common in the marketplace. We adopt this approach owing to the wide variation in developer profits in all three sectors, where project pricing is highly dependent on region and project specifics such as local retail electricity rate structures, local rebate and incentive structures, competitive environment, and overall project or deal structures. Finally, our benchmarks are national averages weighted by state installed capacities.

‘No matter what the cost’: A qualitative study of the financial costs faced by family and whānau caregivers within a palliative care context

Science.gov (United States)

Allen, Ruth; Moeke-Maxwell, Tess; Gardiner, Clare; Robinson, Jackie

2015-01-01

Background: There has been significant attention paid in recent years to the economic costs of health service provision for people with palliative care needs. However, little is known about the costs incurred by family caregivers who typically provide the bulk of care for people at the end of life. Aim: To explore the nature and range of financial costs incurred by family caregiving within a palliative care context. Design: In-depth qualitative interviews were conducted with 30 family/whānau caregivers who were currently caring for someone with a life-limiting illness or had done so within the preceding year. Narrative analysis was used to identify impacts and costs at the personal, interpersonal, sociocultural and structural levels. Setting: Auckland, New Zealand. Findings: Costs of caregiving were significant and, for participants, resulted in debt or even bankruptcy. A range of direct (transport, food and medication) and indirect costs (related to employment, cultural needs and own health) were reported. A multi-level qualitative analysis revealed how costs operated at a number of levels (personal, interpersonal, sociocultural and structural). The palliative care context increased costs, as meeting needs were prioritised over cost. In addition, support from statutory service providers to access sources of financial support was limited. Conclusion: Families incur significant financial costs when caring for someone at the end of life. Research is now needed to quantify the financial contribution of family and whānau caregiving within a palliative care context, particularly given attempts in many countries to shift more palliative care provision into community settings. PMID:25680378

Cost of Transformation among Primary Care Practices Participating in a Medical Home Pilot.

Science.gov (United States)

Martsolf, Grant R; Kandrack, Ryan; Gabbay, Robert A; Friedberg, Mark W

2016-07-01

Medical home initiatives encourage primary care practices to invest in new structural capabilities such as patient registries and information technology, but little is known about the costs of these investments. To estimate costs of transformation incurred by primary care practices participating in a medical home pilot. We interviewed practice leaders in order to identify changes practices had undertaken due to medical home transformation. Based on the principles of activity-based costing, we estimated the costs of additional personnel and other investments associated with these changes. The Pennsylvania Chronic Care Initiative (PACCI), a statewide multi-payer medical home pilot. Twelve practices that participated in the PACCI. One-time and ongoing yearly costs attributed to medical home transformation. Practices incurred median one-time transformation-associated costs of $30,991 per practice (range, $7694 to $117,810), equivalent to $9814 per clinician ($1497 to $57,476) and $8 per patient ($1 to $30). Median ongoing yearly costs associated with transformation were $147,573 per practice (range, $83,829 to $346,603), equivalent to $64,768 per clinician ($18,585 to $93,856) and $30 per patient ($8 to $136). Care management activities accounted for over 60% of practices' transformation-associated costs. Per-clinician and per-patient transformation costs were greater for small and independent practices than for large and system-affiliated practices. Error in interviewee recall could affect estimates. Transformation costs in other medical home interventions may be different. The costs of medical home transformation vary widely, creating potential financial challenges for primary care practices-especially those that are small and independent. Tailored subsidies from payers may help practices make these investments. Agency for Healthcare Research and Quality.

Report: Passaic Valley Sewerage Commissioners – Unallowable Costs Claimed Under EPA Grant XP98237601

Science.gov (United States)

Report #08-2-0226, August 6, 2008. The grantee claimed $2,385,634 for pre-award costs under Grant XP98237601 that were incurred prior to the grant award and thus were unallowable under the grant administrative conditions and OMB Circular A-87.

The prognosis of incurable cachectic cancer patients on home parenteral nutrition: a multi-centre observational study with prospective follow-up of 414 patients

NARCIS (Netherlands)

Bozzetti, F.; Santarpia, L.; Pironi, L.; Thul, P.; Klek, S.; Gavazzi, C.; Tinivella, M.; Joly, F.; Jonkers, C.; Baxter, J.; Gramlich, L.; Chicharro, L.; Staun, M.; van Gossum, A.; Lo Vullo, S.; Mariani, L.

2014-01-01

The role of home parenteral nutrition (HPN) in incurable cachectic cancer patients unable to eat is extremely controversial. The aim of this study is to analyse which factors can influence the outcome. We studied prospectively 414 incurable cachectic (sub)obstructed cancer patients receiving HPN and

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

Beban Biaya Telekomunikasi yang Dikeluarkan Masyarakat Pengaruh dari Adopsi Teknologi [Telecommunication Costs Incurred Expenses Society Effect of Technology Adoption

Directory of Open Access Journals (Sweden)

Sri Ariyanti

2016-07-01

Full Text Available Salah satu Rencana Pita Lebar Indonesiatahun 2014 – 2019 yaitu dapat memberikan akses bergerak  di wilayah pedesaan  menjangkau 52% pupulasi dengan data rate mencapai 1 Mbps.  Agar layanan pita lebar dapat terjangkau oleh masyarakat luas, maka harga layanan pita lebar ditargetkan paling tinggi sebesar 5% dari rata-rata pendapatan bulanan pada akhir tahun 2019.  Rencana pita lebar dengan target minimal data rate tersebut tidak akan tercapai tanpa adanya perubahan teknologi.  Teknologi yang mendukung terpenuhinya data rate tersebut antara lain teknologi 3.5G dan 4G LTE.  Dalam rangka upgrade teknologi, perlu adanya biaya yang cukup besar yang dikeluarkan oleh operator.  Biaya tersebut sangat mempengaruhi besar biaya yang akan dibebankan kepada pelanggan.  Oleh karena itu dalam penelitian ini mengkaji seberapa besar biaya yang ditanggung pelanggan seluler setelah adanya teknologi baru. Penelitian ini bertujuan untuk mengetahui apakah biaya yang dibebankan kepada masyarakat sudah sesuai dengan yang ditetapkan oleh pemerintah dalam Rencana Pita Lebar Indonesia. Teknik peneltiian ini menggunakan pendekatan data kuantitatif yang dianalisis dengan ekonometrika.  Hasil penelitian menunjukkan bahwa berdasarkan data penegeluarna telekomunikasi rumah tangga maupun data ARPU, biaya yang dibebankan kepada pelanggan sudah memenuhih persyaratan yang telah ditetapaka oleh rencana pita lebar Indonesia yaitu kurang dari 5%. *****One of the Indonesia Broadband Plan in 2014 – 2019 is that it can be provided mobile data reaching 52% rural areas with data rate up to 1 Mbps. In order to be affordable, so that maximum price is 5% of the average monthly income at the end of 2019.  That data rate cannot be achieved without upgrading the technology. The technology of 3.5G and 4G are among others technology that can support high data rate.  In order to upgrade technology, it needs a considerable cost from mobile operators, while it can influence the cost

Life-Cycle Costing of Food Waste Management in Denmark: Importance of Indirect Effects.

Science.gov (United States)

Martinez-Sanchez, Veronica; Tonini, Davide; Møller, Flemming; Astrup, Thomas Fruergaard

2016-04-19

Prevention has been suggested as the preferred food waste management solution compared to alternatives such as conversion to animal fodder or to energy. In this study we used societal life-cycle costing, as a welfare economic assessment, and environmental life-cycle costing, as a financial assessment combined with life-cycle assessment, to evaluate food waste management. Both life-cycle costing assessments included direct and indirect effects. The latter are related to income effects, accounting for the marginal consumption induced when alternative scenarios lead to different household expenses, and the land-use-changes effect, associated with food production. The results highlighted that prevention, while providing the highest welfare gains as more services/goods could be consumed with the same income, could also incur the highest environmental impacts if the monetary savings from unpurchased food commodities were spent on goods/services with a more environmentally damaging production than that of the (prevented) food. This was not the case when savings were used, e.g., for health care, education, and insurances. This study demonstrates that income effects, although uncertain, should be included whenever alternative scenarios incur different financial costs. Furthermore, it highlights that food prevention measures should not only demote the purchase of unconsumed food but also promote a low-impact use of the savings generated.

Costs of F-18-FDG PET: experience with a satellite concept

International Nuclear Information System (INIS)

Lottes, G.; Kuwert, T.; Schober, O.; Gorschlueter, P.; Adam, D.

1998-01-01

Aim: One of the main arguments against the acceptance and introduction of FDG PET as a regular benefit in the statutory Medical Insurance system in Germany are its (alleged) high costs. The aim of the present study has been to determine empirically over a period of twelve months the costs of FDG PET, making use of a satellite concept. Methods: Documentation on performance and consumption data have been assembled for purposes of cost analysis. After analysis these data provided the basis for an assessment of the costs. In view of the high proportion of fixed overheads and strong fluctuations in consumption values, it was not possible to allocate reliably in an individual FDG PET investigation the various types of costs to individual causes. A monthly cost assessment procedure was therefore adopted. For this purpose data were recorded in the Department for Nuclear Medicine, while the statistical assessment of the consumption data and analysis of the costs were undertaken in the Institute of Industrial and Hospital Management. Results: Over the twelve month observation period (November 1995 to October 1996, 177 working days) 433 patients were included in the study: 244 with brain diseases, 37 cardiac patients, 130 whole body studies and 22 combined studies (brain and whole body scans). The non volume based costs, maintenance charges and depreciation accounted for the highest proportion of the total costs (48%). The FDG-related costs accounted for 41% of the total costs, while the personnel costs amounted to 11% and the film costs to only 0.45%. The total costs incurred amounted to DM 1,205,050. Conclusion: These data represent a first empirical cost analysis for FDG PET based on a satellite concept and form a starting point for a cost/benefit analysis of this procedure. (orig.) [de

Cost-effective treatment of swine wastes through recovery of energy and nutrients.

Science.gov (United States)

Amini, Adib; Aponte-Morales, Veronica; Wang, Meng; Dilbeck, Merrill; Lahav, Ori; Zhang, Qiong; Cunningham, Jeffrey A; Ergas, Sarina J

2017-11-01

Wastes from concentrated animal feeding operations (CAFOs) are challenging to treat because they are high in organic matter and nutrients. Conventional swine waste treatment options in the U.S., such as uncovered anaerobic lagoons, result in poor effluent quality and greenhouse gas emissions, and implementation of advanced treatment introduces high costs. Therefore, the purpose of this paper is to evaluate the performance and life cycle costs of an alternative system for treating swine CAFO waste, which recovers valuable energy (as biogas) and nutrients (N, P, K + ) as saleable fertilizers. The system uses in-vessel anaerobic digestion (AD) for methane production and solids stabilization, followed by struvite precipitation and ion exchange (IX) onto natural zeolites (chabazite or clinoptilolite) for nutrient recovery. An alternative approach that integrated struvite recovery and IX into a single reactor, termed STRIEX, was also investigated. Pilot- and bench-scale reactor experiments were used to evaluate the performance of each stage in the treatment train. Data from these studies were integrated into a life cycle cost analysis (LCCA) to assess the cost-effectiveness of various process alternatives. Significant improvement in water quality, high methane production, and high nutrient recovery (generally over 90%) were observed with both the AD-struvite-IX process and the AD-STRIEX process. The LCCA showed that the STRIEX system can provide considerable financial savings compared to conventional systems. AD, however, incurs high capital costs compared to conventional anaerobic lagoons and may require larger scales to become financially attractive. Copyright © 2017 Elsevier Ltd. All rights reserved.

Cost-Effectiveness Analysis of Test-Based versus Presumptive Treatment of Uncomplicated Malaria in Children under Five Years in an Area of High Transmission in Central Ghana

DEFF Research Database (Denmark)

Tawiah, Theresa; Hansen, Kristian Schultz; Baiden, Frank

2016-01-01

about household cost incurred on transport, drugs, fees, and special food during a period of one week after the health centre visit as well as days unable to work. A decision model approach was used to calculate the incremental cost-effectiveness ratios (ICERs). Univariate and multivariate sensitivity...... (ACT) in all suspected malaria patients. The use of malaria rapid diagnostic tests (mRDTs) would make it possible for prescribers to diagnose malaria at point-of-care and better target the use of antimalarials. Therefore, a cost-effectiveness analysis was performed on the introduction of m......) or clinical judgement (control) was used to measure the effect of mRDTs on appropriate treatment: ‘a child with a positive reference diagnosis prescribed a course of ACT or a child with a negative reference diagnosis not given an ACT’. Cost data was collected from five purposively selected health centres...

Computational cost for detecting inspiralling binaries using a network of laser interferometric detectors

CERN Document Server

Pai, A; Dhurandhar, S V

2002-01-01

We extend a coherent network data-analysis strategy developed earlier for detecting Newtonian waveforms to the case of post-Newtonian (PN) waveforms. Since the PN waveform depends on the individual masses of the inspiralling binary, the parameter-space dimension increases by one from that of the Newtonian case. We obtain the number of templates and estimate the computational costs for PN waveforms: for a lower mass limit of 1M sub o sub - sub d sub o sub t , for LIGO-I noise and with 3% maximum mismatch, the online computational speed requirement for single detector is a few Gflops; for a two-detector network it is hundreds of Gflops and for a three-detector network it is tens of Tflops. Apart from idealistic networks, we obtain results for realistic networks comprising of LIGO and VIRGO. Finally, we compare costs incurred in a coincidence detection strategy with those incurred in the coherent strategy detailed above.

Customer interruption cost and results

Energy Technology Data Exchange (ETDEWEB)

Eua-Arporn, B.; Bisarnbutra, S. [Chulalongkorn Univ., Bangkok (Thailand)

1997-12-31

Results of a comprehensive study on short-term direct impacts and consumer interruption costs, incurred as a result of power supply interruption, were discussed. The emphasis was on questionnaire development, general responses and the average customer damage function of some selected sectors. The customer damage function was established for each category of customers (agriculture, industry, mining, wholesale, retail merchandising, residential, etc) as well as for different locations. Results showed that the average customer damage function depended mostly on customer category. Size and location were not significant factors. 5 refs., 7 tabs.

26 CFR 1.48-12 - Qualified rehabilitated building; expenditures incurred after December 31, 1981.

Science.gov (United States)

2010-04-01

..., DEPARTMENT OF THE TREASURY INCOME TAX INCOME TAXES Rules for Computing Credit for Investment in Certain Depreciable Property § 1.48-12 Qualified rehabilitated building; expenditures incurred after December 31, 1981... section 48(g) and this section) is section 38 property. Property that is section 38 property by reason of...

Restaging oesophageal cancer after neoadjuvant therapy with {sup 18}F-FDG PET-CT: identifying interval metastases and predicting incurable disease at surgery

Energy Technology Data Exchange (ETDEWEB)

Findlay, John M. [Churchill Hospital, Oxford OesophagoGastric Centre, Oxford (United Kingdom); Churchill Hospital, NIHR Oxford Biomedical Research Centre, Oxford (United Kingdom); Gillies, Richard S.; Maynard, Nicholas D. [Churchill Hospital, Oxford OesophagoGastric Centre, Oxford (United Kingdom); Franklin, James M.; Teoh, Eugene J.; Gleeson, Fergus V.; Bradley, Kevin M. [Churchill Hospital, Department of Nuclear Medicine, Oxford (United Kingdom); Jones, Greg E. [Churchill Hospital, Oxford OesophagoGastric Centre, Oxford (United Kingdom); Royal Berkshire Hospital, Reading (United Kingdom); Di Carlo, Sara [Churchill Hospital, Oxford OesophagoGastric Centre, Oxford (United Kingdom); Queen' s Medical Centre, Nottingham (United Kingdom); Middleton, Mark R. [Churchill Hospital, NIHR Oxford Biomedical Research Centre, Oxford (United Kingdom)

2016-10-15

It is unknown whether restaging oesophageal cancer after neoadjuvant therapy with positron emission tomography-computed tomography (PET-CT) is more sensitive than contrast-enhanced CT for disease progression. We aimed to determine this and stratify risk. This was a retrospective study of patients staged before neoadjuvant chemotherapy (NAC) by {sup 18}F-FDG PET-CT and restaged with CT or PET-CT in a single centre (2006-2014). Three hundred and eighty-three patients were restaged (103 CT, 280 PET-CT). Incurable disease was detected by CT in 3 (2.91 %) and PET-CT in 17 (6.07 %). Despite restaging unsuspected incurable disease was encountered at surgery in 34/336 patients (10.1 %). PET-CT was more sensitive than CT (p = 0.005, McNemar's test). A new classification of FDG-avid nodal stage (mN) before NAC (plus tumour FDG-avid length) predicted subsequent progression, independent of conventional nodal stage. The presence of FDG-avid nodes after NAC and an impassable tumour stratified risk of incurable disease at surgery into high (75.0 %; both risk factors), medium (22.4 %; either), and low risk (3.87 %; neither) groups (p < 0.001). Decision theory supported restaging PET-CT. PET-CT is more sensitive than CT for detecting interval progression; however, it is insufficient in at least higher risk patients. mN stage and response (mNR) plus primary tumour characteristics can stratify this risk simply. (orig.)

Restaging oesophageal cancer after neoadjuvant therapy with "1"8F-FDG PET-CT: identifying interval metastases and predicting incurable disease at surgery

International Nuclear Information System (INIS)

Findlay, John M.; Gillies, Richard S.; Maynard, Nicholas D.; Franklin, James M.; Teoh, Eugene J.; Gleeson, Fergus V.; Bradley, Kevin M.; Jones, Greg E.; Di Carlo, Sara; Middleton, Mark R.

2016-01-01

It is unknown whether restaging oesophageal cancer after neoadjuvant therapy with positron emission tomography-computed tomography (PET-CT) is more sensitive than contrast-enhanced CT for disease progression. We aimed to determine this and stratify risk. This was a retrospective study of patients staged before neoadjuvant chemotherapy (NAC) by "1"8F-FDG PET-CT and restaged with CT or PET-CT in a single centre (2006-2014). Three hundred and eighty-three patients were restaged (103 CT, 280 PET-CT). Incurable disease was detected by CT in 3 (2.91 %) and PET-CT in 17 (6.07 %). Despite restaging unsuspected incurable disease was encountered at surgery in 34/336 patients (10.1 %). PET-CT was more sensitive than CT (p = 0.005, McNemar's test). A new classification of FDG-avid nodal stage (mN) before NAC (plus tumour FDG-avid length) predicted subsequent progression, independent of conventional nodal stage. The presence of FDG-avid nodes after NAC and an impassable tumour stratified risk of incurable disease at surgery into high (75.0 %; both risk factors), medium (22.4 %; either), and low risk (3.87 %; neither) groups (p < 0.001). Decision theory supported restaging PET-CT. PET-CT is more sensitive than CT for detecting interval progression; however, it is insufficient in at least higher risk patients. mN stage and response (mNR) plus primary tumour characteristics can stratify this risk simply. (orig.)

The cost of operating with failed fuel at Virginia power

International Nuclear Information System (INIS)

Ford, C.A.

1988-01-01

Virginia Power has completed a study of the costs incurred due to fuel failures in its pressurized water reactors. This study was prompted by histories of high primary coolant activity and subsequent fuel inspections at the North Anna and Surry power stations. The study included an evaluation of the total costs of fuel failures as well as an evaluation of the economics of postirradiation fuel inspections. The major costs of fuel failures included personnel radiation exposure, permanently discharged failed fuel, radwaste generation, increased labor requirements, containment entry delays due to airborne radioactivity, and ramp rate restrictions. Although fuel failures affect a utility in several other areas, the items evaluated in the study were thought to be the most significant of the costs. The study indicated that performing a postirradiation failed fuel examination can be economically justified at tramp-corrected 131 I levels of > 0.015 μCi/g. The savings to the utility can be on the order of several million dollars. Additionally, the cost penalty of performing a fuel inspection at lower iodine levels is generally in the range of $200,000. This economic penalty is expected to be outweighed by the intangible benefits of operating with a defect-free core

Transaction costs of farmers’ participation in forest management: Policy implications of payments for environmental services schemes in Vietnam

Directory of Open Access Journals (Sweden)

Areeya Manasboonphempool

2015-11-01

Full Text Available Recent research on payments for environmental services (PES has observed that high transaction costs (TCs are incurred through the implementation of PES schemes and farmer participation. TCs incurred by households are considered to be an obstacle to the participation in and efficiency of PES policies. This study aims to understand transactions related to previous forest plantation programmes and to estimate the actual TCs incurred by farmers who participated in these programmes in a mountainous area of northwestern Vietnam. In addition, this study examines determinants of households’ TCs to test the hypothesis of whether the amount of TCs varies according to household characteristics. Results show that average TCs are not likely to be a constraint for participation since they are about 200,000 VND (USD 10 per household per contract, which is equivalent to one person’s average earnings for about two days of labour. However, TCs amount to more than one-third of the programmes’ benefits, which is relatively high compared to PES programmes in developed countries. This implies that rather than aiming to reduce TCs, an appropriate agenda for policy improvement is to balance the level of TCs with PES programme benefits to enhance the overall attractiveness of afforestation programmes for smallholder farmers. Regression analysis reveals that education, gender and perception towards PES programmes have significant effects on the magnitude of TCs. The analyses also points out the importance of local conditions on the level of TCs, with some unexpected results.

Physiotherapy after arthroscopic partial meniscectomy surgery: an assessment of costs to the National Health Service, patients, and society.

Science.gov (United States)

Goodwin, Peter Charles; Ratcliffe, Julie; Morrissey, Matthew Charles

2005-01-01

The purpose of this study was to determine and inform clinicians, managers, and budget allocators of the costs incurred to the British National Health Service (NHS), patient, and society when attending clinic-based physiotherapy compared with not attending clinic-based physiotherapy after arthroscopic partial meniscectomy surgery. The valuation principle used in this study was the economic concept of opportunity cost. Costs were referred to as direct medical (NHS), direct nonmedical (patient), and indirect (societal) costs. Due to the difficulties of their measurement and valuation, intangible costs, in the form of pain and anxiety related to the effect of receiving or not receiving treatment, have not been considered in this analysis. Providing clinic-based physiotherapy after knee arthroscopic partial meniscectomy surgery is more costly to the NHS and patient, but no more costly to society than when not providing it and does not result in reduced contact with the NHS. Clinic-based physiotherapy after knee arthroscopic partial meniscectomy surgery is costly and evidence is needed that its effectiveness is high enough to support its use.

Switching benefits and costs in the Irish health insurance market: an analysis of consumer surveys.

Science.gov (United States)

Keegan, Conor; Teljeur, Conor; Turner, Brian; Thomas, Steve

2018-05-10

Relatively little analysis has taken place internationally on the consumer-reported benefits and costs to switching insurer in multi-payer health insurance markets. Ideally, consumers should be willing to switch out of consideration for price and quality and switching should be able to take place without incurring significant switching costs. Costs to switching come in many forms and understanding the nature of these costs is necessary if policy interventions to improve market competition are to be successful. This study utilises data from consumer surveys of the Irish health insurance market collected between 2009 and 2013 (N [Formula: see text] 1703) to examine consumer-reported benefits and costs to switching insurer. Probit regression models are specified to examine the relationship between consumer characteristics and reported switching costs, and switching behaviour, respectively. Overall evidence suggests that switchers in the Irish market mainly did so out of consideration for price. Transaction cost was the most common switching cost identified, reported by just under 1 in 7 non-switchers. Psychological switching costs may also be impacting behaviour. Moreover, high-risk individuals were more likely to experience switching costs and this was reflected in actual switching behaviour. A recent information campaign launched by the market regulator may prove beneficial in reducing perceived transaction costs in the market, however, a more focused campaign aimed at high-risk consumers may be necessary to reduce inequalities. Policy-makers should also consider the impact insurer behaviour may have on decision-making.

An Analysis of Airline Costs. Lecture Notes for MIT Courses. 16.73 Airline Management and Marketing

Science.gov (United States)

Simpson, R. W.

1972-01-01

The cost analyst must understand the operations of the airline and how the activities of the airline are measured, as well as how the costs are incurred and recorded. The data source is usually a cost accounting process. This provides data on the cumulated expenses in various categories over a time period like a quarter, or year, and must be correlated by the analyst with cumulated measures of airline activity which seem to be causing this expense.

Indirect, out-of-pocket and medical costs from influenza-related illness in young children.

Science.gov (United States)

Ortega-Sanchez, Ismael R; Molinari, Noelle-Angelique M; Fairbrother, Gerry; Szilagyi, Peter G; Edwards, Kathryn M; Griffin, Marie R; Cassedy, Amy; Poehling, Katherine A; Bridges, Carolyn; Staat, Mary Allen

2012-06-13

Studies have documented direct medical costs of influenza-related illness in young children, however little is known about the out-of-pocket and indirect costs (e.g., missed work time) incurred by caregivers of children with medically attended influenza. To determine the indirect, out-of-pocket (OOP), and direct medical costs of laboratory-confirmed medically attended influenza illness among young children. Using a population-based surveillance network, we evaluated a representative group of children aged accounting databases, and follow-up interviews with caregivers. Outcome measures included work time missed, OOP expenses (e.g., over-the-counter medicines, travel expenses), and direct medical costs. Costs were estimated (in 2009 US Dollars) and comparisons were made among children with and without high risk conditions for influenza-related complications. Data were obtained from 67 inpatients, 121 ED patients and 92 outpatients with laboratory-confirmed influenza. Caregivers of hospitalized children missed an average of 73 work hours (estimated cost $1456); caregivers of children seen in the ED and outpatient clinics missed 19 ($383) and 11 work hours ($222), respectively. Average OOP expenses were $178, $125 and $52 for inpatients, ED-patients and outpatients, respectively. OOP and indirect costs were similar between those with and without high risk conditions (p>0.10). Medical costs totaled $3990 for inpatients and $730 for ED-patients. Out-of-pocket and indirect costs of laboratory-confirmed and medically attended influenza in young children are substantial and support the benefits of vaccination. Published by Elsevier Ltd.

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.

Tuberculosis patients in the Dominican Republic face severe direct and indirect costs and need social protection

NARCIS (Netherlands)

Mauch, V.M.C.; Melgen, R.; Marcelino, B.; Acosta, I.; Klinkenberg, E.; Suarez, P.

2013-01-01

OBJECTIVE: To examine direct and indirect costs incurred by new, retreatment, and multidrug-resistant (MDR) tuberculosis (TB) patients in the Dominican Republic before and during diagnosis, and during treatment, to generate an evidence base and formulate recommendations. METHODS: The "Tool to

The cost of screening and brief intervention in employee assistance programs.

Science.gov (United States)

Cowell, Alexander J; Bray, Jeremy W; Hinde, Jesse M

2012-01-01

Few studies examine the costs of conducting screening and brief intervention (SBI) in settings outside health care. This study addresses this gap in knowledge by examining the employer-incurred costs of SBI in an employee assistance program (EAP) when delivered by counselors. Screening was self-administered as part of the intake paperwork, and the brief intervention (BI) was delivered during a regular counseling session. Training costs were $83 per counselor. The cost of a screen to the employer was $0.64; most of this cost comprised the cost of the time the client spent completing the screen. The cost of a BI was $2.52. The cost of SBI is lower than cost estimates of SBI conducted in a health care setting. The low costs for the current study suggest that only modest gains in outcomes would likely be needed to justify delivering SBI in an EAP setting.

Direct healthcare cost of obesity in brazil: an application of the cost-of-illness method from the perspective of the public health system in 2011.

Science.gov (United States)

de Oliveira, Michele Lessa; Santos, Leonor Maria Pacheco; da Silva, Everton Nunes

2015-01-01

Obesity is a global public health problem and a risk factor for several diseases that financially impact healthcare systems. To estimate the direct costs attributable to obesity (body mass index {BMI} ≥ 30 kg/m2) and morbid obesity (BMI ≥ 40 kg/m2) in adults aged ≥ 20 incurred by the Brazilian public health system in 2011. Public hospitals and outpatient care. A cost-of-illness method was adopted using a top-down approach based on prevalence. The proportion of the cost of each obesity-associated comorbidity was calculated and obesity prevalence was used to calculate attributable risk. Direct healthcare cost data (inpatient care, bariatric surgery, outpatient care, medications and diagnostic procedures) were extracted from the Ministry of Health information systems, available on the web. Direct costs attributable to obesity totaled US$ 269.6 million (1.86% of all expenditures on medium- and high-complexity health care). The cost of morbid obesity accounted for 23.8% (US$ 64.2 million) of all obesity-related costs despite being 18 times less prevalent than obesity. Bariatric surgery costs in Brazil totaled US$ 17.4 million in 2011. The cost of morbid obesity in women was five times higher than it was in men. The cost of morbid obesity was found to be proportionally higher than the cost of obesity. If the current epidemic were not reversed, the prevalence of obesity in Brazil will increase gradually in the coming years, as well as its costs, having serious implications for the financial sustainability of the Brazilian public health system.

Utilities Cost Comparison Analysis between a Public Work Center and the Non-DoD Sector

Science.gov (United States)

1992-12-01

construction, consider innovative financing and 14 management arrangements (e.g. cost-sharing, public-private venture, leasing). Integrate...and services by financing all incurred costs. 27 Cash is put back into the working capital fund when customers pay cash from their O&M,N funds for the...firms, and other significantly sized business firms. The actual participants of the study may or may not be included in this listing. Disneyland was

The marginal social cost of headway for a scheduled service

DEFF Research Database (Denmark)

Fosgerau, Mogens

2009-01-01

waiting time costs as well as schedule delay costs measured relative to their desired time of arrival at the destination. They may either arrive at the station to choose just the next departure or they may plan for a specific departure in which case they incur also a planning cost. Then planning......This brief paper derives the marginal social cost of headway for a scheduled service, i.e. the cost for users of marginal increases to the time interval between departures. In brief we may call it the value of headway in analogy with the value of travel time and the value of reliability. Users have...... for a specific departure is costly but becomes more attractive at longer headways. Simple expressions for the user cost result. In particular, the marginal cost of headway is large at short headways and smaller at long headways. The difference in marginal costs is the value of time multiplied by half the headway....

Perineal tap water burns in the elderly: at what cost?

Science.gov (United States)

Potter, Michael D E; Maitz, Peter K M; Kennedy, Peter J; Goltsman, David

2017-11-01

Burn injuries are expensive to treat. Burn injuries have been found to be difficult to treat in elderly patients than their younger counterparts. This is likely to result in higher financial burden on the healthcare system; however, no population-specific study has been conducted to ascertain the inpatient treatment costs of elderly patients with hot tap water burns. Six elderly patients (75-92 years) were admitted for tap water burns at Concord Hospital during 2010. All costs incurred during their hospitalization were followed prospectively, and were apportioned into 'direct' and 'indirect' costs. Direct costs encompassed directly measurable costs, such as consumables used on the ward or in theatres, and indirect costs included hospital overheads, such as bed and theatre costs. Three males and three females admitted with burns to the buttocks, legs or feet. Total burn surface area (TBSA) ranged from 9-21% (mean 12.8%). Length of stay ranged from 26-98 days (mean 46 days). One patient died, and four required surgical management or grafting. Total inpatient costs ranged from $69 782.33 to $254 652.70 per patient (mean $122 800.20, standard deviation $67 484.46). TBSA was directly correlated with length of stay (P < 0.01) and total cost (P < 0.01). Hot water burns among the elderly are associated with high treatment costs, which are proportional to the size of the burn. The cost of treating this cohort is higher than previously reported in a general Australian burn cohort. © 2016 Royal Australasian College of Surgeons.

Market failures, consumer preferences, and transaction costs inenergy efficiency purchase decisions

Energy Technology Data Exchange (ETDEWEB)

Sathaye, Jayant; Murtishaw, Scott

2004-11-23

Several factors limit the energy savings potential and increase the costs of energy-efficient technologies to consumers. These factors may usefully be placed into two categories; one category is what economists would define as market failures and the other is related to consumer preferences. This paper provides a conceptual framework for understanding the roles of these factors, and develops a methodology to quantify their effects on costs and potentials of two energy efficient end uses - residential lighting and clothes washers. It notes the significant roles played by the high implicit cost of obtaining information about the benefits of the two technologies and the apparent inability to process and utilize information. For compact fluorescent lamps, this report finds a conservative estimate of the cost of conserved energy of 3.1 cents per kWh. For clothes washers, including water savings reduces the cost of conserved energy from 13.6 cents to 4.3 cents per equivalent kWh. Despite these benefits, market share remains low. About 18 million tons of CO2 could be saved cost effectively from 2005 sales of these two technologies alone. The paper also notes that trading of carbon emissions will incur transaction costs that will range from less than 10 cents per metric ton of CO2 for larger size projects and programs to a few dollars per metric ton of carbon for the smaller ones.

Cost benefit for assessment of intermediate coronary stenosis with fractional flow reserve in public and private sectors in australia.

Science.gov (United States)

Murphy, J C; Hansen, P S; Bhindi, R; Figtree, G A; Nelson, G I C; Ward, M R

2014-09-01

Fractional Flow Reserve (FFR) is a proven technology for guiding percutaneous coronary intervention (PCI), but is not reimbursed despite the fact that it is frequently used to defer PCI. Costs incurred with use of FFR were compared in both the public and private sectors with the costs that would have been incurred if the technology was not available using consecutive cases over a two year period in a public teaching hospital and its co-located private hospital. FFR was performed on 143 lesions in 120 patients. FFR was cost of $A1200 per wire, FFR actually saved money. Mean savings in the public sector were $1200 per patient while in the private sector the savings were $5000 per patient. FFR use saves money for the Federal Government in the public sector and for the Private Health Funds in the private sector. These financial benefits are seen in addition to the improved outcomes seen with this technology. Copyright © 2014. Published by Elsevier B.V.

The cost of infection in severe open tibial fractures treated with a free flap

DEFF Research Database (Denmark)

Olesen, Ulrik Kähler; Pedersen, Nicolas Jones; Eckardt, Henrik

2017-01-01

procedures performed, including medications and intensive care. We analysed indirect cost in terms of absenteeism and unemployment benefits. The primary goal was to establish the extra cost incurred by an infection. RESULTS: We analysed 46 injuries in 45 patients. Infection increased the LOS from 41 to 74...... rate from 60 to 27 %. CONCLUSIONS: Severe open tibial fractures covered with free flaps, cause over a year of absenteeism. Infection increases direct cost of treatment over 60 % and roughly doubles LOS. Early soft-tissue cover and correct antibiotics have been shown to improve outcomes...

Cost system applied in company of generating and transmitting electric energy - CHESF; Sistema de custos aplicado em empresa geradora e transmissora de energia eletrica - CHESF

Energy Technology Data Exchange (ETDEWEB)

Couto, Crisalvo Sampaio, e-mail: Crisalv@chesf.gov.br

2010-07-01

This paper introduces the Operational Costs System 'SCOPES', developed by Companhia HidroEletrica do Sao Francisco - CHESF, with the objective of providing the leadership, knowledge of costs and expenditures generated in the various activities of the cost formation chain, enabling effective monitoring and management of resources incurred in the chain.

The costs of traumatic brain injury due to motorcycle accidents in Hanoi, Vietnam

Directory of Open Access Journals (Sweden)

Vo Thuy TN

2008-08-01

Full Text Available Abstract Background Road traffic accidents are the leading cause of fatal and non-fatal injuries in Vietnam. The purpose of this study is to estimate the costs, in the first year post-injury, of non-fatal traumatic brain injury (TBI in motorcycle users not wearing helmets in Hanoi, Vietnam. The costs are calculated from the perspective of the injured patients and their families, and include quantification of direct, indirect and intangible costs, using years lost due to disability as a proxy. Methods The study was a retrospective cross-sectional study. Data on treatment and rehabilitation costs, employment and support were obtained from patients and their families using a structured questionnaire and The European Quality of Life instrument (EQ6D. Results Thirty-five patients and their families were interviewed. On average, patients with severe, moderate and minor TBI incurred direct costs at USD 2,365, USD 1,390 and USD 849, with time lost for normal activities averaging 54 weeks, 26 weeks and 17 weeks and years lived with disability (YLD of 0.46, 0.25 and 0.15 year, respectively. Conclusion All three component costs of TBI were high; the direct cost accounted for the largest proportion, with costs rising with the severity of TBI. The results suggest that the burden of TBI can be catastrophic for families because of high direct costs, significant time off work for patients and caregivers, and impact on health-related quality of life. Further research is warranted to explore the actual social and economic benefits of mandatory helmet use.

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

Science.gov (United States)

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

2012-11-01

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

[Cost of hospitalization by the Activity Based Costing method in the neonatal department of Principal Hospital of Dakar].

Science.gov (United States)

Tchamdja, T; Balaka, A; Tchandana, M; Agbétra, A

2015-01-01

To determine the cost of hospitalization per day in the neonatal department of Principal Hospital of Dakar. This prospective study took place during the month of July 2011 in the newborn unit. The activity-based costing method was used to analyze costs. During the study period, 52 newborns were hospitalized for a total of 590 days. The cost of the human resources during that month was 9,907,832 FCFA (US $ 19,815.66), the cost of depreciation of fixed assets was estimated at 571,952 FCFA (US $ 1143.90), and supplies at 112,084 FCFA (US $ 224.17). External services cost 386,753 FCFA (US $ 773.51) and support services 6,917,380.65 FCFA (US $ 13,834.7613). The monthly expenses incurred for the hospitalization of newborns totaled 17,896,002 FCFA (US $ 35,792), for a cost per patient per day of 30,332.20 FCFA (US $ 60.66) and an average cost of hospitalization 334,153.88 FCFA (US $ 668,31). This study is the first of its kind in Senegal and neighboring countries. By applying the ABC approach, we can obtain a more detailed and precise estimate of the cost of activities and services. Process improvements and corrective actions should make it possible to identify cost drivers, such as time.

The external costs of a sedentary life-style.

Science.gov (United States)

Keeler, E B; Manning, W G; Newhouse, J P; Sloss, E M; Wasserman, J

1989-01-01

Using data from the National Health Interview Survey and the RAND Health Insurance Experiment, we estimated the external costs (costs borne by others) of a sedentary life-style. External costs stem from additional payments received by sedentary individuals from collectively financed programs such as health insurance, sick-leave coverage, disability insurance, and group life insurance. Those with sedentary life-styles incur higher medical costs, but their life expectancy at age 20 is 10 months less so they collect less public and private pensions. The pension costs come late in life, as do some of the medical costs, and so the estimate of the external cost is sensitive to the discount rate used. At a 5 percent rate of discount, the lifetime subsidy from others to those with a sedentary life style is $1,900. Our estimate of the subsidy is also sensitive to the assumed effect of exercise on mortality. The subsidy is a rationale for public support of recreational facilities such as parks and swimming pools and employer support of programs to increase exercise. PMID:2502036

Cost studies concerning decontamination and dismantling. The interim store for spent fuel at Studsvik; Kaerntekniska kostnadsstudier avseende dekontaminering och nedlaeggning. Mellanfoervaret foer anvaent kaernbraensle i Studsvik

Energy Technology Data Exchange (ETDEWEB)

Sjoeblom, Rolf; Sjoeoe, Cecilia [Tekedo AB, Nykoeping (Sweden); Lindskog, Staffan; Cato, Anna [Swedish Nuclear Power Inspectorate, Stockholm (Sweden)

2006-04-15

The interim store for spent fuel at Studsvik was designed and constructed in 1962-64. It has been used for wet storage of fuel from the Aagesta Nuclear Power Plant as well as the R2 reactor at Studsvik. The interim store comprises three cylindrical pools for fuel storage as well as equipment for handling and decontamination. The purpose of the present work is to develop methodology for calculation of future costs for decontamination and dismantling of nuclear research facilities. The analysis is based on information from Studsvik as well as results from information searches. The requirements on precision of cost calculations is high, also at early stages. The reason for this is that the funds are to be collected now but are to be used some time in the future. At the same time they should neither be insufficient nor superfluous. It is apparent from the compilation and analysis that when methodology that has been developed for the purpose of cost calculations for power reactors is applied to research facilities certain drawbacks become apparent, e.g. difficulties to carry out variation analyses. Generally, feedback of data on incurred costs for the purpose of cost calculations can be achieved by using one or more scaling factors together with weighing factors which are established based on e.g. expert judgement. For development and utilisation of such tools it is necessary to have access to estimated costs together with incurred ones. In the report, the following combination of aspects is identified as being of primary significance for achieving a high precision: Calculations with the possibility to calibrate against incurred costs; Radiological surveying tailored to the needs for calculations; Technical planning including selection of techniques to be used; Identification of potential sources for systematic deviations. In the case of the interim store, some of the sources of uncertainty are as follows: Damaged surface layers in the pools; Maintenance status for the

Corporate Governance of Sugar Mills in East Java: A Transaction Cost Economics Perspective

Directory of Open Access Journals (Sweden)

Ahmad Erani Yustika

2007-01-01

Full Text Available Despite Indonesia’s overall achievements during the past two decades%2C the economy is encountering a series of problems. One of the biggest challenges is the unsatisfactory performance of the state-owned enterprises (SOEs. Subsidisies and uncovered loans to the SOEs have drained the government’s fiscal resources%2C and the signing off of employees creates many social problems. Compared with the SOEs in other sectors%2C state-owned sugar mills face more serious crises which not only jeopardise the social fabric%2C but also endanger the production. Research results strengthen the statement that the basic problem in sugar mills is management inefficiency resulting in high transaction costs. This research compares the transaction costs between state-owned (Ngadiredjo and privately-owned (Kebon Agung sugar mills. The study shows that in Kebon Agung Sugar Mill transaction costs are higher than production costs%2C while in Ngadiredjo Sugar Mill the reverse is true. However%2C the high transaction costs in Kebon Agung Sugar Mill cannot be attributed directly to inefficient institutions%2C because Ngadiredjo Sugar Mill incurred high costs for plants%2C land preparation%2C and fertilizer%2C which decreased the proportion of transaction costs. If analyzed in detail%2C the following facts are revealed: (i market transaction costs in Kebon Agung Sugar Mill are higher than in Ngadiredjo Sugar Mill. This is because Kebon Agung Sugar Mill has established cooperation with sugarcane farmers in the form of extensions and transport subsidies; and (ii the political transaction costs proportion in Ngadiredjo Sugar Mill is higher than in Kebon Agung Sugar Mill because of the imposition of many ‘illegal’ fees. Abstract in Bahasa Indonesia : transaction cost economics%2C corporate governance%2C sugar mill%2C East Java.

Report: Ozone Transport Commission Incurred Costs Under EPA Assistance Agreements XA98379901, OT83098301, XA97318101, and OT83264901

Science.gov (United States)

Report #2007-4-00068, July 31, 2007. We questioned $2,723,706 of the $9,042,706 in reported outlays because the recipient claimed unallowable outlays for contractual services, indirect costs, and in-kind costs.

The risk-adjusted vision beyond casemix (DRG) funding in Australia. International lessons in high complexity and capitation.

Science.gov (United States)

Antioch, Kathryn M; Walsh, Michael K

2004-06-01

Hospitals throughout the world using funding based on diagnosis-related groups (DRG) have incurred substantial budgetary deficits, despite high efficiency. We identify the limitations of DRG funding that lack risk (severity) adjustment for State-wide referral services. Methods to risk adjust DRGs are instructive. The average price in casemix funding in the Australian State of Victoria is policy based, not benchmarked. Average cost weights are too low for high-complexity DRGs relating to State-wide referral services such as heart and lung transplantation and trauma. Risk-adjusted specified grants (RASG) are required for five high-complexity respiratory, cardiology and stroke DRGs incurring annual deficits of $3.6 million due to high casemix complexity and government under-funding despite high efficiency. Five stepwise linear regressions for each DRG excluded non-significant variables and assessed heteroskedasticity and multicollinearlity. Cost per patient was the dependent variable. Significant independent variables were age, length-of-stay outliers, number of disease types, diagnoses, procedures and emergency status. Diagnosis and procedure severity markers were identified. The methodology and the work of the State-wide Risk Adjustment Working Group can facilitate risk adjustment of DRGs State-wide and for Treasury negotiations for expenditure growth. The Alfred Hospital previously negotiated RASG of $14 million over 5 years for three trauma and chronic DRGs. Some chronic diseases require risk-adjusted capitation funding models for Australian Health Maintenance Organizations as an alternative to casemix funding. The use of Diagnostic Cost Groups can facilitate State and Federal government reform via new population-based risk adjusted funding models that measure health need.

High-value, cost-conscious health care: concepts for clinicians to evaluate the benefits, harms, and costs of medical interventions.

Science.gov (United States)

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.

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

Science.gov (United States)

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

2017-05-01

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

Work–Life Balance: History, Costs, and Budgeting for Balance

OpenAIRE

Raja, Siva; Stein, Sharon L.

2014-01-01

The concept and difficulties of work–life balance are not unique to surgeons, but professional responsibilities make maintaining a work–life balance difficult. Consequences of being exclusively career focused include burn out, physical, and mental ailments. In addition, physician burn out may hinder optimal patient care and incur significant costs on health care in general. Assessing current uses of time, allocating goals catered to an individual surgeon, and continual self-assessment may hel...

Prediction of higher cost of antiretroviral therapy (ART) according to clinical complexity. A validated clinical index.

Science.gov (United States)

Velasco, Cesar; Pérez, Inaki; Podzamczer, Daniel; Llibre, Josep Maria; Domingo, Pere; González-García, Juan; Puig, Inma; Ayala, Pilar; Martín, Mayte; Trilla, Antoni; Lázaro, Pablo; Gatell, Josep Maria

2016-03-01

The financing of antiretroviral therapy (ART) is generally determined by the cost incurred in the previous year, the number of patients on treatment, and the evidence-based recommendations, but not the clinical characteristics of the population. To establish a score relating the cost of ART and patient clinical complexity in order to understand the costing differences between hospitals in the region that could be explained by the clinical complexity of their population. Retrospective analysis of patients receiving ART in a tertiary hospital between 2009 and 2011. Factors potentially associated with a higher cost of ART were assessed by bivariate and multivariate analysis. Two predictive models of "high-cost" were developed. The normalized estimated (adjusted for the complexity scores) costs were calculated and compared with the normalized real costs. In the Hospital Index, 631 (16.8%) of the 3758 patients receiving ART were responsible for a "high-cost" subgroup, defined as the highest 25% of spending on ART. Baseline variables that were significant predictors of high cost in the Clinic-B model in the multivariate analysis were: route of transmission of HIV, AIDS criteria, Spanish nationality, year of initiation of ART, CD4+ lymphocyte count nadir, and number of hospital admissions. The Clinic-B score ranged from 0 to 13, and the mean value (5.97) was lower than the overall mean value of the four hospitals (6.16). The clinical complexity of the HIV patient influences the cost of ART. The Clinic-B and Clinic-BF scores predicted patients with high cost of ART and could be used to compare and allocate costs corrected for the patient clinical complexity. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Cost of installing and operating an electronic clinical decision support system for maternal health care: case of Tanzania rural primary health centres.

Science.gov (United States)

Saronga, Happiness Pius; Dalaba, Maxwell Ayindenaba; Dong, Hengjin; Leshabari, Melkizedeck; Sauerborn, Rainer; Sukums, Felix; Blank, Antje; Kaltschmidt, Jens; Loukanova, Svetla

2015-04-02

Poor quality of care is among the causes of high maternal and newborn disease burden in Tanzania. Potential reason for poor quality of care is the existence of a "know-do gap" where by health workers do not perform to the best of their knowledge. An electronic clinical decision support system (CDSS) for maternal health care was piloted in six rural primary health centers of Tanzania to improve performance of health workers by facilitating adherence to World Health Organization (WHO) guidelines and ultimately improve quality of maternal health care. This study aimed at assessing the cost of installing and operating the system in the health centers. This retrospective study was conducted in Lindi, Tanzania. Costs incurred by the project were analyzed using Ingredients approach. These costs broadly included vehicle, computers, furniture, facility, CDSS software, transport, personnel, training, supplies and communication. These were grouped into installation and operation cost; recurrent and capital cost; and fixed and variable cost. We assessed the CDSS in terms of its financial and economic cost implications. We also conducted a sensitivity analysis on the estimations. Total financial cost of CDSS intervention amounted to 185,927.78 USD. 77% of these costs were incurred in the installation phase and included all the activities in preparation for the actual operation of the system for client care. Generally, training made the largest share of costs (33% of total cost and more than half of the recurrent cost) followed by CDSS software- 32% of total cost. There was a difference of 31.4% between the economic and financial costs. 92.5% of economic costs were fixed costs consisting of inputs whose costs do not vary with the volume of activity within a given range. Economic cost per CDSS contact was 52.7 USD but sensitive to discount rate, asset useful life and input cost variations. Our study presents financial and economic cost estimates of installing and operating an

Costs of Reducing Greenhouse Gas Emissions: A Case Study of India’s Power Generation Sector

OpenAIRE

Manish Gupta

2006-01-01

If India were to participate in any international effort towards mitigating CO2 emissions, the power sector which is one of the largest emitters of CO2 in the country would be required to play a major role. In this context the study estimates the marginal abatement costs, which correspond to the costs incurred by the power plants to reduce one unit of CO2 from the current level. The study uses an output distance function approach and its duality with the revenue function to derive these costs...

Should large Spanish municipalities be financially compensated? Costs and benefits of being a capital/central municipality [WP-IEB

OpenAIRE

Bosch Roca, Núria; Espasa Queralt, Marta; Montolio, Daniel

2013-01-01

This paper analyse the costs and benefits of being a capital or central municipality, where central costs are understood to be incurred specifically as a result of the problems large municipalities located at the centre of an urban agglomeration face and capital costs are understood to result from the presence of regional and/or central government institutions in the municipality. However, these two qualities might also be beneficial to municipalities, resulting in a direct increase in their ...

Clinically significant bleeding in incurable cancer patients: effectiveness of hemostatic radiotherapy

International Nuclear Information System (INIS)

Cihoric, Nikola; Crowe, Susanne; Eychmüller, Steffen; Aebersold, Daniel M; Ghadjar, Pirus

2012-01-01

This study was performed to evaluate the outcome after hemostatic radiotherapy (RT) of significant bleeding in incurable cancer patients. Patients treated by hemostatic RT between November 2006 and February 2010 were retrospectively analyzed. Bleeding was assessed according to the World Health Organization (WHO) scale (grade 0 = no bleeding, 1 = petechial bleeding, 2 = clinically significant bleeding, 3 = bleeding requiring transfusion, 4 = bleeding associated with fatality). The primary endpoint was bleeding at the end of RT. Key secondary endpoints included overall survival (OS) and acute toxicity. The bleeding score before and after RT were compared using the Wilcoxon signed rank test. Time to event endpoints were estimated using the Kaplan Meier method. Overall 62 patients were analyzed including 1 patient whose benign cause of bleeding was pseudomyxoma peritonei. Median age was 66 (range, 37–93) years. Before RT, bleeding was graded as 2 and 3 in 24 (39%) and 38 (61%) patients, respectively. A median dose of 20 (range, 5–45) Gy of hemostatic RT was applied to the bleeding site. At the end of RT, there was a statistically significant difference in bleeding (p < 0.001); it was graded as 0 (n = 39), 1 (n = 12), 2 (n = 6), 3 (n = 4) and 4 (n = 1). With a median follow-up of 19.3 (range, 0.3-19.3) months, the 6-month OS rate was 43%. Forty patients died (65%); 5 due to bleeding. No grade 3 or above acute toxicity was observed. Hemostatic RT seems to be a safe and effective treatment for clinically and statistically significantly reducing bleeding in incurable cancer patients

TTHE ATTITUDE OF THE SOCIETY TOWARDS INCURABLE CHILDREN: HISTORICAL AND CULTURAL ANALYSIS

Directory of Open Access Journals (Sweden)

G. L. Mikirtichan

2012-01-01

Full Text Available This article is an attempt to study the attitude towards the incurable child in different societies throughout the history. The attitude depended on the level of socio-economic development of the society, type and form of the institutionalization of the family and family relations, social, historical and cultural peculiarities of the nature and ierarchy of parental values, on the perception of childhood as a sociocultural phenomena, on existing juridical system, that defines parental and child rights, and on the level of healthcare system development, including pediatrics.

Cost, affordability and cost-effectiveness of strategies to control tuberculosis in countries with high HIV prevalence

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

Responsibilities of Health Care Professionals in Counseling and Educating Patients With Incurable Neurological Diseases Regarding "Stem Cell Tourism": Caveat Emptor.

Science.gov (United States)

Bowman, Michelle; Racke, Michael; Kissel, John; Imitola, Jaime

2015-11-01

"Stem cell tourism" is a rising Internet-based industry that aims to offer unproven procedures to patients with incurable diseases. This unregulated activity is reaching the neurologist's office as well as across the world, as patients request information or clearance for such procedures. Herein, we posit the need for medical societies and licensing boards to bring this issue to the forefront of neurology because it has the potential to affect patient care with risk of morbidity and mortality, as well as to undermine public confidence in legitimate stem cell research for incurable neurological diseases such as multiple sclerosis and amyotrophic lateral sclerosis.

41 CFR 301-2.3 - What standard of care must I use in incurring travel expenses?

Science.gov (United States)

2010-07-01

... Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES INTRODUCTION 2-GENERAL... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false What standard of care... same care in incurring expenses that a prudent person would exercise if traveling on personal business. ...

Nuclear cost studies for decontamination and dismantling. The interim storage for spent fuels at Studsvik.; Kaerntekniska kostnadsstudier avseende dekontaminering och nedlaeggning. Mellanfoervaret foer anvaent kaernbraensle (FA) i Studsvik.

Energy Technology Data Exchange (ETDEWEB)

Sjoeblom, Rolf; Sjoeoe, Cecilia [Tekedo AB, Nykoeping (Sweden); Lindskog, Staffan; Cato, Anna [Swedish Nuclear Power Inspectorate, Stockholm (Sweden)

2005-05-01

The interim store for spent fuel (FA) at Studsvik was designed and constructed in 1962-64. It has been used for wet storage of fuel from the Aagesta Nuclear Power Plant as well as the R2 reactor at Studsvik. FA comprises three cylindrical pools for fuel storage as well as equipment for handling and decontamination. The purpose of the present work is to develop methodology for calculation of future costs for decontamination and dismantling of nuclear research facilities. The analysis is based on information from Studsvik as well as results from information searches. The requirements on precision of cost calculations is high, also at early stages. The reason for this is that the funds are to be collected now but are to be used some time in the future. At the same time they should neither be insufficient nor superfluous. It is apparent from the compilation and analysis that when methodology that has been developed for the purpose of cost calculations for power reactors is applied to research facilities certain drawbacks become apparent, e.g. difficulties to carry out variation analyses. Generally, feedback of data on incurred costs for the purpose of cost calculations can be achieved by using one or more scaling factors together with weighing factors which are established based on e g expert judgement. For development and utilisation of such tools it is necessary to have access to estimated costs together with incurred ones. In the report, the following combination of aspects is identified as being of primary significance for achieving a high precision: Calculations with the possibility to 'calibrate' against incurred costs; Radiological surveying tailored to the needs for calculations; Technical planning including selection of techniques to be used; Identification of potential sources for systematic deviations. In the case of FA, some of the sources of uncertainty are as follows: Damaged surface layers in the pools; Maintenance status for the drains

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.

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.

Method for developing cost estimates for generic regulatory requirements

International Nuclear Information System (INIS)

1985-01-01

The NRC has established a practice of performing regulatory analyses, reflecting costs as well as benefits, of proposed new or revised generic requirements. A method had been developed to assist the NRC in preparing the types of cost estimates required for this purpose and for assigning priorities in the resolution of generic safety issues. The cost of a generic requirement is defined as the net present value of total lifetime cost incurred by the public, industry, and government in implementing the requirement for all affected plants. The method described here is for commercial light-water-reactor power plants. Estimating the cost for a generic requirement involves several steps: (1) identifying the activities that must be carried out to fully implement the requirement, (2) defining the work packages associated with the major activities, (3) identifying the individual elements of cost for each work package, (4) estimating the magnitude of each cost element, (5) aggregating individual plant costs over the plant lifetime, and (6) aggregating all plant costs and generic costs to produce a total, national, present value of lifetime cost for the requirement. The method developed addresses all six steps. In this paper, we discuss on the first three

Bed wise cost analysis of in-patient treatment of brachial plexus injury at a Level I trauma Center in India

OpenAIRE

Pandey, Nityanand; Gupta, Deepak; Mahapatra, Ashok; Harshvardhan, Rajesh

2014-01-01

Aim: The aim was to calculate, in monetary terms, total cost incurred by a Level I trauma center in providing in-patient care to brachial plexus injury patients during their preoperative and the postoperative stay. Subjects and Methods: All patients of brachial plexus injury admitted and discharged between January and December 2010 were included in the study. Total cost per bed was calculated under several cost heads in pre- and post-operative ward care. Intra-operative costs were excluded. R...

Cost Accounting as a Tool for Increasing Cost Transparency in Selective Hepatic Transarterial Chemoembolization.

Science.gov (United States)

Ahmed, Osman; Patel, Mikin; Ward, Thomas; Sze, Daniel Y; Telischak, Kristen; Kothary, Nishita; Hofmann, Lawrence V

2015-12-01

To increase cost transparency and uncover potential areas for savings in patients receiving selective transarterial chemoembolization at a tertiary care academic center. The hospital cost accounting system charge master sheet for direct and total costs associated with selective transarterial chemoembolization in fiscal years 2013 and 2014 was queried for each of the four highest volume interventional radiologists at a single institution. There were 517 cases (range, 83-150 per physician) performed; direct costs incurred relating to care before, during, and after the procedure with respect to labor, supply, and equipment fees were calculated. A median of 48 activity codes were charged per selective transarterial chemoembolization from five cost centers, represented by the angiography suite, units for care before and after the procedure, pharmacy, and observation floors. The average direct cost of selective transarterial chemoembolization did not significantly differ among operators at $9,126.94, $8,768.77, $9,027.33, and $8,909.75 (P = .31). Intraprocedural costs accounted for 82.8% of total direct costs and provided the greatest degree in cost variability ($7,268.47-$7,691.27). The differences in intraprocedural expense among providers were not statistically significant (P = .09), even when separated into more specific procedure-related labor and supply costs. Cost accounting systems could effectively be interrogated as a method for calculating direct costs associated with selective transarterial chemoembolization. The greatest source of expenditure and variability in cost among providers was shown to be intraprocedural labor and supplies, although the effect did not appear to be operator dependent. Copyright © 2015 SIR. Published by Elsevier Inc. All rights reserved.

Costs of Medically Attended Acute Gastrointestinal Infections: The Polish Prospective Healthcare Utilization Survey.

Science.gov (United States)

Czech, Marcin; Rosinska, Magdalena; Rogalska, Justyna; Staszewska, Ewa; Stefanoff, Pawel

The burden of acute gastrointestinal infections (AGIs) on the society has not been well studied in Central European countries, which prevents the implementation of effective, targeted public health interventions. We investigated patients of 11 randomly selected general practices and 8 hospital units. Each patient meeting the international AGI case definition criteria was interviewed on costs incurred related to the use of health care resources. Follow-up interview with consenting patients was conducted 2 to 4 weeks after the general practitioner (GP) visit or discharge from hospital, collecting information on self-medication costs and indirect costs. Costs were recalculated to US dollars by using the purchasing power parity exchange rate for Poland. Weighting the inpatient costs by age-specific probability of hospital referral by GPs, the societal cost of a medically attended AGI case was estimated to be US $168. The main cost drivers of direct medical costs were cost of hospital bed days (US $28), cost of outpatient pharmacotherapy (US $20), and cost of GP consultation (US $10). Patients covered only the cost of outpatient pharmacotherapy. Considering the AGI population GP consultation rate, the age-adjusted societal cost of medically attended AGI episodes was estimated at US $2222 million, of which 53% was attributable to indirect costs. Even though AGIs generate a low cost for individuals, they place a high burden on the society, attributed mostly to indirect costs. Higher resources could be allocated to the prevention and control of AGIs. Copyright © 2013, International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc.

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

DEFF Research Database (Denmark)

Klinge Jacobsen, Henrik; Baldini, Mattia

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

Economic and technical advantages of high temperature processes in high level radioactive waste management

International Nuclear Information System (INIS)

Jouan, A.; Jacquet-Francillon, N.; Cler, M.

1991-01-01

The estimated waste management costs incurred for the three principal waste forms produced by reprocessing spent fuel are compared from a theoretical economic standpoint. The cost of vitrifying concentrated fission product solutions is considered first, together with the estimated additional costs of transportation and final storage in a geological repository. Fuel cladding waste treatments are then examined by comparing the relative costs of cementation, compaction and melting; processes for disposal of incinerable alpha-bearing wastes are also considered. In each case, the processes ensuring the greatest waste volume reduction not only result in the lowest management cost, but are also most effective in ensuring the highest possible containment quality for the final waste package

Economic and technical advantages of high-temperature processes in high-level radioactive waste management

International Nuclear Information System (INIS)

Jouan, A.; Jacquet-Francillon, N.; Cler, M.; Chaudon, L.

1991-01-01

The estimated waste management costs incurred for the three principal waste forms produced by reprocessing spent fuel are compared from a theoretical economic standpoint. The cost of vitrifying concentrated fission product solutions is considered first, together with the estimated additional costs of transportation and final storage in a geological repository. Fuel cladding waste treatments are then examined by comparing the relative costs of cementation, compaction and melting; processes for disposal of incinerable alpha-bearing wastes are also considered. In each case, the processes ensuring the greatest waste volume reduction not only result in the lowest management cost, but are also most effective in ensuring the highest possible containment quality for the final waste package

Coevolution of Synchronization and Cooperation in Costly Networked Interactions

Science.gov (United States)

Antonioni, Alberto; Cardillo, Alessio

2017-06-01

Despite the large number of studies on synchronization, the hypothesis that interactions bear a cost for involved individuals has seldom been considered. The introduction of costly interactions leads, instead, to the formulation of a dichotomous scenario in which an individual may decide to cooperate and pay the cost in order to get synchronized with the rest of the population. Alternatively, the same individual can decide to free ride, without incurring any cost, waiting for others to get synchronized to his or her state. Thus, the emergence of synchronization may be seen as the byproduct of an evolutionary game in which individuals decide their behavior according to the benefit-to-cost ratio they accrued in the past. We study the onset of cooperation and synchronization in networked populations of Kuramoto oscillators and report how topology is essential in order for cooperation to thrive. We also display how different classes of topology foster synchronization differently both at microscopic and macroscopic levels.

Melanoma costs: a dynamic model comparing estimated overall costs of various clinical stages.

Science.gov (United States)

Alexandrescu, Doru Traian

2009-11-15

The rapidly increasing incidence of melanoma occurs at the same time as an increase in general healthcare costs, particularly the expenses associated with cancer care. Previous cost estimates in melanoma have not utilized a dynamic model considering the evolution of the disease and have not integrated the multiple costs associated with different aspects of medical interventions and patient-related factors. Futhermore, previous calculations have not been updated to reflect the modern tendencies in healthcare costs. We designed a comprehensive model of expenses in melanoma that considers the dynamic costs generated by the natural progression of the disease, which produces costs associated with treatment, surveillance, loss of income, and terminal care. The complete range of initial clinical (TNM) stages of the disease and initial tumor stages were analyzed in this model and the total healthcare costs for the five years following melanoma presentation at each particular stage were calculated. We have observed dramatic incremental total costs associated with progressively higher initial stages of the disease, ranging from a total of $4,648.48 for in situ tumors to $159,808.17 for Stage IV melanoma. By stage, early lesions associate 30-55 percent of their costs for the treatment of the primary tumor, due to a low rate of recurrence (local, regional, or distant), which limits the need for additional interventions. For in situ melanoma, T1a, and T1b, surveillance is an important contributor to the medical costs, accounting for more than 25 percent of the total cost over 5 years. In contrast, late lesions incur a much larger proportion of their associated costs (up to 80-85%) from the diagnosis and treatment of metastatic disease because of the increased propensity of those lesions to disseminate. This cost increases with increasing tumor stage (from $2,442.17 for T1a to $6,678.00 for T4b). The most expensive items in the medical care of patients with melanoma consist of

SOR/93-163 AECB Cost Recovery Fees Regulations, 1993

International Nuclear Information System (INIS)

1993-01-01

The Atomic Energy Control Board (Cost Recovery Fees Regulations 1990 and subsequent amendments have been revoked and replaced by those new Regulations of 30 march 1993 which entered into force on 1 April 1993. The regulations were first made in 1990 in order to carry out the Government's policy of introducing the principle of ''user pay'' for the cost incurred by the AECB in its regulatory activities. The objective of the policy was to shift the cost of Government regulatory efforts for the taxpayer at large to those who most benefited from or whose activities were the reason for such effort. This new version of the Regulations reflects licensees' comments, e.g. extension of the period for review of proposed fees, and sets out increases in the fees. (NEA)

End-of-life costs of medical care for advanced stage cancer patients

Directory of Open Access Journals (Sweden)

Kovačević Aleksandra

2015-01-01

Full Text Available Background/Aim. Cancer, one of the leading causes of mortality in the world, imposes a substantial economic burden on each society, including Serbia. The aim of this study was to evaluate the major cancer cost drivers in Serbia. Methods. A retrospective, indepth, bottom-up analysis of two combined databases was performed in order to quantify relevant costs. End-of-life data were obtained from patients with cancer, who deceased within the first year of the established diagnose, including basic demographics, diagnosis, tumour histology, medical resource use and related costs, time and cause of death. All costs were allocated to one of the three categories of cancer health care services: primary care (included home care, hospital outpatient and hospital inpatient care. Results. Exactly 114 patients were analyzed, out of whom a high percent (48.25% had distant metastases at the moment of establishing the diagnosis. Malignant neoplasms of respiratory and intrathoracic organs were leading causes of morbidity. The average costs per patient were significantly different according to the diagnosis, with the highest (13,114.10 EUR and the lowest (4.00 EUR ones observed in the breast cancer and melanoma, respectively. The greatest impact on total costs was observed concerning pharmaceuticals, with 42% of share (monoclonal antibodies amounted to 34% of all medicines and 14% of total costs, followed by oncology medical care (21%, radiation therapy and interventional radiology (11%, surgery (9%, imaging diagnostics (9% and laboratory costs (8%. Conclusion. Cancer treatment incurs high costs, especially for end-of-life pharmaceutical expenses, ensued from medical personnel tendency to improve such patients’ quality of life in spite of nearing the end of life. Reimbursement policy on monoclonal antibodies, in particular at end-stage disease, should rely on cost-effectiveness evidence as well as documented clinical efficiency. [Projekat Ministarstva nauke

Cost-effectiveness landscape analysis of treatments addressing xerostomia in patients receiving head and neck radiation therapy

Science.gov (United States)

Sasportas, Laura S.; Hosford, Andrew T.; Sodini, Maria A.; Waters, Dale J.; Zambricki, Elizabeth A.; Barral, Joëlle K.; Graves, Edward E.; Brinton, Todd J.; Yock, Paul G.; Le, Quynh-Thu; Sirjani, Davud

2014-01-01

Head and neck (H&N) radiation therapy (RT) can induce irreversible damage to the salivary glands thereby causing long-term xerostomia or dry mouth in 68%–85% of the patients. Not only does xerostomia significantly impair patients’ quality-of-life (QOL) but it also has important medical sequelae, incurring high medical and dental costs. In this article, we review various measures to assess xerostomia and evaluate current and emerging solutions to address this condition in H&N cancer patients. These solutions typically seek to accomplish 1 of the 4 objectives: (1) to protect the salivary glands during RT, (2) to stimulate the remaining gland function, (3) to treat the symptoms of xerostomia, or (4) to regenerate the salivary glands. For each treatment, we assess its mechanisms of action, efficacy, safety, clinical utilization, and cost. We conclude that intensity-modulated radiation therapy is both the most widely used prevention approach and the most cost-effective existing solution and we highlight novel and promising techniques on the cost-effectiveness landscape. PMID:23643579

Cost estimation of a standalone photovoltaic power system in remote areas of Sarawak, Malaysia

International Nuclear Information System (INIS)

Jakhrani, A.Q.; Othman, A.K.; Rigit, A.R.H.; Samo, S.R.

2012-01-01

This paper aims to estimate the anticipated costs incurred from a standalone solar photovoltaic power system for the supply of electricity to the rural community in Sarawak, Malaysia. The life cycle cost analysis with net present value technique was employed for the evaluation of cost system. It was found that purchasing of solar photovoltaic components and the system installation cost will contribute 63% of the total investment and future anticipated costs will add to the remaining. Recurring cost will make 25% and components replacements 75% of future anticipated costs. It was discovered that the power generated from the solar photovoltaic system would be 38 times more expensive than electricity produced from the conventional sources. However, its installation in remote areas could be favourable where the grid-connected power supply is not accessible. (author)

Cheaper fuel and higher health costs among the poor in rural Nepal

Energy Technology Data Exchange (ETDEWEB)

Pant, Krishna Prasad [Ministry of Agriculture and Cooperatives, Vidhya Lane, Devnagar, Kathmandu (Nepal)], email: kppant@yahoo.com

2012-03-15

Biomass fuels are used by the majority of resource poor households in low-income countries. Though biomass fuels, such as dung-briquette and firewood are apparently cheaper than the modern fuels indoor pollution from burning biomass fuels incurs high health costs. But, the health costs of these conventional fuels, mostly being indirect, are poorly understood. To address this gap, this study develops probit regression models using survey data generated through interviews from households using either dung-briquette or biogas as the primary source of fuel for cooking. The study investigates factors affecting the use of dung-briquette, assesses its impact on human health, and estimates the associated household health costs. Analysis suggests significant effects of dung-briquette on asthma and eye diseases. Despite of the perception of it being a cheap fuel, the annual health cost per household due to burning dung-briquette (US$ 16.94) is 61.3% higher than the annual cost of biogas (US$ 10.38), an alternative cleaner fuel for rural households. For reducing the use of dung-briquette and its indirect health costs, the study recommends three interventions: (1) educate women and aboriginal people, in particular, and make them aware of the benefits of switching to biogas; (2) facilitate tree planting in communal as well as private lands; and (3) create rural employment and income generation opportunities.

Medicaid care management: description of high-cost addictions treatment clients.

Science.gov (United States)

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.

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

Energy Technology Data Exchange (ETDEWEB)

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

2017-04-26

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

Cost analysis of in-patient cancer chemotherapy at a tertiary care hospital.

Science.gov (United States)

Wani, Mohammad Ashraf; Tabish, S A; Jan, Farooq A; Khan, Nazir A; Wafai, Z A; Pandita, K K

2013-01-01

Cancer remains a major health problem in all communities worldwide. Rising healthcare costs associated with treating advanced cancers present a significant economic challenge. It is a need of the hour that the health sector should devise cost-effective measures to be put in place for better affordability of treatments. To achieve this objective, information generation through indigenous hospital data on unit cost of in-patient cancer chemotherapy in medical oncology became imperative and thus hallmark of this study. The present prospective hospital based study was conducted in Medical Oncology Department of tertiary care teaching hospital. After permission from the Ethical Committee, a prospective study of 6 months duration was carried out to study the cost of treatment provided to in-patients in Medical Oncology. Direct costs that include the cost of material, labor and laboratory investigations, along with indirect costs were calculated, and data analyzed to compute unit cost of treatment. The major cost components of in-patient cancer chemotherapy are cost of drugs and materials as 46.88% and labor as 48.45%. The average unit cost per patient per bed day for in-patient chemotherapy is Rs. 5725.12 ($125.96). This includes expenditure incurred both by the hospital and the patient (out of pocket). The economic burden of cancer treatment is quite high both for the patient and the healthcare provider. Modalities in the form of health insurance coverage need to be established and strengthened for pooling of resources for the treatment and transfer of risks of these patients.

Fee-Free Public or Low-Fee Private Basic Education in Rural Ghana: How Does the Cost Influence the Choice of the Poor?

Science.gov (United States)

Akaguri, Luke

2014-01-01

The paper uses data from a household survey of three rural communities and interviews in the Mfantseman Municipality in the Central Region of Ghana to investigate the costs incurred by households that choose either fee-free public schools or low-fee private schools. The paper shows that both provisions impose costs that place those with lower…

Energetic costs of performance in trained and untrained Anolis carolinensis lizards.

Science.gov (United States)

Lailvaux, Simon P; Wang, Andrew Z; Husak, Jerry F

2018-03-12

The energetic costs of performance constitute a non-trivial component of animals' daily energetic budgets. However, we currently lack an understanding of how those costs are partitioned among the various stages of performance development, maintenance, and production. We manipulated individual investment in performance by training Anolis carolinensis lizards for endurance or sprinting ability. We then measured energetic expenditure both at rest and immediately following exercise to test whether such training alters the maintenance and production costs of performance. Trained lizards had lower resting metabolic rates than controls, suggestive of a maintenance saving associated with enhanced performance as opposed to a cost. Production costs also differed, with sprint-trained lizards incurring the largest energetic performance cost and experiencing the longest recovery times compared to endurance trained and control animals. Although performance training modifies metabolism, production costs are probably the key drivers of trade-offs between performance and other life-history traits in this species. © 2018. Published by The Company of Biologists Ltd.

How do high cost-sharing policies for physician care affect total care costs among people with chronic disease?

Science.gov (United States)

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.

“Just-in-Time” Unmediated Document Delivery Service Provides Fast Delivery, Helps Identify Collection Gaps, but Incurs Extra Costs

Directory of Open Access Journals (Sweden)

Heather MacDonald

2017-06-01

Full Text Available A Review of: Chan, E. K., Mune, C., Wang, Y., & Kendall, S. L. (2016. Three years of unmediated document delivery: An analysis and consideration of collection development priorities. Medical Reference Services Quarterly, 35(1, 42-51. Retrieved from: http://dx.doi.org/10.1080/02763869.2016.1117288 Abstract Objective – Examine the collection development opportunities and challenges of an unmediated document delivery service. Design – Case study. Setting – Large comprehensive public university in the United States of America. Subjects – 11,981 document delivery requests. Methods – This library implemented Copyright Clearance Center’s Get It Now (CCC-GiN service in November 2011 to supplement existing holdings, provide access to embargoed content and help support two new programs. The CCC-GiN service was offered in addition to regular ILL service. Statistical analysis was done using usage data collected for the academic years 2012-2013, 2013-2014, and 2014-2015 (excluding June and July. Usage data included: order date and time, fulfillment date and time, publication name, publication date, article name, article author, publisher name, cost, delivery e-mail address. Taylor and Francis publications were added to the CCC-GiN service in November of 2014. Main Results – The average yearly cost of titles with the largest number of CCC-GiN requests was compared to the annual subscription cost of the same titles. If the annual subscription cost was less than the average yearly cost of CCC-GiN requests, the library purchased a subscription. Patrons ordered older journal content through CCC-GiN requests. This suggested that backfile subscriptions could be cost effective means of providing content. The authors are in the process of analyzing what historical journal content should be purchased. The addition of Taylor and Francis publications resulted in an increase in the average cost per article. Taylor and Francis publications were popular with

Low-cost high-quality crystalline germanium based flexible devices

KAUST Repository

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%.

Low-cost high-quality crystalline germanium based flexible devices

KAUST Repository

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%.

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.)

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.)

Quantification and Classification of E. coli Proteome Utilization and Unused Protein Costs across Environments

DEFF Research Database (Denmark)

O'Brien, Edward J.; Utrilla, Jose; Palsson, Bernhard

2016-01-01

The costs and benefits of protein expression are balanced through evolution. Expression of un-utilized protein (that have no benefits in the current environment) incurs a quantifiable fitness costs on cellular growth rates; however, the magnitude and variability of un-utilized protein expression...... in varying environments. Thus, unused protein expression is the source of large and pervasive fitness costs that may provide the benefit of hedging against environmental change....... in natural settings is unknown, largely due to the challenge in determining environment-specific proteome utilization. We address this challenge using absolute and global proteomics data combined with a recently developed genome-scale model of Escherichia coli that computes the environment-specific cost...

Cost-benefit of infection control interventions targeting methicillin-resistant Staphylococcus aureus in hospitals: systematic review.

Science.gov (United States)

Farbman, L; Avni, T; Rubinovitch, B; Leibovici, L; Paul, M

2013-12-01

Infections caused by methicillin-resistant Staphylococcus aureus (MRSA) incur significant costs. We aimed to examine the cost and cost-benefit of infection control interventions against MRSA and to examine factors affecting economic estimates. We performed a systematic review of studies assessing infection control interventions aimed at preventing spread of MRSA in hospitals and reporting intervention costs, savings, cost-benefit or cost-effectiveness. We searched PubMed and references of included studies with no language restrictions up to January 2012. We used the Quality of Health Economic Studies tool to assess study quality. We report cost and savings per month in 2011 US$. We calculated the median save/cost ratio and the save-cost difference with interquartile range (IQR) range. We examined the effects of MRSA endemicity, intervention duration and hospital size on results. Thirty-six studies published between 1987 and 2011 fulfilled inclusion criteria. Fifteen of the 18 studies reporting both costs and savings reported a save/cost ratio >1. The median save/cost ratio across all 18 studies was 7.16 (IQR 1.37-16). The median cost across all studies reporting intervention costs (n = 31) was 8648 (IQR 2025-19 170) US$ per month; median savings were 38 751 (IQR 14 206-75 842) US$ per month (23 studies). Higher save/cost ratios were observed in the intermediate to high endemicity setting compared with the low endemicity setting, in hospitals with 6 months. Infection control intervention to reduce spread of MRSA in acute-care hospitals showed a favourable cost/benefit ratio. This was true also for high MRSA endemicity settings. Unresolved economic issues include rapid screening using molecular techniques and universal versus targeted screening. © 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.

Costs of stroke and stroke services: Determinants of patient costs and a comparison of costs of regular care and care organised in stroke services

Directory of Open Access Journals (Sweden)

Koopmanschap Marc A

2003-02-01

Full Text Available Abstract Background Stroke is a major cause of death and long-term disability in Western societies and constitutes a major claim on health care budgets. Organising stroke care in a stroke service has recently been demonstrated to result in better health effects for patients. This paper discusses patient costs after stroke and compares costs between regular and stroke service care. Methods Costs were calculated within the framework of the evaluation of three experiments with stroke services in the Netherlands. Cost calculations are base on medical consumption data and actual costs. Results 598 patients were consecutively admitted to hospital after stroke. The average total costs of care per patient for the 6 month follow-up are estimated at €16,000. Costs are dominated by institutional and accommodation costs. Patients who die after stroke incur less costs. For patients that survive the acute phase, the most important determinants of costs are disability status and having a partner – as they influence patients' stroke careers. These determinants also interact. The most efficient stroke service experiment was most successful in co-ordinating patient flow from hospital to (nursing home, through capacity planning and efficient discharge procedures. In this region the costs of stroke service care are the same as for regular stroke care. The other experiments suffered from waiting lists for nursing homes and home care, leading to "blocked beds" in hospitals and nursing homes and higher costs of care. Costs of co-ordination are estimated at about 3% of total costs of care. Conclusion This paper demonstrates that by organising care for stroke patients in a stroke service, better health effects can be achieved with the same budget. In addition, it provides insight in need, predisposing and enabling factors that determine costs of care after stroke.

An integrated model for estimating energy cost of a tidal current turbine farm

International Nuclear Information System (INIS)

Li, Ye; Lence, Barbara J.; Calisal, Sander M.

2011-01-01

A tidal current turbine is a device for harnessing energy from tidal currents and functions in a manner similar to a wind turbine. A tidal current turbine farm consists of a group of tidal current turbines distributed in a site where high-speed current is available. The accurate prediction of energy cost of a tidal current turbine farm is important to the justification of planning and constructing such a farm. However, the existing approaches used to predict energy cost of tidal current turbine farms oversimplify the hydrodynamic interactions between turbines in energy prediction and oversimplify the operation and maintenance strategies involved in cost estimation as well as related fees. In this paper, we develop a model, which integrates a marine hydrodynamic model with high accuracy for predicting energy output and a comprehensive cost-effective operation and maintenance model for estimating the cost that may be incurred in producing the energy, to predict energy cost from a tidal current turbine farm. This model is expected to be able to simulate more complicated cases and generate more accurate results than existing models. As there is no real tidal current turbine farm, we validate this model with offshore wind studies. Finally, case studies about Vancouver are conducted with a scenario-based analysis. We minimize the energy cost by minimizing the total cost and maximizing the total power output under constraints related to the local conditions (e.g., geological and labor information) and the turbine specifications. The results suggest that tidal current energy is about ready to penetrate the electricity market in some major cities in North America if learning curve for the operational and maintenance is minimum. (author)

The Optimization of Transportation Costs in Logistics Enterprises with Time-Window Constraints

Directory of Open Access Journals (Sweden)

Qingyou Yan

2015-01-01

Full Text Available This paper presents a model for solving a multiobjective vehicle routing problem with soft time-window constraints that specify the earliest and latest arrival times of customers. If a customer is serviced before the earliest specified arrival time, extra inventory costs are incurred. If the customer is serviced after the latest arrival time, penalty costs must be paid. Both the total transportation cost and the required fleet size are minimized in this model, which also accounts for the given capacity limitations of each vehicle. The total transportation cost consists of direct transportation costs, extra inventory costs, and penalty costs. This multiobjective optimization is solved by using a modified genetic algorithm approach. The output of the algorithm is a set of optimal solutions that represent the trade-off between total transportation cost and the fleet size required to service customers. The influential impact of these two factors is analyzed through the use of a case study.

Security cost allocation under combined bilateral-pool market dispatch

International Nuclear Information System (INIS)

Abdullah, M.P.; Hassan, M.Y.; Hussin, F.

2008-01-01

Most electricity markets around the world are a combination of bilateral and pool markets, such as NordPool and NYPOOL. In these models, market participants bid into the pool and also make bilateral contracts with each other. This paper addressed the issue of congestion management and security cost allocation in a power pool market model. The basic idea of security cost allocation is to divide the incurred security cost due to congestion relief into pool and bilateral market based on their flow contribution to the congested line. A newly proposed security cost allocation strategy of the combined bilateral-pool market was also presented along with case studies using IEEE-14 bus system that tested the proposed method. Using the proposed method, it was shown that security costs are allocated to market participants at different prices which reflect the load contribution to the security problem. This solves the problem of the uniform security cost allocation in a pure pool market system having uniform pricing, and provides a proper security signal to market participants. 11 refs., 3 tabs., 4 figs

Palliative patients’ and significant others’ experiences of transitions concerning organizational, psychosocial and existential issues during the course of incurable cancer: A systematic review protocol

DEFF Research Database (Denmark)

Madsen, Rikke; Uhrenfeldt, Lisbeth

2014-01-01

ABSTRACT Review question/objective The objective of this review is to identify, appraise and synthesize the best available evidence exploring palliative patients’ or their significant others’ experiences of transitions during the course of incurable cancer. In this review, transitions are concept...... exploring euthanasia will be excluded because euthanasia is not included in the WHO definition of palliation. KEYWORDS Lived experience; incurable cancer; patient; significant other; transition; organizational; psychosocial; existential...

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.

What Are the Costs of Trauma Center Readiness? Defining and Standardizing Readiness Costs for Trauma Centers Statewide.

Science.gov (United States)

Ashley, Dennis W; Mullins, Robert F; Dente, Christopher J; Garlow, Laura; Medeiros, Regina S; Atkins, Elizabeth V; Solomon, Gina; Abston, Dena; Ferdinand, Colville H

2017-09-01

Trauma center readiness costs are incurred to maintain essential infrastructure and capacity to provide emergent services on a 24/7 basis. These costs are not captured by traditional hospital cost accounting, and no national consensus exists on appropriate definitions for each cost. Therefore, in 2010, stakeholders from all Level I and II trauma centers developed a survey tool standardizing and defining trauma center readiness costs. The survey tool underwent minor revisions to provide further clarity, and the survey was repeated in 2013. The purpose of this study was to provide a follow-up analysis of readiness costs for Georgia's Level I and Level II trauma centers. Using the American College of Surgeons Resources for Optimal Care of the Injured Patient guidelines, four readiness cost categories were identified: Administrative, Clinical Medical Staff, Operating Room, and Education/Outreach. Through conference calls, webinars and face-to-face meetings with financial officers, trauma medical directors, and program managers from all trauma centers, standardized definitions for reporting readiness costs within each category were developed. This resulted in a survey tool for centers to report their individual readiness costs for one year. The total readiness cost for all Level I trauma centers was $34,105,318 (avg $6,821,064) and all Level II trauma centers was $20,998,019 (avg $2,333,113). Methodology to standardize and define readiness costs for all trauma centers within the state was developed. Average costs for Level I and Level II trauma centers were identified. This model may be used to help other states define and standardize their trauma readiness costs.

High-Efficient Low-Cost Photovoltaics Recent Developments

CERN Document Server

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.

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.

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

Science.gov (United States)

Gafurov, Andrey; Skotarenko, Oksana; Plotnikov, Vladimir

2018-03-01

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

Work-life balance: history, costs, and budgeting for balance.

Science.gov (United States)

Raja, Siva; Stein, Sharon L

2014-06-01

The concept and difficulties of work-life balance are not unique to surgeons, but professional responsibilities make maintaining a work-life balance difficult. Consequences of being exclusively career focused include burn out, physical, and mental ailments. In addition, physician burn out may hinder optimal patient care and incur significant costs on health care in general. Assessing current uses of time, allocating goals catered to an individual surgeon, and continual self-assessment may help balance time, and ideally will help prevent burn out.

An adverse events potential costs analysis based on Drug Programs in Poland. Dermatology focus

Directory of Open Access Journals (Sweden)

Szkultecka-Debek Monika

2014-09-01