Garibin, Pavel; Ol'khovik, Evgeniy; Rastorguev, Igor
The task of technical and economic regulation within mutual international recognition of testing laboratories are considered. Codes and procedures within requirements of international ISO/IEC standards of a series 17000 for elimination of non-tariff barriers and interlaboratory exchange of experts in the field of high-rise marine construction are considered. In paper, the methods of assessment of formation of economically justified cost of works at inspection and monitoring of technical condition of high-rise marine wharf engineering port structure based on settlement and actual labor input were applied. For the countries of EU, data on the average cost of works of testing laboratory within a week have been taken as a basis. Such approach will be objective as considers only expenses on obligatory actions in the course of inspection of technical condition of port engineering constructions. The analysis of public results of financial activities of the accredited organizations allowed to calculate the main indicators of the size of necessary profit and overheads at observance of all requirements imposed to test laboratories including taking into account their future technical development. The offered practice corresponds to the general direction by mutual international recognition of independent testing laboratories and can be use in the future.
At a recent symposium, the economic costs of nuclear power were examined in four lectures which considered; (1) The performance of different types, size and ages of nuclear power plants. (2) The comparison between coal and nuclear power costs based on the principle of net effective cash. (3) The capital requirements of a nuclear programme. (4) The comparative costs, now and in the future, of coal-fired and nuclear plants. It is concluded that uncertainties seem to get greater rather than smaller with time probably due to the high and fluctuating world inflation rates and the great uncertainty about world economic performance introduced by the politicising of world oil supplies. (UK)
da Fonseca, Elize Massard; Costa, Nilson do Rosario
Brazil has a relevant, although relatively unknown, special medicines programme that distributes high-cost products, such as drugs needed for cancer treatments. In 2009, the purchase of these medicines became the responsibility of the Brazilian Federal Government. Until then, there were no clear norms regarding the responsibilities, in terms of the management/financing of these medicines, of the Brazilian Federal Government and of the states themselves. This qualitative study analyses the policy process needed to transfer this programme to the central government. The study examines the reports of the Tripartite Commission between 2000 and 2012, and in-depth interviews with eleven key informants were conducted. The study demonstrates that throughout the last decade, institutional changes have been made in regard to the federal management of these programmes (such as recentralisation of the purchasing of medicines). It concludes that these changes can be explained because of the efficiency of the coordinating mechanisms of the Federal Government. These findings reinforce the idea that the Ministry of Health is the main driver of public health policies, and it has opted for the recentralisation of activities as a result of the development project implicit in the agenda of the Industrial and Economic Heal.
Frappier, Julie; Tremblay, Gabriel; Charny, Mark; Cloutier, L Martin
Determining the cost-effectiveness of healthcare interventions is key to the decision-making process in healthcare. Cost comparisons are used to demonstrate the economic value of treatment options, to evaluate the impact on the insurer budget, and are often used as a key criterion in treatment comparison and comparative effectiveness; however, little guidance is available to researchers for establishing the costing of clinical events and resource utilization. Different costing methods exist, and the choice of underlying assumptions appears to have a significant impact on the results of the costing analysis. This editorial describes the importance of the choice of the costing technique and it's potential impact on the relative cost of treatment options. This editorial also calls for a more efficient approach to healthcare intervention costing in order to ensure the use of consistent costing in the decision-making process.
Swart, Eric; Vasudeva, Eshan; Makhni, Eric C; Macaulay, William; Bozic, Kevin J
a full-time basis. Additionally, we evaluated the scenario where the necessary staff was already employed at the hospital and could be dedicated to a comanagement service on a part-time basis, and explored the effect of triaging only patients considered high risk to a comanagement service versus comanaging all geriatric patients. Finally, probabilistic sensitivity analysis was conducted on all critical variables, with broad ranges used for values around which there was higher uncertainty. For the base case, universal comanagement was more cost effective than traditional care and risk-stratified comanagement (incremental cost effectiveness ratios of USD 41,100 per quality-adjusted life-year and USD 81,900 per quality-adjusted life-year, respectively). Comanagement was more cost effective than traditional management as long as the case volume was more than 54 patients annually (range, 41-68 patients based on sensitivity analysis) and resulted in cost savings when there were more than 318 patients annually (range, 238-397 patients). In a scenario where staff could be partially dedicated to a comanagement service, universal comanagement was more cost effective than risk-stratified comanagement (incremental cost effectiveness of USD 2300 per quality-adjusted life-year), and both comanagement programs had lower costs and better outcomes compared with traditional management. Sensitivity analysis was conducted and showed that the level of uncertainty in key variables was not high enough to change the core conclusions of the model. Implementation of a systems-based comanagement strategy using a dedicated team to improve perioperative medical care and expedite preoperative evaluation is cost effective in hospitals with moderate volume and can result in cost savings at higher-volume centers. The optimum patient population for a comanagement strategy is still being defined. Level 1, Economic and Decision Analysis.
Jifeng Zhang; Jean Yamanis
Solid oxide fuel cell (SOFC) systems have the potential to generate exhaust gas streams of high temperature, ranging from 400 to 800 C. These high temperature gas streams can be used for additional power generation with bottoming cycle technologies to achieve higher system power efficiency. One of the potential candidate bottoming cycles is power generation by means of thermoelectric (TE) devices, which have the inherent advantages of low noise, low maintenance and long life. This study was to analyze the feasibility of combining coal gas based SOFC and TE through system performance and cost techno-economic modeling in the context of multi-MW power plants, with 200 kW SOFC-TE module as building blocks. System and component concepts were generated for combining SOFC and TE covering electro-thermo-chemical system integration, power conditioning system (PCS) and component designs. SOFC cost and performance models previously developed at United Technologies Research Center were modified and used in overall system analysis. The TE model was validated and provided by BSST. The optimum system in terms of energy conversion efficiency was found to be a pressurized SOFC-TE, with system efficiency of 65.3% and cost of $390/kW of manufacturing cost. The pressurization ratio was approximately 4 and the assumed ZT of the TE was 2.5. System and component specifications were generated based on the modeling study. The major technology and cost barriers for maturing the system include pressurized SOFC stack using coal gas, the high temperature recycle blowers, and system control design. Finally, a 4-step development roadmap is proposed for future technology development, the first step being a 1 kW proof-of-concept demonstration unit.
Couch, N P; Tilney, N L; Rayner, A A; Moore, F D
We conducted a one-year prospective survey to identify adverse outcomes due to error during care in the field of general surgery. We identified 36 such cases among 5612 surgical admissions to the Peter Bent Brigham Hospital, but in 23 cases the initiating mishap had occurred in another hospital before transfer. In two thirds of the cases the mishap was due to an error of commission: an unnecessary, defective or inappropriate operative procedure. Twenty of these patients died in the hospital, and in 11 death was directly attributable to the error. Five of the 16 survivors left the hospital with serious physical impairment. A satisfactory outcome was achieved in only 11 cases (31%). The average hospital stay was 42 days, with the duration ranging from one to 325 days; the total cost for the 36 patients was $1,732,432. We suggest that all hospitals develop comprehensive methods to identify and prevent these costly and unnecessary events.
Jahnke, F.C.; Falsetti, J.S.; Wilson, R.F.
The disposition of petroleum coke remains a problem for modern high conversion refineries. Market uncertainty and the price for coke can prevent the implementation of otherwise attractive projects. The commercially proven Texaco Gasification Process remains an excellent option for clean, cost effective coke disposition as demonstrated by the new coke gasification units coming on-line and under design. Previous papers, have discussed the coke market and general economics of coke gasification. This paper updates the current market situation and economics, and provide more details on cost and performance based on recent studies for commercial plants
Stabile, Mark; Allin, Sara
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
Bosker, E.M.; Garretsen, J.H.
Trade costs are a crucial element of New Economic Geography (NEG) models. Without trade costs there is no role for geography. In empirical NEG studies the unavailability of direct trade cost data calls for the need to approximate these trade costs by introducing a trade cost function. In doing so,
Meyers, B.L.; Braun, C.
Addressing work practices and cost-effectiveness at high-cost or average US nuclear units will improve the economics of the entire industry. Improvements can be made through benchmarking, better planning, close accounting and empowerment of employees. (Author)
The solar economics based on life cycle costs are refuted as both imaginary and irrelevant. It is argued that predicting rates of inflation and fuel escalation, expected life, maintenance costs, and legislation over the next ten to twenty years is pure guesswork. Furthermore, given the high mobility level of the U.S. population, the average consumer is skeptical of long run arguments which will pay returns only to the next owners. In the short term cost analysis, the house is sold prior to the end of the expected life of the system. The cash flow of the seller and buyer are considered. All the relevant factors, including the federal tax credit and the added value of the house because of the solar system are included.
Halasa, Yara A.; Shepard, Donald S.; Zeng, Wu
Dengue, endemic in Puerto Rico, reached a record high in 2010. To inform policy makers, we derived annual economic cost. We assessed direct and indirect costs of hospitalized and ambulatory dengue illness in 2010 dollars through surveillance data and interviews with 100 laboratory-confirmed dengue patients treated in 2008–2010. We corrected for underreporting by using setting-specific expansion factors. Work absenteeism because of a dengue episode exceeded the absenteeism for an episode of influenza or acute otitis media. From 2002 to 2010, the aggregate annual cost of dengue illness averaged $38.7 million, of which 70% was for adults (age 15+ years). Hospitalized patients accounted for 63% of the cost of dengue illness, and fatal cases represented an additional 17%. Households funded 48% of dengue illness cost, the government funded 24%, insurance funded 22%, and employers funded 7%. Including dengue surveillance and vector control activities, the overall annual cost of dengue was $46.45 million ($12.47 per capita). PMID:22556069
Watts, Michael; McCorkle, Sarapage; Meszaros, Bonnie; Smith, Robert F.; Highsmith, Robert J.
This book opens with an exploration of the fundamental trilogy of economics - scarcity, choice, and cost. Students then examine the broad social goals of an economy in preparation for lessons treating many topics new to the precollege level such as the stock market, public choice, and aggregate supply and demand. The set of 20 lessons include: (1)…
Corbeij, M.H.; Jansen, R.A.; Grübström, R.W.; Hinterhuber, H.H.; Lundquist, J.
In many accounting textbooks it is strongly argued that decisions should always be evaluated on relevant costs; that is variable costs and opportunity costs. Surprisingly, when it comes to Economic Order Quantities or Lot Sizes, some textbooks appear to be less straightforward. The question whether
Yang, Bijou; Lester, David
These authors argue that estimates of the net economic cost of suicide should go beyond accounting for direct medical costs and indirect costs from loss of earnings by those who commit suicide. There are potential savings from (a) not having to treat the depressive and other psychiatric disorders of those who kill themselves; (b) avoidance of…
Stabile, Mark; Allin, Sara
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…
The Idaho Transportation Departments Office of Highway Safety contracted with Cambridge Systematics (CS) for an assessment of the feasibility of calculating the Idaho-specific economic and comprehensive costs associated with vehicle crashes. Resea...
Maheswaran, Hendramoorthy; Petrou, Stavros; Cohen, Danielle; MacPherson, Peter; Kumwenda, Felistas; Lalloo, David G; Corbett, Elizabeth L; Clarke, Aileen
Although HIV infection and its associated co-morbidities remain the commonest reason for hospitalisation in Africa, their impact on economic costs and health-related quality of life (HRQoL) are not well understood. This information is essential for decision-makers to make informed choices about how to best scale-up anti-retroviral treatment (ART) programmes. This study aimed to quantify the impact of HIV infection and ART on economic outcomes in a prospective cohort of hospitalised patients with high HIV prevalence. Sequential medical admissions to Queen Elizabeth Central Hospital, Malawi, between June-December 2014 were followed until discharge, with standardised classification of medical diagnosis and estimation of healthcare resources used. Primary costing studies estimated total health provider cost by medical diagnosis. Participants were interviewed to establish direct non-medical and indirect costs. Costs were adjusted to 2014 US$ and INT$. HRQoL was measured using the EuroQol EQ-5D. Multivariable analyses estimated predictors of economic outcomes. Of 892 eligible participants, 80.4% (647/892) were recruited and medical notes found. In total, 447/647 (69.1%) participants were HIV-positive, 339/447 (75.8%) were on ART prior to admission, and 134/647 (20.7%) died in hospital. Mean duration of admission for HIV-positive participants not on ART and HIV-positive participants on ART was 15.0 days (95%CI: 12.0-18.0) and 12.2 days (95%CI: 10.8-13.7) respectively, compared to 10.8 days (95%CI: 8.8-12.8) for HIV-negative participants. Mean total provider cost per hospital admission was US$74.78 (bootstrap 95%CI: US$25.41-US$124.15) higher for HIV-positive than HIV-negative participants. Amongst HIV-positive participants, the mean total provider cost was US$106.87 (bootstrap 95%CI: US$25.09-US$106.87) lower for those on ART than for those not on ART. The mean total direct non-medical and indirect cost per hospital admission was US$87.84. EQ-5D utility scores were lower
Horton, E.P.; Sepa, T.R.
The CANDU-Pressurized Heavy Water (CANDU-PHW) type of nuclear generating station has been developed jointly by Atomic Energy of Canada Limited and Ontario Hydro. This report discusses the cost management principles used for Ontario Hydro's CANDU-PHW program, current cost management initiatives, and the economic benefits of nuclear power to the provinces of Ontario and New Brunswick, in Canada
Beeldman, M.; Solinski, J.
This study presents a methodology for the calculation of the economic costs of the production of electricity. This methodology is applied to assess electricity production cost in Poland by type of power station for the years 1995 and 2000. In addition, an overview is presented of the methods used by the OECD countries, particularly in the Netherlands. The main conclusions of the study are: 1) the real economic costs to generate electricity in Poland are about two times higher compared with the traditional book-keeping data; 2) the investment costs will become the most important cost component in the near future; and 3) there are considerables differences in production cost per kWh for the different types of power plants in Poland. 4 appendices, 14 refs
Filipovic-Pierucci, Antoine; Durand-Zaleski, Isabelle; Butel, Thibault; Greene, Samantha; Hovasse, Thomas; Iñiguez, Andres; Nazzaro, Marco Stefano; Oldroyd, Keith G; Talwar, Suneel; Richardt, Gert; Windhovel, Ute; Urban, Philip; Morice, Marie-Claude
In patients at high risk of bleeding who undergo PCI the biolimus A9 polymer-free drug coated stent (DCS) has superior efficacy and safety compared to a bare metal stent (BMS). We estimated the cost effectiveness of DCS vs. BMS. The Leaders FREE-based economic evaluation estimated service use and quality of life data collected prospectively. The entire trial population was analysed using cost-weights from England, France, Germany, Italy, Scotland and Spain. Country-specific QALYs were derived from EQ-5D scores. We estimated cost per event averted and per QALY gained. DCS use resulted in -0.095 cardiac deaths, target vessel MI, stent thrombosis and revascularization per patient (0.152 vs. 0.237;pcosts for the index admission were similar between groups. One-year costs using cost-weights from each of the 6 countries, including the additional €300 per DCS stent, ranged from €4,664-8,593 for DCS and €4,845-9,742 for BMS and were lower in the DCS group (England:€-428, France:€-137, Germany:€-33, Italy:€-522, Scotland:€-298, Spain:€-854). The probability that DCS dominated BMS was >50% in all countries. At a threshold of €10,000 per event averted DCS had a 98% probability of being cost-effective in all 6 countries.
Moomaw, William R; Birch, Melissa B L
The chemical nitrogen cycle is becoming better characterized in terms of fluxes and reservoirs on a variety of scales. Galloway has demonstrated that reactive nitrogen can cascade through multiple ecosystems causing environmental damage at each stage before being denitrified to N(2). We propose to construct a parallel economic nitrogen cascade (ENC) in which economic impacts of nitrogen fluxes can be estimated by the costs associated with each stage of the chemical cascade. Using economic data for the benefits of damage avoided and costs of mitigation in the Chesapeake Bay basin, we have constructed an economic nitrogen cascade for the region. Since a single ton of nitrogen can cascade through the system, the costs also cascade. Therefore evaluating the benefits of mitigating a ton of reactive nitrogen released needs to consider the damage avoided in all of the ecosystems through which that ton would cascade. The analysis reveals that it is most cost effective to remove a ton of nitrogen coming from combustion since it has the greatest impact on human health and creates cascading damage through the atmospheric, terrestrial, aquatic and coastal ecosystems. We will discuss the implications of this analysis for determining the most cost effective policy option for achieving environmental quality goals.
Rumberger, Russell W.; Losen, Daniel J.
This California study focuses on the economic impact of school suspensions at the district level. Every 10th grade student in California was tracked for three years to determine the degree to which suspensions predicted lower graduation rates at the state and district level. This estimated impact on graduation was then used to calculate the…
This was an prospective audit composed of medical chart review and patient questionnaire. Relapses were stratified into 3 groups: low, moderate and high intensity. Age, gender, MS subtype, disease duration, expanded disability status scale (EDSS) score, disease modifying therapy (DMT) use and employment status were recorded. Direct costs included GP visits, investigations, clinic visit, consultations with medical staff, medication and admission costs. Indirect costs assessed loss of earnings, partner\\'s loss of earnings, childcare, meals and travel costs.
Abdulkarim K Alhowaish
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
... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Economic planning costs... GENERAL CONTRACTING REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations 31.205-12 Economic planning costs. Economic planning costs are the costs of general long-range...
Warnock, J.G.; Merrett, A.J.
The need for levelization has been widely recognized as desirable on grounds of equity. This paper points that it is also essential to the validity of the long-term present value criterion for capital investment. Yet the advocated methods of levelization are generally unacceptable or inefficient. These methods could be made more efficient - for example by the interest differential guarantee proposal outlined above. Until such time as effective and efficient levelization measures are implemented it has to be recognized that under present day inflationary conditions the conventional criteria of long-term present value may well be devoid of any economic validity. These issues can be of very significant importance in judging those energy options for future electrical generator modes.
Arponen, Anni; Cabeza, Mar; Eklund, Johanna; Kujala, Heini; Lehtomäki, Joona
Recent literature on systematic conservation planning has focused strongly on economics. It is a necessary component of efficient conservation planning because the question is about effective resource allocation. Nevertheless, there is an increasing tendency toward economic factors overriding biological considerations. Focusing too narrowly on economic cost may lead us back toward solutions resembling those obtained by opportunistic choice of areas, the avoidance of which was the motivation for development of systematic approaches. Moreover, there are many overlooked difficulties in incorporating economic considerations reliably into conservation planning because available economic data and the free market are complex. For instance, economies based on free markets tend to be shortsighted, whereas biodiversity conservation aims far into the future. Although economic data are necessary, they should not be relied on too heavily or considered separately from other sociopolitical factors. We suggest focusing on development of more-comprehensive ecological-economic modeling, while not forgetting the importance of purely biological analyses that are needed as a point of reference for evaluating conservation outcomes. © 2010 Society for Conservation Biology.
Goodchild, Mark; Nargis, Nigar; Tursan d'Espaignet, Edouard
The detrimental impact of smoking on health has been widely documented since the 1960s. Numerous studies have also quantified the economic cost that smoking imposes on society. However, these studies have mostly been in high income countries, with limited documentation from developing countries. The aim of this paper is to measure the economic cost of smoking-attributable diseases in countries throughout the world, including in low- and middle-income settings. The Cost of Illness approach is used to estimate the economic cost of smoking attributable-diseases in 2012. Under this approach, economic costs are defined as either 'direct costs' such as hospital fees or 'indirect costs' representing the productivity loss from morbidity and mortality. The same method was applied to 152 countries, which had all the necessary data, representing 97% of the world's smokers. The amount of healthcare expenditure due to smoking-attributable diseases totalled purchasing power parity (PPP) $467 billion (US$422 billion) in 2012, or 5.7% of global health expenditure. The total economic cost of smoking (from health expenditures and productivity losses together) totalled PPP $1852 billion (US$1436 billion) in 2012, equivalent in magnitude to 1.8% of the world's annual gross domestic product (GDP). Almost 40% of this cost occurred in developing countries, highlighting the substantial burden these countries suffer. Smoking imposes a heavy economic burden throughout the world, particularly in Europe and North America, where the tobacco epidemic is most advanced. These findings highlight the urgent need for countries to implement stronger tobacco control measures to address these costs. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Cabo-Meseguer, Asensi; Cerdá-Olmedo, Germán; Trillo-Mata, José Luis
Fibromyalgia is an idiopathic chronic condition that causes widespread musculoskeletal pain, hyperalgesia and allodynia. This review aims to approach the general epidemiology of fibromyalgia according to the most recent published studies, identifying the general worldwide prevalence of the disease, its basic epidemiological profiles and its economic costs, with specific interest in the Spanish and Comunidad Valenciana cases. Fibromyalgia affects, on average, 2.10% of the world's population; 2.31% of the European population; 2.40% of the Spanish population; and 3.69% of the population in the Comunidad Valenciana. It supposes a painful loss of the quality of life of the people who suffer it and the economic costs are enormous: in Spain is has been estimated at more than 12,993 million euros annually. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.
Mick, Stephen S Farnsworth; Shay, Patrick D
Using a Transaction Cost Economics (TCE) approach, this paper explores which organizational forms Accountable Care Organizations (ACOs) may take. A critical question about form is the amount of vertical integration that an ACO may have, a topic central to TCE. We posit that contextual factors outside and inside an ACO will produce variable transaction costs (the non-production costs of care) such that the decision to integrate vertically will derive from a comparison of these external versus internal costs, assuming reasonably rational management abilities. External costs include those arising from environmental uncertainty and complexity, small numbers bargaining, asset specificity, frequency of exchanges, and information "impactedness." Internal costs include those arising from human resource activities including hiring and staffing, training, evaluating (i.e., disciplining, appraising, or promoting), and otherwise administering programs. At the extreme, these different costs may produce either total vertical integration or little to no vertical integration with most ACOs falling in between. This essay demonstrates how TCE can be applied to the ACO organization form issue, explains TCE, considers ACO activity from the TCE perspective, and reflects on research directions that may inform TCE and facilitate ACO development. © The Author(s) 2016.
Full Text Available Abstract Medical imaging market consists of several billion tests per year worldwide. Out of these, at least one third are cardiovascular procedures. Keeping in mind that each test represents a cost, often a risk, and a diagnostic hypothesis, we can agree that every unnecessary and unjustifiable test is one test too many. Small individual costs, risks, and wastes multiplied by billions of examinations per year represent an important population, society and environmental burden. Unfortunately, the appropriateness of cardiac imaging is extra-ordinarily low and there is little awareness in patients and physicians of differential costs, radiological doses, and long term risks of different imaging modalities. For a resting cardiac imaging test, being the average cost (not charges of an echocardiogram equal to 1 (as a cost comparator, the cost of a CT is 3.1x, of a SPECT 3.27x, of a Cardiovascular Magnetic Resonance imaging 5.51x, of a PET 14.03x, and of a right and left heart catheterization 19.96x. For stress cardiac imaging, compared with the treadmill exercise test equal to 1 (as a cost comparator, the cost of stress echocardiography is 2.1x and of a stress SPECT scintigraphy is 5.7x. Biohazards and downstream long-term costs linked to radiation-induced oncogenesis should also be considered. The radiation exposure is absent in echo and magnetic resonance, and corresponds to 500 chest x rays for a sestamibi cardiac stress scan and to 1150 chest x rays for a thallium scan. The corresponding extra-risk in a lifetime of fatal cancer is 1 in 2000 exposed patients for a sestamibi stress and 1 in 1000 for a thallium scan. Increased awareness of economic, biologic, and environmental costs of cardiac imaging will hopefully lead to greater appropriateness, wisdom and prudence from both the prescriber and the practitioner. In this way, the sustainability of cardiac imaging will eventually improve.
... 47 Telecommunication 3 2010-10-01 2010-10-01 false Forward-looking economic cost. 51.505 Section... (CONTINUED) INTERCONNECTION Pricing of Elements § 51.505 Forward-looking economic cost. (a) In general. The forward-looking economic cost of an element equals the sum of: (1) The total element long-run incremental...
Full Text Available Background: Road traffic accidents, considered as global tragedies, are in increasing trend however, the safety situation is very severe in developing countries incurring substantial amount of human, economic and social costs. Motorcycle crashes, the commonest form, occur mostly on economically active population. However, there is limited coverage of studies on economic burden of motorcycle crashes. This study aims to estimate the total cost and DALYs lost due to motorbike accidents among victims of Kathmandu Valley.Materials and Methods: Retrospective cross-sectional study was conducted among the patients having history of motorbike accidents within past twelve months and at least 3 months from the date of data collection. Interview was conducted using proforma among 100 victims of accidents and their care giver in case of death from November 15, 2014 to May 15, 2015. Cost estimation of motorbike accident was done based on human capital approach. Data collection tool was pretested and collected data were analyzed by SPSS and Microsoft excel. Results: Males (79% belonging to the economically productive age group shared the highest proportion among total accidents victims. Most common reason for accidents was reported to be poor road condition (41%. Indirect cost was found to be significantly higher than direct costs highlighting its negative impact on economy of family and nation due to productivity loss. Total Disability Adjusted Life Years (DALYs lost per person was found to be 490 years and national estimation showed large burden of motorbike accidents due to huge DALY loss.Conclusions: For low resource countries like Nepal, high economic costs of motorbike accidents can pose additional burden to the fragile health system. These accidents can be prevented, and their consequences can be alleviated. There is an urgent need for reinforcement of appropriate interventions and legislation to decrease the magnitude of it and its associated grave
Kapur, V. K.
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.
The economic growth shows an ascending tendency of the economic evolution over a long period of time, having favorable social and economic effects. Each economic growth factor acts simultaneous trough three dimensions.
Garfinkel, Steven A.; Riley, Gerald F.; Iannacchione, Vincent G.
Based on data from the National Medical Care Utilization and Expenditure Survey, the 10 percent of the noninstitutionalized U.S. population that incurred the highest medical care charges was responsible for 75 percent of all incurred charges. Health status was the strongest predictor of high-cost use, followed by economic factors. Persons 65 years of age or over incurred far higher costs than younger persons and had higher out-of-pocket costs, absolutely and as a percentage of income, althoug...
Belanger, G.; Bernard, J.T.
Low cost electricity was a key factor for establishing an aluminium industry in Quebec. Smelters in the province use 50 terawatt hours of electricity per year, which represents 25 per cent of the total consumed in Quebec. This article assessed the profitability of new industrial projects that require large quantities of electricity at a time when the cost of new power plants is increasing. However, electricity is being sold below cost and the difference is subsidized by the government. The investment is justified by the government because these new projects create high paying jobs. The authors presented cases of 2 new aluminium plants, and concluded that they represented a very high economic cost for the province. 1 tab
Zhang, Juan; Chaaban, Jad
To estimate the total economic burden of physical inactivity in China. The costs of physical inactivity combine the medical and non-medical costs of five major Non Communicable Diseases (NCDs) associated with inactivity. The national data from the Chinese Behavioral Risk Factors Surveillance Surveys (2007) and the National Health Service Survey (2003) are used to compute population attributable risks (PARs) of inactivity for each major NCD. Costs specific to inactivity are obtained by multiplying each disease costs by the PAR for each NCD, by incorporating the inactivity effects through overweight and obesity. Physical inactivity contributes between 12% and 19% to the risks associated with the five major NCDs in China, namely coronary heart disease, stroke, hypertension, cancer, and type 2 diabetes. Physical inactivity is imposing a substantial economic burden on the country, as it is responsible alone for more than 15% of the medical and non-medical yearly costs of the main NCDs in the country. The high economic burden of physical inactivity implies the need to develop more programs and interventions that address this modifiable behavioral risk, in order to curb the rising NCDs epidemic in China. Copyright © 2012 Elsevier Inc. All rights reserved.
Sala, Enric; Mayorga, Juan; Costello, Christopher; Kroodsma, David; Palomares, Maria L D; Pauly, Daniel; Sumaila, U Rashid; Zeller, Dirk
While the ecological impacts of fishing the waters beyond national jurisdiction (the "high seas") have been widely studied, the economic rationale is more difficult to ascertain because of scarce data on the costs and revenues of the fleets that fish there. Newly compiled satellite data and machine learning now allow us to track individual fishing vessels on the high seas in near real time. These technological advances help us quantify high-seas fishing effort, costs, and benefits, and assess whether, where, and when high-seas fishing makes economic sense. We characterize the global high-seas fishing fleet and report the economic benefits of fishing the high seas globally, nationally, and at the scale of individual fleets. Our results suggest that fishing at the current scale is enabled by large government subsidies, without which as much as 54% of the present high-seas fishing grounds would be unprofitable at current fishing rates. The patterns of fishing profitability vary widely between countries, types of fishing, and distance to port. Deep-sea bottom trawling often produces net economic benefits only thanks to subsidies, and much fishing by the world's largest fishing fleets would largely be unprofitable without subsidies and low labor costs. These results support recent calls for subsidy and fishery management reforms on the high seas.
Vassall, Anna; Pickles, Michael; Chandrashekar, Sudhashree; Boily, Marie-Claude; Shetty, Govindraj; Guinness, Lorna; Lowndes, Catherine M; Bradley, Janet; Moses, Stephen; Alary, Michel; Vickerman, Peter
Avahan is a large-scale, HIV preventive intervention, targeting high-risk populations in south India. We assessed the cost-effectiveness of Avahan to inform global and national funding institutions who are considering investing in worldwide HIV prevention in concentrated epidemics. We estimated cost effectiveness from a programme perspective in 22 districts in four high-prevalence states. We used the UNAIDS Costing Guidelines for HIV Prevention Strategies as the basis for our costing method, and calculated effect estimates using a dynamic transmission model of HIV and sexually transmitted disease transmission that was parameterised and fitted to locally observed behavioural and prevalence trends. We calculated incremental cost-effective ratios (ICERs), comparing the incremental cost of Avahan per disability-adjusted life-year (DALY) averted versus a no-Avahan counterfactual scenario. We also estimated incremental cost per HIV infection averted and incremental cost per person reached. Avahan reached roughly 150 000 high-risk individuals between 2004 and 2008 in the 22 districts studied, at a mean cost per person reached of US$327 during the 4 years. This reach resulted in an estimated 61 000 HIV infections averted, with roughly 11 000 HIV infections averted in the general population, at a mean incremental cost per HIV infection averted of $785 (SD 166). We estimate that roughly 1 million DALYs were averted across the 22 districts, at a mean incremental cost per DALY averted of $46 (SD 10). Future antiretroviral treatment (ART) cost savings during the lifetime of the cohort exposed to HIV prevention were estimated to be more than $77 million (compared with the slightly more than $50 million spent on Avahan in the 22 districts during the 4 years of the study). This study provides evidence that the investment in targeted HIV prevention programmes in south India has been cost effective, and is likely to be cost saving if a commitment is made to provide ART to all
Cuijpers, P.; Smit, H.F.E.; Oostenbrink, J.; de Graaf, R.; ten Have, M.; Beekman, A.T.F.
Objective: Although the clinical relevance of minor depression has been demonstrated in many studies, the economic costs are not well explored. In this study, we examine the economic costs of minor depression. Method: In a large-scale, population-based study in the Netherlands (n = 5504) the costs
Cuijpers, P.; Smit, H.F.E.; Oostenbrink, J.; Graaf, de R.; Have, M. ten; Beekman, A.T.F.
Objective: Although the clinical relevance of minor depression has been demonstrated in many studies, the economic costs are not well explored. In this study, we examine the economic costs of minor depression. Method: In a large-scale, population-based study in the Netherlands (n ¼ 5504) the costs
Cuijpers, P.; Smit, H.F.E.; Oostenbrink, J.; de Graaf, R.; ten Have, M.; Beekman, A.T.F.
Objective: Although the clinical relevance of minor depression has been demonstrated in many studies, the economic costs are not well explored. In this study, we examine the economic costs of minor depression. Method: In a large-scale, population-based study in the Netherlands (n = 5504) the costs
Cartwright, William S
This article examines costs as they relate to the financial costs of providing drug abuse treatment in private and public health plans, costs to society relating to drug abuse, and many smaller costing studies of various stakeholders in the health care system. A bibliography is developed from searches across PubMed, Web of Science, and other bibliographic sources. The review indicates that a wide collection of cost findings is available to policy makers. For example, the financial aspects of health plans have been dominated by considerations of actuarial costs of parity for drug abuse treatment. Cost-of-illness methods have been developed and extended to drug abuse costing to measure the national level of burden and are important to the economic evaluation of interventions at the program level. Costing is done in many small and focused studies, reflecting the interests of different stakeholders in the health care system. For costs in programs and health plans, as well as cost offsets of the impact of substance abuse treatment on medical expenditures, findings are surprisingly important to policy makers. Maintaining ongoing research that is highly policy relevant from the point of view of health services, more is needed on costing concepts and measurement applications.
Dreher, A.; Herzfeld, T.
This paper reviews the empirical literature on the economic costs of corruption. Corruption affects economic growth, the level of GDP per capita, investment activity, international trade and price stability negatively. Additionally, it biases the composition of government expenditures. The second
Economics of tobacco control research initiative: Operating costs for capacity building ... (but misinformed) beliefs about the economic benefits of the tobacco industry ... Nutrition, health policy, and ethics in the age of public-private partnerships.
Cost-saving treatment strategies in in vitro fertilization: a combined economic evaluation of two large randomized clinical trials comparing highly purified human menopausal gonadotropin and recombinant follicle-stimulating hormone alpha.
Wechowski, Jaroslaw; Connolly, Mark; Schneider, Dirk; McEwan, Philip; Kennedy, Richard
To assess the cost-effectiveness of two gonadotropin treatments that are available in the United Kingdom in light of limited public funding and the fundamental role of costs in IVF treatment decisions. An economic evaluation based on two large randomized clinical trials in IVF patients using a simulation model. Fifty-three fertility clinics in 13 European countries and Israel. Women indicated for treatment with IVF (N = 986), aged 18-38, participating in double-blind, randomized controlled trials. Highly purified menotropin (HP-hMG, Menopur) or recombinant follitropin alpha (rFSH, Gonal-F). Cost per IVF cycle and cost per live birth for HP-hMG and rFSH alpha. HP-hMG was more effective and less costly versus rFSH for both IVF cost per live birth and for IVF cost per baby (incremental cost-effectiveness ratio was negative). The mean costs per IVF treatment for HP-hMG and rFSH were 2408 pounds (95% confidence interval [CI], 2392 pounds, 2421 pounds) and 2660 pounds (95% CI 2644 pounds, 2678 pounds), respectively. The mean cost saving of 253 pounds per cycle using HP-hMG allows one additional cycle to be delivered for every 9.5 cycles. Treatment with HP-hMG was dominant compared with rFSH in the United Kingdom. Gonadotropin costs should be considered alongside live-birth rates to optimize outcomes using scarce health-care resources.
Full Text Available The exploitation of technologies with which to harness the energy from ocean currents will have considerable possibilities in the future thanks to their enormous potential for electricity production and their high predictability. In this respect, the development of methodologies for the economic viability of these technologies is fundamental to the attainment of a consistent quantification of their costs and the discovery of their economic viability, while simultaneously attracting investment in these technologies. This paper presents a methodology with which to determine the economic viability of tidal energy projects, which includes a technical study of the life-cycle costs into which the development of a tidal farm can be decomposed: concept and definition, design and development, manufacturing, installation, operation and maintenance and dismantling. These cost structures are additionally subdivided by considering their sub-costs and bearing in mind the main components of the tidal farm: the nacelle, the supporting tidal energy converter structure and the export power system. Furthermore, a technical study is developed in order to obtain an estimation of the annual energy produced (and, consequently, the incomes generated if the electric tariff is known by considering its principal attributes: the characteristics of the current, the ability of the device to capture energy and its ability to convert and export the energy. The methodology has been applied (together with a sensibility analysis to the particular case of a farm composed of first generation tidal energy converters in one of the Channel Island Races, the Alderney Race, in the U.K., and the results have been attained by means of the computation of engineering indexes, such as the net present value, the internal rate of return, the discounted payback period and the levelized cost of energy, which indicate that the proposed project is economically viable for all the case studies.
The economic cost of air pollution in Mangaung metro municipality: A case study in South Africa. ... the significance of air quality, to value the benefits of air pollution control ... Key words: Air pollution, air quality, workdays lost, mitigating cost.
López-Bastida, Julio; Oliva-Moreno, Juan
Rare diseases are a major cause of morbidity and mortality in high income countries and have major repercussions on individuals and health care systems. This chapter examines the health economy of rare diseases from two different perspectives: firstly, the study of the economic impact of rare diseases (Cost of Illness studies); and, secondly, cost-effectiveness evaluation, which evaluates both the costs and results of the health care technologies applied in rare diseases. From the point of view of economics, health resource allocation is based on the principle of scarcity, as there are not - and never will be- sufficient resources for all worthy objectives. Hence, policy makers should balance costs and health outcomes. Rare diseases may well represent a significant societal burden that should rightly receive appropriate prioritisation of health care resources. As new and seemingly expensive health care technologies are developed for rare diseases, it will become increasingly important to evaluate potential and real impact of these new technologies in both dimensions: social costs and health outcomes.
The subject is covered in sections: introduction (monetary inflation; US-style rate-base formula; cost escalation); electricity generation costs (rate-base calculation formula; regulatory versus economic costs; inflationary case; cost-of-service rates versus inflation; first year electricity costs); rate shock (A. comparison with oil; B. nuclear case; C. comparison with coal/nuclear system; vintaged electricity costs versus growth and inflation); conclusions. (U.K.)
Full Text Available Abstract Background Alcohol abuse results in problems on various levels in society. In terms of health, alcohol abuse is not only an important risk factor for chronic disease, but it is also related to injuries. Social harms which can be related to drinking include interpersonal problems, work problems, violent and other crimes. The scope of societal costs related to alcohol abuse in principle should be the same for both economic evaluations and cost-of-illness studies. In general, economic evaluations report a small part of all societal costs. To determine the cost- effectiveness of an intervention it is necessary that all costs and benefits are included. The purpose of this study is to describe and quantify the difference in societal costs incorporated in economic evaluations and cost-of-illness studies on alcohol abuse. Method To investigate the economic costs attributable to alcohol in cost-of-illness studies we used the results of a recent systematic review (June 2009. We performed a PubMed search to identify economic evaluations on alcohol interventions. Only economic evaluations in which two or more interventions were compared from a societal perspective were included. The proportion of health care costs and the proportion of societal costs were estimated in both type of studies. Results The proportion of healthcare costs in cost-of-illness studies was 17% and the proportion of societal costs 83%. In economic evaluations, the proportion of healthcare costs was 57%, and the proportion of societal costs was 43%. Conclusions The costs included in economic evaluations performed from a societal perspective do not correspond with those included in cost-of-illness studies. Economic evaluations on alcohol abuse underreport true societal cost of alcohol abuse. When considering implementation of alcohol abuse interventions, policy makers should take into account that economic evaluations from the societal perspective might underestimate the total
van Gils, Paul F; Hamberg-van Reenen, Heleen H; van den Berg, Matthijs; Tariq, Luqman; de Wit, G Ardine
Alcohol abuse results in problems on various levels in society. In terms of health, alcohol abuse is not only an important risk factor for chronic disease, but it is also related to injuries. Social harms which can be related to drinking include interpersonal problems, work problems, violent and other crimes. The scope of societal costs related to alcohol abuse in principle should be the same for both economic evaluations and cost-of-illness studies. In general, economic evaluations report a small part of all societal costs. To determine the cost- effectiveness of an intervention it is necessary that all costs and benefits are included. The purpose of this study is to describe and quantify the difference in societal costs incorporated in economic evaluations and cost-of-illness studies on alcohol abuse. To investigate the economic costs attributable to alcohol in cost-of-illness studies we used the results of a recent systematic review (June 2009). We performed a PubMed search to identify economic evaluations on alcohol interventions. Only economic evaluations in which two or more interventions were compared from a societal perspective were included. The proportion of health care costs and the proportion of societal costs were estimated in both type of studies. The proportion of healthcare costs in cost-of-illness studies was 17% and the proportion of societal costs 83%. In economic evaluations, the proportion of healthcare costs was 57%, and the proportion of societal costs was 43%. The costs included in economic evaluations performed from a societal perspective do not correspond with those included in cost-of-illness studies. Economic evaluations on alcohol abuse underreport true societal cost of alcohol abuse. When considering implementation of alcohol abuse interventions, policy makers should take into account that economic evaluations from the societal perspective might underestimate the total effects and costs of interventions.
Full Text Available The paper argues that there is not necessarily a correlation between political, economic and societal shelter. Iceland received considerable societal and political shelter from Denmark in the period under study, but Denmark failed to provide its remote island with economic cover. Firstly, and most importantly, it provided substantial and highly valuable societal shelter. Copenhagen was the main channel by which new knowledge and technology could enter Iceland. The islanders benefited from educational, health-care and social policies of the crown and it played an invaluable role in preserving Iceland’s cultural heritage. Secondly, Denmark provided partial protection of Icelandic waters and land though Iceland’s peripheral position continued to be its main protection from outside attacks. However, at the end of our period, the Danish kingdom was in decline and unable to provide political cover. Nevertheless, increased centralization, initiated from Denmark, provided internal order and political stability and citizens became more equal before the law. Thirdly, Icelanders paid a heavy price for the Danish trade monopoly though Icelanders continued to receive partial economic and societal shelter from foreign merchants and fishermen. The crown’s policies towards Iceland can largely be explained by current ideological trends at any given time. By being in constant contact with the European continent through Denmark, Icelandic society was part of the societal, political and economic evolution in Europe and managed to avoid isolation despite its geographical remoteness.
Acarturk, C.; Smit, H.F.E.; de Graaf, R.; van Straten, A.; ten Have, M.; Cuijpers, P.
Background: Information about the economic costs of social phobia is scant. In this study, we examine the economic costs of social phobia and subthreshold social phobia. Methods: Data were derived from the Netherlands Mental Health Survey and Incidence Study (NEMESIS) which is a population-based
Drewnowski, Adam; Darmon, Nicole
Obesity in the United States is a socioeconomic issue. It is related to limited social and economic resources and may be linked to disparities in access to healthy foods. Added sugars and added fats are far more affordable than are the recommended "healthful" diets based on lean meats, whole grains, and fresh vegetables and fruit. There is an inverse relationship between energy density of foods (kJ/g) and energy cost ($/MJ), such that energy-dense grains, fats, and sweets represent the lowest-cost dietary options to the consumer. Good taste, high convenience, and the low cost of energy-dense foods, in conjunction with large portions and low satiating power, may be the principal reasons for overeating and weight gain. Financial disparities in access to healthier diets may help explain why the highest rates of obesity and diabetes are found among minorities and the working poor. If so, then encouraging low-income households to consume more costly foods is not an effective strategy for public health. What is needed is a comprehensive policy approach that takes behavioral nutrition and the economics of food choice into account.
A review was conducted by the British Columbia Energy Council to assess the economic and social impacts of the export of long-term firm electricity to the USA and the distribution of these impacts. The objectives of, and the differences between, benefit-cost and socio-economic impact analysis are discussed as they apply to potential electricity export projects. Provincial export project review requirements (project justification, environmental impacts, socio-economic impact assessment) and proposed legislative changes are first reviewed. The concepts and objectives of value added, economic rent, opportunity costs, economic (benefit-cost) analysis, and socio-economic impact analysis are explained. Employment issues including unemployed labor, employment benefits, and regional and occupational considerations are then discussed, as well as transfers to various levels of government in the form of taxes, subsidies, resource royalties, and depletion costs. 8 refs., 4 tabs
Robinson, Rebecca L; Birnbaum, Howard G; Morley, Melissa A; Sisitsky, Tamar; Greenberg, Paul E; Claxton, Ami J
Fibromyalgia (FM) is characterized by widespread pain that can lead to significant patient disability, complex management decisions for physicians, and economic burden on society. We investigated the total costs of FM in an employer population. Administrative claims data of a Fortune 100 manufacturer were used to quantify direct (i.e., medical and pharmaceutical claims) and indirect (i.e., disability claims and imputed absenteeism) costs associated with FM. A total of 4699 patients with at least one FM claim between 1996 and 1998 were contrasted with a 10% random sample of the overall beneficiary population. Employee-only subsets of both samples also were drawn. Medical utilization, receipt of prescription drugs, and annual total costs were proportionately similar yet significantly greater among FM claimants than the overall sample (all p < 0.0001). Total annual costs for FM claimants were $5945 versus $2486 for the typical beneficiary (p < 0.0001). Six percent of these costs were attributable to FM-specific claims. The prevalence of disability was twice as high among FM employees than overall employees (p < 0.0001). For every dollar spent on FM-specific claims, the employer spent another $57 to $143 on additional direct and indirect costs. Hidden costs of disability and comorbidities greatly increase the true burden of FM. Regardless of the clinical understanding of FM, when a claim for FM is present, considerable costs are involved. Findings suggest that within the management of FM there may be large cost-offset opportunities for reductions in patient, physician, and employer burdens.
Clark, Roger Nelson
Approved for public release; distribution is unlimited This thesis investigates the use of comparative maintenance costs of functionally interchangeable equipments in similar U.S. Navy shipboard applications in an economic analysis of standardization. The economics of standardization, life-cycle costing, and the Navy 3-M System are discussed in general. An analysis of 3-M System maintenance costs for a selected equipment, diesel engines, is conducted. The potential use of comparative ma...
Cullinan, John; Gannon, Brenda; Lyons, Seán
Addressing the extra economic costs of disability seems a logical step towards alleviating elements of social exclusion for people with disabilities. This paper estimates the economic cost of disability in Ireland in terms of the additional spending needs that arise due to disability. It defines and estimates models of the private costs borne by families with individuals who have a disability in Ireland when compared to the wider population, both in general and by severity of illness. Our mod...
Acarturk, C; Smit, Filip; de Graaf, R; van Straten, A; Ten Have, M; Cuijpers, P
Information about the economic costs of social phobia is scant. In this study, we examine the economic costs of social phobia and subthreshold social phobia. Data were derived from the Netherlands Mental Health Survey and Incidence Study (NEMESIS) which is a population-based prospective study (n=4,789). Costs related to health service uptake, patients' out-of-pocket expenses, and costs arising from production losses were calculated for the reference year 2003. The costs for people with social phobia were compared with the costs for people with no mental disorder. The annual per capita total costs of social phobia were euro 11,952 (95% CI=7,891-16,013) which is significantly higher than the total costs for people with no mental disorder, euro 2957 (95% CI=2690-3224). When adjusting for mental and somatic co-morbidity, the costs decreased to euro 6,100 (95% CI=2681-9519), or 136 million euro per year per 1 million inhabitants, which was still significantly higher than the costs for people with no mental disorder. The costs of subthreshold social phobia were also significantly higher than the costs for people without any mental disorder, at euro 4,687 (95% CI=2557-6816). The costs presented here are conservative lower estimates because we only included costs related to mental health services. The economic costs associated with social phobia are substantial, and those of subthreshold social phobia approach those of the full-blown disorder.
Nuclear programme, personnel organization-regulatory bodies, utility head office, nuclear power plant, industry. Selection of personnel and job assignment procedures. Training in the home country and abroad. Personnel, social and technical costs of training. Retraining and replacement training. Costs of training centers, local and regional. (orig.)
Sukojo, B. M.; Hidayat, H.; Ratnasari, D.
Indonesia is a vast maritime country; many mangrove conservations is found around coastal areas of Indonesia. Mangroves support the life of a large number of animal species by providing breeding, spawning and feeding. Mangrove forests as one of the unique ecosystems are potential natural resources, supporting the diversity of flora and fauna of terrestrial aquatic communities that directly or indirectly play an important role for human life in economic, social and environmental terms. East Coast Surabaya is an area with the most extensive and diverse mangrove ecosystems along the coast of Surabaya. Currently Pamurbaya used as a recreational object or nature tourism called eco tours. Utilization of mangrove ecosystem as a place of this eco tour bring positive impact on economic potency around pamurbaya area. So, to know the value of the economic potential of mangrove ecosystems for support of nature tourism Pamurbaya region needs to study mapping mangrove ecosystem conditions in the East Coast area of Surabaya. Mapping of mangrove conditions can use remote sensing technology by utilizing satellite image data with high resolution. Data used for mapping mangrove ecosystem conditions on the east coast of Surabaya are high resolution satellite image data of Pleiades 1A and field observation data such as Ground Control Point, soil spectral parameters and water quality. From satellite image data will be classification of mangrove vegetation canopy classification using NDVI vegetation index method using algorithm formula which then will be tested correlation with field observation data on reflectant value of field and water quality parameter. The purpose of this research is to know the condition of mangrove ecosystem to know the economic potential of mangrove ecosystem in supporting Pamurbaya nature tourism. The expected result of this research is the existence of basic geospatial information in the form of mangrove ecosystem condition map. So that can be used as decision
Whitley, Sally; Shinn, Stephen
Increases in NASA mission costs have led to analysis of the causes and magnitude of historical mission overruns as well as mitigation and prevention attempts. This paper hypothesizes that one cause is that the availability of reserves may reduce incentives to control costs. We draw a comparison to the insurance concept of moral hazard, and we use actuarial techniques to better understand the increase in mission costs due to the availability of reserves. NASA's CADRe database provided the data against which we tested our hypothesis and discovered that there is correlation between the amount of available reserves and project overruns, particularly for mission hardware cost increases. We address the question of how to prevent reserves from increasing mission spending without increasing cost risk to projects.
Economic Research Service (USDA), Washington, DC.
This report contains 121 tables that estimate the costs of production of various commodities on United States farms in 1986. The report first assesses costs and returns on a per-unit basis, such as one acre or one animal, under three sections of a budget: cash receipts, cash expenses, and economic costs. The budgets are based on national…
Krol, Marieke; Brouwer, Werner; Rutten, Frans
Productivity costs occur when the productivity of individuals is affected by illness, treatment, disability or premature death. The objective of this paper was to review past and current developments related to the inclusion, identification, measurement and valuation of productivity costs in economic evaluations. The main debates in the theory and practice of economic evaluations of health technologies described in this review have centred on the questions of whether and how to include productivity costs, especially productivity costs related to paid work. The past few decades have seen important progress in this area. There are important sources of productivity costs other than absenteeism (e.g. presenteeism and multiplier effects in co-workers), but their exact influence on costs remains unclear. Different measurement instruments have been developed over the years, but which instrument provides the most accurate estimates has not been established. Several valuation approaches have been proposed. While empirical research suggests that productivity costs are best included in the cost side of the cost-effectiveness ratio, the jury is still out regarding whether the human capital approach or the friction cost approach is the most appropriate valuation method to do so. Despite the progress and the substantial amount of scientific research, a consensus has not been reached on either the inclusion of productivity costs in economic evaluations or the methods used to produce productivity cost estimates. Such a lack of consensus has likely contributed to ignoring productivity costs in actual economic evaluations and is reflected in variations in national health economic guidelines. Further research is needed to lessen the controversy regarding the estimation of health-related productivity costs. More standardization would increase the comparability and credibility of economic evaluations taking a societal perspective.
Full Text Available Abstract Background There is evidence that the adverse consequences of alcohol impose a substantial economic burden on societies worldwide. Given the lack of generalizability of study results across different settings, many attempts have been made to estimate the economic costs of alcohol for various settings; however, these have mostly been confined to industrialized countries. To our knowledge, there are a very limited number of well-designed studies which estimate the economic costs of alcohol consumption in developing countries, including Thailand. Therefore, this study aims to estimate these economic costs, in Thailand, 2006. Methods This is a prevalence-based, cost-of-illness study. The estimated costs in this study included both direct and indirect costs. Direct costs included health care costs, costs of law enforcement, and costs of property damage due to road-traffic accidents. Indirect costs included costs of productivity loss due to premature mortality, and costs of reduced productivity due to absenteeism and presenteeism (reduced on-the-job productivity. Results The total economic cost of alcohol consumption in Thailand in 2006 was estimated at 156,105.4 million baht (9,627 million US$ PPP or about 1.99% of the total Gross Domestic Product (GDP. Indirect costs outweigh direct costs, representing 96% of the total cost. The largest cost attributable to alcohol consumption is that of productivity loss due to premature mortality (104,128 million baht/6,422 million US$ PPP, followed by cost of productivity loss due to reduced productivity (45,464.6 million baht/2,804 million US$ PPP, health care cost (5,491.2 million baht/339 million US$ PPP, cost of property damage as a result of road traffic accidents (779.4 million baht/48 million US$ PPP, and cost of law enforcement (242.4 million baht/15 million US$ PPP, respectively. The results from the sensitivity analysis revealed that the cost ranges from 115,160.4 million baht to 214
Thavorncharoensap, Montarat; Teerawattananon, Yot; Yothasamut, Jomkwan; Lertpitakpong, Chanida; Thitiboonsuwan, Khannika; Neramitpitagkul, Prapag; Chaikledkaew, Usa
There is evidence that the adverse consequences of alcohol impose a substantial economic burden on societies worldwide. Given the lack of generalizability of study results across different settings, many attempts have been made to estimate the economic costs of alcohol for various settings; however, these have mostly been confined to industrialized countries. To our knowledge, there are a very limited number of well-designed studies which estimate the economic costs of alcohol consumption in developing countries, including Thailand. Therefore, this study aims to estimate these economic costs, in Thailand, 2006. This is a prevalence-based, cost-of-illness study. The estimated costs in this study included both direct and indirect costs. Direct costs included health care costs, costs of law enforcement, and costs of property damage due to road-traffic accidents. Indirect costs included costs of productivity loss due to premature mortality, and costs of reduced productivity due to absenteeism and presenteeism (reduced on-the-job productivity). The total economic cost of alcohol consumption in Thailand in 2006 was estimated at 156,105.4 million baht (9,627 million US$ PPP) or about 1.99% of the total Gross Domestic Product (GDP). Indirect costs outweigh direct costs, representing 96% of the total cost. The largest cost attributable to alcohol consumption is that of productivity loss due to premature mortality (104,128 million baht/6,422 million US$ PPP), followed by cost of productivity loss due to reduced productivity (45,464.6 million baht/2,804 million US$ PPP), health care cost (5,491.2 million baht/339 million US$ PPP), cost of property damage as a result of road traffic accidents (779.4 million baht/48 million US$ PPP), and cost of law enforcement (242.4 million baht/15 million US$ PPP), respectively. The results from the sensitivity analysis revealed that the cost ranges from 115,160.4 million baht to 214,053.0 million baht (7,102.1 - 13,201 million US$ PPP
Hovgaard, Tobias Gybel; Larsen, Lars F.S.; Jørgensen, John Bagterp
the formulation of a new cost function for our proposed power management. Hereby the refrigeration system is enabled to contribute with ancillary services to the balancing power market. Since significant amounts of regulating power is needed for a higher penetration of intermittent renewable energy sources...... such as wind turbines this feature is in high demand in a future intelligent power grid (Smart Grid). Our perspective is seen from the refrigeration system but as it is demonstrated the involvement in the balancing market can be economically beneficial for the system itself while delivering crucial services...... that reduces operation costs by utilizing the thermal storage capabilities. In the study we specifically address advantages coming from daily variations in outdoor temperature and electricity prices but other aims such as peak load reduction are also considered. An important contribution of this paper is also...
Whitley, Sally; Shinn, Stephen
Increases in NASA mission costs are well-noted but not well-understood, and there is little evidence that they are decreasing in frequency or amount over time. The need to control spending has led to analysis of the causes and magnitude of historical mission overruns, and many program control efforts are being implemented to attempt to prevent or mitigate the problem (NPR 7120). However, cost overruns have not abated, and while some direct causes of increased spending may be obvious (requirements creep, launch delays, directed changes, etc.), the underlying impetus to spend past the original budget may be more subtle. Gaining better insight into the causes of cost overruns will help NASA and its contracting organizations to avoid .them. This paper hypothesizes that one cause of NASA mission cost overruns is that the availability of reserves gives project team members an incentive to make decisions and behave in ways that increase costs. We theorize that the presence of reserves is a contributing factor to cost overruns because it causes organizations to use their funds less efficiently or to control spending less effectively. We draw a comparison to the insurance industry concept of moral hazard, the phenomenon that the presence of insurance causes insureds to have more frequent and higher insurance losses, and we attempt to apply actuarial techniques to quantifY the increase in the expected cost of a mission due to the availability of reserves. We create a theoretical model of reserve spending motivation by defining a variable ReserveSpending as a function of total reserves. This function has a positive slope; for every dollar of reserves available, there is a positive probability of spending it. Finally, the function should be concave down; the probability of spending each incremental dollar of reserves decreases progressively. We test the model against available NASA CADRe data by examining missions with reserve dollars initially available and testing whether
Full Text Available Eirini Stafyla,1 Theodora Kerenidi,1 Irini Gerogianni,1 Mary Geitona,2 Zoe Daniil,1 Konstantinos I Gourgoulianis1 1Respiratory Medicine Department, University of Thessaly School of Medicine, University Hospital of Larissa, Larissa, 2Department of Social Policy, University of Peloponnese, Korithos, Greece Introduction: The economic crisis in Greece has substantially affected patients with COPD. The reduction of disposable income has its consequences on patients’ ability to afford their medication. The aim of the study is to evaluate the cost of treatment for patients with COPD and the influence of the financial crisis to the patients.Methods: Data were collected from 189 patients (male: 178, mean age: 70.1±8.4 who visited the outpatient department of University Hospital of Larissa in 2014 and 2015. The pharmacological cost of treatment was calculated based on national pharmaceutical formulary prices.Results: COPD patients were classified into four stages according to Global Initiative for Chronic Obstructive Lung Disease (GOLD: 7.4% were in stage I, 43.4% in stage II, 34.4% in stage III, and 14.8% in stage IV. Patients were graded as per GOLD as follows: 18% as grade A, 14.3% as B, 23.3% as C, and 44.4% as D. The annual cost of COPD maintenance treatment per patient was €952.92 (±398.01, of which €239.91 were patients’ expenses. The annual treatment cost for stable disease ranged from €615.44 to €1302.03 depending on disease stages (GOLD stages I–IV and from €715.01 to €1101.05 depending on GOLD grades (grades A–D. The cost of maintenance medication was statistically and significantly higher for patients with advanced disease (GOLD stages III–IV and for patients at high risk (GOLD grades C–D [P=0.000].Conclusion: The pharmacological cost of treatment for COPD patients seems to be considerably high, in all disease stages. As the average income is decreased, patients face difficulties to afford inhaled medication. Keywords
VĂDUVA CECILIA ELENA
Full Text Available The macroeconomic situation of a nation cannot be characterized just by the equilibrium conditions of its economy, but especially by the growth level and rate of the gross domestic product or the national, total income and per inhabitant. These are at the base to ensure the resources to raise the life standard of people, and for the overall progress of the country, for its honorable placement or framing in the national economy. The oscillations of the economic activities and the long term trend interweaved along centuries. Looked in a millenary retrospective by “L'Histoire” known magazine, they appear like: “while the brutal, short-term crises are well sighted, and the tri-decennial cycles have been defined by the Russian economist Kondratieff and are admitted, the long term movements are less known, those trends which make the succession of “The beautiful of the XIV century”, “The gloomy of the XVII century” and the XIX century, considered “grey”, the extraordinary of the XX century, the economics and economic historians are far from agreeing on the reality of these long movements, and if they admit them, they separate on their profound causes.”
Nicolai J. Foss
Full Text Available As the transaction cost theory of the firm was taking shape in the 1970s, another important movement in economics was emerging: a revival of the ‘Austrian’ tradition in economic theory associated with such economists as Ludwig von Mises and F. A. Hayek (1973; Dolan, 1976; Spadaro, 1978. As Oliver Williamson has pointed out, Austrian economics is among the diverse sources for transaction cost economics. In particular, Williamson frequently cites Hayek (e.g., Williamson, 1985, p. 8; 1991, p. 162, particularly Hayek’s emphasis on adaptation as a key problem of economic organisation (Hayek, 1945. Following Williamson’s lead, a reference to Hayek’s ‘The Use of Knowledge in Society’ (Hayek, 1945 has become almost mandatory in discussions of economic organisation (e.g., Ricketts, 1987, p. 59; Milgrom and Roberts, 1992, p. 56; Douma and Schreuder 1991, p. 9. However, there are many other potential links between Austrian and transaction cost economics that have not been explored closely and exploited.This article argues that characteristically Austrian ideas about property, entrepreneurship, economic calculation, tacit knowledge, and the temporal structure of capital have important implications for theories of economic organisation, transaction cost economics in particular. Austrian economists have not, however, devoted substantial attention to the theory of the firm, preferring to focus on business-cycle theory, welfare economics, political economy, comparative economic systems, and other areas. Until recently the theory of the firm was an almost completely neglected area in Austrian economics, but over the last decade, a small Austrian literature on the firm has emerged. While these works cover a wide variety of theoretical and applied topics, their authors share the view that Austrian insights have something to offer students of firm organisation.
Luce, B R; Elixhauser, A
The complexities and nuances of evaluating the costs associated with providing medical technologies are often underestimated by analysts engaged in economic evaluations. This article describes the theoretical underpinnings of cost estimation, emphasizing the importance of accounting for opportunity costs and marginal costs. The various types of costs that should be considered in an analysis are described; a listing of specific cost elements may provide a helpful guide to analysis. The process of identifying and estimating costs is detailed, and practical recommendations for handling the challenges of cost estimation are provided. The roles of sensitivity analysis and discounting are characterized, as are determinants of the types of costs to include in an analysis. Finally, common problems facing the analyst are enumerated with suggestions for managing these problems.
Koch, Carsten Allan
The assumption of opportunistic behavior, familiar from transaction cost economics, has been and remains highly controversial. But opportunistic behavior, albeit undoubtedly an extremely important form of motivation, is not a necessary condition for the contractual problems studied by transaction...
DeHayes, Daniel W.; Lovrinic, Joseph G.
An economic model for evaluating the cost performance of academic and administrative programs in higher education is described. Examples from its application at Indiana University-Purdue University Indianapolis are used to illustrate how the model has been used to control costs and reengineer processes. (Author/MSE)
Pessali, Huascar; Fernández, Ramón
Transaction cost economics is a key topic in many conversations in business and economics related disciplines, much as a result of Oliver Williamson's intellectual crusade. By claiming a "distinct worldview," he develops arguments of association and differentiation to established worldviews, like traditional microeconomics, earlier institutionalism, Austrian and radical economics, and also within the new institutional economics itself, in order to advance his theory. His resourcefulness defie...
The COSYMA program system for evaluating the off-site consequences of accidental releases of radioactive material to the atmosphere includes an ECONOMICS module for assessing economic consequences. The aim of this module is to convert various consequences (radiation-induced health effects and impacts resulting from countermeasures) caused by an accident into the common framework of economic costs; this allows different effects to be expressed in the same terms and thus to make these effects comparable. With respect to the countermeasure 'movement of people', the dominant cost categories are 'loss-of-income costs' and 'costs of lost capital services'. In the original version of the ECONOMICS module these costs are calculated on the basis of the total number of people moved. In order to take into account also regional or local economic peculiarities of a nuclear site, the ECONOMICS module has been extended: Calculation of the above mentioned cost categories is now based on the number of employees in different economic sectors in the affected area. This extension of the COSYMA ECONOMICS module is described in more detail. (orig.)
Angevine, Peter D; Berven, Sigurd
Narrative overview. To provide clinicians with a basic understanding of economic studies, including cost-benefit, cost-effectiveness, and cost-utility analyses. As decisions regarding public health policy, insurance reimbursement, and patient care incorporate factors other than traditional outcomes such as satisfaction or symptom resolution, health economic studies are increasingly prominent in the literature. This trend will likely continue, and it is therefore important for clinicians to have a fundamental understanding of the common types of economic studies and be able to read them critically. In this brief article, the basic concepts of economic studies and the differences between cost-benefit, cost-effectiveness, and cost-utility studies are discussed. An overview of the field of health economic analysis is presented. Cost-benefit, cost-effectiveness, and cost-utility studies all integrate cost and outcome data into a decision analysis model. These different types of studies are distinguished mainly by the way in which outcomes are valued. Obtaining accurate cost data is often difficult and can limit the generalizability of a study. With a basic understanding of health economic analysis, clinicians can be informed consumers of these important studies.
Full Text Available Aims. To examine all relevant literature on the economic costs of osteoarthritis in the UK, and to compare such costs globally. Methods. A search of MEDLINE was performed. The search was expanded beyond peer-reviewed journals into publications by the department of health, national orthopaedic associations, national authorities and registries, and arthritis charities. Results. No UK studies were identified in the literature search. 3 European, 6 North American, and 2 Asian studies were reviewed. Significant variation in direct and indirect costs were seen in these studies. Costs for topical and oral NSAIDs were estimated to be £19.2 million and £25.65 million, respectively. Cost of hip and knee replacements was estimated to exceed £850 million, arthroscopic surgery for osteoarthritis was estimated to be £1.34 million. Indirect costs from OA caused a loss of economic production over £3.2 billion, £43 million was spent on community services and £215 million on social services for osteoarthritis. Conclusions. While estimates of economic costs can be made using information from non-published data, there remains a lack of original research looking at the direct or indirect costs of osteoarthritis in the UK. Differing methodology in calculating costs from overseas studies makes direct comparison with the UK difficult.
Logan, T. K.; Walker, Robert; Hoyt, William
Partner violence affects a significant number of women and their children each year. Estimates of the economic costs of partner violence are substantial. However, most estimates of the costs of partner violence are made at the aggregate level rather than the individual level. Estimating costs at the individual level allows for a wider range of…
Cost-of-illness (COI) was the first economic evaluation technique used in the health field. The principal aim was to measure the economic burden of illness to society. Its usefulness as a decision-making tool has however been questioned since its inception. The main criticism came from welfare economists who rejected COIs because they were not grounded in welfare economics theory. Other attacks related to the use of the human capital approach (HCA) to evaluate morbidity and mortality costs since it was said that the HCA had nothing to do with the value people attach to their lives. Finally, objections were made that COI could not be of any help to decision makers and that other forms of economic evaluation (e.g. cost-effectiveness, cost-benefit analysis) would be much more useful to those taking decisions and ranking priorities. Conversely, it is here suggested that COI can be a good economic tool to inform decision makers if it is considered from another perspective. COI is a descriptive study that can provide information to support the political process as well as the management functions at different levels of the healthcare organisations. To do that, the design of the study must be innovative, capable of measuring the true cost to society; to estimate the main cost components and their incidence over total costs; to envisage the different subjects who bear the costs; to identify the actual clinical management of illness; and to explain cost variability. In order to reach these goals, COI need to be designed as observational bottom-up studies.
Sober, Tamara Leigh
Today's high school students will face a host of economic problems such as the demise of the social safety net, mounting college student debt, and costly health care plans, as stated in the rationale for financial literacy provided by the Council for Economic Education's National Standards for Financial Literacy. These problems are compounded by…
Onkham, Wilawan; Karwowski, Waldemar; Ahram, Tareq Z
Financial costs of investing in people is associated with training, acquisition, recruiting, and resolving human errors have a significant impact on increased total ownership costs. These costs can also affect the exaggerate budgets and delayed schedules. The study of human performance economical assessment in the system acquisition process enhances the visibility of hidden cost drivers which support program management informed decisions. This paper presents the literature review of human total ownership cost (HTOC) and cost impacts on overall system performance. Economic value assessment models such as cost benefit analysis, risk-cost tradeoff analysis, expected value of utility function analysis (EV), growth readiness matrix, multi-attribute utility technique, and multi-regressions model were introduced to reflect the HTOC and human performance-technology tradeoffs in terms of the dollar value. The human total ownership regression model introduces to address the influencing human performance cost component measurement. Results from this study will increase understanding of relevant cost drivers in the system acquisition process over the long term.
Full Text Available doi: http://dx.doi.org/10.15447/sfews.2016v14iss2art4Groundwater management is important and challenging, and nowhere is this more evident than in California. Managed aquifer recharge (MAR projects can play an important role in ensuring California manages its groundwater sustainably. Although the benefits and economic costs of surface water storage have been researched extensively, the benefits and economic costs of MAR have been little researched. Historical groundwater data are sparse or proprietary within the state, often impairing groundwater analyses. General obligation bonds from ballot propositions offer a strategic means of mining information about MAR projects, because the information is available publicly. We used bond-funding applications to identify anticipated MAR project benefits and proposed economic costs. We then compared these costs with actual project costs collected from a survey, and identified factors that promote or limit MAR. Our analysis indicates that the median proposed economic cost for MAR projects in California is $410 per acre-foot per year ($0.33 per cubic meter per year. Increasing Water Supply, Conjunctive Use, and Flood Protection are the most common benefits reported. Additionally, the survey indicates that (1 there are many reported reasons for differences between proposed and actual costs ($US 2015 and (2 there is one primary reason for differences between proposed recharge volumes and actual recharge volumes (AFY: availability of source water for recharge. Although there are differences between proposed and actual costs per recharge volume ($US 2015/AFY, the ranges for proposed costs per recharge volume and actual costs per recharge volume for the projects surveyed generally agree. The two most important contributions to the success of a MAR project are financial support and good communication with stakeholders.
Remer, D. S.
A mathematical model is developed for calculating the life cycle costs for a project where the operating costs increase or decrease in a linear manner with time. The life cycle cost is shown to be a function of the investment costs, initial operating costs, operating cost gradient, project life time, interest rate for capital and salvage value. The results show that the life cycle cost for a project can be grossly underestimated (or overestimated) if the operating costs increase (or decrease) uniformly over time rather than being constant as is often assumed in project economic evaluations. The following range of variables is examined: (1) project life from 2 to 30 years; (2) interest rate from 0 to 15 percent per year; and (3) operating cost gradient from 5 to 90 percent of the initial operating costs. A numerical example plus tables and graphs is given to help calculate project life cycle costs over a wide range of variables.
Adrian IOANA; Nicolae CONSTANTIN; Elena-Claudia DRAGNA; Massimo POLIFRONI
Our article features the elements that make up the cost of production. The economic activity implies a consumption of factors followed-up by products expressed in goods or services. In the first part of the article, we have defined and detailed the cost of production. In the second part we have calculated the cost of the production of one tone of low alloyed steel with vanadium. The prices for the components of cost production have been established within, Tenaris site, located in Calarasi co...
Full Text Available Our article features the elements that make up the cost of production. The economic activity implies a consumption of factors followed-up by products expressed in goods or services. In the first part of the article, we have defined and detailed the cost of production. In the second part we have calculated the cost of the production of one tone of low alloyed steel with vanadium. The prices for the components of cost production have been established within, Tenaris site, located in Calarasi county, Romania.
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.
Finkelstein, Neal; Hanson, Thomas
The primary purpose of this study is to assess student-level impacts of a problem-based instructional approach to high school economics. The curriculum approach examined here was designed to increase class participation and content knowledge for high school students who are learning economics. This study tests the effectiveness of Problem Based…
Pitayatienanan, Paiboon; Butchon, Rukmanee; Yothasamut, Jomkwan; Aekplakorn, Wichai; Teerawattananon, Yot; Suksomboon, Naeti; Thavorncharoensap, Montarat
Over the last decade, the prevalence of obesity (BMI ≥ 25 kg/m2) in Thailand has been rising rapidly and consistently. Estimating the cost of obesity to society is an essential step in setting priorities for research and resource use and helping improve public awareness of the negative economic impacts of obesity. This prevalence-based, cost-of-illness study aims to estimate the economic costs of obesity in Thailand. The estimated costs in this study included health care cost, cost of productivity loss due to premature mortality, and cost of productivity loss due to hospital-related absenteeism. The Obesity-Attributable Fraction (OAF) was used to estimate the extent to which the co-morbidities were attributable to obesity. The health care cost of obesity was further estimated by multiplying the number of patients in each disease category attributable to obesity by the unit cost of treatment. The cost of productivity loss was calculated using the human capital approach. The health care cost attributable to obesity was estimated at 5,584 million baht or 1.5% of national health expenditure. The cost of productivity loss attributable to obesity was estimated at 6,558 million baht - accounting for 54% of the total cost of obesity. The cost of hospital-related absenteeism was estimated at 694 million baht, while the cost of premature mortality was estimated at 5,864 million baht. The total cost of obesity was then estimated at 12,142 million baht (725.3 million US$PPP, 16.74 baht =1 US$PPP accounting for 0.13% of Thailand's Gross Domestic Product (GDP). Obesity imposes a substantial economic burden on Thai society especially in term of health care costs. Large-scale comprehensive interventions focused on improving public awareness of the cost of and problems associated with obesity and promoting a healthy lifestyle should be regarded as a public health priority.
Franck, Raymond; Melese, Francois; Dillard, John
Proceedings Paper (for Acquisition Research Program) This study examines defense acquisition through the new lens of Transaction Cost Economics (TCE). TCE is an emergent field in economics that has multiple applications to defense acquisition practices. TCE''s original focus was to guide ''make-or-buy?'' decisions that define the boundaries of a firm. This study reviews insights afforded by TCE that impact government outsourcing (''buy'' decisions), paying special attention to defense pro...
Shinn, A P; Pratoomyot, J; Bron, J E; Paladini, G; Brooker, E E; Brooker, A J
Parasites have a major impact on global finfish and shellfish aquaculture, having significant effects on farm production, sustainability and economic viability. Parasite infections and impacts can, according to pathogen and context, be considered to be either unpredictable/sporadic or predictable/regular. Although both types of infection may result in the loss of stock and incur costs associated with the control and management of infection, predictable infections can also lead to costs associated with prophylaxis and related activities. The estimation of the economic cost of a parasite event is frequently complicated by the complex interplay of numerous factors associated with a specific incident, which may range from direct production losses to downstream socio-economic impacts on livelihoods and satellite industries associated with the primary producer. In this study, we examine the world's major marine and brackish water aquaculture production industries and provide estimates of the potential economic costs attributable to a range of key parasite pathogens using 498 specific events for the purposes of illustration and estimation of costs. This study provides a baseline resource for risk assessment and the development of more robust biosecurity practices, which can in turn help mitigate against and/or minimise the potential impacts of parasite-mediated disease in aquaculture.
Objectives: To provide new information on the financial and economic costs of providing highly active antiretroviral therapy (HAART) to health care workers in public-sector hospital settings in KwaZulu-Natal. Design: An Excel model was used to estimate the cost of providing HAART to health care workers at two ...
van Gils, Paul F; Hamberg-van Reenen, Heleen H; van den Berg, Matthijs; Tariq, Luqman; de Wit, G Ardine
Abstract Background Alcohol abuse results in problems on various levels in society. In terms of health, alcohol abuse is not only an important risk factor for chronic disease, but it is also related to injuries. Social harms which can be related to drinking include interpersonal problems, work problems, violent and other crimes. The scope of societal costs related to alcohol abuse in principle should be the same for both economic evaluations and cost-of-illness studies. In general, economic e...
Bartsch, Sarah M; Umscheid, Craig A; Fishman, Neil; Lee, Bruce Y
In May 2011, the Food and Drug Administration approved fidaxomicin for the treatment of Clostridium difficile infection (CDI). It has been found to be noninferior to vancomycin; however, its cost-effectiveness for the treatment of CDI remains undetermined. We developed a decision analytic simulation model to determine the economic value of fidaxomicin for CDI treatment from the third-party payer perspective. We looked at CDI treatment in these 3 cases: (1) no fidaxomicin, (2) only fidaxomicin, and (3) fidaxomicin based on strain typing results. The incremental cost-effectiveness ratio for fidaxomicin based on screening given current conditions was >$43.7 million per quality-adjusted life-year and using only fidaxomicin was dominated (ie, more costly and less effective) by the other 2 treatment strategies explored. The fidaxomicin strategy tended to remain dominated, even at lower costs. With approximately 50% of CDI due to the NAP1/BI/027 strain, a course of fidaxomicin would need to cost ≤$150 to be cost-effective in the treatment of all CDI cases and between $160 and $400 to be cost-effective for those with a non-NAP1/BI/027 strain (ie, treatment based on strain typing). Given the current cost and NAP1/BI/027 accounting for approximately 50% of isolates, using fidaxomicin as a first-line treatment for CDI is not cost-effective. However, typing and treatment with fidaxomicin based on strain may be more promising depending on the costs of fidaxomicin.
Incidence and economic cost of cases of bovine trypanosomosis in nomadic herds at the Jos Plateau from 1997 to 2001 were determined. These were done using records kept at the Plateau State Ministry of Animal and Forest Resources headquarters at Jos, and the model described by Alonge et al. (1984). The incidence ...
Feasibility and economic evaluation of low-cost evaporative cooling system in fruit and vegetables storage. ... on fruit and vegetables quality during harvesting, transportation, storage and marketing. ... The coolers were found to be effective in maintaining micro-environmental conditions for ... AJOL African Journals Online.
Full Text Available A major challenge for international development is to assist the poorest regions to achieve development targets while taking climate change into account. Such ‘climate resilient development’ (CRD must identify and implement adaptation strategies for improving livelihoods while also being cost-effective. While the idea that climate resilience and development goals should be compatible is often discussed, empirical evaluations of the economic impacts of actual CRD investments are practically non-existent. This paper outlines a framework to evaluate economic returns to CRD and applies it in two adaptation strategies trialed in Nusa Tenggara Barat Province, eastern Indonesia. The evaluation framework is composed of three models: a household benefit cost model, a diffusion model, and a regional benefit cost model. The models draw upon the impact evaluation, technology diffusion, and risk assessment literatures, respectively. The analyzes are based on expert opinion and locally-derived information, and hence can be applied in data-poor situations typical of developing countries. Our results explore economic costs and benefits at the household and regional scale, and we identify key input variables that greatly influence the economic returns of the strategies. These variables should therefore be a focus of ongoing investment. We also discuss how the framework is more generally applicable, its limitations including challenges in accounting for less tangible social and ecosystem service benefits, potentially leading to the underestimation of impacts, and how the approach should be complemented by qualitative methods.
Stiles, R A; Mick, S S
This article identifies the components that contribute to a healthcare organization's costs in controlling quality. A central tenet of our argument is that at its core, quality is the result of a series of transactions among members of a diverse network. Transaction cost economics is applied internally to analyze intraorganizational transactions that contribute to quality control, and questions for future research are posed.
Assessment of the effect of innovation on the costs of a uranium ore concentration plant by means of a technical and economic model. Examples of applications: direct precipitation of the peroxide UO4 xH2O high temperature and high concentration alkaline treatment
Boutonnet, G.; Roullier, J.P.
Uranium Pechiney Ugine Kuhlmann has developed an economic model for uranium ore treatment plants. In this model, the basic economic data for a given plant, such as capital expenditures, operating costs, etc. are derived from parameters based partly on the size of the plant and the production progamme considered, and partly on the cost and specifications of the ore to be treated. In addition to numerous macro-economic applications (not considered here), the model can be used for making coherent comparisons of the economy of a plant designed for an innovative production process with that of the same plant designed for a conventional process of acid treatment followed by solvent extraction. The model shows that two new processes are highly competitive with the conventional process. They are: 1. Direct precipitation of the peroxide UO 4 xH 2 O in the pregnant liquor without concentration or purification by solvents or exchangers, and 2. High temperature and high concentration alkaline treatment
Anderson, D.M.; Shankle, S.A.; Scott, M.J.; Neitzel, D.A.; Chatters, J.C.
This work resulted from a continuing multidisciplinary analysis of species preservation and global change. The paper explores the economic cost of a potential regional warming as it affects one Pacific Northwest natural resource, the spring chinook salmon (Oncorhynchus tshcawytscha). Climate change and planned habitat improvements impact the production and economic value of soling chinook salmon of the Yakima River tributary of the Columbia River in eastern Washington. The paper presents a derivation of the total economic value of a chinook salmon, which includes the summation of the existence, commercial, recreational, and capital values of the fish. When currently available commercial, recreational, existence, and capital values for chinook salmon were applied to estimated population changes, the estimated change in the economic value per fish associated with reduction of one fish run proved significant
Nuclear operating and maintenance (O and M) costs for U.S. plants have been increasing during the decade of the 1980's. Costs have stabilized over the last five years but have not yet significantly declined. Annual capacity factors have considerably improved during the last eight years and unit O and M costs expressed in Mills Kwh have thus declined. Two other important trends evident over the last five years have been the decline in fossil fuel prices and the transition to deregulated electric utilities market, accelerated with the passage of the 1992 Energy Policy Act. Within the next five years it may be possible for large scale industrial customers to directly contract with electricity generators, by they utilities or independent power producers (IPP's) for supplying their power requirements. The ability of such customers to directly contract with potential supplies based on low cost performance bypassing their local utility, may have significant implications for the structure of the utility industry in the near term and for plant operations. A greater pressure will likely be exerted on all plants, including nuclear to reduce operating costs so as to remain competitive with other power suppliers in their markets. Nuclear O and M costs are likely to be heavily scrutinized for possible savings and reductions. The electric utilities mergers waves and the nuclear industry's initiative on O and M cost control both aim at improving plant economics so as to better compete in the more deregulated environment. In this climate the issues of why nuclear O and M costs have increased, what can be done to reduce costs and what are the implications for advanced reactors design and economics are discussed. 14 figs
Darnton-Hill, Ian; Webb, Patrick; Harvey, Philip W J; Hunt, Joseph M; Dalmiya, Nita; Chopra, Mickey; Ball, Madeleine J; Bloem, Martin W; de Benoist, Bruno
Vitamin and mineral deficiencies adversely affect a third of the world's people. Consequently, a series of global goals and a serious amount of donor and national resources have been directed at such micronutrient deficiencies. Drawing on the extensive experience of the authors in a variety of institutional settings, the article used a computer search of the published scientific literature of the topic, supplemented by reports and published and unpublished work from the various agencies. In examining the effect of sex on the economic and social costs of micronutrient deficiencies, the paper found that: (1) micronutrient deficiencies affect global health outcomes; (2) micronutrient deficiencies incur substantial economic costs; (3) health and nutrition outcomes are affected by sex; (4) micronutrient deficiencies are affected by sex, but this is often culturally specific; and finally, (5) the social and economic costs of micronutrient deficiencies, with particular reference to women and female adolescents and children, are likely to be considerable but are not well quantified. Given the potential impact on reducing infant and child mortality, reducing maternal mortality, and enhancing neuro-intellectual development and growth, the right of women and children to adequate food and nutrition should more explicitly reflect their special requirements in terms of micronutrients. The positive impact of alleviating micronutrient malnutrition on physical activity, education and productivity, and hence on national economies suggests that there is also an urgent need for increased effort to demonstrate the cost of these deficiencies, as well as the benefits of addressing them, especially compared with other health and nutrition interventions.
Langmo, A.; Braun, C.
In the developed countries having existing nuclear programs, the situation necessitates lower total power generation cost. The restructuring of utility industry due to the deregulation causes to reorganize the ownership of some nuclear plants, and the overall economics of nuclear plants in relation to their local competition is reexamined. The reluctance to make any new long term capital cost commitment arises, and it makes new plant construction less likely in near future, and plant upgrading and improvement to be put to intense scrutiny. The capital cost recovery in existing nuclear plants in USA is discussed. It is important to recognize that there is very little that can be done to affect already expended capital, and only that can be done is to improve plant capacity factors, besides write-off. The roles of architects and engineers in improved plant economics are now evaluated by the various organizations which are interested in the participation in new nuclear industry reorganization and restructuring. The reduction of operation and maintenance costs and capital investment, and the improvement of capacity factor are reported. In new ALWR construction program, architects and engineers can significantly support the control of plant capital costs by the selection of the plant design and the sites, and the strategies of procurement and contract, construction schedule and others. (K.I.)
Glenn Jenkins; Bahro BERHAN
In the 1980's it was popular to introduce incentive systems for the promotion of taxpayer compliance. The partial VAT refunds for consumer purchases that are examined in this paper represent one of such schemes. The partial VAT refund system was an idea that was popular amongst professional tax administrators in the 1980s and as a consequence was implemented throughout Central America, Bolivia and Turkey. Such proposals were made with little or no research on the compliance or economic costs ...
Radu A. Păun
We begin by investigating the use of complex contracts in Romania. A transparent transaction cost economics (TCE) model generates the hypothesis that buyer and seller relationship-specific investments have opposite effects on contract complexity. Our analysis counters the problem of unobserved heterogeneity, generates estimates of the effects of specific investments that are opposite in sign on opposite sides of the agreement, and explains the patterns in the biases of ordinary least-squares ...
Panchuk, Anastasiia; Radi, Davide
The book presents the lectures delivered during a short course held at Urbino University in summer 2015 on qualitative theory of dynamical systems, included in the activities of the COST Action IS1104 “The EU in the new economic complex geography: models, tools and policy evaluation”. It provides a basic introduction to dynamical systems and optimal control both in continuous and discrete time, as well as some numerical methods and applications in economic modelling. Economic and social systems are intrinsically dynamic, characterized by interdependence, nonlinearity and complexity, and these features can only be approached using a qualitative analysis based on the study of invariant sets (equilibrium points, limit cycles and more complex attractors, together with the boundaries of their basins of attraction), which requires a trade-off between analytical, geometrical and numerical methods. Even though the early steps of the qualitative theory of dynamical systems have been in continuous time models, in e...
Fragoulakis, Vassilis; Stamoulis, Kostas; Grouzi, Elisabeth; Maniadakis, Nikolaos
The goal of this study was to estimate the cost of production of 1 unit of blood from a National Health Service perspective in Greece. In agreement with guidelines, the cost of blood production in this study accounted only for the resources expended for collection, processing, laboratory testing, and storage. Hence, the costs associated with donor recruitment, pretransfusion preparation, transfusion administration, follow-up management of adverse events, and other long-term relevant costs were not taken into consideration. The indirect cost of blood donations for donors (productivity loss) was also considered. A questionnaire was used to collect data regarding personnel time, annual blood quantities collected, percentage of wastage, utilization of consumables, institutional overhead, information technology expenditure, medical equipment utilized, nuclear acid tests, and other factors. Data gathered by 53 hospitals across the country were assessed. A model was constructed with economic data collected by the National School of Public Health and the Ministry of Health. All data refer to the year 2013. The weighted mean direct cost of producing 1 unit of blood was estimated at €131.49 (SD, €22.12; minimum/maximum, €94.96-€239.20). The mean total indirect cost was estimated at €34 per unit of blood. The cost distribution was positively skewed (skewness, 1.642 [0.327]). The major cost component was the cost of personnel, accounting for 32.5% of total costs, and the average of blood unit wastage was estimated at 4.90%. There were no differences between the cost of producing 1 unit of blood in Athens compared with the rest of the country (Mann-Whitney test, P = 0.341). This study suggests that the cost of producing 1 unit of blood is not insignificant. These figures need to be complemented with those concerning the cost of transfusion to have a complete picture of producing and using 1 unit of blood locally. Copyright © 2014 Elsevier HS Journals, Inc. All
... 47 Telecommunication 3 2010-10-01 2010-10-01 false Proxies for forward-looking economic cost. 51... SERVICES (CONTINUED) INTERCONNECTION Pricing of Elements § 51.513 Proxies for forward-looking economic cost... a cost study that complies with the forward-looking economic cost based pricing methodology...
Oostenbrink, Jan B; Koopmanschap, Marc A; Rutten, Frans F H
The lack of a uniform costing methodology is often considered a weakness of economic evaluations that hinders the interpretation and comparison of studies. Standardisation is therefore an important topic within the methodology of economic evaluations and in national guidelines that formulate the formal requirements for studies to be considered when deciding on the reimbursement of new medical therapies. Recently, the Dutch Manual for Costing: Methods and Standard Costs for Economic Evaluations in Health Care (further referred to as "the manual") has been published, in addition to the Dutch guidelines for pharmacoeconomic research. The objectives of this article are to describe the main content of the manual and to discuss some key issues of the manual in relation to the standardisation of costs. The manual introduces a six-step procedure for costing. These steps concern: the scope of the study;the choice of cost categories;the identification of units;the measurement of resource use;the monetary valuation of units; andthe calculation of unit costs. Each step consists of a number of choices and these together define the approach taken. In addition to a description of the costing process, five key issues regarding the standardisation of costs are distinguished. These are the use of basic principles, methods for measurement and valuation, standard costs (average prices of healthcare services), standard values (values that can be used within unit cost calculations), and the reporting of outcomes. The use of the basic principles, standard values and minimal requirements for reporting outcomes, as defined in the manual, are obligatory in studies that support submissions to acquire reimbursement for new pharmaceuticals. Whether to use standard costs, and the choice of a particular method to measure or value costs, is left mainly to the investigator, depending on the specific study setting. In conclusion, several instruments are available to increase standardisation in
Urdahl, H; Knapp, M; Edgell, E T; Ghandi, G; Haro, J M
We present unit costs corresponding to resource information collected in the Schizophrenia Outpatient Health Outcomes (SOHO) Study. The SOHO study is a 3-year, prospective, observational study of health outcomes associated with antipsychotic treatment in out-patients treated for schizophrenia. The study is being conducted across 10 European countries (Denmark, France, Germany, Greece, Ireland, Italy, the Netherlands, Portugal, Spain and the UK) and includes over 10,800 patients and over 1000 investigators. To identify the best available unit costs of hospital admissions, day care and psychiatrist out-patient visits, a tariff-based approach was used. Unit costs were obtained for nine of the 10 countries and were adjusted to 2000 price levels by consumer price indices and converted to US dollars using purchasing power parity rates (and on to Euro). The paper illustrates the need to balance the search for sound unit costs with pragmatic solutions in the costing of international economic evaluations.
Stelluto, Janis D.
Low-level radioactive waste (LLW) management is a growth industry. Since 1980, when the LLW Policy Act was passed, regional and state LLW bureaucracies have grown, and LLW services and consulting businesses have prospered. Most states and federal agencies have LLW programs with increased regulation of LLW management. Costs of all these programs have soared as facilities for LLW disposal are proposed in sixteen, or more, locations in the country. LLW management costs have also increased as licensees implement comprehensive programs for volume reduction and waste form stabilization. Yet, the total cost of LLW management service is borne by nearly the same universe of payers as in 1980: taxpayers and radioactive materials licensees. Those costs are, in turn, passed on through taxes and consumer costs. Ultimately, everybody pays. Despite this investment, the LLW situation is adrift. New facilities have not been built, and existing facilities are closing or limiting access. LLW management has not advanced to a respected field of engineering and science. Nor does it include exceptional benefit and opportunity to host communities. A new focus is needed to allow an economically sound solution to emerge, one where the supply of LLW management and disposal fits the demand for service. (author)
Jason, Leonard A; Benton, Mary C; Valentine, Lisa; Johnson, Abra; Torres-Harding, Susan
Background ME/CFS is characterized by debilitating fatigue in addition to other physical and cognitive symptoms. It is estimated to affect over 800,000 adults in the U.S. ME/CFS often results in diminished functionality and increased economic impact. The economic impact of an illness is generally divided into two categories: direct and indirect costs. Despite high prevalence rates and the disabling nature of the illness, few studies have examined the costs of ME/CFS at the individual and soci...
Full Text Available Abstract This paper addresses the potential for using economic regulation, e.g. taxes or subsidies, as instruments to combat the increasing problems of inappropriate diets, leading to health problems such as obesity, diabetes 2, cardiovascular diseases etc. in most countries. Such policy measures may be considered as alternatives or supplements to other regulation instruments, including information campaigns, bans or enhancement of technological solutions to the problems of obesity or related diseases. 7 different food tax and subsidy instruments or combinations of instruments are analysed quantitatively. The analyses demonstrate that the average cost-effectiveness with regard to changing the intake of selected nutritional variables can be improved by 10–30 per cent if taxes/subsidies are targeted against these nutrients, compared with targeting selected food categories. Finally, the paper raises a range of issues, which need to be investigated further, before firm conclusions about the suitability of economic instruments in nutrition policy can be drawn.
Jensen, Jørgen Dejgård; Smed, Sinne
This paper addresses the potential for using economic regulation, e.g. taxes or subsidies, as instruments to combat the increasing problems of inappropriate diets, leading to health problems such as obesity, diabetes 2, cardiovascular diseases etc. in most countries. Such policy measures may....... The analyses demonstrate that the average cost-effectiveness with regard to changing the intake of selected nutritional variables can be improved by 10–30 per cent if taxes/subsidies are targeted against these nutrients, compared with targeting selected food categories. Finally, the paper raises a range...... of issues, which need to be investigated further, before firm conclusions about the suitability of economic instruments in nutrition policy can be drawn....
Marston, R. A.
Severe hand injuries constitute the largest number of acute referrals to this plastic surgery unit, the admission of these patients often displacing routine admissions due to bed shortages, thus increasing waiting list time. This study showed that a high percentage of these injuries were alcohol-related and were therefore preventable. The economic cost to the unit is discussed.
Full Text Available This paper estimates the macroeconomic effects of increased spending on defense and internal security necessitated by the decade-long Maoist insurgency in Nepal. An investment equation is specified to examine the relationship between defense spending and investment. The estimation results indicate that there is a significant negative effect of defense spending on investment. A simple Harrod-Domar growth relationship is used to estimate the effect of the increase in defense spending on economic growth. This analysis suggests that between 1996 and 2006, the opportunity cost of the conflict in terms of lost output has been about 3 percent of Nepal’s current GDP.
Sharifi, Laleh; Dashti, Raheleh; Pourpak, Zahra; Fazlollahi, Mohammad Reza; Movahedi, Masoud; Chavoshzadeh, Zahra; Soheili, Habib; Bokaie, Saied; Kazemnejad, Anoushiravan; Moin, Mostafa
Asthma is the first cause of children hospitalization and need for emergency and impose high economic burden on the families and governments. We aimed to investigate the economic burden of pediatric asthma and its contribution to family health budget in Iran. Overall, 283 pediatric asthmatic patients, who referred to two tertiary pediatric referral centers in Tehran capital of Iran, included from 2010-2012. Direct and indirect asthma-related costs were recorded during one-year period. Data were statistically analyzed for finding association between the costs and factors that affect this cost (demographic variables, tobacco smoke exposure, control status of asthma and asthma concomitant diseases). Ninety-two (32.5%) females and 191(67.5%) males with the age range of 1-16 yr old were included. We found the annual total pediatrics asthma related costs were 367.97±23.06 USD. The highest cost belonged to the medications (69%) and the lowest one to the emergency (2%). We noticed a significant increasing in boys' total costs ( P =0.011), and 7-11 yr old age group ( P =0.018). In addition, we found significant association between total asthma costs and asthma control status ( P =0.011). The presence of an asthmatic child can consume nearly half of the health budget of a family. Our results emphasis on improving asthma management programs, which leads to successful control status of the disease and reduction in economic burden of pediatric asthma.
Shanahan, M; Donato, R
The principal objective of this paper is to identify the economic costs and benefits of pedophile treatment programs incorporating both the tangible and intangible cost of sexual abuse to victims. Cost estimates of cognitive behavioral therapy programs in Australian prisons are compared against the tangible and intangible costs to victims of being sexually abused. Estimates are prepared that take into account a number of problematic issues. These include the range of possible recidivism rates for treatment programs; the uncertainty surrounding the number of child sexual molestation offences committed by recidivists; and the methodological problems associated with estimating the intangible costs of sexual abuse on victims. Despite the variation in parameter estimates that impact on the cost-benefit analysis of pedophile treatment programs, it is found that potential range of economic costs from child sexual abuse are substantial and the economic benefits to be derived from appropriate and effective treatment programs are high. Based on a reasonable set of parameter estimates, in-prison, cognitive therapy treatment programs for pedophiles are likely to be of net benefit to society. Despite this, a critical area of future research must include further methodological developments in estimating the quantitative impact of child sexual abuse in the community.
Ogah, Okechukwu S; Stewart, Simon; Onwujekwe, Obinna E; Falase, Ayodele O; Adebayo, Saheed O; Olunuga, Taiwo; Sliwa, Karen
Heart failure (HF) is a deadly, disabling and often costly syndrome world-wide. Unfortunately, there is a paucity of data describing its economic impact in sub Saharan Africa; a region in which the number of relatively younger cases will inevitably rise. Heath economic data were extracted from a prospective HF registry in a tertiary hospital situated in Abeokuta, southwest Nigeria. Outpatient and inpatient costs were computed from a representative cohort of 239 HF cases including personnel, diagnostic and treatment resources used for their management over a 12-month period. Indirect costs were also calculated. The annual cost per person was then calculated. Mean age of the cohort was 58.0 ± 15.1 years and 53.1% were men. The total computed cost of care of HF in Abeokuta was 76, 288,845 Nigerian Naira (US$508, 595) translating to 319,200 Naira (US$2,128 US Dollars) per patient per year. The total cost of in-patient care (46% of total health care expenditure) was estimated as 34,996,477 Naira (about 301,230 US dollars). This comprised of 17,899,977 Naira- 50.9% ($US114,600) and 17,806,500 naira -49.1%($US118,710) for direct and in-direct costs respectively. Out-patient cost was estimated as 41,292,368 Naira ($US 275,282). The relatively high cost of outpatient care was largely due to cost of transportation for monthly follow up visits. Payments were mostly made through out-of-pocket spending. The economic burden of HF in Nigeria is particularly high considering, the relatively young age of affected cases, a minimum wage of 18,000 Naira ($US120) per month and considerable component of out-of-pocket spending for those affected. Health reforms designed to mitigate the individual to societal burden imposed by the syndrome are required.
Okechukwu S Ogah
Full Text Available BACKGROUND: Heart failure (HF is a deadly, disabling and often costly syndrome world-wide. Unfortunately, there is a paucity of data describing its economic impact in sub Saharan Africa; a region in which the number of relatively younger cases will inevitably rise. METHODS: Heath economic data were extracted from a prospective HF registry in a tertiary hospital situated in Abeokuta, southwest Nigeria. Outpatient and inpatient costs were computed from a representative cohort of 239 HF cases including personnel, diagnostic and treatment resources used for their management over a 12-month period. Indirect costs were also calculated. The annual cost per person was then calculated. RESULTS: Mean age of the cohort was 58.0 ± 15.1 years and 53.1% were men. The total computed cost of care of HF in Abeokuta was 76, 288,845 Nigerian Naira (US$508, 595 translating to 319,200 Naira (US$2,128 US Dollars per patient per year. The total cost of in-patient care (46% of total health care expenditure was estimated as 34,996,477 Naira (about 301,230 US dollars. This comprised of 17,899,977 Naira- 50.9% ($US114,600 and 17,806,500 naira -49.1%($US118,710 for direct and in-direct costs respectively. Out-patient cost was estimated as 41,292,368 Naira ($US 275,282. The relatively high cost of outpatient care was largely due to cost of transportation for monthly follow up visits. Payments were mostly made through out-of-pocket spending. CONCLUSION: The economic burden of HF in Nigeria is particularly high considering, the relatively young age of affected cases, a minimum wage of 18,000 Naira ($US120 per month and considerable component of out-of-pocket spending for those affected. Health reforms designed to mitigate the individual to societal burden imposed by the syndrome are required.
An easy and low cost option for economic statistical process control using Excel. ... in both economic and economic statistical designs of the X-control chart. ... in this paper and the numerical examples illustrated are executed on this program.
Sherwood, Brent; Woodcock, Gordon R.
Oxygen is the most commonly discussed lunar resource. It will certainly not be the easiest to retrieve, but oxygen's fundamental place in propulsion and life support guarantees it continued attention as a prime candidate for early in situ resource utilization (ISRU). The findings are reviewed of recent investigation, sponsored by NASA-Ames, into the kinds of technologies, equipment, and scenarios (the engineering and operations costs) that will be required even to initiate lunar oxygen production. The infrastructure necessary to surround and support a viable oxygen-processing operation is explained. Selected details are used to illustrate the depth of technology challenges, extent of operations burdens, and complexity of decision linkages. Basic assumptions, and resulting timelines and mass manifests, are listed. These findings are combined with state-of-the-art knowledge of lunar and Mars propulsion options in simple economic input/output and internal-rate-of-return models, to compare production costs with performance benefits. Implications for three realistic scales of exploration architecture - expeditionary, aggressive science, and industrialization/settlement - are discussed. Conclusions are reached regarding the contextual conditions within which production of lunar oxygen (LLOX) is a reasonable activity. LLOX appears less useful for Mars missions than previously hoped. Its economical use in low Earth orbit hinges on production of lunar hydrogen as well. LLOX shows promise for lunar ascent/descent use, but that depends strongly on the plant mass required.
Full Text Available The objective of this paper is to learn about the effects of the adjustment costs, economic growth, imports and exports on human capital labor demand. The dynamic model proposed by Sargent (1978 was adjusted to consider three types of human capital: (a one with fundamental education (1–8 years of schooling; (b one with secondary education level (9–11 years of education; (c and one with tertiary education level (12 years or more of schooling. Using state level panel data, the dynamic econometrics estimates showed the following results: (i the labor market adjustment costs are very higher; (ii the adjustment cost for the human capital with intermediary education level is the highest one compared to the others; (iii the states’ economic growth favor those with superior education; (iv the imports seems to favor the demand for those with intermediate education levels; (v the degree of openness does show some weak effect on the demand for human capitals with intermediate education. In sum, the growing demand for human capital with some superior education seems to be more associated to its lower adjustment cost and economic growth; the non-significance of real wage elasticity and high adjustment cost seems to indicate that the human capital with intermediate knowledge is in short supply; hence, economic education policy that increases supply of such human capital are in need.
Buresti, Giuliana; Colonna, Fabrizio; Corfiati, Marisa; Valenti, Antonio; Persechino, Benedetta; Marinaccio, Alessandro; Rondinone, Bruna Maria; Iavicoli, Sergio
Despite their considerable interest for public health policies and for occupational disease management and assessment, the economic costs of asbestos-related diseases (ARDs) for society have not been fully estimated or even frequently discussed. The aim of this study was to estimate the economic burden of mesothelioma in Italy by assessing the overall societal cost of the disease, applying an econometric model. We analyzed two main cost groups, public and social. The first includes expenditure borne by the State and other public bodies (medical care costs, insurance, tax and benefits), while the latter uses the human capital approach to measure the loss of productivity suffered by the economy as a whole. We provide an estimate of euro 33,000 per patient for medical care costs and euro 25,000 for insurance and compensation; tax and benefits seem to roughly compensate. We estimated a loss of more than euro 200,000 per patient, in terms of loss of production. This study offers a practical approach for estimating the economic impact of mesothelioma, and provides empirical evidence of the huge economic burden linked to this disease, with its high etiologic fraction.
Cook, C.; Cross, J.
The Maryland legislature approved net-metering legislation for residential consumer generators with photovoltaic systems during 1997. Before the legislation passed, the Maryland Energy Administration (MEA) examined its potential economic impact on both the affected utilities and consumer ratepayers--with and without net-metered PV systems. The MEA discovered that the impact on the affected utility is minimal when the net-metered PV capacity is limited to a small percentage of utility peak load. The analysis also determined that the cost burden on other customers under a net-metered scenario is likewise limited. For Maryland's largest investor-owned utility, the maximum amount of any cross-subsidy (or cost) on a per customer basis is 46 cents annually. Furthermore, their analysis showed that when distribution system savings and environmental externalities are incorporated, net-metered customers may actually subsidize other utility customers. The MEA analysis also determined that about 50% of the value of the energy produced is lost if net metering is not available to those customers with grid tied PV systems. Over the long term, most if not all of any potential cost is borne by other residential customers, not utility shareholders. Finally, the additional cost burden to the utility under net metering--compensating the consumer at the retail rate versus the avoided cost rate--is less than expected when one considers the administrative costs associated with a dual-metered billing approach
Puig-Junoy, Jaume; Ruiz Zamora, Alba
The burden of illness that can be attributed to osteoarthritis is considerable and ever increasing. The aim of this systematic review is to analyze currently available data derived from cost-of-illness studies on the healthcare and non-healthcare costs of osteoarthritis. PubMed, Index Medicus Español (IME), and the Spanish Database of Health Sciences [Índice Bibliográfico Español en Ciencias de la Salud (IBECS)] were searched up to the end of April 2013. This study adhered to the PRISMA guidelines. Articles were reviewed and the study quality assessed by two independent investigators with consensus resolution of discrepancies. We identified 39 studies that investigated the socio-economic cost of osteoarthritis. Only nine studies took a social perspective. Rather than estimating the incremental cost of osteoarthritis, nine studies estimated the total cost of treating patients with osteoarthritis without a control for comorbidity. The other 30 studies determined the incremental cost with or without a control group. Only nine studies assessed a comprehensive list of healthcare resources. The annual incremental healthcare costs of generalized osteoarthritis ranged from €705 to €19,715. The annual incremental non-healthcare-related costs of generalized osteoarthritis ranged from €432 to €11,956. The study concludes that the social cost of osteoarthritis could be between 0.25% and 0.50% of a country׳s GDP. This should be considered in order to foster studies that take into account both healthcare and non-healthcare costs. Copyright © 2014 Elsevier Inc. All rights reserved.
Bell, David R.; Kamens, Richard; Silalertruksa, Thapat; Gheewala, Shabbir H.
Biofuels are expected to represent a growing portion of liquid fuel consumption in Thailand due to environmental and social considerations in conjunction with policy goals supporting their domestic production and consumption. This paper reviews the economic costs associated with biofuel policy implementation in Thailand in the short term target year of 2011. Internal (production) and external (environmental, social, etc.) costs and benefits are evaluated, and, where possible, monetized. Domestic production of biofuel is calculated to be 9.5 billion THB (317 million USD) more expensive than importing the equivalent amount of petroleum. The environmental benefits from GHG savings as well as losses due to increased ground level ozone formation and government expenditure to support the biofuel industry yield a total 'net cost' of 8.6 billion THB or 121 THB (4.04 USD) per capita for the year 2011. This result is contextualized with the (non-monetized) consideration that although biofuels are somewhat more expensive in the short term, their domestic production allows virtually all of the money to stay within the Thai economy as opposed to being sent abroad. This fact, coupled with significant uncertainty in future petroleum prices, could strongly influence the direction of Thai policy with respect to biofuels. (author)
The economic impacts of mycotoxins to human society can be thought of in two ways: (i) the direct market costs associated with lost trade or reduced revenues due to contaminated food or feed, and (ii) the human health losses from adverse effects associated with mycotoxin consumption. Losses related to markets occur within systems in which mycotoxins are being monitored in the food and feed supply. Food that has mycotoxin levels above a particular maximum allowable level is either rejected outright for sale or sold at a lower price for a different use. Such transactions can take place at local levels or at the level of trade among countries. Sometimes this can result in heavy economic losses for food producers, but the benefit of such monitoring systems is a lower risk of mycotoxins in the food supply. Losses related to health occur when mycotoxins are present in food at levels that can cause illness. In developed countries, such losses are often measured in terms of cost of illness; around the world, such losses are more frequently measured in terms of disability-adjusted life years (DALYs). It is also useful to assess the economics of interventions to reduce mycotoxins and their attendant health effects; the relative effectiveness of public health interventions can be assessed by estimating quality-adjusted life years (QALYs) associated with each intervention. Cost-effectiveness assessment can be conducted to compare the cost of implementing the intervention with the resulting benefits, in terms of either improved markets or improved human health. Aside from cost-effectiveness, however, it is also important to assess the technical feasibility of interventions, particularly in low-income countries, where funds and infrastructures are limited.
Gonzalo, Teresa; García Goñi, Manuel; Muñoz-Fernández, María Angeles
Star celebrities such as Rock Hudson, Freddie Mercury, Magic Johnson, and Isaac Asimov have unfortunately something in common: they were all victims of the HIV global pandemic. Since then HIV infection has become considered a pandemic disease, and it is regarded as a priority in healthcare worldwide. It is ranked as the first cause of death among young people in industrialized countries, and it is recognized as a public healthcare problem due to its human, social, mass media, and economic impact. Incorporation of new and highly active antiretroviral treatment, available since 1996 for HIV/AIDS treatment, has provoked a radical change in the disease pattern, as well as in the impact on patient survival and quality of life. The pharmaceutical industry's contribution, based on the research for more active new drugs, has been pivotal. Mortality rates have decreased significantly in 20 years by 50% and now AIDS is considered a chronic and controlled disease. In this review we have studied the impact of HAART treatment on infected patients, allowing them to maintain their status as active workers and the decreased absenteeism from work derived from this, contributing ultimately to overall social wealth and, thus, to economic growth. Furthermore, an analysis of the impact on healthcare costs, quality of life per year, life per year gained, cost economic savings and cost opportunity among other parameters has shown that society and governments are gaining major benefits from the inclusion of antiretroviral therapies in HIV/AIDS patients.
Full Text Available An exploratory study has been carried out to evaluate the cost of heat supplied by a pressurized water reactor type of nuclear reactors to thermal desalination processes. In the context of this work, simplified models have been developed to describe the thermodynamics of power conversion, the energetics of multi-effect evaporation (MED, and the costs of electricity and heat cogenerated by the dual-purpose power plant. Application of these models show that, contrary to widespread belief, (nuclear-powered MED and seawater reverse osmosis are comparable in terms of energy effectiveness. Process heat can be produced, in fact, by a relatively small increase in the core power. As fuel represents just a fraction of the cost of nuclear electricity, the increase in fuel-related expenses is expected to have limited impact on power generation economics.
Ofori, Roland Oduro
I adapt the Harberger formula for deadweight loss to develop approximations for the deadweight loss created by multiple fuel price subsidies. I also estimate the own-price, cross-price, and income elasticities of demand for gasoline and diesel in Africa. I use data on fuel prices and sales in combination with my formulas and elasticity estimates to calculate the deadweight loss of fuel price subsidies in Ghana from 2009 to 2014. I show that the average efficiency cost of the gasoline and diesel price subsidies in Ghana is 0.8% of fuel price subsidy transfers. This result stresses the futility of basing subsidy reforms on economic efficiency losses, which are relatively small due to very inelastic energy demand, and the need for such reforms to be motivated by the poor-targeting of subsidies to low-income households and the impact of subsidies on government debt-financing.
De Leo, G. A.
In this work it has been analysed the potential diffusion of renewable energy sources and co-generation in the Italian market on the basis of the level of maturation of the different technologies, predicted market growth and environmental impacts associated to them. A sensitivity analysis on external costs generated by global climate changes has allowed everybody to assess how possible errors in estimating the potential impact of greenhouse gasses can affect the estimate of the economic performances of different scenarios of energetic development. On the basis of these considerations, it can be outlined a potential doubling of energy production by renewable energies in the next 10 years, with specific reference of small hydroelectric, biogass and eolic power plants [it
Torres Fernández, Alfredo; Díaz de los Ríos, Manuel; Saura Laria, Gustavo
The prices of ammonium salts which are used in the torula yeast production technology are very high nowadays. In the other hand, this technology has very high energy costs which are consumed by blowers in fermentation, separators machines and in the concentration and drying of yeast. In this paper, different technical alternatives are analyzed for reducing the production cost of torula yeast, through changes in production inputs, electric motors and the replacement of a portion of the fuel used for drying by biogas. Then, the economic feasibility in both currencies is evaluated for practical application. (author)
Alfredo Torres Fernández
Full Text Available The prices of ammonium salts which are used in the torula yeast production technology are very high nowadays. In the other hand, this technology has very high energy costs which are consumed by blowers in fermentation, separators machines and in the concentration and drying of yeast. In this paper, different technical alternatives are analyzed for reducing the production cost of torula yeast, through changes in production inputs, electric motors and the replacement of a portion of the fuel used for drying by biogas. Then, the economic feasibility in both currencies is evaluated for practical application.
Mohammed Saad Dwiddar
Full Text Available A methodology of evaluating the economics of the front-end nuclear fuel cycle with a price change sensitivity analysis for a VVER-1000 reactor core as a case study is presented. The effect of increasing the fuel enrichment and its corresponding reactor cycle length on the energy cost is investigated. The enrichment component was found to represent the highly expenses dynamic component affecting the economics of the front-end fuel cycle. Nevertheless, the increase of the fuel enrichment will increase the reactor cycle length, which will have a positive feedback on the electricity generation cost (cent/KWh. A long reactor operation time with a cheaper energy cost set the nuclear energy as a competitive alternative when compared with other energy sources.
Damayanti, Irma; Nur Bambang, Azis; Retnaningsih Soeprobowati, Tri
Petungkriyono is the last tropical forest in Java and provides biodiversity including rare flora and fauna that must be maintained, managed and utilized in order to give meaning for humanity and sustainability. Services of Forest Ecosystem in Petungkriyono are included such as goods supply, soil-water conservation, climate regulation, purification environment and flora fauna habitats. The approach of this study is the literature review from various studies before perceiving the influenced of economic valuation in determining the measurement conservation strategies of Petungkriyono Natural Forest Ecosystem in Pekalongan Regency. The aims of this study are to analyzing an extended benefit cost of natural forest ecosystems and internalizing them in decision making. The method of quantification and valuation of forest ecosystem is Cost and Benefit Analysis (CBA) which is a standard economic appraisal tools government in development economics. CBA offers the possibility capturing impact of the project. By using productivity subtitution value and extended benefit cost analysis any comodity such as Backwoods,Pine Woods, Puspa woods and Pine Gum. Water value, preventive buildings of landslide and carbon sequestration have total economic value of IDR.163.065.858.080, and the value of Extended Benefit Cost Ratio in Petungkriyono is 281.35 %. However, from the result is expected the local government of Pekalongan to have high motivation in preserve the existence of Petungkriyono forest.
Full Text Available With the growing global awareness of the requirement for sustainable development, economic development is no longer the sole objective of business activities. The need to find a balance between environmental impacts and economic benefits is especially the case for airport operations in or around cities. This study measured the environmental costs and economic benefits and of an airport for a period of 10 years, using Taipei Songshan Airport for the empirical analysis, to examine whether the environmental costs could outweigh the economic benefits. Of all the environmental negative side effects, aircraft engine emissions and noise nuisance are considered the main sources of environmental impacts. The dose-response method and the hedonic price method, respectively, were used for estimating the social costs of these. Income generation from both direct and secondary employment is measured as economic benefits by applying the Garin-Lowry model, originally developed in 1966, for estimation of the employment multiplier. The results show that, in general, the operation of Taipei Songshan Airport brought more economic benefits than environmental costs. The sensitivity analysis of emissions and noise social cost parameters shows that the environmental costs might have exceeded the economic benefits in 2008 and 2009 in certain high emissions and noise social cost cases.
Lichterfeld-Kottner, Andrea; Hahnel, Elisabeth; Blume-Peytavi, Ulrike; Kottner, Jan
Skin conditions and dermatological diseases associated with advanced age (e.g. fungal infection, dry skin and itch) receive increasingly attention in clinical practice and research. Cost and economic evaluations are important sources to inform priority setting and ressource allocation decisions in healthcare. The economics of skin conditions in aged populations has not been systematically reviewed so far. The aim of this mapping review was to summarize the economic evidence of selected skin conditions in the aged (65 + years). A mapping literature review and evidence summary was conducted. Searches were conducted in data bases Medline and Embase via OVID. Cinahl was searched using EBSCO. References lists of potential eligible studies, reviews, guidelines or other sources were screened for additional literature. For evaluation of methodological quality of full economic analyses the Consensus on Health Economic Criteria (CHEC) checklist was used. Database searches resulted in 1388 records. A total of 270 articles were read in full-text. Thirty-five publications were finally included in the data analysis reporting 38 economic analyses. Ten cost of illness analyses and 26 cost-effectiveness analyses reporting about pressure ulcers, skin tears, pressure ulcers, incontinence associated dermatitis and intertrigo/contact dermatitis/candidiasis treatment and prevention and onychomycosis testing were identified. Limited evidence indicated that low air loss beds were more cost effective than standard beds for prevention of pressure ulcers. Standardized skin care regimens seem to lower the incidence of pressure ulcers, skin tears and IAD but a cost saving effect was not always observed. Findings of this mapping review indicate that there is a paucity of high quality evidence regarding the economic impact of age-associated skin conditions and diseases. Substantial heterogeneity in terms of study design, evaluation perspective, time period, and way of cost estimation was
Full Text Available Many countries seek to become a global logistics center linking major trading ports. They are competitively constructing container ports. The aggressive competition creates overcapacity situation in the container port sector. Massive investments are required to construct container ports with terminals, docks, storage areas and hinterlands. Nevertheless, it is not easy for container ports to have sufficient container cargo volumes to justify the massive investments. Therefore, container ports of individual countries are required to develop effective strategies to have enough traffic volumes. Based on country-level analysis, this study is designed to investigate empirically internal capabilities and external environments of logistics costs and traffic volumes in individual container ports. A theoretical foundation, the transaction cost economics (TCE is applied to support and explain empirical findings.
Seuring, Till; Archangelidi, Olga; Suhrcke, Marc
There has been a widely documented and recognized increase in diabetes prevalence, not only in high-income countries (HICs) but also in low- and middle-income countries (LMICs), over recent decades. The economic burden associated with diabetes, especially in LMICs, is less clear. We provide a systematic review of the global evidence on the costs of type 2 diabetes. Our review seeks to update and considerably expand the previous major review of the costs of diabetes by capturing the evidence on overall, direct and indirect costs of type 2 diabetes worldwide that has been published since 2001. In addition, we include a body of economic evidence that has hitherto been distinct from the cost-of-illness (COI) work, i.e. studies on the labour market impact of diabetes. We searched PubMed, EMBASE, EconLit and IBSS (without language restrictions) for studies assessing the economic burden of type 2 diabetes published from January 2001 to October 2014. Costs reported in the included studies were converted to international dollars ($) adjusted for 2011 values. Alongside the narrative synthesis and methodological review of the studies, we conduct an exploratory linear regression analysis, examining the factors behind the considerable heterogeneity in existing cost estimates between and within countries. We identified 86 COI and 23 labour market studies. COI studies varied considerably both in methods and in cost estimates, with most studies not using a control group, though the use of either regression analysis or matching has increased. Direct costs were generally found to be higher than indirect costs. Direct costs ranged from $242 for a study on out-of-pocket expenditures in Mexico to $11,917 for a study on the cost of diabetes in the USA, while indirect costs ranged from $45 for Pakistan to $16,914 for the Bahamas. In LMICs-in stark contrast to HICs-a substantial part of the cost burden was attributed to patients via out-of-pocket treatment costs. Our regression analysis
Prices for the rent of a drilling ship are very high. Per day the rent is 1% of the price for building such a ship, and those prices have risen as well. Still, it is attractive for oil companies to rent a drilling ship [nl
The socio-economic consequences of the Danish government's planned further development of wind power energy are discussed in detail. It is claimed that, currently, electricity produced by wind turbines is more expensive than that produced by power stations, if the relative environmental effects are not taken into consideration. It is expected that technological development will contribute to cost reduction by the year 2010 so that electricity produced by wind turbines will be competitive, but until then costs of wind power energy will be high and it is reckoned that losses will be in the range of 5-6 billion Danish crowns, minus 2.5 billion saved by lack of CO 2 emission. The socio-economic factors regarding windmills of various sizes (150 kW and 225 kW) are calculated and the planned development of wind power until 2010 is explained. The socio-economic costs of the development programme under various conditions, including the calculation of the saved emissions of carbon dioxide, are discussed. The author states that, in the light of these arguments, he is not in agreement with the governmental plan for the development of wind-turbine produced electricity. It is suggested that this plan could be postponed until such time as wind-power produced electricity should be more competitive in price, and that it should not be pursued during a period of economic recession. (AB)
Ahmad Erani Yustika
Full Text Available Despite Indonesias 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 governments 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.
...: Economic and Environmental Costs of Alien Plant, Animal, and Microbe Species, this reference discusses how non-native species invade new ecosystems and the subsequent economic and environmental effects of these species...
Forté, P S
Conflict is inevitable, especially in highly stressed environments. Clinical environments marked by nurse-physician conflict (and nurse withdrawal related to conflict avoidance) have been proven to be counterproductive to patients. Clinical environments with nurse-physician professional collegiality and respectful communication show decreased patient morbidity and mortality, thus enhancing outcomes. The growth of managed care, and the organizational turmoil associated with rapid change, makes it imperative to structure the health care environment so that conflict can be dealt with in a safe and healthy manner. Professional health care education programs and employers have a responsibility to provide interactive opportunities for multidisciplinary audiences through which conflict management skills can be learned and truly change the interpersonal environment. Professionals must be free to focus their energy on the needs of the patient, not on staff difficulties.
Tian Li; Wang Yongqing; Liu Jingquan; Guo Jilin; Liu Wei
The main methods of economic evaluation of bid which are in common use are introduced. The characteristics of levelized discounted cost method and its application are presented. The method of levelized discounted cost is applied to the cost calculation of a 200 MW nuclear heating reactor economic evaluation. The results indicate that the method of levelized discounted costs is simple, feasible and which is considered most suitable for the economic evaluation of various case. The method is suggested which is used in the national economic evaluation
Denz, Thomas; Smith, Stephanie; Shrestha, Rajeev
.... This study examined whether there is an economic justification for using seaplanes, the method being a quantitative cost comparison between existing conventional fixed-wing aircraft (land planes...
The aim is to assist in the efficient and effective allocation of scarce health ... Again, the study found the direct annual cost per patient to be GH¢2,070.83 and the indirect ... Cost, Breast Cancer, Direct Cost, Indirect Cost, Human Capital Method ...
Fareed, Naleef; Mick, Stephen S
For almost a decade, public and private organizations have pressured hospitals to improve their patient safety records. Since 2008, the Centers for Medicare & Medicaid Services has no longer been reimbursing hospitals for secondary diagnoses not reported during the point of admission. This ruling has motivated some hospitals to engage in safety-oriented programs to decrease adverse events. This study examined which hospitals may engage in patient safety solutions and whether they create these patient safety solutions within their structures or use suppliers in the market. We used a theoretical model that incorporates the key constructs of resource dependence theory and transaction cost economics theory to predict a hospital's reaction to Centers for Medicare & Medicaid Services "never event" regulations. We present propositions that speculate on how forces conceptualized from the resource dependence theory may affect adoption of patient safety innovations and, when they do, whether the adopting hospitals will do so internally or externally according to the transaction cost economics theory. On the basis of forces identified by the resource dependence theory, we predict that larger, teaching, safety net, horizontally integrated, highly interdependent, and public hospitals in concentrated, high public payer presence, competitive, and resource-rich environments will be more likely to engage in patient safety innovations. Following the logic of the transaction cost economics theory, we predict that of the hospitals that react positively to the never event regulation, most will internalize their innovations in patient safety solutions rather than approach the market, a choice that helps hospitals economize on transaction costs. This study helps hospital managers in their strategic thinking and planning in relation to current and future regulations related to patient safety. For researchers and policy analysts, our propositions provide the basis for empirical testing.
Hamilton, L.D.; Manne, A.S.
coal-fired power plants and that with improved control technology sulfur emissions were equivalent to 0.5% sulfur coal (12500 Btu/lb.), additional estimated deaths were 3,600-36,000 annually from air pollution, 800 additional accidental deaths for transport of coal, and 40 additional deaths by mining. Under this same set of assumptions, it turns out that a nationwide nuclear moratorium could cost the U.S. the one-time equivalent of about 300 billion dollars. This can also be expressed as a recurring annual expense over the next 20-40 years of $150 per person or $600 for a family of four. Three hundred billion dollars is an enormous sum for insurance against nuclear disasters that have extremely low probabilities. Both on economic and health grounds, we question whether this type of disaster insurance is worth buying
Slate, S.C.; McDonell, W.R.
The Department of Energy (DOE) is responsible for managing defense high-level wastes (DHLW) from U.S. defense activities using environmentally safe and cost-effective methods. In parallel with its technical programs, the DOE is performing economic studies to ensure that costs are minimized. To illustrate the cost estimating techniques and to provide a sense of cost magnitude, the DHLW costs for the Savannah River Plant (SRP) are calculated. Since operations at SRP must be optimized within relatively fixed management practices, the estimation of incremental costs is emphasized. Treatment and disposal costs are shown to equally contribute to the incremental cost of almost $400,000/canister
Liu, Liang Y.
This report provides an update of the costs of alcohol and drug abuse for 1997. The 1997 costs were estimated by multiplying the percent changes in various socioeconomic factors from 1989 to 1997 by the cost estimates. The adverse health and social consequences of substance abuse extensively increased costs to the state. The total economic costs…
Evgenia Sergeevna Gracheva; Evgeniya Alexandrovna Ermakova
Despite enterprises, which render outsourcing services, appeared on the Russian services market with the beginning of market relations, there are not many researches that deal with competition and cost-effectiveness analyses of outsourcing services in regard to foreign economic activity. Economic integration of Russian business into international economic relations leads to complication of all national foreign economic complex and to the necessity of international economic infrastructure ...
Trasande, Leonardo; Malecha, Patrick; Attina, Teresa M
Preterm birth (PTB) rates (11.4% in 2013) in the United States remain high and are a substantial cause of morbidity. Studies of prenatal exposure have associated particulate matter ≤ 2.5 μm in diameter (PM2.5) and other ambient air pollutants with adverse birth outcomes; yet, to our knowledge, burden and costs of PM2.5-attributable PTB have not been estimated in the United States. We aimed to estimate burden of PTB in the United States and economic costs attributable to PM2.5 exposure in 2010. Annual deciles of PM2.5 were obtained from the U.S. Environmental Protection Agency. We converted PTB odds ratio (OR), identified in a previous meta-analysis (1.15 per 10 μg/m3 for our base case, 1.07-1.16 for low- and high-end scenarios) to relative risk (RRs), to obtain an estimate that better represents the true relative risk. A reference level (RL) of 8.8 μg/m3 was applied. We then used the RR estimates and county-level PTB prevalence to quantify PM2.5-attributable PTB. Direct medical costs were obtained from the 2007 Institute of Medicine report, and lost economic productivity (LEP) was estimated using a meta-analysis of PTB-associated IQ loss, and well-established relationships of IQ loss with LEP. All costs were calculated using 2010 dollars. An estimated 3.32% of PTBs nationally (corresponding to 15,808 PTBs) in 2010 could be attributed to PM2.5 (PM2.5 > 8.8 μg/m3). Attributable PTBs cost were estimated at $5.09 billion [sensitivity analysis (SA): $2.43-9.66 B], of which $760 million were spent for medical care (SA: $362 M-1.44 B). The estimated PM2.5 attributable fraction (AF) of PTB was highest in urban counties, with highest AFs in the Ohio Valley and the southern United States. PM2.5 may contribute substantially to burden and costs of PTB in the United States, and considerable health and economic benefits could be achieved through environmental regulatory interventions that reduce PM2.5 exposure in pregnancy. Citation: Trasande L, Malecha P, Attina TM. 2016
Hamilton, L D [Biomedical and Environmental Assessment Division, National Center for Analysis of Energy Systems, Brookhaven National Laboratory (United States); Manne, A S [Department of Operations Research, Stanford University (United States)
Before the United States of America can arrive at a coherent national energy policy, several ongoing debates must be resolved - on environmental hazards, health impacts, and the direct economic consequences of alternative future energy options. No one strategy is obviously correct - or uniquely ethical. Each strategy has its drawbacks, each can be blocked by one or another coalition of interest groups. The public is poorly informed by the media. A single large coal-mine accident is far more extensively reported than a long series of isolated accidents at grade crossings for coal trains, and yet the latter causes more deaths each year. Similarly, the public debate on nuclear issues is focused on low-probability, high-consequence events. It is as though national policy were being framed by a gambler whose motto is 'it's only the stakes and not the odds that matter'. The two authors of this paper come from different disciplines, yet they both believe that the odds do matter. It is essential that the public be well informed about the health risks and the economic consequences of a moratorium on the civilian uses of nuclear energy in the USA. We think that such a moratorium would adversely affect health and the economy. These impacts although small in relation, say, to the overall death rate or to the overall gross national product are not small in an absolute sense The adverse consequences of a moratorium are much more certain, and surely outweigh the impacts of any plausible accident associated with the operation of power reactors.
Hamilton, L.D.; Manne, A.S.
Before the United States of America can arrive at a coherent national energy policy, several ongoing debates must be resolved - on environmental hazards, health impacts, and the direct economic consequences of alternative future energy options. No one strategy is obviously correct - or uniquely ethical. Each strategy has its drawbacks, each can be blocked by one or another coalition of interest groups. The public is poorly informed by the media. A single large coal-mine accident is far more extensively reported than a long series of isolated accidents at grade crossings for coal trains, and yet the latter causes more deaths each year. Similarly, the public debate on nuclear issues is focused on low-probability, high-consequence events. It is as though national policy were being framed by a gambler whose motto is 'it's only the stakes and not the odds that matter'. The two authors of this paper come from different disciplines, yet they both believe that the odds do matter. It is essential that the public be well informed about the health risks and the economic consequences of a moratorium on the civilian uses of nuclear energy in the USA. We think that such a moratorium would adversely affect health and the economy. These impacts although small in relation, say, to the overall death rate or to the overall gross national product are not small in an absolute sense The adverse consequences of a moratorium are much more certain, and surely outweigh the impacts of any plausible accident associated with the operation of power reactors
Santos, A.M. dos
An analysis of the electric power tariffs by marginal cost in Brazilian sectors is presented with some considerations bout the economy, politics and a forecasting for 1995. Two tables with tariffs and costs are also shown. (author)
Halsing, David L; Moore, Michael R
The mandate to increase endangered salmon populations in the Columbia River Basin of North America has created a complex, controversial resource-management issue. We constructed an integrated assessment model as a tool for analyzing biological-economic trade-offs in recovery of Snake River spring- and summer-run chinook salmon (Oncorhynchus tshawytscha). We merged 3 frameworks: a salmon-passage model to predict migration and survival of smolts; an age-structured matrix model to predict long-term population growth rates of salmon stocks; and a cost-effectiveness analysis to determine a set of least-cost management alternatives for achieving particular population growth rates. We assessed 6 individual salmon-management measures and 76 management alternatives composed of one or more measures. To reflect uncertainty, results were derived for different assumptions of effectiveness of smolt transport around dams. Removal of an estuarine predator, the Caspian Tern (Sterna caspia), was cost-effective and generally increased long-term population growth rates regardless of transport effectiveness. Elimination of adult salmon harvest had a similar effect over a range of its cost estimates. The specific management alternatives in the cost-effective set depended on assumptions about transport effectiveness. On the basis of recent estimates of smolt transport effectiveness, alternatives that discontinued transportation or breached dams were prevalent in the cost-effective set, whereas alternatives that maximized transportation dominated if transport effectiveness was relatively high. More generally, the analysis eliminated 80-90% of management alternatives from the cost-effective set. Application of our results to salmon management is limited by data availability and model assumptions, but these limitations can help guide research that addresses critical uncertainties and information. Our results thus demonstrate that linking biology and economics through integrated models can
Ikuho Kochi; Geoffrey H. Donovan; Patricia A. Champ; John B. Loomis
The economic costs of adverse health effects associated with exposure to wildfire smoke should be given serious consideration in determining the optimal wildfire management policy. Unfortunately, the literature in this research area is thin. In an effort to better understand the nature of these economic costs, we review and synthesise the relevant literature in three...
Breukers, M.L.H.; Mourits, M.C.M.; Werf, van der W.; Oude Lansink, A.G.J.M.
This article describes a bio-economic model to quantify the costs and benefits of controlling plant quarantine diseases. The model integrates the epidemiology and economic consequences of a quarantine disease. It allows for ex ante evaluation of control scenarios for their cost-effectiveness, taking
McAdams, R.; Nightingale, M.P.S.; Godden, D. [AEA Technology, Oxon (United Kingdom)] [and others
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.
Siregar, Adiatma Y M; Pitriyan, Pipit; Walters, Dylan
In Indonesia, 96% of children (recommendations. Breastfeeding provides protective benefits such as reducing the risk of morbidity and mortality associated with diarrhea and pneumonia/respiratory disease (PRD). This study estimates the potential economic impact of not breastfeeding according to recommendation in Indonesia based on infants suffering from attributable diarrhea and PRD. A cost analysis examined both the healthcare system costs and non-medical costs for children (recommendation from literatures to extrapolate the financial burden of treatment. The healthcare system cost due to not breastfeeding according to recommendation was estimated at US$118 million annually. The mean healthcare system cost and out of pocket costs was US$11.37 and US$3.85 respectively. This cost consists of US$88.64 million of provider costs and US$29.98 million of non-medical patient costs. The cost of not breastfeeding according to recommendation is potentially high, therefore the Indonesian government needs to invest in breastfeeding protection, promotion and support as the potential healthcare system cost savings are significant. As suggested by other studies, the long term cost due to cognitive losses of providing not breastfeeding according to recommendation should also be taken into account to provide a complete understanding of the economic impact of not breastfeeding according to recommendation.
C.E. de Putter (Dennis); R.W. Selles (Ruud); S. Polinder (Suzanne); M.J.M. Panneman (Martien); S.E.R. Hovius (Steven); E.F. van Beeck (Ed)
textabstractBackground: Injuries to the hand and wrist account for approximately 20% of patient visits to emergency departments and may impose a large economic burden. The purpose of this study was to estimate the total health-care costs and productivity costs of injuries to the hand and wrist and
Lee, Man Ki; Nam, Ji Hee
Decommissioning cost of a nuclear power plant includes the costs related with dismantling a nuclear power plant, disposal of a spent fuel and of a low/medium radioactive waste. The decommissioning cost is different from the other expenditures in that it is occurred after the reactor finishes its commercial operation. In this respect, the electricity act was enforced to secure provisions for decommissioning a nuclear power plant during its commercial operation. The purpose of this study is to provide economic evaluation and economic cost for a decommissioning when the cost of a decommissioning is provided as one of input to the national electricity plan. Therefore, this study does not deal with whether the estimated amount of a decommissioning cost is just or not. This study focuses how to transfer the estimated decommissioning cost given in the electricity act to the economic cost, which can be used in the national electricity plan
Pourhashem, G.; Masiello, C. A.; Medlock, K. B., III
Biochar is a product of biomass pyrolysis, one of the main thermal pathways of producing biofuels. In addition to sequestering carbon, biochar's soil application helps sustainable agriculture by enhancing soil's structure and ecological functions, as well as lowering NO release from fertilized soils. However, wide-scale biochar land amendment has been limited in part due to its high cost. To examine biochar's cost dynamics, we develop a comprehensive framework for a representative biochar production facility and identify system inputs that are the key drivers of cost and profitability. We assess the production cost of fast and slow pyrolysis-biochar considering a range of parameters e.g. biomass type, process design and scale. We analyzed techno-economic cost data for producing biochar using simulated data from academic literature, and active producer data collected under confidentiality agreement. The combined approach was used to enhance the depth of the dataset and allowed for a reasonable check on published simulated data. Fast and slow pyrolysis have different biofuel and biochar yields and profit. A slow pyrolysis facility recovers its expenses mainly through biochar sale while a fast pyrolysis facility generates its primary revenue through biofuel sale, largely considering biochar a byproduct. Unlike fast pyrolysis that has received most attention in techno-economic studies, publicly available techno-economic data of slow pyrolysis is sparse. This limits the ability to run a thorough cost-benefit analysis to inform the feasibility of wider adoption of biochar for capturing its carbon sequestration and broader environmental benefits. Our model allows for consideration of various market-based policy instruments and can be used as an analytical decision making tool for investors and policy makers to estimate the cost and optimum facility size. This dynamic framework can also be adapted to account for the availability of new data as technology improves and
Okonta, A.D; Akinwumi, I.O; Siyanbola, W.O.
Solar photovoltaic Water Pumping (PVP) system is becoming a reliable and cost effective method of supplying potable water to remote rural areas of developing countries. Whoever, the high initial investment cost has hindered it widespread application. This paper has reported the outcome of an economic feasibility and cost analysis survey carried out in Nigeria. It involved the administration of a validated set of questionnaires to randomly selected stratified respondents. The outcomes were analysed using graphical displays, a student t-test statistic and the Statistical Package for Social Sciences (SPSS Version 10.0) the survey showed that private investors sourced their funds mostly form commercial banks and through savings. They do not enjoy any government incentives or subsidy. It was found that he number of modules per system and borehole depths are the major initial cost components and that the mean cost of PVP system in Nigeria between 1999- 2003 is 31,690.91 U$$. The paper recommends the establishment and intensive monitoring of PVP pilot projects in different geographical zones of the country to provide the database for Life-cycle-cost analysis and as feedback for the further development of PVP systems in Nigeria
Borella, L; Paraponaris, A
In the healthcare field, the ability to make economic forecasts requires knowledge of the costs of caring for major diseases. In the case of a semi-chronic condition like cancer, this cost covers all the episodes of care associated with a patient. An evaluation of a macro-economic method of calculating costs for treating non-metastatic cancer, covering all hospital episodes, is proposed. This method is based entirely on the use of annual hospital activity databases, linked to data concerning the incidence of cancer. It allows us to obtain the global cost of care for a neoplasm of a particular site, without the need to reconstruct the whole care pathway of the patients. The model was assessed by comparing it's own results, in the particular case of breast cancer to those issuing from a micro-economic follow-up of 115 patients. Data for macro-economic calculation are extracted from the national French hospital database for the year 1999 and from cancer incidence data. The prospective study was done in 1995, in a comprehensive cancer centre. Macro-economic calculation leads to a cost of 14,555 Euro, for primary breast cancer. Prospective follow-up showed a cost of 14,350 Euro (data corrected, 1999 value). With a difference of 1%, there was a clear cohesion of the two results, while a higher level of divergence was noticed (from 1 to 15%) in the comparison between therapeutic techniques. Accuracy and reliability of results were evaluated. This method may be extended to all types of neoplasms. This method cannot be used instead of follow-up studies, for cost-efficacy or cost-severity analysis, but may be interesting beyond economic forecasts, in the field of payment per pathology.
Castano, Ramon; Mills, Anne
Granting autonomy to public hospitals in developing countries has been common over recent decades, and implies a shift from hierarchical to contract-based relationships with health authorities. Theory on transactions costs in contractual relationships suggests they stem from relationship-specific investments and contract incompleteness. Transaction cost economics argues that the parties involved in exchanges seek to reduce transaction costs. The objective of this research was to analyse the relationships observed between purchasers and the 22 public hospitals of the city of Bogota, Colombia, in order to understand the role of relationship-specific investments and contract incompleteness as sources of transaction costs, through a largely qualitative study. We found that contract-based relationships showed relevant transaction costs associated mainly with contract incompleteness, not with relationship-specific investments. Regarding relationships between insurers and local hospitals for primary care services, compulsory contracting regulations locked-in the parties to the contracts. For high-complexity services (e.g. inpatient care), no restrictions applied and relationships suggested transaction-cost minimizing behaviour. Contract incompleteness was found to be a source of transaction costs on its own. We conclude that transaction costs seemed to play a key role in contract-based relationships, and contract incompleteness by itself appeared to be a source of transaction costs. The same findings are likely in other contexts because of difficulties in defining, observing and verifying the contracted products and the underlying information asymmetries. The role of compulsory contracting might be context-specific, although it is likely to emerge in other settings due to the safety-net role of public hospitals.
Svatek, Robert S; Hollenbeck, Brent K; Holmäng, Sten; Lee, Richard; Kim, Simon P; Stenzl, Arnulf; Lotan, Yair
Due to high recurrence rates, intensive surveillance strategies, and expensive treatment costs, the management of bladder cancer contributes significantly to medical costs. To provide a concise evaluation of contemporary cost-related challenges in the care of patients with bladder cancer. An emphasis is placed on the initial diagnosis of bladder cancer and therapy considerations for both non-muscle-invasive bladder cancer (NMIBC) and more advanced disease. A systematic review of the literature was performed using Medline (1966 to February 2011). Medical Subject Headings (MeSH) terms for search criteria included "bladder cancer, neoplasms" OR "carcinoma, transitional cell" AND all cost-related MeSH search terms. Studies evaluating the costs associated with of various diagnostic or treatment approaches were reviewed. Routine use of perioperative chemotherapy following complete transurethral resection of bladder tumor has been estimated to provide a cost savings. Routine office-based fulguration of small low-grade recurrences could decrease costs. Another potential important target for decreasing variation and cost lies in risk-modified surveillance strategies after initial bladder tumor removal to reduce the cost associated with frequent cystoscopic and radiographic procedures. Optimizing postoperative care after radical cystectomy has the potential to decrease length of stay and perioperative morbidity with substantial decreases in perioperative care expenses. The gemcitabine-cisplatin regimen has been estimated to result in a modest increase in cost effectiveness over methotrexate, vinblastine, doxorubicin, and cisplatin. Additional costs of therapies need to be balanced with effectiveness, and there are significant gaps in knowledge regarding optimal surveillance and treatment of both early and advanced bladder cancer. Regardless of disease severity, improvements in the efficiency of bladder cancer care to limit unnecessary interventions and optimize effective
Tyson, Frank D.
1 - Description of problem or function: POWERCO calculates the cost of electricity produced by nuclear power stations, assuming all cash expenses such as investment and fuel costs, operating expenses, and taxes are known. The power cost is held constant throughout the project life. 2 - Method of solution: The cost calculation is based on the requirement that income received must provide for recovery of investment, return on investment, and all operating expenses. Equations are developed to calculate true fixed charge rates and true average fuel working capital
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
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.
Our results demonstrate the economic impact of air pollution which will provide information that could be used to ... health effects of air pollution in developing countries was used as a basis to design ... Standards for Ambient Air Quality, 2010).
Lee, Ji-Yong; Yoo, Moosang; Cha, Kyounghoon; Hur, Tak; Lim, Tae Won
This study uses a life cycle costing (LCC) methodology to identify when hydrogen can become economically feasible compared to the conventional fuels and which energy policy is the most effective at fostering the penetration of hydrogen in the competitive fuel market. The target hydrogen pathways in this study are H 2 via natural gas steam reforming (NG SR), H 2 via naphtha steam reforming (Naphtha SR), H 2 via liquefied petroleum gas steam reforming (LPG SR), and H 2 via water electrolysis (WE). In addition, the conventional fuels (gasoline, diesel) are also included for the comparison with the H 2 pathways. The life cycle costs of the target fuels are computed and several key factors are examined to identify the economical feasibilities of the target systems: fuel cell vehicle (FCV) price, social cost of greenhouse gases (GHGs) and regulated air emissions (CO, VOC, SO x , NO x , PM), fuel efficiency of FCV, capital costs of H 2 equipments at a H 2 fueling station. The life cycle costs of a H 2 pathway also depend on the production capacity. Although, at present, all H 2 pathways are more cost efficient than the conventional fuels in the fuel utilization stage, the H 2 pathways have lack competitiveness against the conventional fuels in the life cycle (well to wheel) costs due to the high price of FCV. From future scenario analyses in 2015, all H 2 pathways are expected to have lower life cycle costs than the conventional fuels as a transportation fuel. It is evident that the FCV price is the most important factor for encouraging the hydrogen economy and FCVs. Unless the FCV price is below US $62,320, it is necessary for the institution to subsidize the FCV price by any amount over US $62,320 in order to inject H 2 into the market of transportation fuel. The incentive or taxes on GHGs and regulated air emissions are also expected to effectively encourage the diffusion of H 2 and FCV, especially for the H 2 pathway of WE with wind power (WE[Wind]). The uncertainties
Evgenia Sergeevna Gracheva
Full Text Available Despite enterprises, which render outsourcing services, appeared on the Russian services market with the beginning of market relations, there are not many researches that deal with competition and cost-effectiveness analyses of outsourcing services in regard to foreign economic activity. Economic integration of Russian business into international economic relations leads to complication of all national foreign economic complex and to the necessity of international economic infrastructure development. One of its most important parts are both services which deal with execution of support international economic operations (interpreting and translation services, transport services, customs services etc. and conducting foreign economic activity for client-enterprise (complex outsourcing FEA. Welcoming environment is formed nowadays for outsourcing business development in regard to foreign economic activity. It dictates the need for more thorough study of this type of business activity and development of indicators system for cost-effectiveness analysis of outsourcing in regard to foreign economic activity. Purpose – to define the complex outsourcing FEA, to develop the indicators system for cost-effectiveness analysis of outsourcing services in regard to foreign economic activity. Methodology: in article following scientific methods are used: functional method and statistical method. Results: is given authorial definition of complex outsourcing FEA, is developed the indicators system for cost-effectiveness analysis of outsourcing. Practical implications: the results of this research may be used by the businesses, which render outsourcing and intermediary services in regard to foreign economic activity.
Economic analysis of three interventions of different intensity in improving school implementation of a government healthy canteen policy in Australia: costs, incremental and relative cost effectiveness.
Reilly, Kathryn L; Reeves, Penny; Deeming, Simon; Yoong, Sze Lin; Wolfenden, Luke; Nathan, Nicole; Wiggers, John
No evaluations of the cost or cost effectiveness of interventions to increase school implementation of food availability policies have been reported. Government and non-government agency decisions regarding the extent of investment required to enhance school implementation of such policies are unsupported by such evidence. This study sought to i) Determine cost and cost-effectiveness of three interventions in improving school implementation of an Australian government healthy canteen policy and; ii) Determine the relative cost-effectiveness of the interventions in improving school implementation of such a policy. An analysis of the cost and cost-effectiveness of three implementation interventions of varying support intensity, relative to usual implementation support conducted during 2013-2015 was undertaken. Secondly, an indirect comparison of the trials was undertaken to determine the most cost-effective of the three strategies. The economic analysis was based on the cost of delivering the interventions by health service delivery staff to increase the proportion of schools 'adherent' with the policy. The total costs per school were $166,971, $70,926 and $75,682 for the high, medium and low intensity interventions respectively. Compared to usual support, the cost effectiveness ratios for each of the three interventions were: A$2982 (high intensity), A$2627 (medium intensity) and A$4730 (low intensity) per percent increase in proportion of schools reporting 'adherence'). Indirect comparison between the 'high' and 'medium intensity' interventions showed no statistically significant difference in cost-effectiveness. The results indicate that while the cost profiles of the interventions varied substantially, the cost-effectiveness did not. This result is valuable to policy makers seeking cost-effective solutions that can be delivered within budget.
Duke, Joshua M; Dundas, Steven J; Messer, Kent D
Economists advocate that the billions of public dollars spent on conservation be allocated to achieve the largest possible social benefit. This is "cost-effective conservation"-a process that incorporates both monetized benefits and costs. Though controversial, cost-effective conservation is poorly understood and rarely implemented by planners. Drawing from the largest publicly financed conservation programs in the United States, this paper seeks to improve the communication from economists to planners and to overcome resistance to cost-effective conservation. Fifteen practical lessons are distilled, including the negative implications of limiting selection with political constraints, using nonmonetized benefit measures or benefit indices, ignoring development risk, using incomplete cost measures, employing cost measures sequentially, and using benefit indices to capture costs. The paper highlights interrelationships between benefits and complications such as capitalization and intertemporal planning. The paper concludes by identifying the challenges at the research frontier, including incentive problems associated with adverse selection, additionality, and slippage. Copyright © 2013 Elsevier Ltd. All rights reserved.
McLaughlin, Anne Marie
To prospectively assess the cost of patients in an adult intensive care unit (ICU) using bottom-up costing methodology and evaluate the usefulness of "severity of illness" scores in estimating ICU cost.
Van den Broek, R
Since the 1990s there has been a renewal of interest in the possibility of sustainable generating energy from biomass, an interest driven in part by the climate issue. Other motives are the search for alternatives for parts of Western agriculture and progress in the technological feasibility of efficiently producing high-quality energy from biomass. World-wide this renewed interest has led to a clear increase in research, demonstration and commercial implementation of biomass energy systems. A recent thesis concludes that biomass can contribute to all aspects of sustainability. In the context of sustainable development (often viewed as a concept having economic, social and ecological dimensions), the central question asked by this Ph.D. research is: How do biomass electricity systems compare to fossil-fuel systems and to the land-use that they may replace, in terms of costs, macro-economic and environmental impacts. This article presents a number of conclusions
Traffic congestion in the U.S. is bad and getting worse, and it is expensive. Appropriate solutions to this problem require appropriate information. A comprehensive and accurate analysis of congestion costs is a critical tool for planning and impleme...
The paper discusses the findings of a survey which explored the implications of ..... this framework, opportunity costs of work or loss of productivity are treated as ..... found in the informal sector, it would be imperative to introduce flexible pre-.
Olesen, J; Gustavsson, A; Svensson, M
In 2005, we presented for the first time overall estimates of annual costs for brain disorders (mental and neurologic disorders) in Europe. This new report presents updated, more accurate, and comprehensive 2010 estimates for 30 European countries.......In 2005, we presented for the first time overall estimates of annual costs for brain disorders (mental and neurologic disorders) in Europe. This new report presents updated, more accurate, and comprehensive 2010 estimates for 30 European countries....
O. V. Dobrovolskaya
Full Text Available Objective: to estimate the cost of treatment in patients with complicated osteoporosis (OP in the first year after fracture under the conditions of the Moscow municipal healthcare system.Patients and methods. The investigation enrolled 196 women (mean age, 65.8±9.1 years who had sustained fractures at five major osteoporotic sites (proximal hip (PH, distal forearm (DF, surgical humeral neck, vertebral column, and medial and/or lateral ankle. A unified questionnaire that included data on inpatient and outpatient treatment, patients' personal costs, and social benefits, as well as tariffs on services of the Moscow City Fund of Obligatory Health Insurance was used to estimate the cost of treatment for complicated OP during one year after fracture.Results. The direct cost of treatment for PH fracture amounted to 101,243 rubles and was significantly higher (p < 0.01 than that for fractures at other sites: DF (22,080 rubles; humeral neck (39,855 rubles, vertebral column (51,167 rubles, and ankle (43,345 rubles. The average cost of treatment in terms of indirect costs of treatment for complicated OP during a year was as high as 61,151 rubles. In the overall cost structure for the disease, hospital costs accounted for 44%; social benefits were 12% and the cost of antiosteoporotic drugs was only 7%, which was associated with the fact that the latter were rarely prescribed by primary healthcare physicians.Conclusion. Costs of treatment in patients with complicated OP in Moscow were estimated in relation to the site of low-energy fracture. The disease was shown to cause considerable economic losses regardless of the site of osteoporotic fracture; however, the cost of antiosteoporotic drugs has an insignificant share in the overall cost structure for treatment. At the same time, secondary prevention of OP requires that combination antiosteoporotic therapy should be performed in all patients who have sustained low-energy fracture.
Gannon, Brenda; Jones, Cheryl; McCabe, Aileen; O'Sullivan, Ronan; Wakai, Abel
High quality data is fundamental to using key performance indicators (KPIs) for performance monitoring. However, the resources required to collect high quality data are often significant and should usually be targeted at high priority areas. As part of a study of 11 emergency department (ED) KPIs in Ireland, the primary objective of this study was to estimate the relative cost of collecting the additional minimum data set (MDS) elements for those 11 KPIs. An economic cost analysis focused on 12 EDs in the Republic of Ireland. The resource use data were obtained using two separate focus group interviews. The number of available MDS elements was obtained from a sample of 100 patient records per KPI per participating ED. Unit costs for all resource use were taken at the midpoint of the relevant staff salary scales. An ED would need to spend an estimated additional &OV0556;3561 per month on average to capture all the MDS elements relevant to the 11 KPIs investigated. The additional cost ranges from 14.8 to 39.2%; this range is 13.9-32.3% for small EDs, whereas the range for medium EDs is 11.7-40%. Regional EDs have a higher additional estimated cost to capture all the relevant MDS elements (&OV0556;3907), compared with urban EDs (&OV0556;3353). The additional cost of data collection, contingent on that already collected, required to capture all the relevant MDS elements for the KPIs examined, ranges from 14.8 to 39.2% per KPI, with variation identified between regional and urban hospitals.
Moshood Keke Mustapha
Full Text Available Qualitative performance and economic analysis of five low cost solar driers were evaluated at the Zoology and Physics Laboratories of the University of Ilorin, Ilorin, Nigeria. The solar driers were constructed from mosquito net, plastic, aluminum and glass with black stone inserted in it. The driers were found to be better than the other driers because they are cheap, reliable, safe to use, easy to repair, well insulated, and cost effective. The solar driers are compact, efficient with drying of fish with lowest moisture content achieved within a few days and the dried products of good quality, with long shelf life, highly acceptable to consumers. The driers save man-hour, money, use renewable energy, with no operational or maintenance costs. The driers have a long life span, with net income to fisher folks very high and the payback time for the driers very low. The adoption of the driers will contribute to the economy of rural populace in the developing countries where there is no electricity and the challenges of deforestation are becoming prominent. The improved low cost solar driers will ensure food safety and security and assist in combating climate change resulting from burning of wood and fossil fuel.
Krozer, Yoram; Abraham, Martin
This article is focused on the economics of sustainable technologies from the mainstream and heterodox perspectives. The aim is to present major concepts, methodologies, and debates for public use. The paper is focused on decision making aiming at the development and use of sustainable technologies.
This paper sketches out how the ways in which a combination of economic geography and international business approaches can shed light on the spatial behaviour of multinational companies. The emphasis of the argument here is on the nature of the knowledge content embedded in the transactions of the
We, therefore, conclude that small-holder-based agricultural development policy is still relevant and an efficient mode of organising production in Kenya, even after the major institutional and economic changes brought about market liberalisation. The pursuit of small-holder-based agricultural development, however, calls ...
OBJECTIVE: To assess the economic impact of post-operative wound infection in trauma patients who had open reduction and internal fixation with implants and prostheses following fractures of the femur. METHOD: This is a 2-year case controlled prospective study carried out at the National Orthopaedic Hospital, Lagos.
Tangka, Florence K L; Subramanian, Sujha; Beebe, Maggie Cole; Weir, Hannah K; Trebino, Diana; Babcock, Frances; Ewing, Jean
The Centers for Disease Control and Prevention (CDC) evaluated the economics of the National Program of Cancer Registries to provide the CDC, the registries, and policy makers with the economics evidence-base to make optimal decisions about resource allocation. Cancer registry budgets are under increasing threat, and, therefore, systematic assessment of the cost will identify approaches to improve the efficiencies of this vital data collection operation and also justify the funding required to sustain registry operations. To estimate the cost of cancer registry operations and to assess the factors affecting the cost per case reported by National Program of Cancer Registries-funded central cancer registries. We developed a Web-based cost assessment tool to collect 3 years of data (2009-2011) from each National Program of Cancer Registries-funded registry for all actual expenditures for registry activities (including those funded by other sources) and factors affecting registry operations. We used a random-effects regression model to estimate the impact of various factors on cost per cancer case reported. The cost of reporting a cancer case varied across the registries. Central cancer registries that receive high-quality data from reporting sources (as measured by the percentage of records passing automatic edits) and electronic data submissions, and those that collect and report on a large volume of cases had significantly lower cost per case. The volume of cases reported had a large effect, with low-volume registries experiencing much higher cost per case than medium- or high-volume registries. Our results suggest that registries operate with substantial fixed or semivariable costs. Therefore, sharing fixed costs among low-volume contiguous state registries, whenever possible, and centralization of certain processes can result in economies of scale. Approaches to improve quality of data submitted and increasing electronic reporting can also reduce cost.
The subject of this book is to introduce a model-based quantitative performance indicator methodology applicable for performance, cost and reliability optimization of non-volatile memories. The complex example of flash memories is used to introduce and apply the methodology. It has been developed by the author based on an industrial 2-bit to 4-bit per cell flash development project. For the first time, design and cost aspects of 3D integration of flash memory are treated in this book. Cell, array, performance and reliability effects of flash memories are introduced and analyzed. Key performance parameters are derived to handle the flash complexity. A performance and array memory model is developed and a set of performance indicators characterizing architecture, cost and durability is defined. Flash memories are selected to apply the Performance Indicator Methodology to quantify design and technology innovation. A graphical representation based on trend lines is introduced to support a requirement based pr...
Choi, Sun Yeong; Jang, Seung-Cheol [KAERI, Daejeon (Korea, Republic of)
Default values for various data provided by MACCS2(MELCOR Accident Consequence Code System Version 2) such as population, weather, food, and economic cost are far from current domestic condition. In the case of economic cost data, related default values came from MACCS and WASH-1400. KAERI (Korea Atomic Energy Research Institute) has been developed a Korean-specific level 3 PSA (Probabilistic Safety Assessment) code package based on MACCS2 to reflect domestic condition for off-site consequence analysis. To this end, we performed a study on the domestic specific technical issues for level 3 PSA, which are a dose conversion factor, food chain model, atmospheric dispersion model, and domestic-specific economic effect model. Based on the study, we developed a level 3 PSA code, so-called KOSCAMACCS2 (Korean-specific Off-Site Consequence Analysis based on MACCS2). The purpose of this paper is to introduce economic cost variable provided by KOSCA-MACCS2 and application of Korean-specific data to the related economic cost estimation with KOSCA-MACCS2. In this paper, we introduced economic cost variable provided by KOSCA-MACCS2 and suggested the application plan of Korean-specific data to the related economic cost estimation. To this end, we considered data sources for those economic cost variables to reflect Korea-specific features such as data by Statistics Korea or Bank of Korea etc. For the decontamination related variables, we applied foreign literatures to apply data, which are Extern-E and UNESCO Chernobyl Forum data. Based on the data resources we estimated data for input variables related to economic cost estimation.
Choi, Sun Yeong; Jang, Seung-Cheol
Default values for various data provided by MACCS2(MELCOR Accident Consequence Code System Version 2) such as population, weather, food, and economic cost are far from current domestic condition. In the case of economic cost data, related default values came from MACCS and WASH-1400. KAERI (Korea Atomic Energy Research Institute) has been developed a Korean-specific level 3 PSA (Probabilistic Safety Assessment) code package based on MACCS2 to reflect domestic condition for off-site consequence analysis. To this end, we performed a study on the domestic specific technical issues for level 3 PSA, which are a dose conversion factor, food chain model, atmospheric dispersion model, and domestic-specific economic effect model. Based on the study, we developed a level 3 PSA code, so-called KOSCAMACCS2 (Korean-specific Off-Site Consequence Analysis based on MACCS2). The purpose of this paper is to introduce economic cost variable provided by KOSCA-MACCS2 and application of Korean-specific data to the related economic cost estimation with KOSCA-MACCS2. In this paper, we introduced economic cost variable provided by KOSCA-MACCS2 and suggested the application plan of Korean-specific data to the related economic cost estimation. To this end, we considered data sources for those economic cost variables to reflect Korea-specific features such as data by Statistics Korea or Bank of Korea etc. For the decontamination related variables, we applied foreign literatures to apply data, which are Extern-E and UNESCO Chernobyl Forum data. Based on the data resources we estimated data for input variables related to economic cost estimation
Laktionova Aleksandra A.
Full Text Available The article offers a system of indicators of the level of costs of financing economic subjects, in the basis of which there is a function of formation of recommendations or identification of directions and priorities in the part of selection of one or another source of financing, its urgency and specific features of attraction of resources, on the basis of information on the level of agent’s costs, information asymmetry costs, financial instability, transaction and market indicators of cost of financial resources. The article pays a special attention to a significant structure forming factor of the ownership structure, which identifies the volume and logic of interconnection of all costs of financing and determining incentives and risks in the system of management of financial activity of an economic subject from the point of view of all participants. It exerts especially big influence upon formation of such implicit costs of financing as agent’s costs and information asymmetry costs. The system of factors of stimulants and de-stimulants of costs of financing includes factors of external environment (macro-economic and market indicators of cost and institutional provision and internal environment (ownership structure, characteristic of investment activity and financing an economic subject, organisation of business and corporate management.
This article presents findings from an investigation of the treatment of wealth distribution by high school economics textbooks. The eight leading high school economics texts in the United States were examined.
Konradsen, F; Hoek, Wim van der; Amerasinghe, P H
. 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...
Full Text Available Background: Determining the disease and economic burden of dengue is critical for the allocation of public health resources. Several studies have used disability-adjusted life-years (DALYs to estimate the disease burden of dengue in different regions. However, there are no published studies discussing the estimates of dengue-related economic and disease burden specifically in Taiwan. Objectives: We assessed the economic cost and disease burden of dengue infections in Taiwan for the period 1998–2014, and compared these during epidemic and non-epidemic years. Methods: We estimated the annual DALYs per million population using the disability weights for dengue fever (DF, dengue hemorrhagic fever (DHF, dengue shock syndrome (DSS, and death cases. Economic costs were estimated and divided into direct (medical costs and indirect costs (lost work days and caregiver fees. Results: For the period 1998–2014, a mean of 115.3 (range: 6.3–934.3 DALYs per million population annually were lost to dengue. In epidemic years, direct costs associated with dengue resulted mostly from hospitalization (86.09%, emergency (7.77%, outpatient (6.10%, and drug costs (0.03%. For indirect costs, lost productivity due to death (70.76% was the dominant contributor. Overall, the costs were 12.3 times higher in epidemic years than in non-epidemic years (Wilcoxon rank sum test, p < 0.05. Conclusions: This study is the first to evaluate the economic costs and disease burden of dengue infections for this period in Taiwan, and reveals significant differences in economic impact between epidemic and non-epidemic years. Keywords: Economic cost of disease, Disease burden, Disability-adjusted life years (DALYs, Dengue, Epidemic
Gautam, Milan; Anderson, Peter; Ridler, Anne; Wilson, Peter; Heuer, Cord
The aims of this study were to estimate the on-fam economic cost of ovine Johne’s disease (OJD) based on collected incidence and mortality data, and the benefit-cost of OJD vaccination in typical OJD affected flocks in New Zealand after having vaccinated for a number of years. Owners of 20 sheep breeding and finishing farms known to be clinically affected by ovine Johne’s disease in New Zealand participated in the study and were monitored for up to two years. Farms were categorized as fine-wool (Merino, Half-Bred, Corriedale, n = 15), and other breeds (Romney, composite breeds, n = 5). Ovine JD was confirmed by gross- and histo-pathology in 358 ewes culled due to chronic progressive wasting. An additional 228 ewes with low body condition score (BCS), but not targeted for culling, were tested with ELISA to estimate the proportion of OJD in ewes in the lower 5% BCS of the flock. Calculations were done separately for fine-wool and other breeds. Based on the data, mortality due to OJD, its associated cost and the benefit-cost of vaccination were evaluated for a hypothetical farm with 2000 ewes by stochastic simulation. Total ewe mortality was similar in fine-wool and other breeds, but the estimated mortality due to OJD was 2.7 times as high in fine-wool (median 1.8%, interquartile range IQR 1.2–2.7%) than other breeds (median 0.69%, IQR 0.3–1.2%), but with large variation between farms. ELISA results demonstrated fine-wool sheep had a higher seroprevalence than other breeds (39%, 95% CI 18–61% vs. 9%, 95% CI 0–22%). Stochastic modelling indicated that the average annual cost of mortality due to OJD in a flock of 2000 ewes was NZD 13,100 (IQR 8900–18,600) in fine-wool and NZD 4300 (IQR 2200–7600) in other breeds. Vaccinating replacement lambs against OJD may be cost-effective in most flocks when the pre-vaccination annual ewe mortality due to OJD is >1%. To make the best-informed decision about vaccination it is therefore essential for farmers to
same firm, in other firms even in other industries (Kempner, 1980). For example ... The main purpose of this paper is to examine the strike cost and productivity in. Nigeria. ... Obnoxious Policies: Workers do go on strike when management makes obnoxious ... ASUU had to go on strike; the FGN had rescinded the decision.
Olesen, J.; Gustavsson, A.; Svensson, M.; Wittchen, H.U.; Jonsson, B.; Vos, P.E.; et al.,
BACKGROUND AND PURPOSE: In 2005, we presented for the first time overall estimates of annual costs for brain disorders (mental and neurologic disorders) in Europe. This new report presents updated, more accurate, and comprehensive 2010 estimates for 30 European countries. METHODS: One-year
provision of free HAART to HIV-infected health professionals should be .... additional working hours is a fixed labour cost (of R55 799 per year). Estimates of staff .... tend to be unreliable as they are often partially completed, long after the actual ...
Yang, Lian; Sung, Hai-Yen; Mao, Zhengzhong; Hu, Teh-wei; Rao, Keqin
Objective To estimate the health-related economic costs attributable to smoking in China for persons aged 35 and older in 2003 and in 2008 and to compare these costs with the respective results from 2000. Methods A prevalence-based, disease-specific approach was used to estimate smoking-attributable direct and indirect economic costs. The primary data source was the 2003 and 2008 China National Health Services Survey, which contains individual participant’s smoking status, healthcare utilization, and expenditures. Results The total economic cost of smoking in China amounted to $17.1 billion in 2003 and $28.9 billion in 2008 (both measured in 2008 constant US dollars). Direct smoking-attributable healthcare costs in 2003 and 2008 were $4.2 billion and $6.2 billion, respectively. Indirect economic costs in 2003 and 2008 were $12.9 billion and $22.7 billion, respectively. Compared to 2000, the direct costs of smoking rose by 72% in 2003 and 154% in 2008, while the indirect costs of smoking rose by 170% in 2003 and 376% in 2008. Conclusion The economic burden of cigarette smoking has increased substantially in China during the past decade and is expected to continue to increase as the national economy and the price of healthcare services grow. Stronger intervention measures against smoking should be taken without delay to reduce the health and financial losses caused by smoking. PMID:21339491
Yang, Lian; Sung, Hai-Yen; Mao, Zhengzhong; Hu, Teh-wei; Rao, Keqin
To estimate the health-related economic costs attributable to smoking in China for persons aged 35 and older in 2003 and in 2008 and to compare these costs with the respective results from 2000. A prevalence-based, disease-specific approach was used to estimate smoking-attributable direct and indirect economic costs. The primary data source was the 2003 and 2008 China National Health Services Survey, which contains individual participant's smoking status, healthcare use and expenditures. The total economic cost of smoking in China amounted to $17.1 billion in 2003 and $28.9 billion in 2008 (both measured in 2008 constant US$). Direct smoking-attributable healthcare costs in 2003 and 2008 were $4.2 billion and $6.2 billion, respectively. Indirect economic costs in 2003 and 2008 were $12.9 billion and $22.7 billion, respectively. Compared to 2000, the direct costs of smoking rose by 72% in 2003 and 154% in 2008, while the indirect costs of smoking rose by 170% in 2003 and 376% in 2008. The economic burden of cigarette smoking has increased substantially in China during the past decade and is expected to continue to increase as the national economy and the price of healthcare services grow. Stronger intervention measures against smoking should be taken without delay to reduce the health and financial losses caused by smoking.
Melikhova Tetiana O.
Full Text Available The article substantiates expediency of introduction of the system of economic security of enterprise on the basis of money flows. The methods proposed in the long-term period stipulate the use as sources of financing: accumulated conditional economic costs, accumulated conditional gross and net money flow; and as costs: cumulative advanced costs and the advanced value of fixed assets. The article suggests methods for calculation of: gross index of conditional yield; gross conditional income of project; gross conditional profitability; gross conditional profitability of money flow. The managerial decision on introduction of the system of economic security of enterprise in the short-term production period has been substantiated on the basis of calculations of the following indicators: gross profitability of annual depreciation; annual gross economic effect; index of conditional yield of the gross money flow; differences between the conditional gross cash flow and the depreciation deductions associated with the implementation of the enterprise’s economic security system.
U.S. Department of Health & Human Services — 2005-2009. SAMMEC - Smoking-Attributable Mortality, Morbidity, and Economic Costs. Smoking-attributable mortality (SAM) is the number of deaths caused by cigarette...
U.S. Department of Health & Human Services — 2005-2009. SAMMEC - Smoking-Attributable Mortality, Morbidity, and Economic Costs. Smoking-attributable expenditures (SAEs) are excess health care expenditures...
Rollin, E; Dhuyvetter, K C; Overton, M W
Clinical mastitis results in considerable economic losses for dairy producers and is most commonly diagnosed in early lactation. The objective of this research was to estimate the economic impact of clinical mastitis occurring during the first 30 days of lactation for a representative US dairy. A deterministic partial budget model was created to estimate direct and indirect costs per case of clinical mastitis occurring during the first 30 days of lactation. Model inputs were selected from the available literature, or when none were available, from herd data. The average case of clinical mastitis resulted in a total economic cost of $444, including $128 in direct costs and $316 in indirect costs. Direct costs included diagnostics ($10), therapeutics ($36), non-saleable milk ($25), veterinary service ($4), labor ($21), and death loss ($32). Indirect costs included future milk production loss ($125), premature culling and replacement loss ($182), and future reproductive loss ($9). Accurate decision making regarding mastitis control relies on understanding the economic impacts of clinical mastitis, especially the longer term indirect costs that represent 71% of the total cost per case of mastitis. Future milk production loss represents 28% of total cost, and future culling and replacement loss represents 41% of the total cost of a case of clinical mastitis. In contrast to older estimates, these values represent the current dairy economic climate, including milk price ($0.461/kg), feed price ($0.279/kg DM (dry matter)), and replacement costs ($2,094/head), along with the latest published estimates on the production and culling effects of clinical mastitis. This economic model is designed to be customized for specific dairy producers and their herd characteristics to better aid them in developing mastitis control strategies. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.
McLaughlin, Anne Marie
OBJECTIVE: To prospectively assess the cost of patients in an adult intensive care unit (ICU) using bottom-up costing methodology and evaluate the usefulness of "severity of illness" scores in estimating ICU cost. METHODS AND DESIGN: A prospective study costing 64 consecutive admissions over a 2-month period in a mixed medical\\/surgical ICU. RESULTS: The median daily ICU cost (interquartile range, IQR) was 2,205 euro (1,932 euro-3,073 euro), and the median total ICU cost (IQR) was 10,916 euro (4,294 euro-24,091 euro). ICU survivors had a lower median daily ICU cost at
Social cost of carbon (SCC) is the key concept in the economics of climate change. It measures the economic cost of climate impacts. SCC has influence on how beneficial it is to prevent climate change: if the value of SCC increases, investments to low-carbon technology become more attractive and profitable. This paper examines the sensitivity of two important assumptions that affect to SCC: the choice of a discount rate and time horizon. Using the integrated assessment model, ...
Brasfield, David W.
Reports on a study of 1,119 students in introductory college economics courses to determine the impact of high school economics on student achievement. Finds that prior high school economics was positively and significantly related to students grades in both introductory microeconomics and macroeconomics courses. (CFR)
which are used to measure the small magnetic signals from brain. Other types of vector magnetometers are fluxgate , coil based, and magnetoresistance...concentrator with the magnetometer currently used in Army multimodal sensor systems, the Brown fluxgate . One sees the MEMS fluxgate magnetometer is...Guedes, A.; et al., 2008: Hybrid - LOW COST, LOW POWER, HIGH SENSITIVITY MAGNETOMETER A.S. Edelstein*, James E. Burnette, Greg A. Fischer, M.G
Ejarque, Joao Miguel
The European Commission wants to implement a single market for gas. One of the components of this market is a regulated provision for ''security of supply'' which consists of rules for the implementation and use of a given reserve stock of gas. We investigate the impact of this policy on the profitability of a storage operator, using data from Denmark and Italy. Keeping storage capacity constant, the costs of the strategic stock are around 20% of the value of the storage market for Denmark, and 16% for Italy. This cost is due to the inability to extract arbitrage profits from the captive stock. Furthermore, the strategic storage restriction induces behavior that would virtually never be replicated by a private storage operator in an unconstrained market, in particular in the first 6 months of the year when unconstrained firms empty their reservoirs much faster, suggesting the strategic restriction is unnecessarily distorting the market. (author)
Swe, Khin Thet; Rahman, Md Mizanur; Rahman, Md Shafiur; Saito, Eiko; Abe, Sarah K; Gilmour, Stuart; Shibuya, Kenji
With an increasing burden of non-communicable disease in Nepal and limited progress towards universal health coverage, country- and disease-specific estimates of financial hardship related to healthcare costs need to be evaluated to protect the population effectively from healthcare-related financial burden. To estimate the cost and economic burden of illness and to assess the inequality in the financial burden due to catastrophic health expenditure from 1995 to 2010 in Nepal. This study used nationally representative Nepal Living Standards Surveys conducted in 1995 and 2010. A Bayesian two-stage hurdle model was used to estimate average cost of illness and Bayesian logistic regression models were used to estimate the disease-specific incidence of catastrophic health payment and impoverishment. The concentration curve and index were estimated by disease category to examine inequality in healthcare-related financial hardship. Inflation-adjusted mean out-of-pocket (OOP) payments for chronic illness and injury increased by 4.6% and 7.3%, respectively, while the cost of recent acute illness declined by 1.5% between 1995 and 2010. Injury showed the highest incidence of catastrophic expenditure (30.7% in 1995 and 22.4% in 2010) followed by chronic illness (12.0% in 1995 and 9.6% in 2010) and recent acute illness (21.1% in 1995 and 7.8% in 2010). Asthma, diabetes, heart conditions, malaria, jaundice and parasitic illnesses showed increased catastrophic health expenditure over time. Impoverishment due to injury declined most (by 12% change in average annual rate) followed by recent acute illness (9.7%) and chronic illness (9.6%) in 15 years. Inequality analysis indicated that poorer populations with recent acute illness suffered more catastrophic health expenditure in both sample years, while wealthier households with injury and chronic illnesses suffered more catastrophic health expenditure in 2010. To minimize the economic burden of illness, several approaches need to be
Le, C; Fang, Y; Linxiong, W; Shulan, Z; Golden, A R
To estimate the economic burden of coronary heart disease (CHD) in a given year (2010), including direct and indirect costs, and examine the impact of contextual and individual socio-economic (SES) predictors on the costs of CHD among adults in rural southwest China. Cross-sectional community survey. In total, 4595 adults (aged ≥18 years) participated in this study. A prevalence-based cost-of-illness approach was used to estimate the economic burden of CHD. Information on demographic characteristics of the study population and the economic consequences of CHD was obtained using a standard questionnaire. Multilevel linear regression was used to model the variation in costs of CHD. In the study population, the overall prevalence of CHD was 2.9% (3.5% for males, 2.3% for females). The total cost of CHD was estimated to be US$17 million. Inpatient hospitalizations represented the main component of direct costs of CHD, and direct costs accounted for the greatest proportion of the economic burden of CHD. Males were more likely to have a higher economic burden of CHD than females. A positive association was found between the individual's level of education and the economic burden of CHD. Residence in a higher-income community was associated with higher costs related to CHD. This study found that both contextual and individual SES were closely associated with the costs of CHD. Future strategies for CHD interventions and improved access to affordable medications to treat and control CHD should focus on less-educated individuals and communities with lower SES. Copyright © 2014 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
Full Text Available Farm machinery managers often need to make complex economic decisions on machinery replacement. Repair and maintenance costs can have significant impacts on this economic decision. The farm manager must be able to predict farm machinery repair and maintenance costs. This study aimed to identify a regression model that can adequately represent the repair and maintenance costs in terms of machine age in cumulative hours of use. The regression model has the ability to predict the repair and maintenance costs for longer time periods. Therefore, it can be used for the estimation of the economic life. The study was conducted using field data collected from 11 John-Deer 955 combine harvesters used in several western provinces of Iran. It was found that power model has a better performance for the prediction of combine repair and maintenance costs. The results showed that the optimum replacement age of John-Deer 955 combine was 54300 cumulative hours.
Daniell, James; Wenzel, Friedemann
Over the past decade, the production of economic indices behind the CATDAT Damaging Earthquakes Database has allowed for the conversion of historical earthquake economic loss and cost events into today's terms using long-term spatio-temporal series of consumer price index (CPI), construction costs, wage indices, and GDP from 1900-2013. As part of the doctoral thesis of Daniell (2014), databases and GIS layers for a country and sub-country level have been produced for population, GDP per capita, net and gross capital stock (depreciated and non-depreciated) using studies, census information and the perpetual inventory method. In addition, a detailed study has been undertaken to collect and reproduce as many historical isoseismal maps, macroseismic intensity results and reproductions of earthquakes as possible out of the 7208 damaging events in the CATDAT database from 1900 onwards. a) The isoseismal database and population bounds from 3000+ collected damaging events were compared with the output parameters of GDP and net and gross capital stock per intensity bound and administrative unit, creating a spatial join for analysis. b) The historical costs were divided into shaking/direct ground motion effects, and secondary effects costs. The shaking costs were further divided into gross capital stock related and GDP related costs for each administrative unit, intensity bound couplet. c) Costs were then estimated based on the optimisation of the function in terms of costs vs. gross capital stock and costs vs. GDP via the regression of the function. Losses were estimated based on net capital stock, looking at the infrastructure age and value at the time of the event. This dataset was then used to develop an economic exposure for each historical earthquake in comparison with the loss recorded in the CATDAT Damaging Earthquakes Database. The production of economic fragility functions for each country was possible using a temporal regression based on the parameters of
... economic power adjustment clauses. 35.14 Section 35.14 Conservation of Power and Water Resources FEDERAL... SCHEDULES AND TARIFFS Other Filing Requirements § 35.14 Fuel cost and purchased economic power adjustment clauses. (a) Fuel adjustment clauses (fuel clause) which are not in conformity with the principles set out...
Turner, Katy; Adams, Elisabeth; Grant, Arabella; Macleod, John; Bell, Gill; Clarke, Jan; Horner, Paddy
To compare the cost, cost effectiveness, and sex equity of different intervention strategies within the English National Chlamydia Screening Programme. To develop a tool for calculating cost effectiveness of chlamydia control programmes at a local, national, or international level. An economic and mathematical modelling study with cost effectiveness analysis. Costs were restricted to those of screening and partner notification from the perspective of the NHS and excluded patient costs, the costs of reinfection, and costs of complications arising from initial infection. England. Population Individuals eligible for the National Chlamydia Screening Programme. Cost effectiveness of National Chlamydia Screening Programme in 2008-9 (as cost per individual tested, cost per positive diagnosis, total cost of screening, number screened, number infected, sex ratio of those tested and treated). Comparison of baseline programme with two different interventions-(i) increased coverage of primary screening in men and (ii) increased efficacy of partner notification. In 2008-9 screening was estimated to cost about £46.3m in total and £506 per infection treated. Provision for partner notification within the screening programme cost between £9 and £27 per index case, excluding treatment and testing. The model results suggest that increasing male screening coverage from 8% (baseline value) to 24% (to match female coverage) would cost an extra £22.9m and increase the cost per infection treated to £528. In contrast, increasing partner notification efficacy from 0.4 (baseline value) to 0.8 partners per index case would cost an extra £3.3m and would reduce the cost per infection diagnosed to £449. Increasing screening coverage to 24% in men would cost over six times as much as increasing partner notification to 0.8 but only treat twice as many additional infections. In the English National Chlamydia Screening Programme increasing the effectiveness of partner notification is likely
Connolly, Mark P; Hoorens, Stijn; Chambers, Georgina M
Despite the growing use of assisted reproductive technologies (ART) worldwide, there is only a limited understanding of the economics of ART to inform policy about effective, safe and equitable financing of ART treatment. A review was undertaken of key studies regarding the costs and consequences of ART treatment, specifically examining the direct and indirect costs of treatment, economic drivers of utilization and clinical practice and broader economic consequences of ART-conceived children. The direct costs of ART treatment vary substantially between countries, with the USA standing out as the most expensive. The direct costs generally reflect the costliness of the underlying healthcare system. If unsubsidized, direct costs represent a significant economic burden to patients. The level of affordability of ART treatment is an important driver of utilization, treatment choices, embryo transfer practices and ultimately multiple birth rates. The costs associated with caring for multiple-birth ART infants and their mothers are substantial, reflecting the underlying morbidity associated with such pregnancies. Investment analysis of ART treatment and ART-conceived children indicates that appropriate funding of ART services appears to represent sound fiscal policy. The complex interaction between the cost of ART treatment and how treatments are subsidized in different healthcare settings and for different patient groups has far-reaching consequences for ART utilization, clinical practice and infant outcomes. A greater understanding of the economics of ART is needed to inform policy decisions and to ensure the best possible outcomes from ART treatment.
The cost benefit of investments is devided into social and economic benefits. The postulates are discussed for the assessment of the cost benefit of capital costs of nuclear power plants. The relations are given for total cost benefit of capital costs expressed by the total profit rate of capital costs, and the absolute effectiveness exoressed by the socio-economic benefit of capital costs. The absolute cost benefit of capital costs is characterized by several complex indexes. Comparable capital cost benefit is used for assessing the effectiveness of interchangeable variants of solution. The minimum calculated costs serve as the criterion for selecting the optimal variant. (E.S.)
Holcomb, David Eugene [ORNL; Peretz, Fred J [ORNL; Qualls, A L [ORNL
The Advanced High Temperature Reactor (AHTR) is a design concept for a large-output [3400 MW(t)] fluoride-salt-cooled high-temperature reactor (FHR). FHRs, by definition, feature low-pressure liquid fluoride salt cooling, coated-particle fuel, a high-temperature power cycle, and fully passive decay heat rejection. The AHTR's large thermal output enables direct comparison of its performance and requirements with other high output reactor concepts. As high-temperature plants, FHRs can support either high-efficiency electricity generation or industrial process heat production. The AHTR analysis presented in this report is limited to the electricity generation mission. FHRs, in principle, have the potential to be low-cost electricity producers while maintaining full passive safety. However, no FHR has been built, and no FHR design has reached the stage of maturity where realistic economic analysis can be performed. The system design effort described in this report represents early steps along the design path toward being able to predict the cost and performance characteristics of the AHTR as well as toward being able to identify the technology developments necessary to build an FHR power plant. While FHRs represent a distinct reactor class, they inherit desirable attributes from other thermal power plants whose characteristics can be studied to provide general guidance on plant configuration, anticipated performance, and costs. Molten salt reactors provide experience on the materials, procedures, and components necessary to use liquid fluoride salts. Liquid metal reactors provide design experience on using low-pressure liquid coolants, passive decay heat removal, and hot refueling. High temperature gas-cooled reactors provide experience with coated particle fuel and graphite components. Light water reactors (LWRs) show the potentials of transparent, high-heat capacity coolants with low chemical reactivity. Modern coal-fired power plants provide design experience
Capros P; Sedee C; Jantzen J; MNV
The economic assessment of priorities for a European environmental policy plan focuses on twelve identified Prominent European Environmental Problems such as climate change, chemical risks and biodiversity. The study, commissioned by the European Commission (DG Environment) to a European consortium
Shih, Sophy T F; Tonmukayakul, Utsana; Imms, Christine; Reddihough, Dinah; Graham, H Kerr; Cox, Liz; Carter, Rob
Economic appraisal can help guide policy-making for purchasing decisions, and treatment and management algorithms for health interventions. We conducted a systematic review of economic studies in cerebral palsy (CP) to inform future research. Economic studies published since 1970 were identified from seven databases. Two reviewers independently screened abstracts and extracted data following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Any discrepancies were resolved by discussion. Of 980 identified references, 115 were included for full-text assessment. Thirteen articles met standard criteria for a full economic evaluation, two as partial economic evaluations, and 18 as cost studies. Six were full economic evaluations alongside clinical studies or randomized controlled trials, whereas seven involved modelling simulations. The economic case for administration of magnesium sulfate for imminent preterm birth is compelling, achieving both health gain and cost savings. Current literature suggests intrathecal baclofen therapy and botulinum toxin injection are cost-effective, but stronger evidence for long-term effects is needed. Lifestyle and web-based interventions are inexpensive, but broader measurement of outcomes is required. Prevention of CP would avoid significant economic burden. Some treatments and interventions have been shown to be cost-effective, although stronger evidence of clinical effectiveness is needed. What this paper adds Cost-effectiveness evidence shows prevention is the most significant strategy. Some treatments are cost-effective, but stronger evidence for long-term effectiveness is required. Comparison of treatment costs is challenging owing to variations in methodologies and varying clinical indications. © 2018 Mac Keith Press.
Khan, K A; Petrou, S; Dritsaki, M; Johnson, S J; Manktelow, B; Draper, E S; Smith, L K; Seaton, S E; Marlow, N; Dorling, J; Field, D J; Boyle, E M
We sought to determine the economic costs associated with moderate and late preterm birth. An economic study was nested within a prospective cohort study. Infants born between 32(+0) and 36(+6) weeks of gestation in the East Midlands of England. A sample of infants born at ≥37 weeks of gestation acted as controls. Data on resource use, estimated from a National Health Service (NHS) and personal social services perspective, and separately from a societal perspective, were collected between birth and 24 months corrected age (or death), and valued in pounds sterling, at 2010-11 prices. Descriptive statistics and multivariable analyses were used to estimate the relationship between gestational age at birth and economic costs. Cumulative resource use and economic costs over the first two years of life. Of all eligible births, 1146 (83%) preterm and 1258 (79%) term infants were recruited. Mean (standard error) total societal costs from birth to 24 months were £12 037 (£1114) and £5823 (£1232) for children born moderately preterm (32(+0) -33(+6) weeks of gestation) and late preterm (34(+0) -36(+6) weeks of gestation), respectively, compared with £2056 (£132) for children born at term. The mean societal cost difference between moderate and late preterm and term infants was £4657 (bootstrap 95% confidence interval, 95% CI £2513-6803; P economic costs over the first 2 years of life. Our economic estimates can be used to inform budgetary and service planning by clinical decision-makers, and economic evaluations of interventions aimed at preventing moderate and late preterm birth or alleviating its adverse consequences. Moderate and late preterm birth is associated with increased economic costs over the first 2 years of life. © 2015 Royal College of Obstetricians and Gynaecologists.
CHERNYSHOVA O. S.
Full Text Available Raising of problem The worldwide design standards high-speed lines are somewhat different. This is due to several reasons: different levels of design speed, differences of characteristics of rolling stock and, in particular, the features of the design plan and longitudinal profile, that are associated primarily with the conditions of the relief. In the design of high-speed railways in Ukraine should take into account these features and determine what the maximum slope values can be used in difficult conditions, as well as how it will affect the operational and capital costs. Purpose. To determine the optimal design parameters of the longitudinal profile. Conclusion. The results are based not only on technical, but also economic indicators and allow the assessment of the necessary capital expenditures and expected cost of the railway in the future. Analytical dependences, to predict the expected operating costs of the railway, depending on the maximum slope, its length and the total length of the section.
Wirth, Kathleen E; Rein, David B
To document the economic costs and benefits associated with providing dog guide services for blind individuals able to benefit from them. This study estimates the annual cost of dog guide services accounting for cost offsets associated with reduced informal and formal care costs over the working life of the animal (8 years). We estimated the cost per dog guide trained using previously unpublished survey data from dog guide training schools in the United States. We also estimated the incremental economic benefits as the reduction in costs associated with formal and informal care using published studies and a set of reasonable assumptions. Costs were discounted to 2006$ using a 3% discount rate. We found the average total cost per dog guide over its working life was $40,598, of which $21,568 were off-set by reductions in other costs. The costs associated with dog guides included $35,536 in dog acquisition costs and $5,061 for annual maintenance over the animal's working life. The economic benefits included $16,324 and $5,244 in reduced formal and informal care costs, respectively. The average net cost of dog guide ownership per year over the working life of the animal was $2,379. Using available information and reasonable assumptions, this study documents the costs of dog guides accounting for a limited number of cost off-setting elements. However, given limited available evidence, further study of the impact of guide dogs on the lives of blind individuals who use them should be conducted to validate this study's results.
Arokiasamy, J T; Krishnan, R
Injuries are one of the leading causes of death in the world. In Malaysia, injuries form one of the three main causes of mortality. They are also an important cause of permanent and temporary disability and work absenteeism in the productive age group. Increasing affluence and industrialization coupled with growing population and transportation needs in rapidly developing countries like Malaysia have resulted in a surge of road and occupational injuries. Three quarters of fatalities due to road, occupational, drowning and home injuries occur in those below 45 years of age. A majority of injuries in these categories are attributed to "human" factors and therefore can be prevented by public education and enforced training of workers. The total annual economic loss due to all types of injuries is estimated to be 2 billion Malaysian Ringgit (US$1 = MR2.76 approximately). The government is currently in the process of setting up full-time departments for road safety and occupational health and safety.
MacNeil Vroomen, Janet; Eekhout, Iris; Dijkgraaf, Marcel G; van Hout, Hein; de Rooij, Sophia E; Heymans, Martijn W; Bosmans, Judith E
Cost and effect data often have missing data because economic evaluations are frequently added onto clinical studies where cost data are rarely the primary outcome. The objective of this article was to investigate which multiple imputation strategy is most appropriate to use for missing
Inorganic scintillation detectors coupled to PMTs are an important element of medical imaging applications such as positron emission tomography (PET). Performance as well as cost of these systems is limited by the properties of the scintillation detectors available at present. The Phase I project was aimed at demonstrating the feasibility of producing high performance scintillators using a low cost fabrication approach. Samples of these scintillators were produced and their performance was evaluated. Overall, the Phase I effort was very successful. The Phase II project will be aimed at advancing the new scintillation technology for PET. Large samples of the new scintillators will be produced and their performance will be evaluated. PET modules based on the new scintillators will also be built and characterized
Schleisner, Lotte; Korhonen, Riitta
This report is part of the SERF (Socio-Economic Research on Fusion) project, Macro Task E2, which covers External Costs and Benefits. The report is the documentation of Task 2, Comparison of External Costs. The aim of Task 2 Comparison of External Costs, has been to compare the external costs of the fusion energy with those from other alternative energy generation technologies. In this task identification and quantification of the external costs for wind energy and photovoltaic have been performed by Risoe, while identification and quantification of the external cost for nuclear fission and fossil fuels have been discussed by VTT. The methodology used for the assessment of the externalities of the fuel cycles selected has been the one developed within the ExternE Project. First estimates for the externalities of fusion energy have been under examination in Macrotask E2. Externalities of fossil fuels and nuclear fission have already been evaluated in the ExternE project and a vast amount of material for different sites in various countries is available. This material is used in comparison. In the case of renewable wind energy and photovoltaic are assessed separately. External costs of the various alternatives may change as new technologies are developed and costs can to a high extent be avoided (e.g. acidifying impacts but also global warming due to carbon dioxide emissions). Also fusion technology can experience major progress and some important cost components probably can be avoided already by 2050. (EG)
Schleisner, Lotte; Korhonen, Riitta
This report is part of the SERF (Socio-Economic Research on Fusion) project, Macro Task E2, which covers External Costs and Benefits. The report is the documentation of Task 2, Comparison of External Costs. The aim of Task 2 Comparison of External Costs, has been to compare the external costs of the fusion energy with those from other alternative energy generation technologies. In this task identification and quantification of the external costs for wind energy and photovoltaic have been performed by Risoe, while identification and quantification of the external cost for nuclear fission and fossil fuels have been discussed by VTT. The methodology used for the assessment of the externalities of the fuel cycles selected has been the one developed within the ExternE Project. First estimates for the externalities of fusion energy have been under examination in Macrotask E2. Externalities of fossil fuels and nuclear fission have already been evaluated in the ExternE project and a vast amount of material for different sites in various countries is available. This material is used in comparison. In the case of renewable wind energy and photovoltaic are assessed separately. External costs of the various alternatives may change as new technologies are developed and costs can to a high extent be avoided (e.g. acidifying impacts but also global warming due to carbon dioxide emissions). Also fusion technology can experience major progress and some important cost components probably can be avoided already by 2050. (EG) 36 refs.
Tackling obesity in areas of high social deprivation: clinical effectiveness and cost-effectiveness of a task-based weight management group programme - a randomised controlled trial and economic evaluation.
McRobbie, Hayden; Hajek, Peter; Peerbux, Sarrah; Kahan, Brennan C; Eldridge, Sandra; Trépel, Dominic; Parrott, Steve; Griffiths, Chris; Snuggs, Sarah; Myers Smith, Katie
An increasing number of people require help to manage their weight. The NHS recommends weight loss advice by general practitioners and/or a referral to a practice nurse. Although this is helpful for some, more effective approaches that can be disseminated economically on a large scale are needed. To assess whether or not a task-based weight management programme [Weight Action Programme (WAP)] has better long-term effects than a 'best practice' intervention provided in primary care by practice nurses. Randomised controlled trial with cost-effectiveness analysis. General practices in east London, UK. Three hundred and thirty adults with a body mass index (BMI) of ≥ 30 kg/m 2 or a BMI of ≥ 28 kg/m 2 plus comorbidities were recruited from local general practices and via media publicity. Those who had a BMI of > 45 kg/m 2 , had lost > 5% of their body weight in the previous 6 months, were currently pregnant or taking psychiatric medications were excluded. Participants were randomised (2 : 1) to the WAP or nurse arms. The WAP intervention was delivered in eight weekly group sessions that combined dietary and physical activity, advice and self-monitoring in a group-oriented intervention. The initial course was followed by 10 monthly group maintenance sessions open to all participants in this study arm. The practice nurse intervention (best usual care) consisted of four one-to-one sessions delivered over 8 weeks, and included standard advice on diet and physical activity based on NHS 'Change4Life' materials and motivational support. The primary outcome measure was weight change at 12 months. Secondary outcome measures included change in BMI, waist circumference and blood pressure, and proportion of participants losing at least 5% and 10% of baseline body weight. Staff collecting measurements at the 6- and 12-month follow-ups were blinded to treatment allocation. The primary outcome measure was analysed according to the intention-to-treat principle
Subsistence: Includes the cost of all edibles , sales taxes, delivery charges, and loading costs. Stores, Supplies, and Equipment: The cost of all...consumable stores, supplies, and expendable equipment other than edibles , fuel, and water. 89 Insurance: Annual cost for H&M, P&I, and port risk for the...Products (50) 3441 3442 3444 3446 3449 105 Screw Machine Products (51) 3450 106 Metal Stampings (51) 3460 107 Cutlery , Hand Tools, Hardware (52) 3420
Guo, X. R.; Cheng, S. Y.; Chen, D. S.; Zhou, Y.; Wang, H. Y.
Valuation of health effects of air pollution is becoming a critical component of the performance of cost-benefit analysis of pollution control measures, which provides a basis for setting priorities for action. Beijing has focused on control of transport emission as vehicular emissions have recently become an important source of air pollution, particularly during Olympic games and Post-games. In this paper, we conducted an estimation of health effects and economic cost caused by road transport-related air pollution using an integrated assessment approach which utilizes air quality model, engineering, epidemiology, and economics. The results show that the total economic cost of health impacts due to air pollution contributed from transport in Beijing during 2004-2008 was 272, 297, 310, 323, 298 million US (mean value), respectively. The economic costs of road transport accounted for 0.52, 0.57, 0.60, 0.62, and 0.58% of annual Beijing GDP from 2004 to 2008. Average cost per vehicle and per ton of PM 10 emission from road transport can also be estimated as 106 US /number and 3584 US $ t -1, respectively. These findings illustrate that the impact of road transport contributed particulate air pollution on human health could be substantial in Beijing, whether in physical and economic terms. Therefore, some control measures to reduce transport emissions could lead to considerable economic benefit.
This paper examines the cost of meeting the Kyoto Protocol commitments under alternative assumptions regarding technology and technical change. Real GDP is modeled as a function of the capital, labor, and energy inputs. The analysis is based on data for 23 Annex 1 countries from 1965 to 1999. Two important results emerge. First, the standard assumption of Hicks neutral technical change and time and scale independent output elasticities is not supported by the data. Second, when technical change is allowed to be biased in favor of the energy and capital inputs, and when the output elasticities vary with the level of factor use and over time, the loss in real GDP due to the Kyoto commitments rises substantially. On average, the loss in real GDP is one and a half times higher than obtained under the standard assumptions. 26 refs
Broeskamp, H.; Brammer, K.-J.; Schlombs, H.
Under the German Atomic Energy Act, the federal government is responsible for the construction of repositories for radioactive waste. Steps to this end were initiated early on when the first nuclear power plants were commissioned in the 1960s. They resulted, among other approaches, in the decisions and site selection procedures for the Gorleben salt dome and the former Konrad iron ore mine as potential repository sites in the 1970s and 1980s. In 2000, the federal government imposed a moratorium of three up to a maximum of ten years on further exploration activities at Gorleben in order to dispel doubts held by the German Federal Ministry for the Environment, Nature Conservation, and Nuclear Safety (BMU). A positive plans approval decision on Konrad was publicized in May 2002. Emplacement could begin roughly in 2010-2012, once legal certainty will have been ensured. In February 1999, BMU appointed a working party to establish site selection procedures for repositories (AkEnd) which was to develop a transparent procedure of finding and selecting sites for the final storage of all kinds of radioactive waste in Germany. The procedure finally proposed by AkEnd implies considerable uncertainty, inter alia, about its legal implementability, the time required, and funding. For the Gorleben salt dome, for instance, additional exploration and procedures alone could give rise to extra costs of euro 3-5 billion, compared to merely continuing project activities. Similar extra costs are likely to arise especially to the government if emplacement in Konrad were to be delayed. Under aspects of technical safety, the speediest possible emplacement of all types of waste in deep geologic formations is preferable to all other options. Hence, further exploration of Gorleben should be completed quickly, and the Konrad project should be implemented, after due consideration of all factors. (orig.) [de
Burniaux, J.M.; Chateau, J.
Complete text of publication follows: In the context of growing scientific evidence about a relationship between ongoing climate change and man-made Greenhouse Gases (GHGs) emissions, policy makers will meet in Copenhagen at the end of 2009 in order to negotiate a new agreement to reduce GHGs emissions. The previous agreement - the Kyoto Protocol that was signed in 1997 and will end in 2012 - encompassed relatively modest emission reductions undertaken by a group of countries (Annex 1 countries). Such a partial action gave rise to concerns about the effectiveness of such a scheme - potentially undermined by the existence of carbon leakages - and its adverse effect on the international competitiveness of the energy-intensive industries in the Annex 1 countries. More importantly, it is now clear that industrialized countries alone are unable to stabilize the earth climate, an objective that is out of range without the active participation of the emerging economies. Therefore, the scenarios that will be discussed at the Copenhagen meeting will need to be much more ambitious, with emissions objectives that will imply a major restructuring of the world economy, putting it on the way of growth without carbon. This presentation will address the trade-offs between economic growth and environmental risks in the choice of a post-Kyoto strategy
Hafner, Marco; Stepanek, Martin; Taylor, Jirka; Troxel, Wendy M.; van Stolk, Christian
Abstract The Centers for Disease Control and Prevention (CDC) in the United States has declared insufficient sleep a “public health problem.” Indeed, according to a recent CDC study, more than a third of American adults are not getting enough sleep on a regular basis. However, insufficient sleep is not exclusively a US problem, and equally concerns other industrialised countries such as the United Kingdom, Japan, Germany, or Canada. According to some evidence, the proportion of people sleeping less than the recommended hours of sleep is rising and associated with lifestyle factors related to a modern 24/7 society, such as psychosocial stress, alcohol consumption, smoking, lack of physical activity and excessive electronic media use, among others. This is alarming as insufficient sleep has been found to be associated with a range of negative health and social outcomes, including success at school and in the labour market. Over the last few decades, for example, there has been growing evidence suggesting a strong association between short sleep duration and elevated mortality risks. Given the potential adverse effects of insufficient sleep on health, well-being and productivity, the consequences of sleep-deprivation have far-reaching economic consequences. Hence, in order to raise awareness of the scale of insufficient sleep as a public-health issue, comparative quantitative figures need to be provided for policy- and decision-makers, as well as recommendations and potential solutions that can help tackling the problem. PMID:28983434
The costs of power generation are an important point in the electricity industry. The present report tries to supply a model representation for these problems. The costs of power generation for base load, average and peak load power stations are examined on the basis of fossil energy sources, nuclear power and water power. The methods of calculation where dynamic investment calculation processes are used, are given in the shape of formulae. From the point of view of long term prediction, power generation cost sensitivity studies are added to the technical, economic and energy-political uncertainties. The sensitivity of models for calculations is examined by deterministic and stochastic processes. In the base load and average region, power generation based on nuclear power and water power is economically more favourable than that from fossilfired power stations. Even including subsidies, this cost advantage is not in doubt. In the peak load region, pumped storage power stations are more economic than fossilfired power stations. (orig.) [de
Full Text Available Abstract Background The aim of the ACE-Obesity study was to determine the economic credentials of interventions which aim to prevent unhealthy weight gain in children and adolescents. We have reported elsewhere on the modelled effectiveness of 13 obesity prevention interventions in children. In this paper, we report on the cost results and associated methods together with the innovative approach to priority setting that underpins the ACE-Obesity study. Methods The Assessing Cost Effectiveness (ACE approach combines technical rigour with 'due process' to facilitate evidence-based policy analysis. Technical rigour was achieved through use of standardised evaluation methods, a research team that assembles best available evidence and extensive uncertainty analysis. Cost estimates were based on pathway analysis, with resource usage estimated for the interventions and their 'current practice' comparator, as well as associated cost offsets. Due process was achieved through involvement of stakeholders, consensus decisions informed by briefing papers and 2nd stage filter analysis that captures broader factors that influence policy judgements in addition to cost-effectiveness results. The 2nd stage filters agreed by stakeholders were 'equity', 'strength of the evidence', 'feasibility of implementation', 'acceptability to stakeholders', 'sustainability' and 'potential for side-effects'. Results The intervention costs varied considerably, both in absolute terms (from cost saving [6 interventions] to in excess of AUD50m per annum and when expressed as a 'cost per child' estimate (from Conclusion The use of consistent methods enables valid comparison of potential intervention costs and cost-offsets for each of the interventions. ACE-Obesity informs policy-makers about cost-effectiveness, health impact, affordability and 2nd stage filters for important options for preventing unhealthy weight gain in children. In related articles cost-effectiveness results and
Thanh, Nguyen Xuan; Hang, Hoang Mihn; Chuc, Nguyen Thi Kim; Lindholm, Lars
Relatively little is known about patterns of injury at the community level in Vietnam and their economic consequences. This study sought to estimate the costs of various unintentional injuries in Bavi District during one year; to describe how costs depended on gender, age, circumstances, and severity of injury; and to describe how the economic burden of unintentional injuries was distributed between households, government, and health insurance agency. A cohort study was undertaken, which involved four cross-sectional household surveys among sampled communities in the Bavi District during the year 2000, each asking about injuries in the preceding three months. The costing system in public healthcare in Vietnam was applied as well as information from the victims. The total cost of injuries over one year in Bavi District was estimated to be D3,412,539,000 (Vietnamese dong) (US$235,347), equivalent to the annual income of 1,800 people. In total, 90% of this economic burden fell on households, only 8% on government, and 2% on the health insurance agency. The cost of a severe injury to the corresponded to approximately seven months of earned income. Home and traffic injuries together accounted for more than 80% of the total cost, 45% and 38% respectively. The highest unit cost was related to traffic injuries, followed by home, "other", work-related, and school injuries in descending order. The results can be considered as an economic baseline that can be used in evaluations of future interventions aimed at preventing injuries.
Nieves, L.A.; Tawil, J.J.
This effort improves the quantitative information available for use in evaluating actions that alter health risks due to population exposure to ionizing radiation. To project the potential future costs of changes in health effects risks, Pacific Northwest Laboratory (PNL) constructed a probabilistic computer model, Health Effects Costs Model (HECOM), which utilizes the health effect incidence estimates from accident consequences models to calculate the discounted sum of the economic costs associated with population exposure to ionizing radiation. Application of HECOM to value-impact and environmental impact analyses should greatly increase the quality of the information available for regulatory decision making. Three major types of health effects present risks for any population sustaining a significant radiation exposure: acute radiation injuries (and fatalities), latent cancers, and impairments due to genetic effects. The literature pertaining to both incidence and treatment of these health effects was reviewed by PNL and provided the basis for developing economic cost estimates. The economic costs of health effects estimated by HECOM represent both the value of resources consumed in diagnosing, treating, and caring for the patient and the value of goods not produced because of illness or premature death due to the health effect. Additional costs to society, such as pain and suffering, are not included in the PNL economic cost measures since they do not divert resources from other uses, are difficult to quantify, and do not have a value observable in the marketplace. 83 refs., 3 figs., 19 tabs
Nieves, L.A.; Tawil, J.J.
This effort improves the quantitative information available for use in evaluating actions that alter health risks due to population exposure to ionizing radiation. To project the potential future costs of changes in health effects risks, Pacific Northwest Laboratory (PNL) constructed a probabilistic computer model, Health Effects Costs Model (HECOM), which utilizes the health effect incidence estimates from accident consequences models to calculate the discounted sum of the economic costs associated with population exposure to ionizing radiation. Application of HECOM to value-impact and environmental impact analyses should greatly increase the quality of the information available for regulatory decision making. Three major types of health effects present risks for any population sustaining a significant radiation exposure: acute radiation injuries (and fatalities), latent cancers, and impairments due to genetic effects. The literature pertaining to both incidence and treatment of these health effects was reviewed by PNL and provided the basis for developing economic cost estimates. The economic costs of health effects estimated by HECOM represent both the value of resources consumed in diagnosing, treating, and caring for the patient and the value of goods not produced because of illness or premature death due to the health effect. Additional costs to society, such as pain and suffering, are not included in the PNL economic cost measures since they do not divert resources from other uses, are difficult to quantify, and do not have a value observable in the marketplace. 83 refs., 3 figs., 19 tabs.
Takei, Masanobu; Kosugiyama, Shinichi; Mouri, Tomoaki; Katanishi, Shoji; Kunitomi, Kazuhiko
Japan Atomic Energy Research Institute (JAERI) has been developing a graphite moderate and helium cooled High Temperature Gas-cooled Reactor (HTGR) with gas turbine, the GTHTR300 based on experience gained in development and operations of the High Temperature Engineering Test Reactor (HTTR) in JAERI. The GTHTR300 is a simplified and economical power plant with a high level of safety characteristics and a high plant efficiency of approximately 46%. Cost evaluation for plant construction and power generation is studied in order to clarify the economical feasibility of the GTHTR300. The construction cost is estimated to be about 200 thousands Yen/kWe. The power generation cost is estimated to be about 3.8 Yen/kWh by the conditions of 90% load factor and 3% discount rate. The economical feasibility of the GTHTR300 is certified. The present study is entrusted from Ministry of Education, Culture, Sports, Science and Technology of Japan. (author)
Bauer, Annette; Knapp, Martin; Wistow, Gerald; Perkins, Margaret; King, Derek; Iemmi, Valentina
Solutions to support older people to live independently and reduce the cost of an ageing population are high on the political agenda of most developed countries. Help-at-home schemes offer a mix of community support with the aim to address a range of well-being needs. However, not much is currently known about the costs, outcomes and economic consequences of such schemes. Understanding their impact on individuals' well-being and the economic consequences for local and central government can contribute to decisions about sustainable long-term care financing. This article presents results from a mixed-methods study of a voluntary sector-provided help-at-home scheme in England for people of 55 years and older. The study followed a participatory approach, which involved staff and volunteers. Data were collected during 2012 and 2013. Social care-related quality of life was measured with the Adult Social Care Outcomes Toolkit for 24 service users (59% response rate) when they started using the scheme and 4-6 months later. A customised questionnaire that captured resource use and well-being information was sent to 1064 service users (63% response rate). The same tool was used in assessment with service users who started using the scheme between November 2012 and April 2013 (100% response rate). Costs of the scheme were established from local budget and activity data. The scheme was likely to achieve a mean net benefit of £1568 per person from a local government and National Health Service (NHS) perspective and £3766 from the perspective of the individual. An expenditure of £2851 per person accrued to central government for the additional redistribution of benefit payments to older people. This article highlights the potential contribution of voluntary sector-run help-at-home schemes to an affordable welfare system for ageing societies. © 2016 John Wiley & Sons Ltd.
Martinez, Gerardo Sanchez; Spadaro, Joseph V; Chapizanis, Dimitris; Kendrovski, Vladimir; Kochubovski, Mihail; Mudu, Pierpaolo
Urban outdoor air pollution, especially particulate matter, remains a major environmental health problem in Skopje, the capital of the former Yugoslav Republic of Macedonia. Despite the documented high levels of pollution in the city, the published evidence on its health impacts is as yet scarce. we obtained, cleaned, and validated Particulate Matter (PM) concentration data from five air quality monitoring stations in the Skopje metropolitan area, applied relevant concentration-response functions, and evaluated health impacts against two theoretical policy scenarios. We then calculated the burden of disease attributable to PM and calculated the societal cost due to attributable mortality. In 2012, long-term exposure to PM 2.5 (49.2 μg/m³) caused an estimated 1199 premature deaths (CI95% 821-1519). The social cost of the predicted premature mortality in 2012 due to air pollution was estimated at between 570 and 1470 million euros. Moreover, PM 2.5 was also estimated to be responsible for 547 hospital admissions (CI95% 104-977) from cardiovascular diseases, and 937 admissions (CI95% 937-1869) for respiratory disease that year. Reducing PM 2.5 levels to the EU limit (25 μg/m³) could have averted an estimated 45% of PM-attributable mortality, while achieving the WHO Air Quality Guidelines (10 μg/m³) could have averted an estimated 77% of PM-attributable mortality. Both scenarios would also attain significant reductions in attributable respiratory and cardiovascular hospital admissions. Besides its health impacts in terms of increased premature mortality and hospitalizations, air pollution entails significant economic costs to the population of Skopje. Reductions in PM 2.5 concentrations could provide substantial health and economic gains to the city.
Gerardo Sanchez Martinez
Full Text Available Background: Urban outdoor air pollution, especially particulate matter, remains a major environmental health problem in Skopje, the capital of the former Yugoslav Republic of Macedonia. Despite the documented high levels of pollution in the city, the published evidence on its health impacts is as yet scarce. Methods: we obtained, cleaned, and validated Particulate Matter (PM concentration data from five air quality monitoring stations in the Skopje metropolitan area, applied relevant concentration-response functions, and evaluated health impacts against two theoretical policy scenarios. We then calculated the burden of disease attributable to PM and calculated the societal cost due to attributable mortality. Results: In 2012, long-term exposure to PM2.5 (49.2 μg/m3 caused an estimated 1199 premature deaths (CI95% 821–1519. The social cost of the predicted premature mortality in 2012 due to air pollution was estimated at between 570 and 1470 million euros. Moreover, PM2.5 was also estimated to be responsible for 547 hospital admissions (CI95% 104–977 from cardiovascular diseases, and 937 admissions (CI95% 937–1869 for respiratory disease that year. Reducing PM2.5 levels to the EU limit (25 μg/m3 could have averted an estimated 45% of PM-attributable mortality, while achieving the WHO Air Quality Guidelines (10 μg/m3 could have averted an estimated 77% of PM-attributable mortality. Both scenarios would also attain significant reductions in attributable respiratory and cardiovascular hospital admissions. Conclusions: Besides its health impacts in terms of increased premature mortality and hospitalizations, air pollution entails significant economic costs to the population of Skopje. Reductions in PM2.5 concentrations could provide substantial health and economic gains to the city.
Full Text Available In the current economic downturn in the furniture industry companies, to face competition, requires new costing methods to succeed, in a flexible manner, fructifying market information, inside to find levers to identify places, resource intensive activities and then cost reduction opportunities. New methods of management cost excess the accounting and economics scope Current economic situation requires this work and converts the cost information into the main tool of insurance competitiveness and profitability of the company. Applying the standard cost in single cost model is a viable business solutions of enterprises in the furniture industry to face strong competition from European Union, specifically in the context of complex economic XXI century.
Bankert, Brian; Coberley, Carter; Pope, James E; Wells, Aaron
This paper presents a new approach to estimating the indirect costs of health-related absenteeism. Productivity losses related to employee absenteeism have negative business implications for employers and these losses effectively deprive the business of an expected level of employee labor. The approach herein quantifies absenteeism cost using an output per labor hour-based method and extends employer-level results to the region. This new approach was applied to the employed population of 3 health insurance carriers. The economic cost of absenteeism was estimated to be $6.8 million, $0.8 million, and $0.7 million on average for the 3 employers; regional losses were roughly twice the magnitude of employer-specific losses. The new approach suggests that costs related to absenteeism for high output per labor hour industries exceed similar estimates derived from application of the human capital approach. The materially higher costs under the new approach emphasize the importance of accurately estimating productivity losses.
Burns, Richeal; Leal, Jose; Sullivan, Richard; Luengo-Fernandez, Ramon
Malignant blood disorders are a leading contributor to cancer incidence and mortality across Europe. Despite their burden, no study has assessed the economic effect of blood cancers in Europe. We aimed to assess the economic burden of malignant blood disorders across the 28 countries in the European Union (EU), Iceland, Norway, and Switzerland. Malignant blood disorder-related costs were estimated for 28 EU countries, Iceland, Norway, and Switzerland for 2012. Country-specific costs were estimated with aggregate data on morbidity, mortality, and health-care resource use obtained from international and national sources. Health-care costs were estimated from expenditure on primary, outpatient, emergency, inpatient care, and drugs. Costs of informal care and productivity losses due to morbidity and early death were also included. For countries in the EU, malignant blood disorders were compared with the economic burden of overall cancer. Malignant blood disorders cost the 31 European countries €12 billion in 2012. Health-care cost €7·3 billion (62% of total costs), productivity losses cost €3·6 billion (30%), and informal care cost €1 billion (8%). For the EU countries, malignant blood disorders cost €6·8 billion (12%) of the total health-care expenditure on cancer (€57 billion), with this proportion being second only to breast cancer. In terms of total cancer costs in the EU (€143 billion), malignant blood disorders cost €12 billion (8%). Malignant blood disorders represent a leading cause of death, health-care service use, and costs, not only to European health-care systems, but to society overall. Our results add to essential public health knowledge needed for effective national cancer-control planning and priorities for public research funding. European Hematology Association. Copyright © 2016 Elsevier Ltd. All rights reserved.
Pizzi, Laura T; Seligman, Neil S; Baxter, Jason K; Jutkowitz, Eric; Berghella, Vincenzo
Preterm birth (PTB) is a costly public health problem in the USA. The PREGNANT trial tested the efficacy of vaginal progesterone (VP) 8 % gel in reducing the likelihood of PTB among women with a short cervix. We calculated the costs and cost effectiveness of VP gel versus placebo using decision analytic models informed by PREGNANT patient-level data. PREGNANT enrolled 459 pregnant women with a cervical length of 10-20 mm and randomized them to either VP 8 % gel or placebo. We used a cost model to estimate the total cost of treatment per mother and a cost-effectiveness model to estimate the cost per PTB averted with VP gel versus placebo. Patient-level trial data informed model inputs and included PTB rates in low- and high-risk women in each study group at <28 weeks gestation, 28-31, 32-36, and ≥37 weeks. Cost assumptions were based on 2010 US healthcare services reimbursements. The cost model was validated against patient-level data. Sensitivity analyses were used to test the robustness of the cost-effectiveness model. The estimated cost per mother was $US23,079 for VP gel and $US36,436 for placebo. The cost-effectiveness model showed savings of $US24,071 per PTB averted with VP gel. VP gel realized cost savings and cost effectiveness in 79 % of simulations. Based on findings from PREGNANT, VP gel was associated with cost savings and cost effectiveness compared with placebo. Future trials designed to include cost metrics are needed to better understand the value of VP.
Angelis, Diana I; Dillard, John; Franck, Raymond; Melese, Francois
The purpose of this report is to explore the possibility of improving DoD cost estimation methods by including explanatory variables that capture the coordination and motivation problems associated with the program...
Few studies have examined the economic cost of psychoses other than schizophrenia and there have been no studies of the economic cost of pathways to care in patients with their first episode of psychosis. The aims of this study were to explore the economic cost of pathways to care in patients with a first episode of psychosis and to examine variation in costs. Data on pathways to care for first episode psychosis patients referred to specialist mental health services in south-east London and Nottingham between 1997-2000. Costs of pathway events were estimated and compared between diagnostic groups. The average costs for patients in south-east London were £54 (CI £33-£75) higher, compared to patients in Nottingham. Across both centres unemployed patients had £25 (CI £7-£43) higher average costs compared to employed patients. Higher costs were associated with being unemployed and living in south-east London and these differences could not be accounted for by any single factor. This should be considered when the National Health Service (NHS) is making decisions about funding.
von Schéele, Birgitta; Fernandez, Maria; Hogue, Susan Lynn; Kwong, Winghan Jacqueline
To summarize the available evidence on the issues in health economics related to oral anticoagulation for stroke prevention in atrial fibrillation (AF) in the US. A literature review was performed using PubMed, EMBASE, Cochrane Library, and International Pharmaceutical Abstracts, as well as the websites of professional organizations. The search was conducted according to a prespecified protocol, limiting articles to those published in English from 2001 to October 2012 and focused on the economics associated with AF and AF-related stroke in the US. Data from 27 studies were extracted and included in the review. Strokes in patients with AF are more debilitating and have higher recurrence rates and mortality compared with strokes unrelated to AF. However, data describing the long-term cost of AF-related stroke and stroke subtypes remain limited. The costs of major gastrointestinal (GI) bleeding and intracranial bleeding related to warfarin are significant, whereas the costs of the more frequent minor GI bleeding are relatively low. Overall, the cost-effectiveness of warfarin versus aspirin or no treatment in patients with at least 1 risk factor for stroke is well established. Economic evaluations based on results from randomized controlled clinical trials generally found that new anticoagulants were a cost-effective alternative to warfarin for stroke prevention in AF. However, these cost-effectiveness results are highly sensitive to how well optimal international normalized ratio control is maintained (within target of 2.0-3.0) for warfarin and the time horizon used for analysis. Time in therapeutic range for warfarin in routine clinical practice was lower than in clinical trials, as shown by previous studies. This review identified several areas of uncertainty regarding the economic benefit of anticoagulants. The generalizability of cost-effectiveness results of anticoagulant therapy in AF based on clinical trial data must be confirmed by comparative effectiveness
Ahmad, Ali; Ramana, M.V.
Saudi Arabia has ambitious plans for nuclear power. Given this context, this paper examines the economics of nuclear power and compares it to two other sources of electricity, natural gas and solar energy. It calculates the costs of electricity generation, water desalination and the opportunity cost associated with forgone oil and gas revenues. A sensitivity analysis is included to account for variations in important parameters within the comparative cost analysis. Our results suggest that for a large range of parameters, the economics of nuclear power are not favorable in comparison with natural gas, even if the currently low domestic natural gas prices in Saudi Arabia were to rise substantially. Further, electricity from solar plants has the potential to be cheaper than nuclear power within the next decade if the rapid decline in solar energy costs in the last decade continue, i.e., before the first planned nuclear power plant would be completed. However, unless the price of oil drops substantially below current values, it would be more economically optimal to export the oil than using it for generating electricity. - Highlights: • Future projections show nuclear power is not cost effective for Saudi Arabia. • A combination of solar and natural gas could largely meet future electricity demand. • There are multiple, non-economic, motivations for Saudi Arabia's nuclear program. • Saudi Arabia would economically benefit by not using oil for electricity generation
Hwan Jin Kim
Full Text Available This paper examines the impact of two main alliance motivation theories, transaction cost economics (TCE and resource based view (RBV, on alliance processes among Korean manufacturing high-tech ventures. Results show that TCE and RBV are complimentarily explaining the formation of inter-firm alliances. TCE variables are more related with alliance partner characteristics while RBV is more linked with partner capabilities. Both show positive effects on performance. No significant effect is found on determining an alliance governance structure. While selecting appropriate technological alliance partners show positive effects on performance, no significant effect is found between alliance governance structure and performance. Factors of both theories impacting each alliance stage and analytical explanations of such impacts are discussed.
Meuldijk, Denise; McCarthy, Alexandra; Bourke, Marianne E.; Grenyer, Brin F. S.
Aim Borderline Personality Disorder (BPD) is a common mental health condition with high patterns of service utilisation of inpatient and community treatment. Over the past five years there has been significant growth in research with economic data, making this systematic review a timely update. Methods Empirical studies written in English or German, published up to December 2015, and cited in major electronic databases were examined using the PRISMA systematic review method. Papers were included that had one of the following: data related to cost of BPD to society, the individual, the carer or families; cost benefits of interventions. Reported cost data were inflated to the year 2015 and converted into US- dollars (USD $) using purchasing power parities. Results We identified 30 economic evaluations providing cost data related to interventions for BPD across 134,136 patients. The methodological quality was good, almost all studies fulfilled ≥ 50% of the quality criteria. The mean cost saving for treating BPD with evidence-based psychotherapy across studies was USD $2,987.82 per patient per year. A further mean weighted reduction of USD $1,551 per patient per year (range $83 - $29,392) was found compared to treatment as usual. Evidence-based psychological treatment was both less expensive as well as more effective, despite considerable differences in health cost arrangements between individual studies and countries. Where it was able to be calculated, a significant difference in cost-savings between different types of evidence-based psychotherapies was found. Discussion Individuals with BPD consistently demonstrate high patterns of service utilization and therefore high costs. The findings of this review present a strong argument in favour of prioritizing BPD treatments in reimbursement decisions, both for the affected individual and the family. The provision of evidence based treatment, irrespective of the type of psychological treatment, may lead to widespread
Full Text Available Borderline Personality Disorder (BPD is a common mental health condition with high patterns of service utilisation of inpatient and community treatment. Over the past five years there has been significant growth in research with economic data, making this systematic review a timely update.Empirical studies written in English or German, published up to December 2015, and cited in major electronic databases were examined using the PRISMA systematic review method. Papers were included that had one of the following: data related to cost of BPD to society, the individual, the carer or families; cost benefits of interventions. Reported cost data were inflated to the year 2015 and converted into US- dollars (USD $ using purchasing power parities.We identified 30 economic evaluations providing cost data related to interventions for BPD across 134,136 patients. The methodological quality was good, almost all studies fulfilled ≥ 50% of the quality criteria. The mean cost saving for treating BPD with evidence-based psychotherapy across studies was USD $2,987.82 per patient per year. A further mean weighted reduction of USD $1,551 per patient per year (range $83 - $29,392 was found compared to treatment as usual. Evidence-based psychological treatment was both less expensive as well as more effective, despite considerable differences in health cost arrangements between individual studies and countries. Where it was able to be calculated, a significant difference in cost-savings between different types of evidence-based psychotherapies was found.Individuals with BPD consistently demonstrate high patterns of service utilization and therefore high costs. The findings of this review present a strong argument in favour of prioritizing BPD treatments in reimbursement decisions, both for the affected individual and the family. The provision of evidence based treatment, irrespective of the type of psychological treatment, may lead to widespread reductions in
Capros P; Sedee C; Jantzen J; MNV
The economic assessment of priorities for a European environmental policy plan focuses on twelve identified Prominent European Environmental Problems such as climate change, chemical risks and biodiversity. The study, commissioned by the European Commission (DG Environment) to a European consortium led by RIVM, provides a basis for priority setting for European environmental policy planning in support of the sixth Environmental Action Programme as follow-up of the current fifth Environmental ...
Vernon, John A; Goldberg, Robert; Golec, Joseph
In this article we describe how reimbursement cost-effectiveness thresholds, per unit of health benefit, whether set explicitly or observed implicitly via historical reimbursement decisions, serve as a signal to firms about the commercial viability of their R&D projects (including candidate products for in-licensing). Traditional finance methods for R&D project valuations, such as net present value analyses (NPV), incorporate information from these payer reimbursement signals to help determine which R&D projects should be continued and which should be terminated (in the case of the latter because they yield an NPV important for reimbursement thresholds to reflect the economic value of the unit of health benefit being considered for reimbursement. Thresholds set too low (below the economic value of the health benefit) will result in R&D investment levels that are too low relative to the economic value of R&D (on the margin). Similarly, thresholds set too high (above the economic value of the health benefit) will result in inefficiently high levels of R&D spending. The US in particular, which represents approximately half of the global pharmaceutical market (based on sales), and which seems poised to begin undertaking cost effectiveness in a systematic way, needs to exert caution in setting policies that explicitly or implicitly establish cost-effectiveness reimbursement thresholds for healthcare products and technologies, such as pharmaceuticals.
Pugliatti, Maura; Beghi, Ettore; Forsgren, Lars; Ekman, Mattias; Sobocki, Patrik
Based on available epidemiologic, health economic, and international population statistics literature, the cost of epilepsy in Europe was estimated. Europe was defined as the 25 European Union member countries, Iceland, Norway, and Switzerland. Guidelines for epidemiological studies on epilepsy were used for a case definition. A bottom-up prevalence-based cost-of-illness approach, the societal perspective for including the cost items, and the human capital approach as valuation principle for indirect costs were used. The cost estimates were based on selected studies with common methodology and valuation principles. The estimated prevalence of epilepsy in Europe in 2004 was 4.3-7.8 per 1,000. The estimated total cost of the disease in Europe was euro15.5 billion in 2004, indirect cost being the single most dominant cost category (euro8.6 billion). Direct health care costs were euro2.8 billion, outpatient care comprising the largest part (euro1.3 billion). Direct nonmedical cost was euro4.2 billion. That of antiepileptic drugs was euro400 million. The total cost per case was euro2,000-11,500 and the estimated cost per European inhabitant was euro33. Epilepsy is a relevant socioeconomic burden at individual, family, health services, and societal level in Europe. The greater proportion of such burden is outside the formal health care sector, antiepileptic drugs representing a smaller proportion. Lack of economic data from several European countries and other methodological limitations make this report an initial estimate of the cost of epilepsy in Europe. Prospective incidence cost-of-illness studies from well-defined populations and common methodology are encouraged.
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.
Zheng, Yaming; Jit, Mark; Wu, Joseph T; Yang, Juan; Leung, Kathy; Liao, Qiaohong; Yu, Hongjie
Hand, foot and mouth disease (HFMD) is a common illness in China that mainly affects infants and children. The objective of this study is to assess the economic cost and health-related quality of life associated with HFMD in China. A telephone survey of caregivers were conducted in 31 provinces across China. Caregivers of laboratory-confirmed HFMD patients who were registered in the national HFMD enhanced surveillance database during 2012-2013 were invited to participate in the survey. Total costs included direct medical costs (outpatient care, inpatient care and self-medication), direct non-medical costs (transportation, nutrition, accommodation and nursery), and indirect costs for lost income associated with caregiving. Health utility weights elicited using EuroQol EQ-5D-3L and EQ-Visual Analogue Scale (VAS) were used to calculate associated loss in quality adjusted life years (QALYs). The subjects comprised 1136 mild outpatients, 1124 mild inpatients, 1170 severe cases and 61 fatal cases. The mean total costs for mild outpatients, mild inpatients, severe cases and fatal cases were $201 (95%CI $187, $215), $1072 (95%CI $999, $1144), $3051 (95%CI $2905, $3197) and $2819 (95%CI $2068, $3571) respectively. The mean QALY losses per HFMD episode for mild outpatients, mild inpatients and severe cases were 3.6 (95%CI 3.4, 3,9), 6.9 (95%CI 6.4, 7.4) and 13.7 (95%CI 12.9, 14.5) per 1000 persons. Cases who were diagnosed with EV-A71 infection and had longer duration of illness were associated with higher total cost and QALY loss. HFMD poses a high economic and health burden in China. Our results provide economic and health utility data for cost-effectiveness analysis for HFMD vaccination in China.
Full Text Available Hand, foot and mouth disease (HFMD is a common illness in China that mainly affects infants and children. The objective of this study is to assess the economic cost and health-related quality of life associated with HFMD in China.A telephone survey of caregivers were conducted in 31 provinces across China. Caregivers of laboratory-confirmed HFMD patients who were registered in the national HFMD enhanced surveillance database during 2012-2013 were invited to participate in the survey. Total costs included direct medical costs (outpatient care, inpatient care and self-medication, direct non-medical costs (transportation, nutrition, accommodation and nursery, and indirect costs for lost income associated with caregiving. Health utility weights elicited using EuroQol EQ-5D-3L and EQ-Visual Analogue Scale (VAS were used to calculate associated loss in quality adjusted life years (QALYs.The subjects comprised 1136 mild outpatients, 1124 mild inpatients, 1170 severe cases and 61 fatal cases. The mean total costs for mild outpatients, mild inpatients, severe cases and fatal cases were $201 (95%CI $187, $215, $1072 (95%CI $999, $1144, $3051 (95%CI $2905, $3197 and $2819 (95%CI $2068, $3571 respectively. The mean QALY losses per HFMD episode for mild outpatients, mild inpatients and severe cases were 3.6 (95%CI 3.4, 3,9, 6.9 (95%CI 6.4, 7.4 and 13.7 (95%CI 12.9, 14.5 per 1000 persons. Cases who were diagnosed with EV-A71 infection and had longer duration of illness were associated with higher total cost and QALY loss.HFMD poses a high economic and health burden in China. Our results provide economic and health utility data for cost-effectiveness analysis for HFMD vaccination in China.
Fuertes-Guiró, Fernando; Girabent-Farrés, Montserrat; Viteri-Velasco, Eduardo
This study aims to demonstrate the importance of the opportunity cost in using da Vinci robotic surgery, assisted by a comprehensive review of the literature to determine the differences in the total cost of surgery and operative time in traditional laparoscopic surgery and da Vinci robotic surgery. We identified the studies comparing the use of traditional laparoscopic surgery with robotics during the period 2002-2012 in the electronic economic evaluation databases, and another electronic search was performed for publications by Spanish hospitals in the same period to calculate the opportunity cost. A meta-analysis of response variables considering the total cost of the intervention and surgical time was completed using the items selected in the first revision, and their differences were analyzed. We then calculated the opportunity cost represented by these time differences using the data obtained from the studies in the second review of the literature. Nine items were selected in the first review and three in the second. Traditional laparoscopic surgery has a lower cost than the da Vinci (p < 0.00001). Robotic surgery takes longer (8.0-65.5 min) than traditional surgery (p < 0.00001), and this difference represents an average opportunity cost for robot use of € 489.98, with a unit cost factor/time which varies according to the pathology dealt with, from € 8.2 to 18.7/min. The opportunity cost is a quantity that must be included in the total cost of using a surgical technology within an economic cost analysis in the context of an economic evaluation.
Gomez-Rosado, Juan-Carlos; Salas-Turrens, Jose; Olry-de-Labry-Lima, Antonio
The aim was to assess the impact on economic costs and length of stay (LOS) of postoperative complications. 5,822 records from BMDS (2014-2015) are included. A descriptive, univariate and multivariate study evaluated the correlation between complications, Clavien-Dindo grade and vacation periods with LOS and economic costs, based on a full-cost model, aggregated by DRG. Mean cost per stay was €676.71, and €4,309.02 per episode. Complications appeared in 639 patients (11%). Admission to ICU was required in 203 patients, re-operation in 134 and re-admission in 243, while 66 patients died (1.1%). Complications caused significantly longer LOS (20.08 vs 5.48 days) and higher economic cost (€11,670.31 vs €3,354.12); infectious complications were the most frequent and respiratory the most expensive (€20,428.53), together with ICU admission (€20,242.66). Clavien-Dindo grade correlated with greater LOS and costs (except gradev). During vacation periods, complications and LOS are increased, but costs of these complications and LOS did not differ significantly from complications detected in non-vacation periods. Copyright © 2018 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.
Full Text Available Abstract Background Asthma is one of the main non-infectious diseases of the respiratory system with substantial economic burden worldwide. The objective of this study was to estimate the economic burden of adult asthma in Cyprus during 2015. Methods A retrospective probabilistic prevalence-based cost of illness model was developed to calculate the economic burden of asthma including direct and indirect costs. The bottom-up approach (person-based data was used for the calculation of direct costs while for the calculation of indirect costs the approach of human capital was employed. In addition, bootstrapped sensitivity analysis with 1000 bootstrap simulations was performed in order to calculate a 95% Confidence Interval (CI. Results Mean patient cost of asthma in Cyprus in 2015 was estimated at €579.64 (95% CI: €376.90–€813.68. Direct costs accounted for 82.08% of the overall expenses, €475.75 per patient (95% CI: €296.94–€697.69. Indirect costs of €103.89 (95% CI: €49.59–€181.46 accounted for 17.92% of the overall expenses. Conclusion This was the first study in Cyprus, which used bootstrapped prevalence-based cost of illness model to estimate the cost of asthma. This study confirms that asthma is an expensive disease for the society. In addition, it provides important information and analysis of the economic consequences of asthma to policy makers in order to strengthen surveillance of the disease as well as draft the national health policy accordingly.
Spanjer, Aldo R.
Shifts at the international gas market indicate that the transaction cost perspective provides better underpinnings for European gas regulation than the current neoclassical perspective. Three implications are that policymakers should: (1) allow alternative coordination measures to complement market exchange; (2) recognize that less than perfect competition outcomes may be optimal and (3) be more reticent in prescribing interventionist measures. Finally, the analysis provides the foundations for the empirical research required to complement this paper's theoretical approach. (author)
López-Bastida, Julio; Peña-Longobardo, Luz María; Aranda-Reneo, Isaac; Tizzano, Eduardo; Sefton, Mark; Oliva-Moreno, Juan
The aim of this study was to determine the economic burden and health-related quality of life (HRQOL) of patients with Spinal Muscular Atrophy (SMA) and their caregivers in Spain. This was a cross-sectional and retrospective study of patients diagnosed with SMA in Spain. We adopted a bottom up, prevalence approach design to study patients with SMA. The patient's caregivers completed an anonymous questionnaire regarding their socio-demographic characteristics, use of healthcare services and non-healthcare services. Costs were estimated from a societal perspective (including healthcare costs and non-healthcare costs), and health-related quality of life (HRQOL) was assessed using the EQ-5D questionnaire. The main caregivers also answered a questionnaire on their characteristics and on their HRQOL. A total of 81 caregivers of patients with different subtypes of SMA completed the questionnaire. Based on the reference unitary prices for 2014, the average annual costs per patient were € 33,721. Direct healthcare costs were € 10,882 (representing around 32.3% of the total cost) and the direct non-healthcare costs were € 22,839 (67.7% of the total cost). The mean EQ-5D social tariff score for patients was 0.16, and the mean score of the EQ-5D visual analogue scale was 54. The mean EQ-5D social tariff score for caregivers was 0.49 and their mean score on the EQ-5D visual analogue scale was 69. The results highlight the burden that SMA has in terms of costs and decreased HRQOL, not only for patients but also for their caregivers. In particular, the substantial social/economic burden is mostly attributable to the high direct non-healthcare costs.
About one-third of Europe's 34 cracker and downstream units lost money in the final quarter of 1992, says Chem Systems (London). Average return on capital employed is negative - at the same level as in the gloomy days of the early 1980s - yet average operating rates are 80% now, compared with 65% a decade ago. Margins at what Chem Systems calls leader cracks (naphtha-based units that use good modern practices) are DM42/m.t. ethylene, DM100/m.t. less than they were in 1991. The consultant firm's recent report, European Petrochemical Strategy in the 1990s, suggests closure of 5%-10% of high-cost production. But, Chem Systems director Roger Longley states: We are not advocating wholesale closure. There are a small number (of plants) where additional investment would not payback that would be economical to shut. Cost reduction through mergers and acquisitions and operational changes is much more important, especially from an international aspect, Longley says. One thing people do not fully appreciate is that Europe is a high-cost region for petrochemical production, he adds. Traditionally, Europe exports 5% of its ethylene output, now it needs to tolerate cheap imports
Kinchin, Irina; Doran, Christopher M; McCalman, Janya; Jacups, Susan; Tsey, Komla; Lines, Katrina; Smith, Kieran; Searles, Andrew
The Family Wellbeing (FWB) program applies culturally appropriate community led empowerment training to enhance the personal development of Aboriginal and Torres Strait Islander people in life skills. This study sought to estimate the economic cost required to deliver the FWB program to a child safety workforce in remote Australian communities. This study was designed as a retrospective cost description taken from the perspective of a non-government child safety agency. The target population were child protection residential care workers aged 24 or older, who worked in safe houses in five remote Indigenous communities and a regional office during the study year (2013). Resource utilization included direct costs (personnel and administrative) and indirect or opportunity costs of participants, regarded as absence from work. The total cost of delivering the FWB program for 66 participants was $182,588 ($2766 per participant), with 45% ($82,995) of costs classified as indirect (i.e., opportunity cost of participants time). Training cost could be further mitigated (∼30%) if offered on-site, in the community. The costs for offering the FWB program to a remotely located workforce were high, but not substantial when compared to the recruitment cost required to substitute a worker in remote settings. An investment of $2766 per participant created an opportunity to improve social and emotional wellbeing of remotely located workforce. This cost study provided policy relevant information by identifying the resources required to transfer the FWB program to other remote locations. It also can be used to support future comparative cost and outcome analyses and add to the evidence base around the cost-effectiveness of empowerment programs. Copyright © 2017 Elsevier Ltd. All rights reserved.
Based upon 50 large and medium hub airports over a 13 year period, this research estimates one and two : output translog models of airport short run operating costs. Output is passengers transported on non-stop : segments and pounds of cargo shipped....
Sarracanie, Mathieu; Lapierre, Cristen D.; Salameh, Najat; Waddington, David E. J.; Witzel, Thomas; Rosen, Matthew S.
Magnetic Resonance Imaging (MRI) is unparalleled in its ability to visualize anatomical structure and function non-invasively with high spatial and temporal resolution. Yet to overcome the low sensitivity inherent in inductive detection of weakly polarized nuclear spins, the vast majority of clinical MRI scanners employ superconducting magnets producing very high magnetic fields. Commonly found at 1.5-3 tesla (T), these powerful magnets are massive and have very strict infrastructure demands that preclude operation in many environments. MRI scanners are costly to purchase, site, and maintain, with the purchase price approaching $1 M per tesla (T) of magnetic field. We present here a remarkably simple, non-cryogenic approach to high-performance human MRI at ultra-low magnetic field, whereby modern under-sampling strategies are combined with fully-refocused dynamic spin control using steady-state free precession techniques. At 6.5 mT (more than 450 times lower than clinical MRI scanners) we demonstrate (2.5 × 3.5 × 8.5) mm3 imaging resolution in the living human brain using a simple, open-geometry electromagnet, with 3D image acquisition over the entire brain in 6 minutes. We contend that these practical ultra-low magnetic field implementations of MRI (standards for affordable (<$50,000) and robust portable devices.
Reid, R.L.; Miller, J.W.
Before the January 1997 Record of Decision (ROD), the U.S. Department of Energy Office of Fissile Materials Disposition (DOE-MD) evaluated three technologies for the disposition of ∼50 MT of surplus plutonium from defense-related programs-reactors, immobilization, and deep boreholes. As part of the process supporting the ROD, and comprehensive assessment of technical viability, cost, and schedule was conducted by DOE-MD and its national laboratory contractors. Oak Ridge National Laboratory managed and coordinated the life-cycle cost (LCC) assessment effort for this program. This report discusses the economic analysis methodology and the results for the reactor options considered prior to ROD. A secondary intent of the report is to discuss major technical and economic issues that impact cost and schedule. To evaluate the economics of the reactor option and other technologies on an equitable basis, a set of cost-estimating guidelines and a common cost-estimating format were utilized by all three technology teams. This report includes the major economic analysis assumptions and the comparative constant-dollar and discounted-dollar LCCs for all nine reactor scenarios
Juchem Neto, J. P.; Claeyssen, J. C. R.; Pôrto Júnior, S. S.
In this paper we introduce capital transport cost in a unidimensional spatial Solow-Swan model of economic growth with capital-induced labor migration, considered in an unbounded domain. Proceeding with a stability analysis, we show that there is a critical value for the capital transport cost where the dynamic behavior of the economy changes, provided that the intensity of capital-induced labor migration is strong enough. On the one hand, if the capital transport cost is higher than this critical value, the spatially homogeneous equilibrium of coexistence of the model is stable, and the economy converges to this spatially homogeneous state in the long run; on the other hand, if transport cost is lower than this critical value, the equilibrium is unstable, and the economy may develop different spatio-temporal dynamics, including the formation of stable economic agglomerations and spatio-temporal economic cycles, depending on the other parameters in the model. Finally, numerical simulations support the results of the stability analysis, and illustrate the spatio-temporal dynamics generated by the model, suggesting that the economy as a whole benefits from the formation of economic agglomerations and cycles, with a higher capital transport cost reducing this gain.
Hu, T W; Slaysman, K S
On March 1979, a nuclear power station at Three-Mile Island (TMI) near Harrisburg, Pennsylvania, had a major breakdown. During the two-week period of the accident, about 150,000 residents were evacuated for reasons associated with safety and health. Many residents during and after the accident, regardless of whether they left or stayed, made mental and physical adjustments due to this accident. This paper is to estimate the economic costs incurred by individuals or communities as a result of a change in physical or mental health status and/or a change in health care services due to the TMI accident. The findings indicate that stress symptoms caused by the accident did affect the health-related behaviors of area residents. Of the costs examined, the economic costs of work days lost and physician visits are the largest cost items. There were some increases in consumption of alcohol, cigarettes, and tranquilizers immediately following the accident.
In order to maintain and develop a universal health insurance system, it is crucial to utilize limited medical resources effectively. In this context, considerations are underway to introduce health technology assessments (HTAs), such as cost-effectiveness analyses (CEAs), into the medical treatment fee system. CEAs, which is the general term for these methods, are classified into four categories, such as cost-effectiveness analyses based on performance indicators, and in the comparison of health technologies, the incremental cost-effectiveness ratio (ICER) is also applied. When I comprehensively consider several Japanese studies based on these concepts, I find that, in the results of the analysis of the economic performance of healthcare systems, Japan shows the most promising trend in the world. In addition, there is research indicating the superior cost-effectiveness of Rituximab against refractory nephrotic syndrome, and it is expected that health economics will be actively applied to the valuation of technical innovations such as drug discovery.
Ronald W. Cotterill; Leonard Egan; William Buckhold
This article reviews the legal standards and the economics of indirect purchaser cases. Drawn from recent cases on behalf of consumers in the ADM price fixing case, it presents cost pass through models for high fructose corn syrup (HFCS), one of the alleged price fixes in the wet corn milling industry. If soft drink bottlers, a primary user of HFCS, have fixed proportion production, constant returns to scale, and if other bottlers input prices are unaffected by variations in soft drink output...
Chen, Jing; McGhee, Sarah; Lam, Tai Hing
Reduction in smoking prevalence does not necessarily reduce the costs of smoking as evidence shows in developed countries. We provide up-to-date estimates for direct and indirect costs attributable to smoking in Hong Kong in 2011 and compare with our 1998 estimates. We took a societal perspective to include lives and life years lost, health care costs and time lost from work in the costing. We followed guidelines on estimating costs of active smoking for those aged 35 years or above (35+) and costs due to SHS exposure for 35+, infants aged 12 months and under and children aged 15 and below. All costs are in US$. We estimated that 6154 deaths among 35+ in Hong Kong in 2011 were attributable to active smoking, an increase of 10% from 1998. Besides, 672 deaths were attributable to SHS exposure, i.e. 10% of the total 6826 smoking-attributable deaths. The estimate of productive life lost due to deaths from active smoking by those aged under 65 years in 2011 was $166 million, an increase of about 4% over the estimate in 1998. Our conservative estimate of the annual tobacco-related disease cost in 2011 was $716 million which accounted for 0.3% of GDP. If we added the value of attributable lives lost, the annual cost would be $4.7 billion. Despite the reduction in smoking prevalence, smoking-attributable disease still imposes a substantial economic burden on Hong Kong society. These findings support more stringent and effective tobacco control legislation, polices and measures. Current evidence shows reduction in smoking prevalence does not necessarily reduce the economic costs of smoking. Most studies in developed countries employed a societal perspective, including costs of productivity loss and indirect costs, but not all studies estimated costs associated with second-hand smoking (SHS). The present study estimated the total costs of smoking in Hong Kong including direct and indirect costs attributable to active smoking and to SHS exposure. Our study confirms the
Nicosia, Nancy; Pacula, Rosalie Liccardo; Kilmer, Beau; Lundberg, Russell; Chiesa, James
This first national estimate suggests that the economic cost of methamphetamine (meth) use in the United States reached $23.4 billion in 2005. Given the uncertainty in estimating the costs of meth use, this book provides a lower-bound estimate of $16.2 billion and an upper-bound estimate of $48.3 billion. The analysis considers a wide range of…
Ierland, E.C. van; Derksen, L.
Proper policies for the prevention or mitigation of the effects of global warming require profound analysis of the costs and benefits of alternative policy strategies. Given the uncertainty about the scientific aspects of the process of global warming, in this paper a sensitivity analysis for the impact of various estimates of costs and benefits of greenhouse gas reduction strategies is carried out to analyze the potential social and economic impacts of climate change
Hirth, Lion (Prof. Dr.); Ueckerdt, Falko (Dr.); Edenhofer, Ottmar (Prof. Dr.)
The integration of wind and solar generators into power systems causes “integration costs” – for grids, balancing services, more flexible operation of thermal plants, and reduced utilization of the capital stock embodied in infrastructure, among other things. This paper proposes a framework to analyze and quantify these costs. We propose a definition of integration costs based on the marginal economic value of electricity, or market value – as such a definition can be more easily used in econ...
Luis R Carrasco
Full Text Available BACKGROUND: Dengue illness causes 50-100 million infections worldwide and threatens 2.5 billion people in the tropical and subtropical regions. Little is known about the disease burden and economic impact of dengue in higher resourced countries or the cost-effectiveness of potential dengue vaccines in such settings. METHODS AND FINDINGS: We estimate the direct and indirect costs of dengue from hospitalized and ambulatory cases in Singapore. We consider inter alia the impacts of dengue on the economy using the human-capital and the friction cost methods. Disease burden was estimated using disability-adjusted life years (DALYs and the cost-effectiveness of a potential vaccine program was evaluated. The average economic impact of dengue illness in Singapore from 2000 to 2009 in constant 2010 US$ ranged between $0.85 billion and $1.15 billion, of which control costs constitute 42%-59%. Using empirically derived disability weights, we estimated an annual average disease burden of 9-14 DALYs per 100 000 habitants, making it comparable to diseases such as hepatitis B or syphilis. The proportion of symptomatic dengue cases detected by the national surveillance system was estimated to be low, and to decrease with age. Under population projections by the United Nations, the price per dose threshold for which vaccines stop being more cost-effective than the current vector control program ranged from $50 for mass vaccination requiring 3 doses and only conferring 10 years of immunity to $300 for vaccination requiring 2 doses and conferring lifetime immunity. The thresholds for these vaccine programs to not be cost-effective for Singapore were $100 and $500 per dose respectively. CONCLUSIONS: Dengue illness presents a serious economic and disease burden in Singapore. Dengue vaccines are expected to be cost-effective if reasonably low prices are adopted and will help to reduce the economic and disease burden of dengue in Singapore substantially.
Wilcox, Brian H.; Schneider, Evan G.; Vaughan, David A.; Hall, Jeffrey L.
This paper provides new analysis of the economics of low-cost propellant launch coupled with dry hardware re-use, and of the thermal control of the liquid hydrogen once on-orbit. One conclusion is that this approach enables an overall reduction in the cost-permission by as much as a factor of five as compared to current approaches for human exploration of the moon, Mars, and near-Earth asteroids.
Sethi, P.; Tiangco, V.; Dee, V.; Simons, G.; Lee, Y.; Yomogida, D.
This paper deals with the economic impacts of the technical, environmental, and institutional barriers in the production, harvesting, and processing of various biomass fuels in California. For each biomass fuel, a base case scenario was developed to characterize the procedures of harvesting, processing and transporting. An economic model was utilized to project the biomass production costs supplied to direct-combustion power plants for each technical, environmental, and institutional barrier. These results will enable the California Energy Commission to identify the most significant barriers to economical biomass energy production (production, harvesting, and processing). (author)
Anna Sanz de Galdeano
Obesity is not only a health but also an economic phenomenon with potentially important direct and indirect economic costs that are unlikely to be fully internalized by the obese. In the US, obesity prevalence is the highest among OECD countries and the issue has long been the focus of policy debate and academic research. However, European obesity rates are rising and there is still a lack of economic analysis of the obesity phenomenon in Europe. This paper attempts to fill in this gap by usi...
Wechowski, Jaroslaw; Connolly, Mark; McEwan, Philip; Kennedy, Richard
Public funding for IVF is increasingly being challenged by health authorities in an attempt to minimize health service costs. In light of treatment rationing, the need to consider costs in relation to outcomes is paramount. To assess the cost implications of gonadotrophin treatment options, an economic evaluation comparing highly purified human menopausal gonadotrophin (HP-HMG) and recombinant FSH (rFSH) has been conducted. The analysis is based on individual patient data from a large randomized controlled trial (n = 731) in a long agonist IVF protocol. The economic evaluation uses a discrete event simulation model to assess treatment costs in relation to live births for both treatments based on published UK costs. After one cycle the mean costs per IVF treatment for HP-HMG and rFSH were pound2396 (95% CI pound2383-2414) and pound2633 ( pound2615-2652), respectively. The average cost-saving of pound237 per IVF cycle using HP-HMG allows one additional cycle to be delivered for every 10 cycles. With maternal and neonatal costs applied, the median cost per IVF baby delivered with HP-HMG was pound8893 compared with pound11,741 for rFSH (P cost-saving potential of HP-HMG in IVF was still apparent after varying critical cost parameters in the probabilistic sensitivity analysis.
Abdelgadir, Jihad; Tran, Tu; Muhindo, Alex; Obiga, Doomwin; Mukasa, John; Ssenyonjo, Hussein; Muhumza, Michael; Kiryabwire, Joel; Haglund, Michael M; Sloan, Frank A
There are no data on cost of neurosurgery in low-income and middle-income countries. The objective of this study was to estimate the cost of neurosurgical procedures in a low-resource setting to better inform resource allocation and health sector planning. In this observational economic analysis, microcosting was used to estimate the direct and indirect costs of neurosurgical procedures at Mulago National Referral Hospital (Kampala, Uganda). During the study period, October 2014 to September 2015, 1440 charts were reviewed. Of these patients, 434 had surgery, whereas the other 1006 were treated nonsurgically. Thirteen types of procedures were performed at the hospital. The estimated mean cost of a neurosurgical procedure was $542.14 (standard deviation [SD], $253.62). The mean cost of different procedures ranged from $291 (SD, $101) for burr hole evacuations to $1,221 (SD, $473) for excision of brain tumors. For most surgeries, overhead costs represented the largest proportion of the total cost (29%-41%). This is the first study using primary data to determine the cost of neurosurgery in a low-resource setting. Operating theater capacity is likely the binding constraint on operative volume, and thus, investing in operating theaters should achieve a higher level of efficiency. Findings from this study could be used by stakeholders and policy makers for resource allocation and to perform economic analyses to establish the value of neurosurgery in achieving global health goals. Copyright © 2017 Elsevier Inc. All rights reserved.
Meier, W.R.; Hogan, W.J.
Parametric studies were carried out for a heavy ion beam (HIB) fusion electric power plant to investigate the effects on the cost of electricity (COE) of variations in several design parameters. In particular, we examined the effects of maximum achievable chamber pulse rate, driver cost, target gain, electric conversion efficiency, and net electric power. We find that with a combination of improvements over our base case, HIB fusion can be economically competitive with other future power sources
Haynes R Brian
Full Text Available Abstract Background Economic evaluations in the medical literature compare competing diagnosis or treatment methods for their use of resources and their expected outcomes. The best evidence currently available from research regarding both cost and economic comparisons will continue to expand as this type of information becomes more important in today's clinical practice. Researchers and clinicians need quick, reliable ways to access this information. A key source of this type of information is large bibliographic databases such as EMBASE. The objective of this study was to develop search strategies that optimize the retrieval of health costs and economics studies from EMBASE. Methods We conducted an analytic survey, comparing hand searches of journals with retrievals from EMBASE for candidate search terms and combinations. 6 research assistants read all issues of 55 journals indexed by EMBASE for the publishing year 2000. We rated all articles using purpose and quality indicators and categorized them into clinically relevant original studies, review articles, general papers, or case reports. The original and review articles were then categorized for purpose (i.e., cost and economics and other clinical topics and depending on the purpose as 'pass' or 'fail' for methodologic rigor. Candidate search strategies were developed for economic and cost studies, then run in the 55 EMBASE journals, the retrievals being compared with the hand search data. The sensitivity, specificity, precision, and accuracy of the search strategies were calculated. Results Combinations of search terms for detecting both cost and economic studies attained levels of 100% sensitivity with specificity levels of 92.9% and 92.3% respectively. When maximizing for both sensitivity and specificity, the combination of terms for detecting cost studies (sensitivity increased 2.2% over the single term but at a slight decrease in specificity of 0.9%. The maximized combination of terms
Sonny S. Bleicher
Full Text Available In environments where food resources are spatially variable and temporarily impoverished, consumers that encounter habitat patches with different food density should focus their foraging initially where food density is highest before they move to patches where food density is lower. Increasing missed opportunity costs should drive individuals progressively to patches with lower food density as resources in the initially high food density patches deplete. To test these expectations, we assessed the foraging decisions of two species of dasyurid marsupials (dunnarts: Sminthopsis hirtipes and S. youngsoni during a deep drought, or bust period, in the Simpson Desert of central Australia. Dunnarts were allowed access to three patches containing different food densities using an interview chamber experiment. Both species exhibited clear preference for the high density over the lower food density patches as measured in total harvested resources. Similarly, when measuring the proportion of resources harvested within the patches, we observed a marginal preference for patches with initially high densities. Models analyzing behavioral choices at the population level found no differences in behavior between the two species, but models analyzing choices at the individual level uncovered some variation. We conclude that dunnarts can distinguish between habitat patches with different densities of food and preferentially exploit the most valuable. As our observations were made during bust conditions, experiments should be repeated during boom times to assess the foraging economics of dunnarts when environmental resources are high.
Schackman, Bruce R; Gold, Heather Taffet; Stone, Patricia W; Neumann, Peter J
There is limited evidence about the extent to which sensitivity analysis has been used in the cost-effectiveness literature. Sensitivity analyses for health-related QOL (HR-QOL), cost and discount rate economic parameters are of particular interest because they measure the effects of methodological and estimation uncertainties. To investigate the use of sensitivity analyses in the pharmaceutical cost-utility literature in order to test whether a change in economic parameters could result in a different conclusion regarding the cost effectiveness of the intervention analysed. Cost-utility analyses of pharmaceuticals identified in a prior comprehensive audit (70 articles) were reviewed and further audited. For each base case for which sensitivity analyses were reported (n = 122), up to two sensitivity analyses for HR-QOL (n = 133), cost (n = 99), and discount rate (n = 128) were examined. Article mentions of thresholds for acceptable cost-utility ratios were recorded (total 36). Cost-utility ratios were denominated in US dollars for the year reported in each of the original articles in order to determine whether a different conclusion would have been indicated at the time the article was published. Quality ratings from the original audit for articles where sensitivity analysis results crossed the cost-utility ratio threshold above the base-case result were compared with those that did not. The most frequently mentioned cost-utility thresholds were $US20,000/QALY, $US50,000/QALY, and $US100,000/QALY. The proportions of sensitivity analyses reporting quantitative results that crossed the threshold above the base-case results (or where the sensitivity analysis result was dominated) were 31% for HR-QOL sensitivity analyses, 20% for cost-sensitivity analyses, and 15% for discount-rate sensitivity analyses. Almost half of the discount-rate sensitivity analyses did not report quantitative results. Articles that reported sensitivity analyses where results crossed the cost
Hodicky, Kamil; Hansen, Sanne; Hulin, Thomas
and HPCSP’s geometrical parameters as well as on material cost function in the HPCSP design. Cost functions are presented for High Performance Concrete (HPC), insulation layer, reinforcement and include labour-related costs. The present study reports the economic data corresponding to specific manufacturing......The paper describes a procedure to find the structurally and thermally efficient design of load-carrying thin-walled precast High Performance Concrete Sandwich Panels (HPCSP) with an optimal economical solution. A systematic optimization approach is based on the selection of material’s performances....... The solution of the optimization problem is performed in the computer package software Matlab® with SQPlab package and integrates the processes of HPCSP design, quantity take-off and cost estimation. The proposed optimization process outcomes in complex HPCSP design proposals to achieve minimum cost of HPCSP....
Ong, Koh Jun; Soldan, Kate; Jit, Mark; Dunbar, J Kevin; Woodhall, Sarah C
Current evidence suggests that chlamydia screening programmes can be cost-effective, conditional on assumptions within mathematical models. We explored differences in cost estimates used in published economic evaluations of chlamydia screening from seven countries (four papers each from UK and the Netherlands, two each from Sweden and Australia, and one each from Ireland, Canada and Denmark). From these studies, we extracted management cost estimates for seven major chlamydia sequelae. In order to compare the influence of different sequelae considered in each paper and their corresponding management costs on the total cost per case of untreated chlamydia, we applied reported unit sequelae management costs considered in each paper to a set of untreated infection to sequela progression probabilities. All costs were adjusted to 2013/2014 Great British Pound (GBP) values. Sequelae management costs ranged from £171 to £3635 (pelvic inflammatory disease); £953 to £3615 (ectopic pregnancy); £546 to £6752 (tubal factor infertility); £159 to £3341 (chronic pelvic pain); £22 to £1008 (epididymitis); £11 to £1459 (neonatal conjunctivitis) and £433 to £3992 (neonatal pneumonia). Total cost of sequelae per case of untreated chlamydia ranged from £37 to £412. There was substantial variation in cost per case of chlamydia sequelae used in published chlamydia screening economic evaluations, which likely arose from different assumptions about disease management pathways and the country perspectives taken. In light of this, when interpreting these studies, the reader should be satisfied that the cost estimates used sufficiently reflect the perspective taken and current disease management for their respective context. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Luengo-Fernandez, Ramon; Leal, Jose; Gray, Alastair; Sullivan, Richard
In 2008, 2·45 million people were diagnosed with cancer and 1·23 million died because of cancer in the 27 countries of the European Union (EU). We aimed to estimate the economic burden of cancer in the EU. In a population-based cost analysis, we evaluated the cost of all cancers and also those associated with breast, colorectal, lung, and prostate cancers. We obtained country-specific aggregate data for morbidity, mortality, and health-care resource use from international and national sources. We estimated health-care costs from expenditure on care in the primary, outpatient, emergency, and inpatient settings, and also drugs. Additionally, we estimated the costs of unpaid care provided by relatives or friends of patients (ie, informal care), lost earnings after premature death, and costs associated with individuals who temporarily or permanently left employment because of illness. Cancer cost the EU €126 billion in 2009, with health care accounting for €51·0 billion (40%). Across the EU, the health-care costs of cancer were equivalent to €102 per citizen, but varied substantially from €16 per person in Bulgaria to €184 per person in Luxembourg. Productivity losses because of early death cost €42·6 billion and lost working days €9·43 billion. Informal care cost €23·2 billion. Lung cancer had the highest economic cost (€18·8 billion, 15% of overall cancer costs), followed by breast cancer (€15·0 billion, 12%), colorectal cancer (€13·1 billion, 10%), and prostate cancer (€8·43 billion, 7%). Our results show wide differences between countries, the reasons for which need further investigation. These data contribute to public health and policy intelligence, which is required to deliver affordable cancer care systems and inform effective public research funds allocation. Copyright © 2013 Elsevier Ltd. All rights reserved.
Stockdale, David; McFerran, Don; Brazier, Peter; Pritchard, Clive; Kay, Tony; Dowrick, Christopher; Hoare, Derek J
There is no standard treatment pathway for tinnitus patients in the UK. Possible therapies include education and reassurance, cognitive behavioural therapies, modified tinnitus retraining therapy (education and sound enrichment), or amplification of external sound using hearing aids. However, the effectiveness of most therapies is somewhat controversial. As health services come under economic pressure to deploy resources more effectively there is an increasing need to demonstrate the value of tinnitus therapies, and how value may be continuously enhanced. The objective of this project was to map out existing clinical practice, estimate the NHS costs associated with the management approaches used, and obtain initial indicative estimates of cost-effectiveness. Current treatment pathways, costs and health outcomes were determined from the tinnitus literature, national statistics, a patient survey, and expert opinion. These were used to create an Excel-based economic model of therapy options for tinnitus patients. The probabilities associated with the likelihood of an individual patient receiving a particular combination of therapies was used to calculate the average cost of treatment per patient, average health outcome per patient measured in QALYs gained, and cost-effectiveness, measured by the average cost per QALY gained. The average cost of tinnitus treatment per patient per year is GB£717, equating to an NHS healthcare bill of GB£750 million per year. Across all pathways, tinnitus therapy costs £10,600 per QALY gained. Results were relatively insensitive to restrictions on access to cognitive behaviour therapy, and a subsequent reliance on other therapies. NHS provisions for tinnitus are cost-effective against the National Institute for Health and Care Excellence cost-effective threshold. Most interventions help, but education alone offers very small QALY gains. The most cost-effective therapies in the model were delivered within audiology.
Berger, Ariel; Hartrick, Craig; Edelsberg, John; Sadosky, Alesia; Oster, Gerry
To estimate direct and indirect economic costs among private-sector employees with osteoarthritis (OA). Using a large US employer benefits database, we identified all employees with evidence of OA during calendar year 2007, and compared their costs of health care and work loss to age-and-sex-matched employees without evidence of OA in that year. Private-sector employees with OA (n = 2399) averaged 62.9 days of absenteeism versus 36.7 days among matched comparators (n = 2399) (P Private-sector employees with OA have higher direct and indirect costs than those without this condition.
Background Ionic liquid (IL) pretreatment could enable an economically viable route to produce biofuels by providing efficient means to extract sugars and lignin from lignocellulosic biomass. However, to realize this, novel IL-based processes need to be developed in order to minimize the overall production costs and accelerate commercial viability. In this study, two variants of IL-based processes are considered: one based on complete removal of the IL prior to hydrolysis using a water-wash (WW) step and the other based on a “one-pot” (OP) process that does not require IL removal prior to saccharification. Detailed techno-economic analysis (TEA) of these two routes was carried out to understand the cost drivers, economic potential (minimum ethanol selling price, MESP), and relative merits and challenges of each route. Results At high biomass loading (50%), both routes exhibited comparable economic performance with an MESP of $6.3/gal. With the possible advances identified (reduced water or acid/base consumption, improved conversion in pretreatment, and lignin valorization), the MESP could be reduced to around $3/gal ($3.2 in the WW route and $2.8 in the OP route). Conclusions It was found that, to be competitive at industrial scale, lowered cost of ILs used and higher biomass loadings (50%) are essential for both routes, and in particular for the OP route. Overall, while the economic potential of both routes appears to be comparable at higher biomass loadings, the OP route showed the benefit of lower water consumption at the plant level, an important cost and sustainability consideration for biorefineries. PMID:24932217
Delene, J.G.; Hermann, O.W.
1 - Description of program or function: REFCO83 utilizes a discounted cash flow (DCF) analysis procedure to calculate batch, cycle, and lifetime levelized average nuclear fuel cycle costs. The DCF analysis establishes an energy 'cost' associated with the fuel by requiring that the revenues from the sale of energy be adequate to pay the required return on outstanding capital, to pay all expenses including taxes, and to retire the outstanding investment to zero by the end of the economic life of the set of fuel investments. The program uses reactor mass flow information together with individual fuel cost parameters and utility capital structure and money costs to calculate levelized costs cumulatively through any batch or cycle. 2 - Method of solution: A fuel cycle cost component is considered to be any fuel material purchase, processing cost, or discharge material credit in the complete fuel cycle. The costs for each individual component, i.e. uranium, enrichment, etc., may either be expensed or capitalized for tax purposes or, in the case of waste disposal, the cost may also be made proportional to power production. To properly account for the effect of income taxes, all calculations in REFCO83 are done using 'then' current dollars, including price escalations caused by inflation. The database used for the default values for REFCO83 was taken from the Nuclear Energy Cost Data Base. 3 - Restrictions on the complexity of the problem: The maximum number of fuel batches is 120
Schakel, Wouter; van der Aa, Hilde P A; Bode, Christina; Hulshof, Carel T J; van Rens, Ger H M B; van Nispen, Ruth M A
To investigate the burden of visual impairment and comorbid fatigue in terms of impact on daily life, by estimating societal costs (direct medical costs and indirect non-health care costs) accrued by these conditions. This cost-of-illness study was performed from a societal perspective. Cross-sectional data of visually impaired adults and normally sighted adults were collected through structured telephone interviews and online surveys, respectively. Primary outcomes were fatigue severity (FAS), impact of fatigue on daily life (MFIS), and total societal costs. Cost differences between participants with and without vision loss, and between participants with and without fatigue, were examined by (adjusted) multivariate regression analyses, including bootstrapped confidence intervals. Severe fatigue (FAS ≥ 22) and high fatigue impact (MFIS ≥ 38) was present in 57% and 40% of participants with vision loss (n = 247), respectively, compared to 22% (adjusted odds ratio [OR] 4.6; 95% confidence interval [CI] [2.7, 7.6]) and 11% (adjusted OR 4.8; 95% CI [2.7, 8.7]) in those with normal sight (n = 233). A significant interaction was found between visual impairment and high fatigue impact for total societal costs (€449; 95% CI [33, 1017]). High fatigue impact was associated with significantly increased societal costs for participants with visual impairment (mean difference €461; 95% CI [126, 797]), but this effect was not observed for participants with normal sight (€12; 95% CI [-527, 550]). Visual impairment is associated with an increased prevalence of high fatigue impact that largely determines the economic burden of visual impairment. The substantial costs of visual impairment and comorbid fatigue emphasize the need for patient-centered interventions aimed at decreasing its impact.
Sutton, N J; Armsworth, P R
Facing tight resource constraints, conservation organizations must allocate funds available for habitat protection as effectively as possible. Often, they combine spatially referenced economic and biodiversity data to prioritize land for protection. We tested how sensitive these prioritizations could be to differences in the spatial grain of these data by demonstrating how the conclusion of a classic debate in conservation planning between cost and benefit targeting was altered based on the available information. As a case study, we determined parcel-level acquisition costs and biodiversity benefits of land transactions recently undertaken by a nonprofit conservation organization that seeks to protect forests in the eastern United States. Then, we used hypothetical conservation plans to simulate the types of ex ante priorities that an organization could use to prioritize areas for protection. We found the apparent effectiveness of cost and benefit targeting depended on the spatial grain of the data used when prioritizing parcels based on local species richness. However, when accounting for complementarity, benefit targeting consistently was more efficient than a cost targeting strategy regardless of the spatial grain of the data involved. More pertinently for other studies, we found that combining data collected over different spatial grains inflated the apparent effectiveness of a cost targeting strategy and led to overestimation of the efficiency gain offered by adopting a more integrative return-on-investment approach. © 2014 Society for Conservation Biology.
Stecher, Luiza C.; Sabundjian, Gaiane; Menzel, Francine
The availability of energy resources is a central point to economic development. The energy matrix of most countries is based on the consumption of fossil fuels, which adds annually over 5 billion tons of carbon into the atmosphere. The energy consumption in developing countries has quadrupled since the 60s further aggravating global environmental conditions. The need to implement alternative energy sources to the energy matrix was proved. In addition, Brazil has a large number of people without access to electricity, which affects the quality of life of these populations. In this context, it is necessary to think in economic development way, and then the sustainable and alternative sources appear as an option for its features and its availability in Brazil. The solar energy captured by photovoltaic cells can be highlighted in the Brazilian scenario because of its wide availability, especially in the Northeast. The aim of this paper is to estimate the economic feasibility of insertion of solar systems in small communities in the Brazilian Northeast, considering environmental costs involved in electricity generation. The methodology is based on economic concepts and economic valuation of environmental resources. The results shows that solar power is becoming increasingly competitive due to reduced costs of components and due to the environmental costs reduced when compared with fossil fuels. (author)
Stecher, Luiza C.; Sabundjian, Gaianes; Menzel, Francine, E-mail: firstname.lastname@example.org [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)
The availability of energy resources is a central point to economic development. The energy matrix of most countries is based on the consumption of fossil fuels, which adds annually over 5 billion tons of carbon into the atmosphere. The energy consumption in developing countries has quadrupled since the 60s further aggravating global environmental conditions. The need to implement alternative energy sources to the energy matrix was proved. In addition, Brazil has a large number of people without access to electricity, which affects the quality of life of these populations. In this context, it is necessary to think in economic development way, and then the sustainable and alternative sources appear as an option for its features and its availability in Brazil. The solar energy captured by photovoltaic cells can be highlighted in the Brazilian scenario because of its wide availability, especially in the Northeast. The aim of this paper is to estimate the economic feasibility of insertion of solar systems in small communities in the Brazilian Northeast, considering environmental costs involved in electricity generation. The methodology is based on economic concepts and economic valuation of environmental resources. The results shows that solar power is becoming increasingly competitive due to reduced costs of components and due to the environmental costs reduced when compared with fossil fuels. (author)
Newell, C; Carey, L B
Health care reform is also occurring in Australia and effects hospital chaplaincy programs. "Economic rationalism" is the philosophic foundation of this effort and its contrast with the values inherit in hospital chaplaincy are highlighted. Selected research results from the Australian system are described and the authors offer a perspective on the cost efficiency of hospital chaplaincy.
Connolly, Mark P.; Hoorens, Stijn; Chambers, Georgina M.
Despite the growing use of assisted reproductive technologies (ART) worldwide, there is only a limited understanding of the economics of ART to inform policy about effective, safe and equitable financing of ART treatment. A review was undertaken of key studies regarding the costs and consequences of
Blom-Hansen, Jens; Houlberg, Kurt; Serritzlew, Søren
, are amalgamated to harvest scale effects. The purpose of this article is to evaluate the argument on economies of scale in the economic costs of running political systems. Our testing ground is a recent Danish reform. It allows us to avoid endogeneity problems often facing researchers of size reforms. The reform...
Sun, Xin; Qin, Wen-Xia; Li, You-Ping; Jiang, Xu-Hua
Economic efficiency of the alternative antiviral therapies for chronic hepatitis B has not been systematically investigated and their quality remains unknown. The aim of the present study was to systematically overview economic evidence of antiviral therapies for chronic hepatitis B. We searched six databases and eight major journals supplemented with screening references of eligible studies. Full economic evaluations comparing alternative antiviral therapies in patients with chronic hepatitis B virus infection were included. Two investigators assessed the study quality and transferability, independently. Data were analyzed qualitatively with adjustment when appropriate. Fourteen studies (six modeling vs eight trials and database analyses) were included. Quality was high in five studies, moderate in one US and five Chinese studies, and low in three Chinese studies. The major problems of quality are costing methods and analysis and the presentation of results. In Australia and Poland, lamivudine-preferred strategies dominated interferon (IFN)-alpha and its related strategy from the health-care sector perspective. In the US, adefovir salvage produced US$8446 per additional quality-adjusted life years (QALY) compared with IFN-alpha. In Spain, the cost of adefovir was US$34,840 for additional virological response. In Taiwan, the use of pegylated IFN-alpha (pegIFN-alpha) produced US$11,711.4 per additional QALY, compared with lamivudine. In China, the incremental cost-effectiveness ratios of combination therapy lamivudine ranged from US$2860 to US$22,160 per additional loss of hepatitis B e antigen (HBeAg), and IFN-alpha versus lamivudine ranged from US$2490 to US$8890 per additional loss of HBeAg. The cost-effectiveness frontiers of treatment alternatives vary and are influenced by the comparators and socioeconomic conditions of countries. Lamivudine-containing therapy is cost-effective when newer antiviral agents (e.g. adefovir/pegIFN-alpha) were not available
Heimann, S M; Cruz Aguilar, M R; Mellinghof, S; Vehreschild, M J G T
Clostridium difficile infection (CDI) is the most important cause of healthcare-associated infectious diarrhea in industrialized countries. We performed a literature review of the overall economic burden of initial and recurrent CDI as well as of the cost-effectiveness of the various treatment strategies applied in these settings. Even though analysis of health economic data is complicated by the limited comparability of results, our review identified several internationally consistent results. Authors from different countries have shown that recurrent CDI disproportionally contributes to the overall economic burden of CDI and therefore offers considerable saving potential. Subsequent cost-effectiveness analyses almost exclusively identified fidaxomicin as the preferred treatment option for initial CDI and fecal microbiota transplant (FMT) for recurrent CDI. Among the various FMT protocols, optimum results were obtained using early colonoscopy-based FMT. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
Slabinskiy, V T
Mining enrichment enterprises of the ferrous and nonferrous metallurgy, coal and chemical industry have much in common in the area of technology of production, technical base, organization of labor and production. This in turn presupposes the possible development of a common procedure of accounting of expenditures for production, calculation of net cost of output and analysis of production-economic activity of enterprises. Based on scientific research and generalization of advanced experience of practical workers, means of improvement of economic operation in mining enrichment enterprises are outlined according to increasing demands of production control. An outline of analytic accounting of expenditures which provides for multitarget use of information has been developed: for organization of operational control of the formulation of net cost of output, determination of the results of self support activities of structural subdivisions of an enterprise, computation of the efficiency of scientific and technical progress. Experience of use of economic and mathematical methods in computers for this purpose is discussed.
Narrod, Clare; Zinsstag, Jakob; Tiongco, Marites
This article presents an integrated epidemiological and economic framework for assessing zoonoses using a "one health" concept. The framework allows for an understanding of the cross-sector economic impact of zoonoses using modified risk analysis and detailing a range of analytical tools. The goal of the framework is to link the analysis outputs of animal and human disease transmission models, economic impact models and evaluation of risk management options to gain improved understanding of factors affecting the adoption of risk management strategies so that investment planning includes the most promising interventions (or sets of interventions) in an integrated fashion. A more complete understanding of the costs of the disease and the costs and benefits of control measures would promote broader implementation of the most efficient and effective control measures, contributing to improved animal and human health, better livelihood outcomes for the poor and macroeconomic growth.
Jacobs, P; Baladi, J F
This paper addresses the issue of biases in cost measures which used in economic evaluation studies. The basic measure of hospital costs which is used by most investigators is unit cost. Focusing on this measure, a set of criteria which the basic measures must fulfil in order to approximate the marginal cost (MC) of a service for the relevant product, in the representative site, was identified. Then four distinct biases--a scale bias, a case mix bias, a methods bias and a site selection bias--each of which reflects the divergence of the unit cost measure from the desired MC measure, were identified. Measures are proposed for several of these biases and it is suggested how they can be corrected.
Knealing, Todd W.; Roebuck, M. Christopher; Wong, Conrad J.; Silverman, Kenneth
The therapeutic workplace is a novel intervention that uses access to paid training and employment to reinforce drug abstinence within the context of standard methadone maintenance. We used the Drug Abuse Treatment Cost Analysis Program as a standard method of estimating the economic costs of this intervention. Over a one-year period, the therapeutic workplace served 122 methadone maintenance clients who had a median length of stay of 22 weeks. The workplace maintained a mean daily census of 48 clients. The combined cost of methadone maintenance and the therapeutic workplace was estimated at $362 per week. This cost is less than other treatments that might be used to promote abstinence in individuals who continue to use drugs during methadone treatment. Given prior evidence of effectiveness, these cost data may be useful to policymakers, social service agencies, and researchers interested in using or further developing the therapeutic workplace intervention. PMID:17614239
Lo, Yuan-Ting; Chang, Yu-Hung; Lee, Meei-Shyuan; Wahlqvist, Mark L
The WHO asserts that the global food price crisis threatens public health and jeopardizes the health of the most disadvantaged groups such as women, children, the elderly and low-income families. Economic factors play a crucial role and could affect personal nutrition status and health. Economic decision factors such as food price and income do influence people's food choices. Moreover, food costs are a barrier for low income-families to healthier food choices. Several studies indicate that diet costs are associated with dietary quality and also food safety. Food prices have surged over the past couple of years (2007-9) and raised serious concerns about food security around the world. Rising food prices are having severe impacts on population health and nutritional status. Therefore, people who change their diet pattern for economic reasons may develop a range of nutritionally-related disorders and diseases, from so-called over-nutrition to or with under-nutrition even within the one household. This is likely to increase with growing food insecurity. Presently, economics is not integrated with mainstream nutrition science or practice, other than in "home economics", but it can enable greater understanding of how socioeconomic status may interplay with human nutritional status and health and how these situations might be resolved. Collaborative, cross-disciplinary nutritional economics research should play a greater role in the prevention and management of food crises.
Prajati, Gita; Padmi, Tri; Benno Rahardyan, dan
Nowadays, solid waste management continues to be a major challenge in urban areas, especially in developing country. It is triggered by population growth, economic growth, industrialization and urbanization. Indonesia itselfs categorized into developing country. Indonesia's government has many program in order to increase the economic growth. One of them is MP3EI (Masterplan Percepatan dan Perluasan Pembangunan Ekonomi Indonesia. This program should be suppported by right waste management system. If Indonesia's waste management system can't afford the economic growth, it will trigger health and environmental problems. This study's purpose is to develop the socio-economic-environment model that can be used as a basis planning for the facility and cost of waste management systems. In this paper we used the development of Khajuria model test method. This method used six variables, which are GDP, population, population density, illiteracy, school's period and economic growth. The result showed that development of Khajuria test could explained the influence of economic and demographic factors to waste generation, 65.6%. The projection of waste generation shows that Pangkalpinang, Pekanbaru and Serang are the cities with the highest waste generation for the next five years. The number of dump truck and TPS in DKI Jakarata is the highest within another city, which is 39.37%. For the next five years, the waste management system in our study areas cost maximum 0.8% from GDP (Gross Domestic Products).
Wera, Ewaldus; Velthuis, Annet G. J.; Geong, Maria; Hogeveen, Henk
Background Rabies is a zoonotic disease that, in most human cases, is fatal once clinical signs appear. The disease transmits to humans through an animal bite. Dogs are the main vector of rabies in humans on Flores Island, Indonesia, resulting in about 19 human deaths each year. Currently, rabies control measures on Flores Island include mass vaccination and culling of dogs, laboratory diagnostics of suspected rabid dogs, putting imported dogs in quarantine, and pre- and post-exposure treatment (PET) of humans. The objective of this study was to estimate the costs of the applied rabies control measures on Flores Island. Methodology/principal findings A deterministic economic model was developed to calculate the costs of the rabies control measures and their individual cost components from 2000 to 2011. The inputs for the economic model were obtained from (i) relevant literature, (ii) available data on Flores Island, and (iii) experts such as responsible policy makers and veterinarians involved in rabies control measures in the past. As a result, the total costs of rabies control measures were estimated to be US$1.12 million (range: US$0.60–1.47 million) per year. The costs of culling roaming dogs were the highest portion, about 39 percent of the total costs, followed by PET (35 percent), mass vaccination (24 percent), pre-exposure treatment (1.4 percent), and others (1.3 percent) (dog-bite investigation, diagnostic of suspected rabid dogs, trace-back investigation of human contact with rabid dogs, and quarantine of imported dogs). Conclusions/significance This study demonstrates that rabies has a large economic impact on the government and dog owners. Control of rabies by culling dogs is relatively costly for the dog owners in comparison with other measures. Providing PET for humans is an effective way to prevent rabies, but is costly for government and does not provide a permanent solution to rabies in the future. PMID:24386244
Iyengar, Swathi; Tay-Teo, Kiu; Vogler, Sabine; Beyer, Peter; Wiktor, Stefan; de Joncheere, Kees; Hill, Suzanne
New hepatitis C virus (HCV) medicines have markedly improved treatment efficacy and regimen tolerability. However, their high prices have limited access, prompting wide debate about fair and affordable prices. This study systematically compared the price and affordability of sofosbuvir and ledipasvir/sofosbuvir across 30 countries to assess affordability to health systems and patients. Published 2015 ex-factory prices for a 12-wk course of treatment were provided by the Pharma Price Information (PPI) service of the Austrian public health institute Gesundheit Österreich GmbH or were obtained from national government or drug reimbursement authorities and recent press releases, where necessary. Prices in Organisation for Economic Co-operation and Development (OECD) member countries and select low- and middle-income countries were converted to US dollars using period average exchange rates and were adjusted for purchasing power parity (PPP). We analysed prices compared to national economic performance and estimated market size and the cost of these drugs in terms of countries' annual total pharmaceutical expenditure (TPE) and in terms of the duration of time an individual would need to work to pay for treatment out of pocket. Patient affordability was calculated using 2014 OECD average annual wages, supplemented with International Labour Organization median wage data where necessary. All data were compiled between 17 July 2015 and 25 January 2016. For the base case analysis, we assumed a 23% rebate/discount on the published price in all countries, except for countries with special pricing arrangements or generic licensing agreements. The median nominal ex-factory price of a 12-wk course of sofosbuvir across 26 OECD countries was US$42,017, ranging from US$37,729 in Japan to US$64,680 in the US. Central and Eastern European countries had higher PPP-adjusted prices than other countries: prices of sofosbuvir in Poland and Turkey (PPP$101,063 and PPP$70,331) and of
Full Text Available New hepatitis C virus (HCV medicines have markedly improved treatment efficacy and regimen tolerability. However, their high prices have limited access, prompting wide debate about fair and affordable prices. This study systematically compared the price and affordability of sofosbuvir and ledipasvir/sofosbuvir across 30 countries to assess affordability to health systems and patients.Published 2015 ex-factory prices for a 12-wk course of treatment were provided by the Pharma Price Information (PPI service of the Austrian public health institute Gesundheit Österreich GmbH or were obtained from national government or drug reimbursement authorities and recent press releases, where necessary. Prices in Organisation for Economic Co-operation and Development (OECD member countries and select low- and middle-income countries were converted to US dollars using period average exchange rates and were adjusted for purchasing power parity (PPP. We analysed prices compared to national economic performance and estimated market size and the cost of these drugs in terms of countries' annual total pharmaceutical expenditure (TPE and in terms of the duration of time an individual would need to work to pay for treatment out of pocket. Patient affordability was calculated using 2014 OECD average annual wages, supplemented with International Labour Organization median wage data where necessary. All data were compiled between 17 July 2015 and 25 January 2016. For the base case analysis, we assumed a 23% rebate/discount on the published price in all countries, except for countries with special pricing arrangements or generic licensing agreements. The median nominal ex-factory price of a 12-wk course of sofosbuvir across 26 OECD countries was US$42,017, ranging from US$37,729 in Japan to US$64,680 in the US. Central and Eastern European countries had higher PPP-adjusted prices than other countries: prices of sofosbuvir in Poland and Turkey (PPP$101,063 and PPP$70
Tay-Teo, Kiu; Vogler, Sabine; Beyer, Peter; Wiktor, Stefan; de Joncheere, Kees; Hill, Suzanne
Introduction New hepatitis C virus (HCV) medicines have markedly improved treatment efficacy and regimen tolerability. However, their high prices have limited access, prompting wide debate about fair and affordable prices. This study systematically compared the price and affordability of sofosbuvir and ledipasvir/sofosbuvir across 30 countries to assess affordability to health systems and patients. Methods and Findings Published 2015 ex-factory prices for a 12-wk course of treatment were provided by the Pharma Price Information (PPI) service of the Austrian public health institute Gesundheit Österreich GmbH or were obtained from national government or drug reimbursement authorities and recent press releases, where necessary. Prices in Organisation for Economic Co-operation and Development (OECD) member countries and select low- and middle-income countries were converted to US dollars using period average exchange rates and were adjusted for purchasing power parity (PPP). We analysed prices compared to national economic performance and estimated market size and the cost of these drugs in terms of countries’ annual total pharmaceutical expenditure (TPE) and in terms of the duration of time an individual would need to work to pay for treatment out of pocket. Patient affordability was calculated using 2014 OECD average annual wages, supplemented with International Labour Organization median wage data where necessary. All data were compiled between 17 July 2015 and 25 January 2016. For the base case analysis, we assumed a 23% rebate/discount on the published price in all countries, except for countries with special pricing arrangements or generic licensing agreements. The median nominal ex-factory price of a 12-wk course of sofosbuvir across 26 OECD countries was US$42,017, ranging from US$37,729 in Japan to US$64,680 in the US. Central and Eastern European countries had higher PPP-adjusted prices than other countries: prices of sofosbuvir in Poland and Turkey (PPP
Luengo-Fernandez, Ramon; Burns, Richeal; Leal, Jose
Blood disorders comprise a wide range of diseases including anaemia, malignant blood disorders, and haemorrhagic disorders. Although they are a common cause of disease, no systematic cost-of-illness studies have been done to assess the economic effect of non-malignant blood disorders in Europe. We aimed to assess the economic burden of non-malignant blood disorders across the 28 countries of the European Union (EU), Iceland, Norway, and Switzerland. Non-malignant blood disorder-related costs (WHO International Classification of Diseases, 10th revision [ICD] D50-89) were estimated for 28 EU countries, Iceland, Norway, and Switzerland for 2012. Country-specific costs were estimated with aggregate data on morbidity, mortality, and health-care resource use obtained from international and national sources. Health-care costs were estimated from expenditure on primary care, outpatient care, emergency care, hospital inpatient care, and drugs. Costs of informal care and productivity losses due to morbidity and early death were also included. To these costs we added those due to malignant blood disorders (ICD-10 C81-96 and D47) as estimated in a Burns and colleagues' companion Article to obtain the total costs of blood disorders. Non-malignant disorders of the blood cost the 31 European countries €11 billion in 2012. Health-care costs accounted for €8 billion (75% of total costs), productivity losses for €2 billion (19%), and informal care for less than €1 billion (6%). Averaged across the European population studied, non-malignant disorders of the blood represented an annual health-care cost of €159 per ten citizens. Combining malignant and non-malignant blood disorders, the total cost of blood disorders was €23 billion in 2012. Our study highlights the economic burden that non-malignant blood disorders place on European health-care systems and societies. Our study also shows that blood disorder costs were evenly distributed between malignant and non
Sanchez Martinez, Gerardo; Spadaro, Joseph V.; Chapizanis, Dimitris
the burden of disease attributable to PM and calculated the societal cost due to attributable mortality. In 2012, long-term exposure to PM2.5 (49.2 μg/m³) caused an estimated 1199 premature deaths (CI95% 821-1519). The social cost of the predicted premature mortality in 2012 due to air pollution...... was estimated at between 570 and 1470 million euros. Moreover, PM2.5 was also estimated to be responsible for 547 hospital admissions (CI95% 104-977) from cardiovascular diseases, and 937 admissions (CI95% 937-1869) for respiratory disease that year. Reducing PM2.5 levels to the EU limit (25 μg/m³) could have....... Besides its health impacts in terms of increased premature mortality and hospitalizations, air pollution entails significant economic costs to the population of Skopje. Reductions in PM2.5 concentrations could provide substantial health and economic gains to the city....
Full Text Available One aim of higher education is to develop professional identities in students to equip them for future working life. Health professional students will work under financial pressures in a market-based environment, which can lead to conflicts with professional ethical values. This study explores how Swedish dental students perceive economic aspects of dentistry. The article is based on a study of undergraduate research projects. In the analysis of the projects, two themes were identified: (1 cost-effective organizing of dentistry and (2 costs and benefits of interventions. The students displayed socially responsible values by emphasizing the need for dentists to utilize resources effectively, which implies that professional education can support the development of the perception that economic values can be compatible with professional ethical values.Keywords: cost-effectiveness, ethics, healthcare, higher education, social responsibility
Achana, F A; Fleming, K M; Tata, L J; Sultan, A A; Petrou, S
To estimate resource use and costs associated with peripartum hysterectomy for the English National Health Service. Analysis of linked Clinical Practice Research Datalink and Hospital Episodes Statistics (CPRD-HES) data. Women undergoing peripartum hysterectomy between 1997 and 2013 and matched controls. Inverse probability weighted generalised estimating equations were used to model the non-linear trend in healthcare service use and costs over time, accounting for missing data, adjusting for maternal age, body mass index, delivery year, smoking and socio-economic indicators. Primary care, hospital outpatient and inpatient attendances and costs (UK 2015 prices). The study sample included 1362 women (192 cases and 1170 controls) who gave birth between 1997 and 2013; 1088 (153 cases and 935 controls) of these were deliveries between 2003 and 2013 when all categories of hospital resource use were available. Based on the 2003-2013 delivery cohort, peripartum hysterectomy was associated with a mean adjusted additional total cost of £5380 (95% CI £4436-6687) and a cost ratio of 1.76 (95% CI 1.61-1.98) over 5 years of follow up compared with controls. Inpatient costs, mostly incurred during the first year following surgery, accounted for 78% excluding or 92% including delivery-related costs. Peripartum hysterectomy is associated with increased healthcare costs driven largely by increased post-surgery hospitalisation rates. To reduce healthcare costs and improve outcomes for women who undergo hysterectomy, interventions that reduce avoidable repeat hospitalisations following surgery such as providing active follow up, treatment and support in the community should be considered. A large amount of NHS data on peripartum hysterectomy suggests active community follow up could reduce costs, #HealthEconomics. © 2017 Royal College of Obstetricians and Gynaecologists.
Full Text Available United European Gastroenterology provide wide studies and researches on the economic impact of the digestive diseases across the countries that are members of the European Union, very useful in planning health services, in making the case for investment in research where there are clear gaps in knowledge, and in reflecting the economic differences across the EU member states in the funding available to support health services. These studies reflect that there are important disparities in the accessibility to high-quality healthcare even among the industrialized countries. Out of all the digestive diseases, the gallstone disease is one of the most common and expensive of the health problems, in industrialized countries, like those of the European Union are. In general, symptomatic or complicated gallstone disease is treated by cholecystectomy, with surgical removal of the gallbladder. The advent of laparoscopic cholecystectomy has revolutionized the management of the gallstone disease, causing an increase in the rate of cholecystectomies. This study represents an analysis of the hospitalization costs involved by two surgical treatment options: laparoscopic cholecystectomy and open cholecystectomy. The investigation of the costs was done according to the type of intervention chosen and comprised the direct costs of hospitalization, including diagnostic tests and general expenses of medical assistance, pharmaceutical and medical supplies. The results are based on the analysis of the costs of cholecystectomies in the surgical department of the Emergency County Hospital Oradea for the year 2014 (781 cases. The average cost per hospitalized patient was 1.970 RON, lower in patients with laparoscopic cholecystectomy (1.579 RON. The average cost per patient with open cholecystectomy was 55% higher than for laparoscopic surgery (2.442 RON. Even if the laparoscopic operation cost is higher because of the equipment it uses, the reduction of the number of
Kagedan, Daniel J; Devitt, Katharine S; Tremblay St-Germain, Amélie; Ramjaun, Aliya; Cleary, Sean P; Wei, Alice C
Clinical pathways (CPW) are considered safe and effective at decreasing postoperative length of stay (LoS), but the effect on economic costs is uncertain. This study sought to elucidate the effect of a CPW on direct hospitalization costs for patients undergoing pancreaticoduodenectomy (PD). A CPW for PD patients at a single Canadian institution was implemented. Outcomes included LoS, 30-day readmissions, and direct costs of hospital care. A retrospective cost minimization analysis compared patients undergoing PD prior to and following CPW implementation, using a bootstrapped t test and deviation-based cost modeling. 121 patients undergoing PD after CPW implementation were compared to 74 controls. Index LoS was decreased following CPW implementation (9 vs. 11 days, p = 0.005), as was total LoS (10 vs. 11 days, p = 0.003). The mean total cost of postoperative hospitalization per patient decreased in the CPW group ($15,678.45 CAD vs. $25,732.85 CAD, p = 0.024), as was the mean 30-day cost including readmissions ($16,627.15 CAD vs. $29,872.72 CAD, p = 0.016). Areas of significant cost savings included laboratory tests and imaging investigations. CPWs may generate cost savings by reducing unnecessary investigations, and improve quality of care through process standardization and decreasing practice variation. Copyright © 2017 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.
A technical and design evaluation was carried out to meet DOE hydrogen fuel targets for 2010. These targets consisted of a system gravimetric capacity of 2.0 kWh/kg, a system volumetric capacity of 1.5 kWh/L and a system cost of $4/kWh. In compressed hydrogen storage systems, the vast majority of the weight and volume is associated with the hydrogen storage tank. In order to meet gravimetric targets for compressed hydrogen tanks, 10,000 psi carbon resin composites were used to provide the high strength required as well as low weight. For the 10,000 psi tanks, carbon fiber is the largest portion of their cost. Quantum Technologies is a tier one hydrogen system supplier for automotive companies around the world. Over the course of the program Quantum focused on development of technology to allow the compressed hydrogen storage tank to meet DOE goals. At the start of the program in 2004 Quantum was supplying systems with a specific energy of 1.1-1.6 kWh/kg, a volumetric capacity of 1.3 kWh/L and a cost of $73/kWh. Based on the inequities between DOE targets and Quantum’s then current capabilities, focus was placed first on cost reduction and second on weight reduction. Both of these were to be accomplished without reduction of the fuel system’s performance or reliability. Three distinct areas were investigated; optimization of composite structures, development of “smart tanks” that could monitor health of tank thus allowing for lower design safety factor, and the development of “Cool Fuel” technology to allow higher density gas to be stored, thus allowing smaller/lower pressure tanks that would hold the required fuel supply. The second phase of the project deals with three additional distinct tasks focusing on composite structure optimization, liner optimization, and metal.
Windfarm developers often have good reason to question the costs they are quoted by their local distribution company for connection to the system, and these costs can now be challenged under the 'Competition in Connection' initiative. Econnect Ltd specialise in electrical connections for renewable generation throughout the UK and Europe, and have worked on many projects where alternative connections have been designed at more competitive prices. This paper provides some examples which illustrate the importance of acquiring a thorough understanding of all power system issues and PES concerns if the most cost-effective connection is to be realised. (Author)
Kareksela, Santtu; Moilanen, Atte; Ristaniemi, Olli; Välivaara, Reima; Kotiaho, Janne S
The frequently discussed gap between conservation science and practice is manifest in the gap between spatial conservation prioritization plans and their implementation. We analyzed the research-implementation gap of one zoning case by comparing results of a spatial prioritization analysis aimed at avoiding ecological impact of peat mining in a regional zoning process with the final zoning plan. We examined the relatively complex planning process to determine the gaps among research, zoning, and decision making. We quantified the ecological costs of the differing trade-offs between ecological and socioeconomic factors included in the different zoning suggestions by comparing the landscape-level loss of ecological features (species occurrences, habitat area, etc.) between the different solutions for spatial allocation of peat mining. We also discussed with the scientists and planners the reasons for differing zoning suggestions. The implemented plan differed from the scientists suggestion in that its focus was individual ecological features rather than all the ecological features for which there were data; planners and decision makers considered effects of peat mining on areas not included in the prioritization analysis; zoning was not truly seen as a resource-allocation process and not emphasized in general minimizing ecological losses while satisfying economic needs (peat-mining potential); and decision makers based their prioritization of sites on site-level information showing high ecological value and on single legislative factors instead of finding a cost-effective landscape-level solution. We believe that if the zoning and decision-making processes are very complex, then the usefulness of science-based prioritization tools is likely to be reduced. Nevertheless, we found that high-end tools were useful in clearly exposing trade-offs between conservation and resource utilization. © 2017 Society for Conservation Biology.
Jędrkiewicz, Renata; Orłowski, Aleksander; Namieśnik, Jacek; Tobiszewski, Marek
In this study we perform ranking of analytical procedures for 3-monochloropropane-1,2-diol determination in soy sauces by PROMETHEE method. Multicriteria decision analysis was performed for three different scenarios - metrological, economic and environmental, by application of different weights to decision making criteria. All three scenarios indicate capillary electrophoresis-based procedure as the most preferable. Apart from that the details of ranking results differ for these three scenarios. The second run of rankings was done for scenarios that include metrological, economic and environmental criteria only, neglecting others. These results show that green analytical chemistry-based selection correlates with economic, while there is no correlation with metrological ones. This is an implication that green analytical chemistry can be brought into laboratories without analytical performance costs and it is even supported by economic reasons. Copyright © 2015 Elsevier B.V. All rights reserved.
Bekas, C.; Curioni, A.; Fedulova, I.
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
Hjuler Jensen, P.; Morthorst, P.E.; Skriver, S.; Rasmussen, M.; Larsen, H.; Hansen, L.H.; Nielsen, P.; Lemming, J.
During the last two decades of operational experience with wind turbines in Denmark, a number of investigations on wind energy economics have been carried out on behalf of the Danish Energy Agency. The aim of this study has been to analyse the development of investments cost, O and M-cost, insurance costs etc. including the economic and technical lifetime of wind turbines. Based on a questionnaire and an existing database, time series for O and M-cost components are established going back to the early 80's. These time series are used to analyse the development of O and M-costs during the lifetime of different turbine sizes and vintages. A major issue of the project is to use the results achieved for older turbines (55kW to 150 kW) to establish an expected development of O and M-costs for newer larger turbines, typically of the 500kW to 750kW sizes. (au)
Retroactive safety standards were found to account for over half the costs of a nuclear power plant and point up the need for an effective cost-benefit analysis of changes made by the Nuclear Regulatory Commission after construction has started. The author compared the Davis-Besse Unit No. 1 construction-cost estimates with the final-cost increases during a rate-case investigation in Ohio. He presents data furnished for ten of the largest construction contracts to illustrate the cost increases involving fixed hardware and intensive labor. The situation was found to repeat with other utilities across the country even though safeguards against irresponsible low bidding were introduced. Low bidding was found to continue, encouraged by the need for retrofitting to meet regulation changes. The average cost per kilowatt of major light-water reactors is shown to have increased from $171 in 1970 to $555 in 1977, while construction duration increased from 43.4 to 95.6 months during the same period
Liu, Zhicen; Koerwer, Joel; Nemoto, Jiro; Imura, Hidefumi
Energy supply is mandatory for the production of economic value. Nevertheless, tradition dictates that an enigmatic 'invisible hand' governs economic valuation. Physical scientists have long proposed alternative but testable energy cost theories of economic valuation, and have shown the gross correlation between energy consumption and economic output at the national level through input-output energy analysis. However, due to the difficulty of precise energy analysis and highly complicated real markets, no decisive evidence directly linking energy costs to the selling prices of individual commodities has yet been found. Over the past century, the US metal market has accumulated a huge body of price data, which for the first time ever provides us the opportunity to quantitatively examine the direct energy-value correlation. Here, by analyzing the market price data of 65 purified chemical elements (mainly metals) relative to the total energy consumption for refining them from naturally occurring geochemical conditions, we found a clear correlation between the energy cost and their market prices. The underlying physics we proposed has compatibility with conventional economic concepts such as the ratio between supply and demand or scarcity's role in economic valuation. It demonstrates how energy cost serves as the 'invisible hand' governing economic valuation. Thorough understanding of this energy connection between the human economic and the Earth's biogeochemical metabolism is essential for improving the overall energy efficiency and furthermore the sustainability of the human society. (author)
A widely held view is that good schools are essential to a nation's international economic success and that high test scores on international tests of academic skills and knowledge indicate how good a nation's schools are. The widespread belief that good schools are an important contributor to a nation's economic success in the world is supported…
Biofuels such as ethanol from sugar cane remain an important element to help mitigate the impacts of fossil fuels on the atmosphere. However, meeting fuel demands with biofuels requires technological advancement for water productivity and scale of production. This may translate into increased water demands for biofuel crops and potential for conflicts with incumbent crops and other water uses including domestic, hydropower generation and environmental. It is therefore important to evaluate the effects of increased biofuel production on the verge of water scarcity costs and hydropower production. The present research applies a hydro-economic optimization model to compare different scenarios of irrigated biofuel and hydropower production, and estimates the potential tradeoffs. A case study from the Araguari watershed in Brazil is provided. These results should be useful to (i) identify improved water allocation among competing economic demands, (ii) support water management and operations decisions in watersheds where biofuels are expected to increase, and (iii) identify the impact of bio fuel production in the water availability and economic value. Under optimized conditions, adoption of sugar cane for biofuel production heavily relies on the opportunity costs of other crops and hydropower generation. Areas with a lower value crop groups seem more suitable to adopt sugar cane for biofuel when the price of ethanol is sufficiently high and the opportunity costs of hydropower productions are not conflicting. The approach also highlights the potential for insights in water management from studying regional versus larger scales bundled systems involving water use, food production and power generation.
Full Text Available The wine sector is going through a significant evolution dealing with the challenges of competition issues in international markets and with necessary commitments to sustainability improvement. In the wine supply chain, the agricultural phase represents a potential source of pollution and costs. From the farmers’ point of view, these contexts require them to be more attentive and find a compromise among environmental benefits, economic benefits, and costs linked to farming practices. This paper aims to make a sustainability assessment of different wine-growing scenarios located in Calabria (Southern Italy that combines conflicting insights, i.e., environmental and economic ones, by applying Life Cycle Assessment (LCA and Life Cycle Costing (LCC to identify the main hotspots and select the alternative scenarios closest to the ideal solution through the VIKOR multicriteria method. In particular, the latter allowed us to obtain synthetic indices for a two-dimensional sustainability assessment. Conventional practices associated to the espalier training system represent the best compromise from both environmental and economic points of view, due to the higher yield per hectare. The choices regarding Functional Unit (FU and indicators were shown to have a high influence on results.
Ganda, F.; Kim, T.K.; Taiwo, T.A.; Wigeland, R.
In this paper we present work aimed at enhancing the capability to perform nuclear fuel cycle cost estimates and evaluation of financial risk. Reactor capital costs are of particular relevance, since they typically comprise about 60% to 70% of the calculated Levelized Cost of Electricity at Equilibrium (LCAE). The work starts with the collection of historical construction cost and construction duration of nuclear plants in the U.S. and France, as well as forecasted costs of nuclear plants currently under construction in the U.S. This data has the primary goal of supporting the introduction of an appropriate framework, supported in this paper by two case studies with historical data, which allows the development of solid and defensible assumptions on nuclear reactor capital costs. Work is also presented on the enhancement of the capability to model interdependence of cost estimates between facilities and uncertainties. The correlated sampling capabilities in the nuclear economic code NECOST have been expanded to include partial correlations between input variables, according to a given correlation matrix. Accounting for partial correlations correctly allows a narrowing, where appropriate, of the probability density function of the difference in the LCAE between alternative, but correlated, fuel cycles. It also allows the correct calculation of the standard deviation of the LCAE of multistage systems, which appears smaller than the correct value if correlated input costs are treated as uncorrelated. (authors)
Wen, Zongguo; Chen, Jining
Currently, traditional development issues such as income inequality, depletion of natural resources, environmental pollution as well as retardation of infrastructure have occurred in China. In the future, more pressures would be imposed on China by the continuous fast development of industrialization, and with transfer of the world manufacture center to China. Sustainable development, including its economic, environmental and social elements, is a key goal of decision-makers. This paper develops a methodology on cost benefit analysis of economic growth at macroscopic level to identify issues of China's sustainability. In order to address some important issues on how to make policies to improve the quality of economic growth, the CBA framework developed in this study analyses economic-ecological-social interaction, building three accounts that reflect three dimensions of sustainable development that includes 26 sub-models in all, and finally is integrated into an index as Net Progress Proceeds (NPP). The estimation methods of these submodels, such as cost of environmental pollution, depletion of natural resources and defensive expenditures are described in detail. Based on the framework and methods, this paper examines the costs and benefits of economic growth in three aspects of economy, ecology and society. The results illustrate that NPR of China's economic growth had been negative for a long time and has just became positive since year 2000 but was quite low. Even the best was only 1.6% in 2002 (the worst was - 24.2% in 1982). Based on the comparison between three accounts, we can draw a conclusion that ecological cost is the dominant factor that affects China's NPR. The empirical results show that if no other innovative measures or policies are taken in the future the costs of growth would outweigh its benefits, resulting in un-sustainability. Basically, the long-term economic growth would be unsustainable due to increasing environmental damage and depletion of
Wen, Zongguo; Chen, Jining [Department of Environmental Science and Engineering, Tsinghua University, Beijing 100084 (China)
Currently, traditional development issues such as income inequality, depletion of natural resources, environmental pollution as well as retardation of infrastructure have occurred in China. In the future, more pressures would be imposed on China by the continuous fast development of industrialization, and with transfer of the world manufacture center to China. Sustainable development, including its economic, environmental and social elements, is a key goal of decision-makers. This paper develops a methodology on cost benefit analysis of economic growth at macroscopic level to identify issues of China's sustainability. In order to address some important issues on how to make policies to improve the quality of economic growth, the CBA framework developed in this study analyses economic-ecological-social interaction, building three accounts that reflect three dimensions of sustainable development that includes 26 sub-models in all, and finally is integrated into an index as Net Progress Proceeds (NPP). The estimation methods of these submodels, such as cost of environmental pollution, depletion of natural resources and defensive expenditures are described in detail. Based on the framework and methods, this paper examines the costs and benefits of economic growth in three aspects of economy, ecology and society. The results illustrate that NPR of China's economic growth had been negative for a long time and has just became positive since year 2000 but was quite low. Even the best was only 1.6% in 2002 (the worst was - 24.2% in 1982). Based on the comparison between three accounts, we can draw a conclusion that ecological cost is the dominant factor that affects China's NPR. The empirical results show that if no other innovative measures or policies are taken in the future the costs of growth would outweigh its benefits, resulting in un-sustainability. Basically, the long-term economic growth would be unsustainable due to increasing environmental damage
Sinicrope, Brent J; Roberts, Craig S; Sussman, Lyle
Health care is a business. Health care providers must become familiar with terms such as opportunity costs, the potential loss or gain when one choice is made in lieu of another. The purpose of this study was to calculate the opportunity cost of two orthopaedic surgery society board meetings and discuss these in the context of behavioral economics and regret. A literature search was conducted to determine an orthopaedic surgeon's average yearly salary, hours worked per week, and weeks worked per year. The details of two orthopaedic surgery professional society meetings that one senior author (CSR) attended were used to calculate opportunity cost. Although the true benefits are multifactorial and difficult to objectively quantify, awareness of the cost-benefit ratio can help guide time and resource management to maximize the return on investment while minimizing buyer's remorse and perhaps influence the media by which medical meetings are held in the future. (Journal of Surgical Orthopaedic Advances 27(1):10-13, 2018).
Golov, Roman; Dikareva, Varvara; Gorshkov, Roman; Agarkov, Anatoly
The article is devoted to the analysis of technical and economic efficiency of application of tube confined concrete structures in high-rise construction. The study of comparative costs of materials with the use of different supporting columns was carried out. The main design, operational, technological and economic advantages of the tube confined concrete technology were evaluated, conclusions were drawn about the high strength and deformation properties of axial compression of steel tubes filled with high-strength concrete. The efficiency of the tube confined concrete use is substantiated, which depends mainly on the scale factor and percentage of reinforcement affecting its load-bearing capacity.
Ginsburg, Paul B
The U.S. is spending a growing share of the GDP on health care, outpacing other industrialized countries. This synthesis examines why costs are higher in the U.S. and what is driving their growth. Key findings include: health care inefficiency, medical technology and health status (particularly obesity) are the primary drivers of rising U.S. health care costs. Health payer systems that reward inefficiencies and preempt competition have impeded productivity gains in the health care sector. The best evidence indicates medical technology accounts for one-half to two-thirds of spending growth. While medical malpractice insurance and defensive medicine contribute to health costs, they are not large enough factors to significantly contribute to a rise in spending. Research is consistent that demographics will not be a significant factor in driving spending despite the aging baby boomers.
Sarker, Abdur Razzaque; Sultana, Marufa; Mahumud, Rashidul Alam; Ali, Nausad; Huda, Tanvir M; Salim Uzzaman, M; Haider, Sabbir; Rahman, Hafizur; Islam, Ziaul; Khan, Jahangir A M; Van Der Meer, Robert; Morton, Alec
Diarrheal diseases are a major threat to human health and still represent a leading cause of morbidity and mortality worldwide. Although the burden of the diarrheal diseases is much lower in developed countries, it is a significant public health problem in low and middle-income countries like Bangladesh. Though diarrhea is preventable and managed with low-cost interventions, it is still the leading cause of morbidity according to the patient who sought care from public hospitals in Bangladesh indicating that significant resources are consumed in treating those patients. The aim of the study is to capture the inpatients and outpatient treatment cost of diarrheal disease and to measure the cost burden and coping mechanisms associated with diarrheal illness. This study was conducted in six randomly selected district hospitals from six divisions (larger administrative units) in Bangladesh. The study was performed from the societal perspective which means all types of costs were identified, measured and valued no matter who incurred them. Cost analysis was estimated using the guideline proposed by the World Health Organization for estimating the economic burden of diarrheal diseases. The study adopted quantitative techniques to collect the household and hospital level data including structured and semi-structured questionnaires, observation checklists, analysis of hospital database, telephone interviews and compilation of service statistics. The average total societal cost of illness per episode was BDT 5274.02 (US $ 67.18) whereas the average inpatient and outpatient costs were BDT 8675.09 (US $ 110.51) and BDT 1853.96 (US $ 23.62) respectively. The cost burden was significantly highest for poorest households, 21.45% of household income, compared to 4.21% of the richest quintile. Diarrheal diseases continue to be an overwhelming problem in Bangladesh. The economic impact of any public health interventions (either preventive or promotive) that can reduce the prevalence
Musial, Walter D. [National Renewable Energy Lab. (NREL), Golden, CO (United States)
This report provides information for decision-makers about floating offshore wind technologies in the state of Maine. It summarizes research efforts performed at the National Renewable Energy Laboratory between 2015 and 2017 to analyze the resource potential, cost of offshore wind, and economic potential of offshore wind from four primary reports: Musial et al. (2016); Beiter et al. (2016, 2017); and Mone et al. (unpublished). From Musial et al. (2016), Maine's technical offshore wind resource potential ranked seventh in the nation overall with more than 411 terawatt-hours/year of offshore resource generating potential. Although 90% of this wind resource is greater than 9.0-meters-per-second average velocity, most of the resource is over deep water, where floating wind technology is needed. Levelized cost of energy and levelized avoided cost of energy were computed to estimate the unsubsidized 'economic potential' for Maine in the year 2027 (Beiter et al. 2016, 2017). The studies found that Maine may have 65 gigawatts of economic potential by 2027, the highest of any U.S. state. Bottom-line costs for the Aqua Ventus project, which is part of the U.S. Department of Energy's Advanced Technology Demonstration project, were released from a proprietary report written by NREL in 2016 for the University of Maine (Mone et al. unpublished). The report findings were that economies of scale and new technology advancements lowered the cost from $300/megawatt-hour (MWh) for the two-turbine 12-megawatt (MW) Aqua Ventus 1 project, to $126/MWh for the commercial-scale, 498-MW Aqua Ventus-2 project. Further cost reductions to $77/MWh were found when new technology advancements were applied for the 1,000-MW Aqua Ventus-3 project in 2030. No new analysis was conducted for this report.
Beauchemin, C; Letarte, N; Mathurin, K; Yelle, L; Lachaine, J
Objective Considering the increasing number of treatment options for metastatic breast cancer (MBC), it is important to develop high-quality methods to assess the cost-effectiveness of new anti-cancer drugs. This study aims to develop a global economic model that could be used as a benchmark for the economic evaluation of new therapies for MBC. Methods The Global Pharmacoeconomics of Metastatic Breast Cancer (GPMBC) model is a Markov model that was constructed to estimate the incremental cost per quality-adjusted life years (QALY) of new treatments for MBC from a Canadian healthcare system perspective over a lifetime horizon. Specific parameters included in the model are cost of drug treatment, survival outcomes, and incidence of treatment-related adverse events (AEs). Global parameters are patient characteristics, health states utilities, disutilities, and costs associated with treatment-related AEs, as well as costs associated with drug administration, medical follow-up, and end-of-life care. The GPMBC model was tested and validated in a specific context, by assessing the cost-effectiveness of lapatinib plus letrozole compared with other widely used first-line therapies for post-menopausal women with hormone receptor-positive (HR+) and epidermal growth factor receptor 2-positive (HER2+) MBC. Results When tested, the GPMBC model led to incremental cost-utility ratios of CA$131 811 per QALY, CA$56 211 per QALY, and CA$102 477 per QALY for the comparison of lapatinib plus letrozole vs letrozole alone, trastuzumab plus anastrozole, and anastrozole alone, respectively. Results of the model testing were quite similar to those obtained by Delea et al., who also assessed the cost-effectiveness of lapatinib in combination with letrozole in HR+/HER2 + MBC in Canada, thus suggesting that the GPMBC model can replicate results of well-conducted economic evaluations. Conclusions The GPMBC model can be very valuable as it allows a quick and valid assessment of the cost
Hayman, D T S; Marshall, J C; French, N P; Carpenter, T E; Roberts, M G; Kiedrzynski, T
As endemic measles is eliminated from countries through increased immunisation, the economic benefits of enhanced immunisation programs may come into question. New Zealand has suffered from outbreaks after measles introductions from abroad and we use it as a model system to understand the benefits of catch up immunisation in highly immunised populations. We provide cost-benefit analyses for measles supplementary immunisation in New Zealand. We model outbreaks based on estimates of the basic reproduction number in the vaccinated population (R v , the number of secondary infections in a partially immunised population), based on the number of immunologically-naïve people at district and national levels, considering both pre- and post-catch up vaccination scenarios. Our analyses suggest that measles R v often includes or exceeds one (0.18-3.92) despite high levels of population immunity. We calculate the cost of the first 187 confirmed and probable measles cases in 2014 to be over NZ$1 million (∼US$864,200) due to earnings lost, case management and hospitalization costs. The benefit-cost ratio analyses suggest additional vaccination beyond routine childhood immunisation is economically efficient. Supplemental vaccination-related costs are required to exceed approximately US$66 to US$1877 per person, depending on different scenarios, before supplemental vaccination is economically inefficient. Thus, our analysis suggests additional immunisation beyond childhood programs to target naïve individuals is economically beneficial even when childhood immunisation rates are high. Copyright © 2017 Elsevier Ltd. All rights reserved.
Full Text Available The paper presents an economic cost evaluation on the feasibility of offshore wind turbine (OWT farms development in Nigeria, using a 500 MW OWT farm as an incident study. A developed model was used to evaluate the economic cost of the OWTs at different phases of the project. Additionally, the effect of the cost drivers at the changed phases of the OWTs was studied correspondingly. Results obtained showed that over 50% of the OWT project cost emanated from CAPEX while a value less than 50% came from OPEX. However, further analysis indicates at maximum power of 4 MW a 4.95% diminution in LCOE. For comparable power rating (PR between 5⩽PR⩽6MW, a 2.7% reduction in LCOE exists. Cost stability was apparent at a growth of WTs between 300⩽WT⩽500 MW. The study also observed a decrease in LCOE for all development stages of the OWT while a decrease in the CMS detectability was considered marginal. Subsequently, it can be inferred that Nigeria has the potential for OWT farm expansion. However, the demonstrated model was appropriate for handling preliminary variations in OWT studies.
Paileeklee, Suchada; Kanato, Manop; Kaenmanee, Sumeth; McGhee, Sarah M
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.
Full Text Available In this study, a techno–economic model was used to calculate the costs of CO2 transport and specify the major equipment required for transport in order to demonstrate and implement CO2 sequestration in the offshore sediments of South Korea. First, three different carbon capture and storage demonstration scenarios were set up involving the use of three CO2 capture plants and one offshore storage site. Each transport scenario considered both the pipeline transport and ship transport options. The temperature and pressure conditions of CO2 in each transport stage were determined from engineering and economic viewpoints, and the corresponding specifications and equipment costs were calculated. The transport costs for a 1 MtCO2/year transport rate were estimated to be US$33/tCO2 and US$28/tCO2 for a pipeline transport of ~530 km and ship transport of ~724 km, respectively. Through the economies of scale effect, the pipeline and ship transport costs for a transport rate of 3 MtCO2/year were reduced to approximately US$21/tCO2 and US$23/tCO2, respectively. A CO2 hub terminal did not significantly reduce the cost because of the short distance from the hub to the storage site and the small number of captured sources.
This report aims at analysing, from a methodological point of view, the main problems associated with the integration of socio-economical dimensions in the cost-benefit model recommended by the ICRP in its publication no. 26. After recalling the basic principles of cost-benefit analysis, the elements to be retained in the objective function characterizing the analysis, and the question of the social benefit definitions are discussed. The theory of social surplus with an illustration taken from the radiological protection field is presented [fr
Brem, Harold; Maggi, Jason; Nierman, David; Rolnitzky, Linda; Bell, David; Rennert, Robert; Golinko, Michael; Yan, Alan; Lyder, Courtney; Vladeck, Bruce
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.
In alternative financing a private company provides the capital and expertise for improving school energy efficiency. Savings are split between the school system and the company. Options for municipal leasing, cost sharing, and shared savings are explained along with financial, procedural, and legal considerations. (MLF)
McColl, D.; Masri, M.
This article provided a synopsis of oil sands research recently conducted at the Canadian Energy Research Institute (CERI). The production profiles and capital expenditures that CERI has projected for oil sands projects were explored along with the macroeconomic benefits associated with oil sands development. In addition to rising capital and operating costs, bitumen producers are challenged by labour shortages and environmental concerns. However, CERI warrants continued growth in production from the oil sands industry, given the current high price state of the global oil market and security of supply concerns from oil importing countries. This article also provided background information and analysis to assess the implications of future development. The projected growth in the oil sands industry creates demands for infrastructure, housing, health care, education, and business services. The economic impacts were measured at the local, provincial, national and global levels in terms of changes in gross domestic product; changes in employment; and, changes in government revenues. It was concluded that with continued investment and development, Alberta's oil sands resource is expected to continue to produce oil for decades, and would eventually achieve 6 MMbpd production. 8 refs., 3 tabs., 10 figs
Neubauer, A S; Reznicek, L; Minartz, C; Ziemssen, F
Stereotactic radiation therapy (Oraya, OT) is available as a second line therapy for patients who, despite intensive anti-VEGF therapy for neovascular AMD, do not show an improvement in CNV. As OT is expensive (5,308 €), the short term economics for starting this therapy were investigated. A short-term cost model was set up in MS Excel with a two year time horizon. On the basis of the data of the randomised, controlled INTREPID pivotal trial and current treatment practice in Germany, the costs were compared of conventional anti-VEGF therapy, with or without a single OT treatment. Patients with an active lesion after initial anti-VEGF therapy and a maximum lesion diameter ≤ 4 mm were included. Modeled cost components/aspects were direct savings from injection number, control follow-up examinations and aids, as well as anti-VEGF switches. Costs for Germany were employed and a univariate sensitivity analysis was performed to address the existing uncertainty. For the patients with a maximum AMD lesion diameter ≤ 4 mm and a macula volume > 7.4 mm(3), the INTREPID trial showed a mean reduction of 3.68 intravitreal injections for 16 Gy radiation versus sham over a time period of 2 years. These 3.68 IVM result in ~ 4,500 € direct cost savings. Moreover, due to the higher response rate with 16 Gy radiation, the number of follow-up visits and aids can be reduced, which results in savings between 207 € and 1,224 € over 2 years. After radiation, fewer anti-VEGF switches for low or non-responders are expected, which is modeled to result in ~ 1.7 fewer injections over 2 years. Due to overall fewer injections, fewer endophthalmitis cases would be expected. However, endophthalmitis and microvascular abnormalities, which can be observed in a few cases, are associated with low or non-quantifiable costs in this cost-cost comparison model. In summary, cost reductions of between 6,400 and 8,500 € are predicted in the model over two years
Gee Kee, E; Stockton, K; Kimble, R M; Cuttle, L; McPhail, S M
Partial thickness burns of up to 10% total body surface area (TBSA) in children are common injuries primarily treated in the outpatient setting using expensive silver-containing dressings. However, economic evaluations in the paediatric burns population are lacking to assist healthcare providers when choosing which dressing to use. The aim of this study was to conduct a cost-effectiveness analysis of three silver dressings for partial thickness burns ≤10% TBSA in children aged 0-15 years using days to full wound re-epithelialization as the health outcome. This study was a trial based economic evaluation (incremental cost effectiveness) conducted from a healthcare provider perspective. Ninety-six children participated in the trial investigating Acticoat™, Acticoat™ with Mepitel™ or Mepilex Ag™. Costs directly related to the management of partial thickness burns ≤10% TBSA were collected during the trial from March 2013 to July 2014 and for a one year after re-epithelialization time horizon. Incremental cost effectiveness ratios were estimated and dominance probabilities calculated from bootstrap resampling trial data. Sensitivity analyses were conducted to examine the potential effect of accounting for infrequent, but high cost, skin grafting surgical procedures. Costs (dressing, labour, analgesics, scar management) were considerably lower in the Mepilex Ag™ group (median AUD$94.45) compared to the Acticoat™ (median $244.90) and Acticoat™ with Mepitel™ (median $196.66) interventions. There was a 99% and 97% probability that Mepilex Ag™ dominated (cheaper and more effective than) Acticoat™ and Acticoat™ with Mepitel™, respectively. This pattern of dominance was consistent across raw cost and effects, after a priori adjustments, and sensitivity analyses. There was an 82% probability that Acticoat™ with Mepitel dominated Acticoat™ in the primary analysis, although this probability was sensitive to the effect of skin graft procedures. This
Stephan, G.; Van Nieuwkoop, R.; Wiedmer, T. (Institute for Applied Microeconomics, Univ. of Bern (Switzerland))
Both distributional and allocational effects of limiting carbon dioxide emissions in a small and open economy are discussed. It starts from the assumption that Switzerland attempts to stabilize its greenhouse gas emissions over the next 25 years, and evaluates costs and benefits of the respective reduction programme. From a methodological viewpoint, it is illustrated how a computable general equilibrium approach can be adopted for identifying economic effects of cutting greenhouse gas emissions on the national level. From a political economy point of view it considers the social incidence of a greenhouse policy. It shows in particular that public acceptance can be increased and economic costs of greenhouse policies can be reduced, if carbon taxes are accompanied by revenue redistribution. 8 tabs., 1 app., 17 refs.
Kiryanov Igor, V.
Full Text Available The present paper contains a study of the phenomenon of company’s specific internal divisions called “trading house”. The analysis of different approaches (based on results obtained by R. Coase and O. Williamson towards the problem of impact of transaction cost on company size leads to the following conclusion: the company size mostly depends on its institutional architecture which includes specific divisions that ensure outsourcing of intergroup transaction cost. I propose to call these divisions centers of transaction cost. I suppose that the wide popularity of trading houses among companies belonging to different branches can be explained by the fact that a trading house is mostly used not as selling and purchasing division, but as a center of transaction cost that concentrates the biggest transaction cost (by its share within company’s general expenses. This reasoning leads to possibility of existence of a set of methodological principles that allow to build up an a priori model of expanding company. The process of expansion represents a series of inclusion of centers of transactions cost by the company after institutional advantages of an earlier institutional architecture disappear. This methodology allows to set up a classification between a classical company as a structure with low level of integration and frozen institutional architecture and an economic organization that represents an explicitly constructed composition including centers of transaction cost that help to extend the transformational space of an expanding company.
Salti, Nisreen; Chaaban, Jad; Naamani, Nadia
Assess the socioeconomic costs of smoking in Lebanon and understand the tobacco market and identify the winners and losers from the Lebanese tobacco trade. We take a close look at the market for tobacco and related markets to identify the main stakeholders and estimate the direct costs and benefits of tobacco. We also estimate lower bounds for the costs of tobacco, in terms of lost productivity, the cost of medical treatment, lost production due to premature death, and environmental damage. The paucity of data means our cost estimates are conservative lower bounds and we explicitly list the effects that we are unable to include. We identify the main actors in the tobacco trade: the Régie (the state-owned monopoly which regulates the tobacco trade), tobacco farmers, international tobacco companies, local distributors, retailers, consumers, and advertising firms. We identify as proximate actors the Ministries of Finance and Health, employers, and patients of smoking-related illnesses. In 2008, tobacco trade in Lebanon led to a total social cost of $326.7 million (1.1% of GDP). Low price tags on imported cigarettes not only increase smoking prevalence, but they also result in a net economic loss. Lebanese policymakers should consider the overall deficit from tobacco trade and implement the guidelines presented in the Framework Convention on Tobacco Control to at once increase government revenue and reduce government outlays, and save the labor market and the environment substantial costs.
Full Text Available Smoking is a health problem, the costs of which include sickness, pain, grief and misery. But tobacco use also imposes a significant economic burden on society. One efficient way to assess the adverse health effects of smoking on a society is to translate smoking-caused illnesses, premature mortality, and productivity losses into economic terms, a universal marker for measuring the adverse effects of smoking. Due to the high proportion of smokers, Latvia faces high male mortality from smoking-related diseases; life expectancy for men in the age group 35–64 years is 2.44 years less than for non-smokers in the same age group, losing 37% of total lost years of life and therefore the government loses approximately 45 88346 Euro per year from YPLL from smoking related diseases.
Treacy, Daniel; Howard, Kirsten; Hayes, Alison; Hassett, Leanne; Schurr, Karl; Sherrington, Catherine
Among people admitted for inpatient rehabilitation, is usual care plus standing balance circuit classes more cost-effective than usual care alone? Cost-effectiveness study embedded within a randomised controlled trial with concealed allocation, assessor blinding and intention-to-treat analysis. 162 rehabilitation inpatients from a metropolitan hospital in Sydney, Australia. The experimental group received a 1-hour standing balance circuit class, delivered three times a week for 2 weeks, in addition to usual therapy. The circuit classes were supervised by one physiotherapist and one physiotherapy assistant for up to eight patients. The control group received usual therapy alone. Costs were estimated from routinely collected hospital use data in the 3 months after randomisation. The functional outcome measure was mobility measured at 3 months using the Short Physical Performance Battery administered by a blinded assessor. An incremental analysis was conducted and the joint probability distribution of costs and outcomes was examined using bootstrapping. The median cost savings for the intervention group was AUD4,741 (95% CI 137 to 9,372) per participant; 94% of bootstraps showed that the intervention was both effective and cost saving. Two weeks of additional standing balance circuit classes delivered in addition to usual therapy resulted in decreased healthcare costs at 3 months in hospital inpatients admitted for rehabilitation. There is a high probability that this intervention is both cost saving and effective. ACTRN12611000412932. [Treacy D, Howard K, Hayes A, Hassett L, Schurr K, Sherrington C (2018) Two weeks of additional standing balance circuit classes during inpatient rehabilitation are cost saving and effective: an economic evaluation. Journal of Physiotherapy 64: 41-47]. Copyright © 2017 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.
Soilly, A L; Lejeune, C; Quantin, C; Bejean, S; Gouyon, J B
To analyse published cost-of-illness studies that had assessed the cost of prematurity according to gestational age at birth. A review of the literature was carried out in March 2011 using the following databases: Medline, ScienceDirect, The Cochrane Library, Econlit and Business Source Premier, and a French Public-Health database. Key-word sequences related to 'prematurity' and 'costs' were considered. Studies that assessed costs according to the gestational age (GA) at the premature birth (prematurity (extreme, early, moderate and late). Results showed that whatever the follow-up period, costs correlated inversely with GA. They also showed considerable variability in costs within the same GA group. Differences between studies could be explained by the choices made, concerning i/the study populations, ii/contextual information, iii/and various economic criteria. Despite these variations, a global trend of costs was estimated in the short-term period using mean costs from four American studies that presented similar methodologies. Costs stand at over US$ 100,000 for extreme prematurity, between US$ 40,000 and US$ 100,000 for early prematurity, between US$ 10,000 and US$ 30,000 for moderate prematurity and below US$ 4500 for late prematurity. This review underlined not only the clear inverse relationship between costs and GA at birth, but also the difficulty to transfer the results to the French context. It suggests that studies specific to the French health system need to be carried out. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
Sinha, Anushua; Levine, Orin; Knoll, Maria D; Muhib, Farzana; Lieu, Tracy A
Routine vaccination of infants against Streptococcus pneumoniae (pneumococcus) needs substantial investment by governments and charitable organisations. Policymakers need information about the projected health benefits, costs, and cost-effectiveness of vaccination when considering these investments. Our aim was to incorporate these data into an economic analysis of pneumococcal vaccination of infants in countries eligible for financial support from the Global Alliance for Vaccines & Immunization (GAVI). We constructed a decision analysis model to compare pneumococcal vaccination of infants aged 6, 10, and 14 weeks with no vaccination in the 72 countries that were eligible as of 2005. We used published and unpublished data to estimate child mortality, effectiveness of pneumococcal conjugate vaccine, and immunisation rates. Pneumococcal vaccination at the rate of diptheria-tetanus-pertussis vaccine coverage was projected to prevent 262,000 deaths per year (7%) in children aged 3-29 months in the 72 developing countries studied, thus averting 8.34 million disability-adjusted life years (DALYs) yearly. If every child could be reached, up to 407,000 deaths per year would be prevented. At a vaccine cost of International 5 dollars per dose, vaccination would have a net cost of 838 million dollars, a cost of 100 dollars per DALY averted. Vaccination at this price was projected to be highly cost-effective in 68 of 72 countries when each country's per head gross domestic product per DALY averted was used as a benchmark. At a vaccine cost of between 1 dollar and 5 dollars per dose, purchase and accelerated uptake of pneumococcal vaccine in the world's poorest countries is projected to substantially reduce childhood mortality and to be highly cost-effective.
Jardine, L.J.; Carlton, R.E.; Steindler, M.J.
A comparative economic analysis was made of four solidification processes for liquid high-level radioactive waste. Two processes produced borosilicate glass monoliths and two others produced metal matrix composites of lead and borosilicate glass beads and lead and supercalcine pellets. Within the uncertainties of the cost (1979 dollars) estimates, the cost of the four processes was about the same, with the major cost component being the cost of the primary building structure. Equipment costs and operating and maintenance costs formed only a small portion of the building structure costs for all processes
This thesis was submitted for the degree of Doctor of Business Administration and awarded by Brunel University on behalf of Henley Management College This thesis tests Oliver Williamson’s proposition that transaction cost economics can explain the limits of firm size. Williamson suggests that diseconomies of scale are manifested through four interrelated factors: atmospheric consequences due to specialisation, bureaucratic insularity, incentive limits of the employment relation and communi...
Tong, Tammy Y.N.; Imamura, Fumiaki; Monsivais, Pablo; Brage, Søren; Griffin, Simon J.; Wareham, Nicholas J.; Forouhi, Nita G.
High cost of healthy foods could be a barrier to healthy eating. We aimed to examine the association between dietary cost and adherence to the Mediterranean diet in a non-Mediterranean country. We evaluated cross-sectional data from 12,417 adults in the UK Fenland Study. Responses to 130-item food frequency questionnaires were used to calculate a Mediterranean diet score (MDS). Dietary cost was estimated by matching food consumption data with retail prices of five major supermarkets. Using multivariable-adjusted linear regression, we examined the association of MDS and individual foods with dietary cost in absolute and relative scales. Subsequently, we assessed how much the association was explained by education, income, marital status, and occupation, by conducting mediation analysis and testing interaction by these variables. High compared to low MDS (top to bottom third) was associated with marginally higher cost by 5.4% (95% CI 4.4. 6.4%) or £0.20/day (£0.16, 0.25). Participants with high adherence had higher cost associated with the healthier components (e.g. vegetables, fruits, and fish), and lower cost associated with the unhealthy components (e.g. red meat, processed meat and sweets) (pMediterranean diet was associated with marginally higher dietary cost, partly modified and explained by socio-economic status, but the potential economic barriers of high adherence might be offset by cost saving from reducing unhealthy food consumption. PMID:29553031
Ibrahim, Ashraf S; Edwards, John E; Bryant, Richard; Spellberg, Brad
Mucormycosis is a life-threatening infection which causes unacceptably high morbidity and mortality despite treatment. Therefore, a vaccine to prevent mucormycosis is desirable. A major barrier to developing an anti-mucormycosis vaccine is the perception that such a vaccine would not be cost-effective to deploy because the disease is rare. We used data from a recent retrospective study to calculate the annual cost to the US healthcare system caused by mucormycosis infections. We created a model to estimate the cost-efficacy of a niche, anti-mucormycosis vaccine deployed in a targeted manner to high-risk patients. We found that each case of mucormycosis results in an average direct cost to the US healthcare system of $97,743, for an overall cost of mucormycosis of $50 million per year. In the base case scenario, targeted deployment of an anti-mucormycosis vaccine would result in a net cost per quality adjusted life year saved (QUALY) of $17,249. Variations in the price of the vaccine, its market penetration, or the cost of infection could dramatically decrease the net cost, and could even result in net savings per QUALY. In conclusion, mucormycosis causes considerable cost to the US health care system. Targeted deployment of a niche vaccine could decrease infection rates and mortality from mucormycosis in a cost-effective manner.
Hjelmgren, Jonas; Bruce Wirta, Sara; Huetson, Pernilla; Myrén, Karl-Johan; Göthberg, Sylvia
Asynchrony between patient and ventilator breaths is associated with increased duration of mechanical ventilation (MV). Neurally Adjusted Ventilatory Assist (NAVA) controls MV through an esophageal reading of diaphragm electrical activity via a nasogastric tube mounted with electrode rings. NAVA has been shown to decrease asynchrony in comparison to pressure support ventilation (PSV). The objective of this study was to conduct a health economic evaluation of NAVA compared with PSV. We developed a model based on an indirect link between improved synchrony with NAVA versus PSV and fewer days spent on MV in synchronous patients. Unit costs for MV were obtained from the Swedish intensive care unit register, and used in the model along with NAVA-specific costs. The importance of each parameter (proportion of asynchronous patients, costs, and average MV duration) for the overall results was evaluated through sensitivity analyses. Base case results showed that 21% of patients ventilated with NAVA were asynchronous versus 52% of patients receiving PSV. This equals an absolute difference of 31% and an average of 1.7 days less on MV and a total cost saving of US$7886 (including NAVA catheter costs). A breakeven analysis suggested that NAVA was cost effective compared with PSV given an absolute difference in the proportion of asynchronous patients greater than 2.5% (49.5% versus 52% asynchronous patients with NAVA and PSV, respectively). The base case results were stable to changes in parameters, such as difference in asynchrony, duration of ventilation and daily intensive care unit costs. This study showed economically favorable results for NAVA versus PSV. Our results show that only a minor decrease in the proportion of asynchronous patients with NAVA is needed for investments to pay off and generate savings. Future studies need to confirm this result by directly relating improved synchrony to the number of days on MV. © The Author(s), 2015.
Choi, Y. S.; Choi, K. S.; Choi, K. W.; Song, I. J.; Park, D. K.
For the optimization of nuclear safety regulation, understanding of economic aspects of it becomes increasingly important together with the technical approach used so far to secure nuclear safety. Relevant economic theories on private and public goods were reviewed to re-illuminate nuclear safety from the economic perspective. The characteristics of nuclear safety as a public good was reviewed and discussed in comparison with the car safety as a private safety good. It was shown that the change of social welfare resulted from the policy change induced can be calculated by the summation of compensating variation(CV) of individuals. It was shown that the value of nuclear safety could be determined in monetary term by this approach. The theoretical background and history of cost benefit analysis of nuclear safety regulation were presented and topics for future study were suggested
Seawater desalination is now widely accepted as an attractive alternative source of freshwater for domestic and industrial uses. Despite the considerable progress made in the relevant technologies desalination, however, remains an energy intensive process in which the energy cost is the paramount factor. Many papers have already been published on desalination economics but a comprehensive study, based on the exhaustive analysis of a combination of energy sources and desalination processes, using state of the art economic models and realistic assumptions, is still quite rare. The aim of this paper is to fulfil this gap with a view to provide clear choices of techno-economic options to decision makers in a wide range of countries be they from the developed regions or emerging countries
Blondin, Stacy A; Cash, Sean B; Goldberg, Jeanne P; Griffin, Timothy S; Economos, Christina D
To measure fluid milk waste in a US School Breakfast in the Classroom Program and estimate its nutritional, economic, and environmental effects. Fluid milk waste was directly measured on 60 elementary school classroom days in a medium-sized, urban district. The US Department of Agriculture nutrition database, district cost data, and carbon dioxide equivalent (CO 2 e) emissions and water footprint estimates for fluid milk were used to calculate the associated nutritional, economic, and environmental costs. Of the total milk offered to School Breakfast Program participants, 45% was wasted. A considerably smaller portion of served milk was wasted (26%). The amount of milk wasted translated into 27% of vitamin D and 41% of calcium required of School Breakfast Program meals. The economic and environmental costs amounted to an estimated $274 782 (16% of the district's total annual School Breakfast Program food expenditures), 644 893 kilograms of CO 2 e, and 192 260 155 liters of water over the school year in the district. These substantial effects of milk waste undermine the School Breakfast Program's capacity to ensure short- and long-term food security and federal food waste reduction targets. Interventions that reduce waste are urgently needed.
de Rus, Ginés
The allocation of traffic between different transport modes follows transport user decisions which depend on the generalized cost of travel in the available alternatives. High Speed Rail (HSR) investment is a government decision with significant effects on the generalized cost of rail transport; and therefore on the modal split in corridors where private operators compete for traffic and charge prices close to total producer costs (infrastructure included). The rationale for HSR investment is...
Ali, B M; de Mey, Y; Bastiaansen, J W M; Oude Lansink, A G J M
Economic values (EVs) of traits, accounting for environmental impacts and risk preferences of farmers, are required to design breeding goals that contribute to both economic and environmental sustainability. The objective of this study was to assess the effects of incorporating environmental costs and the risk preferences of farmers on the EVs of pig breeding goal traits. A breeding goal consisting of both sow efficiency and production traits was defined for a typical Brazilian farrow-to-finish pig farm with 1,500 productive sows. A mean-variance utility function was employed for deriving the EVs at finishing pig level assuming fixed slaughter weight. The inclusion of risk and risk aversion reduces the economic weights of sow efficiency traits (17%) while increasing the importance of production traits (7%). For a risk-neutral producer, inclusion of environmental cost reduces the economic importance of sow efficiency traits (3%) while increasing the importance of production traits (1%). Genetic changes of breeding goal traits by their genetic standard deviations reduce emissions of greenhouse gases, and excretions of nitrogen and phosphorus per finished pig by up to 6% while increasing farm profit. The estimated EVs could be used to improve selection criteria and thereby contribute to the sustainability of pig production systems. © 2018 The Authors. Journal of Animal Breeding and Genetics published by Blackwell Verlag GmbH.
Manuel Alejandro Cardenete
Full Text Available El objetivo de este artículo es analizar la evolución de la competitividad externa de la economía andaluza. Para ello se toman dos dimensiones principales de análisis: En primer lugar, se analiza la evolución de los costes laborales unitarios y su relación con el desempeño exportador andaluz a nivel agregado. En segundo lugar, se analizarán una serie de indicadores de la actuación tanto empresarial, como del sector público, en los ámbitos determinantes de la posición competitiva regional a nivel microeconómico. El análisis de la evolución seguida por las variables en nuestra economía se hará en comparación con diversas economías y regiones del entorno. Los resultados obtenidos apuntan a que a pesar de que los costes laborales han seguido una marcada tendencia a la baja, hasta el momento, la crisis no se ha convertido en una oportunidad para mejorar de manera sustancial el posicionamiento de la economía andaluza.
Full Text Available Laboratory testing as a part of laboratory in vitro diagnostic (IVD has become required tool in clinical practice for diagnosing, monitoring and prognosis of diseases, as well as for prediction of treatment response. The number of IVD tests available in laboratory practice has increased over the past decades and is likely to further increase in the future. Consequently, there is growing concern about the overutilization of laboratory tests and rising costs for laboratory testing. It is estimated that IVD accounts for between 1.4 and 2.3% of total healthcare expenditure and less than 5% of total hospital cost (Lewin Group report. These costs are rather low when compared to pharmaceuticals and medical aids which account for 15 and 5%, respectively. On the other hand, IVD tests play an important role in clinical practice, as they influence from 60% to 70% of clinical decision-making. Unfortunately, constant increases in healthcare spending are not directly related to healthcare benefit. Since healthcare resources are limited, health payers are interested whether the benefits of IVD tests are actually worth their cost. Many articles have introduced frameworks to assess the economic value of IVD tests. The most appropriate tool for quantitative assessment of their economic value is cost-effectiveness (CEA and cost-utility (CUA analysis. The both analysis determine cost in terms of effectiveness or utilities (combine quantity and quality of life of new laboratory test against its alternative. On the other hand, some investigators recommended calculation of laboratory test value as product of two ratios: Laboratory test value = (Technical accuracy/Turnaround time × (Utility/Costs. Recently, some researches used multicriteria decision analysis which allows comparison of diagnostic strategies in terms of benefits, opportunities, costs and risks. All analyses are constructed to identify laboratory test that produce the greatest healthcare benefit with
Klose, M.; Damm, B.
The nature of landslides is complex in many respects, with landslide hazard and impact being dependent on a variety of factors. This obviously requires an integrated assessment for fundamental understanding of landslide risk. Integrated risk assessment, according to the approach presented in this contribution, implies combining prediction of future landslide occurrence with analysis of landslide impact in the past. A critical step for assessing landslide risk in integrated perspective is to analyze what types of landslide damage affected people and property in which way and how people contributed and responded to these damage types. In integrated risk assessment, the focus is on systematic identification and monetization of landslide damage, and analytical tools that allow deriving economic costs from physical landslide processes are at the heart of this approach. The broad spectrum of landslide types and process mechanisms as well as nonlinearity between landslide magnitude, damage intensity, and direct costs are some main factors explaining recent challenges in risk assessment. The two prevailing approaches for assessing the impact of landslides in economic terms are cost survey (ex-post) and risk analysis (ex-ante). Both approaches are able to complement each other, but yet a combination of them has not been realized so far. It is common practice today to derive landslide risk without considering landslide process-based cause-effect relationships, since integrated concepts or new modeling tools expanding conventional methods are still widely missing. The approach introduced in this contribution is based on a systematic framework that combines cost survey and GIS-based tools for hazard or cost modeling with methods to assess interactions between land use practices and landslides in historical perspective. Fundamental understanding of landslide risk also requires knowledge about the economic and fiscal relevance of landslide losses, wherefore analysis of their
Stacy K. Tanaka
Full Text Available Stacy K. Tanaka, Christina R. Connell–Buck, Kaveh Madani, Josue Medellín-Azuara, Jay R. Lund, and Ellen Hanakdoi: http://dx.doi.org/10.15447/sfews.2014v9iss2art4Water exports from California’s Sacramento–San Joaquin Delta are an environmental concern because they reduce net outflows of fresh water from the Delta, and can entrain fish and disrupt flows within the Delta. If exports were no longer pumped from within the Delta, the regulatory issue becomes one of maintaining appropriate flows into and out of the Delta. This paper presents the results of two sets of hydro-economic optimization modeling runs, which were developed to represent a range of modified Delta operations and their economic and operational effects on California’s water supply system. The first set of runs represents decreasing export capacity from the Delta. The second set increases minimum net Delta outflow (MNDO requirements. The hydro-economic model seeks the least–cost statewide water management scheme for water supply, including a wide range of resources and water management options. Results show that reducing exports or increasing MNDO requirements increase annual average statewide water scarcity, scarcity costs, and operating costs (from greater use of desalination, wastewater recycling, water treatment, and pumping. Effects of reduced exports are especially concentrated in agricultural communities in the southern Central Valley because of their loss of access to overall water supply exports and their ability to transfer remaining water to southern California. Increased outflow requirements increase water scarcity and associated costs throughout California. For an equivalent amount of average Delta outflows, statewide costs increase more rapidly when exports alone are reduced than when minimum outflow requirements are increased and effects are more widely distributed statewide.
Toseva, Elka Ilieva; Stoyanova, Rumyana; Turnovska, Tanya
The compensatory mechanisms of social security include expenses for sick leave. The aim of the study is to determine the economic cost due to sick leave among workers in wastewater treatment plants (WWTPs), comparing with the same economic indicators of the National Social Security Institute (NSSI) in Bulgaria. The sick leave of 111 workers at 3 WWTPs was studied in the period 2012-2014 on the grounds of registered absences from work due to temporary incapacity for work. The economic indicators of the NSSI, the gross salary at WWTPs, payable social security contributions and compensatory payments for sick leave have been used for economic cost calculation for temporary incapacity of the workers. The frequency of cases and the frequency of lost days due to temporary incapacity were increased in the observed period at WWTPs and in Bulgaria, and it is significantly higher for the employed at WWTPs. The percentage share of workers equivalent to 1.66% at WWTPs have not worked for an entire year as a result of temporary incapacity in 2012, 2.76% - in 2013, and 4.61% - in 2014. The economic burden due to sick leave at WWTPs was raised from EUR 4913.02 in 2012 to EUR 16 895.80 for 2014 for employers and the NSSI. The frequency of cases and the frequency of lost days due to temporary incapacity were increased in the observed period at WWTPs and in Bulgaria, and it is significantly higher for the employed at WWTPs. The economic burden was equally distributed between employers and the NSSI. Med Pr 2018;69(2):129-141. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.
Krish Homagain; Chander Shahi; Nancy Luckai; Mahadev Sharma
Background:Replacement of fossil fuel based energy with biochar-based bioenergy production can help reduce greenhouse gas emissions while mitigating the adverse impacts of climate change and global warming.However,the production of biochar-based bioenergy depends on a sustainable supply of biomass.Although,Northwestern Ontario has a rich and sustainable supply of woody biomass,a comprehensive life cycle cost and economic assessment of biochar-based bioenergy production technology has not been done so far in the region.Methods:In this paper,we conducted a thorough life cycle cost assessment (LCCA) of biochar-based bioenergy production and its land application under four different scenarios:1) biochar production with low feedstock availability;2) biochar production with high feedstock availability;3) biochar production with low feedstock availability and its land application;and 4) biochar production with high feedstock availability and its land application-using SimaPro(R),EIOLCA(R) software and spreadsheet modeling.Based on the LCCA results,we further conducted an economic assessment for the break-even and viability of this technology over the project period.Results:It was found that the economic viability of biochar-based bioenergy production system within the life cycle analysis system boundary based on study assumptions is directly dependent on costs of pyrolysis,feedstock processing (drying,grinding and pelletization) and collection on site and the value of total carbon offset provided by the system.Sensitivity analysis of transportation distance and different values of C offset showed that the system is profitable in case of high biomass availability within 200 km and when the cost of carbon sequestration exceeds CAD S60 per tonne of equivalent carbon (CO2e).Conclusions:Biochar-based bioenergy system is economically viable when life cycle costs and environmental assumptions are accounted for.This study provides a medium scale slow-pyrolysis plant scenario and
Ali, A N; Howe, J; Majid, A; Redgrave, J; Pownall, S; Abdelhafiz, A H
Introduction Stroke-associated pneumonia (SAP) is common, however, data on the economic impact of SAP are scarce. This study aimed to prospectively evaluate the impact of SAP on acute stroke care costs in a UK setting. Methods Prospective cohort study of 213 consecutive patients with stroke (196 ischemic, 17 hemorrhagic) was admitted to a UK hospital over 1 year. Socio demographic and clinical characteristics were recorded along with all treatments and rehabilitation activity. Patients were classified as having SAP if they fulfilled criteria for "probable" or "definite" respiratory tract infection according to the Centres for Disease Control and Prevention definition, within the first seven days following stroke. Resource use was calculated using a "bottom up" approach of cumulative unit costs. Univariate and multivariate regression analyses were used to establish independent predictors of direct costs. Results Probable or definite SAP occurred in 13.2% (28/213) of patients. Patients with SAP experienced greater inpatient stays (31 days vs. 9 days, p ≤ 0.001) and higher in-hospital mortality (29.2% vs. 10.2%, p = 0.007). Mean (SD) acute care costs per patient was £7035 (6767), but costs were significantly greater for patients with SAP than without [£14,371 (9484) versus £6,103 (5,735); p ≤ 0.001]. SAP was an independent predictor of costs along with increasing stroke severity (NIHSS) and age. Occurrence of SAP resulted in an adjusted incremental additional cost of £5817 (95% CI 4945-6689; p = 0.001) per patient. Conclusions SAP increased acute care costs for stroke by approximately 80%. This provides further impetus for research aimed at reducing SAP, and will inform cost-effectiveness analyses of potential therapeutic strategies.
Stafford, Gary L; Nourzad, Farrokh; Lobb, William K; Beall, Jason R
The rising costs associated with obtaining a dental education have caused some to question the financial benefit of pursuing a dental degree. There is a concern that recent graduates may have difficulty finding professional opportunities that provide the income necessary to service their accumulated educational debt. The aim of this study was to evaluate the trends in educational costs to aid in making an accurate appraisal of the financial benefit of a dental education. Adjusted into constant dollar terms, data from a variety of sources were collected for economic variables such as tuition, fees, student indebtedness, and dentists' earnings. These variables were then analyzed to determine the true costs and benefits of obtaining a dental education. The results showed that, over the course of the last decade, educational costs increased faster than the real net income of practicing dentists, which led to a decline in the return on investment in dental education. However, regardless of an applicant's choice of public or private dental school, there continues to be a positive economic return on students' commitment of both financial resources and time to receive a dental education.
Wu, D B C; Chaiyakunapruk, N; Pratoomsoot, C; Lee, K K C; Chong, H Y; Nelson, R E; Smith, P F; Kirkpatrick, C M; Kamal, M A; Nieforth, K; Dall, G; Toovey, S; Kong, D C M; Kamauu, A; Rayner, C R
Simulation models are used widely in pharmacology, epidemiology and health economics (HEs). However, there have been no attempts to incorporate models from these disciplines into a single integrated model. Accordingly, we explored this linkage to evaluate the epidemiological and economic impact of oseltamivir dose optimisation in supporting pandemic influenza planning in the USA. An HE decision analytic model was linked to a pharmacokinetic/pharmacodynamics (PK/PD) - dynamic transmission model simulating the impact of pandemic influenza with low virulence and low transmissibility and, high virulence and high transmissibility. The cost-utility analysis was from the payer and societal perspectives, comparing oseltamivir 75 and 150 mg twice daily (BID) to no treatment over a 1-year time horizon. Model parameters were derived from published studies. Outcomes were measured as cost per quality-adjusted life year (QALY) gained. Sensitivity analyses were performed to examine the integrated model's robustness. Under both pandemic scenarios, compared to no treatment, the use of oseltamivir 75 or 150 mg BID led to a significant reduction of influenza episodes and influenza-related deaths, translating to substantial savings of QALYs. Overall drug costs were offset by the reduction of both direct and indirect costs, making these two interventions cost-saving from both perspectives. The results were sensitive to the proportion of inpatient presentation at the emergency visit and patients' quality of life. Integrating PK/PD-EPI/HE models is achievable. Whilst further refinement of this novel linkage model to more closely mimic the reality is needed, the current study has generated useful insights to support influenza pandemic planning.
Li, Chendan; Federico, de Bosio; Chen, Fang
In this paper, an economic dispatch problem for total operation cost minimization in DC microgrids is formulated. An operating cost is associated with each generator in the microgrid, including the utility grid, combining the cost-efficiency of the system with demand response requirements...... achieving higher control accuracy and faster response. The optimization problem is solved in a heuristic method. In order to test the proposed algorithm, a six-bus droop-controlled DC microgrid is used in the case studies. Simulation results show that under variable renewable energy generation, load...... of the utility. The power flow model is included in the optimization problem, thus the transmission losses can be considered for generation dispatch. By considering the primary (local) control of the grid-forming converters of a microgrid, optimal parameters can be directly applied to this control level, thus...
ROLAND IOSIF MORARU
Full Text Available Occupational Health and Safety management is more and more strongly related to the costs of occupational injuries and illnesses, as a top priority in most companies. The present article presents a synthesis of authors’ attempts to identify the elements which should be taken into account in determining the cost of occupational injuries and diseases at the national level, with a focus on basic influence factors. Our aim is to help companies managers to emphasize the economic costs of not improving workplace safety and health – to employers, to workers and to society as a whole – and to inform decision-makers on further developments to be considered in the occupational risk management processes.
Baird, R.D.; Chau, N. [Rogers & Associates Engineering Corp., Salt Lake City, UT (United States); Breeds, C.D. [SubTerra, Inc., Redmond, WA (United States)
Total life-cycle costs were estimated in support of the New York LLRW Siting Commission`s project to select a disposal method from four near-surface LLRW disposal methods (namely, uncovered above-grade vaults, covered above-grade vaults, below-grade vaults, and augered holes) and two mined methods (namely, vertical shaft mines and drift mines). Conceptual designs for the disposal methods were prepared and used as the basis for the cost estimates. Typical economic performance of each disposal method was assessed. Life-cycle costs expressed in 1994 dollars ranged from $ 1,100 million (for below-grade vaults and both mined disposal methods) to $2,000 million (for augered holes). Present values ranged from $620 million (for below-grade vaults) to $ 1,100 million (for augered holes).
Armsworth, Paul R; Jackson, Heather B; Cho, Seong-Hoon; Clark, Melissa; Fargione, Joseph E; Iacona, Gwenllian D; Kim, Taeyoung; Larson, Eric R; Minney, Thomas; Sutton, Nathan A
Conservation organizations must redouble efforts to protect habitat given continuing biodiversity declines. Prioritization of future areas for protection is hampered by disagreements over what the ecological targets of conservation should be. Here we test the claim that such disagreements will become less important as conservation moves away from prioritizing areas for protection based only on ecological considerations and accounts for varying costs of protection using return-on-investment (ROI) methods. We combine a simulation approach with a case study of forests in the eastern United States, paying particular attention to how covariation between ecological benefits and economic costs influences agreement levels. For many conservation goals, agreement over spatial priorities improves with ROI methods. However, we also show that a reliance on ROI-based prioritization can sometimes exacerbate disagreements over priorities. As such, accounting for costs in conservation planning does not enable society to sidestep careful consideration of the ecological goals of conservation.
Three FORTRAN programs, CAPITAL, VENTURE, and INDEXER, have been developed to automate computations used in assessing the economic viability of proposed or conceptual laser fusion and other advanced-technology facilities, as well as conventional projects. The types of calculations performed by these programs are, respectively, capital cost estimation, lifetime economic performance simulation, and computation of cost indexes. The codes permit these three topics to be addressed with considerable sophistication commensurate with user requirements and available data
Yu, Tzu-Ying; Donovan, Tim; Armfield, Nigel; Gole, Glen A
Demand for retinopathy of prematurity (ROP) screening is increasing for infants born at rural and regional hospitals where the service is not generally available. The health system cost for screening regional/remote infants has not been reported. The objective of this study is to evaluate the cost of ROP screening at a large centralized tertiary neonatal service for infants from regional/rural hospitals. This is a retrospective study to establish the cost of transferring regional/rural infants to the Royal Brisbane and Women's Hospital for ROP screening over a 28-month period. A total of 131 infants were included in this study. Individual infant costs were calculated from analysis of clinical and administrative records. Economic cost of ROP screening for all transfers from regional/rural hospitals to Royal Brisbane and Women's Hospital. The average economic cost of ROP screening for this cohort was AUD$5110 per infant screened and the total cost was AUD$669 413. The average cost per infant screened was highest for infants from a regional centre with a population of 75 000 (AUD$14 856 per child), which was also geographically furthest from Brisbane. No infant in this cohort transferred from a regional nursery reached criteria for intervention for ROP by standard guidelines. Health system costs for ROP screening of remote infants at a centralized hospital are high. Alternative strategies using telemedicine can now be compared with centralized screening. © 2018 Royal Australian and New Zealand College of Ophthalmologists.
Gabbard, Lydia Carol Moore
A study compared the cost effectiveness of secondary child care and commercial foods occupational home economics programs in Kentucky. Identified as dependent variables in the study were program effectiveness, cost efficiency, and cost effectiveness ratio. Program expenditures, community size, and program age were considered as independent…
Stephen, Dimity Maree; Barnett, Adrian Gerard
The incidence of salmonellosis, a costly foodborne disease, is rising in Australia. Salmonellosis increases during high temperatures and rainfall, and future incidence is likely to rise under climate change. Allocating funding to preventative strategies would be best informed by accurate estimates of salmonellosis costs under climate change and by knowing which population subgroups will be most affected. We used microsimulation models to estimate the health and economic costs of salmonellosis in Central Queensland under climate change between 2016 and 2036 to inform preventative strategies. We projected the entire population of Central Queensland to 2036 by simulating births, deaths, and migration, and salmonellosis and two resultant conditions, reactive arthritis and postinfectious irritable bowel syndrome. We estimated salmonellosis risks and costs under baseline conditions and under projected climate conditions for Queensland under the A1FI emissions scenario using composite projections from 6 global climate models (warm with reduced rainfall). We estimated the resulting costs based on direct medical expenditures combined with the value of lost quality-adjusted life years (QALYs) based on willingness-to-pay. Estimated costs of salmonellosis between 2016 and 2036 increased from 456.0 QALYs (95% CI: 440.3, 473.1) and AUD29,900,000 million (95% CI: AUD28,900,000, AUD31,600,000), assuming no climate change, to 485.9 QALYs (95% CI: 469.6, 503.5) and AUD31,900,000 (95% CI: AUD30,800,000, AUD33,000,000) under the climate change scenario. We applied a microsimulation approach to estimate the costs of salmonellosis and its sequelae in Queensland during 2016-2036 under baseline conditions and according to climate change projections. This novel application of microsimulation models demonstrates the models' potential utility to researchers for examining complex interactions between weather and disease to estimate future costs. https://doi.org/10.1289/EHP1370.
Van Hal G
Full Text Available Guido Van Hal Medical Sociology and Health Policy, University of Antwerp, Antwerp, Belgium Abstract: The recent economic crisis has led to many negative consequences, not the least having to do with the mental health and well-being of the populations involved. Although some researchers say it is still too early to speak about a relationship between the economic crisis and a rise in mental health problems resulting in suicides, there is solid evidence for the existence of such a relationship. However, several moderating or mediating mechanisms can also play a role. The main reactions of most policy makers to the economic crisis are (severe austerity measures. These measures seem to have, however, a detrimental effect on the mental health of the population: Just when people have the highest need for mental help, cost-cutting measures in the health care sector lead to a (substantial drop in the supply of services for the prevention, early detection, and cure of mental health problems. Policy makers should support moderating mechanisms such as financial and psychological coping and acculturation and the role of primary health care workers in the early detection of suicidal thoughts, suicide attempts, and suicide in times of economic recession. Several examples show that the countries best off regarding the mental health of their populations during the economic crisis are those countries with the strongest social safety net. Therefore, instead of cutting back on health care and social welfare measures, policy makers should in the future invest even more in social protection measures during economic crises. Keywords: economic recession, mental health, suicide, social protection, austerity, review
The reasons for the employment of higher transmission voltages are listed and the points decisive for the selection of three phase ac or dc systems are reviewed. This is followed by treatment of the technical and economic problems arising in three phase-extra high voltage transmission. These include selection of voltage, economical design of power lines, insulation problems, power supply dependability, equipment rating, and reactive power and stability problems.
The reasons for the employment of higher transmission voltages are listed and the points decisive for the selection of three phase ac or dc systems are reviewed. The technical and economic problems arising in three phase extra high voltage transmission are discussed. These include selection of voltage, economical design of power lines, insulation problems, power supply dependability, equipment rating and reactive power and stability problems.
Qu Jun; Guo Zongzhi; Yang Lirong; Hu Jiang
In this paper, based on the research and analysis about the repository construction cost of the European, US and Japan, together with the concept design pattern of China's high level radioactive waste repository, the preliminary economic analysis of China is presented. Meanwhile, combining with China's nuclear power development layout and picking-up policy of spent fuel fund, the preliminary measurement concerning the capital resource of high level radioactive waste disposal is implemented, which contribute to the conclusion initiatively that the spent fuel fund could meet the need of the financial demand of disposal cost. (authors)
Glassman, Amanda; Cañón, Oscar; Silverman, Rachel
In middle-income countries, vaccines against pneumococcal disease, rotavirus, and human papilloma virus are in general more costly, not necessarily cost saving, and less consistently cost-effective than earlier generation vaccines against measles, diphtheria, tetanus, and pertussis. Budget impact is also substantial; public spending on vaccines in countries adopting new vaccines is, on average, double the amount of countries that have not adopted. Policymakers must weigh the costs and benefits of the adoption decision carefully, given the low coverage of other kinds of cost-effective health and nonhealth interventions in these same settings and relatively flat overall public spending on health as a share of gross domestic product (GDP) over time. This paper considers lessons learned from recent vaccine cost-effectiveness analyses and subsequent adoption decisions in Latin America a, largely under the auspices of the Pro Vac Initiative. The paper illustrates how small methodological choices and seemingly minor technical limitations of cost-effectiveness models can have major implications for the studies' conclusions, potentially influencing countries' subsequent vaccine adoption decisions. We evaluate the ProVac models and technical outputs against the standards and framework set out by the International Decision Support Initiative Reference Case for economic evaluation and consider the practical effects of deviations from those standards. Lessons learned are discussed, including issues of appropriate comparators, GDP-based thresholds, and use of average versus incremental cost-effectiveness ratios as a convention are assessed. The article ends with recommendations for the future. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
Nuijten, Mark; Marczewska, Agnieszka; Araujo Torress, Krysmaru; Rasouli, Bahareh; Perugini, Moreno
Obesity is associated with high direct medical costs and indirect costs resulting from productivity loss. High prevalence of obesity generates a justified need to identify cost-effective weight loss approaches from a payer's perspective. Within the variety of weight management techniques, OPTIFAST ® is a clinically recognized and scientifically proven total meal replacement Low Calorie Diet that provides meaningful results in terms of weight loss and reduction in comorbidities. The objective of this study is assess potential cost-savings of OPTIFAST ® program in the USA, as compared to "no intervention" and pharmacotherapy. An event-driven decision analytic model was used to estimate payer's cost-savings from reimbursement of the 1-year OPTIFAST ® program over 3 years in the USA. The analysis was performed for the broad population of obese persons (BMI >30 kg/m 2 ) undergoing the OPTIFAST ® program versus liraglutide 3 mg, naltrexone/bupropion and versus "no intervention". The model included risk of complications related to increased BMI. Data sources included published literature, clinical trials, official USA price/tariff lists and national population statistics. The primary perspective was that of a USA payer; costs provided in 2016 US dollars. OPTIFAST ® leads over a period of 3 years to cost-savings of USD 9,285 per class I and II obese patient (BMI 30-39.9 kg/m 2 ) as compared to liraglutide and USD 685 as compared to naltrexone/bupropion. In the same time perspective, the OPTIFAST ® program leads to a reduction of cost of obesity complications of USD 1,951 as compared to "no intervention" with the incremental cost-effectiveness ratio of USD 6,475 per QALY. Scenario analyses show also substantial cost-savings in patients with class III obesity (BMI ≥40.0 kg/m 2 ) and patients with obesity (BMI 30-39.9 kg/m2) and type 2 diabetes versus all three previous comparators and bariatric surgery. Reimbursing OPTIFAST ® leads to meaningful cost
Liu Yu; Dong Yujie
In recent years, as the increasing demand of energy all over the world, and the pressure on greenhouse emissions, there's a new opportunity for the development of nuclear energy. Modular High Temperature Gas-cooled Reactor (MHTR) received recognition for its inherent safety feature and high outlet temperature. Whether the Modular High Temperature Gas-cooled Reactor would be accepted extensively, its economy is a key point. In this paper, the methods of qualitative analysis and the method of quantitative analysis, the economic models designed by Economic Modeling Working Group (EMWG) of the Generation IV International Forum (GIF), as well as the HTR-PM's main technical features, are used to analyze the economy of the MHTR. A prediction is made on the basis of summarizing High Temperature Gas-cooled Reactor module characteristics, construction cost, total capital cost, fuel cost and operation and maintenance (O and M) cost and so on. In the following part, comparative analysis is taken measures to the economy and cost ratio of different designs, to explore the impacts of modularization and standardization on the construction of multiple-module reactor nuclear power plant. Meanwhile, the analysis is also adopted in the research of key factors such as the learning effect and yield to find out their impacts on the large scale development of MHTR. Furthermore, some reference would be provided to its wide application based on these analysis. (author)
Baggaley, Rebecca F; Irvine, Michael A; Leber, Werner; Cambiano, Valentina; Figueroa, Jose; McMullen, Heather; Anderson, Jane; Santos, Andreia C; Terris-Prestholt, Fern; Miners, Alec; Hollingsworth, T Déirdre; Griffiths, Chris J
Early HIV diagnosis reduces morbidity, mortality, the probability of onward transmission, and their associated costs, but might increase cost because of earlier initiation of antiretroviral treatment (ART). We investigated this trade-off by estimating the cost-effectiveness of HIV screening in primary care. We modelled the effect of the four-times higher diagnosis rate observed in the intervention arm of the RHIVA2 randomised controlled trial done in Hackney, London (UK), a borough with high HIV prevalence (≥0·2% adult prevalence). We constructed a dynamic, compartmental model representing incidence of infection and the effect of screening for HIV in general practices in Hackney. We assessed cost-effectiveness of the RHIVA2 trial by fitting model diagnosis rates to the trial data, parameterising with epidemiological and behavioural data from the literature when required, using trial testing costs and projecting future costs of treatment. Over a 40 year time horizon, incremental cost-effectiveness ratios were £22 201 (95% credible interval 12 662-132 452) per quality-adjusted life-year (QALY) gained, £372 207 (268 162-1 903 385) per death averted, and £628 874 (434 902-4 740 724) per HIV transmission averted. Under this model scenario, with UK cost data, RHIVA2 would reach the upper National Institute for Health and Care Excellence cost-effectiveness threshold (about £30 000 per QALY gained) after 33 years. Scenarios using cost data from Canada (which indicate prolonged and even higher health-care costs for patients diagnosed late) suggest this threshold could be reached in as little as 13 years. Screening for HIV in primary care has important public health benefits as well as clinical benefits. We predict it to be cost-effective in the UK in the medium term. However, this intervention might be cost-effective far sooner, and even cost-saving, in settings where long-term health-care costs of late-diagnosed patients in high
Al-Othman, A.K.; El-Naggar, K.M.
Direct search methods are evolutionary algorithms used to solve optimization problems. (DS) methods do not require any information about the gradient of the objective function at hand while searching for an optimum solution. One of such methods is Pattern Search (PS) algorithm. This paper presents a new approach based on a constrained pattern search algorithm to solve a security constrained power system economic dispatch problem (SCED) with non-smooth cost function. Operation of power systems demands a high degree of security to keep the system satisfactorily operating when subjected to disturbances, while and at the same time it is required to pay attention to the economic aspects. Pattern recognition technique is used first to assess dynamic security. Linear classifiers that determine the stability of electric power system are presented and added to other system stability and operational constraints. The problem is formulated as a constrained optimization problem in a way that insures a secure-economic system operation. Pattern search method is then applied to solve the constrained optimization formulation. In particular, the method is tested using three different test systems. Simulation results of the proposed approach are compared with those reported in literature. The outcome is very encouraging and proves that pattern search (PS) is very applicable for solving security constrained power system economic dispatch problem (SCED). In addition, valve-point effect loading and total system losses are considered to further investigate the potential of the PS technique. Based on the results, it can be concluded that the PS has demonstrated ability in handling highly nonlinear discontinuous non-smooth cost function of the SCED. (author)
United Engineers and Constructors (UE and C) and the Babcock and Wilcox Company (B and W) have performed several studies over the last eight years related to small integral pressurized water reactors. These reactors include the 365 MWt (100 MWe) Consolidated Nuclear Steam Generator (CNSG) and the 1200 MWt Consolidated Nuclear Steam System (CNSS). The studies, mostly performed under contract to the Oak Ridge National Laboratory, have led to a 1250 MWt (400 MWe) Consolidated Nuclear Steam System (CNSS) plant concept, with unique design and cost features. This report contains an update of earlier studies of the CNSS reactor and balance-of-plant concept design, capital costs, and multi-unit plant economics incorporating recent design developments, improvements, and post-TMI-2 upgrades. The economic evaluation compares the total system economic impact of a phased, three stage 400 MWe CNSS implementation program, i.e., a three-unit station, to the installation of a single 1200 MWe Pressurized Water Reactor (PWR) into a typical USA utility system.
United Engineers and Constructors (UE and C) and the Babcock and Wilcox Company (B and W) have performed several studies over the last eight years related to small integral pressurized water reactors. These reactors include the 365 MWt (100 MWe) Consolidated Nuclear Steam Generator (CNSG) and the 1200 MWt Consolidated Nuclear Steam System (CNSS). The studies, mostly performed under contract to the Oak Ridge National Laboratory, have led to a 1250 MWt (400 MWe) Consolidated Nuclear Steam System (CNSS) plant concept, with unique design and cost features. This report contains an update of earlier studies of the CNSS reactor and balance-of-plant concept design, capital costs, and multi-unit plant economics incorporating recent design developments, improvements, and post-TMI-2 upgrades. The economic evaluation compares the total system economic impact of a phased, three stage 400 MWe CNSS implementation program, i.e., a three-unit station, to the installation of a single 1200 MWe Pressurized Water Reactor (PWR) into a typical USA utility system
Miller, Patrick; Olateju, Babatunde; Kumar, Amit
Highlights: ► Techno-economic models were developed to assess the retrofitting of aerial coolers. ► The IRR for retrofitting with VFDs exceeds 10% for motor sizes above 20 hp. ► The IRR reaches a maximum of 220% for a cooler with fifty, 250 hp motors. ► The simple payback becomes less than 1 year for motors larger than 120 hp. ► Ambient temperature and location affects the profitability of VFD investment. - Abstract: A techno-economic model was created in order to develop curves that show the typical annual energy savings, rate of return, and payback for retrofitting aerial coolers with variable frequency drives (VFDs) for up to 50 motors, motor sizes from 4 to 186 kW (5–250 hp), and varying climate conditions. The cost savings due to installing a VFD depends on the reduction in energy used, as well as the reduction in power demand, the capital cost of the VFD, installation cost of the VFD, change in operating cost, and cost of electricity. The geographic locations examined in this report were Fort McMurray, Calgary, Vancouver, and Thunder Bay. This study found that the IRR increases rapidly with motor size, becomes greater than 10% at a motor size of approximately 15 kW, and may be as high as 220% (for the case of fifty, 186 kW motors). The IRR is sensitive to the number of fan motors retrofitted with VFDs, however the sensitivity rapidly declines as the number of motors is increased beyond five. The simple payback period becomes less than 1 year and nearly independent of number of motors and motor size for motors larger than 90 kW. Ambient temperature and geographic location affect the profitability of the investment, although the IRR only changes by approximately 4%.
Full Text Available Objective: To provide an overview of the healthcare and societal consequences and costs of untreated obstructive sleep apnea syndrome. Data sources: PubMed database for English-language studies with no start date restrictions and with an end date of September 2014. Methods: A comprehensive literature review was performed to identify all studies that discussed the physiologic, clinical and societal consequences of obstructive sleep apnea syndrome as well as the costs associated with these consequences. There were 106 studies that formed the basis of this analysis. Conclusions: Undiagnosed and untreated obstructive sleep apnea syndrome can lead to abnormal physiology that can have serious implications including increased cardiovascular disease, stroke, metabolic disease, excessive daytime sleepiness, work-place errors, traffic accidents and death. These consequences result in significant economic burden. Both, the health and societal consequences and their costs can be decreased with identification and treatment of sleep apnea. Implications for practice: Treatment of obstructive sleep apnea syndrome, despite its consequences, is limited by lack of diagnosis, poor patient acceptance, lack of access to effective therapies, and lack of a variety of effective therapies. Newer modes of therapy that are effective, cost efficient and more accepted by patients need to be developed. Keywords: Obstructive sleep apnea syndrome, Cost, Continuous positive airway pressure, Mandibular advancement device
Jiang, Yu; Dinar, Ariel; Hellegers, Petra
We have developed a social optimization model that integrates the financial and ecological costs associated with wastewater treatment and ecosystem damage. The social optimal abatement level of water pollution is determined by finding the trade-off between the cost of pollution control and its resulting ecosystem damage. The model is applied to data from the Lake Taihu region in China to demonstrate this trade-off. A wastewater treatment cost function is estimated with a sizable sample from China, and an ecological damage cost function is estimated following an ecosystem service valuation framework. Results show that the wastewater treatment cost function has economies of scale in facility capacity, and diseconomies in pollutant removal efficiency. Results also show that a low value of the ecosystem service will lead to serious ecological damage. One important policy implication is that the assimilative capacity of the lake should be enhanced by forbidding over extraction of water from the lake. It is also suggested that more work should be done to improve the accuracy of the economic valuation. Copyright © 2018 Elsevier Ltd. All rights reserved.
Halsnæs, Kirsten; Kaspersen, Per Skougaard; Drews, Martin
The consequences of high-end climate scenarios and the risks of extreme events involve a number of critical assumptions and methodological challenges related to key uncertainties in climate scenarios and modelling, impact analysis, and economics. A methodological framework for integrated analysis...... of extreme events increase beyond scaling, and in combination with economic assumptions we find a very wide range of risk estimates for urban precipitation events. A sensitivity analysis addresses 32 combinations of climate scenarios, damage cost curve approaches, and economic assumptions, including risk...... aversion and equity represented by discount rates. Major impacts of alternative assumptions are investigated. As a result, this study demonstrates that in terms of decision making the actual expectations concerning future climate scenarios and the economic assumptions applied are very important...
Full Text Available When several microgrids (MG are interconnected into microgrid clusters (MGC, they have great potential to improve their reliability. Traditional droop control tends to make the total operating costs higher as the power is distributed by capacity ratios of distributed energy resources (DERs. This paper proposes an adaptive distributed economic control for islanded microgrids which considers line loss, specifically, an interesting marginal costs-based economic droop control is proposed, and consensus-based adaptive controller is applied, to deal with power limits and capacity constraints for storage. The whole expense can be effectively lowered by achieving identical marginal costs for DERs in MGC. Specially, the capacity constraints only for storages are also included to do further optimization. Moreover, consensus-based distributed secondary controllers are used to rapidly restore system frequency and voltage magnitudes. The above controllers only need to interact with neighbor DERs by a sparse communication network, eliminating the necessity of a central controller and enhancing the stability. A MGC, incorporating three microgrids, is used to verify the effectiveness of the proposed methods.
Cost-benefit analysis is one of the fundamental tools for the development of economic instruments for pollution control. The costs of various abatement measures are reasonably well characterised. However, assessment of the economic costs of pollutant impacts is less well developed. This paper reports on two studies carried out for DGXII of the European Commission, the ExternE-Project and the Green Accounting Research Project. Both studies have been performed by international, multi-disciplinary research teams. Analysis of the effects of emissions of PM 10 , SO 2 , NO x and VOCs (as ozone precursors) has included assessment of human health, materials, crops and other terrestrial ecosystems, and freshwater fisheries. The analysis follows the 'impact pathway' approach, linking dose-response functions, valuation data and other models. It differs significantly to earlier 'top-down' approaches that made only very limited use of the wealth of scientific data available. Most success has been achieved in analysis of impacts on human health, building materials and crops. Significant uncertainties exist for these receptors, though these have been identified and are now being addressed. Assessment of impacts on other receptors, perhaps most notably forests, is more limited. The methodology is particularly applicable for analysis of impacts on receptors for which the critical loads approach is not appropriate. 7 refs., 3 figs., 1 tab
Wan Rahmah Mohd Zaki; Abdul Hadi Nawawi; Sabarinah Sh Ahmad
Energy Efficient (EE) appliances such as Compact Fluorescent Light (CFL) bulbs and Renewable Energy (RE), namely solar Photovoltaic (PV) can help to reduce Operational Energy (OE) in a house. In addition, a house should also incorporate Passive Architecture (PA) design strategies which in the hot and humid tropical climate, mean avoiding direct heat gain, encouraging natural cross ventilation and optimising the abundant daylight. Nevertheless, reducing OE must also mean economic gain to households to encourage their participation. Common economic gauges such as Return on Investment, Payback Period, Cost Benefit Analysis, Life Cycle Assessment and Life Cycle Cost are not suitable to validate OE options in households. These economic gauges approach economic assessment as an end-result on the cost side of the product and may result for good intention to be shelved, primarily because EE equipment and RE have high capital cost compared with the alternatives. On the other hand, reducing OE in houses is actually a continual progression from the status quo and there is always a marginal gain in doing so. The challenge is to know how much is the marginal benefit against the marginal cost of investing in EE and RE. In Economics, the ratio of Marginal Cost (MC) and Marginal Benefits (MB) measure additional benefits of every additional costs of investment at a specific level of production and consumption; and Economists suggests that effective gain and loss should be compared to the status quo, i.e., Relative Position (RP). The Economics theories of MC, MB and RP are being adapted to measure the progression of reducing OE. The living/dining area in two types of houses: with and without PA design strategies are simulated to use conventional incandescent light bulbs and CFL as well as solar PV in lieu of the mains electricity supply. The power requirement for artificial lighting in every case is translated into monetary value and the ratio of MB against MC for each case shows
Hill, Jason; Nelson, Erik; Tilman, David; Polasky, Stephen; Tiffany, Douglas
Negative environmental consequences of fossil fuels and concerns about petroleum supplies have spurred the search for renewable transportation biofuels. To be a viable alternative, a biofuel should provide a net energy gain, have environmental benefits, be economically competitive, and be producible in large quantities without reducing food supplies. We use these criteria to evaluate, through life-cycle accounting, ethanol from corn grain and biodiesel from soybeans. Ethanol yields 25% more energy than the energy invested in its production, whereas biodiesel yields 93% more. Compared with ethanol, biodiesel releases just 1.0%, 8.3%, and 13% of the agricultural nitrogen, phosphorus, and pesticide pollutants, respectively, per net energy gain. Relative to the fossil fuels they displace, greenhouse gas emissions are reduced 12% by the production and combustion of ethanol and 41% by biodiesel. Biodiesel also releases less air pollutants per net energy gain than ethanol. These advantages of biodiesel over ethanol come from lower agricultural inputs and more efficient conversion of feedstocks to fuel. Neither biofuel can replace much petroleum without impacting food supplies. Even dedicating all U.S. corn and soybean production to biofuels would meet only 12% of gasoline demand and 6% of diesel demand. Until recent increases in petroleum prices, high production costs made biofuels unprofitable without subsidies. Biodiesel provides sufficient environmental advantages to merit subsidy. Transportation biofuels such as synfuel hydrocarbons or cellulosic ethanol, if produced from low-input biomass grown on agriculturally marginal land or from waste biomass, could provide much greater supplies and environmental benefits than food-based biofuels. corn | soybean | life-cycle accounting | agriculture | fossil fuel
Hill, Jason; Nelson, Erik; Tilman, David; Polasky, Stephen; Tiffany, Douglas
Negative environmental consequences of fossil fuels and concerns about petroleum supplies have spurred the search for renewable transportation biofuels. To be a viable alternative, a biofuel should provide a net energy gain, have environmental benefits, be economically competitive, and be producible in large quantities without reducing food supplies. We use these criteria to evaluate, through life-cycle accounting, ethanol from corn grain and biodiesel from soybeans. Ethanol yields 25% more energy than the energy invested in its production, whereas biodiesel yields 93% more. Compared with ethanol, biodiesel releases just 1.0%, 8.3%, and 13% of the agricultural nitrogen, phosphorus, and pesticide pollutants, respectively, per net energy gain. Relative to the fossil fuels they displace, greenhouse gas emissions are reduced 12% by the production and combustion of ethanol and 41% by biodiesel. Biodiesel also releases less air pollutants per net energy gain than ethanol. These advantages of biodiesel over ethanol come from lower agricultural inputs and more efficient conversion of feedstocks to fuel. Neither biofuel can replace much petroleum without impacting food supplies. Even dedicating all U.S. corn and soybean production to biofuels would meet only 12% of gasoline demand and 6% of diesel demand. Until recent increases in petroleum prices, high production costs made biofuels unprofitable without subsidies. Biodiesel provides sufficient environmental advantages to merit subsidy. Transportation biofuels such as synfuel hydrocarbons or cellulosic ethanol, if produced from low-input biomass grown on agriculturally marginal land or from waste biomass, could provide much greater supplies and environmental benefits than food-based biofuels.
When designing digital controllers for critical plant control it is important to provide several features. Among these are reliability, availability, maintainability, environmental protection, and low cost. An examination of several applications has lead to a design that can be produced for approximately $20,000 (1000 control points). This design is compatible with modern concepts in distributed and hierarchical control. The canonical controller element is a dual-redundant self-checking computer that communicates with a cross-strapped, electrically isolated input/output system. The input/output subsystem comprises multiple intelligent input/output cards. These cards accept commands from the primary processor which are validated, executed, and acknowledged. Each card may be hot replaced to facilitate sparing. The implementation of the dual-redundant computer architecture is discussed. Called the FS-86, this computer can be used for a variety of applications. It has most recently found application in the upgrade of San Francisco's Bay Area Rapid Transit (BART) train control currently in progress and has been proposed for feedwater control in a boiling water reactor
Akimaya, Muhammad I.
A gasoline subsidy distorts the gasoline market with the resulting inefficiencies and takes substantial revenues that arguably could be spent elsewhere with a better impact on economic growth. Governments with such subsidies are aware of their cost yet face difficulties in removing the policy because of strong resistance from the public. This thesis discusses in three essays the problem faced by the government in removing the gasoline subsidy and provides an alternative policy in reducing the subsidy cost applied to the case of Indonesia. In the first essay, we examine the decision-making process from the government's perspective that has an objective of generating savings to fund other programs while maintaining political power, and the influence that the general population has over the decision. Despite the immense literature on political power, there has yet to be any research that mathematically models the decision-making process of a government with influences from the general population. Under the benchmark scenario, the equilibrium strategy is to keep the subsidy intact. However, the results are found to be very sensitive to the magnitude of the shift in political power as well as the preferences of both the government and the people. In the second essay, we estimate the cross-price elasticity of regular gasoline with respect to premium gasoline price. The importance of such knowledge is to accurately determine the impact of fuel pricing policy that tends to have different rates of tax or subsidy depending on the grade of gasoline. Using data on the Mexican gasoline market, regular gasoline demand is estimated with an Autoregressive Distributed Lag (ARDL) model. Endogeneity of the price and structural break are also investigated. The cross-price elasticities between regular and premium gasoline is found to be -0.895, which confirms high substitutability among gasoline with different grades. In the third essay, we look at the unique case of Indonesia that
Dunnewind, Tom; Dvortsin, Evgeni P; Smeets, Hugo M; Konijn, Rob M; Bos, Jens H J; de Boer, Pieter T; van den Bergh, Joop P; Postma, Maarten J
Osteoporosis often does not involve symptoms, and so the actual number of patients with osteoporosis is higher than the number of diagnosed individuals. This underdiagnosis results in a treatment gap. To estimate the total health care resource use and costs related to osteoporosis in the Netherlands, explicitly including fractures, and to estimate the proportion of fracture costs that are linked to the treatment gap and might therefore be potentially preventable; to also formulate, on the basis of these findings, strategies to optimize osteoporosis care and treatment and reduce its related costs. In this retrospective study, data of the Achmea Health Database representing 4.2 million Dutch inhabitants were used to investigate the economic consequence of osteoporosis in the Netherlands in 2010. Specific cohorts were created to identify osteoporosis-related fractures and their costs. Besides, costs of pharmaceutical treatment regarding osteoporosis were included. Using data from the literature, the treatment gap was estimated. Sensitivity analysis was performed on the base-case results. A total of 108,013 individuals with a history of fractures were included in this study. In this population, 59,193 patients were using anti-osteoporotic medication and 86,776 patients were using preventive supplements. A total number of 3,039 osteoporosis-related fractures occurred. The estimated total costs were €465 million. On the basis of data presented in the literature, the treatment gap in our study population was estimated to vary from 60% to 72%. The estimated total costs corrected for treatment gap were €1.15 to €1.64 billion. These results indicate room for improvement in the health care policy against osteoporosis. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
Okolelova, Ella; Shibaeva, Marina; Trukhina, Natalya
The article considers problems and potential of high-rise construction as a global urbanization. The results of theoretical and practical studies on the appraisal of investments in high-rise construction are provided. High-rise construction has a number of apparent upsides in modern terms of development of megapolises and primarily it is economically efficient. Amid serious lack of construction sites, skyscrapers successfully deal with the need of manufacturing, office and living premises. Nevertheless, there are plenty issues, which are related with high-rise construction, and only thorough scrutiny of them allow to estimate the real economic efficiency of this branch. The article focuses on the question of economic efficiency of high-rise construction. The suggested model allows adjusting the parameters of a facility under construction, setting the tone for market value as well as the coefficient for appreciation of the construction net cost, that depends on the number of storey's, in the form of function or discrete values.
Busk, R.; Larsen, Anderse; Skovsgaard Nielsen, L.; Nielsen, Uffe; Pade, L.L.; Mulvad Jeppesen, L. [Inst. for Miljoevurdering (Denmark); Munksgaard, J. [Amternes of Kommunernes Forskningsinst. (Denmark)
This report was prepared in order to inform the basis for making energy policy decisions, particularly in with respect to Denmark's goals for renewable energy and wind power. The report estimates the socio-economic costs of expanding Danish wind power to a share of 30, 40 and 50%, respectively, of the electricity consumption by 2025. The report also analyses barriers to and instruments for the expansion of Danish wind power. The main analysis is a socio-economic cost analysis which includes, among other factors, costs of investments, infrastructure and tax distortion losses. (au)
Shepard, Donald S.; Undurraga, Eduardo A.; Lees, Rosemary Susan; Halasa, Yara; Lum, Lucy Chai See; Ng, Chiu Wan
Dengue represents a substantial burden in many tropical and sub-tropical regions of the world. We estimated the economic burden of dengue illness in Malaysia. Information about economic burden is needed for setting health policy priorities, but accurate estimation is difficult because of incomplete data. We overcame this limitation by merging multiple data sources to refine our estimates, including an extensive literature review, discussion with experts, review of data from health and surveillance systems, and implementation of a Delphi process. Because Malaysia has a passive surveillance system, the number of dengue cases is under-reported. Using an adjusted estimate of total dengue cases, we estimated an economic burden of dengue illness of US$56 million (Malaysian Ringgit MYR196 million) per year, which is approximately US$2.03 (Malaysian Ringgit 7.14) per capita. The overall economic burden of dengue would be even higher if we included costs associated with dengue prevention and control, dengue surveillance, and long-term sequelae of dengue. PMID:23033404
Shepard, Donald S; Undurraga, Eduardo A; Lees, Rosemary Susan; Halasa, Yara; Lum, Lucy Chai See; Ng, Chiu Wan
Dengue represents a substantial burden in many tropical and sub-tropical regions of the world. We estimated the economic burden of dengue illness in Malaysia. Information about economic burden is needed for setting health policy priorities, but accurate estimation is difficult because of incomplete data. We overcame this limitation by merging multiple data sources to refine our estimates, including an extensive literature review, discussion with experts, review of data from health and surveillance systems, and implementation of a Delphi process. Because Malaysia has a passive surveillance system, the number of dengue cases is under-reported. Using an adjusted estimate of total dengue cases, we estimated an economic burden of dengue illness of US$56 million (Malaysian Ringgit MYR196 million) per year, which is approximately US$2.03 (Malaysian Ringgit 7.14) per capita. The overall economic burden of dengue would be even higher if we included costs associated with dengue prevention and control, dengue surveillance, and long-term sequelae of dengue.
Guerer, N.; Ban, J.
The present state of subsidies on major oil products (gasoline, kerosene, diesel and fuel oil) in OPEC Member Countries is analysed, in order to quantify their economic cost, keeping in mind the importance of reforming or gradually removing subsidies as one of the crucial economic challenges facing many Member Countries. The paper begins with a general definition and description of subsidies, then discusses briefly the key issues in reforming/removing them, with the potential benefits. Following a section on subsidy level estimations in recent years, the subsidy implications in terms of the accruing budget burden and foregone revenues from additional export potential are presented. This is together with some arguments supporting the process of adjustment towards internationally competitive prices for oil products as an inescapable development for Member Countries; this should progress in gradual, but firm steps. (author)
Full Text Available The start of the financial crisis in mid-2007 at a global scale had a major impact on the European Union’s economy. All member states have been economically affected, but the social effects were mainly of large amplitude. This paper focuses precisely on analysing the social costs which the economic-financial crisis has generated in the European Union. After finishing the study we have noticed that numerous social consequences of the recession have manifested intensely since the beginning of the crisis and continue to do so even today. These consist in the increase of poverty and social exclusion, rise in unemployment, decrease in birth rate, changes regarding the migration process, reduction in income, excessive indebtedness, the disparities between countries contributing to the augmentation of all these.
Connock Martin J
Full Text Available Abstract Background Acromegaly, an orphan disease usually caused by a benign pituitary tumour, is characterised by hyper-secretion of growth hormone (GH and insulin-like growth factor I (IGF-1. It is associated with reduced life expectancy, cardiovascular problems, a variety of insidiously progressing detrimental symptoms and metabolic malfunction. Treatments include surgery, radiotherapy and pharmacotherapy. Pegvisomant (PEG is a genetically engineered GH analogue licensed as a third or fourth line option when other treatments have failed to normalise IGF-1 levels. Methods Evidence about effectiveness and cost-effectiveness of PEG was systematically reviewed. Data were extracted from published studies and used for a narrative synthesis of evidence. A decision analytical economic model was identified and modified to assess the cost-effectiveness of PEG. Results One RCT and 17 non-randomised studies were reviewed for effectiveness. PEG substantially reduced and rapidly normalised IGF-1 levels in the majority of patients, approximately doubled GH levels, and improved some of the signs and symptoms of the disease. Tumour size was unaffected at least in the short term. PEG had a generally safe adverse event profile but a few patients were withdrawn from treatment because of raised liver enzymes. An economic model was identified and adapted to estimate the lower limit for the cost-effectiveness of PEG treatment versus standard care. Over a 20 year time horizon the incremental cost-effectiveness ratio was £81,000/QALY and £212,000/LYG. To reduce this to £30K/QALY would require a reduction in drug cost by about one third. Conclusion PEG is highly effective for improving patients' IGF-1 level. Signs and symptoms of disease improve but evidence is lacking about long term effects on improved signs and symptoms of disease, quality of life, patient compliance and safety. Economic evaluation indicated that if current standards (UK for determining cost
Prince, B.E.; Turnage, J.C.
1 - Description of problem or function: ORSIM is an electric power generating system integration model which simulates the multi-year operation of a mixed power system consisting of fossil, nuclear, hydroelectric, and pumped-storage units. For any specified refueling schedule for nuclear units and future load forecast, the model determines a plan of operation for the system which attempts to minimize the total discounted operating cost over a specified study period. The analysis considers the effects of forced outages, spinning reserve operating constraints, and scheduled introduction and retirement of generating stations. The model determines a maintenance schedule for the non-nuclear stations (nuclear stations are maintained during refueling outages) and the optimum allocation of energy-fixed nuclear and hydroelectric resources. It calculates the expected energy generated by each station in the system, by period over the planning horizon, based on input or calculated incremental operating cost. It also calculates the expected loss-of- load probability and un-served energy demand for each period in the planning horizon. An optimum operating plan, designed to minimize the discounted total production cost, is then calculated, as are the costs of operating each station in the system and the discounted total production cost for the derived plan of operation. 2 - Method of solution: ORSIM searches for a particular mode of operation which, over a multi-year planning horizon, will minimize the total system operating cost of a particular electric power generation system discounted to the beginning of the planning horizon. It does this by: (a) calculating the planned maintenance outages for all units; (b) estimating the incremental discounted cost of energy produced by each station in the system for every subinterval of the planning horizon; (c) utilizing the incremental discounted costs of energy generation to calculate, via probabilistic simulation, the economic optimum
Wong, K.P.; Doan, K.
This paper develops an efficient, recursive algorithm for determining the economic power dispatch of thermal generators within the unit commitment environment. A method for incorporating the operation limits of all on-line generators and limits due to ramping generators is developed in the paper. The developed algorithm is amenable for computer implementation using the artificial intelligence programming language, Prolog. The performance of the developed algorithm is demonstrated through its application to evaluate the costs of dispatching 13 thermal generators within a generator schedule in a 24-hour schedule horizon
Manuel Alejandro Cardenete; M. Carmen Delgado; Ricardo Molero-Simarro
El objetivo de este artículo es analizar la evolución de la competitividad externa de la economía andaluza. Para ello se toman dos dimensiones principales de análisis: En primer lugar, se analiza la evolución de los costes laborales unitarios y su relación con el desempeño exportador andaluz a nivel agregado. En segundo lugar, se analizarán una serie de indicadores de la actuación tanto empresarial, como del sector público, en los ámbitos determinantes de la posición competitiva regional a ni...
Pothiya, Saravuth; Kongprawechnon, Waree [School of Communication, Instrumentation and Control, Sirindhorn International Institute of Technology, Thammasat University, P.O. Box 22, Pathumthani (Thailand); Ngamroo, Issarachai [Center of Excellence for Innovative Energy Systems, Faculty of Engineering, King Mongkut' s Institute of Technology Ladkrabang, Bangkok 10520 (Thailand)
This paper presents a novel and efficient optimisation approach based on the ant colony optimisation (ACO) for solving the economic dispatch (ED) problem with non-smooth cost functions. In order to improve the performance of ACO algorithm, three additional techniques, i.e. priority list, variable reduction, and zoom feature are presented. To show its efficiency and effectiveness, the proposed ACO is applied to two types of ED problems with non-smooth cost functions. Firstly, the ED problem with valve-point loading effects consists of 13 and 40 generating units. Secondly, the ED problem considering the multiple fuels consists of 10 units. Additionally, the results of the proposed ACO are compared with those of the conventional heuristic approaches. The experimental results show that the proposed ACO approach is comparatively capable of obtaining higher quality solution and faster computational time. (author)
Li, Li; Zhang, Qingling; Zhu, Baoyan
This paper establishes a bio-economic singular Markovian jump model by considering the price of the commodity as a Markov chain. The controller is designed for this system such that its biomass achieves the specified range with the least cost in a finite-time. Firstly, this system is described by Takagi-Sugeno fuzzy model. Secondly, a new design method of fuzzy state-feedback controllers is presented to ensure not only the regularity, nonimpulse, and stochastic singular finite-time boundedness of this kind of systems, but also an upper bound achieved for the cost function in the form of strict linear matrix inequalities. Finally, two examples including a practical example of eel seedling breeding are given to illustrate the merit and usability of the approach proposed in this paper.
Brennan, Victoria K; Colosia, Ann D; Copley-Merriman, Catherine; Mauskopf, Josephine; Hass, Bastian; Palencia, Roberto
To identify cost estimates related to myocardial infarction (MI) or stroke in patients with type 2 diabetes mellitus (T2DM) for use in economic models. A systematic literature review was conducted. Electronic databases and conference abstracts were screened against inclusion criteria, which included studies performed in patients who had T2DM before experiencing an MI or stroke. Primary cost studies and economic models were included. Costs were converted to 2012 pounds sterling. Fifty-four studies were identified: 13 primary cost studies and 41 economic evaluations using secondary sources for complication costs. Primary studies provided costs from 10 countries. Estimates for a fatal event ranged from £2482-£5222 for MI and from £4900-£6694 for stroke. Costs for the year a non-fatal event occurred ranged from £5071-£29,249 for MI and from £5171-£38,732 for stroke. Annual follow-up costs ranged from £945-£1616 for an MI and from £4704-£12,926 for a stroke. Economic evaluations from 12 countries were identified, and costs of complications showed similar variability to the primary studies. The costs identified within primary studies varied between and within countries. Many studies used costs estimated in studies not specific to patients with T2DM. Data gaps included a detailed breakdown of resource use, which affected the ability to compare data across countries. In the development of economic models for patients with T2DM, the use of accurate estimates of costs associated with MI and stroke is important. When country-specific costs are not available, clear justification for the choice of estimates should be provided.
Hodge, Brian S [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Kroposki, Benjamin D [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Du, Ershun [Tsinghua University; Zhang, Ning [Tsinghua University; Kang, Chongqing [Tsinghua University; Xia, Qing [Tsinghua University
Concentrating solar power (CSP) plants are able to provide both renewable energy and operational flexibility at the same time due to its thermal energy storage (TES). It is ideal generation to power systems lacking in flexibility to accommodate variable renewable energy (VRE) generation such as wind power and photovoltaics. However, its investment cost currently is too high to justify its benefit in terms of providing renewable energy only. In this paper we evaluate the economic benefit of CSP in high renewable energy penetrated power systems from two aspects: generating renewable energy and providing operational flexibility to help accommodating VRE. In order to keep the same renewable energy penetration level during evaluation, we compare the economic costs between the system with a high share of VRE and another in which some part of the VRE generation is replaced by CSP generation. The generation cost of a power system is analyzed through chronological operation simulation over a whole year. The benefit of CSP is quantified into two parts: (1) energy benefit - the saving investment of substituted VRE generation and (2) flexibility benefit - the reduction in operating cost due to substituting VRE with CSP. The break-even investment cost of CSP is further discussed. The methodology is tested on a modified IEEE RTS-79 system. The economic justifications of CSP are demonstrated in two practical provincial power systems with high penetration of renewable energy in northwestern China, Qinghai and Gansu, where the former province has massive inflexible thermal power plants but later one has high share of flexible hydro power. The results suggest that the CSP is more beneficial in Gansu system than in Qinghai. The levelized benefit of CSP, including both energy benefit and flexibility benefit, is about 0.177-0.191 $/kWh in Qinghai and about 0.238-0.300 $/kWh in Gansu, when replacing 5-20% VRE generation with CSP generation.
Full Text Available William Montgomery,1 Masayo Sato,2 Yasuo Nagasaka,2 Jeffrey Vietri3 1Global Patient Outcomes & Real World Evidence, Eli Lilly Australia Pty Ltd., West Ryde, Australia; 2Medical Development Unit Japan, Eli Lilly Japan K.K., Kobe, Japan; 3Kantar Health, Horsham, PA, USA Background: Few data are available that provide estimates of the economic impact of chronic lower back pain (CLBP in Japan. The current study estimated the patient burden and the direct and indirect medical costs associated with CLBP in Japan using data from a large cross-sectional patient survey. CLBP was hypothesized to be associated with a considerable burden of illness and a large economic impact.Methods: Study participants completed the Japan National Health and Wellness Survey in 2014, which included measures of health-related quality of life (HRQoL, work impairment, impairment to daily activities, and healthcare service use. Data from those reporting CLBP (N=392 were contrasted against those from matched controls without back pain, using age and sex-adjusted models.Results: CLBP patients reported significantly lower HRQoL relative to matched controls. Age- and sex-adjusted models estimated mean annual per patient direct and indirect costs attributable to CLBP to be ¥1,820,297 ($15,239 or €12,551 and ¥1,479,899 ($12,389 or €10,203, respectively, with the majority of direct costs related to hospital expenses (¥1,584,759, which is equivalent to $13,267 and €10,927. In estimating the economic impact of CLBP on society, the CLBP respondents were estimated to include 1,508,524 individuals when extrapolated to the Japanese population (815,461 of them employed. Ultimately, this represented approximately ¥1.2 trillion ($10 billion and €8.3 billion per year in lost productivity at the time of this study.Conclusion: This study of patients with CLBP in Japan has shown it to be associated with a significant burden on patients and to have a considerable negative impact on the
Sienicki, James J. [Argonne National Lab. (ANL), Argonne, IL (United States). Nuclear Engineering Division; Lv, Qiuping [Argonne National Lab. (ANL), Argonne, IL (United States). Nuclear Engineering Division; Moisseytsev, Anton [Argonne National Lab. (ANL), Argonne, IL (United States). Nuclear Engineering Division; Bucknor, Matthew [Argonne National Lab. (ANL), Argonne, IL (United States). Nuclear Engineering Division
BgtL, LLC (BgtL) is focused on developing and commercializing its proprietary compact technology for processes in the energy sector. One such application is a compact high efficiency Thermal Energy Storage (TES) system that utilizes the heat of fusion through phase change between solid and liquid to store and release energy at high temperatures and incorporate state-of-the-art insulation to minimize heat dissipation. BgtL’s TES system would greatly improve the economics of existing nuclear and coal-fired power plants by allowing the power plant to store energy when power prices are low and sell power into the grid when prices are high. Compared to existing battery storage technology, BgtL’s novel thermal energy storage solution can be significantly less costly to acquire and maintain, does not have any waste or environmental emissions, and does not deteriorate over time; it can keep constant efficiency and operates cleanly and safely. BgtL’s engineers are experienced in this field and are able to design and engineer such a system to a specific power plant’s requirements. BgtL also has a strong manufacturing partner to fabricate the system such that it qualifies for an ASME code stamp. BgtL’s vision is to be the leading provider of compact systems for various applications including energy storage. BgtL requests that all technical information about the TES designs be protected as proprietary information. To honor that request, only non-proprietay summaries are included in this report.
National Oceanic and Atmospheric Administration, Department of Commerce — This dataset combines the research results from a number of papers carried out under the study "Assessment of Economic Benefits and Costs of Marine Managed Areas in...
National Oceanic and Atmospheric Administration, Department of Commerce — This dataset combines the research results from a number of papers carried out under the study "Assessment of Economic Benefits and Costs of Marine Managed Areas in...
The business risks of nuclear plant ownership are identified as a constraint on the expanded use of nuclear power. Such risks stem from the exacting demands placed on owner/operator organizations of current plants to demonstrate ongoing compliance with safety regulations and the resulting high costs for operation and maintenance. This paper describes the Modular High-Temperature Gas-Cooled Reactor (MHTGR) design, competitive economics, and approach to reducing the business risks of nuclear plant ownership
Mochamad Nasrullah; Nurlaila
The government plan to build Experimental Power Reactor (EPR) requires measurable economic assessment. The purpose of the study was to recalculate Gas Turbine High Temperature Reactor of 300 MWe (GTHTR 300) and compare the results with reference data. Then calculate generation cost of GTHTR 3, 5 and 10 MWe using the scale factor calculation. The methodology used is covered the generation cost calculation using the Mini G4Econs spread sheet models published by IAEA. Result of the verification calculation showed that a relatively similar, which means that the calculation model could be used to calculate for same other cases. Afterward, using scale factor, smaller scale reactor could be calculated. The calculation result show that electricity generation cost of SMR-HTR type with load factor 90% and discount rate 10% for power capacity 3, 5 and 10 MWe are 29.5, 22.68 and 16.17 cents$/kWh respectively. However, because the EPR is planning to be built as a non-commercial power reactors, then 5 % and 3 % of discount rate could be chosen, each of those discount rate will result electricity generation cost of 10.37 cents$/kWh and 8.56 cents$/kWh respectively. These result could be considered by the government for developing SMR type of HTR. (author)
Weimar, Mark R.; Wood, Thomas W.; Reichmuth, Barbara A.; Johnson, Wayne L.
This paper analyzes outcomes for a 3000 MWt High Temperature Gas Reaction nuclear power plant, given price and cost assumptions, and determined what level of hydrogen and electricity production would optimize the plant economically and environmentally (carbon reduction). The tradeoff between producing hydrogen through steam methane reformation and producing electricity is so disproportionate, that advanced reactors will likely be used only as peaking plants for electricity unless policymakers intervene with incentives to change the mix of electricity and hydrogen. The magnitude of the increase in electric prices or decrease in hydrogen prices required to allow electricity production indicate that substantial error in cost estimates would be required to change our analysis.
Grimes, Caris E; Quaife, Matthew; Kamara, Thaim B; Lavy, Christopher B D; Leather, Andy J M; Bolkan, Håkon A
The Lancet Commission on Global Surgery estimated that low/middle-income countries will lose an estimated cumulative loss of US$12.3 trillion from gross domestic product (GDP) due to the unmet burden of surgical disease. However, no country-specific data currently exist. We aimed to estimate the costs to the Sierra Leone economy from death and disability which may have been averted by surgical care. We used estimates of total, met and unmet need from two main sources-a cluster randomised, cross-sectional, countrywide survey and a retrospective, nationwide study on surgery in Sierra Leone. We calculated estimated disability-adjusted life years from morbidity and mortality for the estimated unmet burden and modelled the likely economic impact using three different methods-gross national income per capita, lifetime earnings foregone and value of a statistical life. In 2012, estimated, discounted lifetime losses to the Sierra Leone economy from the unmet burden of surgical disease was between US$1.1 and US$3.8 billion, depending on the economic method used. These lifetime losses equate to between 23% and 100% of the annual GDP for Sierra Leone. 80% of economic losses were due to mortality. The incremental losses averted by scale up of surgical provision to the Lancet Commission target of 80% were calculated to be between US$360 million and US$2.9 billion. There is a large economic loss from the unmet need for surgical care in Sierra Leone. There is an immediate need for massive investment to counteract ongoing economic losses. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Full Text Available Objective: This article provides a non-technical introduction to analyses of fertility which are based on a rational-choice paradigm and which acknowledge that raising children may have a strong impact on the well-being of parents that can be described in terms of costs and benefits. It surveys different types of economic fertility models which can be used to address a variety of research questions, and it also discusses some basic strengths and weaknesses of applying economic analyses in this particular field. Results: Starting from a seminal contribution by Becker (1960 which may have been of little use for applied research or for interdisciplinary work, the economic theory of fertility has unfolded a differentiated research programme with indispensable contributions to the broader field of fertility research. Important features are the inclusion of (i different bargaining positions and differing incentives of partners interacting in fertility choices; (ii simultaneous decisions regarding labour force participation (as well as education and fertility, and the role played by employers, labour market institutions, and other public interventions; (iii the idea that children (or their "human capital" are investment goods with various kinds of returns that may be dispersed over an extremely long period of time, are subject to enormous uncertainties, and are strongly influenced by the social context and, again, by public policies. Conclusions: Economic aspects and elements of economic models should be included in any large-scale attempt at understanding fertility behaviour through interdisciplinary research. Improvements in the data infrastructure, which are only partly underway thus far, would be an important pre-requisite.
Emanuel, Ezekiel J; Ubel, Peter A; Kessler, Judd B; Meyer, Gregg; Muller, Ralph W; Navathe, Amol S; Patel, Pankaj; Pearl, Robert; Rosenthal, Meredith B; Sacks, Lee; Sen, Aditi P; Sherman, Paul; Volpp, Kevin G
Behavioral economics provides insights about the development of effective incentives for physicians to deliver high-value care. It suggests that the structure and delivery of incentives can shape behavior, as can thoughtful design of the decision-making environment. This article discusses several principles of behavioral economics, including inertia, loss aversion, choice overload, and relative social ranking. Whereas these principles have been applied to motivate personal health decisions, retirement planning, and savings behavior, they have been largely ignored in the design of physician incentive programs. Applying these principles to physician incentives can improve their effectiveness through better alignment with performance goals. Anecdotal examples of successful incentive programs that apply behavioral economics principles are provided, even as the authors recognize that its application to the design of physician incentives is largely untested, and many outstanding questions exist. Application and rigorous evaluation of infrastructure changes and incentives are needed to design payment systems that incentivize high-quality, cost-conscious care.
de Lissovoy, Greg; Fraeman, Kathy; Teerlink, John R; Mullahy, John; Salon, Jeff; Sterz, Raimund; Durtschi, Amy; Padley, Robert J
Acute heart failure (AHF) is the leading cause of hospital admission among older Americans. The Randomized EValuation of Intravenous Levosimendan Efficacy (REVIVE II) trial compared patients randomly assigned to a single infusion of levosimendan (levo) or placebo (SOC), each in addition to local standard treatments for AHF. We report an economic analysis of REVIVE II from the hospital perspective. REVIVE II enrolled patients (N = 600) hospitalized for treatment of acute decompensated heart failure (ADHF) who remained dyspneic at rest despite treatment with intravenous diuretics. Case report forms documented index hospital treatment (drug administration, procedures, days of treatment by care unit), as well as subsequent hospital and emergency department admissions during follow-up ending 90 days from date of randomization. These data were used to impute cost of admission based on an econometric cost function derived from >100,000 ADHF hospital billing records selected per REVIVE II inclusion criteria. Index admission mean length of stay (LOS) was shorter for the levo group compared with standard of care (SOC) (7.03 vs 8.96 days, P = 0.008) although intensive care unit (ICU)/cardiac care unit (CCU) days were similar (levo 2.88, SOC 3.22, P = 0.63). Excluding cost for levo, predicted mean (median) cost for the index admission was levo US $13,590 (9,458), SOC $19,021 (10,692) with a difference of $5,431 (1,234) favoring levo (P = 0.04). During follow-up through end of study day 90, no significant differences were observed in numbers of hospital admissions (P = 0.67), inpatient days (P = 0.81) or emergency department visits (P = 0.41). Cost-effectiveness was performed with a REVIVE-II sub-set conforming to current labeling, which excluded patients with low baseline blood pressure. Assuming an average price for levo in countries where currently approved, there was better than 50% likelihood that levo was both cost-saving and improved survival. Likelihood that levo would
Padula, William V; McQueen, Robert Brett; Pronovost, Peter J
The Second Panel on Cost-Effectiveness in Health and Medicine convened on December 7, 2016 at the National Academy of Medicine to disseminate their recommendations for conduct, methodological practices, and reporting of cost-effectiveness analyses (CEAs). Following its summary, panel proceedings included lengthy discussions including the field's struggle to disseminate findings efficiently through peer-reviewed literature to target audiences. With editors of several medical and outcomes research journals in attendance, there was consensus that findings of cost-effectiveness analyses do not effectively reach other researchers or health care providers. The audience members suggested several solutions including providing additional training to clinicians in cost-effectiveness research and requiring that cost-effectiveness models are made publicly available. However, there remains the questions of whether making economic modelers' work open-access through journals is fair under the defense that these models remain one's own intellectual property, or whether journals can properly manage the peer-review process specifically for cost-effectiveness analyses. In this article, we elaborate on these issues and provide some suggested solutions that may increase the dissemination and application of cost-effectiveness literature to reach its intended audiences and ultimately benefit the patient. Ultimately, it is our combined view as economic modelers and clinicians that cost-effectiveness results need to reach the clinician to improve the efficiency of medical practice, but that open-access models do not improve clinician access or interpretation of the economics of medicine.
Child Care Aware of America, 2012
"Parents and the High Cost of Child Care: 2012 Report" presents 2011 data reflecting what parents pay for full-time child care in America. It includes average fees for both child care centers and family child care homes. Information was collected through a survey conducted in January 2012 that asked for the average costs charged for…
why high socio-economic class women in the Cape Metropole decide ... as barriers to breast-feeding include a lack of knowledge and experience (38%) as well as a lack of facilities at public ... private practising paediatrician in Stellenbosch for face validity. .... While mothers (n = 39; 70.9%) indicated that the facilities at work.
Steenkamp, J.E.B.M.; Geyskens, I.
Transaction cost economics (TCE) is probably the most widely accepted theory on how firms can gain competitive advantage through efficient organization of their economic transactions. However, by focusing on the competitive environment in which companies operate, it abstracts from the cultural
Harrison, G.W.; Kristroem, B.
Our most important conclusion is that unilateral increases in carbon, diesel and petrol taxes do not appear to generate emission reductions that are sufficient to justify the cost they impose on the consumers. Using twice the economic gross benefit estimated by IPCC WG3 per ton of CO2 avoided, the benefit is of the order of one percent of the costs for individuals or households for carbon, diesel or petrol taxes. The model we use is incomplete in a number of important parameters. Specifically, we need to (1) add better data on the differences in factor endowments of households, to better reflect differences in the income sources; (2) incorporate data-based estimates of leisure consumption in the benchmark, as well as labor supply elasticities for different household types; and (3) employ data-based estimates of differences in carbon emissions in foreign countries relative to Sweden. The model may also be incomplete in terms of it's treatment of the economic structure of some sectors. 38 refs., 13 tabs
Harrison, G.W. [South Carolina Univ., Columbia, SC (United States). Dept. of Economics, College of Business Administration; Kristroem, B. [Swedish Univ. of Agricultural Sciences, Umeaa (Sweden). Dept. of Forest Economics
Our most important conclusion is that unilateral increases in carbon, diesel and petrol taxes do not appear to generate emission reductions that are sufficient to justify the cost they impose on the consumers. Using twice the economic gross benefit estimated by IPCC WG3 per ton of CO2 avoided, the benefit is of the order of one percent of the costs for individuals or households for carbon, diesel or petrol taxes. The model we use is incomplete in a number of important parameters. Specifically, we need to (1) add better data on the differences in factor endowments of households, to better reflect differences in the income sources; (2) incorporate data-based estimates of leisure consumption in the benchmark, as well as labor supply elasticities for different household types; and (3) employ data-based estimates of differences in carbon emissions in foreign countries relative to Sweden. The model may also be incomplete in terms of it`s treatment of the economic structure of some sectors. 38 refs., 13 tabs.
Full Text Available The article considers the costs of the interaction between the state and business as a threat to the development of the economy of the Russian Federation from the point of view of ensuring economic security. The authors identified significant obstacles both from the business and from the government side, which pose a threat to economic security. The study is of interest for the further development of a system of providing the economic security of the Russian Federation.
Enslin, Johan (Petra Solar, Inc., South Plainfield, NJ); Hamaoui, Ronald (Petra Solar, Inc., South Plainfield, NJ); Gonzalez, Sigifredo; Haddad, Ghaith (Petra Solar, Inc., South Plainfield, NJ); Rustom, Khalid (Petra Solar, Inc., South Plainfield, NJ); Stuby, Rick (Petra Solar, Inc., South Plainfield, NJ); Kuran, Mohammad (Petra Solar, Inc., South Plainfield, NJ); Mark, Evlyn (Petra Solar, Inc., South Plainfield, NJ); Amarin, Ruba (Petra Solar, Inc., South Plainfield, NJ); Alatrash, Hussam (Petra Solar, Inc., South Plainfield, NJ); Bower, Ward Isaac; Kuszmaul, Scott S.; Sena-Henderson, Lisa; David, Carolyn; Akhil, Abbas Ali
Initiated in 2008, the SEGIS initiative is a partnership involving the U.S. DOE, Sandia National Laboratories, private sector companies, electric utilities, and universities. Projects supported under the initiative have focused on the complete-system development of solar technologies, with the dual goal of expanding renewable PV applications and addressing new challenges of connecting large-scale solar installations in higher penetrations to the electric grid. Petra Solar, Inc., a New Jersey-based company, received SEGIS funds to develop solutions to two of these key challenges: integrating increasing quantities of solar resources into the grid without compromising (and likely improving) power quality and reliability, and moving the design from a concept of intelligent system controls to successful commercialization. The resulting state-of-the art technology now includes a distributed photovoltaic (PV) architecture comprising AC modules that not only feed directly into the electrical grid at distribution levels but are equipped with new functions that improve voltage stability and thus enhance overall grid stability. This integrated PV system technology, known as SunWave, has applications for 'Power on a Pole,' and comes with a suite of technical capabilities, including advanced inverter and system controls, micro-inverters (capable of operating at both the 120V and 240V levels), communication system, network management system, and semiconductor integration. Collectively, these components are poised to reduce total system cost, increase the system's overall value and help mitigate the challenges of solar intermittency. Designed to be strategically located near point of load, the new SunWave technology is suitable for integration directly into the electrical grid but is also suitable for emerging microgrid applications. SunWave was showcased as part of a SEGIS Demonstration Conference at Pepco Holdings, Inc., on September 29, 2011, and is presently
Full Text Available In this chapter we discuss the economics of climate change. We begin with a discussion of economic considerations that are important to take into account when designing and evaluating climate policy, including cost effectiveness and efficiency. We then discuss specific policies at the state, national, and international level in light of these economic considerations. We have several recommendations for the path forward for climate policy. First, the goal of climate policy should be to reduce the damages caused by greenhouse gases. In addition to mitigation policy to reduce greenhouse gas concentrations in the atmosphere, one can also reduce the damages causes by greenhouse gases by adaptation measures that reduce our vulnerability to climate change impacts. Second, policy-makers should use incentive- (or market- based instruments as opposed to command and control policies (including quantity-based mandates whenever possible. Whenever unpriced emissions are the sole market failure, incentive-based instruments such as a carbon tax or cap and trade program are more likely to achieve the social optimum and maximize social net benefits [1, 2]. Lin and Prince  calculate that the optimal gasoline tax for the state of California is $1.37 per gallon. Our third recommendation is to address the risk of emissions leakage, which arises when only one jurisdiction (e.g., California imposes climate policy, but not the entire world. One way to reduce emissions leakage is to use the strategic distribution of emissions allowances to local producers. This method, known as “output-based allocation” or benchmarking, effectively subsidizes local producers and at least partially offsets the increase in their costs caused by an emissions cap . Importantly, only local production is eligible for an allocation of valuable allowances, providing a counterweight to the incentive for emission leakage. Our fourth recommendation is that if they are used instead
Kazuhiko, Kunitomi; Shusaku, Shiozawa; Xing, Yan
High Temperature Gas-cooled Reactor (HTGR) combined with a direct cycle gas turbine offers one of the most promising nuclear electricity generation options after 2010. Japan Atomic Energy Agency has been engaging in the basic design and development of Gas Turbine High Temperature Reactor 300 (GTHTR300) since 2003. Costs of capital, fuel, and operation and maintenance have been estimated. The capital cost of the GTHTR300 is lower than that of the existing light water reactor (LWR) because the generation efficiency is considerably higher whereas the construction cost is lower owing to the design simplicity of the gas turbine power conversion unit and the reactor safety system. The fuel cost is shown to equal that of LWR. The operation and maintenance cost has a slight advantage due to the use of chemically inert helium coolant. In sum, the cost of electricity for the GTHTR300 is estimated to be below US 3.3 cents/kWh (4 yen/kWh), which is about two-third of that of current LWRs in Japan. The results confirm that the net power generation cost of the GTHTR300 is much lower than that of the LWR, indicating that the GTHTR300 plant consisting of small-scale reactor units can be economically competitive to the latest large-scale LWR. (authors)
Kinchin, Irina; Doran, Christopher M
Suicide and non-fatal suicide behavior (NFSB) are significant problems faced by most countries. The objective of this research is to quantify the economic cost of suicide and NFSB in the Australian workforce and to examine the potential impact of introducing a workplace suicide prevention intervention to reduce this burden. The analysis used the best available suicide data, a well-established costing methodology, and a proven workplace intervention. In 2014, 903 workers died by suicide, 2303 workers harmed themselves resulting in full incapacity, and 11,242 workers harmed themselves resulting in a short absence from work. The present value of the economic cost of suicide and NFSB is estimated at $6.73 billion. Our analysis suggests the economic benefit of implementing a universal workplace strategy would considerably outweigh the cost of the strategy. For every one dollar invested, the benefits would be in excess of $1.50 ($1.11-$3.07), representing a positive economic investment. All variations of the key parameter hold the positive benefit-cost ratio. Rates of suicide and NFSB are far too high in Australia and elsewhere. More needs to be done to reduce this burden. Although workplace strategies are appropriate for those employed, these interventions must be used within a multifaceted approach that reflects the complex nature of self-harming behavior.
Full Text Available Suicide and non-fatal suicide behavior (NFSB are significant problems faced by most countries. The objective of this research is to quantify the economic cost of suicide and NFSB in the Australian workforce and to examine the potential impact of introducing a workplace suicide prevention intervention to reduce this burden. The analysis used the best available suicide data, a well-established costing methodology, and a proven workplace intervention. In 2014, 903 workers died by suicide, 2303 workers harmed themselves resulting in full incapacity, and 11,242 workers harmed themselves resulting in a short absence from work. The present value of the economic cost of suicide and NFSB is estimated at $6.73 billion. Our analysis suggests the economic benefit of implementing a universal workplace strategy would considerably outweigh the cost of the strategy. For every one dollar invested, the benefits would be in excess of $1.50 ($1.11–$3.07, representing a positive economic investment. All variations of the key parameter hold the positive benefit-cost ratio. Rates of suicide and NFSB are far too high in Australia and elsewhere. More needs to be done to reduce this burden. Although workplace strategies are appropriate for those employed, these interventions must be used within a multifaceted approach that reflects the complex nature of self-harming behavior.
West, R R
Many individual and societal decisions over purchase (or investment) involve consideration of timing, in that either the price may be paid now and the benefit enjoyed some time in the future or the converse the benefit enjoyed now and the price paid later. Since most individuals generally prefer the present to the future, economic theory has conventionally discounted future costs or benefits to estimate 'net present values'. The rationale for this is principally based on future uncertainty. In recent years, economists have turned their attention to valuing health as an economic 'good'. Observations of individual behaviour would imply that individuals discount future health, as other potential benefits, mostly because there is some uncertainty about their futures. Although economic theory is strongly predicated on the 'sovereignty of the individual', it does not necessarily follow that society discounts the future as do individuals, since for society the future is not so uncertain. Society's endorsement of many public health and preventive medicine objectives, which seek health gains in the future (rather than the present), imply that society's rate of discount may be appreciably lower than that of individuals. In immunisation, arguably one of the most effective of preventive measures, there is the additional benefit to others attributable to herd immunity. This paper argues that the future health gains for society arising from immunisation should not be underestimated by application of inappropriate discounting.
Odnoshevnaya Olga Aleksandrovna
Full Text Available The purpose of the article deals with the analysis of the concept transaction costs incurred by the agricultural enterprise in the course of their activities. To investigate the effect of transaction costs in the context of improving the economic security of the enterprise. Elements scientific novelty. As element of scientific novelty in the work optimization structure of the formative groups of transaction costs agriculture costs for enterprises is presented . With a view of the effectiveness increase business processes management in the enterprise optimization and provision expenses we consider it necessary to the select transaction costs in separate classification group. As a result of conducted work been detected was the number of research transaction costs agriculture enterprise and recommended conducted work such costs of recommended way. Theoretically was studied classification features of transaction costs for agricultural enterprises, as a condition for the full impact of their recording and that the state of economic security. The practical significance. For the study, the results justified the conclusion that the transaction costs – is a special category of costs, which requires a separate account management for the improvement of its economic security.
The economic benefits, cost analysis, and industrial uses of the manned space station are investigated. Mission payload costs are examined in relation to alternative architectures and projected technological evolution. Various approaches to industrial involvement for financing, development, and marketing of space station resources are described.
Oberje, E.J.M.; Kinderen, de R.J.A.; Evers, S.M.A.A.; Woerkum, van C.M.J.; Bruin, de M.
Background In light of the pressure to reduce unnecessary healthcare expenditure in the current economic climate, a systematic review that assesses evidence of cost effectiveness of adherence-enhancing interventions would be timely. Objective Our objective was to examine the cost effectiveness of
Wu Linchun; Qin Zhenya
Our world, including China (especially in big cities and foreland), is facing the increased global shortage of potable water and pollution of water. It is ideal to promote seawater desalination to satisfy the potable water demand in these areas. Among the various processes, MED, RO and VC have proven well developed and promising. Due to the inherent safety and its vapor produced with high parameters and features of small size and modular design, HTGR (High Temperature Gas-cooled Reactor) of 2x200MW is chosen as the energy source for the desalination in dual production of clean water and power. This paper discusses the techno-economic feasibility of different seawater desalting systems using 2x200MW HTGR in the areas mentioned above, that is, ST-MED (Steam Turbine Cycle), RO, MED/TVC, RO/MED and GT-MED (Gas Turbine Cycle). The exergy concept is used in calculating availability to get cost of energy in desalination, and power credit method is used in economic assessment of different systems to get reasonable evaluating, while economic-life levelized cost method is adopted for calculating electricity cost of referred HTGR plant. In addition, sensitivity analysis on ST-MED economy is also presented. (author)
Boardman, Ch.E. [GE Nuclear Energy San Jose (United States)
S-PRISM is an advanced Fast Reactor plant design that utilizes compact modular pool-type reactors sized to enable factory fabrication and an affordable prototype test of a single Nuclear Steam Supply System (NSSS) for design certification at minimum cost and risk. S-PRISM retains all of the key ALMR (advanced liquid metal reactor) design features including passive reactor shutdown, passive shutdown heat removal, and passive reactor cavity cooling that were developed under an earlier DOE program. Key factors that make S-PRISM competitive include: 1) The use of passive safety systems that eliminate the need for diesel generators and hardened active heat sinks to assure that sufficient heat is removed from the core, reactor, and containment systems following design and beyond design basis events. 2) A seven point advantage in the plant capacity factor (93 versus 86%) over a single large plant. 3) A much shorter construction schedule (45%) made possible by a modular design that allows near parallel (sequenced) construction of three relatively small, simple factory fabricated NSSSs instead of one large complex NSSS. This paper describes the approach, methods, and results of an in-depth economic assessment of S-PRISM. The assessment found that the generation cost from an NOAK plant would be less than 3 cents/kW-hr and that a design certification could be obtained in less than 15 years at a cost of 2.1 billion dollars. (authors)
A global economic analysis methodology is proposed in order to simplify the cost and the profitability assessment of energy and services delivered by photovoltaic (PV) systems. As examples, equations and graphic tools derived from this methodology give directly the overall discounted costs (ODC) of electricity delivered by grid-connected PV power plants and the ODC of water delivered by a stand-alone PV pumping system. The main criteria used for profitability analysis of PV projects are reviewed: net present value, internal rate of return and profitability index (PI). A simple method with associated equations and graphic tools is presented in order to assess the profitability of PV projects from their PI. Examples of profitability analysis of present and future grid-connected PV power plants built and operated by an independent power producers are presented and discussed, together with examples of stand-alone PV water pumping systems operated by the local community in developing countries. In both cases, equations and specific graphic tools are presented. Specific graphs can be used with different monetary units, different sizes and different investment costs of PV projects. (Author)
Tekola, Fasil; Mariam, Damen H; Davey, Gail
Endemic non-filarial elephantiasis or podoconiosis is a chronic and debilitating geochemical disease occurring in individuals exposed to red clay soil derived from alkalic volcanic rock. It is a major public health problem in countries in tropical Africa, Central America and North India. To estimate the direct and the average productivity cost attributable to podoconiosis, and to compare the average productivity time of podoconiosis patients with non-patients. Matched comparative cross sectional survey involving 702 study subjects (patients and non-patients) supplemented by interviews with key informants in Wolaita Zone, southern Ethiopia. Total direct costs of podoconiosis amounted to the equivalent of US$ 143 per patient per year. The total productivity loss for a patient amounted to 45% of the total working days per year, causing a monetary loss equivalent to US$ 63. In Wolaita zone, the overall cost of podoconiosis exceeds US$ 16 million per year. Podoconiosis has enormous economic impact in affected areas. Simple preventive measures (such as use of robust footwear) must be promoted by health policy makers.
S-PRISM is an advanced Fast Reactor plant design that utilizes compact modular pool-type reactors sized to enable factory fabrication and an affordable prototype test of a single Nuclear Steam Supply System (NSSS) for design certification at minimum cost and risk. S-PRISM retains all of the key ALMR (advanced liquid metal reactor) design features including passive reactor shutdown, passive shutdown heat removal, and passive reactor cavity cooling that were developed under an earlier DOE program. Key factors that make S-PRISM competitive include: 1) The use of passive safety systems that eliminate the need for diesel generators and hardened active heat sinks to assure that sufficient heat is removed from the core, reactor, and containment systems following design and beyond design basis events. 2) A seven point advantage in the plant capacity factor (93 versus 86%) over a single large plant. 3) A much shorter construction schedule (45%) made possible by a modular design that allows near parallel (sequenced) construction of three relatively small, simple factory fabricated NSSSs instead of one large complex NSSS. This paper describes the approach, methods, and results of an in-depth economic assessment of S-PRISM. The assessment found that the generation cost from an NOAK plant would be less than 3 cents/kW-hr and that a design certification could be obtained in less than 15 years at a cost of 2.1 billion dollars. (authors)
McCaffrey, Nikki; Agar, Meera; Harlum, Janeane; Karnon, Jonathon; Currow, David; Eckermann, Simon
The aim of this study was to evaluate the cost-effectiveness of a home-based palliative care model relative to usual care in expediting discharge or enabling patients to remain at home. Economic evaluation of a pilot randomised controlled trial with 28 days follow-up. Mean costs and effectiveness were calculated for the Palliative Care Extended Packages at Home (PEACH) and usual care arms including: days at home; place of death; PEACH intervention costs; specialist palliative care service use; acute hospital and palliative care unit inpatient stays; and outpatient visits. PEACH mean intervention costs per patient ($3489) were largely offset by lower mean inpatient care costs ($2450) and in this arm, participants were at home for one additional day on average. Consequently, PEACH is cost-effective relative to usual care when the threshold value for one extra day at home exceeds $1068, or $2547 if only within-study days of hospital admission are costed. All estimates are high uncertainty. The results of this small pilot study point to the potential of PEACH as a cost-effective end-of-life care model relative to usual care. Findings support the feasibility of conducting a definitive, fully powered study with longer follow-up and comprehensive economic evaluation.
Chambers, Jeffrey; Généreux, Philippe; Lee, Arthur; Lewin, Jack; Young, Christopher; Crittendon, Janna; Mann, Marita; Garrison, Louis P
Patients who undergo percutaneous coronary intervention (PCI) for severely calcified coronary lesions have long been known to have worse clinical and economic outcomes than patients with no or mildly calcified lesions. We sought to assess the likely cost-effectiveness of using the Diamondback 360(®) Orbital Atherectomy System (OAS) in the treatment of de novo, severely calcified lesions from a health-system perspective. In the absence of a head-to-head trial and long-term follow up, cost-effectiveness was based on a modeled synthesis of clinical and economic data. A cost-effectiveness model was used to project the likely economic impact. To estimate the net cost impact, the cost of using the OAS technology in elderly (⩾ 65 years) Medicare patients with de novo severely calcified lesions was compared with cost offsets. Elderly OAS patients from the ORBIT II trial (Evaluate the Safety and Efficacy of OAS in Treating Severely Calcified Coronary Lesions) [ClinicalTrials.gov identifier: NCT01092426] were indirectly compared with similar patients using observational data. For the index procedure, the comparison was with Medicare data, and for both revascularization and cardiac death in the following year, the comparison was with a pooled analysis of the Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI)/Acute Catheterization and Urgent Intervention Triage Strategy (ACUITY) trials. After adjusting for differences in age, gender, and comorbidities, the ORBIT II mean index procedure costs were 17% (p economic modeling, the recently approved coronary OAS device is projected to be highly cost-effective for patients who undergo PCI for severely calcified lesions. © The Author(s), 2015.
Chambers, Jeffrey; Généreux, Philippe; Lee, Arthur; Lewin, Jack; Young, Christopher; Crittendon, Janna; Mann, Marita; Garrison, Louis P.
Background: Patients who undergo percutaneous coronary intervention (PCI) for severely calcified coronary lesions have long been known to have worse clinical and economic outcomes than patients with no or mildly calcified lesions. We sought to assess the likely cost-effectiveness of using the Diamondback 360® Orbital Atherectomy System (OAS) in the treatment of de novo, severely calcified lesions from a health-system perspective. Methods and results: In the absence of a head-to-head trial and long-term follow up, cost-effectiveness was based on a modeled synthesis of clinical and economic data. A cost-effectiveness model was used to project the likely economic impact. To estimate the net cost impact, the cost of using the OAS technology in elderly (⩾ 65 years) Medicare patients with de novo severely calcified lesions was compared with cost offsets. Elderly OAS patients from the ORBIT II trial (Evaluate the Safety and Efficacy of OAS in Treating Severely Calcified Coronary Lesions) [ClinicalTrials.gov identifier: NCT01092426] were indirectly compared with similar patients using observational data. For the index procedure, the comparison was with Medicare data, and for both revascularization and cardiac death in the following year, the comparison was with a pooled analysis of the Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI)/Acute Catheterization and Urgent Intervention Triage Strategy (ACUITY) trials. After adjusting for differences in age, gender, and comorbidities, the ORBIT II mean index procedure costs were 17% (p < 0.001) lower, approximately US$2700. Estimated mean revascularization costs were lower by US$1240 in the base case. These cost offsets in the first year, on average, fully cover the cost of the device with an additional 1.2% cost savings. Even in the low-value scenario, the use of the OAS is cost-effective with a cost per life-year gained of US$11,895. Conclusions: Based on economic modeling
El-Hawary, M.E.; El-Hawary, F.; Mbamalu, G.A.N.
A questionnaire was mailed to ten Canadian utilities to determine the methods the utilities use in determining the incremental cost of delivering energy at any time. The questionnaire was divided into three parts: generation, transmission and general. The generation section dealt with heat rates, fuel, operation and maintenance, startup and shutdown, and method of prioritizing and economic evaluation of interchange transactions. Transmission dealt with inclusion of transmission system incremental maintenance costs, and transmission losses determination. The general section dealt with incremental costs aspects, and various other economic considerations. A summary is presented of responses to the questionnaire
The official Danish environmental plan involves a reduction of CO 2 within the next 30-50 years. This report describes the analysis of socio-economic cost/consequences of marginal CO 2 reduction by means of various technical solution models. Calculations by means of the special program subroutine SAMFOKO are based on energy balance in annual, monthly, daily and hourly scale. Heat and power savings as well as the development of decentralized power plants are considered in the supply model. Socio-economic consequences in form of charges and cost are discussed. (EG)
Mohammadi-ivatloo, Behnam; Rabiee, Abbas; Ehsan, Mehdi
Highlights: ► New approach to solve power systems dynamic economic dispatch. ► Considering Valve-point effect, prohibited operation zones. ► Proposing TVAC-IPSO algorithm. - Abstract: The objective of the dynamic economic dispatch (DED) problem is to schedule power generation for the online units for a given time horizon economically, satisfying various operational constraints. Due to the effect of valve-point effects and prohibited operating zones (POZs) in the generating units cost functions, DED problem is a highly non-linear and non-convex optimization problem. The DED problem even may be more complicated if transmission losses and ramp-rate constraints are taken into account. This paper presents a novel and heuristic algorithm to solve DED problem of generating units, by employing time varying acceleration coefficients iteration particle swarm optimization (TVAC-IPSO) method. The effectiveness of the proposed method is examined and validated by carrying out extensive tests on different test systems, i.e. 5-unit and 10-unit test systems. Valve-point effects, POZs and ramp-rate constraints along with transmission losses are considered. To examine the efficiency of the proposed TVAC-IPSO algorithm, comprehensive studies are carried out, which compare convergence properties of the proposed TVAC-IPSO approach with conventional PSO algorithm, in addition to the other recently reported approaches. Numerical results show that the TVAC-IPSO method has good convergence properties and the generation costs resulted from the proposed method are lower than other algorithms reported in recent literature.
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.
Jouan, A.; Jacquet-Francillon, N.; Cler, M.
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
Jouan, A.; Jacquet-Francillon, N.; Cler, M.; Chaudon, L.
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
This dissertation combines three perspectives on the potential of cost reductions of renewable energy--a relevant topic, as high energy costs have traditionally been cited as major reason to vindicate developments of fossil fuel and nuclear power plants, and to justify financial support mechanisms and special incentives for renewable energy generators. First, I highlight the role of market and policy drivers in an international comparison of upfront capital expenses of residential photovoltaic systems in Germany and the United States that result in price differences of a factor of two and suggest cost reduction opportunities. In a second article I examine engineering approaches and siting considerations of large-scale photovoltaic projects in the United States that enable substantial system performance increases and allow thus for lower energy costs on a levelized basis. Finally, I investigate future cost reduction options of wind energy, ranging from capital expenses, operating expenses, and performance over a project's lifetime to financing costs. The assessment shows both substantial further cost decline potential for mature technologies like land-based turbines, nascent technologies like fixed-bottom offshore turbines, and experimental technologies like floating offshore turbines. The following paragraphs summarize each analysis: International upfront capital cost comparison of residential solar systems: Residential photovoltaic (PV) systems were twice as expensive in the United States as in Germany in 2012. This price discrepancy stems primarily from differences in non-hardware or "soft" costs between the two countries, of which only 35% be explained by differences in cumulative market size and associated learning. A survey of German PV installers was deployed to collect granular data on PV soft costs in Germany, and the results are compared to those of a similar survey of U.S. PV installers. Non-module hardware costs and all analyzed soft costs are lower in
Baudouin, Amandine; Fargier, Emilie; Cerruti, Ariane; Dubromel, Amélie; Vantard, Nicolas; Ranchon, Florence; Schwiertz, Vérane; Salles, Gilles; Souquet, Pierre-Jean; Thomas, Luc; Bérard, Frédéric; Nancey, Stéphane; Freyer, Gilles; Trillet-Lenoir, Véronique; Rioufol, Catherine
In the context of health expenses control, reimbursement of high-cost medicines with a 'minor' or 'nonexistent' improvement in actual health benefit evaluated by the Haute Autorité de santé is revised by the decree of March 24, 2016 related to the procedure and terms of registration of high-cost pharmaceutical drugs. This study aims to set up the economic impact of this measure. A six months retrospective study was conducted within a French university hospital from July 1, 2015 to December 31, 2015. For each injectable high-cost anticancer drug prescribed to a patient with cancer, the therapeutic indication, its status in relation to the marketing authorization and the associated improvement in actual health benefit were examined. The total costs of these treatments, the cost per type of indication and, in the case of marketing authorization indications, the cost per improvement in actual health benefit were evaluated considering that all drugs affected by the decree would be struck off. Over six months, 4416 high-cost injectable anticancer drugs were prescribed for a total cost of 4.2 million euros. The costs of drugs with a minor or nonexistent improvement in actual benefit and which comparator is not onerous amount 557,564 euros. The reform of modalities of inscription on the list of onerous drugs represents a significant additional cost for health institutions (1.1 million euros for our hospital) and raises the question of the accessibility to these treatments for cancer patients. Copyright © 2017 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.
Ryu, Changkook; Khor, Adela; Sharifi, Vida N.; Swithenbank, Jim
Due to the growing market for sustainable energy, in order to increase the quality of the fuels, pellets are being produced from various materials such as wood and other biomass energy crops, and municipal waste. This paper presents the results from an economic feasibility study for pellet production using blends of two residue materials: coal tailings from coal cleaning and spent mushroom compost (SMC) from mushroom production. Key variables such as the mixture composition, raw material haulage and plant scale were considered and the production costs were compared to coal and biomass energy prices. For both wet materials, the moisture content was the critical parameter that influenced the fuel energy costs. The haulage distance of the raw materials was another factor that can pose a high risk. The results showed that the pellet production from the above two materials can be viable when a less energy-intensive drying process is utilised. Potential market outlets and ways to lower the costs are also discussed in this paper. (author)
Jacobs, Ulrich [Haarslev Industries A/S, Herlev (Denmark). Marketing and Business Development
New methods of the thermal utilization have to be created due to the fact that agricultural utilisation of sewage sludge and the use in the reclamation due to stringent limit values and enhanced quality criteria are available restricted in future. The incineration of mechanically dewatered and dried sewage sludge is performed in mono-combustion plants as well as in coal-fired power plants. The author of the contribution under consideration reports on the costs and economic efficiency of the drying of sewage sludge. The drying of sewage sludge may perform an important and reasonable contribution to the utilization of municipal sewage sludge. The selection of a suitable drying process should ever depend on the local realities. Proved and suitable technologies are available for every application. Before the decision for a certain provider, one should examine reference plants and consider specific experiences of the operator among the decision-making.
Cronshaw, Ian; Grafton, R. Quentin
We review the economic benefits and external costs of unconventional gas production (UCG) in the United States from a policy perspective. Based on an overview of state regulation in Pennsylvania, a state that has witnessed very rapid growth of gas production over the past 5 years, and global experiences we present 10 key principles that are proposed to reduce the risks and to increase the net rewards of UCG. Application of these principles has the potential to reduce the risks of UCG, especially at a local level, while maximizing the benefits of gas developments. - Highlights: • SWOT summary of unconventional gas developments. • Risks and returns of unconventional gas highlighted. • 10 principles given to reduce risks and increase rewards of gas extraction.
San-José, Luis A.; Sicilia, Joaquín; González-de-la-Rosa, Manuel; Febles-Acosta, Jaime
In this article, a deterministic inventory model with a ramp-type demand depending on price and time is developed. The cumulative holding cost is assumed to be a nonlinear function of time. Shortages are allowed and are partially backlogged. Thus, the fraction of backlogged demand depends on the waiting time and on the stock-out period. The aim is to maximize the total profit per unit time. To do this, a procedure that determines the economic lot size, the optimal inventory cycle and the maximum profit is presented. The inventory system studied here extends diverse inventory models proposed in the literature. Finally, some numerical examples are provided to illustrate the theoretical results previously propounded.
Full Text Available Dynamic economic dispatch (DED is one of the major operational decisions in electric power systems. DED problem is an optimization problem with an objective to determine the optimal combination of power outputs for all generating units over a certain period of time in order to minimize the total fuel cost while satisfying dynamic operational constraints and load demand in each interval. This paper presents an improved differential evolution (IDE method to solve the DED problem of generating units considering valve-point effects. Heuristic crossover technique and gene swap operator are introduced in the proposed approach to improve the convergence characteristic of the differential evolution (DE algorithm. To illustrate the effectiveness of the proposed approach, two test systems consisting of five and ten generating units have been considered. The results obtained through the proposed method are compared with those reported in the literature.
Bayesian decision theory, combined with conventional systems analysis techniques into the discipline called decision analysis, has been applied in this work to assess economic and social cost-benefits associated with reprocessing nuclear fuel. Particular attention in this paper is given to the models which have been developed to place numerical estimates in dollar terms on the three categories of social risks that have been identified with reprocessing. These categories include: (1) health, environment, and safety, (2) diversion of fissile material, including sabotage, terrorist acts, and subnational diversion, and (3) nuclear proliferation, defined to be a diversion at the national level to obtain weapons capability. The emphasis is placed on the third category, as proliferation risk has not been treated elsewhere in a quantitative fashion; most arguments have in the main been qualitative conjectures put forth by political scientists
Young Eun Kim
Full Text Available Onchocerciasis (river blindness is a parasitic disease transmitted by blackflies. Symptoms include severe itching, skin lesions, and vision impairment including blindness. More than 99% of all cases are concentrated in sub-Saharan Africa. Fortunately, vector control and community-directed treatment with ivermectin have significantly decreased morbidity, and the treatment goal is shifting from control to elimination in Africa.We estimated financial resources and societal opportunity costs associated with scaling up community-directed treatment with ivermectin and implementing surveillance and response systems in endemic African regions for alternative treatment goals--control, elimination, and eradication. We used a micro-costing approach that allows adjustment for time-variant resource utilization and for the heterogeneity in the demographic, epidemiological, and political situation.The elimination and eradication scenarios, which include scaling up treatments to hypo-endemic and operationally challenging areas at the latest by 2021 and implementing intensive surveillance, would allow savings of $1.5 billion and $1.6 billion over 2013-2045 as compared to the control scenario. Although the elimination and eradication scenarios would require higher surveillance costs ($215 million and $242 million than the control scenario ($47 million, intensive surveillance would enable treatments to be safely stopped earlier, thereby saving unnecessary costs for prolonged treatments as in the control scenario lacking such surveillance and response systems.The elimination and eradication of onchocerciasis are predicted to allow substantial cost-savings in the long run. To realize cost-savings, policymakers should keep empowering community volunteers, and pharmaceutical companies would need to continue drug donation. To sustain high surveillance costs required for elimination and eradication, endemic countries would need to enhance their domestic funding capacity
Hanly, Paul A; Sharp, Linda
Most measures of the cancer burden take a public health perspective. Cancer also has a significant economic impact on society. To assess this economic burden, we estimated years of potential productive life lost (YPPLL) and costs of lost productivity due to premature cancer-related mortality in Ireland. All cancers combined and the 10 sites accounting for most deaths in men and in women were considered. To compute YPPLL, deaths in 5-year age-bands between 15 and 64 years were multiplied by average working-life expectancy. Valuation of costs, using the human capital approach, involved multiplying YPPLL by age-and-gender specific gross wages, and adjusting for unemployment and workforce participation. Sensitivity analyses were conducted around retirement age and wage growth, labour force participation, employment and discount rates, and to explore the impact of including household production and caring costs. Costs were expressed in €2009. Total YPPLL was lower in men than women (men = 10,873; women = 12,119). Premature cancer-related mortality costs were higher in men (men: total cost = €332 million, cost/death = €290,172, cost/YPPLL = €30,558; women: total cost = €177 million, cost/death = €159,959, cost/YPPLL = €14,628). Lung cancer had the highest premature mortality cost (€84.0 million; 16.5% of total costs), followed by cancers of the colorectum (€49.6 million; 9.7%), breast (€49.4 million; 9.7%) and brain & CNS (€42.4 million: 8.3%). The total economic cost of premature cancer-related mortality in Ireland amounted to €509.5 million or 0.3% of gross domestic product. An increase of one year in the retirement age increased the total all-cancer premature mortality cost by 9.9% for men and 5.9% for women. The inclusion of household production and caring costs increased the total cost to €945.7 million. Lost productivity costs due to cancer-related premature mortality are significant. The higher premature mortality cost in males than
Herzog, Thomas J.; Hu, Lilian; Monk, Bradley J.; Kiet, Tuyen; Blansit, Kevin; Kapp, Daniel S.; Yu, Xinhua
Objective. The objective of this study was to evaluate a cost-effectiveness strategy of bevacizumab in a subset of high-risk advanced ovarian cancer patients with survival benefit. Methods. A subset analysis of the International Collaboration on Ovarian Neoplasms 7 trial showed that additions of bevacizumab (B) and maintenance bevacizumab (mB) to paclitaxel (P) and carboplatin (C) improved the overall survival (OS) of high-risk advanced cancer patients. Actual and estimated costs of treatment were determined from Medicare payment. Incremental cost-effectiveness ratio per life-year saved was established. Results. The estimated cost of PC is $535 per cycle; PCB + mB (7.5 mg/kg) is $3,760 per cycle for the first 6 cycles and then $3,225 per cycle for 12 mB cycles. Of 465 high-risk stage IIIC (>1 cm residual) or stage IV patients, the previously reported OS after PC was 28.8 months versus 36.6 months in those who underwent PCB + mB. With an estimated 8-month improvement in OS, the incremental cost-effectiveness ratio of B was $167,771 per life-year saved. Conclusion. In this clinically relevant subset of women with high-risk advanced ovarian cancer with overall survival benefit after bevacizumab, our economic model suggests that the incremental cost of bevacizumab was approximately $170,000. PMID:24721817
overrun rates for compressor station material, labor, miscellaneous, land, and total costs are 3%, 60%, 2%, -14%, and 11%, respectively, and cost overruns for cost components are influenced by location and year of completion to different degrees. Monte Carlo models are developed and simulated to evaluate the feasibility of an Alaska in-state gas pipeline by assigning triangular distribution of the values of economic parameters. Simulated results show that the construction of an Alaska in-state natural gas pipeline is feasible at three scenarios: 500 million cubic feet per day (mmcfd), 750 mmcfd, and 1000 mmcfd.
Weber, W.; Hutter, J.