Cost-effectiveness of annual versus biennial screening mammography for women with high mammographic breast density.

Science.gov (United States)

Pataky, Reka; Ismail, Zahra; Coldman, Andrew J; Elwood, Mark; Gelmon, Karen; Hedden, Lindsay; Hislop, Greg; Kan, Lisa; McCoy, Bonnie; Olivotto, Ivo A; Peacock, Stuart

2014-12-01

The sensitivity of screening mammography is much lower among women who have dense breast tissue, compared with women who have largely fatty breasts, and they are also at much higher risk of developing the disease. Increasing mammography screening frequency from biennially to annually has been suggested as a policy option to address the elevated risk in this population. The purpose of this study was to assess the cost-effectiveness of annual versus biennial screening mammography among women aged 50-79 with dense breast tissue. A Markov model was constructed based on screening, diagnostic, and treatment pathways for the population-based screening and cancer care programme in British Columbia, Canada. Model probabilities and screening costs were calculated from screening programme data. Costs for breast cancer treatment were calculated from treatment data, and utility values were obtained from the literature. Incremental cost-effectiveness was expressed as cost per quality adjusted life year (QALY), and probabilistic sensitivity analysis was conducted. Compared with biennial screening, annual screening generated an additional 0.0014 QALYs (95% CI: -0.0480-0.0359) at a cost of $819 ($ = Canadian dollars) per patient (95% CI: 506-1185), resulting in an incremental cost effectiveness ratio of $565,912/QALY. Annual screening had a 37.5% probability of being cost-effective at a willingness-to-pay threshold of $100,000/QALY. There is considerable uncertainty about the incremental cost-effectiveness of annual mammography. Further research on the comparative effectiveness of screening strategies for women with high mammographic breast density is warranted, particularly as digital mammography and density measurement become more widespread, before cost-effectiveness can be reevaluated. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Production of solidified high level wastes: a cost comparison of solidification processes

International Nuclear Information System (INIS)

1977-06-01

Differential cost estimates of the annual operating and maintenance costs and the capital costs for five HLW Waste Solidification Alternates were developed. The annual operating and maintenance cost estimates included the cost of labor, consumables, utilities, shipping casks, shipping and disposal at a federal repository. The capital cost included the cost of the component, installation and building. The differential cost estimates do not include equipment and facilities which are either shared with the reprocessing facility or are common between all of the alternates. Total annual cost differential between the five waste form alternates is summarized in tabular form. The Borosilicate Glass Alternate has the lowest total annual cost. The other alternates have higher costs which range from $6.6 M to $7.4 M per year higher than the Glass alternate with the Supercalcine being the highest cost at $7.4 M per year differential. The major items in the cost estimates are then disposal costs in the operating cost estimates and the HLW Storage Tanks in the capital cost estimates. The Supercalcine Multibarrier Alternate ships 180 canisters per year more than the other alternates and consequently has a significantly higher operating cost. However, off-setting this the Supercalcine Multibarrier Alternate does not require HLW Storage Tanks for decay because of the high heat conductivity of this product and correspondingly the capital cost for this alternate is significantly lower than the other alternates. The radiological risk values are correlated with the cost evaluation normalized to cost ($)/MWe-yr

evaluation of total annual costs of heat exchanger networks using

African Journals Online (AJOL)

user

after solving the first problem using RPA based heat integration gave a minimum total annual cost (TAC) of $237, ... mathematical programming and non-RPA based Hint software. ... The concept of pinch analysis evolved over the years.

78 FR 8389 - Natural Gas Pipelines; Project Cost and Annual Limits

Science.gov (United States)

2013-02-06

... Director of the Office of Energy Projects. The cost limits for calendar year 2013, as published in Table I.... ACTION: Final rule. SUMMARY: Pursuant to the authority delegated by 18 CFR 375.308(x)(1), the Director of the Office of Energy Projects (OEP) computes and publishes the project cost and annual limits for...

Assessment of the requirements for DOE's annual report to congress on low-level radioactive waste

International Nuclear Information System (INIS)

1987-10-01

The Low-level Radioactive Waste Policy Amendments Act of 1985 (PL99-240; LLRWPAA) requires the Department of Energy (DOE) to ''submit to Congress on an annual basis a report which: (1) summarizes the progress of low-level waste disposal siting and licensing activities within each compact region, (2) reviews the available volume reduction technologies, their applications, effectiveness, and costs on a per unit volume basis, (3) reviews interim storage facility requirements, costs, and usage, (4) summarizes transportation requirements for such wastes on an inter- and intra-regional basis, (5) summarizes the data on the total amount of low-level waste shipped for disposal on a yearly basis, the proportion of such wastes subjected to volume reduction, the average volume reduction attained,, and the proportion of wastes stored on an interim basis, and (6) projects the interim storage and final disposal volume requirements anticipated for the following year, on a regional basis (Sec. 7(b)).'' This report reviews and assesses what is required for development of the annual report specified in the LLRWPAA. This report addresses each of the subject areas set out in the LLRWPAA

12 CFR Appendix K to Part 226 - Total Annual Loan Cost Rate Computations for Reverse Mortgage Transactions

Science.gov (United States)

2010-01-01

... Appendix K to Part 226—Total Annual Loan Cost Rate Computations for Reverse Mortgage Transactions (a... loan cost rate for various transactions, as well as instructions, explanations, and examples for.... (2) Term of the transaction. For purposes of total annual loan cost disclosures, the term of a...

38th Annual Maintenance & Operations Cost Study for Colleges

Science.gov (United States)

Agron, Joe

2009-01-01

The nation's colleges are feeling the pinch of the economic downturn, and maintenance and operations (M&O) budgets especially are under pressure. This article presents data from the 38th annual Maintenance & Operations Cost Study for colleges that can help one in benchmarking expenditures at one's institution. Data provided only targets two-year…

38th Annual Maintenance & Operations Cost Study for Schools

Science.gov (United States)

Agron, Joe

2009-01-01

Despite the worst economic environment in generations, spending by K-12 institutions on maintenance and operations (M&O) held its own--defying historical trends that have shown M&O spending among the most affected in times of budget tightening. This article presents data from the 38th annual Maintenance & Operations Cost Study for…

Annual Direct Medical Costs of Diabetic Foot Disease in Brazil: A Cost of Illness Study

Directory of Open Access Journals (Sweden)

Cristiana M. Toscano

2018-01-01

Full Text Available The aim of this study was to estimate the annual costs for the treatment of diabetic foot disease (DFD in Brazil. We conducted a cost-of-illness study of DFD in 2014, while considering the Brazilian Public Healthcare System (SUS perspective. Direct medical costs of outpatient management and inpatient care were considered. For outpatient costs, a panel of experts was convened from which utilization of healthcare services for the management of DFD was obtained. When considering the range of syndromes included in the DFD spectrum, we developed four well-defined hypothetical DFD cases: (1 peripheral neuropathy without ulcer, (2 non-infected foot ulcer, (3 infected foot ulcer, and (4 clinical management of amputated patients. Quantities of each healthcare service was then multiplied by their respective unit costs obtained from national price listings. We then developed a decision analytic tree to estimate nationwide costs of DFD in Brazil, while taking into the account the estimated cost per case and considering epidemiologic parameters obtained from a national survey, secondary data, and the literature. For inpatient care, ICD10 codes related to DFD were identified and costs of hospitalizations due to osteomyelitis, amputations, and other selected DFD related conditions were obtained from a nationwide hospitalization database. Direct medical costs of DFD in Brazil was estimated considering the 2014 purchasing power parity (PPP (1 Int$ = 1.748 BRL. We estimated that the annual direct medical costs of DFD in 2014 was Int$ 361 million, which denotes 0.31% of public health expenses for this period. Of the total, Int$ 27.7 million (13% was for inpatient, and Int$ 333.5 million (87% for outpatient care. Despite using different methodologies to estimate outpatient and inpatient costs related to DFD, this is the first study to assess the overall economic burden of DFD in Brazil, while considering all of its syndromes and both outpatients and inpatients

Annual Direct Medical Costs of Diabetic Foot Disease in Brazil: A Cost of Illness Study.

Science.gov (United States)

Toscano, Cristiana M; Sugita, Tatiana H; Rosa, Michelle Q M; Pedrosa, Hermelinda C; Rosa, Roger Dos S; Bahia, Luciana R

2018-01-08

The aim of this study was to estimate the annual costs for the treatment of diabetic foot disease (DFD) in Brazil. We conducted a cost-of-illness study of DFD in 2014, while considering the Brazilian Public Healthcare System (SUS) perspective. Direct medical costs of outpatient management and inpatient care were considered. For outpatient costs, a panel of experts was convened from which utilization of healthcare services for the management of DFD was obtained. When considering the range of syndromes included in the DFD spectrum, we developed four well-defined hypothetical DFD cases: (1) peripheral neuropathy without ulcer, (2) non-infected foot ulcer, (3) infected foot ulcer, and (4) clinical management of amputated patients. Quantities of each healthcare service was then multiplied by their respective unit costs obtained from national price listings. We then developed a decision analytic tree to estimate nationwide costs of DFD in Brazil, while taking into the account the estimated cost per case and considering epidemiologic parameters obtained from a national survey, secondary data, and the literature. For inpatient care, ICD10 codes related to DFD were identified and costs of hospitalizations due to osteomyelitis, amputations, and other selected DFD related conditions were obtained from a nationwide hospitalization database. Direct medical costs of DFD in Brazil was estimated considering the 2014 purchasing power parity (PPP) (1 Int$ = 1.748 BRL). We estimated that the annual direct medical costs of DFD in 2014 was Int$ 361 million, which denotes 0.31% of public health expenses for this period. Of the total, Int$ 27.7 million (13%) was for inpatient, and Int$ 333.5 million (87%) for outpatient care. Despite using different methodologies to estimate outpatient and inpatient costs related to DFD, this is the first study to assess the overall economic burden of DFD in Brazil, while considering all of its syndromes and both outpatients and inpatients. Although we

Analysis of capital and operating costs associated with high level waste solidification processes

International Nuclear Information System (INIS)

Heckman, R.A.; Kniazewycz, B.G.

1978-03-01

An analysis was performed to evaluate the sensitivity of annual operating costs and capital costs of waste solidification processes to various parameters defined by the requirements of a proposed Federal waste repository. Five process methods and waste forms examined were: salt cake, spray calcine, fluidized bed calcine, borosilicate glass, and supercalcine multibarrier. Differential cost estimates of the annual operating and maintenance costs and the capital costs for the five HLW solidification alternates were developed

evaluation of total annual costs of heat exchanger networks using

African Journals Online (AJOL)

This study presents pinch analysis of some heat exchanger networks (HENs) problems using Hint integration (HINT) software. Three examples reported to have been solved using different approaches by various researchers to obtain the least possible total annual cost (TAC) were solved using the Hint software. In this work ...

Annual tax compliance costs for small businesses: a survey of tax practitioners in South Africa

Directory of Open Access Journals (Sweden)

Sharon Smulders

2012-10-01

Full Text Available This study provides a baseline measurement for annual tax compliance costs for small businesses. An empirical study performed amongst tax practitioners to identify and measure the annual tax compliance costs for small businesses throughout South Africa revealed that R7 030 per annum is the average fee that tax practitioners charge their small business clients to ensure that their tax returns (for four key taxes – income tax, provisional tax, value added tax and employees’ tax are prepared, completed and submitted as SARS requires. From the perspective of time and cost, preparing, completing and submitting VAT returns takes the longest and costs the most. It is evident that, overall, the compliance costs are regressive: the smaller the business, the heavier the burden.

Annual incremental health benefit costs and absenteeism among employees with and without rheumatoid arthritis.

Science.gov (United States)

Kleinman, Nathan L; Cifaldi, Mary A; Smeeding, James E; Shaw, James W; Brook, Richard A

2013-03-01

To assess the impact of rheumatoid arthritis (RA) on absence time, absence payments, and other health benefit costs from the perspective of US employers. Retrospective regression-controlled analysis of a database containing US employees' administrative health care and payroll data for those who were enrolled for at least 1 year in an employer-sponsored health insurance plan. Employees with RA (N = 2705) had $4687 greater average annual medical and prescription drug costs (P employees with RA used an additional 3.58 annual absence days, including 1.2 more sick leave and 1.91 more short-term disability days (both P Employees with RA have greater costs across all benefits than employees without RA.

77 FR 8724 - Natural Gas Pipelines; Project Cost and Annual Limits

Science.gov (United States)

2012-02-15

...] Natural Gas Pipelines; Project Cost and Annual Limits February 9, 2012. AGENCY: Federal Energy Regulatory... limits for natural gas pipelines blanket construction certificates for each calendar year. DATES: This... CFR Part 157 Administrative practice and procedure, Natural gas, Reporting and recordkeeping...

Annual mean sea level and its sensitivity to wind climate

Science.gov (United States)

Gerkema, Theo; Duran Matute, Matias

2017-04-01

Changes in relative mean sea level affect coastal areas in various ways, such as the risk of flooding, the evolution of barrier island systems, or the development of salt marshes. Long-term trends in these changes are partly masked by variability on shorter time scales. Some of this variability, for instance due to wind waves and tides (with the exception of long-period tides), is easily averaged out. In contrast, inter-annual variability is found to be irregular and large, of the order of several decimeters, as is evident from tide gauge records. This is why the climatic trend, typically of a few millimeters per year, can only be reliably identified by examining a record that is long enough to outweigh the inter-annual and decadal variabilities. In this presentation we examine the relation between the annual wind conditions from meteorological records and annual mean sea level along the Dutch coast. To do this, we need reliable and consistent long-term wind records. Some wind records from weather stations in the Netherlands date back to the 19th century, but they are unsuitable for trend analysis because of changes in location, height, surroundings, instrument type or protocol. For this reason, we will use only more recent, homogeneous wind records, from the past two decades. The question then is whether such a relatively short record is sufficient to find a convincing relation with annual mean sea level. It is the purpose of this work to demonstrate that the answer is positive and to suggest methods to find and exploit such a relation. We find that at the Dutch coast, southwesterly winds are dominant in the wind climate, but the west-east direction stands out as having the highest correlation with annual mean sea level. For different stations in the Dutch Wadden Sea and along the coast, we find a qualitatively similar pattern, although the precise values of the correlations vary. The inter-annual variability of mean sea level can already be largely explained by

76 FR 8293 - Natural Gas Pipelines; Project Cost and Annual Limits

Science.gov (United States)

2011-02-14

...] Natural Gas Pipelines; Project Cost and Annual Limits February 8, 2011. AGENCY: Federal Energy Regulatory... for natural gas pipelines blanket construction certificates for each calendar year. DATES: Effective... of Subjects in 18 CFR Part 157 Administrative practice and procedure, Natural Gas, Reporting and...

75 FR 8245 - Natural Gas Pipelines; Project Cost and Annual Limits

Science.gov (United States)

2010-02-24

...] Natural Gas Pipelines; Project Cost and Annual Limits February 18, 2010. AGENCY: Federal Energy Regulatory... for natural gas pipelines blanket construction certificates for each calendar year. DATES: This final..., Natural gas, Reporting and recordkeeping requirements. Jeff C. Wright, Director, Office of Energy Projects...

Level of voluntary disclosure and the cost of capital of Brazilian companies: 2008 to 2012

Directory of Open Access Journals (Sweden)

Ariana Ballestero

2016-12-01

Full Text Available This study analyzed whether the level of voluntary disclosure in the Brazilian market affects the cost of capital of companies listed on Bovespa during the period covering 2008 through 2012.  The sample was composed of 46 Brazilian non-financial institutions, building on and complementing previous research such as that carried out by Lima, Lima, Favero and Galdi (2007, Murcia and Santos (2009a, and Li and Yang (2013. The panel data regression model is employed to relate the independent variables with the following dependent variables: Cost of Equity, Cost of Debt and Weighted Average Cost of Capital. Findings permit the conclusion that some voluntary disclosure practices influence the cost of capital, i.e., when a company chooses to voluntarily disclose information in its annual reports, this information can affect its cost of equity and cost of debt.

Cost Analysis of an Air Brayton Receiver for a Solar Thermal Electric Power System in Selected Annual Production Volumes

Science.gov (United States)

1981-01-01

Pioneer Engineering and Manufacturing Company estimated the cost of manufacturing and Air Brayton Receiver for a Solar Thermal Electric Power System as designed by the AiResearch Division of the Garrett Corporation. Production costs were estimated at annual volumes of 100; 1,000; 5,000; 10,000; 50,000; 100,000 and 1,000,000 units. These costs included direct labor, direct material and manufacturing burden. A make or buy analysis was made of each part of each volume. At high volumes special fabrication concepts were used to reduce operation cycle times. All costs were estimated at an assumed 100% plant capacity. Economic feasibility determined the level of production at which special concepts were to be introduced. Estimated costs were based on the economics of the last half of 1980. Tooling and capital equipment costs were estimated for ach volume. Infrastructure and personnel requirements were also estimated.

LPGC, Levelized Steam Electric Power Generator Cost

International Nuclear Information System (INIS)

Coen, J.J.; Delene, J.G.

1994-01-01

1 - Description of program or function: LPGC is a set of nine microcomputer programs for estimating power generation costs for large steam-electric power plants. These programs permit rapid evaluation using various sets of economic and technical ground rules. The levelized power generation costs calculated may be used to compare the relative economics of nuclear and coal-fired plants based on life-cycle costs. Cost calculations include capital investment cost, operation and maintenance cost, fuel cycle cost, decommissioning cost, and total levelized power generation cost. These programs can be used for quick analyses of power generation costs using alternative economic parameters, such as interest rate, escalation rate, inflation rate, plant lead times, capacity factor, fuel prices, etc. The two major types of electric generating plants considered are pressurized-water reactor (PWR) and pulverized coal-fired plants. Data are also provided for the Large Scale Prototype Breeder (LSPB) type liquid metal reactor. Costs for plant having either one or two units may be obtained. 2 - Method of solution: LPGC consists of nine individual menu-driven programs controlled by a driver program, MAINPWR. The individual programs are PLANTCAP, for calculating capital investment costs; NUCLOM, for determining operation and maintenance (O and M) costs for nuclear plants; COALOM, for computing O and M costs for coal-fired plants; NFUEL, for calculating levelized fuel costs for nuclear plants; COALCOST, for determining levelized fuel costs for coal-fired plants; FCRATE, for computing the fixed charge rate on the capital investment; LEVEL, for calculating levelized power generation costs; CAPITAL, for determining capitalized cost from overnight cost; and MASSGEN, for generating, deleting, or changing fuel cycle mass balance data for use with NFUEL. LPGC has three modes of operation. In the first, each individual code can be executed independently to determine one aspect of the total

Impacts of supplyshed-level differences in productivity and land Costs on the economics of hybrid poplar production in Minnesota, USA

Science.gov (United States)

William Lazarus; William L. Headlee; Ronald S. Zalesny

2015-01-01

The joint effects of poplar biomass productivity and land costs on poplar production economics were compared for 12 Minnesota counties and two genetic groups, using a process-based model (3-PG) to estimate productivity. The counties represent three levels of productivity and a range of land costs (annual rental rates) from $128/ha to $534/ha. An optimal rotation age...

Multi-Country Analysis of Treatment Costs for HIV/AIDS (MATCH): Facility-Level ART Unit Cost Analysis in Ethiopia, Malawi, Rwanda, South Africa and Zambia

Science.gov (United States)

Tagar, Elya; Sundaram, Maaya; Condliffe, Kate; Matatiyo, Blackson; Chimbwandira, Frank; Chilima, Ben; Mwanamanga, Robert; Moyo, Crispin; Chitah, Bona Mukosha; Nyemazi, Jean Pierre; Assefa, Yibeltal; Pillay, Yogan; Mayer, Sam; Shear, Lauren; Dain, Mary; Hurley, Raphael; Kumar, Ritu; McCarthy, Thomas; Batra, Parul; Gwinnell, Dan; Diamond, Samantha; Over, Mead

2014-01-01

Background Today's uncertain HIV funding landscape threatens to slow progress towards treatment goals. Understanding the costs of antiretroviral therapy (ART) will be essential for governments to make informed policy decisions about the pace of scale-up under the 2013 WHO HIV Treatment Guidelines, which increase the number of people eligible for treatment from 17.6 million to 28.6 million. The study presented here is one of the largest of its kind and the first to describe the facility-level cost of ART in a random sample of facilities in Ethiopia, Malawi, Rwanda, South Africa and Zambia. Methods & Findings In 2010–2011, comprehensive data on one year of facility-level ART costs and patient outcomes were collected from 161 facilities, selected using stratified random sampling. Overall, facility-level ART costs were significantly lower than expected in four of the five countries, with a simple average of $208 per patient-year (ppy) across Ethiopia, Malawi, Rwanda and Zambia. Costs were higher in South Africa, at $682 ppy. This included medications, laboratory services, direct and indirect personnel, patient support, equipment and administrative services. Facilities demonstrated the ability to retain patients alive and on treatment at these costs, although outcomes for established patients (2–8% annual loss to follow-up or death) were better than outcomes for new patients in their first year of ART (77–95% alive and on treatment). Conclusions This study illustrated that the facility-level costs of ART are lower than previously understood in these five countries. While limitations must be considered, and costs will vary across countries, this suggests that expanded treatment coverage may be affordable. Further research is needed to understand investment costs of treatment scale-up, non-facility costs and opportunities for more efficient resource allocation. PMID:25389777

Assessment of levelized cost of electricity for a 10-MW solar chimney power plant in Yinchuan China

International Nuclear Information System (INIS)

Guo, Penghua; Zhai, Yaxin; Xu, Xinhai; Li, Jingyin

2017-01-01

Highlights: • An unsteady model is proposed for annual power generation prediction of SCPPs. • LCOE of a 10-MW SCPP in China is estimated through a cost benefit analysis. • Cost advantage and concessional loan under conditions in China are considered. • SCPP is proven to be economically feasible under favorable conditions in China. - Abstract: Solar chimney power plant (SCPP) is a promising renewable energy technology that needs policy support and market cultivation at the early stage of its development. An accurate prediction of the levelized cost of electricity (LCOE) can be used as basis for crafting effective support policies. This study presents an unsteady theoretical model that considers hourly meteorological data and soil heat storage in estimating the annual power generation of an SCPP. A cost benefit model is adopted to calculate the LCOE of a 10-MW SCPP in Yinchuan, a representative geographical location in the Northwestern region of China. By considering the cost advantage of China, the concessional loan, as well as the low operation and maintenance cost, the LCOE of the SCPP is estimated to be 0.4178 Yuan/kWh, which can compete with those of wind power and solar PV in China. This work lays a good foundation for the accurate prediction of power generation and provides a reference for the Chinese government in crafting effective support policies for SCPPs.

Evaluation of Uniform Cost Accounting System to Fully Capture Depot Level Repair Costs.

Science.gov (United States)

1985-12-01

RD-RI65 522 EVALUATION OF UNIFORM COST ACCOUNTING SYSTEM TO FULLY i/I CAPTURE DEPOT LEVEL REPAIR COSTS (U) NAVAL POSTGRADUATE SCHOOL MONTEREY CA D R...8217.LECTE B ,- THESIS EVALUATION OF UNIFORM COST ACCOUNTING SYSTEM 0TO FULLY CAPTURE DEPOT LEVEL REPAIR COSTS Jby __jDavid Richmond O’Brien lj,,, December...Include Security Classification) EVALUATION OF UNIFORM COST ACCOUNTING SYSTEM TO FULLY CAPTURE DEPOT LEVEL REPAIR COSTS 12 PERSONAL AUTHOR(S) O’Brien- David

Effect of heliostat size on the levelized cost of electricity for power towers

Science.gov (United States)

Pidaparthi, Arvind; Hoffmann, Jaap

2017-06-01

The objective of this study is to investigate the effects of heliostat size on the levelized cost of electricity (LCOE) for power tower plants. These effects are analyzed in a power tower with a net capacity of 100 MWe, 8 hours of thermal energy storage and a solar multiple of 1.8 in Upington, South Africa. A large, medium and a small size heliostat with a total area of 115.56 m2, 43.3 m2 and 15.67 m2 respectively are considered for comparison. A radial-staggered pattern and an external cylindrical receiver are considered for the heliostat field layouts. The optical performance of the optimized heliostat field layouts has been evaluated by the Hermite (analytical) method using SolarPILOT, a tool used for the generation and optimization of the heliostat field layout. The heliostat cost per unit is calculated separately for the three different heliostat sizes and the effects due to size scaling, learning curve benefits and the price index is included. The annual operation and maintenance (O&M) costs are estimated separately for the three heliostat fields, where the number of personnel required in the field is determined by the number of heliostats in the field. The LCOE values are used as a figure of merit to compare the different heliostat sizes. The results, which include the economic and the optical performance along with the annual O&M costs, indicate that lowest LCOE values are achieved by the medium size heliostat with an area of 43.3 m2 for this configuration. This study will help power tower developers determine the optimal heliostat size for power tower plants currently in the development stage.

Cost-efficient staffing under annualized hours

NARCIS (Netherlands)

van der Veen, Egbert; Hans, Elias W.; Veltman, Bart; Berrevoets, Leo M.; Berden, Hubert J.J.M.

2012-01-01

We study how flexibility in workforce capacity can be used to efficiently match capacity and demand. Flexibility in workforce capacity is introduced by the annualized hours regime. Annualized hours allow organizations to measure working time per year, instead of per month or per week. An additional

Annual biologic treatment cost for new and existing patients with moderate to severe plaque psoriasis in Greece

Directory of Open Access Journals (Sweden)

Fragoulakis V

2015-01-01

Full Text Available Vassilis Fragoulakis,1 Efklidis Raptis,2 Elli Vitsou,2 Nikolaos Maniadakis1 1Health Services Organization and Management, National School of Public Health, 2Pfizer Hellas, Athens, Greece Aim: The aim of the present study was to estimate the annual per-patient cost of treatment with adalimumab, etanercept, infliximab, and ustekinumab by response status for new and existing patients with moderate to severe psoriasis in Greece. Methods: An economic analysis was developed from a national health care perspective to estimate the direct cost of treatment alternatives for new and existing patients within a 1-year time horizon. The model included drug acquisition and administration costs for responders and nonresponders. Real-world treatment pattern and resource use data were extracted through nationwide field research using telephone-based interviews with a representative sample of dermatologists. Unit costs were collected from official sources in the public domain. Results: The mean annual cost of treatment for new patients who responded (or did not respond to treatment was as follows: adalimumab €10,686 (€3,821, etanercept €10,415 (€3,224, infliximab €14,738 (€7,582, and ustekinumab €17,155 (€9,806. For existing patients the mean annual cost was €9,916, €9,462, €12,949, and €17,149, respectively. Results did not change significantly under several one-way sensitivity and scenario analyses. Conclusion: Under the base-case scenario, the cost of treatment with etanercept is lower than that of the other biological agents licensed for moderate to severe plaque psoriasis in Greece, for both new and existing patients, irrespective of response status. Keywords: adalimumab, etanercept, infliximab, ustekinumab, economic evaluation, biologics

Economic Burden of Pediatric Asthma: Annual Cost of Disease in Iran.

Science.gov (United States)

Sharifi, Laleh; Dashti, Raheleh; Pourpak, Zahra; Fazlollahi, Mohammad Reza; Movahedi, Masoud; Chavoshzadeh, Zahra; Soheili, Habib; Bokaie, Saied; Kazemnejad, Anoushiravan; Moin, Mostafa

2018-02-01

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.

Cost Efficiency in Public Higher Education.

Science.gov (United States)

Robst, John

This study used the frontier cost function framework to examine cost efficiency in public higher education. The frontier cost function estimates the minimum predicted cost for producing a given amount of output. Data from the annual Almanac issues of the "Chronicle of Higher Education" were used to calculate state level enrollments at two-year and…

[Cost per capita in outpatients by gender].

Science.gov (United States)

Villarreal-Ríos, Enrique; Campos Esparza, Maribel; Galicia Rodríguez, Liliana; Martínez González, Lidia; Vargas Daza, Emma Rosa; Torres Labra, Guadalupe; Patiño Vega, Adolfo; Rivera Martínez, María Teresa; Aparicio Rojas, Raúl; Juárez Durán, Martín

2011-03-01

The objective of this study is to identify the annual cost per capita by gender in first level of attention. It is a cost study in Family Physician Units in Mexico. The information corresponded to the year of 2004 and the study divided in the use profile and cost attention. USE PROFILE OF SERVICES: it was studied 1,585 clinical registries of patients, use profile defined by average and attention reasons by department, gender and age group. COST ATTENTION: considered in American dollars it included fixed unit cost (departmentalization adjusted by productivity), variable unit cost (micro cost technical), department unite cost by type attention, and department unit cost by age and gender. The life expectancy was of 73 years for men and 78 for women. Three scenes were identified. The annual cost per capita is superior among woman [US$73.24 (IC 95% $11.38 - $197.49)] than in man [$ 53.11 (IC 95% 2.51 - 207.71)]. The conclusion found that in the first level of attention the cost per capita is greater in woman than in man.

How to calculate the annual costs of NGO-implemented programmes to support orphans and vulnerable children: a six-step approach.

Science.gov (United States)

Larson, Bruce A; Wambua, Nancy

2011-12-19

Information on the costs of implementing programmes designed to provide support of orphans and vulnerable children (OVC) in sub-Saharan Africa and elsewhere is increasingly being requested by donors for programme evaluation purposes. To date, little information exists to document the costs and structure of costs of OVC programmes as actually implemented "on the ground" by local non-governmental organizations (NGOs). This analysis provides a practical, six-step approach that NGOs can incorporate into routine operations to evaluate their costs of implementing their OVC programmes annually. This approach is applied to the Community-Based Care for Orphans and Vulnerable Children (CBCO) Program implemented by BIDII (a Kenyan NGO) in Eastern Province of Kenya. The costing methodology involves the following six steps: accessing and organizing the NGO's annual financial report into logical sub-categories; reorganizing the sub-categories into input cost categories to create a financial cost profile; estimating the annual equivalent payment for programme equipment; documenting donations to the NGO for programme implementation; including a portion of NGO organizational costs not attributed to specific programmes; and including the results of Steps 3-5 into an expanded cost profile. Detailed results are provided for the CBCO programme. This paper shows through a concrete example how NGOs implementing OVC programmes (and other public health programmes) can organize themselves for data collection and documentation prospectively during the implementation of their OVC programmes so that costing analyses become routine practice to inform programme implementation rather than a painful and flawed retrospective activity. Such information is required if the costs and outcomes achieved by OVC programmes will ever be clearly documented and compared across OVC programmes and other types of programmes (prevention, treatment, etc.).

[Levels of glycosylated hemoglobin and the difference in the cost of health care for diabetic patients: an econometric study].

Science.gov (United States)

Lenz, Rony; Zarate, Aldo; Rodríguez, Jorge; Ramírez, Jorge

2014-07-01

Complications increase treatment costs of diabetes mellitus (DM). An adequate metabolic control of the disease could reduce these costs. To evaluate the costs of medical care for a cohort of patients with DM, according to their degree of metabolic compensation. All diabetic patients attended in a regional hospital from 2005 to 2010 were analyzed. A correlational study between costs of individual healthcare and levels of glycosylated hemoglobin (HbA1c), was performed in a series of annual cross-sectional measurements. The study comprised 1,644 diabetic patients. During the study period the average cost of healthcare per patient increased from $878,000 to more than $1,000,000 Chilean pesos (CLP) during the study period. The percentage of patients with HbA1c levels below 7.0% varied between 43.0% and 54.9%. Costs for patients with HbA1c levels between 7 and 8.9% were 1.3 to 1.5 times greater. For the group of patients with HbA1c levels between 9 and 10.9% the costs increased 1.4 to 1.6 times. For patients with HbA1c levels greater than 11.0%, healthcare costs doubled. Healthcare expenditure varied according to metabolic control, which is consistent with international findings. This study was limited by its selected population, incomplete information on health expenditures, and the inclusion of only direct costs to the health system. If all patients would achieve metabolic compensation, the yearly savings would be CLP $308,000,000 (or USD $657,000).

2013 Cost of Wind Energy Review

Energy Technology Data Exchange (ETDEWEB)

Mone, C. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Smith, A. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Maples, B. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Hand, M. [National Renewable Energy Lab. (NREL), Golden, CO (United States)

2015-02-01

This report uses representative project types to estimate the levelized cost of wind energy (LCOE) in the United States for 2013. Scheduled to be published on an annual basis, it relies on both market and modeled data to maintain a current understanding of wind generation cost trends and drivers. It is intended to provide insight into current component-level costs and a basis for understanding current component-level costs and a basis for understanding variability in the LCOE across the industry. Data and tools developed from this analysis are used to inform wind technology cost projections, goals, and improvement opportunities.

Treatment of self-poisoning at a tertiary-level hospital in Bangladesh: cost to patients and government.

Science.gov (United States)

Verma, Vasundhara; Paul, Sujat; Ghose, Aniruddha; Eddleston, Michael; Konradsen, Flemming

2017-12-01

Approximately 10 000 people die from suicide annually in Bangladesh, many from pesticide poisoning. We aimed to estimate financial costs to patients and health services of treating patients with self-poisoning. Data on direct costs to families, sources of funds for treatment and family wealth were collected prospectively over a one-month period in 2016 at the tertiary Chittagong Medical College Hospital, Bangladesh. Aggregate operational costs to the government were calculated using annual budget, bed occupancy and length-of-stay data. Agrochemicals were the most common substances ingested (58.8%). Median duration of stay and of illness was 2 and 5 days, respectively. Median total cost to patients was conservatively estimated at US$ 98.40, highest in agrochemical poisoning (US$ 179.50), with the greatest cost due to medicines and equipment. Misdiagnosis as organophosphorus poisoning in 17.0% of agrochemical cases resulted in increased cost to patients. Only 51.9% of patients had indicators of wealth; 78.1% borrowed money to cover costs. Conservatively estimated median healthcare costs (US$ 21.30 per patient) were markedly lower than costs to patients. Cost to patients of treating a case of agrochemical poisoning was approximately three times the cost of one month's essential items basket. Incorrect diagnosis at admission costs families substantial sums of money and increased length of stay; it costs the national government an estimated US$ 80 428.80 annually. Widespread access to a list of pesticides used in self-poisoning plus greater focus on training doctors to better manage different forms of agrochemical poisoning should reduce the financial burden to patients and healthcare systems. © 2017 John Wiley & Sons Ltd.

Cost of delivering secondary-level health care services through public sector district hospitals in India

Science.gov (United States)

Prinja, Shankar; Balasubramanian, Deepak; Jeet, Gursimer; Verma, Ramesh; Kumar, Dinesh; Bahuguna, Pankaj; Kaur, Manmeet; Kumar, Rajesh

2017-01-01

Background & objectives: Despite an impetus for strengthening public sector district hospitals for provision of secondary health care in India, there is lack of robust evidence on cost of services provided through these district hospitals. In this study, an attempt was made to determine the unit cost of an outpatient visit consultation, inpatient bed-day of hospitalization, surgical procedure and overall per-capita cost of providing secondary care through district hospitals. Methods: Economic costing of five randomly selected district hospitals in two north Indian States - Haryana and Punjab, was undertaken. Cost analysis was done using a health system perspective and employing bottom-up costing methodology. Quantity of all resources - capital or recurrent, used for delivering services was measured and valued. Median unit costs were estimated along with their 95 per cent confidence intervals. Sensitivity analysis was undertaken to assess the effect of uncertainties in prices and other assumptions; and to generalize the findings for Indian set-up. Results: The overall annual cost of delivering secondary-level health care services through a public sector district hospital in north India was 11,44,13,282 [US Dollars (USD) 2,103,185]. Human resources accounted for 53 per cent of the overall cost. The unit cost of an inpatient bed-day, surgical procedure and outpatient consultation was 844 (USD 15.5), i; 3481 (USD 64) and 170 (USD 3.1), respectively. With the current set of resource allocation, per-capita cost of providing health care through district hospitals in north India was 139 (USD 2.5). Interpretation & conclusions: The estimates obtained in our study can be used for Fiscal planning of scaling up secondary-level health services. Further, these may be particularly useful for future research such as benefit-incidence analysis, cost-effectiveness analysis and national health accounts including disease-specific accounts in India. PMID:29355142

Cost of delivering secondary-level health care services through public sector district hospitals in India.

Science.gov (United States)

Prinja, Shankar; Balasubramanian, Deepak; Jeet, Gursimer; Verma, Ramesh; Kumar, Dinesh; Bahuguna, Pankaj; Kaur, Manmeet; Kumar, Rajesh

2017-09-01

Despite an impetus for strengthening public sector district hospitals for provision of secondary health care in India, there is lack of robust evidence on cost of services provided through these district hospitals. In this study, an attempt was made to determine the unit cost of an outpatient visit consultation, inpatient bed-day of hospitalization, surgical procedure and overall per-capita cost of providing secondary care through district hospitals. Economic costing of five randomly selected district hospitals in two north Indian States - Haryana and Punjab, was undertaken. Cost analysis was done using a health system perspective and employing bottom-up costing methodology. Quantity of all resources - capital or recurrent, used for delivering services was measured and valued. Median unit costs were estimated along with their 95 per cent confidence intervals. Sensitivity analysis was undertaken to assess the effect of uncertainties in prices and other assumptions; and to generalize the findings for Indian set-up. The overall annual cost of delivering secondary-level health care services through a public sector district hospital in north India was ' 11,44,13,282 [US Dollars (USD) 2,103,185]. Human resources accounted for 53 per cent of the overall cost. The unit cost of an inpatient bed-day, surgical procedure and outpatient consultation was ' 844 (USD 15.5), ' 3481 (USD 64) and ' 170 (USD 3.1), respectively. With the current set of resource allocation, per-capita cost of providing health care through district hospitals in north India was ' 139 (USD 2.5). The estimates obtained in our study can be used for Fiscal planning of scaling up secondary-level health services. Further, these may be particularly useful for future research such as benefit-incidence analysis, cost-effectiveness analysis and national health accounts including disease-specific accounts in India.

Twelfth annual US DOE low-level waste management conference

International Nuclear Information System (INIS)

1990-01-01

The papers in this document comprise the proceedings of the Department of Energy's Twelfth Annual Low-Level Radioactive Waste Management Conference, which was held in Chicago, Illinois, on August 28 and 29, 1990. General subjects addressed during the conference included: mixed waste, low-level radioactive waste tracking and transportation, public involvement, performance assessment, waste stabilization, financial assurance, waste minimization, licensing and environmental documentation, below-regulatory-concern waste, low-level radioactive waste temporary storage, current challenges, and challenges beyond 1990

Effectiveness, cost-effectiveness and cost-benefit of a single annual professional intervention for the prevention of childhood dental caries in a remote rural Indigenous community.

Science.gov (United States)

Lalloo, Ratilal; Kroon, Jeroen; Tut, Ohnmar; Kularatna, Sanjeewa; Jamieson, Lisa M; Wallace, Valda; Boase, Robyn; Fernando, Surani; Cadet-James, Yvonne; Scuffham, Paul A; Johnson, Newell W

2015-08-29

The aim of the study is to reduce the high prevalence of tooth decay in children in a remote, rural Indigenous community in Australia, by application of a single annual dental preventive intervention. The study seeks to (1) assess the effectiveness of an annual oral health preventive intervention in slowing the incidence of dental caries in children in this community, (2) identify the mediating role of known risk factors for dental caries and (3) assess the cost-effectiveness and cost-benefit of the intervention. The intervention is novel in that most dental preventive interventions require regular re-application, which is not possible in resource constrained communities. While tooth decay is preventable, self-care and healthy habits are lacking in these communities, placing more emphasis on health services to deliver an effective dental preventive intervention. Importantly, the study will assess cost-benefit and cost-effectiveness for broader implementation across similar communities in Australia and internationally. There is an urgent need to reduce the burden of dental decay in these communities, by implementing effective, cost-effective, feasible and sustainable dental prevention programs. Expected outcomes of this study include improved oral and general health of children within the community; an understanding of the costs associated with the intervention provided, and its comparison with the costs of allowing new lesions to develop, with associated treatment costs. Findings should be generalisable to similar communities around the world. The research is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR), registration number ACTRN12615000693527; date of registration: 3rd July 2015.

Costs associated with the management of waste from healthcare facilities: An analysis at national and site level.

Science.gov (United States)

Vaccari, Mentore; Tudor, Terry; Perteghella, Andrea

2018-01-01

Given rising spend on the provision of healthcare services, the sustainable management of waste from healthcare facilities is increasingly becoming a focus as a means of reducing public health risks and financial costs. Using data on per capita healthcare spend at the national level, as well as a case study of a hospital in Italy, this study examined the relationship between trends in waste generation and the associated costs of managing the waste. At the national level, healthcare spend as a percentage of gross domestic product positively correlated with waste arisings. At the site level, waste generation and type were linked to department type and clinical performance, with the top three highest generating departments of hazardous healthcare waste being anaesthetics (5.96 kg day -1 bed -1 ), paediatric and intensive care (3.37 kg day -1 bed -1 ) and gastroenterology-digestive endoscopy (3.09 kg day -1 bed -1 ). Annual overall waste management costs were $US5,079,191, or approximately $US2.36 kg -1 , with the management of the hazardous fraction of the waste being highest at $US3,707,939. In Italy, reduction in both waste arisings and the associated costs could be realised through various means, including improved waste segregation, and linking the TARI tax to waste generation.

A periodic review integrated inventory model with controllable setup cost, imperfect items, and inspection errors under service level constraint

Science.gov (United States)

Saga, R. S.; Jauhari, W. A.; Laksono, P. W.

2017-11-01

This paper presents an integrated inventory model which consists of single vendor and buyer. The buyer managed its inventory periodically and orders products from the vendor to satisfy the end customer’s demand, where the annual demand and the ordering cost were in the fuzzy environment. The buyer used a service level constraint instead of the stock-out cost term, so that the stock-out level per cycle was bounded. Then, the vendor produced and delivered products to the buyer. The vendor had a choice to commit an investment to reduce the setup cost. However, the vendor’s production process was imperfect, thus the lot delivered contained some defective products. Moreover, the buyer’s inspection process was not error-free since the inspector could be mistaken in categorizing the product’s quality. The objective was to find the optimum value for the review period, the setup cost, and the number of deliveries in one production cycle which might minimize the joint total cost. Furthermore, the algorithm and numerical example were provided to illustrate the application of the model.

Costs analysis of a population level rabies control programme in Tamil Nadu, India.

Directory of Open Access Journals (Sweden)

Syed Shahid Abbas

2014-02-01

Full Text Available The study aimed to determine costs to the state government of implementing different interventions for controlling rabies among the entire human and animal populations of Tamil Nadu. This built upon an earlier assessment of Tamil Nadu's efforts to control rabies. Anti-rabies vaccines were made available at all health facilities. Costs were estimated for five different combinations of animal and human interventions using an activity-based costing approach from the provider perspective. Disease and population data were sourced from the state surveillance data, human census and livestock census. Program costs were extrapolated from official documents. All capital costs were depreciated to estimate annualized costs. All costs were inflated to 2012 Rupees. Sensitivity analysis was conducted across all major cost centres to assess their relative impact on program costs. It was found that the annual costs of providing Anti-rabies vaccine alone and in combination with Immunoglobulins was $0.7 million (Rs 36 million and $2.2 million (Rs 119 million, respectively. For animal sector interventions, the annualised costs of rolling out surgical sterilisation-immunization, injectable immunization and oral immunizations were estimated to be $ 44 million (Rs 2,350 million, $23 million (Rs 1,230 million and $ 11 million (Rs 590 million, respectively. Dog bite incidence, health systems coverage and cost of rabies biologicals were found to be important drivers of costs for human interventions. For the animal sector interventions, the size of dog catching team, dog population and vaccine costs were found to be driving the costs. Rabies control in Tamil Nadu seems a costly proposition the way it is currently structured. Policy makers in Tamil Nadu and other similar settings should consider the long-term financial sustainability before embarking upon a state or nation-wide rabies control programme.

Costs analysis of a population level rabies control programme in Tamil Nadu, India.

Science.gov (United States)

Abbas, Syed Shahid; Kakkar, Manish; Rogawski, Elizabeth Tacket

2014-02-01

The study aimed to determine costs to the state government of implementing different interventions for controlling rabies among the entire human and animal populations of Tamil Nadu. This built upon an earlier assessment of Tamil Nadu's efforts to control rabies. Anti-rabies vaccines were made available at all health facilities. Costs were estimated for five different combinations of animal and human interventions using an activity-based costing approach from the provider perspective. Disease and population data were sourced from the state surveillance data, human census and livestock census. Program costs were extrapolated from official documents. All capital costs were depreciated to estimate annualized costs. All costs were inflated to 2012 Rupees. Sensitivity analysis was conducted across all major cost centres to assess their relative impact on program costs. It was found that the annual costs of providing Anti-rabies vaccine alone and in combination with Immunoglobulins was $0.7 million (Rs 36 million) and $2.2 million (Rs 119 million), respectively. For animal sector interventions, the annualised costs of rolling out surgical sterilisation-immunization, injectable immunization and oral immunizations were estimated to be $ 44 million (Rs 2,350 million), $23 million (Rs 1,230 million) and $ 11 million (Rs 590 million), respectively. Dog bite incidence, health systems coverage and cost of rabies biologicals were found to be important drivers of costs for human interventions. For the animal sector interventions, the size of dog catching team, dog population and vaccine costs were found to be driving the costs. Rabies control in Tamil Nadu seems a costly proposition the way it is currently structured. Policy makers in Tamil Nadu and other similar settings should consider the long-term financial sustainability before embarking upon a state or nation-wide rabies control programme.

Twelfth annual US DOE low-level waste management conference

Energy Technology Data Exchange (ETDEWEB)

1990-01-01

The papers in this document comprise the proceedings of the Department of Energy's Twelfth Annual Low-Level Radioactive Waste Management Conference, which was held in Chicago, Illinois, on August 28 and 29, 1990. General subjects addressed during the conference included: mixed waste, low-level radioactive waste tracking and transportation, public involvement, performance assessment, waste stabilization, financial assurance, waste minimization, licensing and environmental documentation, below-regulatory-concern waste, low-level radioactive waste temporary storage, current challenges, and challenges beyond 1990.

Ventilation cost impact of reduced radon-daughter working levels

International Nuclear Information System (INIS)

Bates, R.C.

1981-01-01

Published information on costs of radon-daughter control in uranium mines was analyzed to develop estimates of the cost per ton for any level of radiation exposure control. All data were converted to 1967 cost of living index to provide a common analysis base. Results of the analysis show that the cost per ton increases exponentially as the radiation level is lowered. A linear relationship with the cost of living index is assumed, and equations and graphs are provided to estimate control cost per ton for any exposure control level and cost of living index

A model to evaluate the costs and clinical effectiveness of human papilloma virus screening compared with annual papanicolaou cytology in Germany.

Science.gov (United States)

Petry, Karl Ulrich; Barth, Cordula; Wasem, Jürgen; Neumann, Anja

2017-05-01

We modelled human papilloma virus (HPV) primary screening scenarios compared with Pap cytology to evaluate clinical effectiveness and projected annual costs in Germany. A Markov cohort model was built to compare the budget impact of annual Pap cytology with different 5-yearly HPV screening scenarios: (1) a positive HPV test followed by Pap cytology; (2) a positive HPV test followed by p16/Ki-67 dual-stained cytology; (3) a positive HPV test followed by colposcopy if HPV-16/18-positive or p16/Ki-67 dual-stained cytology if positive for other subtypes; (4) co-testing with HPV and Pap. Screening scenarios were based on a 10-year horizon. All HPV screening scenarios in the model were associated with fewer deaths from missed diagnosis of cervical cancer compared with Pap screening; 10-year totals n=172-344 (1.5-3 per 100,000) versus n=477 (4.1 per 100,000), respectively. Total annual costs were lower with HPV screening than Pap cytology. The projected average annual cost for HPV screening ranged from €117 million to €136 million compared with €177 million for Pap screening, representing annual savings of €41-60 million. The greatest clinical impact was achieved with primary HPV screening (with genotyping) followed by colposcopy for HPV 16/18-positive women or p16/Ki-67 dual-stained cytology for women positive for other HPV subtypes. Screening strategies including primary HPV testing for high-risk subtypes (HPV-16/18) in conjunction with p16/Ki-67 dual-stained cytology can improve the detection of cervical cancer at a lower total annual cost than conventional Pap cytology screening. Copyright © 2017. Published by Elsevier B.V.

The extent of cost disclosure in trade company annual reports on the example of the it branch – pilot studies

Directory of Open Access Journals (Sweden)

Anna Dyhdalewicz

2014-12-01

Full Text Available The paper presents the results of a research study, whose focal issue was the extent of disclosure in annual reports of costs of trade enterprises on the example of IT companies listed on the Warsaw Stock Exchange. Due to its limited scope, this study should be treated as a pilot, constituting the introduction to further and more detailed research and analyses, which ultimately will include all companies listed on the WSE within the Polish Classification of Activities (PKD wholesale and retail trade, and car repair. The aim of the study is to evaluate the usefulness of the annual report as a source of information about the costs of a  trading company. Information on costs in annual reports results from informational obligations defined by current regulations of law, environmental needs, as well as each economic entity’s individual approach to the presentation of financial information in financial reports and to disclosure of additional information (qualitative and financial in explanatory notes and in an activity report. It should also be noted that the presentation in the same costs group of different specific items proves that factors influencing the amount and structure of costs in a given period in particular entities conducting trading activity in the same sector have various significance for the results. Presenting information on risk within holdings indicates cost- determining factors both of operational and strategic natures, external and internal, dependent on the enterprise and independent of it. The sector in which the researched economic entities operate is an important factor which has an influence on the identification of cost drivers and costs whose source is risk related to the economic activity conducted.

Determining Mean Annual Energy Production

DEFF Research Database (Denmark)

Kofoed, Jens Peter; Folley, Matt

2016-01-01

This robust book presents all the information required for numerical modelling of a wave energy converter, together with a comparative review of the different available techniques. The calculation of the mean annual energy production (MAEP) is critical to the assessment of the levelized cost...... of energy for a wave energy converter or wave farm. Fundamentally, the MAEP is equal to the sum of the product of the power capture of a set of sea-states and their average annual occurrence. In general, it is necessary in the calculation of the MAEP to achieve a balance between computational demand...

Patient level costing in Ireland: process, challenges and opportunities.

Science.gov (United States)

Murphy, A; McElroy, B

2015-03-01

In 2013, the Department of Health released their policy paper on hospital financing entitled Money Follows the Patient. A fundamental building block for the proposed financing model is patient level costing. This paper outlines the patient level costing process, identifies the opportunities and considers the challenges associated with the process in the Irish hospital setting. Methods involved a review of the existing literature which was complemented with an interview with health service staff. There are considerable challenges associated with implementing patient level costing including deficits in information and communication technologies and financial expertise as well as timeliness of coding. In addition, greater clinical input into the costing process is needed compared to traditional costing processes. However, there are long-term benefits associated with patient level costing; these include empowerment of clinical staff, improved transparency and price setting and greater fairness, especially in the treatment of outliers. These can help to achieve the Government's Health Strategy. The benefits of patient level costing need to be promoted and a commitment to investment in overcoming the challenges is required.

Comparison of provincial prescription drug plans and the impact on patients' annual drug expenditures.

Science.gov (United States)

Demers, Virginie; Melo, Magda; Jackevicius, Cynthia; Cox, Jafna; Kalavrouziotis, Dimitri; Rinfret, Stéphane; Humphries, Karin H; Johansen, Helen; Tu, Jack V; Pilote, Louise

2008-02-12

Reimbursement for outpatient prescription drugs is not mandated by the Canada Health Act or any other federal legislation. Provincial governments independently establish reimbursement plans. We sought to describe variations in publicly funded provincial drug plans across Canada and to examine the impact of this variation on patients' annual expenditures. We collected information, accurate to December 2006, about publicly funded prescription drug plans from all 10 Canadian provinces. Using clinical scenarios, we calculated the impact of provincial cost-sharing strategies on individual annual drug expenditures for 3 categories of patients with different levels of income and 2 levels of annual prescription burden ($260 and $1000). We found that eligibility criteria and cost-sharing details of the publicly funded prescription drug plans differed markedly across Canada, as did the personal financial burden due to prescription drug costs. Seniors pay 35% or less of their prescription costs in 2 provinces, but elsewhere they may pay as much as 100%. With few exceptions, nonseniors pay more than 35% of their prescription costs in every province. Most social assistance recipients pay 35% or less of their prescription costs in 5 provinces and pay no costs in the other 5. In an example of a patient with congestive heart failure, his out-of-pocket costs for a prescription burden of $1283 varied between $74 and $1332 across the provinces. Considerable interprovincial variation in publicly funded prescription drug plans results in substantial variation in annual expenditures by Canadians with identical prescription burdens. A revised pharmaceutical strategy might reduce these major inequities.

2011 Cost of Wind Energy Review

Energy Technology Data Exchange (ETDEWEB)

Tegen, S.; Lantz, E.; Hand, M.; Maples, B.; Smith, A.; Schwabe, P.

2013-03-01

This report describes the levelized cost of energy (LCOE) for a typical land-based wind turbine installed in the United States in 2011, as well as the modeled LCOE for a fixed-bottom offshore wind turbine installed in the United States in 2011. Each of the four major components of the LCOE equation are explained in detail, such as installed capital cost, annual energy production, annual operating expenses, and financing, and including sensitivity ranges that show how each component can affect LCOE. These LCOE calculations are used for planning and other purposes by the U.S. Department of Energy's Wind Program.

The costs of inequality: whole-population modelling study of lifetime inpatient hospital costs in the English National Health Service by level of neighbourhood deprivation

Science.gov (United States)

Doran, Tim; Cookson, Richard

2016-01-01

Background There are substantial socioeconomic inequalities in both life expectancy and healthcare use in England. In this study, we describe how these two sets of inequalities interact by estimating the social gradient in hospital costs across the life course. Methods Hospital episode statistics, population and index of multiple deprivation data were combined at lower-layer super output area level to estimate inpatient hospital costs for 2011/2012 by age, sex and deprivation quintile. Survival curves were estimated for each of the deprivation groups and used to estimate expected annual costs and cumulative lifetime costs. Results A steep social gradient was observed in overall inpatient hospital admissions, with rates ranging from 31 298/100 000 population in the most affluent fifth of areas to 43 385 in the most deprived fifth. This gradient was steeper for emergency than for elective admissions. The total cost associated with this inequality in 2011/2012 was £4.8 billion. A social gradient was also observed in the modelled lifetime costs where the lower life expectancy was not sufficient to outweigh the higher average costs in the more deprived populations. Lifetime costs for women were 14% greater than for men, due to higher costs in the reproductive years and greater life expectancy. Conclusions Socioeconomic inequalities result in increased morbidity and decreased life expectancy. Interventions to reduce inequality and improve health in more deprived neighbourhoods have the potential to save money for health systems not only within years but across peoples’ entire lifetimes, despite increased costs due to longer life expectancies. PMID:27189975

User's manual for levelized power generation cost using a microcomputer

International Nuclear Information System (INIS)

Fuller, L.C.

1984-08-01

Microcomputer programs for the estimation of levelized electrical power generation costs are described. Procedures for light-water reactor plants and coal-fired plants include capital investment cost, operation and maintenance cost, fuel cycle cost, nuclear decommissioning cost, and levelized total generation cost. Programs are written in Pascal and are run on an Apple II Plus microcomputer

Annual Costs of Care for Pediatric Irritable Bowel Syndrome, Functional Abdominal Pain, and Functional Abdominal Pain Syndrome

NARCIS (Netherlands)

Hoekman, Daniël R.; Rutten, Juliette M. T. M.; Vlieger, Arine M.; Benninga, Marc A.; Dijkgraaf, Marcel G. W.

2015-01-01

To estimate annual medical and nonmedical costs of care for children diagnosed with irritable bowel syndrome (IBS) or functional abdominal pain (syndrome; FAP/FAPS). Baseline data from children with IBS or FAP/FAPS who were included in a multicenter trial (NTR2725) in The Netherlands were analyzed.

2015 Cost of Wind Energy Review

Energy Technology Data Exchange (ETDEWEB)

Mone, Christopher; Hand, Maureen; Bolinger, Mark; Rand, Joseph; Heimiller, Donna; Ho, Jonathan

2017-04-05

This report uses representative commercial projects to estimate the levelized cost of energy (LCOE) for both land-based and offshore wind plants in the United States for 2015. Scheduled to be published on an annual basis, the analysis relies on both market and modeled data to maintain an up-to-date understanding of wind generation cost trends and drivers. It is intended to provide insight into current component-level costs and a basis for understanding variability in the LCOE across the industry. Data and tools developed by the National Renewable Energy Laboratory (NREL) are used in this analysis to inform wind technology cost projections, goals, and improvement opportunities.

2014 Cost of Wind Energy Review

Energy Technology Data Exchange (ETDEWEB)

Mone, Christopher [National Renewable Energy Lab. (NREL), Golden, CO (United States); Stehly, Tyler [National Renewable Energy Lab. (NREL), Golden, CO (United States); Maples, Ben [National Renewable Energy Lab. (NREL), Golden, CO (United States); Settle, Edward [National Renewable Energy Lab. (NREL), Golden, CO (United States)

2015-10-01

This report uses representative commercial projects to estimate the levelized cost of energy (LCOE) for both land-based and offshore wind plants in the United States for 2014. Scheduled to be published on an annual basis, the analysis relies on both market and modeled data to maintain an up-to-date understanding of wind generation cost trends and drivers. It is intended to provide insight into current component-level costs and a basis for understanding variability in the LCOE across the industry. Data and tools developed by the National Renewable Energy Laboratory (NREL) are used in this analysis to inform wind technology cost projections, goals, and improvement opportunities.

Cost estimate of high-level radioactive waste containers for the Yucca Mountain Site Characterization Project

Energy Technology Data Exchange (ETDEWEB)

Russell, E.W.; Clarke, W. [Lawrence Livermore National Lab., CA (United States); Domian, H.A. [Babcock and Wilcox Co., Lynchburg, VA (United States); Madson, A.A. [Kaiser Engineers California Corp., Oakland, CA (United States)

1991-08-01

This report summarizes the bottoms-up cost estimates for fabrication of high-level radioactive waste disposal containers based on the Site Characterization Plan Conceptual Design (SCP-CD). These estimates were acquired by Babcock and Wilcox (B&S) under sub-contract to Lawrence Livermore National Laboratory (LLNL) for the Yucca Mountain Site Characterization Project (YMP). The estimates were obtained for two leading container candidate materials (Alloy 825 and CDA 715), and from other three vendors who were selected from a list of twenty solicited. Three types of container designs were analyzed that represent containers for spent fuel, and for vitrified high-level waste (HLW). The container internal structures were assumed to be AISI-304 stainless steel in all cases, with an annual production rate of 750 containers. Subjective techniques were used for estimating QA/QC costs based on vendor experience and the specifications derived for the LLNL-YMP Quality Assurance program. In addition, an independent QA/QC analysis is reported which was prepared by Kasier Engineering. Based on the cost estimates developed, LLNL recommends that values of $825K and $62K be used for the 1991 TSLCC for the spent fuel and HLW containers, respectively. These numbers represent the most conservative among the three vendors, and are for the high-nickel anstenitic steel (Alloy 825). 6 refs., 7 figs.

Cost estimate of high-level radioactive waste containers for the Yucca Mountain Site Characterization Project

International Nuclear Information System (INIS)

Russell, E.W.; Clarke, W.; Domian, H.A.; Madson, A.A.

1991-08-01

This report summarizes the bottoms-up cost estimates for fabrication of high-level radioactive waste disposal containers based on the Site Characterization Plan Conceptual Design (SCP-CD). These estimates were acquired by Babcock and Wilcox (B ampersand S) under sub-contract to Lawrence Livermore National Laboratory (LLNL) for the Yucca Mountain Site Characterization Project (YMP). The estimates were obtained for two leading container candidate materials (Alloy 825 and CDA 715), and from other three vendors who were selected from a list of twenty solicited. Three types of container designs were analyzed that represent containers for spent fuel, and for vitrified high-level waste (HLW). The container internal structures were assumed to be AISI-304 stainless steel in all cases, with an annual production rate of 750 containers. Subjective techniques were used for estimating QA/QC costs based on vendor experience and the specifications derived for the LLNL-YMP Quality Assurance program. In addition, an independent QA/QC analysis is reported which was prepared by Kasier Engineering. Based on the cost estimates developed, LLNL recommends that values of $825K and $62K be used for the 1991 TSLCC for the spent fuel and HLW containers, respectively. These numbers represent the most conservative among the three vendors, and are for the high-nickel anstenitic steel (Alloy 825). 6 refs., 7 figs

Costs of mixed low-level waste stabilization options

International Nuclear Information System (INIS)

Schwinkendorf, W.E.; Cooley, C.R.

1998-01-01

Selection of final waste forms to be used for disposal of DOE's mixed low-level waste (MLLW) depends on the waste form characteristics and total life cycle cost. In this paper the various cost factors associated with production and disposal of the final waste form are discussed and combined to develop life-cycle costs associated with several waste stabilization options. Cost factors used in this paper are based on a series of treatment system studies in which cost and mass balance analyses were performed for several mixed low-level waste treatment systems and various waste stabilization methods including vitrification, grout, phosphate bonded ceramic and polymer. Major cost elements include waste form production, final waste form volume, unit disposal cost, and system availability. Production of grout costs less than the production of a vitrified waste form if each treatment process has equal operating time (availability) each year; however, because of the lower volume of a high temperature slag, certification and handling costs and disposal costs of the final waste form are less. Both the total treatment cost and life cycle costs are higher for a system producing grout than for a system producing high temperature slag, assuming equal system availability. The treatment costs decrease with increasing availability regardless of the waste form produced. If the availability of a system producing grout is sufficiently greater than a system producing slag, then the cost of treatment for the grout system will be less than the cost for the slag system, and the life cycle cost (including disposal) may be less depending on the unit disposal cost. Treatment and disposal costs will determine the return on investment in improved system availability

2015 Cost of Wind Energy Review

Energy Technology Data Exchange (ETDEWEB)

Moné, Christopher [National Renewable Energy Lab. (NREL), Golden, CO (United States); Hand, Maureen [National Renewable Energy Lab. (NREL), Golden, CO (United States); Bolinger, Mark [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Rand, Joseph [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Heimiller, Donna [National Renewable Energy Lab. (NREL), Golden, CO (United States); Ho, Jonathan [National Renewable Energy Lab. (NREL), Golden, CO (United States)

2017-06-27

This report uses representative utility-scale projects to estimate the levelized cost of energy (LCOE) for land-based and offshore wind plants in the United States. Data and results detailed here are derived from 2015 commissioned plants. More specifically, analysis detailed here relies on recent market data and state-of-the-art modeling capabilities to maintain an up-to-date understanding of wind energy cost trends and drivers. It is intended to provide insight into current component-level costs as well as a basis for understanding variability in LCOE across the industry. This publication reflects the fifth installment of this annual report.

Cost of intensive routine control and incremental cost of insecticide-treated curtain deployment in a setting with low Aedes aegypti infestation

Directory of Open Access Journals (Sweden)

Alberto Baly

Full Text Available Abstract: INTRODUCTION Information regarding the cost of implementing insecticide-treated curtains (ITCs is scarce. Therefore, we evaluated the ITC implementation cost, in addition to the costs of intensive conventional routine activities of the Aedes control program in the city of Guantanamo, Cuba. METHODS A cost-analysis study was conducted from the perspective of the Aedes control program, nested in an ITC effectiveness trial, during 2009-2010. Data for this study were obtained from bookkeeping records and activity registers of the Provincial Aedes Control Programme Unit and the account records of the ITC trial. RESULTS The annual cost of the routine Aedes control program activities was US$16.80 per household (p.h. Among 3,015 households, 6,714 ITCs were distributed. The total average cost per ITC distributed was US$3.42, and 74.3% of this cost was attributed to the cost of purchasing the ITCs. The annualized costs p.h. of ITC implementation was US$3.80. The additional annualized cost for deploying ITCs represented 19% and 48.4% of the total cost of the routine Aedes control and adult-stage Aedes control programs, respectively. The trial did not lead to further reductions in the already relatively low Aedes infestation levels. CONCLUSIONS At current curtain prices, ITC deployment can hardly be considered an efficient option in Guantanamo and other comparable environments.

Cost of intensive routine control and incremental cost of insecticide-treated curtain deployment in a setting with low Aedes aegypti infestation.

Science.gov (United States)

Baly, Alberto; Toledo, Maria Eugenia; Lambert, Isora; Benítez, Elizabeth; Rodriguez, Karina; Rodriguez, Esther; Vanlerberghe, Veerle; Stuyft, Patrick Van der

2016-01-01

Information regarding the cost of implementing insecticide-treated curtains (ITCs) is scarce. Therefore, we evaluated the ITC implementation cost, in addition to the costs of intensive conventional routine activities of the Aedes control program in the city of Guantanamo, Cuba. A cost-analysis study was conducted from the perspective of the Aedes control program, nested in an ITC effectiveness trial, during 2009-2010. Data for this study were obtained from bookkeeping records and activity registers of the Provincial Aedes Control Programme Unit and the account records of the ITC trial. The annual cost of the routine Aedes control program activities was US$16.80 per household (p.h). Among 3,015 households, 6,714 ITCs were distributed. The total average cost per ITC distributed was US$3.42, and 74.3% of this cost was attributed to the cost of purchasing the ITCs. The annualized costs p.h. of ITC implementation was US$3.80. The additional annualized cost for deploying ITCs represented 19% and 48.4% of the total cost of the routine Aedes control and adult-stage Aedes control programs, respectively. The trial did not lead to further reductions in the already relatively low Aedes infestation levels. At current curtain prices, ITC deployment can hardly be considered an efficient option in Guantanamo and other comparable environments.

Manufacturing Cost Levelization Model – A User’s Guide

Energy Technology Data Exchange (ETDEWEB)

Morrow, William R. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Shehabi, Arman [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Smith, Sarah Josephine [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

2015-08-01

The Manufacturing Cost Levelization Model is a cost-performance techno-economic model that estimates total large-scale manufacturing costs for necessary to produce a given product. It is designed to provide production cost estimates for technology researchers to help guide technology research and development towards an eventual cost-effective product. The model presented in this user’s guide is generic and can be tailored to the manufacturing of any product, including the generation of electricity (as a product). This flexibility, however, requires the user to develop the processes and process efficiencies that represents a full-scale manufacturing facility. The generic model is comprised of several modules that estimate variable costs (material, labor, and operating), fixed costs (capital & maintenance), financing structures (debt and equity financing), and tax implications (taxable income after equipment and building depreciation, debt interest payments, and expenses) of a notional manufacturing plant. A cash-flow method is used to estimate a selling price necessary for the manufacturing plant to recover its total cost of production. A levelized unit sales price ($ per unit of product) is determined by dividing the net-present value of the manufacturing plant’s expenses ($) by the net present value of its product output. A user defined production schedule drives the cash-flow method that determines the levelized unit price. In addition, an analyst can increase the levelized unit price to include a gross profit margin to estimate a product sales price. This model allows an analyst to understand the effect that any input variables could have on the cost of manufacturing a product. In addition, the tool is able to perform sensitivity analysis, which can be used to identify the key variables and assumptions that have the greatest influence on the levelized costs. This component is intended to help technology researchers focus their research attention on tasks

Marginal cost curves for water footprint reduction in irrigated agriculture: guiding a cost-effective reduction of crop water consumption to a permit or benchmark level

Directory of Open Access Journals (Sweden)

A. D. Chukalla

2017-07-01

Full Text Available Reducing the water footprint (WF of the process of growing irrigated crops is an indispensable element in water management, particularly in water-scarce areas. To achieve this, information on marginal cost curves (MCCs that rank management packages according to their cost-effectiveness to reduce the WF need to support the decision making. MCCs enable the estimation of the cost associated with a certain WF reduction target, e.g. towards a given WF permit (expressed in m3  ha−1 per season or to a certain WF benchmark (expressed in m3  t−1 of crop. This paper aims to develop MCCs for WF reduction for a range of selected cases. AquaCrop, a soil-water-balance and crop-growth model, is used to estimate the effect of different management packages on evapotranspiration and crop yield and thus the WF of crop production. A management package is defined as a specific combination of management practices: irrigation technique (furrow, sprinkler, drip or subsurface drip; irrigation strategy (full or deficit irrigation; and mulching practice (no, organic or synthetic mulching. The annual average cost for each management package is estimated as the annualized capital cost plus the annual costs of maintenance and operations (i.e. costs of water, energy and labour. Different cases are considered, including three crops (maize, tomato and potato; four types of environment (humid in UK, sub-humid in Italy, semi-arid in Spain and arid in Israel; three hydrologic years (wet, normal and dry years and three soil types (loam, silty clay loam and sandy loam. For each crop, alternative WF reduction pathways were developed, after which the most cost-effective pathway was selected to develop the MCC for WF reduction. When aiming at WF reduction one can best improve the irrigation strategy first, next the mulching practice and finally the irrigation technique. Moving from a full to deficit irrigation strategy is found to be a no-regret measure: it reduces the WF

Marginal cost curves for water footprint reduction in irrigated agriculture: guiding a cost-effective reduction of crop water consumption to a permit or benchmark level

Science.gov (United States)

Chukalla, Abebe D.; Krol, Maarten S.; Hoekstra, Arjen Y.

2017-07-01

Reducing the water footprint (WF) of the process of growing irrigated crops is an indispensable element in water management, particularly in water-scarce areas. To achieve this, information on marginal cost curves (MCCs) that rank management packages according to their cost-effectiveness to reduce the WF need to support the decision making. MCCs enable the estimation of the cost associated with a certain WF reduction target, e.g. towards a given WF permit (expressed in m3  ha-1 per season) or to a certain WF benchmark (expressed in m3  t-1 of crop). This paper aims to develop MCCs for WF reduction for a range of selected cases. AquaCrop, a soil-water-balance and crop-growth model, is used to estimate the effect of different management packages on evapotranspiration and crop yield and thus the WF of crop production. A management package is defined as a specific combination of management practices: irrigation technique (furrow, sprinkler, drip or subsurface drip); irrigation strategy (full or deficit irrigation); and mulching practice (no, organic or synthetic mulching). The annual average cost for each management package is estimated as the annualized capital cost plus the annual costs of maintenance and operations (i.e. costs of water, energy and labour). Different cases are considered, including three crops (maize, tomato and potato); four types of environment (humid in UK, sub-humid in Italy, semi-arid in Spain and arid in Israel); three hydrologic years (wet, normal and dry years) and three soil types (loam, silty clay loam and sandy loam). For each crop, alternative WF reduction pathways were developed, after which the most cost-effective pathway was selected to develop the MCC for WF reduction. When aiming at WF reduction one can best improve the irrigation strategy first, next the mulching practice and finally the irrigation technique. Moving from a full to deficit irrigation strategy is found to be a no-regret measure: it reduces the WF by reducing water

User's manual for levelized power generation cost using an IBM PC

International Nuclear Information System (INIS)

Fuller, L.C.

1985-06-01

Programs for the estimation of levelized electric power generation costs using the BASIC interpreter on an IBM PC are described. Procedures for light-water reactor plants and coal-fired plants include capital investment cost, operation and maintenance cost, fuel cycle cost, nuclear decommissioning cost, and levelized total generation cost

Waste Management Facilities cost information for low-level waste

Energy Technology Data Exchange (ETDEWEB)

Shropshire, D.; Sherick, M.; Biadgi, C.

1995-06-01

This report contains preconceptual designs and planning level life-cycle cost estimates for managing low-level waste. The report`s information on treatment, storage, and disposal modules can be integrated to develop total life-cycle costs for various waste management options. A procedure to guide the US Department of Energy and its contractor personnel in the use of cost estimation data is also summarized in this report.

Cost-optimal levels for energy performance requirements

DEFF Research Database (Denmark)

Thomsen, Kirsten Engelund; Aggerholm, Søren; Kluttig-Erhorn, Heike

2011-01-01

The CA conducted a study on experiences and challenges for setting cost optimal levels for energy performance requirements. The results were used as input by the EU Commission in their work of establishing the Regulation on a comparative methodology framework for calculating cost optimal levels...... of minimum energy performance requirements. In addition to the summary report released in August 2011, the full detailed report on this study is now also made available, just as the EC is about to publish its proposed Regulation for MS to apply in their process to update national building requirements....

A periodic review integrated inventory model with controllable safety stock and setup cost under service level constraint and distribution-free demand

Science.gov (United States)

Kurdhi, N. A.; Jamaluddin, A.; Jauhari, W. A.; Saputro, D. R. S.

2017-06-01

In this study, we consider a stochastic integrated manufacturer-retailer inventory model with service level constraint. The model analyzed in this article considers the situation in which the vendor and the buyer establish a long-term contract and strategic partnership to jointly determine the best strategy. The lead time and setup cost are assumed can be controlled by an additional crashing cost and an investment, respectively. It is assumed that shortages are allowed and partially backlogged on the buyer’s side, and that the protection interval (i.e., review period plus lead time) demand distribution is unknown but has given finite first and second moments. The objective is to apply the minmax distribution free approach to simultaneously optimize the review period, the lead time, the setup cost, the safety factor, and the number of deliveries in order to minimize the joint total expected annual cost. The service level constraint guarantees that the service level requirement can be satisfied at the worst case. By constructing Lagrange function, the analysis regarding the solution procedure is conducted, and a solution algorithm is then developed. Moreover, a numerical example and sensitivity analysis are given to illustrate the proposed model and to provide some observations and managerial implications.

COST EFFICIENCY LEVEL OF RURAL BANKS IN EAST JAVA

Directory of Open Access Journals (Sweden)

Abdul Mongid

2017-03-01

Full Text Available Abstract: Rural Bank (BPR was an important part of financial service industry in Indonesia.Their pivotal role on lending to SMEs in the rural area made their existence very strategic torural development. However, due to its operational scale, rural bank charged higher interestrate than commercial bank. The study estimated the cost efficiency of rural banks usingparametric approach. The result found that rural bank efficiency was very high. The two yearcost efficiency estimated using frontier 4.1 was 95% and median was 100%. The lowest of costefficiency level was 32%. It meant cost inefficiency of the banks under investigated was around10%. The cost efficiency level in 2006 was on average 95% and the median was 100%. It meantthat 50% or more of the observation enjoyed 100% cost efficiency. The minimum was only67%. It meant they operated at very efficient level, leaving only 5% inefficiency. In 2007, adramatic change on efficiency level was going on. The average efficiency was dropped from11% to 89.9% due to increase on interest rate and price level.

Manual of phosphoric acid fuel cell power plant cost model and computer program

Science.gov (United States)

Lu, C. Y.; Alkasab, K. A.

1984-01-01

Cost analysis of phosphoric acid fuel cell power plant includes two parts: a method for estimation of system capital costs, and an economic analysis which determines the levelized annual cost of operating the system used in the capital cost estimation. A FORTRAN computer has been developed for this cost analysis.

Cost analysis and exploratory cost-effectiveness of youth-friendly sexual and reproductive health services in the Republic of Moldova

Science.gov (United States)

2014-01-01

Background Youth-friendly sexual and reproductive health services (YFHS) have high priority in many countries. Yet, little is known about the cost and cost-effectiveness of good quality YFHS in resource limited settings. This paper analyses retrospectively costs and potential cost-effectiveness of four well performing youth-friendly health centres (YFHC) in Moldova. This study assesses: (1) what were the costs of YFHSs at centre level, (2) how much would scaling-up to a national good quality YFHS programme cost, and (3) was the programme potentially cost-effective? Methods Four well performing YFHCs were selected for the study. YFHS costs were analysed per centre, funding source, service and person reached. The costing results were extrapolated to estimate cost of a good quality national YFHS programme in Moldova. A threshold analysis was carried out to estimate the required impact level for the YFHSs to break-even (become cost saving). Results Average annual cost of a well performing YFHC was USD 26,000 in 2011. 58% was financed by the National Health Insurance Company and the rest by external donors (42%). Personnel salaries were the largest expense category (47%). The annual implementation costs of a good quality YFHSs in all 38 YFHCs of Moldova were estimated to be USD 1.0 million. The results of the threshold analysis indicate that the annual break-even impact points in a YFHC for: 1) STI services would be >364 averted STIs, 2) early pregnancy and contraceptive services >178 averted unwanted pregnancies, and 3) HIV services only >0.65 averted new HIV infections. Conclusions The costing results highlight the following: 1) significant additional resources would be required for implementation of a good quality national YFHS programme, 2) the four well performing YFHCs rely heavily on external funding (42%), 3) which raises questions about financial sustainability of the programme. At the same time results of the threshold analysis are encouraging. The result

Cost analysis and exploratory cost-effectiveness of youth-friendly sexual and reproductive health services in the Republic of Moldova.

Science.gov (United States)

Kempers, Jari; Ketting, Evert; Lesco, Galina

2014-07-21

Youth-friendly sexual and reproductive health services (YFHS) have high priority in many countries. Yet, little is known about the cost and cost-effectiveness of good quality YFHS in resource limited settings. This paper analyses retrospectively costs and potential cost-effectiveness of four well performing youth-friendly health centres (YFHC) in Moldova. This study assesses: (1) what were the costs of YFHSs at centre level, (2) how much would scaling-up to a national good quality YFHS programme cost, and (3) was the programme potentially cost-effective? Four well performing YFHCs were selected for the study. YFHS costs were analysed per centre, funding source, service and person reached. The costing results were extrapolated to estimate cost of a good quality national YFHS programme in Moldova. A threshold analysis was carried out to estimate the required impact level for the YFHSs to break-even (become cost saving). Average annual cost of a well performing YFHC was USD 26,000 in 2011. 58% was financed by the National Health Insurance Company and the rest by external donors (42%). Personnel salaries were the largest expense category (47%). The annual implementation costs of a good quality YFHSs in all 38 YFHCs of Moldova were estimated to be USD 1.0 million. The results of the threshold analysis indicate that the annual break-even impact points in a YFHC for: 1) STI services would be >364 averted STIs, 2) early pregnancy and contraceptive services >178 averted unwanted pregnancies, and 3) HIV services only >0.65 averted new HIV infections. The costing results highlight the following: 1) significant additional resources would be required for implementation of a good quality national YFHS programme, 2) the four well performing YFHCs rely heavily on external funding (42%), 3) which raises questions about financial sustainability of the programme. At the same time results of the threshold analysis are encouraging. The result suggest that, together the three SRH

2016 Cost of Wind Energy Review

Energy Technology Data Exchange (ETDEWEB)

Stehly, Tyler J. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Heimiller, Donna M. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Scott, George N. [National Renewable Energy Lab. (NREL), Golden, CO (United States)

2017-12-29

This report uses representative utility-scale projects to estimate the levelized cost of energy (LCOE) for land-based and offshore wind power plants in the United States. Data and results detailed here are derived from 2016 commissioned plants. More specifically, analysis detailed here relies on recent market data and state-of-the-art modeling capabilities to maintain an up-to-date understanding of wind energy cost trends and drivers. This report is intended to provide insight into current component-level costs as well as a basis for understanding variability in LCOE across the country. This publication represents the sixth installment of this annual report.

PV O&M Cost Model and Cost Reduction

Energy Technology Data Exchange (ETDEWEB)

Walker, Andy

2017-03-15

This is a presentation on PV O&M cost model and cost reduction for the annual Photovoltaic Reliability Workshop (2017), covering estimating PV O&M costs, polynomial expansion, and implementation of Net Present Value (NPV) and reserve account in cost models.

Estimating the cost to U.S. health departments to conduct HIV surveillance.

Science.gov (United States)

Shrestha, Ram K; Sansom, Stephanie L; Laffoon, Benjamin T; Farnham, Paul G; Shouse, R Luke; MacMaster, Karen; Hall, H Irene

2014-01-01

HIV case surveillance is a primary source of information for monitoring HIV burden in the United States and guiding the allocation of prevention and treatment funds. While the number of people living with HIV and the need for surveillance data have increased, little is known about the cost of surveillance. We estimated the economic cost to health departments of conducting high-quality HIV case surveillance. We collected primary data on the unit cost and quantity of resources used to operate the HIV case surveillance program in Michigan, where HIV burden (i.e., the number of HIV cases) is moderate to high (n=14,864 cases). Based on Michigan's data, we projected the expected annual HIV surveillance cost for U.S., state, local, and territorial health departments. We based our cost projection on the variation in the number of new and established cases, area-specific wages, and potential economies of scale. We estimated the annual total HIV surveillance cost to the Michigan health department to be $1,286,524 ($87/case), the annual total cost of new cases to be $108,657 ($133/case), and the annual total cost of established cases to be $1,177,867 ($84/case). Our projected median annual HIV surveillance cost per health department ranged from $210,600 in low-HIV burden sites to $1,835,000 in high-HIV burden sites. Our analysis shows that a systematic approach to costing HIV surveillance at the health department level is feasible. For HIV surveillance, a substantial portion of total surveillance costs is attributable to maintaining established cases.

Ventilation cost and air cleaning

Science.gov (United States)

Goodfellow, H. D.

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

Integrating conservation costs into sea level rise adaptive conservation prioritization

Directory of Open Access Journals (Sweden)

Mingjian Zhu

2015-07-01

Full Text Available Biodiversity conservation requires strategic investment as resources for conservation are often limited. As sea level rises, it is important and necessary to consider both sea level rise and costs in conservation decision making. In this study, we consider costs of conservation in an integrated modeling process that incorporates a geomorphological model (SLAMM, species habitat models, and conservation prioritization (Zonation to identify conservation priorities in the face of landscape dynamics due to sea level rise in the Matanzas River basin of northeast Florida. Compared to conservation priorities that do not consider land costs in the analysis process, conservation priorities that consider costs in the planning process change significantly. The comparison demonstrates that some areas with high conservation values might be identified as lower priorities when integrating economic costs in the planning process and some areas with low conservation values might be identified as high priorities when considering costs in the planning process. This research could help coastal resources managers make informed decisions about where and how to allocate conservation resources more wisely to facilitate biodiversity adaptation to sea level rise.

[Cost at the first level of care].

Science.gov (United States)

Villarreal-Ríos, E; Montalvo-Almaguer, G; Salinas-Martínez, M; Guzmán-Padilla, J E; Tovar-Castillo, N H; Garza-Elizondo, M E

1996-01-01

To estimate the unit cost of 15 causes of demand for primary care per health clinic in an institutional (social security) health care system, and to determine the average cost at the state level. The cost of 80% of clinic visits was estimated in 35 of 40 clinics in the social security health care system in the state of Nuevo Leon, Mexico. The methodology for fixed costs consisted of: departmentalization, inputs, cost, weights and construction of matrices. Variable costs were estimated for standard patients by type of health care sought and with the consensus of experts; the sum of fixed and variable costs gave the unit cost. A computerized model was employed for data processing. A large variation in unit cost was observed between health clinics studied for all causes of demand, in both metropolitan and non-metropolitan areas. Prenatal care ($92.26) and diarrhea ($93.76) were the least expensive while diabetes ($240.42) and hypertension ($312.54) were the most expensive. Non-metropolitan costs were higher than metropolitan costs (p < 0.05); controlling for number of physician's offices showed that this was determined by medical units with only one physician's office. Knowledge of unit costs is a tool that, when used by medical administrators, allows adequate health care planning and efficient allocation of health resources.

Costing the Australian National Hand Hygiene Initiative.

Science.gov (United States)

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

2014-11-01

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

NLP model of a LiBr–H2O absorption refrigeration system for the minimization of the annual operating cost

International Nuclear Information System (INIS)

Rubio-Maya, Carlos; Pacheco-Ibarra, J. Jesús; Belman-Flores, Juan M.; Galván-González, Sergio R.; Mendoza-Covarrubias, Crisanto

2012-01-01

In this paper the optimization of a LiBr–H 2 O absorption refrigeration system with the annual operating cost as the objective function to be minimized is presented. The optimization problem is established as a Non-Linear Programming (NLP) model allowing a formulation of the problem in a simple and structured way, and reducing the typical complexity of the thermal systems. The model is composed of three main parts: the thermodynamic model based on the exergy concept including also the proper formulation for the thermodynamic properties of the LiBr–H 2 O mixture, the second is the economic model and the third part composed by inequality constraints. The solution of the model is obtained using the CONOPT solver suitable for NLP problems (code is available on request). The results show the values of the decision variables that minimize the annual cost under the set of assumptions considered in the model and agree well with those reported in other works using different optimization approaches. - Highlights: ► The optimization of an ARS is presented using the annual operating cost as the objective function. ► The problem is established as an NLP model allowing a formulation in a simple and structured way. ► Several formulations for the thermodynamic properties were tested to implement the simpler ones. ► The results obtained agree well with those reported in the work being in comparison.

Population-based cost-offset estimation for the treatment of borderline personality disorder: projected costs in a currently running, ideal health system.

Science.gov (United States)

Wunsch, Eva-Maria; Kliem, Sören; Kröger, Christoph

2014-09-01

Borderline personality disorder (BPD) is considered one of the most expensive mental disorders in terms of direct and indirect costs. The aim of this study was to carry out a cost-offset estimation of disorder-specific psychotherapy for BPD at the population level. The study investigated whether the possible financial benefits of dialectical behavior therapy outweigh the therapy costs, assuming a currently running, ideal health system, and whether the estimated cost-benefit relationships change depending upon the number of patients willing to be treated. A formula was elaborated that allows the user to calculate cost-benefit relationships for various conservative or progressive scenarios, with different stages of individuals' willingness to be treated (10%-90%). The possible costs and benefits of BPD-related treatment were evaluated using a 12-month, prevalence-based approach. The annual costs for untreated BPD were 8.69 billion EUR annually. The cost-benefit relationship for the treatment remained constant at 1.52 for all scenarios, implying that for each EUR invested, 1.52 EUR can be gained within one year, independent of the willingness to be treated. Additional intangible benefits were calculated with the aid of Quality-Adjusted Life Years. Findings suggest that BPD-related treatment might well be efficient at the population level. Copyright © 2014 Elsevier Ltd. All rights reserved.

ORCOST-2, PWR, BWR, HTGR, Fossil Fuel Power Plant Cost and Economics

International Nuclear Information System (INIS)

Fuller, L.C.; Myers, M.L.

1975-01-01

1 - Description of problem or function: ORCOST2 estimates the cost of electrical energy production from single-unit steam-electric power plants. Capital costs and operating and maintenance costs are calculated using base cost models which are included in the program for each of the following types of plants: PWR, BWR, HTGR, coal, oil, and gas. The user may select one of several input/output options for calculation of capital cost, operating and maintenance cost, levelized energy costs, fixed charge rate, annual cash flows, cumulative cash flows, and cumulative discounted cash flows. Options include the input of capital cost and/or fixed charge rate to override the normal calculations. Transmission and distribution costs are not included. Fuel costs must be input by the user. 2 - Method of solution: The code follows the guidelines of AEC Report NUS-531. A base capital-cost model and a base operating- and maintenance-cost model are selected and adjusted for desired size, location, date, etc. Costs are discounted to the year of first commercial operation and levelized to provide annual cost of electric power generation. 3 - Restrictions on the complexity of the problem: The capital cost models are of doubtful validity outside the 500 to 1500 MW(e) range

Annual national direct and indirect cost estimates of the prevention and treatment of cervical cancer in Brazil

Science.gov (United States)

Novaes, Hillegonda Maria Dutilh; Itria, Alexander; Silva, Gulnar Azevedo e; Sartori, Ana Marli Christovam; Rama, Cristina Helena; de Soárez, Patrícia Coelho

2015-01-01

OBJECTIVE: To estimate the annual direct and indirect costs of the prevention and treatment of cervical cancer in Brazil. METHODS: This cost description study used a "gross-costing" methodology and adopted the health system and societal perspectives. The estimates were grouped into sets of procedures performed in phases of cervical cancer care: the screening, diagnosis and treatment of precancerous lesions and the treatment of cervical cancer. The costs were estimated for the public and private health systems, using data from national health information systems, population surveys, and literature reviews. The cost estimates are presented in 2006 USD. RESULTS: From the societal perspective, the estimated total costs of the prevention and treatment of cervical cancer amounted to USD $1,321,683,034, which was categorized as follows: procedures (USD $213,199,490), visits (USD $325,509,842), transportation (USD $106,521,537) and productivity losses (USD $676,452,166). Indirect costs represented 51% of the total costs, followed by direct medical costs (visits and procedures) at 41% and direct non-medical costs (transportation) at 8%. The public system represented 46% of the total costs, and the private system represented 54%. CONCLUSION: Our national cost estimates of cervical cancer prevention and treatment, indicating the economic importance of cervical cancer screening and care, will be useful in monitoring the effect of the HPV vaccine introduction and are of interest in research and health care management. PMID:26017797

Cost-effectiveness of canine vaccination to prevent human rabies in rural Tanzania.

Science.gov (United States)

Fitzpatrick, Meagan C; Hampson, Katie; Cleaveland, Sarah; Mzimbiri, Imam; Lankester, Felix; Lembo, Tiziana; Meyers, Lauren A; Paltiel, A David; Galvani, Alison P

2014-01-21

The annual mortality rate of human rabies in rural Africa is 3.6 deaths per 100 000 persons. Rabies can be prevented with prompt postexposure prophylaxis, but this is costly and often inaccessible in rural Africa. Because 99% of human exposures occur through rabid dogs, canine vaccination also prevents transmission of rabies to humans. To evaluate the cost-effectiveness of rabies control through annual canine vaccination campaigns in rural sub-Saharan Africa. We model transmission dynamics in dogs and wildlife and assess empirical uncertainty in the biological variables to make probability-based evaluations of cost-effectiveness. Epidemiologic variables from a contact-tracing study and literature and cost data from ongoing vaccination campaigns. Two districts of rural Tanzania: Ngorongoro and Serengeti. 10 years. Health policymaker. Vaccination coverage ranging from 0% to 95% in increments of 5%. Life-years for health outcomes and 2010 U.S. dollars for economic outcomes. Annual canine vaccination campaigns were very cost-effective in both districts compared with no canine vaccination. In Serengeti, annual campaigns with as much as 70% coverage were cost-saving. Across a wide range of variable assumptions and levels of societal willingness to pay for life-years, the optimal vaccination coverage for Serengeti was 70%. In Ngorongoro, although optimal coverage depended on willingness to pay, vaccination campaigns were always cost-effective and lifesaving and therefore preferred. Canine vaccination was very cost-effective in both districts, but there was greater uncertainty about the optimal coverage in Ngorongoro. Annual canine rabies vaccination campaigns conferred extraordinary value and dramatically reduced the health burden of rabies. National Institutes of Health.

The determinants of hospital cost: a cost-volume-profit analysis of health services in the occupied territories: Palestine.

Science.gov (United States)

Younis, Mustafa Z; Jaber, Samer; Smith, Pamela C; Hartmann, Michael; Bongyu, Moye

2010-06-01

The purpose of this study is to examine the unit costs of a multi-service hospital in Palestine for the period 2005-2007. We investigate the cost structure of the Rafidya Hospital located in Nablus city, for both inpatient and outpatient departments. This study uses cost-volume-profit (CVP) analysis, also known as breakeven analysis. CVP analysis requires examining total costs, along with fixed and variable costs. CVP analysis illuminates how changes in assumptions about cost behaviour and the relevant range in which those assumptions are valid affect the relationships among revenues, variable costs and fixed costs at various production levels. For the hospital of interest, we find that fixed costs account for 70% of total costs, and variable costs were 30% of total costs. Inpatient departments accounted for 86% of total costs, and outpatient departments were 14% of total costs. Results of the breakeven analysis illustrate that several departments charge sufficient fees to cover all unit costs. Results provide useful information about unit cost based on four categories: (1) unit cost per admission of each department, (2) unit cost per patient day of each department, (3) unit cost per admission with annual capital cost of each department and (4) unit cost per patient day with annual capital cost. Our results provide hospital cost information that can be used by decision-makers to provide and expand healthcare services, in an effort to increase sustainability and profitability. The use of cost analysis by administrators and regulators will improve the quality of financial information, as well as enhance the efficient use of scarce resources.

User instructions for levelized power generation cost codes using an IBM-type PC

International Nuclear Information System (INIS)

Coen, J.J.; Delene, J.G.

1989-01-01

Programs for the calculation of levelized power generation costs using an IBM or compatible PC are described. Cost calculations for nuclear plants and coal-fired plants include capital investment cost, operation and maintenance cost, fuel cycle cost, decommissioning cost, and total levelized power generation cost. 7 refs., 36 figs., 4 tabs

FORECAST: Regulatory effects cost analysis software annual

International Nuclear Information System (INIS)

Lopez, B.; Sciacca, F.W.

1991-11-01

Over the past several years the NRC has developed a generic cost methodology for the quantification of cost/economic impacts associated with a wide range of new or revised regulatory requirements. This methodology has been developed to aid the NRC in preparing Regulatory Impact Analyses (RIAs). These generic costing methods can be useful in quantifying impacts both to industry and to the NRC. The FORECAST program was developed to facilitate the use of the generic costing methodology. This PC program integrates the major cost considerations that may be required because of a regulatory change. FORECAST automates much of the calculations typically needed in an RIA and thus reduces the time and labor required to perform these analysis. More importantly, its integrated and consistent treatment of the different cost elements should help assure comprehensiveness, uniformity, and accuracy in the preparation of needed cost estimates

Annual plan of research on safety techniques against low level radioactive wastes, 1984-1988

International Nuclear Information System (INIS)

1984-01-01

The establishment of the countermeasures for treating and disposing radioactive wastes has become an important subject for promoting the utilization of atomic energy. Especially as to low level radioactive wastes, the cumulative quantity has reached about 460,000 in terms of 200 l drums as of the end of March, 1983, and accompanying the development of the utilization of atomic energy, its rapid increase is expected. So far, as for the disposal of low level radioactive wastes, the research and development and the preparation of safety criteria and safety evaluation techniques have been carried out, following the basic policy of the Atomic Energy Commission to execute land disposal and ocean disposal in combination, first to make the test disposal after preliminary safety evaluation, and to shift to the full scale disposal based on the results. The annual plan was decided on July 22, 1983, and the first revision was carried out this time, therefore, it is reported here. The basic policy of establishing this annual plan, and the annual plan for safety technique research are described. (Kako, I.)

Thirteenth annual U.S. DOE low-level radioactive waste management conference: Proceedings

Energy Technology Data Exchange (ETDEWEB)

NONE

1991-12-31

The 40 papers in this document comprise the proceedings of the Department of Energy`s Thirteenth Annual Low-Level Radioactive Waste Management Conference that was held in Atlanta, Georgia, on November 19--21, 1991. General subjects addressed during the conference included: disposal facility design; greater-than-class C low-level waste; public acceptance considerations; waste certification; site characterization; performance assessment; licensing and documentation; emerging low-level waste technologies; waste minimization; mixed waste; tracking and transportation; storage; and regulatory changes. Papers have been processed separately for inclusion on the data base.

Cost of individual peer counselling for the promotion of exclusive breastfeeding in Uganda

Directory of Open Access Journals (Sweden)

Nankunda Jolly

2011-06-01

Full Text Available Abstract Background Exclusive breastfeeding (EBF for 6 months is the recommended form of infant feeding. Support of mothers through individual peer counselling has been proved to be effective in increasing exclusive breastfeeding prevalence. We present a costing study of an individual peer support intervention in Uganda, whose objective was to raise exclusive breastfeeding rates at 3 months of age. Methods We costed the peer support intervention, which was offered to 406 breastfeeding mothers in Uganda. The average number of counselling visits was about 6 per woman. Annual financial and economic costs were collected in 2005-2008. Estimates were made of total project costs, average costs per mother counselled and average costs per peer counselling visit. Alternative intervention packages were explored in the sensitivity analysis. We also estimated the resources required to fund the scale up to district level, of a breastfeeding intervention programme within a public health sector model. Results Annual project costs were estimated to be US$56,308. The largest cost component was peer supporter supervision, which accounted for over 50% of total project costs. The cost per mother counselled was US$139 and the cost per visit was US$26. The cost per week of EBF was estimated to be US$15 at 12 weeks post partum. We estimated that implementing an alternative package modelled on routine public health sector programmes can potentially reduce costs by over 60%. Based on the calculated average costs and annual births, scaling up modelled costs to district level would cost the public sector an additional US$1,813,000. Conclusion Exclusive breastfeeding promotion in sub-Saharan Africa is feasible and can be implemented at a sustainable cost. The results of this study can be incorporated in cost effectiveness analyses of exclusive breastfeeding promotion programmes in sub-Saharan Africa.

Assessing the cost of electronic health records: a review of cost indicators.

Science.gov (United States)

Gallego, Ana Isabel; Gagnon, Marie-Pierre; Desmartis, Marie

2010-11-01

We systematically reviewed PubMed and EBSCO business, looking for cost indicators of electronic health record (EHR) implementations and their associated benefit indicators. We provide a set of the most common cost and benefit (CB) indicators used in the EHR literature, as well as an overall estimate of the CB related to EHR implementation. Overall, CB evaluation of EHR implementation showed a rapid capital-recovering process. On average, the annual benefits were 76.5% of the first-year costs and 308.6% of the annual costs. However, the initial investments were not recovered in a few studied implementations. Distinctions in reporting fixed and variable costs are suggested.

Northeast Commercial Fishing Vessel Cost Survey

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Typically, commercial fishing businesses incur three major types of costs: fixed or annual costs; which are incurred annually irrespective of whether any fishing...

Cost-risk optimization of nondestructive inspection level

International Nuclear Information System (INIS)

Johnson, D.P.

1978-01-01

This paper develops a quantitative methodology for determining the nondestructive inspection (NDI) level that will result in a minimum cost product considering both type one inspection errors, acceptance of defective material units, and type two inspection errors, rejection of sound material units. This methodology represents an advance over fracture mechanics - nondestructive inspection (FM-NDI) design systems that do not consider type two inspection errors or the pre-inspection material quality. The inputs required for the methodology developed in this paper are (1) the rejection probability as a function of inspection size and imperfection size, (2) the flaw frequency (FF), as a function of imperfection size, (3) the probability of failure given the material unit contains an imperfection of a given size as a function of that given size, (4) the manufacturing cost per material unit, (5) the inspection cost per material unit, and (6) the average cost per failure including indirect costs. Four methods are identified for determining the flaw-frequency and three methods are identified for determining the conditional failure probability (one of these methods is probabilistic fracture mechanics). Methods for determining the rejection probability are discussed elsewhere. The NDI-FF methodology can have significant impact where the cost of failures represents a significant fraction of the manufacturing costs, or when a significant fraction of the components are being rejected by the inspection. (Auth.)

The longitudinal study of turnover and the cost of turnover in EMS

Science.gov (United States)

Patterson, P. Daniel; Jones, Cheryl B.; Hubble, Michael W.; Carr, Matthew; Weaver, Matthew D.; Engberg, John; Castle, Nicholas

2010-01-01

Purpose Few studies have examined employee turnover and associated costs in emergency medical services (EMS). The purpose of this study was to quantify the mean annual rate of turnover, total median cost of turnover, and median cost per termination in a diverse sample of EMS agencies. Methods A convenience sample of 40 EMS agencies was followed over a 6 month period. Internet, telephone, and on-site data collection methods were used to document terminations, new hires, open positions, and costs associated with turnover. The cost associated with turnover was calculated based on a modified version of the Nursing Turnover Cost Calculation Methodology (NTCCM). The NTCCM identified direct and indirect costs through a series of questions that agency administrators answered monthly during the study period. A previously tested measure of turnover to calculate the mean annual rate of turnover was used. All calculations were weighted by the size of the EMS agency roster. The mean annual rate of turnover, total median cost of turnover, and median cost per termination were determined for 3 categories of agency staff mix: all paid staff, mix of paid and volunteer (mixed), and all-volunteer. Results The overall weighted mean annual rate of turnover was 10.7%. This rate varied slightly across agency staffing mix: (all-paid=10.2%, mixed=12.3%, all-volunteer=12.4%). Among agencies that experienced turnover (n=25), the weighted median cost of turnover was $71,613.75, which varied across agency staffing mix: (all-paid=$86,452.05, mixed=$9,766.65, and all-volunteer=$0). The weighted median cost per termination was $6,871.51 and varied across agency staffing mix: (all-paid=$7,161.38, mixed=$1,409.64, and all-volunteer=$0). Conclusions Annual rates of turnover and costs associated with turnover vary widely across types of EMS agencies. The study’s mean annual rate of turnover was lower than expected based on information appearing in the news media and EMS trade magazines. Findings

Determination of indoor radon concentration levels and the associated annual effective dose rate in some Ghanaian dwellings

International Nuclear Information System (INIS)

Nsiah-Akoto, I.

2010-01-01

Radon and its decay products in indoor air are the main source of natural internal irradiation of man. In this present work, the indoor radon concentration, the annual exposure, the annual effective dose and the annual dose equivalent to the lung received by the population were estimated in the dwellings at Dome in the Ga-East District of the Greater Accra Region, Ghana using time-integrated passive radon detectors; LR-115 Type II solid state nuclear track detector (SSNTD) technique. The primary objective of this project was to assess the annual effective dose rate due to the indoor radon concentration levels and the associated level of risk. Measurements were carried out from December 2009 to March 2010. After the 3 months exposure, the detectors were subjected to chemical etching in a 2.5M analytical grade sodium hydroxide solution at (60 ±1) o C, for 90mins in a constant temperature water bath to enlarge the latent tracks produced by alpha particles from the decay of radon. The etched tracks were magnified using the microfiche reader and counted with a tally counter. The mean indoor radon concentration was found to be (466.9±1.2) Bqm -3 and the mean annual exposure was (2.03±0.08) WLM. Assuming an indoor occupancy factor of 0.4 and 0.4 for equilibrium factor for radon indoors, we found out that the mean Rn-222 effective dose rate and the annual equivalent dose rate to the lung in the present study dwellings was (14.13±0.22)mSvy -1 and (3.74 E-07 ±3.50 E-06)Svy -1 respectively. The mean values of radon concentrations at Dome, Kwabenya, Biakpa, and South-Eastern part of Ghana, Prestea and Kassena-Nakana District in the previous research ranged from (9.4±0.5) to (518.7±4.0) Bqm -3 . The mean annual exposure, annual effective dose rate and the annual equivalent for the previous work ranged from (0.04±0.03)WLM to (0.58±0.05)WLM, (0.28±0.08) to (15.54±0.69mSvy -1 ), (8.23E-12±4.33E-07) to (4.15E-07± 1.13E-04) respectively. Odds ratios (ORs) for lung

Cost estimating Brayton and Stirling engines

Science.gov (United States)

Fortgang, H. R.

1980-01-01

Brayton and Stirling engines were analyzed for cost and selling price for production quantities ranging from 1000 to 400,000 units per year. Parts and components were subjected to indepth scrutiny to determine optimum manufacturing processes coupled with make or buy decisions on materials and small parts. Tooling and capital equipment costs were estimated for each detail and/or assembly. For low annual production volumes, the Brayton engine appears to have a lower cost and selling price than the Stirling Engine. As annual production quantities increase, the Stirling becomes a lower cost engine than the Brayton. Both engines could benefit cost wise if changes were made in materials, design and manufacturing process as annual production quantities increase.

Nuclear Waste Fund fee adequacy: an assessment. Second annual report

International Nuclear Information System (INIS)

1984-07-01

This is the second report of an annual series that evaluates whether the revenues collected from the waste disposal fees established under Section 302 of the Nuclear Waste Policy Act of 1982 (Public Law 97-425) are sufficient to offset the federal government's costs for the disposal of commercially generated spent nuclear fuel (SNF) and high-level radioactive waste. Nuclear wastes produced from defense activities are not considered in this report. The principal findings of this year's analysis are: The current 1.0 mill per kilowatt-hour (kWh) fee is projected to produce revenues sufficient to offset total system life cycle costs associated with the cases specified later in the report, assuming that the average annual rate of inflation does not exceed 2 to 3%. Higher average annual rates of inflation, or unanticipated real cost growth, would cause cumulative program costs to approach and then surpass cumulative revenues generated from the current 1.0 mill per kWh fee. Based on an analysis of different inflation rates and program cost growth projections discussed herein, indexing of the fee to correct for inflation would not need to begin until 1985, at the earliest, or perhaps as late as the year 2000. There is substantial uncertainty about both the program cost and revenue projections. However, more reliable data are expected to become available in the late 1980s as the program evolves from its present conceptual design phase to the engineering phase. Hence, any recommendation to raise the 1.0 mill per kWh fee before that time should be measured against the uncertainties that attend the present program. 4 references, 4 tables

Advice concerning the advantages of a reference incinerator for low-level and intermediate-level radioactive waste processing

International Nuclear Information System (INIS)

Luyten, G.B.

1985-05-01

In this report, an inventory is presented of new incinerators and flue gas filters used in low and intermediate-level radioactive waste combustion. It is argued that a 'reference equipment' for the combustion of solid and liquid low- and intermediate-level wastes best meets existing Dutch radiation protection standards. A cost-benefit analysis of such an equipment is given including annual costs of investment, capital and exploration. A separate combustion process of organic liquids and carrions is considered finally. (G.J.P.)

Total generating costs: coal and nuclear plants

International Nuclear Information System (INIS)

1979-02-01

The study was confined to single and multi-unit coal- and nuclear-fueled electric-generating stations. The stations are composed of 1200-MWe PWRs; 1200-MWe BWRs; 800-and 1200-MWe High-Sulfur Coal units, and 800- and 1200-MWe Low-Sulfur Coal units. The total generating cost estimates were developed for commercial operation dates of 1985 and 1990; for 5 and 8% escalation rates, for 10 and 12% discount rates; and, for capacity factors of 50, 60, 70, and 80%. The report describes the methodology for obtaining annualized capital costs, levelized coal and nuclear fuel costs, levelized operation and maintenance costs, and the resulting total generating costs for each type of station. The costs are applicable to a hypothetical Middletwon site in the Northeastern United States. Plant descriptions with general design parameters are included. The report also reprints for convenience, summaries of capital cost by account type developed in the previous commercial electric-power cost studies. Appropriate references are given for additional detailed information. Sufficient detail is given to allow the reader to develop total generating costs for other cases or conditions

Herd-Level Mastitis-Associated Costs on Canadian Dairy Farms

Science.gov (United States)

Aghamohammadi, Mahjoob; Haine, Denis; Kelton, David F.; Barkema, Herman W.; Hogeveen, Henk; Keefe, Gregory P.; Dufour, Simon

2018-01-01

Mastitis imposes considerable and recurring economic losses on the dairy industry worldwide. The main objective of this study was to estimate herd-level costs incurred by expenditures and production losses associated with mastitis on Canadian dairy farms in 2015, based on producer reports. Previously, published mastitis economic frameworks were used to develop an economic model with the most important cost components. Components investigated were divided between clinical mastitis (CM), subclinical mastitis (SCM), and other costs components (i.e., preventive measures and product quality). A questionnaire was mailed to 374 dairy producers randomly selected from the (Canadian National Dairy Study 2015) to collect data on these costs components, and 145 dairy producers returned a completed questionnaire. For each herd, costs due to the different mastitis-related components were computed by applying the values reported by the dairy producer to the developed economic model. Then, for each herd, a proportion of the costs attributable to a specific component was computed by dividing absolute costs for this component by total herd mastitis-related costs. Median self-reported CM incidence was 19 cases/100 cow-year and mean self-reported bulk milk somatic cell count was 184,000 cells/mL. Most producers reported using post-milking teat disinfection (97%) and dry cow therapy (93%), and a substantial proportion of producers reported using pre-milking teat disinfection (79%) and wearing gloves during milking (77%). Mastitis costs were substantial (662 CAD per milking cow per year for a typical Canadian dairy farm), with a large portion of the costs (48%) being attributed to SCM, and 34 and 15% due to CM and implementation of preventive measures, respectively. For SCM, the two most important cost components were the subsequent milk yield reduction and culling (72 and 25% of SCM costs, respectively). For CM, first, second, and third most important cost components were culling (48

Herd-Level Mastitis-Associated Costs on Canadian Dairy Farms

Directory of Open Access Journals (Sweden)

Mahjoob Aghamohammadi

2018-05-01

Full Text Available Mastitis imposes considerable and recurring economic losses on the dairy industry worldwide. The main objective of this study was to estimate herd-level costs incurred by expenditures and production losses associated with mastitis on Canadian dairy farms in 2015, based on producer reports. Previously, published mastitis economic frameworks were used to develop an economic model with the most important cost components. Components investigated were divided between clinical mastitis (CM, subclinical mastitis (SCM, and other costs components (i.e., preventive measures and product quality. A questionnaire was mailed to 374 dairy producers randomly selected from the (Canadian National Dairy Study 2015 to collect data on these costs components, and 145 dairy producers returned a completed questionnaire. For each herd, costs due to the different mastitis-related components were computed by applying the values reported by the dairy producer to the developed economic model. Then, for each herd, a proportion of the costs attributable to a specific component was computed by dividing absolute costs for this component by total herd mastitis-related costs. Median self-reported CM incidence was 19 cases/100 cow-year and mean self-reported bulk milk somatic cell count was 184,000 cells/mL. Most producers reported using post-milking teat disinfection (97% and dry cow therapy (93%, and a substantial proportion of producers reported using pre-milking teat disinfection (79% and wearing gloves during milking (77%. Mastitis costs were substantial (662 CAD per milking cow per year for a typical Canadian dairy farm, with a large portion of the costs (48% being attributed to SCM, and 34 and 15% due to CM and implementation of preventive measures, respectively. For SCM, the two most important cost components were the subsequent milk yield reduction and culling (72 and 25% of SCM costs, respectively. For CM, first, second, and third most important cost components were

The cost of pressure ulcers in the UK.

Science.gov (United States)

Bennett, Gerry; Dealey, Carol; Posnett, John

2004-05-01

To estimate the annual cost of treating pressure ulcers in the UK. Costs were derived from a bottom-up methodology, based on the daily resources required to deliver protocols of care reflecting good clinical practice. Health and social care system in the UK. Patients developing a pressure ulcer. A bottom-up costing approach is used to estimate treatment cost per episode of care and per patient for ulcers of different grades and level of complications. Also, total treatment cost to the health and social care system in the UK. The cost of treating a pressure ulcer varies from pound 1,064 (Grade 1) to pound 10,551 (Grade 4). Costs increase with ulcer grade because the time to heal is longer and because the incidence of complications is higher in more severe cases. The total cost in the UK is pound 1.4- pound 2.1 billion annually (4% of total NHS expenditure). Most of this cost is nurse time. Pressure ulcers represent a very significant cost burden in the UK. Without concerted effort this cost is likely to increase in the future as the population ages. To the extent that pressure ulcers are avoidable, pressure damage may be indicative of clinical negligence and there is evidence that litigation could soon become a significant threat to healthcare providers in the UK, as it is in the USA.

Annual Equivalent Value, Benefit Cost Ratio, and Composite Performance Index as Valuation Appraisal Support of Teakwood Plantation

Directory of Open Access Journals (Sweden)

Sugiharto Soeleman

2014-04-01

Full Text Available Teak (Tectona grandis L.f is a premium high-value hardwood species being viewed as the most preferred species for investment opportunity. Recently, there has been a gradual move away from state control of teakwood plantation toward the participation of private enterprises. Several enterprises offer investment opportunity of teakwood plantation in which one of the main selling points being offered is a quick harvesting schedule. A quick harvesting time, however, might not provide the best outcome to the investors. This research exercise and compare the valuation appraisal of different harvesting schedules. The research focused on project planning, enterprise budget, financial projection, and valuation measurements to arrive at overall appraisal. To avoid any possible bias of individual investor's preference on common valuation criteria such as total investment, net cash flow (NCF, net present value (NPV, internal rate of return (IRR, profit on investment (P/I, and payback period (PBP, 3 otherS criteria namely benefit cost ratio (BCR, annual equivalent value (AEV, and composite performance index (CPI have been applied to arrive at a more fair valuation. It is concluded that the longer the harvesting schedule, the better valuation outcome could be achieved, and therefore, investors should critically review any investment proposal in accordance to their preference on valuation criteria. Keywords : annual equivalent value, benefit cost ratio, composite performance index, valuation appraisal

The Annual Economic Burden of Syphilis: An Estimation of Direct, Productivity, and Intangible Costs for Syphilis in Guangdong Initiative for Comprehensive Control of Syphilis Sites.

Science.gov (United States)

Zou, Yaming; Liao, Yu; Liu, Fengying; Chen, Lei; Shen, Hongcheng; Huang, Shujie; Zheng, Heping; Yang, Bin; Hao, Yuantao

2017-11-01

Syphilis has continuously posed a great challenge to China. However, very little data existed regarding the cost of syphilis. Taking Guangdong Initiative for Comprehensive Control of Syphilis area as the research site, we aimed to comprehensively measure the annual economic burden of syphilis from a societal perspective. Newly diagnosed and follow-up outpatient cases were investigated by questionnaire. Reported tertiary syphilis cases and medical institutions cost were both collected. The direct economic burden was measured by the bottom-up approach, the productivity cost by the human capital method, and the intangible burden by the contingency valuation method. Three hundred five valid early syphilis cases and 13 valid tertiary syphilis cases were collected in the investigation to estimate the personal average cost. The total economic burden of syphilis was US $729,096.85 in Guangdong Initiative for Comprehensive Control of Syphilis sites in the year of 2014, with medical institutions cost accounting for 73.23% of the total. Household average direct cost of early syphilis was US $23.74. Average hospitalization cost of tertiary syphilis was US $2,749.93. Of the cost to medical institutions, screening and testing comprised the largest proportion (26%), followed by intervention and case management (22%) and operational cost (21%). Household average productivity cost of early syphilis was US $61.19. Household intangible cost of syphilis was US $15,810.54. Syphilis caused a substantial economic burden on patients, their families, and society in Guangdong. Household productivity and intangible costs both shared positive relationships with local economic levels. Strengthening the prevention and effective treatment of early syphilis could greatly help to lower the economic burden of syphilis.

The burden of prenatal exposure to alcohol: revised measurement of cost.

Science.gov (United States)

Stade, Brenda; Ali, Alaa; Bennett, Dainel; Campbell, Douglas; Johnston, Mary; Lens, Cynthia; Tran, Sofia; Koren, Gideon

2009-01-01

In Canada the incidence of Fetal Alcohol Spectrum Disorder (FASD) is estimated to be 1 in 100 live births. FASD is the leading cause of developmental and cognitive disabilities in Canada. Only one study has examined the cost of FASD in Canada. In that study we did not include prospective data for infants under the age of one year, costs for adults beyond 21 years or costs for individuals living in institutions. To calculate a revised estimate of direct and indirect costs associated with FASD at the patient level. Cross-sectional study design was used. Two-hundred and fifty (250) participants completed the study tool. Participants included caregivers of children, youth and adults, with FASD, from day of birth to 53 years, living in urban and rural communities throughout Canada participated. Participants completed the Health Services Utilization Inventory (HSUI). Key cost components were elicited: direct costs: medical, education, social services, out-of-pocket costs; and indirect costs: productivity losses. Total average costs per individual with FASD were calculated by summing the costs for each in each cost component, and dividing by the sample size. Costs were extrapolated to one year. A stepwise multiple regression analysis was used to identify significant determinants of costs and to calculate the adjusted annual costs associated with FASD. Total adjusted annual costs associated with FASD at the individual level was $21,642 (95% CI, $19,842; $24,041), compared to $14,342 (95% CI, $12,986; $15,698) in the first study. Severity of the individual's condition, age, and relationship of the individual to the caregiver (biological, adoptive, foster) were significant determinants of costs (p Cost of FASD annually to Canada of those from day of birth to 53 years old, was $5.3 billion (95% CI, $4.12 billion; $6.4 billion). Study results demonstrated the cost burden of FASD in Canada was profound. Inclusion of infants aged 0 to 1 years, adults beyond the age of 21 years

The annual cost of not breastfeeding in Indonesia: the economic burden of treating diarrhea and respiratory disease among children (recommendation.

Science.gov (United States)

Siregar, Adiatma Y M; Pitriyan, Pipit; Walters, Dylan

2018-01-01

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.

Levelized Costs for Nuclear, Gas and Coal for Electricity, under the Mexican Scenario

Energy Technology Data Exchange (ETDEWEB)

Palacios, J.C.; Alonso, G.; Ramirez, R.; Gomez, A.; Ortiz, J.; Longoria, L.C.

2004-10-06

In the case of new nuclear power stations, it is necessary to pay special attention to the financial strategy that will be applied, time of construction, investment cost, and the discount and return rate. The levelized cost quantifies the unitary cost of the electricity (the kWh) generated during the lifetime of the nuclear power plant; and allows the immediate comparison with the cost of other alternative technologies. The present paper shows levelized cost for different nuclear technologies and it provides comparison among them as well as with gas and coal electricity plants. For the calculations we applied our own methodology to evaluate the levelized cost considering investment, fuel and operation and maintenance costs, making assumptions for the Mexican market, and taking into account the gas prices projections. The study also shows comparisons using different discount rates (5% and 10%), and some comparisons between our results and an OECD 1998 study. The results are i n good agreement and shows that nuclear option is cost competitive in Mexico on the basis of levelized costs.

Levelized Costs for Nuclear, Gas and Coal for Electricity, under the Mexican Scenario

International Nuclear Information System (INIS)

Palacios, J.C.; Alonso, G.; Ramirez, R.; Gomez, A.; Ortiz, J.; Longoria, L.C.

2004-01-01

In the case of new nuclear power stations, it is necessary to pay special attention to the financial strategy that will be applied, time of construction, investment cost, and the discount and return rate. The levelized cost quantifies the unitary cost of the electricity (the kWh) generated during the lifetime of the nuclear power plant; and allows the immediate comparison with the cost of other alternative technologies. The present paper shows levelized cost for different nuclear technologies and it provides comparison among them as well as with gas and coal electricity plants. For the calculations we applied our own methodology to evaluate the levelized cost considering investment, fuel and operation and maintenance costs, making assumptions for the Mexican market, and taking into account the gas prices projections. The study also shows comparisons using different discount rates (5% and 10%), and some comparisons between our results and an OECD 1998 study. The results are i n good agreement and shows that nuclear option is cost competitive in Mexico on the basis of levelized costs

Prevalence and healthcare costs of obesity-related comorbidities: evidence from an electronic medical records system in the United States.

Science.gov (United States)

Li, Qian; Blume, Steven W; Huang, Joanna C; Hammer, Mette; Ganz, Michael L

2015-01-01

This study estimated the economic burden of obesity-related comorbidities (ORCs) in the US, at both the person and population levels. The Geisinger Health System provided electronic medical records and claims between January 2004 and May 2013 for a sample of 153,561 adults (50% males and 97% white). Adults with A total of 21 chronic conditions, with established association with obesity in the literature, were identified by diagnosis codes and/or lab test results. The total healthcare costs were measured in each year. The association between annual costs and ORCs was assessed by a regression, which jointly considered all the ORCs. The per-person incremental costs of a single comorbidity, without any of the other ORCs, were calculated. The population-level economic burden was the product of each ORC's incremental costs and the annual prevalence of the ORC among 100,000 individuals. The prevalence of ORCs was stratified by obesity status to estimate the economic burden among 100,000 individuals with obesity and among those without. This study identified 56,895 adults (mean age = 47 years; mean BMI = 29.6 kg/m(2)). The annual prevalence of ORCs ranged from 0.5% for pulmonary embolism (PE) to 41.8% for dyslipidemia. The per-person annual incremental costs of a single ORC ranged from $120 for angina to $1665 for PE. Hypertensive diseases (HTND), dyslipidemia, and osteoarthritis were the three most expensive ORCs at the population level; each responsible for ≥$18 million annually among 100,000 individuals. HTND and osteoarthritis were much more costly among individuals with obesity than those without obesity. Data were from a small geographic region. ORCs are associated with substantial economic burden, especially for those requiring continuous treatments.

Capital and operating cost estimates for high temperature superconducting magnetic energy storage

International Nuclear Information System (INIS)

Schoenung, S.M.; Meier, W.R.; Fagaly, R.L.; Heiberger, M.; Stephens, R.B.; Leuer, J.A.; Guzman, R.A.

1992-01-01

Capital and operating costs have been estimated for mid-scale (2 to 200 Mwh) superconducting magnetic energy storage (SMES) designed to use high temperature superconductors (HTS). Capital costs are dominated by the cost of superconducting materials. Operating costs, primarily for regeneration, are significantly reduced for HTS-SMES in comparison to low temperature, conventional systems. This cost component is small compared to other O and M and capital components, when levelized annual costs are projected. In this paper, the developments required for HTS-SMES feasibility are discussed

Medicare Cost Reports

Data.gov (United States)

U.S. Department of Health & Human Services — Medicare certified institutional providers are required to submit an annual cost report to a Medicare Administrative Contractor. The cost report contains provider...

Direct costs of chronic obstructive pulmonary disease among managed care patients

Directory of Open Access Journals (Sweden)

An

2010-09-01

Full Text Available Anand A Dalal1, Laura Christensen2, Fang Liu3, Aylin A Riedel31US Health Outcomes, GlaxoSmithKline, Research Triangle Park, NC, USA; 2Health Economics Outcomes Research, i3 Innovus, Ann Arbor, MI, USA; 3Health Economics Outcomes Research, i3 Innovus, Eden Prairie, MN, USAPurpose: To estimate patient- and episode-level direct costs of chronic obstructive pulmonary disease (COPD among commercially insured patients in the US.Methods: In this retrospective claims-based analysis, commercial enrollees with evidence of COPD were grouped into five mutually exclusive cohorts based on the most intensive level of COPD-related care they received in 2006, ie, outpatient, urgent outpatient (outpatient care in addition to a claim for an oral corticosteroid or antibiotic within seven days, emergency department (ED, standard inpatient admission, and intensive care unit (ICU cohorts. Patient-level COPD-related annual health care costs, including patient- and payer-paid costs, were compared among the cohorts. Adjusted episode-level costs were calculated.Results: Of the 37,089 COPD patients included in the study, 53% were in the outpatient cohort, 37% were in the urgent outpatient cohort, 3% were in the ED cohort, and the standard admission and ICU cohorts together comprised 6%. Mean (standard deviation, SD annual COPD-related health care costs (2008 US$ increased across the cohorts (P < 0.001, ranging from $2003 ($3238 to $43,461 ($76,159 per patient. Medical costs comprised 96% of health care costs for the ICU cohort. Adjusted mean (SD episode-level costs were $305 ($310 for an outpatient visit, $274 ($336 for an urgent outpatient visit, $327 ($65 for an ED visit, $9745 ($2968 for a standard admission, and $33,440 for an ICU stay.Conclusion: Direct costs of COPD-related care for commercially insured patients are driven by hospital stays with or without ICU care. Exacerbation prevention resulting in reduced need for inpatient care could lower costs

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

International Nuclear Information System (INIS)

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

1993-09-01

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

2016 Annual Technology Baseline (ATB) - Webinar Presentation

Energy Technology Data Exchange (ETDEWEB)

Cole, Wesley; Kurup, Parthiv; Hand, Maureen; Feldman, David; Sigrin, Benjamin; Lantz, Eric; Stehly, Tyler; Augustine, Chad; Turchi, Craig; Porro, Gian; O' Connor, Patrick; Waldoch, Connor

2016-09-13

This deck was presented for the 2016 Annual Technology Baseline Webinar. The presentation describes the Annual Technology Baseline, which is a compilation of current and future cost and performance data for electricity generation technologies.

Compliance with the annual NO 2 air quality standard in Athens. Required NO x levels and expected health implications

Science.gov (United States)

Chaloulakou, A.; Mavroidis, I.; Gavriil, I.

Recent risk assessment studies have shown that high outdoor NO 2 levels observed in residential areas contribute to increased respiratory and cardiovascular diseases and mortality. Detailed information on present NO 2 levels as well as predictions of NO 2 concentrations corresponding to reduced NO x levels in urban areas are very useful to decision and policy makers in order to protect the public health. In the present paper, monitoring stations of the Athens network are initially classified into two main groups, traffic affected and urban background, using effectively a criterion based on the ratio of annual mean NO:NO 2 concentrations. Two empirical methodologies are then considered and compared for assessing the effect of different NO x levels on the attainment of the annual NO 2 air quality standard at urban-background locations in the Athens area. An interesting finding is that these two methodologies, one more general and one both year and site dependent, give similar results for the specific study area and can be applied alternatively based on the length of available concentration time series. The results show that in order to meet the EU annual mean NO 2 objective at all the urban-background locations of the Athens area, annual NO x concentrations should be reduced to approximately 60 μg m -3, requiring NO x emission reductions of up to 30%. An analysis of the health implications of the currently observed NO 2 levels is conducted, based on a dose-response relationship, and is coupled with available health-related data for the Athens area. This analysis suggests that if NO 2 concentrations were reduced to the levels of the annual EU air quality standard, then a decrease of hospital admissions of up to 2.6% would be observed, depending on the levels of NO 2 measured at different monitoring sites of the Athens conurbation.

Petroleum marketing annual 1994

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-08-24

The Petroleum Marketing Annual (PMA) provides information and statistical data on a variety of crude oils and refined petroleum products. The publication presents statistics on crude oil costs and refined petroleum products sales for use by industry, government, private sector analysis, educational institutions, and consumers. Data on crude oil include the domestic first purchase price, the fob and landed cost of imported crude oil, and the refiners` acquisition cost of crude oil. Refined petroleum product sales data include motor gasoline, distillates, residuals, aviation fuels, kerosene, and propane. The Petroleum Marketing Division, Office of Oil and Gas, Energy Information Administration ensures the accuracy, quality, and confidentiality of the published data in the Petroleum Marketing Annual. For this production, all estimates have been recalculated since their earlier publication in the Petroleum Marketing Monthly (PMM). These calculations made use of additional data and corrections that were received after the PMM publication date.

Petroleum marketing annual 1994

International Nuclear Information System (INIS)

1995-01-01

The Petroleum Marketing Annual (PMA) provides information and statistical data on a variety of crude oils and refined petroleum products. The publication presents statistics on crude oil costs and refined petroleum products sales for use by industry, government, private sector analysis, educational institutions, and consumers. Data on crude oil include the domestic first purchase price, the fob and landed cost of imported crude oil, and the refiners' acquisition cost of crude oil. Refined petroleum product sales data include motor gasoline, distillates, residuals, aviation fuels, kerosene, and propane. The Petroleum Marketing Division, Office of Oil and Gas, Energy Information Administration ensures the accuracy, quality, and confidentiality of the published data in the Petroleum Marketing Annual. For this production, all estimates have been recalculated since their earlier publication in the Petroleum Marketing Monthly (PMM). These calculations made use of additional data and corrections that were received after the PMM publication date

The impact of HMO penetration on the rate of hospital cost inflation, 1985-1993.

Science.gov (United States)

Gaskin, D J; Hadley, J

1997-01-01

This paper provides evidence that growth in health maintenance organization (HMO) enrollment slows hospital cost inflation. During the period 1985-1993, hospitals in areas with high rates of HMO penetration and growth had a slower rate of growth in expenses (8.3%) than hospitals in low penetration areas (11.2%). From 1992-1993, HMO growth lowered the rate of hospital cost inflation by .34 to 3.40 percentage points, depending on the base-year level and the annual change in HMO penetration. Declines in Medicare Prospective Payment System (PPS) margins also lowered hospital cost inflation; over the time period, annual hospital cost inflation was reduced by .38 percentage points. The estimates imply that the cumulative effect of HMO growth on hospital costs has been a $56.2 billion reduction (in 1993 dollars).

Realistic generation cost of solar photovoltaic electricity

International Nuclear Information System (INIS)

Singh, Parm Pal; Singh, Sukhmeet

2010-01-01

Solar photovoltaic (SPV) power plants have long working life with zero fuel cost and negligible maintenance cost but requires huge initial investment. The generation cost of the solar electricity is mainly the cost of financing the initial investment. Therefore, the generation cost of solar electricity in different years depends on the method of returning the loan. Currently levelized cost based on equated payment loan is being used. The static levelized generation cost of solar electricity is compared with the current value of variable generation cost of grid electricity. This improper cost comparison is inhibiting the growth of SPV electricity by creating wrong perception that solar electricity is very expensive. In this paper a new method of loan repayment has been developed resulting in generation cost of SPV electricity that increases with time like that of grid electricity. A generalized capital recovery factor has been developed for graduated payment loan in which capital and interest payment in each installment are calculated by treating each loan installment as an independent loan for the relevant years. Generalized results have been calculated which can be used to determine the cost of SPV electricity for a given system at different places. Results show that for SPV system with specific initial investment of 5.00 cents /kWh/year, loan period of 30 years and loan interest rate of 4% the levelized generation cost of SPV electricity with equated payment loan turns out to be 28.92 cents /kWh, while the corresponding generation cost with graduated payment loan with escalation in annual installment of 8% varies from 9.51 cents /kWh in base year to 88.63 cents /kWh in 30th year. So, in this case, the realistic current generation cost of SPV electricity is 9.51 cents /kWh and not 28.92 cents /kWh. Further, with graduated payment loan, extension in loan period results in sharp decline in cost of SPV electricity in base year. Hence, a policy change is required

Productivity Costs in Patients with Refractory Chronic Rhinosinusitis

Science.gov (United States)

Rudmik, Luke; Smith, Timothy L.; Schlosser, Rodney J.; Hwang, Peter H.; Mace, Jess C.; Soler, Zachary M.

2014-01-01

Objective Disease-specific reductions in patient productivity can lead to substantial economic losses to society. The purpose of this study was to: 1) define the annual productivity cost for a patient with refractory chronic rhinosinusitis (CRS) and 2) evaluate the relationship between degree of productivity cost and CRS-specific characteristics. Study Design Prospective, multi-institutional, observational cohort study. Methods The human capital approach was used to define productivity costs. Annual absenteeism, presenteeism, and lost leisure time was quantified to define annual lost productive time (LPT). LPT was monetized using the annual daily wage rates obtained from the 2012 US National Census and the 2013 US Department of Labor statistics. Results A total of 55 patients with refractory CRS were enrolled. The mean work days lost related to absenteeism and presenteeism was 24.6 and 38.8 days per year, respectively. A total of 21.2 household days were lost per year related to daily sinus care requirements. The overall annual productivity cost was $10,077.07 per patient with refractory CRS. Productivity costs increased with worsening disease-specific QoL (r=0.440; p=0.001). Conclusion Results from this study have demonstrated that the annual productivity cost associated with refractory CRS is $10,077.07 per patient. This substantial cost to society provides a strong incentive to optimize current treatment protocols and continue evaluating novel clinical interventions to reduce this cost. PMID:24619604

Productivity costs in patients with refractory chronic rhinosinusitis.

Science.gov (United States)

Rudmik, Luke; Smith, Timothy L; Schlosser, Rodney J; Hwang, Peter H; Mace, Jess C; Soler, Zachary M

2014-09-01

Disease-specific reductions in patient productivity can lead to substantial economic losses to society. The purpose of this study was to: 1) define the annual productivity cost for a patient with refractory chronic rhinosinusitis (CRS) and 2) evaluate the relationship between degree of productivity cost and CRS-specific characteristics. Prospective, multi-institutional, observational cohort study. The human capital approach was used to define productivity costs. Annual absenteeism, presenteeism, and lost leisure time was quantified to define annual lost productive time (LPT). LPT was monetized using the annual daily wage rates obtained from the 2012 U.S. National Census and the 2013 U.S. Department of Labor statistics. A total of 55 patients with refractory CRS were enrolled. The mean work days lost related to absenteeism and presenteeism were 24.6 and 38.8 days per year, respectively. A total of 21.2 household days were lost per year related to daily sinus care requirements. The overall annual productivity cost was $10,077.07 per patient with refractory CRS. Productivity costs increased with worsening disease-specific QoL (r = 0.440; p = 0.001). Results from this study have demonstrated that the annual productivity cost associated with refractory CRS is $10,077.07 per patient. This substantial cost to society provides a strong incentive to optimize current treatment protocols and continue evaluating novel clinical interventions to reduce this cost. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

The longitudinal study of turnover and the cost of turnover in emergency medical services.

Science.gov (United States)

Patterson, P Daniel; Jones, Cheryl B; Hubble, Michael W; Carr, Matthew; Weaver, Matthew D; Engberg, John; Castle, Nicholas

2010-01-01

Few studies have examined employee turnover and associated costs in emergency medical services (EMS). To quantify the mean annual rate of turnover, total median cost of turnover, and median cost per termination in a diverse sample of EMS agencies. A convenience sample of 40 EMS agencies was followed over a six-month period. Internet, telephone, and on-site data-collection methods were used to document terminations, new hires, open positions, and costs associated with turnover. The cost associated with turnover was calculated based on a modified version of the Nursing Turnover Cost Calculation Methodology (NTCCM). The NTCCM identified direct and indirect costs through a series of questions that agency administrators answered monthly during the study period. A previously tested measure of turnover to calculate the mean annual rate of turnover was used. All calculations were weighted by the size of the EMS agency roster. The mean annual rate of turnover, total median cost of turnover, and median cost per termination were determined for three categories of agency staff mix: all-paid staff, mix of paid and volunteer (mixed) staff, and all-volunteer staff. The overall weighted mean annual rate of turnover was 10.7%. This rate varied slightly across agency staffing mix (all-paid = 10.2%, mixed = 12.3%, all-volunteer = 12.4%). Among agencies that experienced turnover (n = 25), the weighted median cost of turnover was $71,613.75, which varied across agency staffing mix (all-paid = $86,452.05, mixed = $9,766.65, and all-volunteer = $0). The weighted median cost per termination was $6,871.51 and varied across agency staffing mix (all-paid = $7,161.38, mixed = $1,409.64, and all-volunteer = $0). Annual rates of turnover and costs associated with turnover vary widely across types of EMS agencies. The study's mean annual rate of turnover was lower than expected based on information appearing in the news media and EMS trade magazines. Findings provide estimates of two key

How Much Will It Cost To Monitor Microbial Drinking Water Quality in Sub-Saharan Africa?

Science.gov (United States)

Delaire, Caroline; Peletz, Rachel; Kumpel, Emily; Kisiangani, Joyce; Bain, Robert; Khush, Ranjiv

2017-06-06

Microbial water quality monitoring is crucial for managing water resources and protecting public health. However, institutional testing activities in sub-Saharan Africa are currently limited. Because the economics of water quality testing are poorly understood, the extent to which cost may be a barrier to monitoring in different settings is unclear. This study used cost data from 18 African monitoring institutions (piped water suppliers and health surveillance agencies in six countries) and estimates of water supply type coverage from 15 countries to assess the annual financial requirements for microbial water testing at both national and regional levels, using World Health Organization recommendations for sampling frequency. We found that a microbial water quality test costs 21.0 ± 11.3 USD, on average, including consumables, equipment, labor, and logistics, which is higher than previously calculated. Our annual cost estimates for microbial monitoring of piped supplies and improved point sources ranged between 8 000 USD for Equatorial Guinea and 1.9 million USD for Ethiopia, depending primarily on the population served but also on the distribution of piped water system sizes. A comparison with current national water and sanitation budgets showed that the cost of implementing prescribed testing levels represents a relatively modest proportion of existing budgets (water sources in sub-Saharan Africa would cost 16.0 million USD per year, which is minimal in comparison to the projected annual capital costs of achieving Sustainable Development Goal 6.1 of safe water for all (14.8 billion USD).

Cost-effectiveness of cervical total disc replacement vs fusion for the treatment of 2-level symptomatic degenerative disc disease.

Science.gov (United States)

Ament, Jared D; Yang, Zhuo; Nunley, Pierce; Stone, Marcus B; Kim, Kee D

2014-12-01

Cervical total disc replacement (CTDR) was developed to treat cervical spondylosis, while preserving motion. While anterior cervical discectomy and fusion (ACDF) has been the standard of care for 2-level disease, a randomized clinical trial (RCT) suggested similar outcomes. Cost-effectiveness of this intervention has never been elucidated. To determine the cost-effectiveness of CTDR compared with ACDF. Data were derived from an RCT that followed up 330 patients over 24 months. The original RCT consisted of multi-institutional data including private and academic institutions. Using linear regression for the current study, health states were constructed based on the stratification of the Neck Disability Index and a visual analog scale. Data from the 12-item Short-Form Health Survey questionnaires were transformed into utilities values using the SF-6D mapping algorithm. Costs were calculated by extracting Diagnosis-Related Group codes from institutional billing data and then applying 2012 Medicare reimbursement rates. The costs of complications and return-to-work data were also calculated. A Markov model was built to evaluate quality-adjusted life-years (QALYs) for both treatment groups. The model adopted a third-party payer perspective and applied a 3% annual discount rate. Patients included in the original RCT had to be diagnosed as having radiculopathy or myeloradiculopathy at 2 contiguous levels from C3-C7 that was unresponsive to conservative treatment for at least 6 weeks or demonstrated progressive symptoms. Incremental cost-effectiveness ratio of CTDR compared with ACDF. A strong correlation (R2 = 0.6864; P sensitivity analysis, the incremental cost-effectiveness ratio value stays below the threshold of $50,000 per QALY in most scenarios (range, -$58,194 to $147,862 per QALY). The incremental cost-effectiveness ratio of CTDR compared with traditional ACDF is lower than the commonly accepted threshold of $50,000 per QALY. This remains true with varying input

Waste Management Facilities cost information for mixed low-level waste. Revision 1

International Nuclear Information System (INIS)

Shropshire, D.; Sherick, M.; Biadgi, C.

1995-06-01

This report contains preconceptual designs and planning level life-cycle cost estimates for managing mixed low-level waste. The report's information on treatment, storage, and disposal modules can be integrated to develop total life-cycle costs for various waste management options. A procedure to guide the US Department of Energy and its contractor personnel in the use of cost estimation data is also summarized in this report

Dynamic evaluation of the levelized cost of wind power generation

International Nuclear Information System (INIS)

Díaz, Guzmán; Gómez-Aleixandre, Javier; Coto, José

2015-01-01

Highlights: • Conventional levelized cost of energy is static and does not consider flexibility. • This paper defines a dynamic version by means of stochastic programming. • A penalty for early exercising is proposed to differentiate static and dynamic. • Results show the effects of feed-in tariff support in low wind sites. • Policy implications are derived on the basis of the static and dynamic measures. - Abstract: This paper discusses an alternative computation method of the levelized cost of energy of distributed wind power generators. Unlike in the conventional procedures, it includes time of commencement as an optimization variable. For that purpose, a methodology from Longstaff and Schwartz’s dynamic program for pricing financial American options is derived, which provides the ability to find the optimum time and value while coping with uncertainty revenues from energy sales and variable capital costs. The results obtained from the analysis of wind records of 50 sites entail that the conventional levelized cost of energy can be broken down into an optimum, minimum (time-dependent) value and a penalty for early exercising, which can be employed to define investment strategies and support policies

The costs, efects and cost-effetiveness of counteracting overweight on a population level.

NARCIS (Netherlands)

Bemelmans, W.; van Baal, P; Wendel-Vos, W.; Schuit, A.J.; Feskens, E.; Ament, A.; Hoogenveen, R.

2008-01-01

Objectives: To gain insight in realistic policy targets for overweight at a population level and the accompanying costs. Therefore, the effect on overweight prevalence was estimated of large scale implementation of a community intervention (applied to 90% of general population) and an intensive

Incentive-Based Primary Care: Cost and Utilization Analysis.

Science.gov (United States)

Hollander, Marcus J; Kadlec, Helena

2015-01-01

In its fee-for-service funding model for primary care, British Columbia, Canada, introduced incentive payments to general practitioners as pay for performance for providing enhanced, guidelines-based care to patients with chronic conditions. Evaluation of the program was conducted at the health care system level. To examine the impact of the incentive payments on annual health care costs and hospital utilization patterns in British Columbia. The study used Ministry of Health administrative data for Fiscal Year 2010-2011 for patients with diabetes, congestive heart failure, chronic obstructive pulmonary disease, and/or hypertension. In each disease group, cost and utilization were compared across patients who did, and did not, receive incentive-based care. Health care costs (eg, primary care, hospital) and utilization measures (eg, hospital days, readmissions). After controlling for patients' age, sex, service needs level, and continuity of care (defined as attachment to a general practice), the incentives reduced the net annual health care costs, in Canadian dollars, for patients with hypertension (by approximately Can$308 per patient), chronic obstructive pulmonary disease (by Can$496), and congestive heart failure (by Can$96), but not diabetes (incentives cost about Can$148 more per patient). The incentives were also associated with fewer hospital days, fewer admissions and readmissions, and shorter lengths of hospital stays for all 4 groups. Although the available literature on pay for performance shows mixed results, we showed that the funding model used in British Columbia using incentive payments for primary care might reduce health care costs and hospital utilization.

Cost calculation and financial measures for high-level waste disposal business

International Nuclear Information System (INIS)

Sekiguchi, Hiromasa.

1987-01-01

A study is made on the costs for disposal of high-level wastes, centering on financial problems involving cost calculation for disposal business and methods and systems for funding the business. The first half of the report is focused on calculation of costs for disposal business. Basic equations are shown to calculate the total costs required for a disposal plant and the costs for disposal of one unit of high-level wastes. A model is proposed to calculate the charges to be paid by electric power companies to the plant for disposal of their wastes. Another equation is derived to calculate the disposal charge per kWh of power generation in a power plant. The second half of the report is focused on financial measures concerning expenses for disposal. A financial basis should be established for the implementation of high-level waste disposal. It is insisted that a reasonable method for estimating the disposal costs should be set up and it should be decided who will pay the expenses. Discussions are made on some methods and systems for funding the disposal business. An additional charge should be included in the electricity bill to be paid by electric power users, or it should be included in tax. (Nogami, K.)

Malaria community health workers in Myanmar: a cost analysis.

Science.gov (United States)

Kyaw, Shwe Sin; Drake, Tom; Thi, Aung; Kyaw, Myat Phone; Hlaing, Thaung; Smithuis, Frank M; White, Lisa J; Lubell, Yoel

2016-01-25

Myanmar has the highest malaria incidence and attributed mortality in South East Asia with limited healthcare infrastructure to manage this burden. Establishing malaria Community Health Worker (CHW) programmes is one possible strategy to improve access to malaria diagnosis and treatment, particularly in remote areas. Despite considerable donor support for implementing CHW programmes in Myanmar, the cost implications are not well understood. An ingredients based micro-costing approach was used to develop a model of the annual implementation cost of malaria CHWs in Myanmar. A cost model was constructed based on activity centres comprising of training, patient malaria services, monitoring and supervision, programme management, overheads and incentives. The model takes a provider perspective. Financial data on CHWs programmes were obtained from the 2013 financial reports of the Three Millennium Development Goal fund implementing partners that have been working on malaria control and elimination in Myanmar. Sensitivity and scenario analyses were undertaken to outline parameter uncertainty and explore changes to programme cost for key assumptions. The range of total annual costs for the support of one CHW was US$ 966-2486. The largest driver of CHW cost was monitoring and supervision (31-60% of annual CHW cost). Other important determinants of cost included programme management (15-28% of annual CHW cost) and patient services (6-12% of annual CHW cost). Within patient services, malaria rapid diagnostic tests are the major contributor to cost (64% of patient service costs). The annual cost of a malaria CHW in Myanmar varies considerably depending on the context and the design of the programme, in particular remoteness and the approach to monitoring and evaluation. The estimates provide information to policy makers and CHW programme planners in Myanmar as well as supporting economic evaluations of their cost-effectiveness.

Sea level anomaly on the Patagonian continental shelf: Trends, annual patterns and geostrophic flows

Science.gov (United States)

Saraceno, M.; Piola, A. R.; Strub, P. T.

2016-01-01

Abstract We study the annual patterns and linear trend of satellite sea level anomaly (SLA) over the southwest South Atlantic continental shelf (SWACS) between 54ºS and 36ºS. Results show that south of 42°S the thermal steric effect explains nearly 100% of the annual amplitude of the SLA, while north of 42°S it explains less than 60%. This difference is due to the halosteric contribution. The annual wind variability plays a minor role over the whole continental shelf. The temporal linear trend in SLA ranges between 1 and 5 mm/yr (95% confidence level). The largest linear trends are found north of 39°S, at 42°S and at 50°S. We propose that in the northern region the large positive linear trends are associated with local changes in the density field caused by advective effects in response to a southward displacement of the South Atlantic High. The causes of the relative large SLA trends in two southern coastal regions are discussed as a function meridional wind stress and river discharge. Finally, we combined the annual cycle of SLA with the mean dynamic topography to estimate the absolute geostrophic velocities. This approach provides the first comprehensive description of the seasonal component of SWACS circulation based on satellite observations. The general circulation of the SWACS is northeastward with stronger/weaker geostrophic currents in austral summer/winter. At all latitudes, geostrophic velocities are larger (up to 20 cm/s) close to the shelf‐break and decrease toward the coast. This spatio‐temporal pattern is more intense north of 45°S. PMID:27840784

Activity-based costing methodology as tool for costing in hematopathology laboratory.

Science.gov (United States)

Gujral, Sumeet; Dongre, Kanchan; Bhindare, Sonal; Subramanian, P G; Narayan, Hkv; Mahajan, Asim; Batura, Rekha; Hingnekar, Chitra; Chabbria, Meenu; Nair, C N

2010-01-01

Cost analysis in laboratories represents a necessary phase in their scientific progression. To calculate indirect cost and thus total cost per sample of various tests at Hematopathology laboratory (HPL). Activity-based costing (ABC) method is used to calculate per cost test of the hematopathology laboratory. Information is collected from registers, purchase orders, annual maintenance contracts (AMCs), payrolls, account books, hospital bills and registers along with informal interviews with hospital staff. Cost per test decreases as total number of samples increases. Maximum annual expense at the HPL is on reagents and consumables followed by manpower. Cost per test is higher for specialized tests which interpret morphological or flow data and are done by a pathologist. Despite several limitations and assumptions, this was an attempt to understand how the resources are consumed in a large size government-run laboratory. The rate structure needs to be revised for most of the tests, mainly for complete blood counts (CBC), bone marrow examination, coagulation tests and Immunophenotyping. This costing exercise is laboratory specific and each laboratory needs to do its own costing. Such an exercise may help a laboratory redesign its costing structure or at least understand the economics involved in the laboratory management.

Waste Management Facilities cost information for mixed low-level waste. Revision 1

Energy Technology Data Exchange (ETDEWEB)

Shropshire, D.; Sherick, M.; Biadgi, C.

1995-06-01

This report contains preconceptual designs and planning level life-cycle cost estimates for managing mixed low-level waste. The report`s information on treatment, storage, and disposal modules can be integrated to develop total life-cycle costs for various waste management options. A procedure to guide the US Department of Energy and its contractor personnel in the use of cost estimation data is also summarized in this report.

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

Science.gov (United States)

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

2010-12-01

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

UMTRA Project-Level Cost Reduction/Productivity Improvement Program manual

International Nuclear Information System (INIS)

1995-06-01

Mission of the Uranium Mill Tailings Remedial Action (UMTRA) Project Cost Reduction/Productivity Improvement Program (CR/PIP) is to contribute to the UMTRA Project's environmental restoration mission by providing the means to achieve and recognize continuous improvements and cost savings. This manual includes program definition, description of UMTRA project organizational responsibilities and interfaces with existing project functions, guidance to contractors, and definition of project-level functions

Expanding ART for Treatment and Prevention of HIV in South Africa: Estimated Cost and Cost-Effectiveness 2011-2050

Science.gov (United States)

Granich, Reuben; Kahn, James G.; Bennett, Rod; Holmes, Charles B.; Garg, Navneet; Serenata, Celicia; Sabin, Miriam Lewis; Makhlouf-Obermeyer, Carla; De Filippo Mack, Christina; Williams, Phoebe; Jones, Louisa; Smyth, Caoimhe; Kutch, Kerry A.; Ying-Ru, Lo; Vitoria, Marco; Souteyrand, Yves; Crowley, Siobhan; Korenromp, Eline L.; Williams, Brian G.

2012-01-01

Background Antiretroviral Treatment (ART) significantly reduces HIV transmission. We conducted a cost-effectiveness analysis of the impact of expanded ART in South Africa. Methods We model a best case scenario of 90% annual HIV testing coverage in adults 15–49 years old and four ART eligibility scenarios: CD4 count ART costs reflect South African data and international generic prices. ART reduces transmission by 92%. We conducted sensitivity analyses. Results Expanding ART to CD4 count ART and monitoring costs, all CD4 levels saves $0.6 billion versus current; other ART scenarios cost $9–194 per DALY averted. If ART reduces transmission by 99%, savings from all CD4 levels reach $17.5 billion. Sensitivity analyses suggest that poor retention and predominant acute phase transmission reduce DALYs averted by 26% and savings by 7%. Conclusion Increasing the provision of ART to ART uptake, retention, and adherence should be evaluated. PMID:22348000

28 CFR 43.4 - Annual reports.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Annual reports. 43.4 Section 43.4 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) RECOVERY OF COST OF HOSPITAL AND MEDICAL CARE AND TREATMENT FURNISHED BY THE UNITED STATES § 43.4 Annual reports. The head of each Department or Agency...

Cost-effectiveness of dog rabies vaccination programs in East Africa

Science.gov (United States)

Borse, Rebekah H.; Atkins, Charisma Y.; Gambhir, Manoj; Undurraga, Eduardo A.; Blanton, Jesse D.; Kahn, Emily B.; Dyer, Jessie L.; Rupprecht, Charles E.

2018-01-01

Background Dog rabies annually causes 24,000–70,000 deaths globally. We built a spreadsheet tool, RabiesEcon, to aid public health officials to estimate the cost-effectiveness of dog rabies vaccination programs in East Africa. Methods RabiesEcon uses a mathematical model of dog-dog and dog-human rabies transmission to estimate dog rabies cases averted, the cost per human rabies death averted and cost per year of life gained (YLG) due to dog vaccination programs (US 2015 dollars). We used an East African human population of 1 million (approximately 2/3 living in urban setting, 1/3 rural). We considered, using data from the literature, three vaccination options; no vaccination, annual vaccination of 50% of dogs and 20% of dogs vaccinated semi-annually. We assessed 2 transmission scenarios: low (1.2 dogs infected per infectious dog) and high (1.7 dogs infected). We also examined the impact of annually vaccinating 70% of all dogs (World Health Organization recommendation for dog rabies elimination). Results Without dog vaccination, over 10 years there would a total of be approximately 44,000–65,000 rabid dogs and 2,100–2,900 human deaths. Annually vaccinating 50% of dogs results in 10-year reductions of 97% and 75% in rabid dogs (low and high transmissions scenarios, respectively), approximately 2,000–1,600 human deaths averted, and an undiscounted cost-effectiveness of $451-$385 per life saved. Semi-annual vaccination of 20% of dogs results in in 10-year reductions of 94% and 78% in rabid dogs, and approximately 2,000–1,900 human deaths averted, and cost $404-$305 per life saved. In the low transmission scenario, vaccinating either 50% or 70% of dogs eliminated dog rabies. Results were most sensitive to dog birth rate and the initial rate of dog-to-dog transmission (Ro). Conclusions Dog rabies vaccination programs can control, and potentially eliminate, dog rabies. The frequency and coverage of vaccination programs, along with the level of dog rabies

Economic Analysis on Direct Use of Spent Pressurized Water Reactor Fuel in CANDU Reactors - I: DUPIC Fuel Fabrication Cost

International Nuclear Information System (INIS)

Choi, Hangbok; Ko, Won Il; Yang, Myung Seung

2001-01-01

A preliminary conceptual design of a Direct Use of spent Pressurized water reactor (PWR) fuel In Canada deuterium uranium (CANDU) reactors (DUPIC) fuel fabrication plant was studied, which annually converts spent PWR fuel of 400 tonnes heavy element (HE) into CANDU fuel. The capital and operating costs were estimated from the viewpoint of conceptual design. Assuming that the annual discount rate is 5% during the construction (5 yr) and operation period (40 yr) and contingency is 25% of the capital cost, the levelized unit cost (LUC) of DUPIC fuel fabrication was estimated to be 616 $/kg HE, which is mostly governed by annual operation and maintenance costs that correspond to 63% of LUC. Among the operation and maintenance cost components being considered, the waste disposal cost has the dominant effect on LUC (∼49%). From sensitivity analyses of production capacity, discount rate, and contingency, it was found that the production capacity of the plant is the major parameter that affects the LUC

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

Directory of Open Access Journals (Sweden)

Smita Nayak

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

Levelized cost of energy and sensitivity analysis for the hydrogen-bromine flow battery

Science.gov (United States)

Singh, Nirala; McFarland, Eric W.

2015-08-01

The technoeconomics of the hydrogen-bromine flow battery are investigated. Using existing performance data the operating conditions were optimized to minimize the levelized cost of electricity using individual component costs for the flow battery stack and other system units. Several different configurations were evaluated including use of a bromine complexing agent to reduce membrane requirements. Sensitivity analysis of cost is used to identify the system elements most strongly influencing the economics. The stack lifetime and round-trip efficiency of the cell are identified as major factors on the levelized cost of electricity, along with capital components related to hydrogen storage, the bipolar plate, and the membrane. Assuming that an electrocatalyst and membrane with a lifetime of 2000 cycles can be identified, the lowest cost market entry system capital is 220 kWh-1 for a 4 h discharge system and for a charging energy cost of 0.04 kWh-1 the levelized cost of the electricity delivered is 0.40 kWh-1. With systems manufactured at large scales these costs are expected to be lower.

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

Science.gov (United States)

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

2015-02-01

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

Comparison of costs for alternative mixed low-level waste treatment systems

International Nuclear Information System (INIS)

Schwinkendorf, W.E.; Harvego, L.; Cooley, C.R.; Biagi, C.

1996-01-01

Total life cycle costs (TLCCs), including disposal costs, of thermal, nonthermal and enhanced nonthermal systems were evaluated to guide future research and development programs for the treatment of mixed low-level waste (MLLW) consisting of RCRA hazardous and low-level radioactive wastes. In these studies, nonthermal systems are defined as those systems that process waste at temperatures less than 350 C. Preconceptual designs and costs were developed for thirty systems with a capacity (2,927 lbs/hr) to treat the DOE MLLW stored inventor y(approximately 236 million pounds) in 20 years in a single, centralized facility. A limited comparison of the studies' results is presented in this paper. Sensitivity of treatment costs with respect to treatment capacity, number of treatment facilities, and system availability were also determined. The major cost element is operations and maintenance (O and M), which is 50 to 60% of the TLCC for both thermal and nonthermal systems. Energy costs constitute a small fraction (< 1%) of the TLCCs. Equipment cost is only 3 to 5% of the treatment cost. Evaluation of subsystem costs demonstrate that receiving and preparation is the highest cost subsystem at about 25 to 30% of the TLCC for both thermal and nonthermal systems. These studies found no cost incentives to use nonthermal or hybrid (combined nonthermal treatment with stabilization by vitrification) systems in place of thermal systems. However, there may be other incentives including fewer air emissions and less local objection to a treatment facility. Building multiple treatment facilities to treat the same total mass of waste as a single facility would increase the total treatment cost significantly, and improved system availability decreases unit treatment costs by 17% to 30%

Determination of leveled costs of electric generation for gas plants, coal and nuclear

International Nuclear Information System (INIS)

Alonso V, G.; Palacios H, J.C.; Ramirez S, J.R.; Gomez, A.

2005-01-01

The present work analyzes the leveled costs of electric generation for different types of nuclear reactors known as Generation III, these costs are compared with the leveled costs of electric generation of plants with the help of natural gas and coal. In the study several discount rates were used to determine their impact in the initial investment. The obtained results are comparable with similar studies and they show that it has more than enough the base of the leveled cost the nuclear option it is quite competitive in Mexico. Also in this study it is also thinks about the economic viability of a new nuclear power station in Mexico. (Author)

The Cost-Effectiveness of Dual Mobility Implants for Primary Total Hip Arthroplasty: A Computer-Based Cost-Utility Model.

Science.gov (United States)

Barlow, Brian T; McLawhorn, Alexander S; Westrich, Geoffrey H

2017-05-03

Dislocation remains a clinically important problem following primary total hip arthroplasty, and it is a common reason for revision total hip arthroplasty. Dual mobility (DM) implants decrease the risk of dislocation but can be more expensive than conventional implants and have idiosyncratic failure mechanisms. The purpose of this study was to investigate the cost-effectiveness of DM implants compared with conventional bearings for primary total hip arthroplasty. Markov model analysis was conducted from the societal perspective with use of direct and indirect costs. Costs, expressed in 2013 U.S. dollars, were derived from the literature, the National Inpatient Sample, and the Centers for Medicare & Medicaid Services. Effectiveness was expressed in quality-adjusted life years (QALYs). The model was populated with health state utilities and state transition probabilities derived from previously published literature. The analysis was performed for a patient's lifetime, and costs and effectiveness were discounted at 3% annually. The principal outcome was the incremental cost-effectiveness ratio (ICER), with a willingness-to-pay threshold of $100,000/QALY. Sensitivity analyses were performed to explore relevant uncertainty. In the base case, DM total hip arthroplasty showed absolute dominance over conventional total hip arthroplasty, with lower accrued costs ($39,008 versus $40,031 U.S. dollars) and higher accrued utility (13.18 versus 13.13 QALYs) indicating cost-savings. DM total hip arthroplasty ceased being cost-saving when its implant costs exceeded those of conventional total hip arthroplasty by $1,023, and the cost-effectiveness threshold for DM implants was $5,287 greater than that for conventional implants. DM was not cost-effective when the annualized incremental probability of revision from any unforeseen failure mechanism or mechanisms exceeded 0.29%. The probability of intraprosthetic dislocation exerted the most influence on model results. This model

2017 Annual Technology Baseline

Energy Technology Data Exchange (ETDEWEB)

Cole, Wesley J [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Hand, M. M [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Eberle, Annika [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Beiter, Philipp C [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Kurup, Parthiv [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Turchi, Craig S [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Feldman, David J [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Margolis, Robert M [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Augustine, Chad R [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Maness, Michael [Formerly NREL; O' Connor, Patrick [Oak Ridge National Laboratory

2018-03-26

Consistent cost and performance data for various electricity generation technologies can be difficult to find and may change frequently for certain technologies. With the Annual Technology Baseline (ATB), the National Renewable Energy Laboratory annually provides an organized and centralized set of such cost and performance data. The ATB uses the best information from the Department of Energy national laboratories' renewable energy analysts as well as information from the Energy Information Administration for fuel-based technologies. The ATB has been reviewed by experts and it includes the following electricity generation technologies: land-based wind, offshore wind, utility-scale solar photovoltaics (PV), commercial-scale solar PV, residential-scale solar PV, concentrating solar power, geothermal power, hydropower, coal, natural gas, nuclear, and conventional biopower. This webinar presentation introduces the 2017 ATB.

Supply disruption cost for power network planning

International Nuclear Information System (INIS)

Kjoelle, G.H.

1992-09-01

A description is given of the method of approach to calculate the total annual socio-economic cost of power supply disruption and non-supplied energy, included the utilities' cost for planning. The total socio-economic supply disruption cost is the sum of the customers' disruption cost and the utilities' cost for failure and disruption. The mean weighted disruption cost for Norway for one hour disruption is NOK 19 per kWh. The customers' annual disruption cost is calculated with basis in the specific disruption cost referred to heavy load (January) and dimensioning maximum loads. The loads are reduced by factors taking into account the time variations of the failure frequency, duration, the loads and the disruption cost. 6 refs

The cost of Alzheimer's disease in China and re-estimation of costs worldwide.

Science.gov (United States)

Jia, Jianping; Wei, Cuibai; Chen, Shuoqi; Li, Fangyu; Tang, Yi; Qin, Wei; Zhao, Lina; Jin, Hongmei; Xu, Hui; Wang, Fen; Zhou, Aihong; Zuo, Xiumei; Wu, Liyong; Han, Ying; Han, Yue; Huang, Liyuan; Wang, Qi; Li, Dan; Chu, Changbiao; Shi, Lu; Gong, Min; Du, Yifeng; Zhang, Jiewen; Zhang, Junjian; Zhou, Chunkui; Lv, Jihui; Lv, Yang; Xie, Haiqun; Ji, Yong; Li, Fang; Yu, Enyan; Luo, Benyan; Wang, Yanjiang; Yang, Shanshan; Qu, Qiumin; Guo, Qihao; Liang, Furu; Zhang, Jintao; Tan, Lan; Shen, Lu; Zhang, Kunnan; Zhang, Jinbiao; Peng, Dantao; Tang, Muni; Lv, Peiyuan; Fang, Boyan; Chu, Lan; Jia, Longfei; Gauthier, Serge

2018-04-01

The socioeconomic costs of Alzheimer's disease (AD) in China and its impact on global economic burden remain uncertain. We collected data from 3098 patients with AD in 81 representative centers across China and estimated AD costs for individual patient and total patients in China in 2015. Based on this data, we re-estimated the worldwide costs of AD. The annual socioeconomic cost per patient was US $19,144.36, and total costs were US $167.74 billion in 2015. The annual total costs are predicted to reach US $507.49 billion in 2030 and US $1.89 trillion in 2050. Based on our results, the global estimates of costs for dementia were US $957.56 billion in 2015, and will be US $2.54 trillion in 2030, and US $9.12 trillion in 2050, much more than the predictions by the World Alzheimer Report 2015. China bears a heavy burden of AD costs, which greatly change the estimates of AD cost worldwide. Copyright © 2017 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

Estimating average inpatient and outpatient costs and childhood pneumonia and diarrhoea treatment costs in an urban health centre in Zambia

Directory of Open Access Journals (Sweden)

Chola Lumbwe

2009-10-01

Full Text Available Abstract Background Millions of children die every year in developing countries, from preventable diseases such as pneumonia and diarrhoea, owing to low levels of investment in child health. Investment efforts are hampered by a general lack of adequate information that is necessary for priority setting in this sector. This paper measures the health system costs of providing inpatient and outpatient services, and also the costs associated with treating pneumonia and diarrhoea in under-five children at a health centre in Zambia. Methods Annual economic and financial cost data were collected in 2005-2006. Data were summarized in a Microsoft excel spreadsheet to obtain total department costs and average disease treatment costs. Results The total annual cost of operating the health centre was US$1,731,661 of which US$1 284 306 and US$447,355 were patient care and overhead departments costs, respectively. The average cost of providing out-patient services was US$3 per visit, while the cost of in-patient treatment was US$18 per bed day. The cost of providing dental services was highest at US$20 per visit, and the cost of VCT services was lowest, with US$1 per visit. The cost per out-patient visit for under-five pneumonia was US$48, while the cost per bed day was US$215. The cost per outpatient visit attributed to under-five diarrhoea was US$26, and the cost per bed day was US$78. Conclusion In the face of insufficient data, a cost analysis exercise is a difficult but feasible undertaking. The study findings are useful and applicable in similar settings, and can be used in cost effectiveness analyses of health interventions.

Activity-based costing methodology as tool for costing in hematopathology laboratory

Directory of Open Access Journals (Sweden)

Gujral Sumeet

2010-01-01

Full Text Available Background: Cost analysis in laboratories represents a necessary phase in their scientific progression. Aim: To calculate indirect cost and thus total cost per sample of various tests at Hematopathology laboratory (HPL Settings and Design: Activity-based costing (ABC method is used to calculate per cost test of the hematopathology laboratory. Material and Methods: Information is collected from registers, purchase orders, annual maintenance contracts (AMCs, payrolls, account books, hospital bills and registers along with informal interviews with hospital staff. Results: Cost per test decreases as total number of samples increases. Maximum annual expense at the HPL is on reagents and consumables followed by manpower. Cost per test is higher for specialized tests which interpret morphological or flow data and are done by a pathologist. Conclusions: Despite several limitations and assumptions, this was an attempt to understand how the resources are consumed in a large size government-run laboratory. The rate structure needs to be revised for most of the tests, mainly for complete blood counts (CBC, bone marrow examination, coagulation tests and Immunophenotyping. This costing exercise is laboratory specific and each laboratory needs to do its own costing. Such an exercise may help a laboratory redesign its costing structure or at least understand the economics involved in the laboratory management.

Petroleum marketing annual, 1990

International Nuclear Information System (INIS)

1991-01-01

The Petroleum Marketing Annual contains statistical data on a variety of crude oils and refined petroleum products. The publication provides statistics on crude oil costs and refined petroleum products sales for use by industry, government, private sector analysts, educational institutions, and consumers. Data on crude oil include the domestic first purchase price, the free-on-board and landed cost of imported crude oil, and the refiners' acquisition cost of crude oil. Sales data for motor gasoline, distillates, residuals, aviation fuels, kerosene, and propane are presented. (VC)

Marginal ambulatory teaching cost under varying levels of service utilization.

Science.gov (United States)

Panton, D M; Mushlin, A I; Gavett, J W

1980-06-01

The ambulatory component of residency training jointly produces two products, namely, training and patient services. In costing educational programs of this type, two approaches are frequently taken. The first considers the total costs of the educational program, including training and patient services. These costs are usually constructed from historical accounting records. The second approach attempts to cost the joint products separately, based upon estimates of future changes in program costs, if the product in question is added to or removed from the program. The second approach relates to typical decisions facing the managers of medical centers and practices used for teaching purposes. This article reports such a study of costs in a primary-care residency training program in a hospital outpatient setting. The costs of the product, i.e., on-the-job training, are evaluated using a replacement-cost concept under different levels of patient services. The results show that the cost of the product, training, is small at full clinical utilization and is sensitive to changes in the volume of services provided.

Ambient radioactivity levels and radiation doses. Annual report 2011

International Nuclear Information System (INIS)

Bernhard-Stroel, Claudia; Hachenburger, Claudia; Trugenberger-Schnabel, Angela; Peter, Josef

2013-07-01

The annual report 2011 on ambient radioactivity levels and radiation doses covers the following issues: Part A: Natural environmental radioactivity, artificial radioactivity in the environment, occupational radiation exposure, radiation exposure from medical applications, the handling of radioactive materials and sources of ionizing radiation, non-ionizing radiation. Part B; Current data and their evaluation: Natural environmental radioactivity, artificial radioactivity in the environment, occupational radiation exposure, radiation exposure from medical applications, the handling of radioactive materials and sources of ionizing radiation, non-ionizing radiation. The Appendix includes Explanations of terms, radiation doses and related units, external and internal radiation exposure, stochastic and deterministic radiation effects, genetic radiation effects, induction of malignant neoplasm, risk assessment, physical units and glossary, laws, ordinances, guidelines, recommendations and other regulations concerning radiation protection, list of selected radionuclides.

Evaluation of Low-Cost, Centimeter-Level Accuracy OEM GNSS Receivers

Science.gov (United States)

2018-02-02

This report discusses the results of a study to quantify the performance of low-cost, centimeter-level accurate Global Navigation Satellite Systems (GNSS) receivers that have appeared on the market in the last few years. Centimeter-level accuracy is ...

Method of levelized discounted costs applied in economic evaluation of nuclear power plant project

International Nuclear Information System (INIS)

Tian Li; Wang Yongqing; Liu Jingquan; Guo Jilin; Liu Wei

2000-01-01

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

Managing costs at Ginna Station

International Nuclear Information System (INIS)

Mecredy, R.C.

1990-01-01

A nuclear power plant with a capital cost of $88 million and an annual operations and maintenance (O and M) cost of $3.2 million that is operated by a plant staff of 59 people? The Ginna nuclear power plant was indeed such a plant in 1970, its first full year of operation. Today that same plant has a total invested capital cost of $400 million with an annual capital cost, including upgrade projects which are being amortized, of $37 million. The annual O and M expenditure is nearly $60 million, and the total staffing, both plant and corporate support, is nearly 600 people. The result of this increased cost has been a dramatic narrowing of the cost margin between Ginna and coal units in the rochester Gas and Electric system. While increased expenditures have resulted in improved reliability and operability, and have increased the margins of safety, it is becoming necessary to implement cost monitoring and control measures so that each dollar spent provides maximum value. The factors which have contributed to the increased capital and O and M expenditures are well known. They include a broad range of safety, reliability, and operating projects and activities. Current upward pressures on cost include initiatives such as procurement control, procedure upgrades, configuration management, enhanced maintenance activities, and equipment replacements and upgrades

Design of annual storage solar space heating systems

Energy Technology Data Exchange (ETDEWEB)

Hooper, F C; Cook, J D

1979-11-01

Design considerations for annual storage solar space heating systems are discussed. A simulation model for the performance of suh systems is described, and a method of classifying system configurations is proposed. It is shown that annual systems sized for unconstrained performance, with no unused collector or storage capacity, and no rejected heat, minimize solar acquisition costs. The optimal performance corresponds to the condition where the marginal storage-to-collector sizing ratio is equal to the corresponding marginal cost ratio.

Electric power annual 1997. Volume 1

Energy Technology Data Exchange (ETDEWEB)

NONE

1998-07-01

The Electric Power Annual presents a summary of electric power industry statistics at national, regional, and State levels. The objective of the publication is to provide industry decisionmakers, government policy-makers, analysts, and the general public with data that may be used in understanding US electricity markets. The Electric Power Annual is prepared by the Electric Power Division; Office of Coal, Nuclear, Electric and Alternate Fuels; Energy Information Administration (EIA); US Department of Energy. Volume 1 -- with a focus on US electric utilities -- contains final 1997 data on net generation and fossil fuel consumption, stocks, receipts, and cost; preliminary 1997 data on generating unit capability, and retail sales of electricity, associated revenue, and the average revenue per kilowatthour of electricity sold (based on a monthly sample: Form EIA-826, ``Monthly Electric Utility Sales and Revenue Report with State Distributions``). Additionally, information on net generation from renewable energy sources and on the associated generating capability is included in Volume 1 of the EPA.

Economic Cost of Dengue in Puerto Rico

Science.gov (United States)

Halasa, Yara A.; Shepard, Donald S.; Zeng, Wu

2012-01-01

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

48 CFR 1552.211-73 - Level of effort-cost-reimbursement term contract.

Science.gov (United States)

2010-10-01

...-reimbursement term contract. 1552.211-73 Section 1552.211-73 Federal Acquisition Regulations System... Provisions and Clauses 1552.211-73 Level of effort—cost-reimbursement term contract. As prescribed in 1511.011-73, insert the following contract clause in cost-reimbursement term contracts including cost...

Annual plan of research on safety techniques against low level radioactive wastes, FY1994-FY1999

International Nuclear Information System (INIS)

1994-01-01

The safety research on the disposal of low level radioactive waste has been promoted based on the annual plan decided by the committee on radiative waste safety regulation of the Nuclear Safety Commission. Hereafter, the disposal of low level radioactive waste in ocean is never selected. As to the subjects of the safety research which should be carried out for five years from 1994, the necessity, the contents of research, the organs that carry out the research and so on were deliberated, and the results are made into the annual plan, therefore, it is reported. The way of thinking on the safety research, the contents for which efforts should be exerted as the safety research, and the matters to which attention should be paid are shown. As for the annual plan of safety research, the necessity and the outline of the safety research on the disposal in strata, the concrete subjects and their contents, and the necessity and the outline of the safety research on the reuse, the concrete subjects and their contents are reported. The radioactive waste is those produced by the operation of nuclear reactor facilities, those containing TRU nuclides and RI waste. (K.I.)

Long-term costs and health impact of continued global fund support for antiretroviral therapy.

Directory of Open Access Journals (Sweden)

John Stover

Full Text Available BACKGROUND: By the end of 2011 Global Fund investments will be supporting 3.5 million people on antiretroviral therapy (ART in 104 low- and middle-income countries. We estimated the cost and health impact of continuing treatment for these patients through 2020. METHODS AND FINDINGS: Survival on first-line and second-line ART regimens is estimated based on annual retention rates reported by national AIDS programs. Costs per patient-year were calculated from country-reported ARV procurement prices, and expenditures on laboratory tests, health care utilization and end-of-life care from in-depth costing studies. Of the 3.5 million ART patients in 2011, 2.3 million will still need treatment in 2020. The annual cost of maintaining ART falls from $1.9 billion in 2011 to $1.7 billion in 2020, as a result of a declining number of surviving patients partially offset by increasing costs as more patients migrate to second-line therapy. The Global Fund is expected to continue being a major contributor to meeting this financial need, alongside other international funders and domestic resources. Costs would be $150 million less in 2020 with an annual 5% decline in first-line ARV prices and $150-370 million less with a 5%-12% annual decline in second-line prices, but $200 million higher in 2020 with phase out of stavudine (d4T, or $200 million higher with increased migration to second-line regimens expected if all countries routinely adopted viral load monitoring. Deaths postponed by ART correspond to 830,000 life-years saved in 2011, increasing to around 2.3 million life-years every year between 2015 and 2020. CONCLUSIONS: Annual patient-level direct costs of supporting a patient cohort remain fairly stable over 2011-2020, if current antiretroviral prices and delivery costs are maintained. Second-line antiretroviral prices are a major cost driver, underscoring the importance of investing in treatment quality to improve retention on first-line regimens.

The Cost-Effectiveness of Three Screening Alternatives for People with Diabetes with No or Early Diabetic Retinopathy

Science.gov (United States)

Rein, David B; Wittenborn, John S; Zhang, Xinzhi; Allaire, Benjamin A; Song, Michael S; Klein, Ronald; Saaddine, Jinan B

2011-01-01

Objective To determine whether biennial eye evaluation or telemedicine screening are cost-effective alternatives to current recommendations for the estimated 10 million people aged 30–84 with diabetes but no or minimal diabetic retinopathy. Data Sources United Kingdom Prospective Diabetes Study, National Health and Nutrition Examination Survey, American Academy of Ophthalmology Preferred Practice Patterns, Medicare Payment Schedule. Study Design Cost-effectiveness Monte Carlo simulation. Data Collection/Extraction Methods Literature review, analysis of existing surveys. Principal Findings Biennial eye evaluation was the most cost-effective treatment option when the ability to detect other eye conditions was included in the model. Telemedicine was most cost-effective when other eye conditions were not considered or when telemedicine was assumed to detect refractive error. The current annual eye evaluation recommendation was costly compared with either treatment alternative. Self-referral was most cost-effective up to a willingness to pay (WTP) of U.S.$37,600, with either biennial or annual evaluation most cost-effective at higher WTP levels. Conclusions Annual eye evaluations are costly and add little benefit compared with either plausible alternative. More research on the ability of telemedicine to detect other eye conditions is needed to determine whether it is more cost-effective than biennial eye evaluation. PMID:21492158

Societal costs of diabetes mellitus in Denmark

DEFF Research Database (Denmark)

Sortsø, C; Green, A; Jensen, Peter Bjødstrup

2016-01-01

AIM: To provide comprehensive real-world evidence on societal diabetes-attributable costs in Denmark. METHODS: National register data are linked on an individual level through unique central personal registration numbers in Denmark. All patients in the Danish National Diabetes Register in 2011 (N...... = 318 729) were included in this study. Complication status was defined according to data from the Danish National Hospital Register. Diabetes-attributable costs were calculated as the difference between costs of patients with diabetes and the expected costs given the annual resource consumption...... of the diabetes-free population. RESULTS: Societal costs attributable to diabetes were estimated to be at least 4.27 billion EUR in 2011, corresponding to 14,349 EUR per patient-year. A twofold higher healthcare resource usage was found for patients with diabetes as compared with the diabetes-free population...

Health, Health Inequality, and Cost Impacts of Annual Increases in Tobacco Tax: Multistate Life Table Modeling in New Zealand.

Directory of Open Access Journals (Sweden)

Tony Blakely

2015-07-01

Full Text Available Countries are increasingly considering how to reduce or even end tobacco consumption, and raising tobacco taxes is a potential strategy to achieve these goals. We estimated the impacts on health, health inequalities, and health system costs of ongoing tobacco tax increases (10% annually from 2011 to 2031, compared to no tax increases from 2011 ["business as usual," BAU], in a country (New Zealand with large ethnic inequalities in smoking-related and noncommunicable disease (NCD burden.We modeled 16 tobacco-related diseases in parallel, using rich national data by sex, age, and ethnicity, to estimate undiscounted quality-adjusted life-years (QALYs gained and net health system costs over the remaining life of the 2011 population (n = 4.4 million. A total of 260,000 (95% uncertainty interval [UI]: 155,000-419,000 QALYs were gained among the 2011 cohort exposed to annual tobacco tax increases, compared to BAU, and cost savings were US$2,550 million (95% UI: US$1,480 to US$4,000. QALY gains and cost savings took 50 y to peak, owing to such factors as the price sensitivity of youth and young adult smokers. The QALY gains per capita were 3.7 times greater for Māori (indigenous population compared to non-Māori because of higher background smoking prevalence and price sensitivity in Māori. Health inequalities measured by differences in 45+ y-old standardized mortality rates between Māori and non-Māori were projected to be 2.31% (95% UI: 1.49% to 3.41% less in 2041 with ongoing tax rises, compared to BAU. Percentage reductions in inequalities in 2041 were maximal for 45-64-y-old women (3.01%. As with all such modeling, there were limitations pertaining to the model structure and input parameters.Ongoing tobacco tax increases deliver sizeable health gains and health sector cost savings and are likely to reduce health inequalities. However, if policy makers are to achieve more rapid reductions in the NCD burden and health inequalities, they will also

Health, Health Inequality, and Cost Impacts of Annual Increases in Tobacco Tax: Multistate Life Table Modeling in New Zealand

Science.gov (United States)

Blakely, Tony; Cobiac, Linda J.; Cleghorn, Christine L.; Pearson, Amber L.; van der Deen, Frederieke S.; Kvizhinadze, Giorgi; Nghiem, Nhung; McLeod, Melissa; Wilson, Nick

2015-01-01

Background Countries are increasingly considering how to reduce or even end tobacco consumption, and raising tobacco taxes is a potential strategy to achieve these goals. We estimated the impacts on health, health inequalities, and health system costs of ongoing tobacco tax increases (10% annually from 2011 to 2031, compared to no tax increases from 2011 [“business as usual,” BAU]), in a country (New Zealand) with large ethnic inequalities in smoking-related and noncommunicable disease (NCD) burden. Methods and Findings We modeled 16 tobacco-related diseases in parallel, using rich national data by sex, age, and ethnicity, to estimate undiscounted quality-adjusted life-years (QALYs) gained and net health system costs over the remaining life of the 2011 population (n = 4.4 million). A total of 260,000 (95% uncertainty interval [UI]: 155,000–419,000) QALYs were gained among the 2011 cohort exposed to annual tobacco tax increases, compared to BAU, and cost savings were US$2,550 million (95% UI: US$1,480 to US$4,000). QALY gains and cost savings took 50 y to peak, owing to such factors as the price sensitivity of youth and young adult smokers. The QALY gains per capita were 3.7 times greater for Māori (indigenous population) compared to non-Māori because of higher background smoking prevalence and price sensitivity in Māori. Health inequalities measured by differences in 45+ y-old standardized mortality rates between Māori and non-Māori were projected to be 2.31% (95% UI: 1.49% to 3.41%) less in 2041 with ongoing tax rises, compared to BAU. Percentage reductions in inequalities in 2041 were maximal for 45–64-y-old women (3.01%). As with all such modeling, there were limitations pertaining to the model structure and input parameters. Conclusions Ongoing tobacco tax increases deliver sizeable health gains and health sector cost savings and are likely to reduce health inequalities. However, if policy makers are to achieve more rapid reductions in the NCD

Proceedings of the Third Annual Information Meeting DOE Low-Level Waste-Management Program

Energy Technology Data Exchange (ETDEWEB)

Large, D.E.; Lowrie, R.S.; Stratton, L.E.; Jacobs, D.G. (comps.)

1981-12-01

The Third Annual Participants Information Meeting of the Low-Level Waste Management Program was held in New Orleans, Louisiana, November 4-6, 1981 The specific purpose was to bring together appropriate representatives of industry, USNRC, program management, participating field offices, and contractors to: (1) exchange information and analyze program needs, and (2) involve participants in planning, developing and implementing technology for low-level waste management. One hundred seven registrants participated in the meeting. Presentation and workshop findings are included in these proceedings under the following headings: low-level waste activities; waste treatment; shallow land burial; remedial action; greater confinement; ORNL reports; panel workshops; and summary. Forty-six papers have been abstracted and indexed for the data base.

Proceedings of the Third Annual Information Meeting DOE Low-Level Waste-Management Program

International Nuclear Information System (INIS)

Large, D.E.; Lowrie, R.S.; Stratton, L.E.; Jacobs, D.G.

1981-12-01

The Third Annual Participants Information Meeting of the Low-Level Waste Management Program was held in New Orleans, Louisiana, November 4-6, 1981 The specific purpose was to bring together appropriate representatives of industry, USNRC, program management, participating field offices, and contractors to: (1) exchange information and analyze program needs, and (2) involve participants in planning, developing and implementing technology for low-level waste management. One hundred seven registrants participated in the meeting. Presentation and workshop findings are included in these proceedings under the following headings: low-level waste activities; waste treatment; shallow land burial; remedial action; greater confinement; ORNL reports; panel workshops; and summary. Forty-six papers have been abstracted and indexed for the data base

Costing the OMNIUM-G system 7500

Science.gov (United States)

Fortgang, H. R.

1980-01-01

A complete OMNIUM-G System 7500 was cost analyzed for annual production quantities ranging from 25 to 10,000 units per year. Parts and components were subjected to in-depth scrutiny to determine optimum manufacturing processes, coupled with make or buy decisions on materials and small parts. When production quantities increase both labor and material costs reduce substantially. A redesign of the system that was analyzed could result in lower costs when annual production runs approach 100,000 units/year. Material and labor costs for producing 25, 100, 25,000 and 100,00 units are given for 17 subassembly units.

Annual low-cost monitoring of a coastal site in Greece by an unmanned aerial vehicle

Science.gov (United States)

Hoffmeister, Dirk; Bareth, Georg

2016-04-01

Coastal areas are under permanent change and are also the result of past processes. These processes are for example sediment transport, accumulation and erosion by normal and extreme waves (storms or tsunamis). As about 23% of the World's population lives within a 100 km distance of coasts, knowledge about coastal processes is important, in particular for possible changes in the nearby future. The past devastating tsunami events demonstrated profoundly the high vulnerability of coastal areas. In order to estimate the different effects, coastal monitoring approaches are of interest. Several different methods exist in order to determine changes in the sedimentary budget and coastline configuration. In order to estimate constant annual changes, we have applied terrestrial laser scanning (TLS) in an annual monitoring approach (2009-2011). In 2014, we changed to an approach based on dense imaging and structure-from-motion, applying an unmanned aerial vehicle (UAV) in order to conduct an annual monitoring of a coastal site in western Greece. Therefore, a GoPro Hero 3+ and a Canon PowerShot S110 mounted on a DJI-Phantom 2 were used. All surveys were conducted in a manually structured image acquisition with a huge overlap. Ground control points (GCP) were measured by tachymetric surveying. This successful approach was repeated again in 2015 with the Canon camera. The measurements of 2014 were controlled by an additional TLS survey, which revealed the high accuracy and more suitable coverage for the UAV-based data. Likewise, the large picture datasets were artificially reduced in order to estimate the most efficient number of images for dense point cloud processing. In addition, also the number of GCPs was decreased for one dataset. Overall, high-resolution digital elevation models with a ground resolution of 10 mm and an equal accuracy were achieved with this low-cost equipment. The data reveals the slight changes on this selected site.

Cost Analysis of MRI Services in Iran: An Application of Activity Based Costing Technique

International Nuclear Information System (INIS)

Bayati, Mohsen; Mahboub Ahari, Alireza; Badakhshan, Abbas; Gholipour, Mahin; Joulaei, Hassan

2015-01-01

Considerable development of MRI technology in diagnostic imaging, high cost of MRI technology and controversial issues concerning official charges (tariffs) have been the main motivations to define and implement this study. The present study aimed to calculate the unit-cost of MRI services using activity-based costing (ABC) as a modern cost accounting system and to fairly compare calculated unit-costs with official charges (tariffs). We included both direct and indirect costs of MRI services delivered in fiscal year 2011 in Shiraz Shahid Faghihi hospital. Direct allocation method was used for distribution of overhead costs. We used micro-costing approach to calculate unit-cost of all different MRI services. Clinical cost data were retrieved from the hospital registering system. Straight-line method was used for depreciation cost estimation. To cope with uncertainty and to increase the robustness of study results, unit costs of 33 MRI services was calculated in terms of two scenarios. Total annual cost of MRI activity center (AC) was calculated at USD 400,746 and USD 532,104 based on first and second scenarios, respectively. Ten percent of the total cost was allocated from supportive departments. The annual variable costs of MRI center were calculated at USD 295,904. Capital costs measured at USD 104,842 and USD 236, 200 resulted from the first and second scenario, respectively. Existing tariffs for more than half of MRI services were above the calculated costs. As a public hospital, there are considerable limitations in both financial and administrative databases of Shahid Faghihi hospital. Labor cost has the greatest share of total annual cost of Shahid Faghihi hospital. The gap between unit costs and tariffs implies that the claim for extra budget from health providers may not be relevant for all services delivered by the studied MRI center. With some adjustments, ABC could be implemented in MRI centers. With the settlement of a reliable cost accounting system

Cost Analysis of MRI Services in Iran: An Application of Activity Based Costing Technique.

Science.gov (United States)

Bayati, Mohsen; Mahboub Ahari, Alireza; Badakhshan, Abbas; Gholipour, Mahin; Joulaei, Hassan

2015-10-01

Considerable development of MRI technology in diagnostic imaging, high cost of MRI technology and controversial issues concerning official charges (tariffs) have been the main motivations to define and implement this study. The present study aimed to calculate the unit-cost of MRI services using activity-based costing (ABC) as a modern cost accounting system and to fairly compare calculated unit-costs with official charges (tariffs). We included both direct and indirect costs of MRI services delivered in fiscal year 2011 in Shiraz Shahid Faghihi hospital. Direct allocation method was used for distribution of overhead costs. We used micro-costing approach to calculate unit-cost of all different MRI services. Clinical cost data were retrieved from the hospital registering system. Straight-line method was used for depreciation cost estimation. To cope with uncertainty and to increase the robustness of study results, unit costs of 33 MRI services was calculated in terms of two scenarios. Total annual cost of MRI activity center (AC) was calculated at USD 400,746 and USD 532,104 based on first and second scenarios, respectively. Ten percent of the total cost was allocated from supportive departments. The annual variable costs of MRI center were calculated at USD 295,904. Capital costs measured at USD 104,842 and USD 236, 200 resulted from the first and second scenario, respectively. Existing tariffs for more than half of MRI services were above the calculated costs. As a public hospital, there are considerable limitations in both financial and administrative databases of Shahid Faghihi hospital. Labor cost has the greatest share of total annual cost of Shahid Faghihi hospital. The gap between unit costs and tariffs implies that the claim for extra budget from health providers may not be relevant for all services delivered by the studied MRI center. With some adjustments, ABC could be implemented in MRI centers. With the settlement of a reliable cost accounting system

Commercial Vessel Safety. Economic Costs. Appendix A. Estimation Procedures for Costs and Cost Impacts of Marine Safety Regulations.

Science.gov (United States)

1979-12-01

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

Estimating pharmacy level prescription drug acquisition costs for third-party reimbursement.

Science.gov (United States)

Kreling, D H; Kirk, K W

1986-07-01

Accurate payment for the acquisition costs of drug products dispensed is an important consideration in a third-party prescription drug program. Two alternative methods of estimating these costs among pharmacies were derived and compared. First, pharmacists were surveyed to determine the purchase discounts offered to them by wholesalers. A 10.00% modal and 11.35% mean discount resulted for 73 responding pharmacists. Second, cost-plus percents derived from gross profit margins of wholesalers were calculated and applied to wholesaler product costs to estimate pharmacy level acquisition costs. Cost-plus percents derived from National Median and Southwestern Region wholesaler figures were 9.27% and 10.10%, respectively. A comparison showed the two methods of estimating acquisition costs would result in similar acquisition cost estimates. Adopting a cost-plus estimating approach is recommended because it avoids potential pricing manipulations by wholesalers and manufacturers that would negate improvements in drug product reimbursement accuracy.

Design of an Actinide Burning, Lead or Lead-Bismuth Cooled Reactor That Produces Low Cost Electricty - FY-02 Annual Report

Energy Technology Data Exchange (ETDEWEB)

Mac Donald, Philip Elsworth; Buongiorno, Jacopo

2002-10-01

The purpose of this collaborative Idaho National Engineering and Environmental Laboratory (INEEL) and Massachusetts Institute of Technology (MIT) Laboratory Directed Research and Development (LDRD) project is to investigate the suitability of lead or lead-bismuth cooled fast reactors for producing low-cost electricity as well as for actinide burning. The goal is to identify and analyze the key technical issues in core neutronics, materials, thermal-hydraulics, fuels, and economics associated with the development of this reactor concept. Work has been accomplished in four major areas of research: core neutronic design, plant engineering, material compatibility studies, and coolant activation. The publications derived from work on this project (since project inception) are listed in Appendix A. This is the third in a series of Annual Reports for this project, the others are also listed in Appendix A as FY-00 and FY-01 Annual Reports.

Cost of Delivering Health Care Services in Public Sector Primary and Community Health Centres in North India.

Science.gov (United States)

Prinja, Shankar; Gupta, Aditi; Verma, Ramesh; Bahuguna, Pankaj; Kumar, Dinesh; Kaur, Manmeet; Kumar, Rajesh

2016-01-01

With the commitment of the national government to provide universal healthcare at cheap and affordable prices in India, public healthcare services are being strengthened in India. However, there is dearth of cost data for provision of health services through public system like primary & community health centres. In this study, we aim to bridge this gap in evidence by assessing the total annual and per capita cost of delivering the package of health services at PHC and CHC level. Secondly, we determined the per capita cost of delivering specific health services like cost per antenatal care visit, per institutional delivery, per outpatient consultation, per bed-day hospitalization etc. We undertook economic costing of fourteen public health facilities (seven PHCs and CHCs each) in three North-Indian states viz., Haryana, Himachal Pradesh and Punjab. Bottom-up costing method was adopted for collection of data on all resources spent on delivery of health services in selected health facilities. Analysis was undertaken using a health system perspective. The joint costs like human resource, capital, and equipment were apportioned as per the time value spent on a particular service. Capital costs were discounted and annualized over the estimated life of the item. Mean annual costs and unit costs were estimated along with their 95% confidence intervals using bootstrap methodology. The overall annual cost of delivering services through public sector primary and community health facilities in three states of north India were INR 8.8 million (95% CI: 7,365,630-10,294,065) and INR 26.9 million (95% CI: 22,225,159.3-32,290,099.6), respectively. Human resources accounted for more than 50% of the overall costs at both the level of PHCs and CHCs. Per capita per year costs for provision of complete package of preventive, curative and promotive services at PHC and CHC were INR 170.8 (95% CI: 131.6-208.3) and INR162.1 (95% CI: 112-219.1), respectively. The study estimates can be used

The Indirect Costs of Financial Distress in Indonesia

OpenAIRE

Wijantini, Wijantini

2007-01-01

This paper presents quantitative estimates of the indirect cost of financial distress and its determinants. In order to measure the cost, this study estimates the annualized changes in industry-adjusted operation profit and sales from a year before the onset of distress to the resolution year. Using those approaches, the median of indirect financial distress cost is estimated between three and 11 percent annually. To the extent that the direct cost of financial distress reduces reported opera...

The costs of heart failure in Poland from the public payer's perspective. Polish programme assessing diagnostic procedures, treatment and costs in patients with heart failure in randomly selected outpatient clinics and hospitals at different levels of care: POLKARD.

Science.gov (United States)

Czech, Marcin; Opolski, Grzegorz; Zdrojewski, Tomasz; Dubiel, Jacek S; Wizner, Barbara; Bolisęga, Dorota; Fedyk-Łukasik, Małgorzata; Grodzicki, Tomasz

2013-01-01

Heart failure (HF) is a chronic disease of great clinical and economic significance for both the healthcare system and patients themselves. To determine the consumption of medical resources for treatment and care of HF patients and to estimate the related costs. The study involved 400 primary care practices and 396 specialist outpatient clinics, as well as 259 hospitals at all reference levels. The sample was representative and supplemented with patient interview data. Based on the consumption of particular resources and the unit costs of services in 2011, costs of care for HF patients in Poland were estimated. Separate analyses were conducted depending on the stage of the disease (according to NYHA classification I-IV). The public payer's perspective and a one year time horizon were adopted. Direct annual costs of an HF patient's treatment in Poland may range between PLN 3,373.23 and 7,739.49 (2011), the main cost item being hospitalisation. The total costs for the healthcare system could be as high as PLN 1,703 million, which is 3.16% of the National Health Fund's budget (Ex. rate from 05.03.2012: 1 EUR = 4.14 PLN). The costs of treating heart failure in Poland are high; proper allocation of resources to diagnostic procedures and treatment may contribute to rationalisation of the relevant expenditure.

Energy: annual report and accounts 1994

International Nuclear Information System (INIS)

1994-01-01

The annual report and accounts (1994) of the Midlands Electricity plc contains the Chairman's statement, the Chief Executive's review, and the Directors and Auditors' reports. A financial review is presented, and the group's historical cost profit and loss account, the group's financial history, and summary current cost accounting information are detailed. (UK)

Explaining the heterogeneity in average costs per HIV/AIDS patient in Nigeria: The role of supply-side and service delivery characteristics

Science.gov (United States)

Amanze, Ogbonna O.; La Hera-Fuentes, Gina; Silverman-Retana, Omar; Contreras-Loya, David; Ashefor, Gregory A.; Ogungbemi, Kayode M.

2018-01-01

Objective We estimated the average annual cost per patient of ART per facility (unit cost) in Nigeria, described the variation in costs across facilities, and identified factors associated with this variation. Methods We used facility-level data of 80 facilities in Nigeria, collected between December 2014 and May 2015. We estimated unit costs at each facility as the ratio of total costs (the sum of costs of staff, recurrent inputs and services, capital, training, laboratory tests, and antiretroviral and TB treatment drugs) divided by the annual number of patients. We applied linear regressions to estimate factors associated with ART cost per patient. Results The unit ART cost in Nigeria was $157 USD nationally and the facility-level mean was $231 USD. The study found a wide variability in unit costs across facilities. Variations in costs were explained by number of patients, level of care, task shifting (shifting tasks from doctors to less specialized staff, mainly nurses, to provide ART) and provider´s competence. The study illuminated the potentially important role that management practices can play in improving the efficiency of ART services. Conclusions Our study identifies characteristics of services associated with the most efficient implementation of ART services in Nigeria. These results will help design efficient program scale-up to deliver comprehensive HIV services in Nigeria by distinguishing features linked to lower unit costs. PMID:29718906

Explaining the heterogeneity in average costs per HIV/AIDS patient in Nigeria: The role of supply-side and service delivery characteristics.

Directory of Open Access Journals (Sweden)

Sergio Bautista-Arredondo

Full Text Available We estimated the average annual cost per patient of ART per facility (unit cost in Nigeria, described the variation in costs across facilities, and identified factors associated with this variation.We used facility-level data of 80 facilities in Nigeria, collected between December 2014 and May 2015. We estimated unit costs at each facility as the ratio of total costs (the sum of costs of staff, recurrent inputs and services, capital, training, laboratory tests, and antiretroviral and TB treatment drugs divided by the annual number of patients. We applied linear regressions to estimate factors associated with ART cost per patient.The unit ART cost in Nigeria was $157 USD nationally and the facility-level mean was $231 USD. The study found a wide variability in unit costs across facilities. Variations in costs were explained by number of patients, level of care, task shifting (shifting tasks from doctors to less specialized staff, mainly nurses, to provide ART and provider´s competence. The study illuminated the potentially important role that management practices can play in improving the efficiency of ART services.Our study identifies characteristics of services associated with the most efficient implementation of ART services in Nigeria. These results will help design efficient program scale-up to deliver comprehensive HIV services in Nigeria by distinguishing features linked to lower unit costs.

Estimated cost of overactive bladder in Thailand.

Science.gov (United States)

Prasopsanti, Kriangsak; Santi-Ngamkun, Apirak; Pornprasit, Kanokwan

2007-11-01

To estimate the annual direct and indirect costs of overactive bladder (OAB) in indigenous Thai people aged 18 years and over in the year 2005. Economically based models using diagnostic and treatment algorithms from clinical practice guidelines and current disease prevalence data were used to estimate direct and indirect costs of OAB. Prevalence and event probability estimates were obtained from the literature, national data sets, and expert opinion. Costs were estimated from a small survey using a cost questionnaire and from unit costs of King Chulalongkorn Memorial Hospital. The annual cost of OAB in Thailand is estimated as 1.9 billion USD. It is estimated to consume 1.14% of national GDP The cost includes 0.33 billion USD for direct medical costs, 1.3 billion USD for direct, nonmedical costs and 0.29 billion USD for indirect costs of lost productivity. The largest costs category was direct treatment costs of comorbidities associated with OAB. Costs of OAB medication accountedfor 14% of the total costs ofOAB.

Determining the Cost of Producing Ethanol from Corn Starch and Lignocellulosic Feedstocks

Energy Technology Data Exchange (ETDEWEB)

McAloon, A.; Taylor, F.; Yee, W.; Ibsen, K.; Wooley, R.

2000-10-25

The mature corn-to-ethanol industry has many similarities to the emerging lignocellulose-to-ethanol industry. It is certainly possible that some of the early practitioners of this new technology will be the current corn ethanol producers. In order to begin to explore synergies between the two industries, a joint project between two agencies responsible for aiding these technologies in the Federal government was established. This joint project of the USDA-ARS and DOE/NREL looked at the two processes on a similar process design and engineering basis, and will eventually explore ways to combine them. This report describes the comparison of the processes, each producing 25 million annual gallons of fuel ethanol. This paper attempts to compare the two processes as mature technologies, which requires assuming that the technology improvements needed to make the lignocellulosic process commercializable are achieved, and enough plants have been built to make the design well-understood. Ass umptions about yield and design improvements possible from continued research were made for the emerging lignocellulose process. In order to compare the lignocellulose-to-ethanol process costs with the commercial corn-to-ethanol costs, it was assumed that the lignocellulose plant was an Nth generation plant, built after the industry had been sufficiently established to eliminate first-of-a-kind costs. This places the lignocellulose plant costs on a similar level with the current, established corn ethanol industry, whose costs are well known. The resulting costs of producing 25 million annual gallons of fuel ethanol from each process were determined. The figure below shows the production cost breakdown for each process. The largest cost contributor in the corn starch process is the feedstock; for the lignocellulosic process it is the capital cost, which is represented by depreciation cost on an annual basis.

Economic analysis of solar industrial process heat systems: A methodology to determine annual required revenue and internal rate of return

Science.gov (United States)

Dickinson, W. C.; Brown, K. C.

1981-08-01

An economic evaluation of solar industrial process heat systems, is developed to determine the annual required revenue and the internal rate of return. First, a format is provided to estimate the solar system's installed cost, annual operating and maintenance expenses, and net annual solar energy delivered to the industrial process. The annual required revenue and the price of solar is calculated. The economic attractiveness of the potential solar investment can be determined by comparing the price of solar energy with the price of fossilfuel, both expressed in levelized terms. This requires calcuation of the internal rate of return on the solar investment or, in certain cases, the growth rate of return.

Counting Costs under Severe Financial Constraints: A Cost-of-Illness Analysis of Spondyloarthropathies in a Tertiary Hospital in Greece.

Science.gov (United States)

Tsifetaki, Niki; Migkos, Michail P; Papagoras, Charalampos; Voulgari, Paraskevi V; Athanasakis, Kostas; Drosos, Alexandros A

2015-06-01

To investigate the total annual direct cost of patients with spondyloarthritis (SpA) in Greece. Retrospective study with 156 patients diagnosed and followed up in the rheumatology clinic of the University Hospital of Ioannina. Sixty-four had ankylosing spondylitis (AS) and 92 had psoriatic arthritis (PsA). Health resource use for each patient was elicited through a retrospective chart review that documented the use of monitoring visits, medications, laboratory/diagnostic tests, and inpatient stays for the previous year from the date that the review took place. Costs were calculated from a third-party payer perspective and are reported in 2014 euros. The mean ± SD annual direct cost for the patients with SpA reached €8680 ± 6627. For the patients with PsA and AS, the cost was estimated to be €8097 ± 6802 and €9531 ± 6322, respectively. The major cost was medication, which represented 88.9%, 88.2%, and 89.3% of the mean total direct cost for SpA, AS, and PsA, respectively. The annual amount of the scheduled tests for all patients corresponded to 7.5%, and for those performed on an emergency basis, 1.1%. Further, the cost for scheduled and emergency hospitalization, as well as the cost of scheduled visits to an outpatient clinic, corresponded to 2.5% of the mean total annual direct cost for the patients with SpA. SpA carries substantial financial cost, especially in the era of new treatment options. Adequate access and treatment for patients with SpA remains a necessity, even in times of fiscal constraint. Thus, the recommendations of the international scientific organizations should be considered when administering high-cost drugs such as biological treatments.

The Community's research and development programme on radioactive waste management and storage. Shared cost action. Annual progress report 1988. Volume 2

International Nuclear Information System (INIS)

Anon.

1989-01-01

Third annual progress report of the European Community's 1985-89 programme of research and development on radioactive waste management and disposal, carried out by public organizations and private firms in the Community under cost-sharing contracts with the Commission of the European Communities. This report describes the work to be carried out under research contracts already concluded before the end of 1988, as well as the work performed and the results obtained so far

The Community's research and development programme on radioactive waste management and storage. Shared cost action. Annual progress report 1988. Volume 1

International Nuclear Information System (INIS)

Anon.

1989-01-01

Third annual progress report of the European Community's 1985-89 programme of research and development on radioactive waste management and disposal, carried out by public organizations and private firms in the Community under cost-sharing contracts with the Commission of the European Communities. This report describes the work to be carried out under research contracts already concluded before the end of 1988, as well as the work performed and the results obtained so far

Interim report: Waste management facilities cost information for mixed low-level waste

International Nuclear Information System (INIS)

Feizollahi, F.; Shropshire, D.

1994-03-01

This report contains preconceptual designs and planning level life-cycle cost estimates for treating alpha and nonalpha mixed low-level radioactive waste. This report contains information on twenty-seven treatment, storage, and disposal modules that can be integrated to develop total life cycle costs for various waste management options. A procedure to guide the US Department of Energy and its contractor personnel in the use of estimating data is also summarized in this report

Review of the cost of venous thromboembolism

Science.gov (United States)

Fernandez, Maria M; Hogue, Susan; Preblick, Ronald; Kwong, Winghan Jacqueline

2015-01-01

Background Venous thromboembolism (VTE) is the second most common medical complication and a cause of excess length of hospital stay. Its incidence and economic burden are expected to increase as the population ages. We reviewed the recent literature to provide updated cost estimates on VTE management. Methods Literature search strategies were performed in PubMed, Embase, Cochrane Collaboration, Health Economic Evaluations Database, EconLit, and International Pharmaceutical Abstracts from 2003–2014. Additional studies were identified through searching bibliographies of related publications. Results Eighteen studies were identified and are summarized in this review; of these, 13 reported data from the USA, four from Europe, and one from Canada. Three main cost estimations were identified: cost per VTE hospitalization or per VTE readmission; cost for VTE management, usually reported annually or during a specific period; and annual all-cause costs in patients with VTE, which included the treatment of complications and comorbidities. Cost estimates per VTE hospitalization were generally similar across the US studies, with a trend toward an increase over time. Cost per pulmonary embolism hospitalization increased from $5,198–$6,928 in 2000 to $8,764 in 2010. Readmission for recurrent VTE was generally more costly than the initial index event admission. Annual health plan payments for services related to VTE also increased from $10,804–$16,644 during the 1998–2004 period to an estimated average of $15,123 for a VTE event from 2008 to 2011. Lower costs for VTE hospitalizations and annualized all-cause costs were estimated in European countries and Canada. Conclusion Costs for VTE treatment are considerable and increasing faster than general inflation for medical care services, with hospitalization costs being the primary cost driver. Readmissions for VTE are generally more costly than the initial VTE admission. Further studies evaluating the economic impact of new

Costs of endometriosis in Austria: a survey of direct and indirect costs.

Science.gov (United States)

Prast, Johanna; Oppelt, Peter; Shamiyeh, Andreas; Shebl, Omar; Brandes, Iris; Haas, Dietmar

2013-09-01

The literature includes a wealth of medical data on endometriosis, but the economic significance of the condition has so far been neglected. An analysis of hospital costs for endometriosis in Austria was, therefore, carried out for economic purposes. Seventy-three patients with endometriosis were included in the study. A bottom-up approach was used to collect data on the average hospital costs of an endometriosis patient over a time period of 1 year. In addition, a prevalence approach was used that allows subsequent estimation of the total costs of endometriosis for the health-care system in Austria for that period. Retrospective questionnaire survey was conducted. The average annual costs of one case of endometriosis are 7,712, with 5,605.55 attributable to direct costs and 2,106.34 to indirect costs. This indicates an overall economic burden of 328 million. In-patient care (45 %) and loss of productivity (27 %) were identified as the major cost factors. The patients themselves pay for 13 % of the costs (through out-of-pocket payments). This study impressively demonstrates the financial burden on the economy and on each individually affected patient caused by the disease of endometriosis. The massive consumption of resources represents a high level of usage of the medical services provided. The question arises as to whether more timely diagnosis, followed by better-targeted treatment, might have the potential to reduce these costs. The overall economic burden of endometriosis in Austria is currently comparable with that of Parkinson's disease.

Cost-effectiveness of screening for asymptomatic carotid atherosclerotic disease.

Science.gov (United States)

Derdeyn, C P; Powers, W J

1996-11-01

The value of screening for asymptomatic carotid stenosis has become an important issue with the recently reported beneficial effect of endarterectomy. The purpose of this study is to evaluate the cost-effectiveness of using Doppler ultrasound as a screening tool to select subjects for arteriography and subsequent surgery. A computer model was developed to simulate the cost-effectiveness of screening a cohort of 1000 men during a 20-year period. The primary outcome measure was incremental present-value dollar expenditures for screening and treatment per incremental present-value quality-adjusted life-year (QALY) saved. Estimates of disease prevalence and arteriographic and surgical complication rates were obtained from the literature. Probabilities of stroke and death with surgical and medical treatment were obtained from published clinical trials. Doppler ultrasound sensitivity and specificity were obtained through review of local experience. Estimates of costs were obtained from local Medicare reimbursement data. A one-time screening program of a population with a high prevalence (20%) of > or = 60% stenosis cost $35130 per incremental QALY gained. Decreased surgical benefit or increased annual discount rate was detrimental, resulting in lost QALYs. Annual screening cost $457773 per incremental QALY gained. In a low-prevalence (4%) population, one-time screening cost $52588 per QALY gained, while annual screening was detrimental. The cost-effectiveness of a one-time screening program for an asymptomatic population with a high prevalence of carotid stenosis may be cost-effective. Annual screening is detrimental. The most sensitive variables in this simulation model were long-term stroke risk reduction after surgery and annual discount rate for accumulated costs and QALYs.

Cost and quality of fuels for electric utility plants, 1994

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-07-14

This document presents an annual summary of statistics at the national, Census division, State, electric utility, and plant levels regarding the quantity, quality, and cost of fossil fuels used to produce electricity. Purpose of this publication is to provide energy decision-makers with accurate, timely information that may be used in forming various perspectives on issues regarding electric power.

Annual report 1995

Energy Technology Data Exchange (ETDEWEB)

NONE

1996-10-01

The annual report from IKU (Continental Shelf Institute) in Norway deals with the market adjustment of research activities at the institute as a result of offshore cost-cutting policy in the petroleum industry. The market is about to shift focus from volume to competence. In practice, that means buying competence instead of project ideas or proposals

System of Indicators of the Level of Costs of Financing an Economic Subject

Directory of Open Access Journals (Sweden)

Laktionova Aleksandra A.

2013-11-01

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.

The Cost of Clean Water in the Delaware River Basin (USA

Directory of Open Access Journals (Sweden)

Gerald J. Kauffman

2018-01-01

Full Text Available The Delaware River has made a marked recovery in the half-century since the adoption of the Delaware River Basin Commission (DRBC Compact in 1961 and passage of the Federal Clean Water Act amendments during the 1970s. During the 1960s, the DRBC set a 3.5 mg/L dissolved oxygen criterion for the river based on an economic analysis that concluded that a waste load abatement program designed to meet fishable water quality goals would generate significant recreational and environmental benefits. Scientists with the Delaware Estuary Program have recently called for raising the 1960s dissolved oxygen criterion along the Delaware River from 3.5 mg/L to 5.0 mg/L to protect anadromous American shad and Atlantic sturgeon, and address the prospect of rising temperatures, sea levels, and salinity in the estuary. This research concludes, through a nitrogen marginal abatement cost (MAC analysis, that it would be cost-effective to raise dissolved oxygen levels to meet a more stringent standard by prioritizing agricultural conservation and some wastewater treatment investments in the Delaware River watershed to remove 90% of the nitrogen load by 13.6 million kg N/year (30 million lb N/year for just 35% ($160 million of the $449 million total cost. The annual least cost to reduce nitrogen loads and raise dissolved oxygen levels to meet more stringent water quality standards in the Delaware River totals $45 million for atmospheric NOX reduction, $130 million for wastewater treatment, $132 million for agriculture conservation, and $141 million for urban stormwater retrofitting. This 21st century least cost analysis estimates that an annual investment of $50 million is needed to reduce pollutant loads in the Delaware River to raise dissolved oxygen levels to 4.0 mg/L, $150 million is needed for dissolved oxygen levels to reach 4.5 mg/L, and $449 million is needed for dissolved oxygen levels to reach 5.0 mg/L.

The health system cost of post-abortion care in Rwanda

Science.gov (United States)

Vlassoff, Michael; Musange, Sabine F; Kalisa, Ina R; Ngabo, Fidele; Sayinzoga, Felix; Singh, Susheela; Bankole, Akinrinola

2015-01-01

Based on research conducted in 2012, we estimate the cost to the Rwandan health-care system of providing post-abortion care (PAC) due to unsafe abortions, a subject of policy importance not studied before at the national level. Thirty-nine public and private health facilities representing three levels of health care were randomly selected for data collection from key care providers and administrators for all five regions. Using an ingredients approach to costing, data were gathered on drugs, supplies, material, personnel time and hospitalization. Additionally, direct non-medical costs such as overhead and capital costs were also measured. We found that the average annual PAC cost per client, across five types of abortion complications, was $93. The total cost of PAC nationally was estimated to be $1.7 million per year, 49% of which was expended on direct non-medical costs. Satisfying all demands for PAC would raise the national cost to $2.5 million per year. PAC comprises a significant share of total expenditure in reproductive health in Rwanda. Investing more resources in provision of contraceptive services to prevent unwanted or mistimed pregnancies would likely reduce health systems costs. PMID:24548846

When are solar refrigerators less costly than on-grid refrigerators: A simulation modeling study☆

Science.gov (United States)

Haidari, Leila A.; Brown, Shawn T.; Wedlock, Patrick; Connor, Diana L.; Spiker, Marie; Lee, Bruce Y.

2017-01-01

Background Gavi recommends solar refrigerators for vaccine storage in areas with less than eight hours of electricity per day, and WHO guidelines are more conservative. The question remains: Can solar refrigerators provide value where electrical outages are less frequent? Methods Using a HERMES-generated computational model of the Mozambique routine immunization supply chain, we simulated the use of solar versus electric mains-powered refrigerators (hereafter referred to as “electric refrigerators”) at different locations in the supply chain under various circumstances. Results At their current price premium, the annual cost of each solar refrigerator is 132% more than each electric refrigerator at the district level and 241% more at health facilities. Solar refrigerators provided savings over electric refrigerators when one-day electrical outages occurred more than five times per year at either the district level or the health facilities, even when the electric refrigerator holdover time exceeded the duration of the outage. Two-day outages occurring more than three times per year at the district level or more than twice per year at the health facilities also caused solar refrigerators to be cost saving. Lowering the annual cost of a solar refrigerator to 75% more than an electric refrigerator allowed solar refrigerators to be cost saving at either level when one-day outages occurred more than once per year, or when two-day outages occurred more than once per year at the district level or even once per year at the health facilities. Conclusion Our study supports WHO and Gavi guidelines. In fact, solar refrigerators may provide savings in total cost per dose administered over electrical refrigerators when electrical outages are less frequent. Our study identified the frequency and duration at which electrical outages need to occur for solar refrigerators to provide savings in total cost per dose administered over electric refrigerators at different solar

When are solar refrigerators less costly than on-grid refrigerators: A simulation modeling study.

Science.gov (United States)

Haidari, Leila A; Brown, Shawn T; Wedlock, Patrick; Connor, Diana L; Spiker, Marie; Lee, Bruce Y

2017-04-19

Gavi recommends solar refrigerators for vaccine storage in areas with less than eight hours of electricity per day, and WHO guidelines are more conservative. The question remains: Can solar refrigerators provide value where electrical outages are less frequent? Using a HERMES-generated computational model of the Mozambique routine immunization supply chain, we simulated the use of solar versus electric mains-powered refrigerators (hereafter referred to as "electric refrigerators") at different locations in the supply chain under various circumstances. At their current price premium, the annual cost of each solar refrigerator is 132% more than each electric refrigerator at the district level and 241% more at health facilities. Solar refrigerators provided savings over electric refrigerators when one-day electrical outages occurred more than five times per year at either the district level or the health facilities, even when the electric refrigerator holdover time exceeded the duration of the outage. Two-day outages occurring more than three times per year at the district level or more than twice per year at the health facilities also caused solar refrigerators to be cost saving. Lowering the annual cost of a solar refrigerator to 75% more than an electric refrigerator allowed solar refrigerators to be cost saving at either level when one-day outages occurred more than once per year, or when two-day outages occurred more than once per year at the district level or even once per year at the health facilities. Our study supports WHO and Gavi guidelines. In fact, solar refrigerators may provide savings in total cost per dose administered over electrical refrigerators when electrical outages are less frequent. Our study identified the frequency and duration at which electrical outages need to occur for solar refrigerators to provide savings in total cost per dose administered over electric refrigerators at different solar refrigerator prices. Copyright © 2017. Published

Cost-benefit analysis of improved air quality in an office building

DEFF Research Database (Denmark)

Djukanovic, R.; Wargocki, Pawel; Fanger, Povl Ole

2002-01-01

A cost-benefit analysis of measures to improve air quality in an existing air-conditoned office building (11581 m2, 864 employees) was carried out for hot, temperate and cold climates and for two operating modes: Variable Air Volume (VAV) with economizer; and Constant Air Volume (CAV) with heat...... recovery. The annual energy cost and first cost of the HVAC system were calculat4ed using DOE 2.1E for different levels of air quality (10-50% dissatisfied). This was achieved by changing the outdoor air supply rate and the pollution loads. Previous studies have documented a 1.1% increase in office...

Report on waste burial charges: Escalation of decommissioning waste disposal costs at low-level waste burial facilities

International Nuclear Information System (INIS)

1988-07-01

One of the requirements placed upon nuclear power reactor licensees by the US Nuclear Regulatory Commission (NRC) is for the licensees to periodically adjust the estimate of the cost of decommissioning their plant, in dollars of the current year, as part of the process to provide reasonable assurance that adequate funds for decommissioning will be available when needed. This report, which is scheduled to be revised annually, contains the development of a formula for escalating decommissioning cost estimates that is acceptable to the NRC, and contains values for the escalation of radioactive waste burial costs, by site and by year. The licensees may use the formula, the coefficients, and the burial escalation factors from this report in their escalation analysis, or may use an escalation rate at least equal to the escalation approach presented herein. 4 refs., 2 tabs

Prioritising Disclosures in the Annual Report

DEFF Research Database (Denmark)

Riise Johansen, Thomas; Plenborg, Thomas

2013-01-01

Drawing upon information economics, this paper presents a relative assessment of 24 of the most common disclosure items in the management commentary and notes sections of the annual report. We design and conduct an Internet survey using a large representative sample of users with an investment...... responsibility and corporate governance, the least demanded disclosure items in the management commentary, are also costly items to prepare. Further, preparers do not consider indirect costs (i.e. competitive position costs and potential litigation costs) of information provided in the management commentary...

Secukinumab Significantly Reduces Psoriasis-Related Work Impairment and Indirect Costs Compared With Ustekinumab and Etanercept in the United Kingdom.

Science.gov (United States)

Warren, R B; Halliday, A; Graham, C N; Gilloteau, I; Miles, L; McBride, D

2018-05-30

Psoriasis causes work productivity impairment that increases with disease severity. Whether differential treatment efficacy translates into differential indirect cost savings is unknown. To assess work hours lost and indirect costs associated with secukinumab versus ustekinumab and etanercept in the United Kingdom (UK). This was a post hoc analysis of work impairment data collected in the CLEAR study (secukinumab vs. ustekinumab) and applied to the FIXTURE study (secukinumab vs. etanercept). Weighted weekly and annual average indirect costs per patient per treatment were calculated from (1) overall work impairment derived from Work Productivity and Activity Impairment data collected in CLEAR at 16 and 52 weeks by Psoriasis Area and Severity Index (PASI) response level; (2) weekly/annual work productivity loss by PASI response level; (3) weekly and annual indirect costs by PASI response level, based on hours of work productivity loss; and (4) weighted average indirect costs for each treatment. In the primary analysis, work impairment data for employed patients in CLEAR at Week 16 were used to compare secukinumab and ustekinumab. Secondary analyses were conducted at different timepoints and with patient cohorts, including FIXTURE. In CLEAR, 452 patients (67%) were employed at baseline. At Week 16, percentages of weekly work impairment/mean hours lost decreased with higher PASI: PASI hours; PASI 50-74: 13.3%/4.45 hours; PASI 75-89: 6.4%/2.14 hours; PASI ≥90: 4.9%/1.65 hours. Weighted mean weekly/annual work hours lost were significantly lower for secukinumab than ustekinumab (1.96/102.51 vs. 2.40/125.12; P=0.0006). Results were consistent for secukinumab versus etanercept (2.29/119.67 vs. 3.59/187.17; Ρreduced work impairment and associated indirect costs of psoriasis compared with ustekinumab and etanercept at Week 16 through 52 in the UK. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

2016 Annual Technology Baseline (ATB)

Energy Technology Data Exchange (ETDEWEB)

Cole, Wesley; Kurup, Parthiv; Hand, Maureen; Feldman, David; Sigrin, Benjamin; Lantz, Eric; Stehly, Tyler; Augustine, Chad; Turchi, Craig; O' Connor, Patrick; Waldoch, Connor

2016-09-01

Consistent cost and performance data for various electricity generation technologies can be difficult to find and may change frequently for certain technologies. With the Annual Technology Baseline (ATB), National Renewable Energy Laboratory provides an organized and centralized dataset that was reviewed by internal and external experts. It uses the best information from the Department of Energy laboratory's renewable energy analysts and Energy Information Administration information for conventional technologies. The ATB will be updated annually in order to provide an up-to-date repository of current and future cost and performance data. Going forward, we plan to revise and refine the values using best available information. The ATB includes both a presentation with notes (PDF) and an associated Excel Workbook. The ATB includes the following electricity generation technologies: land-based wind; offshore wind; utility-scale solar PV; concentrating solar power; geothermal power; hydropower plants (upgrades to existing facilities, powering non-powered dams, and new stream-reach development); conventional coal; coal with carbon capture and sequestration; integrated gasification combined cycle coal; natural gas combustion turbines; natural gas combined cycle; conventional biopower. Nuclear laboratory's renewable energy analysts and Energy Information Administration information for conventional technologies. The ATB will be updated annually in order to provide an up-to-date repository of current and future cost and performance data. Going forward, we plan to revise and refine the values using best available information.

A probabilistic approach to the computation of the levelized cost of electricity

International Nuclear Information System (INIS)

Geissmann, Thomas

2017-01-01

This paper sets forth a novel approach to calculate the levelized cost of electricity (LCOE) using a probabilistic model that accounts for endogenous input parameters. The approach is applied to the example of a nuclear and gas power project. Monte Carlo simulation results show that a correlation between input parameters has a significant effect on the model outcome. By controlling for endogeneity, a statistically significant difference in the mean LCOE estimate and a change in the order of input leverages is observed. Moreover, the paper discusses the role of discounting options and external costs in detail. In contrast to the gas power project, the economic viability of the nuclear project is considerably weaker. - Highlights: • First model of levelized cost of electricity accounting for uncertainty and endogeneities in input parameters. • Allowance for endogeneities significantly affects results. • Role of discounting options and external costs is discussed and modelled.

ABC's of Higher Education. Getting Back to the Basics: An Activity-Based Costing Approach to Planning and Financial Decision Making. AIR 1999 Annual Forum Paper.

Science.gov (United States)

Cox, Kelline S.; Downey, Ronald G.; Smith, Laurinda G.

This paper describes the activity-based costing approach used to report and capture the time spent by faculty for specified activities at one Midwestern university. For each department, four major areas (instruction, research, public service, and administration) and 14 activities were identified. During the annual goal-setting period, each faculty…

Cost-benefit analysis for management of low-level radioactive waste

International Nuclear Information System (INIS)

Jacobs, D.G.

1979-01-01

There are several types of cost-benefit analyses that can be used in evaluating a technical activity such as waste management. A direct comparison can be made of the benefits to be gained versus the costs to be accrued. If the balance is favorable the activity is considered to be acceptable. In many cases, however, a number of alternatives may be available requiring a comparative cost-benefit analysis so that the most favorable option is chosen. After the basic option is chosen, a further analysis is required in which additional control technologies can be considered to further reduce specific types of impact; this represents a differential cost-benefit analysis or, perhaps more properly, a study of cost-effectiveness. Also, because of the wide variety of parameters that go into a cost-benefit analysis and the range of value judgements that may be applied by different interest groups, it is likely that each additional increment of technology will have a slightly different balance point. Factors and impacts that need to be considered in management of low-level wastes will be discussed and a simplified example will be used to demonstrate the difficulties that may be encountered

Cost-benefit analysis for management of low-level radioactive waste

International Nuclear Information System (INIS)

Jacobs, D.G.

1977-01-01

There are several types of cost-benefit analyses that can be used in evaluating a technical activity such as waste management. A direct comparison can be made of the benefits to be gained versus the costs to be accrued. If the balance is favorable, the activity is considered to be acceptable. In many cases, however, a number of alternatives may be available requiring a comparative cost-benefit analysis so that the most favorable option is chosen. After the basic option is chosen, a further analysis is required in which additional control technologies can be considered to further reduce specific types of impact; this represents a differential cost-benefit analysis or, perhaps more properly, a study of cost-effectiveness. Also, because of the wide variety of parameters that go into a cost-benefit analysis and the range of value judgements that may be applied by different interest groups, it is likely that each additional increment of technology will have a slightly different balance point. Factors and impacts that need to be considered in management of low-level wastes will be discussed and a simplified example will be used to demonstrate the difficulties that may be encountered

Measuring diet cost at the individual level: a comparison of three methods.

Science.gov (United States)

Monsivais, P; Perrigue, M M; Adams, S L; Drewnowski, A

2013-11-01

Household-level food spending data are not suitable for population-based studies of the economics of nutrition. This study compared three methods of deriving diet cost at the individual level. Adult men and women (n=164) completed 4-day diet diaries and a food frequency questionnaire (FFQ). Food expenditures over 4 weeks and supermarket prices for 384 foods were obtained. Diet costs (US$/day) were estimated using: (1) diet diaries and expenditures; (2) diet diaries and supermarket prices; and (3) FFQs and supermarket prices. Agreement between the three methods was assessed on the basis of Pearson correlations and limits of agreement. Income-related differences in diet costs were estimated using general linear models. Diet diaries yielded mean (s.d.) diet costs of $10.04 (4.27) based on Method 1 and $8.28 (2.32) based on Method 2. FFQs yielded mean diet costs of $7.66 (2.72) based on Method 3. Correlations between energy intakes and costs were highest for Method 3 (r(2)=0.66), lower for Method 2 (r(2)=0.24) and lowest for Method 1 (r(2)=0.06). Cost estimates were significantly associated with household incomes. The weak association between food expenditures and food intake using Method 1 makes it least suitable for diet and health research. However, merging supermarket food prices with standard dietary assessment tools can provide estimates of individual diet cost that are more closely associated with food consumed. The derivation of individual diet cost can provide insights into some of the economic determinants of food choice, diet quality and health.

A level playing field-obtaining consistent cost estimates for advanced reactor designs

International Nuclear Information System (INIS)

Hudson, C.R.; Rohm, H.H.; Humphreys, J.R.

1987-01-01

A level playing field in sports is necessary to avoid a situation in which a team has an unfair advantage over its competition. Similarly, rules and guidelines for developing cost estimates can be established which, in effect, provide a level playing field whereby cost estimates for advanced power plant concepts can be presented on a consistent and equitable basis. As an example, consider the capital costs shown in Table 1. Both sets of cost are for the exact same power plant; Estimate 1 is expressed in constant dollars while Estimate 2 is presented in nominal or as-spent dollars. As shown, the costs in Table 1 are not directly comparable. Similar problems can be introduced as a result of differing assumptions in any number of parameters including the scope of the cost estimate, inflation/escalation and interest rates, contingency costs, and site location. Of course, the motivation for having consistent cost estimates is to permit comparison among various concepts. As the U.S. Department of Energy sponsors research and development work on several advanced reactor concepts in which expected cost is a key evaluation parameter, the emphasis in this particular endeavor has been in promoting the comparability of advanced reactor cost estimates among themselves and to existing power plant types. To continue with the analogy, the idea is to lay out the playing field and the rules of the contest such that each team participates in the match on an equal basis with the final score being solely determined by the inherent strengths and abilities of the teams. A description of the playing field and some of the more important rules will now be provided

University-level nutrition training in West Africa: cost and financing issues

Directory of Open Access Journals (Sweden)

Roger Sodjinou

2015-11-01

. Recent master's programs appeared to charge higher fees than older ones. We found a significant negative correlation between tuition fees and the age of the program, after controlling for school ownership (r=−0.33, p<0.001. Conclusions: Our findings underscore the urgent need for national governments in the region to establish benchmarks and regulate nutrition training costs. In a region where the average annual gross national income (GNI per capita is barely 890$, the rising cost of tuition fees is likely to hinder access of students from poor background to nutrition training. Governments should institute financing mechanisms such as scholarships, public–private partnerships, credit facilities, and donor funding to facilitate access to tertiary-level nutrition training in the region.

Canadian Potential Healthcare and Societal Cost Savings from Consumption of Pulses: A Cost-Of-Illness Analysis

Directory of Open Access Journals (Sweden)

Mohammad M. H. Abdullah

2017-07-01

Full Text Available Consumption of dietary pulses, including beans, peas and lentils, is recommended by health authorities across jurisdictions for their nutritional value and effectiveness in helping to prevent and manage major diet-related illnesses of significant socioeconomic burden. The aim of this study was to estimate the potential annual healthcare and societal cost savings relevant to rates of reduction in complications from type 2 diabetes (T2D and incidence of cardiovascular disease (CVD following a low glycemic index (GI or high fiber diet that includes pulses, or 100 g/day pulse intake in Canada, respectively. A four-step cost-of-illness analysis was conducted to: (1 estimate the proportions of individuals who are likely to consume pulses; (2 evaluate the reductions in established risk factors for T2D and CVD; (3 assess the percent reduction in incidences or complications of the diseases of interest; and (4 calculate the potential annual savings in relevant healthcare and related costs. A low GI or high fiber diet that includes pulses and 100 g/day pulse intake were shown to potentially yield Can$6.2 (95% CI $2.6–$9.9 to Can$62.4 (95% CI $26–$98.8 and Can$31.6 (95% CI $11.1–$52 to Can$315.5 (95% CI $110.6–$520.4 million in savings on annual healthcare and related costs of T2D and CVD, respectively. Specific provincial/territorial analyses suggested annual T2D and CVD related cost savings that ranged from up to Can$0.2 million in some provinces to up to Can$135 million in others. In conclusion, with regular consumption of pulse crops, there is a potential opportunity to facilitate T2D and CVD related socioeconomic cost savings that could be applied to Canadian healthcare or re-assigned to other priority domains. Whether these potential cost savings will be offset by other healthcare costs associated with longevity and diseases of the elderly is to be investigated over the long term.

Annual report to Congress, FY 1992

International Nuclear Information System (INIS)

1993-07-01

The Office of Civilian Radioactive Waste Management (OCRWM) is responsible for disposing of the Nation's spent nuclear fuel from civilian nuclear power reactors and high-level radioactive waste from its defense activities in a cost-effective manner that protects the health and safety of the public and workers and the quality of the environment. To accomplish this mission OCRWM is developing a waste management system consisting of a geologic repository, a facility for monitored retrievable storage, and a system for transporting the waste. This is the ninth annual report submitted by the OCRWM to Congress. The OCRWM submits this report to inform Congress of its activities and expenditures during fiscal year 1992 (October 1, 1991 through September 30, 1992)

Cost estimate of Olkiluoto disposal facility for spent nuclear fuel

International Nuclear Information System (INIS)

Kukkola, T.; Saanio, T.

2005-03-01

The cost estimate covers the underground rock characterisation facility ONKALO, the investment and the operating costs of the above and underground facilities, the decommissioning of the encapsulation plant and the closure costs of the repository. The above ground facility is a once-investment; a re-investment takes place after 37 years operation. The repository is extended stepwise thus also the investment take place in stages. Annual operating costs are calculated with different operating efficiencies. The total investment costs of the disposal facility are estimated to be 503 M euro (Million Euros), the total operating costs are 1,923 M euro and the decommissioning and the closure costs are 116 M euro totaling 2,542 M euro. The investment costs of the above ground facility are 142 M euro, the operating costs are 1,678 M euro. The repository investment costs are 360 M euro and the operating costs are 245 M euro. The decommissioning costs are 7 M euro and the closure costs are 109 M euro. The costs are calculated by using the price level of December 2003. The cost estimate is based on a plan, where the spent fuel is encapsulated and the disposal canisters are disposed into the bedrock at a depth of about 420 meters in one storey. In the encapsulation process, the fuel assemblies are closed into composite canisters, in which the inner part of the canister is made of nodular cast iron and the outer wall of copper having a thickness of 50 mm. The inner canister is closed gas-tight by a bolted steel lid, and the electron beam welding method is used to close the outer copper lid. The encapsulation plant is independent and located above the deep repository spaces. The disposal canisters are transported to the repository by the lift. The disposal tunnels are constructed and closed in stages according the disposal canisters disposal. The operating time of the Loviisa nuclear power plant units is assumed to be 50 years and the operating time of the Olkiluoto nuclear power

Review of the cost of venous thromboembolism

Directory of Open Access Journals (Sweden)

Fernandez MM

2015-08-01

Full Text Available Maria M Fernandez,1 Susan Hogue,1 Ronald Preblick,2 Winghan Jacqueline Kwong2 1RTI-Health Solutions, Market Access and Outcomes Strategy, Research Triangle Park, NC, 2Daiichi Sankyo, Inc., Health Economics & Outcomes Research, Parsippany, NJ, USA Background: Venous thromboembolism (VTE is the second most common medical complication and a cause of excess length of hospital stay. Its incidence and economic burden are expected to increase as the population ages. We reviewed the recent literature to provide updated cost estimates on VTE management. Methods: Literature search strategies were performed in PubMed, Embase, Cochrane Collaboration, Health Economic Evaluations Database, EconLit, and International Pharmaceutical Abstracts from 2003–2014. Additional studies were identified through searching bibliographies of related publications. Results: Eighteen studies were identified and are summarized in this review; of these, 13 reported data from the USA, four from Europe, and one from Canada. Three main cost estimations were identified: cost per VTE hospitalization or per VTE readmission; cost for VTE management, usually reported annually or during a specific period; and annual all-cause costs in patients with VTE, which included the treatment of complications and comorbidities. Cost estimates per VTE hospitalization were generally similar across the US studies, with a trend toward an increase over time. Cost per pulmonary embolism hospitalization increased from $5,198–$6,928 in 2000 to $8,764 in 2010. Readmission for recurrent VTE was generally more costly than the initial index event admission. Annual health plan payments for services related to VTE also increased from $10,804–$16,644 during the 1998–2004 period to an estimated average of $15,123 for a VTE event from 2008 to 2011. Lower costs for VTE hospitalizations and annualized all-cause costs were estimated in European countries and Canada. Conclusion: Costs for VTE treatment are

Lowering the UK domestic radon Action Level to prevent more lung cancers-is it cost-effective?

International Nuclear Information System (INIS)

Denman, A R; Groves-Kirkby, C J; Coskeran, T; Phillips, P S; Crockett, R G M; Tornberg, R

2008-01-01

Case studies have shown that radon gas can accumulate within domestic properties at sufficiently high levels that it can cause lung cancer, and recent studies have suggested that this risk remains significant below the UK domestic Action Level of 200 Bq m -3 . Raised radon levels can be reduced by engineering measures, and it has been shown that domestic radon remediation programmes in UK Affected Areas can result in reduced risks to the population and can be cost-effective. We consider here the benefits and costs of the domestic radon remediation programme in Northamptonshire, UK, and consider the implications for that programme of reducing the UK Action Level below its present value. A radon remediation programme based on an Action Level above 200 Bq m -3 will cost less and will target those most at risk, but will be less cost-effective and will lead to higher residual dose and greater risk of cancer in the remaining population. Reducing the Action Level below 200 Bq m -3 will prevent more cancers, but at significantly higher cost. It will also be less cost-effective, because remediation of a significant number of houses with moderate radon levels will provide only a modest health benefit to occupants. Overall, a completed radon remediation programme of the type implemented in Northamptonshire is most cost-effective for an Action Level between 200 and 300 Bq m -3 . The implications for future health policy are discussed

Deep uncertainty and broad heterogeneity in country-level social cost of carbon

Science.gov (United States)

Ricke, K.; Drouet, L.; Caldeira, K.; Tavoni, M.

2017-12-01

The social cost of carbon (SCC) is a commonly employed metric of the expected economic damages expected from carbon dioxide (CO2) emissions. Recent estimates of SCC range from approximately 10/tonne of CO2 to as much as 1000/tCO2, but these have been computed at the global level. While useful in an optimal policy context, a world-level approach obscures the heterogeneous geography of climate damages and vast differences in country-level contributions to global SCC, as well as climate and socio-economic uncertainties, which are much larger at the regional level. For the first time, we estimate country-level contributions to SCC using recent climate and carbon-cycle model projections, empirical climate-driven economic damage estimations, and information from the Shared Socio-economic Pathways. Central specifications show high global SCC values (median: 417 /tCO2, 66% confidence intervals: 168 - 793 /tCO2) with country-level contributions ranging from -11 (-8 - -14) /tCO2 to 86 (50 - 158) /tCO2. We quantify climate-, scenario- and economic damage- driven uncertainties associated with the calculated values of SCC. We find that while the magnitude of country-level social cost of carbon is highly uncertain, the relative positioning among countries is consistent. Countries incurring large fractions of the global cost include India, China, and the United States. The share of SCC distributed among countries is robust, indicating climate change winners and losers from a geopolitical perspective.

Comparing climate and cost impacts of reference levels for reducing emissions from deforestation

Energy Technology Data Exchange (ETDEWEB)

Busch, Jonah [Center for Applied Biodiversity Science, Conservation International, 2011 Crystal Drive, Suite 500, Arlington, VA (United States); Strassburg, Bernardo [Center for Social and Economic Research on the Global Environment, University of East Anglia, Norwich NR4 7TJ (United Kingdom); Cattaneo, Andrea [Woods Hole Research Center, 149 Woods Hole Road, Falmouth, MA 02540-1644 (United States); Lubowski, Ruben [Environmental Defense Fund, 1875 Connecticut Avenue NW, Washington, DC (United States); Bruner, Aaron; Rice, Richard; Boltz, Frederick [Conservation International, 2011 Crystal Drive, Suite 500, Arlington, VA (United States); Creed, Anna; Ashton, Ralph, E-mail: jbusch@conservation.or [Terrestrial Carbon Group, 900 17th Street NW, Suite 700, Washington, DC (United States)

2009-10-15

The climate benefit and economic cost of an international mechanism for reducing emissions from deforestation and degradation (REDD) will depend on the design of reference levels for crediting emission reductions. We compare the impacts of six proposed reference level designs on emission reduction levels and on cost per emission reduction using a stylized partial equilibrium model (the open source impacts of REDD incentives spreadsheet; OSIRIS). The model explicitly incorporates national incentives to participate in an international REDD mechanism as well as international leakage of deforestation emissions. Our results show that a REDD mechanism can provide cost-efficient climate change mitigation benefits under a broad range of reference level designs. We find that the most effective reference level designs balance incentives to reduce historically high deforestation emissions with incentives to maintain historically low deforestation emissions. Estimates of emission reductions under REDD depend critically on the degree to which demand for tropical frontier agriculture generates leakage. This underscores the potential importance to REDD of complementary strategies to supply agricultural needs outside of the forest frontier.

Comparing climate and cost impacts of reference levels for reducing emissions from deforestation

International Nuclear Information System (INIS)

Busch, Jonah; Strassburg, Bernardo; Cattaneo, Andrea; Lubowski, Ruben; Bruner, Aaron; Rice, Richard; Boltz, Frederick; Creed, Anna; Ashton, Ralph

2009-01-01

The climate benefit and economic cost of an international mechanism for reducing emissions from deforestation and degradation (REDD) will depend on the design of reference levels for crediting emission reductions. We compare the impacts of six proposed reference level designs on emission reduction levels and on cost per emission reduction using a stylized partial equilibrium model (the open source impacts of REDD incentives spreadsheet; OSIRIS). The model explicitly incorporates national incentives to participate in an international REDD mechanism as well as international leakage of deforestation emissions. Our results show that a REDD mechanism can provide cost-efficient climate change mitigation benefits under a broad range of reference level designs. We find that the most effective reference level designs balance incentives to reduce historically high deforestation emissions with incentives to maintain historically low deforestation emissions. Estimates of emission reductions under REDD depend critically on the degree to which demand for tropical frontier agriculture generates leakage. This underscores the potential importance to REDD of complementary strategies to supply agricultural needs outside of the forest frontier.

Costs of diarrheal disease and the cost-effectiveness of a rotavirus vaccination program in kyrgyzstan.

Science.gov (United States)

Flem, Elmira T; Latipov, Renat; Nurmatov, Zuridin S; Xue, Yiting; Kasymbekova, Kaliya T; Rheingans, Richard D

2009-11-01

We examined the cost-effectiveness of a rotavirus immunization program in Kyrgyzstan, a country eligible for vaccine funding from the GAVI Alliance. We estimated the burden of rotavirus disease and its economic consequences by using national and international data. A cost-effectiveness analysis was conducted from government and societal perspectives, along with a range of 1-way sensitivity analyses. Rotavirus-related hospitalizations and outpatient visits cost US$580,864 annually, of which $421,658 (73%) is direct medical costs and $159,206 (27%) is nonmedical and indirect costs. With 95% coverage, vaccination could prevent 75% of rotavirus-related hospitalizations and deaths and 56% of outpatient visits and could avert $386,193 (66%) in total costs annually. The medical break-even price at which averted direct medical costs equal vaccination costs is $0.65/dose; the societal break-even price is $1.14/dose for a 2-dose regimen. At the current GAVI Alliance-subsidized vaccine price of $0.60/course, rotavirus vaccination is cost-saving for the government. Vaccination is cost-effective at a vaccine price $9.41/dose, according to the cost-effectiveness standard set by the 2002 World Health Report. Addition of rotavirus vaccines to childhood immunization in Kyrgyzstan could substantially reduce disease burden and associated costs. Vaccination would be cost-effective from the national perspective at a vaccine price $9.41 per dose.

HEALTH INFO SANTE ANNUAL DEDUCTIBLE AND REIMBURSEMENT CLAIMS: HINTS FOR USE

CERN Multimedia

1999-01-01

Information from the CHIS Board and the Personnel DivisionOne should bear in mind that the annual deductible is an amount (currently CHF 100) charged automatically by the Administrator of the scheme for every adult aged 18 and above. This is what happens: The amount is deducted annually for all medical services received over a calendar year.It is triggered by the date of the treatment and not by the date of the bill nor that of the reimbursement claim.In other words, if you receive medical treatment in December for the first time in a given year, the CHF 100 will be deducted from the claim for that treatment. So, except for urgent cases, it would be better to wait till the following month, thus avoiding one annual deductible.It is also worth remembering that the cost of processing our reimbursement claims - and there were 55, 000 in 1998 - is part of the cost of our insurance.Help keep administrative costs down : do not submit reimbursement claims for amounts less than the annual deductible unless your claims...

Dietary fibre intakes and reduction in functional constipation rates among Canadian adults: a cost-of-illness analysis

Directory of Open Access Journals (Sweden)

Mohammad M. H. Abdullah

2015-12-01

Full Text Available Background: Evidence-based research highlights beneficial impacts of dietary fibre on several aspects of the gut pathophysiology that are accompanied by a considerable financial burden in healthcare services. Recommended intakes of dietary fibre may thus associate with financial benefits at a population level. Objective: We sought to systematically assess the potential annual savings in healthcare costs that would follow the reduction in rates of functional constipation and irregularity with increased dietary fibre intakes among Canadian adults. Design: A cost-of-illness analysis was developed on the basis of current and recommended levels of fibre intake in Canada, constipation reduction per 1 g fibre intake, proportion of adults who are likely to consume fibre-rich diets, and population expected to respond to fibre intake. Sensitivity analyses covering a range of assumptions were further implemented within the economic simulation. Results: Our literature searches assumed a 1.8% reduction in constipation rates with each 1 g/day increase in fibre intake. With intakes corresponding to the Institute of Medicine's adequate levels of 38 g/day for men and 25 g/day for women, among 5 and 100% of the adult populations, anywhere between CAD$1.5 and CAD$31.9 million could be saved on constipation-related healthcare costs annually. Each 1 g/day increase in dietary fibre was estimated to result in total annual healthcare cost savings that ranged between CAD$0.1 and CAD$2.5 million. Conclusions: The present research suggests an economic value of increasing dietary fibre intake beyond its well-known health benefits. Healthy-eating behaviours consistent with the recommended intakes of dietary fibre by the general public should hence be advocated as a practical approach for reducing costs associated with the management of constipation in Canada.

Estimating the cost of a smoking employee.

Science.gov (United States)

Berman, Micah; Crane, Rob; Seiber, Eric; Munur, Mehmet

2014-09-01

We attempted to estimate the excess annual costs that a US private employer may attribute to employing an individual who smokes tobacco as compared to a non-smoking employee. Reviewing and synthesising previous literature estimating certain discrete costs associated with smoking employees, we developed a cost estimation approach that approximates the total of such costs for U.S. employers. We examined absenteeism, presenteesim, smoking breaks, healthcare costs and pension benefits for smokers. Our best estimate of the annual excess cost to employ a smoker is $5816. This estimate should be taken as a general indicator of the extent of excess costs, not as a predictive point value. Employees who smoke impose significant excess costs on private employers. The results of this study may help inform employer decisions about tobacco-related policies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Male reproductive disorders, diseases, and costs of exposure to endocrine-disrupting chemicals in the European Union.

Science.gov (United States)

Hauser, Russ; Skakkebaek, Niels E; Hass, Ulla; Toppari, Jorma; Juul, Anders; Andersson, Anna Maria; Kortenkamp, Andreas; Heindel, Jerrold J; Trasande, Leonardo

2015-04-01

Increasing evidence suggests that endocrine-disrupting chemicals (EDCs) contribute to male reproductive diseases and disorders. To estimate the incidence/prevalence of selected male reproductive disorders/diseases and associated economic costs that can be reasonably attributed to specific EDC exposures in the European Union (EU). An expert panel evaluated evidence for probability of causation using the Intergovernmental Panel on Climate Change weight-of-evidence characterization. Exposure-response relationships and reference levels were evaluated, and biomarker data were organized from carefully identified studies from the peer-reviewed literature to represent European exposure and approximate burden of disease as it occurred in 2010. The cost-of-illness estimation utilized multiple peer-reviewed sources. The expert panel identified low epidemiological and strong toxicological evidence for male infertility attributable to phthalate exposure, with a 40-69% probability of causing 618,000 additional assisted reproductive technology procedures, costing €4.71 billion annually. Low epidemiological and strong toxicological evidence was also identified for cryptorchidism due to prenatal polybrominated diphenyl ether exposure, resulting in a 40-69% probability that 4615 cases result, at a cost of €130 million (sensitivity analysis, €117-130 million). A much more modest (0-19%) probability of causation in testicular cancer by polybrominated diphenyl ethers was identified due to very low epidemiological and weak toxicological evidence, with 6830 potential cases annually and costs of €848 million annually (sensitivity analysis, €313-848 million). The panel assigned 40-69% probability of lower T concentrations in 55- to 64-year-old men due to phthalate exposure, with 24 800 associated deaths annually and lost economic productivity of €7.96 billion. EDCs may contribute substantially to male reproductive disorders and diseases, with nearly €15 billion annual

Cost analysis of an integrated disease surveillance and response system: case of Burkina Faso, Eritrea, and Mali.

Science.gov (United States)

Somda, Zana C; Meltzer, Martin I; Perry, Helen N; Messonnier, Nancy E; Abdulmumini, Usman; Mebrahtu, Goitom; Sacko, Massambou; Touré, Kandioura; Ki, Salimata Ouédraogo; Okorosobo, Tuoyo; Alemu, Wondimagegnehu; Sow, Idrissa

2009-01-08

Communicable diseases are the leading causes of illness, deaths, and disability in sub-Saharan Africa. To address these threats, countries within the World Health Organization (WHO) African region adopted a regional strategy called Integrated Disease Surveillance and Response (IDSR). This strategy calls for streamlining resources, tools, and approaches to better detect and respond to the region's priority communicable disease. The purpose of this study was to analyze the incremental costs of establishing and subsequently operating activities for detection and response to the priority diseases under the IDSR. We collected cost data for IDSR activities at central, regional, district, and primary health care center levels from Burkina Faso, Eritrea, and Mali, countries where IDSR is being fully implemented. These cost data included personnel, transportation items, office consumable goods, media campaigns, laboratory and response materials and supplies, and annual depreciation of buildings, equipment, and vehicles. Over the period studied (2002-2005), the average cost to implement the IDSR program in Eritrea was $0.16 per capita, $0.04 in Burkina Faso and $0.02 in Mali. In each country, the mean annual cost of IDSR was dependent on the health structure level, ranging from $35,899 to $69,920 at the region level, $10,790 to $13,941 at the district level, and $1,181 to $1,240 at the primary health care center level. The proportions spent on each IDSR activity varied due to demand for special items (e.g., equipment, supplies, drugs and vaccines), service availability, distance, and the epidemiological profile of the country. This study demonstrates that the IDSR strategy can be considered a low cost public health system although the benefits have yet to be quantified. These data can also be used in future studies of the cost-effectiveness of IDSR.

Cost analysis of an integrated disease surveillance and response system: case of Burkina Faso, Eritrea, and Mali

Directory of Open Access Journals (Sweden)

Touré Kandioura

2009-01-01

Full Text Available Abstract Background Communicable diseases are the leading causes of illness, deaths, and disability in sub-Saharan Africa. To address these threats, countries within the World Health Organization (WHO African region adopted a regional strategy called Integrated Disease Surveillance and Response (IDSR. This strategy calls for streamlining resources, tools, and approaches to better detect and respond to the region's priority communicable disease. The purpose of this study was to analyze the incremental costs of establishing and subsequently operating activities for detection and response to the priority diseases under the IDSR. Methods We collected cost data for IDSR activities at central, regional, district, and primary health care center levels from Burkina Faso, Eritrea, and Mali, countries where IDSR is being fully implemented. These cost data included personnel, transportation items, office consumable goods, media campaigns, laboratory and response materials and supplies, and annual depreciation of buildings, equipment, and vehicles. Results Over the period studied (2002–2005, the average cost to implement the IDSR program in Eritrea was $0.16 per capita, $0.04 in Burkina Faso and $0.02 in Mali. In each country, the mean annual cost of IDSR was dependent on the health structure level, ranging from $35,899 to $69,920 at the region level, $10,790 to $13,941 at the district level, and $1,181 to $1,240 at the primary health care center level. The proportions spent on each IDSR activity varied due to demand for special items (e.g., equipment, supplies, drugs and vaccines, service availability, distance, and the epidemiological profile of the country. Conclusion This study demonstrates that the IDSR strategy can be considered a low cost public health system although the benefits have yet to be quantified. These data can also be used in future studies of the cost-effectiveness of IDSR.

77 FR 1521 - FY 2010 Annual Compliance Report; Comment Request

Science.gov (United States)

2012-01-10

... Web site, http://www.prc.gov . The filing begins a review process that results in an Annual Compliance.... Scope of filing. The material appended to the narrative consists of (1) domestic product costing... international costing material, summarized in the International Cost and Revenue Analysis (ICRA); (3...

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

Science.gov (United States)

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

2012-11-01

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

[The cost of applying the Dependency Law to Alzheimer disease].

Science.gov (United States)

Soto-Gordoa, Myriam; Arrospide, Arantzazu; Zapiain, Ander; Aiarza, Arantza; Abecia, Luis Carlos; Mar, Javier

2014-01-01

To calculate the formal cost of social care for people with Alzheimer disease according to the implementation of the dependency law in Gipuzkoa (Spain). A retrospective observational study was carried out of the database of the Dependency Care Services of Gipuzkoa from 2007 to 2012, using a prevalence-based bottom-up approach. The average annual formal cost per person was €11,730. The annual population cost was €34.7 million, representing 19% of the annual expenditure corresponding to the dependency law and 29% of the total cost of Alzheimer disease. Despite the implementation of the new law, most of the burden of the disease is bourne by the family. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

Cost/Benefit Analysis of Leasing Versus Purchasing Computers

National Research Council Canada - National Science Library

Arceneaux, Alan

1997-01-01

.... In constructing this model, several factors were considered, including: The purchase cost of computer equipment, annual lease payments, depreciation costs, the opportunity cost of purchasing, tax revenue implications and various leasing terms...

Modeling the impact and costs of semiannual mass drug administration for accelerated elimination of lymphatic filariasis.

Directory of Open Access Journals (Sweden)

Wilma A Stolk

Full Text Available The Global Program to Eliminate Lymphatic Filariasis (LF has a target date of 2020. This program is progressing well in many countries. However, progress has been slow in some countries, and others have not yet started their mass drug administration (MDA programs. Acceleration is needed. We studied how increasing MDA frequency from once to twice per year would affect program duration and costs by using computer simulation modeling and cost projections. We used the LYMFASIM simulation model to estimate how many annual or semiannual MDA rounds would be required to eliminate LF for Indian and West African scenarios with varied pre-control endemicity and coverage levels. Results were used to estimate total program costs assuming a target population of 100,000 eligibles, a 3% discount rate, and not counting the costs of donated drugs. A sensitivity analysis was done to investigate the robustness of these results with varied assumptions for key parameters. Model predictions suggested that semiannual MDA will require the same number of MDA rounds to achieve LF elimination as annual MDA in most scenarios. Thus semiannual MDA programs should achieve this goal in half of the time required for annual programs. Due to efficiency gains, total program costs for semiannual MDA programs are projected to be lower than those for annual MDA programs in most scenarios. A sensitivity analysis showed that this conclusion is robust. Semiannual MDA is likely to shorten the time and lower the cost required for LF elimination in countries where it can be implemented. This strategy may improve prospects for global elimination of LF by the target year 2020.

Neuroscience Intermediate-Level Care Units Staffed by Intensivists: Clinical Outcomes and Cost Analysis.

Science.gov (United States)

Kyeremanteng, Kwadwo; Hendin, Ariel; Bhardwaj, Kalpana; Thavorn, Kednapa; Neilipovitz, Dave; Kubelik, Dalibour; D'Egidio, Gianni; Stotts, Grant; Rosenberg, Erin

2017-01-01

With an aging population and increasing numbers of intensive care unit admissions, novel ways of providing quality care at reduced cost are required. Closed neurointensive care units improve outcomes for patients with critical neurological conditions, including decreased mortality and length of stay (LOS). Small studies have demonstrated the safety of intermediate-level units for selected patient populations. However, few studies analyze both cost and safety outcomes of these units. This retrospective study assessed clinical and cost-related outcomes in an intermediate-level neurosciences acute care unit (NACU) before and after the addition of an intensivist to the unit's care team. Starting in October 2011, an intensivist-led model was adopted in a 16-bed NACU unit, including daytime coverage by a dedicated intensivist. Data were obtained from all patients admitted 1 year prior to and 2 years after this intervention. Primary outcomes were LOS and hospital costs. Safety outcomes included mortality and readmissions. Descriptive and analytic statistics were calculated. Individual and total patient costs were calculated based on per-day NACU and ward cost estimates and significance measured using bootstrapping. A total of 2931 patients were included over the study period. Patients were on average 59.5 years and 53% male. The most common reasons for admission were central nervous system (CNS) tumor (27.6%), ischemic stroke (27%), and subarachnoid hemorrhage (11%). Following the introduction of an intensivist, there was a significant reduction in NACU and hospital LOS, by 1 day and 3 days, respectively. There were no differences in readmissions or mortality. Adding an intensivist produced an individual cost savings of US$963 in NACU and US$2687 per patient total hospital stay. An intensivist-led model of intermediate-level neurointensive care staffed by intensivists is safe, decreases LOS, and produces cost savings in a system increasingly strained to provide quality

Site specific optimization of wind turbines energy cost: Iterative approach

International Nuclear Information System (INIS)

Rezaei Mirghaed, Mohammad; Roshandel, Ramin

2013-01-01

Highlights: • Optimization model of wind turbine parameters plus rectangular farm layout is developed. • Results show that levelized cost for single turbine fluctuates between 46.6 and 54.5 $/MW h. • Modeling results for two specific farms reported optimal sizing and farm layout. • Results show that levelized cost of the wind farms fluctuates between 45.8 and 67.2 $/MW h. - Abstract: The present study was aimed at developing a model to optimize the sizing parameters and farm layout of wind turbines according to the wind resource and economic aspects. The proposed model, including aerodynamic, economic and optimization sub-models, is used to achieve minimum levelized cost of electricity. The blade element momentum theory is utilized for aerodynamic modeling of pitch-regulated horizontal axis wind turbines. Also, a comprehensive cost model including capital costs of all turbine components is considered. An iterative approach is used to develop the optimization model. The modeling results are presented for three potential regions in Iran: Khaf, Ahar and Manjil. The optimum configurations and sizing for a single turbine with minimum levelized cost of electricity are presented. The optimal cost of energy for one turbine is calculated about 46.7, 54.5 and 46.6 dollars per MW h in the studied sites, respectively. In addition, optimal size of turbines, annual electricity production, capital cost, and wind farm layout for two different rectangular and square shaped farms in the proposed areas have been recognized. According to the results, optimal system configuration corresponds to minimum levelized cost of electricity about 45.8 to 67.2 dollars per MW h in the studied wind farms

Top Level Space Cost Methodology (TLSCM)

Science.gov (United States)

1997-12-02

Software 7 6. ACEIT . 7 C. Ground Rules and Assumptions 7 D. Typical Life Cycle Cost Distribution 7 E. Methodologies 7 1. Cost/budget Threshold 9 2. Analogy...which is based on real-time Air Force and space programs. Ref.(25:2- 8, 2-9) 6. ACEIT : Automated Cost Estimating Integrated Tools( ACEIT ), Tecolote...Research, Inc. There is a way to use the ACEIT cost program to get a print-out of an expanded WBS. Therefore, find someone that has ACEIT experience and

Least cost 100% renewable electricity scenarios in the Australian National Electricity Market

International Nuclear Information System (INIS)

Elliston, Ben; MacGill, Iain; Diesendorf, Mark

2013-01-01

Least cost options are presented for supplying the Australian National Electricity Market (NEM) with 100% renewable electricity using wind, photovoltaics, concentrating solar thermal (CST) with storage, hydroelectricity and biofuelled gas turbines. We use a genetic algorithm and an existing simulation tool to identify the lowest cost (investment and operating) scenarios of renewable technologies and locations for NEM regional hourly demand and observed weather in 2010 using projected technology costs for 2030. These scenarios maintain the NEM reliability standard, limit hydroelectricity generation to available rainfall, and limit bioenergy consumption. The lowest cost scenarios are dominated by wind power, with smaller contributions from photovoltaics and dispatchable generation: CST, hydro and gas turbines. The annual cost of a simplified transmission network to balance supply and demand across NEM regions is a small proportion of the annual cost of the generating system. Annual costs are compared with a scenario where fossil fuelled power stations in the NEM today are replaced with modern fossil substitutes at projected 2030 costs, and a carbon price is paid on all emissions. At moderate carbon prices, which appear required to address climate change, 100% renewable electricity would be cheaper on an annual basis than the replacement scenario

Capital and Operating Costs of Full-Scale Fecal Sludge Management and Wastewater Treatment Systems in Dakar, Senegal

Science.gov (United States)

2012-01-01

A financial comparison of a parallel sewer based (SB) system with activated sludge, and a fecal sludge management (FSM) system with onsite septic tanks, collection and transport (C&T) trucks, and drying beds was conducted. The annualized capital for the SB ($42.66 capita–1 year–1) was ten times higher than the FSM ($4.05 capita–1 year–1), the annual operating cost for the SB ($11.98 capita–1 year–1) was 1.5 times higher than the FSM ($7.58 capita–1 year–1), and the combined capital and operating for the SB ($54.64 capita–1 year–1) was five times higher than FSM ($11.63 capita–1 year–1). In Dakar, costs for SB are almost entirely borne by the sanitation utility, with only 6% of the annualized cost borne by users of the system. In addition to costing less overall, FSM operates with a different business model, with costs spread among households, private companies, and the utility. Hence, SB was 40 times more expensive to implement for the utility than FSM. However, the majority of FSM costs are borne at the household level and are inequitable. The results of the study illustrate that in low-income countries, vast improvements in sanitation can be affordable when employing FSM, whereas SB systems are prohibitively expensive. PMID:22413875

Capital and operating costs of full-scale fecal sludge management and wastewater treatment systems in Dakar, Senegal.

Science.gov (United States)

Dodane, Pierre-Henri; Mbéguéré, Mbaye; Sow, Ousmane; Strande, Linda

2012-04-03

A financial comparison of a parallel sewer based (SB) system with activated sludge, and a fecal sludge management (FSM) system with onsite septic tanks, collection and transport (C&T) trucks, and drying beds was conducted. The annualized capital for the SB ($42.66 capita(-1) year(-1)) was ten times higher than the FSM ($4.05 capita(-1) year(-1)), the annual operating cost for the SB ($11.98 capita(-1) year(-1)) was 1.5 times higher than the FSM ($7.58 capita(-1) year(-1)), and the combined capital and operating for the SB ($54.64 capita(-1) year(-1)) was five times higher than FSM ($11.63 capita(-1) year(-1)). In Dakar, costs for SB are almost entirely borne by the sanitation utility, with only 6% of the annualized cost borne by users of the system. In addition to costing less overall, FSM operates with a different business model, with costs spread among households, private companies, and the utility. Hence, SB was 40 times more expensive to implement for the utility than FSM. However, the majority of FSM costs are borne at the household level and are inequitable. The results of the study illustrate that in low-income countries, vast improvements in sanitation can be affordable when employing FSM, whereas SB systems are prohibitively expensive.

Cost analysis in interventional radiology-A tool to optimize management costs

International Nuclear Information System (INIS)

Clevert, D.-A.; Stickel, M.; Jung, E.M.; Reiser, M.; Rupp, N.

2007-01-01

Objective: The objective of the study was to analyze the methods to reduce cost in interventional radiology departments by reorganizing procurement. Materials and methods: All products used in Department of Interventional Radiology were inventoried. An ABC-analysis was completed and A-products (high-value and high turnover products) underwent a XYZ-analysis which predicted demand on the basis of ordering frequency. Then criteria for a procurement strategy for the different material categories were fixed. The net working capital (NWC) was calculated using an interest rate of 8%/year. Results: Total annual material turnover was 353,000 Euro . The value of all A-products determined by the inventory was 260,000 Euro . Changes in the A-product procurement strategy tapped a cost reduction potential of 14,500/year Euro . The resulting total saving was 17,200 Euro . Improved stores management added another 37,500 Euro. The total cost cut of 52,000 Euro is equivalent to 14.7% of annual expenses. Conclusion: A flexible procurement strategy helps to reduce the storage and capital tie-up costs of A-products in interventional radiology without affecting the quality of service provided to patients

Report on financing the disposal of commercial spent nuclear fuel and processed high-level radioactive waste

International Nuclear Information System (INIS)

Benny, R.I.; Sprecher, W.M.

1983-06-01

Projected revenues generated from the 1.0 mill per kWh fee mandated by the Act are sufficient to cover the full range of reference case program costs, assuming 3% annual inflation and nuclear installed capacity of 165 gigawatts-electric by the year 2000. Total estimated costs of the reference waste disposal program, encompassing either spent nuclear fuel disposal or reprocessing waste disposal, range between $18 to 20 billion in constant 1982 dollars. Sensitivity case analyses established upper and lower program cost bounds of $28 billion and $16 billion, respectively (in 1982 dollars). In terms of discounted levelized unit costs, the disposal of spent fuel equates to $122 to 125 per kilogram (uranium) compared with $115 to 119 per kilogram for the reprocessing waste equivalent. The levelized unit costs for reprocessing exclude the solidification of liquid wastes. Such costs are estimated to be $8 per kilogram. Discounted levelized unit costs corresponding to the upper and lower limits of the sensitivity cases equate to $176 per kilogram and $107 per kilogram. The 1.0 mill per kWh fee will be reviewed annually and adjusted, if necessary, to accommodate changes in program costs due to inflation and program shifts. When adjustments are made for applicable discount rates, inflation, repository design changes, and other factors, levelized unit costs for the reference case presented in this analysis agree closely with the results of two previous Department of Energy studies concerning charges for spent fuel storage and disposal services provided by the Federal government. The cost estimates developed for the program were based on the best available data

Admissibility of building cost subsidy in the power grid above the low voltage level

International Nuclear Information System (INIS)

Foerster, Sven

2015-01-01

Electricity networks are essential to the provision of electrical power to businesses and individuals. In particular for manufacturing businesses a connection to the grid above the low-voltage level is often useful. Network operators demand a subsidy for the new connection and for the change to a higher network level under the auspices of construction cost. The power network market above the low-voltage level is a natural monopoly. This leaves consumers looking for a connection to the power grid with no possibility to select among different network operators. Construction cost subsidies are not regulated by law above the low voltage level. The lack of legal regulation and the natural monopoly above the low-voltage level affect the balance of power between network operators and system users. The lawfulness of the construction cost subsidies, the prerequisites for their demand and a review of the calculation models (Leistungspreismodell, 2-Ebenen-Modell) as well as a proposal for a reform of this system form the subject of this work.

The Indirect Costs of Financial Distress in Indonesia

Directory of Open Access Journals (Sweden)

Wijantini Wijantini

2007-06-01

Full Text Available This paper presents quantitative estimates of the indirect cost of financial distress and its determinants. In order to measure the cost, this study estimates the annualized changes in industry-adjusted operation profit and sales from a year before the onset of distress to the resolution year. Using those approaches, the median of indirect financial distress cost is estimated between three and 11 percent annually. To the extent that the direct cost of financial distress reduces reported operating income, the estimated costs are overstated. The simple regressions analysis suggest that the indirect cost of financial distress significantly increases with size, leverage, number of creditors, and poor industry performance, but is not related to degree of bank loan reliance. The findings provide a weak support for the financial distress theory which suggests that conflicts of interest render the costs of financial distress.

Lower cost air measurement technology – what is on the ...

Science.gov (United States)

This presentation is to the MARAMA 2014 annual monitoring meeting and is an invited talk to provide an overview on lower cost air measurement technology. This presentation is to the MARAMA 2014 annual monitoring meeting and is an invited talk to provide an overview on lower cost air measurement technology.

18 CFR 11.12 - Determination of section 10(f) costs.

Science.gov (United States)

2010-04-01

... I OF THE FEDERAL POWER ACT Charges for Headwater Benefits § 11.12 Determination of section 10(f... determine on a case-by-case basis what portion of the annual interest, maintenance, and depreciation costs... portion of the annual joint-use power cost that represents the interest, maintenance, and depreciation...

High level waste transport and disposal cost calculations for the United Kingdom

International Nuclear Information System (INIS)

Nattress, P.C.; Ward, R.D.

1992-01-01

Commercial nuclear power has been generated in the United Kingdom since 1962, and throughout that time fuel has been reprocessed giving rise to high level waste. This has been managed by storing fission products and related wastes as highly active liquor, and more recently by a program of vitrification and storage of the glass blocks produced. Government policy is that vitrified high level waste should be stored for at least 50 years, which has the technical advantage of allowing the heat output rate of the waste to fall, making disposal easier and cheaper. Thus, there is no immediate requirement to develop a deep geological repository in the UK, but the nuclear companies do have a requirement to make financial provision out of current revenues for high level waste disposal at a future repository. In 1991 the interested organizations undertook a new calculation of costs for such provisions, which is described here. The preliminary work for the calculation included the assumption of host geology characteristics, a compatible repository concept including overpacking, and a range of possible nuclear programs. These have differing numbers of power plants, and differing mixes of high level waste from reprocessing and spent fuel for direct disposal. An algorithm was then developed so that the cost of high level waste disposal could be calculated for any required case within a stated envelope of parameters. An Example Case was then considered in detail leading to the conclusion that a repository to meet the needs of a constant UK nuclear economy up to the middle of the next century would have a cash cost of UK Pounds 1194M (US$2011M). By simple division the cost to a kWh of electricity is UK Pounds 0.00027 (0.45 US mil). (author)

Societal costs of multiple sclerosis in Ireland.

Science.gov (United States)

Carney, Peter; O'Boyle, Derek; Larkin, Aidan; McGuigan, Christopher; O'Rourke, Killian

2018-05-01

This paper evaluates the impact of multiple sclerosis (MS) in Ireland, and estimates the associated direct, indirect, and intangible costs to society based on a large nationally representative sample. A questionnaire was developed to capture the demographics, disease characteristics, healthcare use, informal care, employment, and wellbeing. Referencing international studies, standardized survey instruments were included (e.g. CSRI, MFIS-5, EQ-5D) or adapted (EDSS) for inclusion in an online survey platform. Recruitment was directed at people with MS via the MS Society mailing list and social media platforms, as well as in traditional media. The economic costing was primarily conducted using a 'bottom-up' methodology, and national estimates were achieved using 'prevalence-based' extrapolation. A total of 594 people completed the survey in full. The sample had geographic, disease, and demographic characteristics indicating good representativeness. At an individual level, average societal cost was estimated at €47,683; the average annual costs for those with mild, moderate, and severe MS were calculated as €34,942, €57,857, and €100,554, respectively. For a total Irish MS population of 9,000, the total societal costs of MS amounted to €429m. Direct costs accounted for just 30% of the total societal costs, indirect costs amounted to 50% of the total, and intangible or QoL costs represented 20%. The societal cost associated with a relapse in the sample is estimated as €2,438. The findings highlight that up to 70% of the total costs associated with MS are not routinely counted. These "hidden" costs are higher in Ireland than the rest of Europe, due in part to significantly lower levels of workforce participation, a higher likelihood of permanent workforce withdrawal, and higher levels of informal care needs. The relationship between disease progression and costs emphasize the societal importance of managing and slowing the progression of the illness.

Working long hours: less productive but less costly? Firm-level evidence from Belgium

OpenAIRE

DELMEZ, Françoise; Vandenberghe, Vincent

2017-01-01

From the point of view of a profit-maximizing firm, the optimal number of working hours depends not only on the marginal productivity of hours but also on the marginal labour cost. This paper develops and assesses empirically a simple model of firms' decision making where productivity varies with hours and where the firm faces labour costs per worker that are invariant to the number of hours worked: i.e. quasi-fixed labour costs. Using Belgian firm-level data on production, labour costs, work...

Estimation of the conditioning and storage costs of low- and intermediate-level solid radioactive wastes

International Nuclear Information System (INIS)

Lo Moro, A.; Panciatici, G.

1977-01-01

The conditioning and storage costs of low- and intermediate-level solid radioactive wastes are analyzed. The cost of direct labour is assumed as the reference cost for their computation and the storage cost is considered as resulting from the contract cost ''una tantum'' and from the leasing cost. As an example, the cost trends are reported, relevant to the solution adopted at CAMEN (conditioning in concrete containers and storage on concrete open-air bed)

Ocean Thermal Energy Conversion Life Cycle Cost Assessment, Final Technical Report, 30 May 2012

Energy Technology Data Exchange (ETDEWEB)

Martel, Laura [Lockheed Martin, Manassas, VA (United States); Smith, Paul [John Halkyard and Associates: Glosten Associates, Houston, TX (United States); Rizea, Steven [Makai Ocean Engineering, Waimanalo, HI (United States); Van Ryzin, Joe [Makai Ocean Engineering, Waimanalo, HI (United States); Morgan, Charles [Planning Solutions, Inc., Vancouver, WA (United States); Noland, Gary [G. Noland and Associates, Inc., Pleasanton, CA (United States); Pavlosky, Rick [Lockheed Martin, Manassas, VA (United States); Thomas, Michael [Lockheed Martin, Manassas, VA (United States); Halkyard, John [John Halkyard and Associates: Glosten Associates, Houston, TX (United States)

2012-05-30

The Ocean Thermal Energy Conversion (OTEC) Life Cycle Cost Assessment (OLCCA) is a study performed by members of the Lockheed Martin (LM) OTEC Team under funding from the Department of Energy (DOE), Award No. DE-EE0002663, dated 01/01/2010. OLCCA objectives are to estimate procurement, operations and maintenance, and overhaul costs for two types of OTEC plants: -Plants moored to the sea floor where the electricity produced by the OTEC plant is directly connected to the grid ashore via a marine power cable (Grid Connected OTEC plants) -Open-ocean grazing OTEC plant-ships producing an energy carrier that is transported to designated ports (Energy Carrier OTEC plants) Costs are developed using the concept of levelized cost of energy established by DOE for use in comparing electricity costs from various generating systems. One area of system costs that had not been developed in detail prior to this analysis was the operations and sustainment (O&S) cost for both types of OTEC plants. Procurement costs, generally referred to as capital expense and O&S costs (operations and maintenance (O&M) costs plus overhaul and replacement costs), are assessed over the 30 year operational life of the plants and an annual annuity calculated to achieve a levelized cost (constant across entire plant life). Dividing this levelized cost by the average annual energy production results in a levelized cost of electricity, or LCOE, for the OTEC plants. Technical and production efficiency enhancements that could result in a lower value of the OTEC LCOE were also explored. The thermal OTEC resource for Oahu, Hawaii and projected build out plan were developed. The estimate of the OTEC resource and LCOE values for the planned OTEC systems enable this information to be displayed as energy supplied versus levelized cost of the supplied energy; this curve is referred to as an Energy Supply Curve. The Oahu Energy Supply Curve represents initial OTEC deployment starting in 2018 and demonstrates the

Petroleum marketing annual, 1991

International Nuclear Information System (INIS)

1992-08-01

The Petroleum Marketing Annual contains statistical data on a variety of crude oils and refined petroleum products. The publication provides statistics on crude oil costs and refined petroleum products sales for use by industry, government, private sector analysts, educational institutions, and consumers. Data on crude oil include the domestic first purchase price, the free-on-board and landed cost of imported crude oil, and the refiners' acquisition cost of crude oil. Sales data for motor gasoline, distillates, residuals, aviation fuels, kerosene, and propane are presented. For this publication, all estimates have been recalculated since their earlier publication in the Petroleum Marketing Monthly (PMM). These calculations made use of additional data and corrections that were received after the PMM publication dates

Petroleum marketing annual 1993

International Nuclear Information System (INIS)

1995-01-01

The Petroleum Marketing Annual (PMA) contains statistical data on a variety of crude oils and refined petroleum products. The publication provides statistics on crude oil costs and refined petroleum products sales for use by industry, government, private sector analysts, educational institutions, and consumers. Data on crude oil include the domestic first purchase price, the free-on-board (f.o.b.) and landed cost of imported crude oil, and the refiners acquisition cost of crude oil. Sales data for motor gasoline, distillates, residuals, aviation fuels, kerosene, and propane are presented. For this publication, all estimates have been recalculated since their earlier publication in the Petroleum Marketing Monthly (PMM). These calculations made use of additional data and corrections that were received after the PMM publication dates

Petroleum marketing annual 1993

Energy Technology Data Exchange (ETDEWEB)

1995-01-01

The Petroleum Marketing Annual (PMA) contains statistical data on a variety of crude oils and refined petroleum products. The publication provides statistics on crude oil costs and refined petroleum products sales for use by industry, government, private sector analysts, educational institutions, and consumers. Data on crude oil include the domestic first purchase price, the free-on-board (f.o.b.) and landed cost of imported crude oil, and the refiners acquisition cost of crude oil. Sales data for motor gasoline, distillates, residuals, aviation fuels, kerosene, and propane are presented. For this publication, all estimates have been recalculated since their earlier publication in the Petroleum Marketing Monthly (PMM). These calculations made use of additional data and corrections that were received after the PMM publication dates.

Trends in transmission, distribution, and administration costs for U.S. investor-owned electric utilities

International Nuclear Information System (INIS)

Fares, Robert L.; King, Carey W.

2017-01-01

This paper analyzes the cost of transmission, distribution, and administration for U.S. investor-owned electric utilities. We analyze data reported to the Federal Energy Regulatory Commission (FERC) from 1994 to 2014 using linear regression to understand how the number of customers in a utility's territory, annual peak demand, and annual energy sales affect annual TD&A spending. Then, we use Edison Electric Institute data for 1960 to 1992 to show trends in TD&A spending between 1960 and 2014. We find that the number of customers in a utility's territory is the single best predictor for annual TD&A costs. Between 1994 and 2014, the average cost per customer was $119/Customer-Year for transmission, $291/Customer-Year for distribution, and $333/Customer-Year for utility administration. Total TD&A costs per customer have been approximately $700–$800/Customer-Year since 1960, but the cost per kWh of energy sold was significantly higher in the 1960s because the average customer used less than half as much energy annually versus 2014. Thus, TD&A costs per kWh are likely to increase if kWh energy sales decline in the future unless cost recovery is transitioned to a mechanism not based solely on kWh sales. - Highlights: • U.S. investor-owned electric utility delivery costs from 1960? 2014 are investigated. • Transmission, distribution, and utility administrative costs are analyzed separately. • The number of utility customers is the best predictor for annual delivery costs. • Delivery costs per kWh are likely to increase if kWh sales decrease in the future.

Improving patient-level costing in the English and the German 'DRG' system.

Science.gov (United States)

Vogl, Matthias

2013-03-01

The purpose of this paper is to develop ways to improve patient-level cost apportioning (PLCA) in the English and German inpatient 'DRG' cost accounting systems, to support regulators in improving costing schemes, and to give clinicians and hospital management sophisticated tools to measure and link their management. The paper analyzes and evaluates the PLCA step in the cost accounting schemes of both countries according to the impact on the key aspects of DRG introduction: transparency and efficiency. The goal is to generate a best available PLCA standard with enhanced accuracy and managerial relevance, the main requirements of cost accounting. A best available PLCA standard in 'DRG' cost accounting uses: (1) the cost-matrix from the German system; (2) a third axis in this matrix, representing service-lines or clinical pathways; (3) a scoring system for key cost drivers with the long-term objective of time-driven activity-based costing and (4) a point of delivery separation. Both systems have elements that the other system can learn from. By combining their strengths, regulators are supported in enhancing PLCA systems, improving the accuracy of national reimbursement and the managerial relevance of inpatient cost accounting systems, in order to reduce costs in health care. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Costs along the service cascades for HIV testing and counselling and prevention of mother-to-child transmission

Science.gov (United States)

Bautista-Arredondo, Sergio; Sosa-Rubí, Sandra G.; Opuni, Marjorie; Contreras-Loya, David; Kwan, Ada; Chaumont, Claire; Chompolola, Abson; Condo, Jeanine; Galárraga, Omar; Martinson, Neil; Masiye, Felix; Nsanzimana, Sabin; Ochoa-Moreno, Ivan; Wamai, Richard; Wang’ombe, Joseph

2016-01-01

Objective: We estimate facility-level average annual costs per client along the HIV testing and counselling (HTC) and prevention of mother-to-child transmission (PMTCT) service cascades. Design: Data collected covered the period 2011–2012 in 230 HTC and 212 PMTCT facilities in Kenya, Rwanda, South Africa, and Zambia. Methods: Input quantities and unit prices were collected, as were output data. Annual economic costs were estimated from the service providers’ perspective using micro-costing. Average annual costs per client in 2013 United States dollars (US$) were estimated along the service cascades. Results: For HTC, average cost per client tested ranged from US$5 (SD US$7) in Rwanda to US$31 (SD US$24) in South Africa, whereas average cost per client diagnosed as HIV-positive ranged from US$122 (SD US$119) in Zambia to US$1367 (SD US$2093) in Rwanda. For PMTCT, average cost per client tested ranged from US$18 (SD US$20) in Rwanda to US$89 (SD US$56) in South Africa; average cost per client diagnosed as HIV-positive ranged from US$567 (SD US$417) in Zambia to US$2021 (SD US$3210) in Rwanda; average cost per client on antiretroviral prophylaxis ranged from US$704 (SD US$610) in South Africa to US$2314 (SD US$3204) in Rwanda; and average cost per infant on nevirapine ranged from US$888 (SD US$884) in South Africa to US$2359 (SD US$3257) in Rwanda. Conclusion: We found important differences in unit costs along the HTC and PMTCT service cascades within and between countries suggesting that more efficient delivery of these services is possible. PMID:27753679

User Delay Cost Model and Facilities Maintenance Cost Model for a Terminal Control Area : Volume 3. User's Manual and Program Documentation for the Facilities Maintenance Cost Model

Science.gov (United States)

1978-05-01

The Facilities Maintenance Cost Model (FMCM) is an analytic model designed to calculate expected annual labor costs of maintenance within a given FAA maintenance sector. The model is programmed in FORTRAN IV and has been demonstrated on the CDC Krono...

Economics of trees versus annual crops on marginal agricultural lands

Energy Technology Data Exchange (ETDEWEB)

Gupta, T.; Mohan, D.

1982-01-01

The results of a study conducted by the CMA in Rajasthan, selected as one of the major problem states because of its hot, arid and drought-prone character, and its present declining agricultural, livestock and fuelwood production coupled with an expansion of the area under annual crops. The present situation in Rajasthan is described and estimates made of returns from current land based enterprises (annual crops and livestock rearing) in comparison with the expected costs and returns of establishing suitable tree crops in the area. The financial and social feasibility of changing land use from annual to tree crops (while maintaining livestock production) is discussed, together with a consideration of some management and policy issues. Six tree species (Acacia tortilis, Albizzia (Albizia) lebbek, Prosopis cineraria, P. juliflora, Zizyphus species and Leucaena leucocephala) were identified as adaptable for the region and the economics of raising each over 1 felling cycle calculated. Depending on the species and cycle length, net annual returns were Rs 360-3270/ha (using a discount factor of 11%), with an expected return of Rs1680/ha if the species were allocated equally; this is considerably better than the expected returns from annual crops and standing farm trees (Rs-40 to Rs30/ha, with or without including the costs of family labor). Fifteen tables in the text and 9 in appendices give detailed breakdowns of costs and returns. 104 references.

FY 1999 annual work plan for infrastructure program WBS 6

Energy Technology Data Exchange (ETDEWEB)

Donley, C.D.

1998-08-27

The Fiscal Year (FY) 1999 DynCorp Annual Work Plan (AWP) relates DOE-RL work breakdown structure (WBS) to Cost Accounts and to Organizational Structure. Each Cost Account includes a workscope narrative and justification performance and service standards, goals, and deliverables. Basis of estimates are included within each Cost Account to demonstrate the relationship of budget to defined workscope. The FY 1999 AWP reflects the planning assumptions and initiatives that are included in the PHMC Strategic Plan for Infrastructure Optimization which was established in FY 1998. Development of the FY 1999 AWP was in accordance with a sequential series of events and efforts described in the Infrastructure Annual Work Planning and Budget Cycle which was developed and established in conjunction with the Strategic Plan. The Strategic Plan covers a rolling five year span of time and is updated at the start of each fiscal year as the beginning of the annual work planning and budget cycle for the following fiscal year. Accordingly the planning for the FY 1999 AWP began in January 1998. Also included in the annual work planning and budget cycle, and the basis for the budget in this AWP, is the development of a requirements-based budget.

A Meta Analysis on Farm-Level Costs and Benefits of GM Crops

Directory of Open Access Journals (Sweden)

Nataliya Stupak

2011-05-01

Full Text Available This paper reviews the evidence on the socio-economic impacts of GM crops and analyzes whether there are patterns across space and time. To this end, we investigate the effect of GM crops on farm-level costs and benefits using global data from more than one decade of field trials and surveys. More specifically, we analyze the effects of GM-crops on crop yields, seed costs, pesticide costs, and management and labor costs and finally gross margins. Based on collected data from studies on Bt cotton and Bt maize, statistical analyses are conducted to estimate the effect of GM crop adoption on these parameters. Our results show that, compared to conventional crops, GM crops can lead to yield increases and can lead to reductions in the costs of pesticide application, whereas seed costs are usually substantially higher. Thus, the results presented here do support the contention that the adoption of GM crops leads on average to a higher economic performance, which is also underlined by the high adoption rates for GM crops in a number of countries. However, the kind and magnitude of benefits from GM crops are very heterogeneous between countries and regions, particularly due to differences in pest pressure and pest management practices. Countries with poor pest management practices benefited most from a reduction in yield losses, whereas other countries benefited from cost reductions. However, our study also reveals limitations for meta-analyses on farm-level costs and benefits of GM crops. In particular, published data are skewed towards some countries and the employed individual studies rely on different assumptions, purposes and methodologies (e.g., surveys and field trials. Furthermore, a summary of several (often short-term individual studies may not necessarily capture long-term effects of GM crop adoption.

Cost and price estimate of Brayton and Stirling engines in selected production volumes

Science.gov (United States)

Fortgang, H. R.; Mayers, H. F.

1980-01-01

The methods used to determine the production costs and required selling price of Brayton and Stirling engines modified for use in solar power conversion units are presented. Each engine part, component and assembly was examined and evaluated to determine the costs of its material and the method of manufacture based on specific annual production volumes. Cost estimates are presented for both the Stirling and Brayton engines in annual production volumes of 1,000, 25,000, 100,000 and 400,000. At annual production volumes above 50,000 units, the costs of both engines are similar, although the Stirling engine costs are somewhat lower. It is concluded that modifications to both the Brayton and Stirling engine designs could reduce the estimated costs.

Why invest in a national public health program for stroke? An example using Australian data to estimate the potential benefits and cost implications.

Science.gov (United States)

Cadilhac, Dominique A; Carter, Robert C; Thrift, Amanda G; Dewey, Helen M

2007-10-01

Stroke is the world's second leading cause of death in people aged over 60 years. Approximately 50,000 strokes occur annually in Australia with numbers predicted to increase by about one third over 10-years. Our objectives were to assess the economic implications of a public health program for stroke by: (1) predicting what potential health-gains and cost-offsets could be achieved; and (2) determining the net level of annual investment that would offer value-for-money. Lifetime costs and outcomes were calculated for additional cases that would benefit if 'current practice' was feasibly improved, estimated for one indicative year using: (i) local epidemiological data, coverage rates and costs; and (ii) pooled effect sizes from systematic reviews. blood pressure lowering; warfarin for atrial fibrillation; increased access to stroke units; intravenous thrombolysis and aspirin for ischemic events; and carotid endarterectomy. Value-for-money threshold: AUD$30,000/DALY recovered. Improved, prevention and management could prevent about 27,000 (38%) strokes in 2015. In present terms (2004), about 85,000 DALYs and AUD$1.06 billion in lifetime cost-offsets could be recovered. The net level of annual warranted investment was AUD$3.63 billion. Primary prevention, in particular blood pressure lowering, was most effective. A public health program for stroke is warranted.

The cost to successfully apply for level 3 medical home recognition

Science.gov (United States)

Mottus, Kathleen; Reiter, Kristin; Mitchell, C. Madeline; Donahue, Katrina E.; Gabbard, Wilson M.; Gush, Kimberly

2016-01-01

BACKGROUND The NCQA Patient Centered Medical Home (PCMH) recognition program provides practices an opportunity to implement Medical home activities. Understanding the costs to apply for recognition may enable practices to plan their work. METHODS Practice coaches identified 5 exemplar practices that received level 3 recognition (3 pediatric and 2 family medicine practices). This analysis focuses on 4 that received 2011 recognition. Clinical, informatics and administrative staff participated in 2–3 hour interviews. We collected the time required to develop, implement and maintain required activities. We categorized costs as: 1) non-personnel, 2) developmental 3) those to implement activities 4) those to maintain activities, 5) those to document the work and 6) consultant costs. Only incremental costs were included and are presented as costs per full-time equivalent provider (pFTE) RESULTS Practice size ranged from 2.5 – 10.5 pFTE’s, payer mixes from 7–43 % Medicaid. There was variation in the distribution of costs by activity by practice; but the costs to apply were remarkably similar ($11,453–$15,977 pFTE). CONCLUSION The costs to apply for 2011 recognition were noteworthy. Work to enhance care coordination and close loops were highly valued. Financial incentives were key motivators. Future efforts to minimize the burden of low value activities could benefit practices. PMID:26769879

Socio-economic costs of osteoarthritis: a systematic review of cost-of-illness studies.

Science.gov (United States)

Puig-Junoy, Jaume; Ruiz Zamora, Alba

2015-04-01

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.

Health plan utilization and costs of specialty drugs within 4 chronic conditions.

Science.gov (United States)

Gleason, Patrick P; Alexander, G Caleb; Starner, Catherine I; Ritter, Stephen T; Van Houten, Holly K; Gunderson, Brent W; Shah, Nilay D

2013-09-01

Drugs are most typically defined as specialty because they are expensive; however, other criteria used to define a drug as specialty include biologic drugs, the need to inject or infuse the drug, the requirement for special handling, or drug availability only via a limited distribution network. Specialty drugs play an increasingly important role in the treatment of chronic conditions such as multiple sclerosis (MS), rheumatoid arthritis (RA), psoriasis, and inflammatory bowel disease (IBD), yet little is known regarding the comprehensive medical and pharmacy benefit utilization and cost trends for these conditions. To describe MS, RA, psoriasis, and IBD trends for condition prevalence, treatment with specialty drugs, specialty costs, nonspecialty costs, and total direct costs of care within the medical and pharmacy benefits. This was a descriptive analysis of a commercially insured population made up of 1 million members, using integrated medical and pharmacy administrative claims data from 2008 to 2010. Analyses were limited to continuously enrolled commercially insured individuals less than 65 years of age. Condition-specific cohorts for MS, RA, psoriasis, and IBD were defined using standardized criteria. Trends in condition prevalence, specialty drug use for the conditions, and direct total cost of care were analyzed. The direct costs were subcategorized into the following: medical benefit specialty drug costs, medical benefit all other costs, pharmacy benefit specialty drug costs, and pharmacy benefit all other costs. Trends and compound annual growth rates were calculated for the total cost of care and subcategory costs from 2008 through 2010. Condition prevalence ranged from a low of 1,720 per million members for MS to a high of 4,489 per million members for RA. Psoriasis and MS condition prevalence rates were unchanged over the 3 years; however, IBD prevalence increased 7.0%, and RA prevalence increased 9.7%. The rate of specialty drug use was lowest for IBD

BEST-4, Fuel Cycle and Cost Optimization for Discrete Power Levels

International Nuclear Information System (INIS)

1973-01-01

1 - Nature of physical problem solved: Determination of optimal power strategy for a fuel cycle, for discrete power levels and n temporal stages, taking into account replacement energy costs and de-rating. 2 - Method of solution: Dynamic programming. 3 - Restrictions on the complexity of the problem: Restrictions may arise from number of power levels and temporal stages, due to machine limitations

Experimental determination of optimum annual cleaning frequency and costs for transparent glass covers used in solar devices in Sokoto, Nigeria

International Nuclear Information System (INIS)

Maduekwe, A. A. L.; Garba, B.; Atiku, A. T.

1997-01-01

Transparent covers used in solar collectors collect both solar radiation and dirt from the environment. The dirt collected reduces the amount of useful incident solar radiation that would have been transmitted into system. Samples of ordinary glass used as transparent covers in solar devices at Sokoto Energy Research Centre were exposed to the weather for a period of one year. Cleaning was done on daily, weekly, bi-monthly and monthly basis. A sample was left uncleaned throughout the period. Using the measured average daily transmittance for all seasons as a constant for such glass covers in Sokoto showed that varying the cost/wash/collector for a collector of one-square metre receiver area from =N=0.50 to =N=50.00, would vary the frequency of washing the collector covers from 160 down to 25 times annually respectively. Cost of washing per annum would also vary from 79.90 Naira to 834.46 Naira

A methodology for calculating the levelized cost of electricity in nuclear power systems with fuel recycling

International Nuclear Information System (INIS)

De Roo, Guillaume; Parsons, John E.

2011-01-01

In this paper we show how the traditional definition of the levelized cost of electricity (LCOE) can be extended to alternative nuclear fuel cycles in which elements of the fuel are recycled. In particular, we define the LCOE for a cycle with full actinide recycling in fast reactors in which elements of the fuel are reused an indefinite number of times. To our knowledge, ours is the first LCOE formula for this cycle. Others have approached the task of evaluating this cycle using an 'equilibrium cost' concept that is different from a levelized cost. We also show how the LCOE implies a unique price for the recycled elements. This price reflects the ultimate cost of waste disposal postponed through the recycling, as well as other costs in the cycle. We demonstrate the methodology by estimating the LCOE for three classic nuclear fuel cycles: (i) the traditional Once-Through Cycle, (ii) a Twice-Through Cycle, and (iii) a Fast Reactor Recycle. Given our chosen input parameters, we show that the 'equilibrium cost' is typically larger than the levelized cost, and we explain why.

The economic cost of brain disorders in Europe

DEFF Research Database (Denmark)

Olesen, J; Gustavsson, A; Svensson, M

2012-01-01

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....

The importance of maintainability in maintenance cost management

International Nuclear Information System (INIS)

Allen, R.R.

1996-01-01

This paper provides specific examples and results from ongoing projects at Power Plants, and for offshore oil platforms. The paper describes the vital role maintainability has on plant availability. How the application of equipment maintainability principles, if addressed using state of the art computer tools and advanced business processes can bring annual return on investment results as high as 15 to 1. The maintenance process of today and for the future must provide for high plant availability at the lowest possible cost. The high cost of obtaining equipment reliability levels necessary to meet required availability demands has not proved to be sustainable. Therefore new business decision processes that address equipment failures as part of the maintenance process have been developed. Repair costs require that equipment failures be selective and controlled so that a high level of safety and plant availability is assurance. This can only be accomplished by the use of advanced computer tools in the hands of well trained maintenance-engineering specialist. The relationship between Reliability Centered Maintenance (RCM), Condition Directed Planned Maintenance (CDPM), and maintainability is also presented

Welfare effects of the internalization of external cost

International Nuclear Information System (INIS)

Lijesen, M.; Korteweg, J.A.; Derriks, H.

2009-03-01

The effect of passing through the cost of external effects such as accidents, environment and noise to traffic and transport have been mapped. In nine out of the ten examined variants this 'internalization' will lead to an increase in welfare in the Netherlands. Internalization leads to a decrease of external costs of over 100 million to more than 1.7 billion euros annually. Internalization also brings about collection costs, international transfers and logistic adjustments. The balance of these effects varies from a welfare loss of 20 million euros to a welfare increase of 1.2 billion euros annually. [nl

Additional costs to Finnish dairy farms due to occupational safety and health

Directory of Open Access Journals (Sweden)

Tapio Klen

1988-03-01

Full Text Available The additional costs incurred by work safety measures to dairy farms were estimated by interviewing 95 dairy farmers and inspecting with them production buildings, machines and the need for personal protective devices at a commune. The present value of the implemented safety and health improvements rose to FIM 22 000 per farm in 1983. About FIM 17000 were due to the tractors, FIM 3 000 to the cow houses and FIM 2 000 to other machines and tools than tractors. The protective equipment of tractors caused the annual maintenance cost of FIM 4 350 and cow house FIM 650, if the interest rate were 10 %. The annual total cost was over FIM 6 000. The replacement value would have been about FIM 31 000 in 1983. If all deficiences still remaining in 1983 had been corrected at once, the total cost would have been about FIM 12000 per farm, which leads to an annual cost of FIM 3 100. As for still remaining deficiencies, the study suggested need for an annual cost of about FIM 1 500 due to personal protectors. Half of this sum was due to need for the acquisition of personal safety equipment for forest work. Correcting the safety and health deficiencies of the cowshed and agricultural machines would produce each an annual cost of about FIM 800 per farm. The present value of the labor protection investments in 1983 was FIM 22 000 per farm, and there still remained need to invest an additional FIM 12000 in order to eliminate the remaining deficiencies. So, the theoretical total of the annual maintenance cost would have been FIM 6 600—9 200 per farm depending on the interest rate. Because the study concerned only one commune, the results cannot be generalized to the whole country.

Measuring costs of data collection at village clinics by village doctors for a syndromic surveillance system-a cross sectional survey from China.

Science.gov (United States)

Ding, Yan; Fei, Yang; Xu, Biao; Yang, Jun; Yan, Weirong; Diwan, Vinod K; Sauerborn, Rainer; Dong, Hengjin

2015-07-25

Studies into the costs of syndromic surveillance systems are rare, especially for estimating the direct costs involved in implementing and maintaining these systems. An Integrated Surveillance System in rural China (ISSC project), with the aim of providing an early warning system for outbreaks, was implemented; village clinics were the main surveillance units. Village doctors expressed their willingness to join in the surveillance if a proper subsidy was provided. This study aims to measure the costs of data collection by village clinics to provide a reference regarding the subsidy level required for village clinics to participate in data collection. We conducted a cross-sectional survey with a village clinic questionnaire and a staff questionnaire using a purposive sampling strategy. We tracked reported events using the ISSC internal database. Cost data included staff time, and the annual depreciation and opportunity costs of computers. We measured the village doctors' time costs for data collection by multiplying the number of full time employment equivalents devoted to the surveillance by the village doctors' annual salaries and benefits, which equaled their net incomes. We estimated the depreciation and opportunity costs of computers by calculating the equivalent annual computer cost and then allocating this to the surveillance based on the percentage usage. The estimated total annual cost of collecting data was 1,423 Chinese Renminbi (RMB) in 2012 (P25 = 857, P75 = 3284), including 1,250 RMB (P25 = 656, P75 = 3000) staff time costs and 134 RMB (P25 = 101, P75 = 335) depreciation and opportunity costs of computers. The total costs of collecting data from the village clinics for the syndromic surveillance system was calculated to be low compared with the individual net income in County A.

A system-level cost-of-energy wind farm layout optimization with landowner modeling

International Nuclear Information System (INIS)

Chen, Le; MacDonald, Erin

2014-01-01

Highlights: • We model the role of landowners in determining the success of wind projects. • A cost-of-energy (COE) model with realistic landowner remittances is developed. • These models are included in a system-level wind farm layout optimization. • Basic verification indicates the optimal COE is in-line with real-world data. • Land plots crucial to a project’s success can be identified with the approach. - Abstract: This work applies an enhanced levelized wind farm cost model, including landowner remittance fees, to determine optimal turbine placements under three landowner participation scenarios and two land-plot shapes. Instead of assuming a continuous piece of land is available for the wind farm construction, as in most layout optimizations, the problem formulation represents landowner participation scenarios as a binary string variable, along with the number of turbines. The cost parameters and model are a combination of models from the National Renewable Energy Laboratory (NREL), Lawrence Berkeley National Laboratory, and Windustry. The system-level cost-of-energy (COE) optimization model is also tested under two land-plot shapes: equally-sized square land plots and unequal rectangle land plots. The optimal COEs results are compared to actual COE data and found to be realistic. The results show that landowner remittances account for approximately 10% of farm operating costs across all cases. Irregular land-plot shapes are easily handled by the model. We find that larger land plots do not necessarily receive higher remittance fees. The model can help site developers identify the most crucial land plots for project success and the optimal positions of turbines, with realistic estimates of costs and profitability

Investigation levels of radioisotopes in the body and in urine consequences of the recent recommendations on the annual limits of intake

International Nuclear Information System (INIS)

Shamai, Y.; Tirkel, M.; Schlesinger, T.

1980-01-01

The recently presented recommendations of Committee 2 of the International Commission on Radiological Protection (ICRP) concerning annual limits of intake (ALI) for workers differ in many cases from the maximum permissible annual intake (MPAI) previously recommended. The new recommendations directly influence the derived health physics parameters, such as the acceptable body burden and concentration of radioisotopes in the urine. The investigation level at any time after intake was defined as the concentration of activity in the urine arising from an intake of 1/20 of an ALI. An analogous definition is used for the total body investigation level. A computer code was written which calculates the investigation levels in the body and urine. Results are given for some commonly used radioisotopes, as a function of time after ingestion. From these investigation levels it is possible to calculate the levels in urine and the body arising from an intake that corresponds to a particular committed dose. (H.K.)

Aircraft bi-level life cycle cost estimation

NARCIS (Netherlands)

Zhao, X.; Verhagen, W.J.C.; Curan, R.

2015-01-01

n an integrated aircraft design and analysis practice, Life Cycle Cost (LCC) is essential for decision making. The LCC of an aircraft is ordinarily partially estimated by emphasizing a specific cost type. However, an overview of the LCC including design and development cost, production cost,

Benefits and costs of increased levels of corticosterone in seabird chicks

Science.gov (United States)

Kitaysky, A.S.; Kitaiskaia, E.V.; Piatt, John F.; Wingfield, J.C.

2003-01-01

Seabird chicks respond to food shortages by increasing corticosterone (cort) secretion, which is probably associated with fitness benefits and costs. To examine this, we experimentally increased levels of circulating cort in captive black-legged kittiwake chicks fed ad libitum. We found that cort-implanted chicks begged more frequently and were more aggressive compared to controls. These behavioral modifications must be beneficial to chicks as they facilitate acquisition of food from the parents and might trigger brood reduction and reduced competition for food. Cort-implanted chicks also increased food intake; however, their growth rates were similar to controls. To examine the costs of chronically increased circulating levels of cort, we removed cort implants and, after a 10-day recovery period, tested cognitive abilities of young kittiwakes. We found that the ability of kittiwakes to associate a visual cue with the presence of food in a choice situation was compromised by the experimental elevation of cort during development. To examine the long-term costs of increased levels of cort, 8 months later we tested the performance of the same individuals in a spatial task requiring them to make a detour around a barrier in order to escape from an enclosure. Individuals treated with cort during development took significantly more time to solve this task compared to controls. The results of this study suggest that the adrenocortical response of a developing bird to environmental stressors is associated with both benefits (increased food intake, foraging behavior, and aggression) and costs (low growth efficiency and compromised cognitive abilities later in life). This provides an evolutionary framework for relating juvenile physiological traits to fitness of birds in subsequent life-history stages. ?? 2003 Elsevier Science (USA). All rights reserved.

US nuclear power plant operating cost and experience summaries

International Nuclear Information System (INIS)

Kohn, W.E.; Reid, R.L.; White, V.S.

1998-02-01

NUREG/CR-6577, U.S. Nuclear Power Plant Operating Cost and Experience Summaries, has been prepared to provide historical operating cost and experience information on U.S. commercial nuclear power plants. Cost incurred after initial construction are characterized as annual production costs, representing fuel and plant operating and maintenance expenses, and capital expenditures related to facility additions/modifications which are included in the plant capital asset base. As discussed in the report, annual data for these two cost categories were obtained from publicly available reports and must be accepted as having different degrees of accuracy and completeness. Treatment of inconclusive and incomplete data is discussed. As an aid to understanding the fluctuations in the cost histories, operating summaries for each nuclear unit are provided. The intent of these summaries is to identify important operating events; refueling, major maintenance, and other significant outages; operating milestones; and significant licensing or enforcement actions. Information used in the summaries is condensed from annual operating reports submitted by the licensees, plant histories contained in Nuclear Power Experience, trade press articles, and the Nuclear Regulatory Commission (NRC) web site (www.nrc.gov)

US nuclear power plant operating cost and experience summaries

Energy Technology Data Exchange (ETDEWEB)

Kohn, W.E.; Reid, R.L.; White, V.S.

1998-02-01

NUREG/CR-6577, U.S. Nuclear Power Plant Operating Cost and Experience Summaries, has been prepared to provide historical operating cost and experience information on U.S. commercial nuclear power plants. Cost incurred after initial construction are characterized as annual production costs, representing fuel and plant operating and maintenance expenses, and capital expenditures related to facility additions/modifications which are included in the plant capital asset base. As discussed in the report, annual data for these two cost categories were obtained from publicly available reports and must be accepted as having different degrees of accuracy and completeness. Treatment of inconclusive and incomplete data is discussed. As an aid to understanding the fluctuations in the cost histories, operating summaries for each nuclear unit are provided. The intent of these summaries is to identify important operating events; refueling, major maintenance, and other significant outages; operating milestones; and significant licensing or enforcement actions. Information used in the summaries is condensed from annual operating reports submitted by the licensees, plant histories contained in Nuclear Power Experience, trade press articles, and the Nuclear Regulatory Commission (NRC) web site (www.nrc.gov).

Power Supply Interruption Costs: Models and Methods Incorporating Time Dependent Patterns

International Nuclear Information System (INIS)

Kjoelle, G.H.

1996-12-01

This doctoral thesis develops models and methods for estimation of annual interruption costs for delivery points, emphasizing the handling of time dependent patterns and uncertainties in the variables determining the annual costs. It presents an analytical method for calculation of annual expected interruption costs for delivery points in radial systems, based on a radial reliability model, with time dependent variables. And a similar method for meshed systems, based on a list of outage events, assuming that these events are found in advance from load flow and contingency analyses. A Monte Carlo simulation model is given which handles both time variations and stochastic variations in the input variables and is based on the same list of outage events. This general procedure for radial and meshed systems provides expectation values and probability distributions for interruption costs from delivery points. There is also a procedure for handling uncertainties in input variables by a fuzzy description, giving annual interruption costs as a fuzzy membership function. The methods are developed for practical applications in radial and meshed systems, based on available data from failure statistics, load registrations and customer surveys. Traditional reliability indices such as annual interruption time, power- and energy not supplied, are calculated as by-products. The methods are presented as algorithms and/or procedures which are available as prototypes. 97 refs., 114 figs., 62 tabs

Power Supply Interruption Costs: Models and Methods Incorporating Time Dependent Patterns

Energy Technology Data Exchange (ETDEWEB)

Kjoelle, G.H.

1996-12-01

This doctoral thesis develops models and methods for estimation of annual interruption costs for delivery points, emphasizing the handling of time dependent patterns and uncertainties in the variables determining the annual costs. It presents an analytical method for calculation of annual expected interruption costs for delivery points in radial systems, based on a radial reliability model, with time dependent variables. And a similar method for meshed systems, based on a list of outage events, assuming that these events are found in advance from load flow and contingency analyses. A Monte Carlo simulation model is given which handles both time variations and stochastic variations in the input variables and is based on the same list of outage events. This general procedure for radial and meshed systems provides expectation values and probability distributions for interruption costs from delivery points. There is also a procedure for handling uncertainties in input variables by a fuzzy description, giving annual interruption costs as a fuzzy membership function. The methods are developed for practical applications in radial and meshed systems, based on available data from failure statistics, load registrations and customer surveys. Traditional reliability indices such as annual interruption time, power- and energy not supplied, are calculated as by-products. The methods are presented as algorithms and/or procedures which are available as prototypes. 97 refs., 114 figs., 62 tabs.

Productivity Costs Decrease After Endoscopic Sinus Surgery for Refractory Chronic Rhinosinusitis

Science.gov (United States)

Rudmik, Luke; Smith, Timothy L.; Mace, Jess C.; Schlosser, Rodney J.; Hwang, Peter H.; Soler, Zachary M.

2015-01-01

Objective The primary objective of this pilot study was to define the change in productivity costs following endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS). Secondary objectives were to identify CRS-related characteristics that may influence the degree of productivity improvement after ESS. Study Design Prospective, multi-institutional, observational cohort study. Methods The human capital approach was used to define productivity costs. Annual absenteeism, presenteeism, and lost leisure time was quantified to define annual lost productive time (LPT). LPT was monetized using the annual daily wage rates obtained from the 2012 US National Census and the 2013 US Department of Labor statistics. Results 27 patients with refractory CRS who underwent ESS were followed for a mean of 15 [SD 4.0] months (range: 8 – 25 months). Following ESS, there were improvements in annual absenteeism (22 days reduced to 3 days), annual presenteeism (41 days reduced to 19 days), and annual household days lost (12 days reduced to 6 days). Overall, the preoperative productivity costs were reduced after ESS, $9,097 vs. $3,301, respectively (pproductivity is negatively impacted by the presence of CRS. The outcomes from this study provide the first insights into the reduced productivity costs associated with receiving ESS for refractory CRS. Future studies with larger sample sizes will need to validate the results from this pilot study. PMID:26371457

Productivity costs decrease after endoscopic sinus surgery for refractory chronic rhinosinusitis.

Science.gov (United States)

Rudmik, Luke; Smith, Timothy L; Mace, Jess C; Schlosser, Rodney J; Hwang, Peter H; Soler, Zachary M

2016-03-01

The primary objective of this pilot study was to define the change in productivity costs following endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS). Secondary objectives were to identify CRS-related characteristics that may influence the degree of productivity improvement after ESS. Prospective, multi-institutional, observational cohort study. The human capital approach was used to define productivity costs. Annual absenteeism, presenteeism, and lost leisure time were quantified to define annual lost productive time (LPT). LPT was monetized using the annual daily wage rates obtained from the 2012 US Census and the 2013 US Department of Labor statistics. Twenty-seven patients with refractory CRS who underwent ESS were followed for a mean of 15 months (range, 8-25 months). Following ESS, there were improvements in annual absenteeism (22 days reduced to 3 days), annual presenteeism (41 days reduced to 19 days), and annual household days lost (12 days reduced to 6 days). Overall, the preoperative productivity costs were reduced after ESS ($9,190 vs. $3,373, respectively; P productivity is negatively impacted by the presence of CRS. The outcomes from this study provide the first insights into the reduced productivity costs associated with receiving ESS for refractory CRS. Future studies with larger sample sizes will need to validate the results from this pilot study. 2c Laryngoscope, 126:570-574, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

A low cost, printed microwave based level sensor with integrated oscillator readout circuitry

KAUST Repository

Karimi, Muhammad Akram; Arsalan, Muhammad; Shamim, Atif

2017-01-01

This paper presents an extremely low cost, tube conformable, printed T-resonator based microwave level sensor, whose resonance frequency shifts by changing the level of fluids inside the tube. Printed T-resonator forms the frequency selective

AES, Automated Construction Cost Estimation System

International Nuclear Information System (INIS)

Holder, D.A.

1995-01-01

A - Description of program or function: AES (Automated Estimating System) enters and updates the detailed cost, schedule, contingency, and escalation information contained in a typical construction or other project cost estimates. It combines this information to calculate both un-escalated and escalated and cash flow values for the project. These costs can be reported at varying levels of detail. AES differs from previous versions in at least the following ways: The schedule is entered at the WBS-Participant, Activity level - multiple activities can be assigned to each WBS-Participant combination; the spending curve is defined at the schedule activity level and a weighing factor is defined which determines percentage of cost for the WBS-Participant applied to the schedule activity; Schedule by days instead of Fiscal Year/Quarter; Sales Tax is applied at the Line Item Level- a sales tax codes is selected to indicate Material, Large Single Item, or Professional Services; a 'data filter' has been added to allow user to define data the report is to be generated for. B - Method of solution: Average Escalation Rate: The average escalation for a Bill of is calculated in three steps. 1. A table of quarterly escalation factors is calculated based on the base fiscal year and quarter of the project entered in the estimate record and the annual escalation rates entered in the Standard Value File. 2. The percentage distribution of costs by quarter for the Bill of Material is calculated based on the schedule entered and the curve type. 3. The percent in each fiscal year and quarter in the distribution is multiplied by the escalation factor for the fiscal year and quarter. The sum of these results is the average escalation rate for that Bill of Material. Schedule by curve: The allocation of costs to specific time periods is dependent on three inputs, starting schedule date, ending schedule date, and the percentage of costs allocated to each quarter. Contingency Analysis: The

Spinal Surgeon Variation in Single-Level Cervical Fusion Procedures: A Cost and Hospital Resource Utilization Analysis.

Science.gov (United States)

Hijji, Fady Y; Massel, Dustin H; Mayo, Benjamin C; Narain, Ankur S; Long, William W; Modi, Krishna D; Burke, Rory M; Canar, Jeff; Singh, Kern

2017-07-01

Retrospective analysis. To compare perioperative costs and outcomes of patients undergoing single-level anterior cervical discectomy and fusions (ACDF) at both a service (orthopedic vs. neurosurgical) and individual surgeon level. Hospital systems are experiencing significant pressure to increase value of care by reducing costs while maintaining or improving patient-centered outcomes. Few studies have examined the cost-effectiveness cervical arthrodesis at a service level. A retrospective review of patients who underwent a primary 1-level ACDF by eight surgeons (four orthopedic and four neurosurgical) at a single academic institution between 2013 and 2015 was performed. Patients were identified by Diagnosis-Related Group and procedural codes. Patients with the ninth revision of the International Classification of Diseases coding for degenerative cervical pathology were included. Patients were excluded if they exhibited preoperative diagnoses or postoperative social work issues affecting their length of stay. Comparisons of preoperative demographics were performed using Student t tests and chi-squared analysis. Perioperative outcomes and costs for hospital services were compared using multivariate regression adjusted for preoperative characteristics. A total of 137 patients diagnosed with cervical degeneration underwent single-level ACDF; 44 and 93 were performed by orthopedic surgeons and neurosurgeons, respectively. There was no difference in patient demographics. ACDF procedures performed by orthopedic surgeons demonstrated shorter operative times (89.1 ± 25.5 vs. 96.0 ± 25.5 min; P = 0.002) and higher laboratory costs (Δ+$6.53 ± $5.52 USD; P = 0.041). There were significant differences in operative time (P = 0.014) and labor costs (P = 0.034) between individual surgeons. There was no difference in total costs between specialties or individual surgeons. Surgical subspecialty training does not significantly affect total costs of

HEALTH INFO SANTÉ – REMINDER ANNUAL DEDUCTIBLE AND REIMBURSEMENT CLAIMS HINTS FOR USE

CERN Multimedia

CHIS Board

2000-01-01

Information from the CHIS Board and the Human Resources Division:Annual deductible and reimbursement claims: hints for useOne should bear in mind that the annual deductible is an amount (currently CHF 100) charged automatically by the Administrator of the scheme for every adult aged 18 and above. This is what happens: The amount is deducted annually for all medical services received over a calendar year.It is triggered by the date of the treatment and neither by the date of the bill nor that of the reimbursement claim.In other words, if you receive medical treatment in December for the first time in a given year, the CHF 100 will be deducted from the claim for that treatment. So, except for urgent cases, it would be better to wait till the following month, thus avoiding one annual deductible.It is also worth remembering that the cost of processing our reimbursement claims - and there were 54, 000 in 1999 - is part of the cost of our insurance.Help keep administrative costs down: do not submit reimbursement cl...

An integrated radar model solution for mission level performance and cost trades

Science.gov (United States)

Hodge, John; Duncan, Kerron; Zimmerman, Madeline; Drupp, Rob; Manno, Mike; Barrett, Donald; Smith, Amelia

2017-05-01

A fully integrated Mission-Level Radar model is in development as part of a multi-year effort under the Northrop Grumman Mission Systems (NGMS) sector's Model Based Engineering (MBE) initiative to digitally interconnect and unify previously separate performance and cost models. In 2016, an NGMS internal research and development (IR and D) funded multidisciplinary team integrated radio frequency (RF), power, control, size, weight, thermal, and cost models together using a commercial-off-the-shelf software, ModelCenter, for an Active Electronically Scanned Array (AESA) radar system. Each represented model was digitally connected with standard interfaces and unified to allow end-to-end mission system optimization and trade studies. The radar model was then linked to the Air Force's own mission modeling framework (AFSIM). The team first had to identify the necessary models, and with the aid of subject matter experts (SMEs) understand and document the inputs, outputs, and behaviors of the component models. This agile development process and collaboration enabled rapid integration of disparate models and the validation of their combined system performance. This MBE framework will allow NGMS to design systems more efficiently and affordably, optimize architectures, and provide increased value to the customer. The model integrates detailed component models that validate cost and performance at the physics level with high-level models that provide visualization of a platform mission. This connectivity of component to mission models allows hardware and software design solutions to be better optimized to meet mission needs, creating cost-optimal solutions for the customer, while reducing design cycle time through risk mitigation and early validation of design decisions.

77 FR 64361 - Report on Waste Burial Charges: Changes in Decommissioning Waste Disposal Costs at Low-Level...

Science.gov (United States)

2012-10-19

... Decommissioning Waste Disposal Costs at Low-Level Waste Burial Facilities AGENCY: Nuclear Regulatory Commission... 15, ``Report on Waste Burial Charges: Changes in Decommissioning Waste Disposal Costs at Low-Level... for low-level waste. DATES: Submit comments by November 15, 2012. Comments received after this date...

Generalized cost-effectiveness analysis for national-level priority-setting in the health sector

Directory of Open Access Journals (Sweden)

Edejer Tessa

2003-12-01

Full Text Available Abstract Cost-effectiveness analysis (CEA is potentially an important aid to public health decision-making but, with some notable exceptions, its use and impact at the level of individual countries is limited. A number of potential reasons may account for this, among them technical shortcomings associated with the generation of current economic evidence, political expediency, social preferences and systemic barriers to implementation. As a form of sectoral CEA, Generalized CEA sets out to overcome a number of these barriers to the appropriate use of cost-effectiveness information at the regional and country level. Its application via WHO-CHOICE provides a new economic evidence base, as well as underlying methodological developments, concerning the cost-effectiveness of a range of health interventions for leading causes of, and risk factors for, disease. The estimated sub-regional costs and effects of different interventions provided by WHO-CHOICE can readily be tailored to the specific context of individual countries, for example by adjustment to the quantity and unit prices of intervention inputs (costs or the coverage, efficacy and adherence rates of interventions (effectiveness. The potential usefulness of this information for health policy and planning is in assessing if current intervention strategies represent an efficient use of scarce resources, and which of the potential additional interventions that are not yet implemented, or not implemented fully, should be given priority on the grounds of cost-effectiveness. Health policy-makers and programme managers can use results from WHO-CHOICE as a valuable input into the planning and prioritization of services at national level, as well as a starting point for additional analyses of the trade-off between the efficiency of interventions in producing health and their impact on other key outcomes such as reducing inequalities and improving the health of the poor.

Healthcare Utilization and Costs of Systemic Lupus Erythematosus in Medicaid

Directory of Open Access Journals (Sweden)

Hong J. Kan

2013-01-01

Full Text Available Objective. Healthcare utilization and costs associated with systemic lupus erythematosus (SLE in a US Medicaid population were examined. Methods. Patients ≥ 18 years old with SLE diagnosis (ICD-9-CM 710.0x were extracted from a large Medicaid database 2002–2009. Index date was date of the first SLE diagnosis. Patients with and without SLE were matched. All patients had a variable length of followup with a minimum of 12 months. Annualized healthcare utilization and costs associated with SLE and costs of SLE flares were assessed during the followup period. Multivariate regressions were conducted to estimate incremental healthcare utilization and costs associated with SLE. Results. A total of 14,777 SLE patients met the study criteria, and 14,262 were matched to non-SLE patients. SLE patients had significantly higher healthcare utilization per year than their matched controls. The estimated incremental annual cost associated with SLE was $10,984, with the highest increase in inpatient costs (P<0.001. Cost per flare was $11,716 for severe flares, $562 for moderate flares, and $129 for mild flares. Annual total costs for patients with severe flares were $49,754. Conclusions. SLE patients had significantly higher healthcare resource utilization and costs than non-SLE patients. Patients with severe flares had the highest costs.

Seasonal Changes in Atmospheric Noise Levels and the Annual Variation in Pigeon Homing Performance

Science.gov (United States)

Hagstrum, J. T.; McIsaac, H. P.; Drob, D. P.

2015-12-01

The remarkable navigational ability of homing pigeons (Columba livia) is influenced by a number of factors, an unknown one of which causes the "Wintereffekt"1 or annual variation in homing performance. Minima in homeward orientation and return speeds have been observed in winter, with maxima in summer, during repetitive pigeon releases from single sites near experimental lofts in Wilhelmshaven, Göttingen, and Munich, Germany, and near Pisa, Italy1-4. Overall the annual variation is more pronounced in northern Germany than Italy4, and both mature and juvenile cohorts respond to this seasonal factor. Older, more experienced pigeons are better at compensating for its effects than naïve ones, but are still affected after numerous releases. The narrow low-frequency band of atmospheric background noise (microbaroms; 0.1-0.3 Hz) also varies with an annual cycle that generally has higher amplitudes in winter than in summer depending on location5. In addition, homing pigeons, and possibly other birds, apparently use infrasonic signals of similar frequency as navigational cues6, and a seasonal variation in background noise levels could cause corresponding changes in signal-to-noise ratios and thus in homing performance. The annual variation in homing performance, however, was not observed during long-term pigeon releases at two sites in eastern North America. The annual and geographic variability in homing performance in the northern hemisphere can be explained to a first order by seasonal changes in infrasonic noise sources related to ocean storm activity, and to the direction and intensity of stratospheric winds. In addition, increased dispersion in departure bearings of individual birds for some North American releases were likely caused by additional infrasonic noise associated with severe weather events during tornado and Atlantic hurricane seasons. 1Kramer, G. & von Saint Paul, U., J. Ornithol. 97, 353-370 (1956); 2Wallraff, H. G., Z. Tierpsychol. 17, 82-113 (1960

Employer Health Benefit Costs and Demand for Part-Time Labor

OpenAIRE

Jennifer Feenstra Schultz; David Doorn

2009-01-01

The link between rising employer costs for health insurance benefits and demand for part-time workers is investigated using non-public data from the Medical Expenditure Panel Survey- Insurance Component (MEPS-IC). The MEPS-IC is a nationally representative, annual establishment survey from the Agency for Healthcare Research and Quality (AHRQ). Pooling the establishment level data from the MEPS-IC from 1996-2004 and matching with the Longitudinal Business Database and supplemental economic dat...

Case Managers for High-Risk, High-Cost Patients as Agents and Street-Level Bureaucrats.

Science.gov (United States)

Swanson, Jeffrey; Weissert, William G

2017-08-01

Case management programs often designate a nurse or social worker to take responsibility for guiding care when patients are expected to be expensive or risk a major decline. We hypothesized that though an intuitively appealing idea, careful program design and faithful implementation are essential if case management programs are to succeed. We employed two theory perspectives, principal-agent framework and street-level bureaucratic theory to describe the relationship between program designers (principals) and case managers (agents/street-level bureaucrats) to review 65 case management studies. Most programs were successful in limited program-specific process and outcome goals. But there was much less success in cost-saving or cost-effectiveness-the original and overarching goal of case management. Cost results might be improved if additional ideas of agency and street-level theory were adopted, specifically, incentives, as well as "green tape," clear rules, guidelines, and algorithms relating to resource allocation among patients.

Levelized cost of electricity (LCOE) of renewable energies and required subsidies in China

International Nuclear Information System (INIS)

Ouyang, Xiaoling; Lin, Boqiang

2014-01-01

The development and utilization of renewable energy (RE), a strategic choice for energy structural adjustment, is an important measure of carbon emissions reduction in China. High cost is a main restriction element for large-scale development of RE, and accurate cost estimation of renewable power generation is urgently necessary. This is the first systemic study on the levelized cost of electricity (LCOE) of RE in China. Results indicate that feed-in-tariff (FIT) of RE should be improved and dynamically adjusted based on the LCOE to provide a better support of the development of RE. The current FIT in China can only cover the LCOE of wind (onshore) and solar photovoltaic energy (PV) at a discount rate of 5%. Subsidies to renewables-based electricity generation, except biomass energy, still need to be increased at higher discount rates. Main conclusions are drawn as follows: (1) Government policy should focus on solving the financing problem of RE projects because fixed capital investment exerts considerable influence over the LCOE; and (2) the problem of high cost could be solved by providing subsidies in the short term and more importantly, by reforming electricity price in the mid-and long-term to make the RE competitive. - Highlights: • Levelized cost of electricity (LCOE) of renewable energies is systemically studied. • Renewable power generation costs are estimated based on data of 17 power plants. • Required subsidies for renewable power generation are calculated. • Electricity price reform is the long-term strategy for solving problem of high cost

Economic analysis of a volume reduction/polyethylene solidification system for low-level radioactive wastes

International Nuclear Information System (INIS)

Kalb, P.D.; Colombo, P.

1985-01-01

A study was conducted at Brookhaven National Laboratory to determine the economic feasibility of a fluidized bed volume reduction/polyethylene solidification system for low-level radioactive wastes. These results are compared with the ''null'' alternative of no volume reduction and solidification of aqueous waste streams in hydraulic cement. The economic analysis employed a levelized revenue requirement (LRR) technique conducted over a ten year period. An interactive computer program was written to conduct the LRR calculations. Both of the treatment/solidification options were considered for a number of scenarios including type of plant (BWR or PWR) and transportation distance to the disposal site. If current trends in the escalation rates of cost components continue, the volume reduction/polyethylene solidification option will be cost effective for both BWRs and PWRs. Data indicate that a minimum net annual savings of $0.8 million per year (for a PWR shipping its waste 750 miles) and a maximum net annual savings of $9 million per year (for a BWR shipping its waste 2500 miles) can be achieved. A sensitivity analysis was performed for the burial cost escalation rate, which indicated that variation of this factor will impact the total levelized revenue requirement. The burial cost escalation rate which yields a break-even condition was determined for each scenario considered. 11 refs., 8 figs., 39 tabs

[Socioeconomic costs of food-borne disease using the cost-of-illness model: applying the QALY method].

Science.gov (United States)

Shin, Hosung; Lee, Suehyung; Kim, Jong Soo; Kim, Jinsuk; Han, Kyu Hong

2010-07-01

This study estimated the annual socioeconomic costs of food-borne disease in 2008 from a societal perspective and using a cost-of-illness method. Our model employed a comprehensive set of diagnostic disease codes to define food-borne diseases with using the Korea National Health Insurance (KNHI) reimbursement data. This study classified the food borne illness as three types of symptoms according to the severity of the illness: mild, moderate, severe. In addition to the traditional method of assessing the cost-of-illness, the study included measures to account for the lost quality of life. We estimated the cost of the lost quality of life using quality-adjusted life years and a visual analog scale. The direct cost included medical and medication costs, and the non-medical costs included transportation costs, caregiver's cost and administration costs. The lost productivity costs included lost workdays due to illness and lost earnings due to premature death. The study found the estimated annual socioeconomic costs of food-borne disease in 2008 were 954.9 billion won (735.3 billion won-996.9 billion won). The medical cost was 73.4 - 76.8% of the cost, the lost productivity cost was 22.6% and the cost of the lost quality of life was 26.0%. Most of the cost-of-illness studies are known to have underestimated the actual socioeconomic costs of the subjects, and these studies excluded many important social costs, such as the value of pain, suffering and functional disability. The study addressed the uncertainty related to estimating the socioeconomic costs of food-borne disease as well as the updated cost estimates. Our estimates could contribute to develop and evaluate policies for food-borne disease.

Life cycle costs for disposal and assured isolation of low-level radioactive waste in Connecticut

International Nuclear Information System (INIS)

Chau, B.; Sutherland, A.A.; Baird, R.D.

1998-03-01

This document presents life cycle costs for a low-level radioactive disposal facility and a comparable assured isolation facility. Cost projections were based on general plans and assumptions, including volume projections and operating life, provided by the Connecticut Hazardous Waste Management Service, for a facility designed to meet the State's needs. Life cycle costs include the costs of pre-construction activities, construction, operations, closure, and post-closure institutional control. In order to provide a better basis for understanding the relative magnitude of near-term costs and future costs, the results of present value analysis of ut-year costs are provided

Energy and life-cycle cost analysis of a six-story office building

Science.gov (United States)

Turiel, I.

1981-10-01

An energy analysis computer program, DOE-2, was used to compute annual energy use for a typical office building as originally designed and with several energy conserving design modifications. The largest energy use reductions were obtained with the incorporation of daylighting techniques, the use of double pane windows, night temperature setback, and the reduction of artificial lighting levels. A life-cycle cost model was developed to assess the cost-effectiveness of the design modifications discussed. The model incorporates such features as inclusion of taxes, depreciation, and financing of conservation investments. The energy conserving strategies are ranked according to economic criteria such as net present benefit, discounted payback period, and benefit to cost ratio.

Operating cost guidelines for benchmarking DOE thermal treatment systems for low-level mixed waste

International Nuclear Information System (INIS)

Salmon, R.; Loghry, S.L.; Hermes, W.H.

1994-11-01

This report presents guidelines for estimating operating costs for use in benchmarking US Department of Energy (DOE) low-level mixed waste thermal treatment systems. The guidelines are based on operating cost experience at the DOE Toxic Substances Control Act (TSCA) mixed waste incinerator at the K-25 Site at Oak Ridge. In presenting these guidelines, it should be made clear at the outset that it is not the intention of this report to present operating cost estimates for new technologies, but only guidelines for estimating such costs

Examining the cost of delivering routine immunization in Honduras.

Science.gov (United States)

Janusz, Cara Bess; Castañeda-Orjuela, Carlos; Molina Aguilera, Ida Berenice; Felix Garcia, Ana Gabriela; Mendoza, Lourdes; Díaz, Iris Yolanda; Resch, Stephen C

2015-05-07

Many countries have introduced new vaccines and expanded their immunization programs to protect additional risk groups, thus raising the cost of routine immunization delivery. Honduras recently adopted two new vaccines, and the country continues to broaden the reach of its program to adolescents and adults. In this article, we estimate and examine the economic cost of the Honduran routine immunization program for the year 2011. The data were gathered from a probability sample of 71 health facilities delivering routine immunization, as well as 8 regional and 1 central office of the national immunization program. Data were collected on vaccinations delivered, staff time dedicated to the program, cold chain equipment and upkeep, vehicle use, infrastructure, and other recurrent and capital costs at each health facility and administrative office. Annualized economic costs were estimated from a modified societal perspective and reported in 2011 US dollars. With the addition of rotavirus and pneumococcal conjugate vaccines, the total cost for routine immunization delivery in Honduras for 2011 was US$ 32.5 million. Vaccines and related supplies accounted for 23% of the costs. Labor, cold chain, and vehicles represented 54%, 4%, and 1%, respectively. At the facility level, the non-vaccine system costs per dose ranged widely, from US$ 25.55 in facilities delivering fewer than 500 doses per year to US$ 2.84 in facilities with volume exceeding 10,000 doses per year. Cost per dose was higher in rural facilities despite somewhat lower wage rates for health workers in these settings; this appears to be driven by lower demand for services per health worker in sparsely populated areas, rather than increased cost of outreach. These more-precise estimates of the operational costs to deliver routine immunizations provide program managers with important information for mobilizing resources to help sustain the program and for improving annual planning and budgeting as well as longer

The indirect costs of ankylosing spondylitis: a systematic review and meta-analysis.

Science.gov (United States)

Malinowski, Krzysztof Piotr; Kawalec, Paweł

2015-04-01

The aim of this systematic review was to collect and summarize all current data on the indirect costs related to absenteeism and presenteeism associated with ankylosing spondylitis. The search was conducted using Medline, Embase and Centre for Reviews and Dissemination databases. All collected costs were recalculated to average annual cost per patient, expressed in 2013 prices USD using the consumer price index and purchasing power parity. Identified studies were then analyzed to assess their possible inclusion in the meta-analysis. We identified 32 records. The average annual indirect cost per patient varies among all the identified results from US$660.95 to 45,953.87. The mean annual indirect per patient equals US$6454.76. This systematic review summarizes current data related to indirect costs generated by ankylosing spondylitis; it revealed the great economic burden of the disease for society. We observed a great variety of the considered components of indirect costs and their definitions.

Direct medical costs of motorcycle crashes in Ontario.

Science.gov (United States)

Pincus, Daniel; Wasserstein, David; Nathens, Avery B; Bai, Yu Qing; Redelmeier, Donald A; Wodchis, Walter P

2017-11-20

There is no reliable estimate of costs incurred by motorcycle crashes. Our objective was to calculate the direct costs of all publicly funded medical care provided to individuals after motorcycle crashes compared with automobile crashes. We conducted a population-based, matched cohort study of adults in Ontario who presented to hospital because of a motorcycle or automobile crash from 2007 through 2013. For each case, we identified 1 control absent a motor vehicle crash during the study period. Direct costs for each case and control were estimated in 2013 Canadian dollars from the payer perspective using methodology that links health care use to individuals over time. We calculated costs attributable to motorcycle and automobile crashes within 2 years using a difference-in-differences approach. We identified 26 831 patients injured in motorcycle crashes and 281 826 injured in automobile crashes. Mean costs attributable to motorcycle and automobile crashes were $5825 and $2995, respectively ( p motorcycle crashes compared with automobile crashes (2194 injured annually/100 000 registered motorcycles v. 718 injured annually/100 000 registered automobiles; incidence rate ratio [IRR] 3.1, 95% confidence interval [CI] 2.8 to 3.3, p motorcycles v. 12 severe injuries annually/100 000 registered automobiles; IRR 10.4, 95% CI 8.3 to 13.1, p motorcycle in Ontario costs the public health care system 6 times the amount of each registered automobile. Medical costs may provide an additional incentive to improve motorcycle safety. © 2017 Joule Inc. or its licensors.

Historical Cost Dan General Price Level Accounting: Analisis Relevansi Indikator Keuangan

OpenAIRE

-, Meythi; Teresa, Sheffie

2012-01-01

In conventional accounting, financial statements are based on the historical cost principle that assumes that prices (monetary unit) are stable. Conventional accounting recognizes neither changes in the general price level nor changes in the specific price level. Consequently, if there are any changes in purchasing power such as in inflation period, the historical financial statement are not economically relevant and also income is usually overstated, and the fixed assets are usually understa...

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

Science.gov (United States)

Adhikari, Bhim; Lovett, Jon C

2006-01-01

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

18 CFR 382.203 - Annual charges under the Interstate Commerce Act.

Science.gov (United States)

2010-04-01

... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Annual charges under the Interstate Commerce Act. 382.203 Section 382.203 Conservation of Power and Water Resources FEDERAL... § 382.203 Annual charges under the Interstate Commerce Act. (a) The adjusted costs of administration of...

Conventional method for the calculation of the global energy cost of buildings; Methode conventionnelle de calcul du cout global energetique des batiments

Energy Technology Data Exchange (ETDEWEB)

NONE

2002-05-01

A working group driven by Electricite de France (EdF), Chauffage Fioul and Gaz de France (GdF) companies has been built with the sustain of several building engineering companies in order to clarify the use of the method of calculation of the global energy cost of buildings. This global cost is an economical decision help criterion among others. This press kit presents, first, the content of the method (input data, calculation of annual expenses, calculation of the global energy cost, display of results and limitations of the method). Then it fully describes the method and its appendixes necessary for its implementation: economical and financial context, general data of the project in progress, environmental data, occupation and comfort level, variants, investment cost of energy systems, investment cost for the structure linked with the energy system, investment cost for other invariant elements of the structure, calculation of consumptions (space heating, hot water, ventilation), maintenance costs (energy systems, structure), operation and exploitation costs, tariffs and consumption costs and taxes, actualized global cost, annualized global cost, comparison between variants. The method is applied to a council building of 23 flats taken as an example. (J.S.)

42. Annual Report: 31 December 1985

International Nuclear Information System (INIS)

1986-01-01

This annual report mainly presents information on the industrial activities, costs, results, production, business economics, administration, ore reserves, ores, boreholes, shares and finances of the Vaal Reefs Exploration and Mining Company. It includes information on uranium and uranium oxides. Almost all the information is presented in statistical form

Cost-benefit of ventilation and averted radon in dwellings

International Nuclear Information System (INIS)

Katona, T.; Kanyar, B.

2003-01-01

To assess an economically optimal ventilation rate we have introduced a cost-benefit analysis taking into account the cost of heating and benefit of averted dose due to ventilation. The cost of heating due to the elevated ventilation for mitigation of radon content in dwellings can be compensated by the monetary benefit of the averted dose, in case of higher (annually 3-10 mSv) exposure. During the heating season the economically optimal ventilation takes 0.1-0.5 h -1 , meanwhile the radon concentration in the indoor air decreases to 200-800 Bq/m 3 , depending on the exhalation of radon, number of persons living in the dwellings and other local parameters. Our results from the optimal planning correspond to the radon concentrations recommended by the international organizations as action levels. In general, the periodic ventilation in daytime provides a higher averted dose than the constant one in case of the same heating cost. (authors)

The "Phantom Costs" of Florida's Citrus Industry

OpenAIRE

Muraro, Ronald P.; Roka, Fritz M.; Spreen, Thomas H.

2006-01-01

Regulatory compliance, the "phantom costs of production," is an increasingly "fact-of-life" for U.S. agriculture. A survey was developed and implemented to enumerate regulatory compliance costs for Florida's 748,500 acres citrus industry. Complying with 61 production related regulations, 643,757 hours were expended at a total annual cost of over $24.3 million.

The cost of publishing in Danish astronomy

DEFF Research Database (Denmark)

Dorch, Bertil F.

I investigate the cost of publishing in Danish astronomy on a fine scale, including all direct publication costs: The figures show how the annual number of publications with authors from Denmark in astronomy journals increased by a factor approximately four during 15 years (Elsevier’s Scopus...... database), and the increase of the corresponding potential (maximum) cost of publishing....

Cost Evaluation with G4-ECONS Program for SI based Nuclear Hydrogen Production Plant

International Nuclear Information System (INIS)

Kim, Jong-ho; Lee, Ki-young; Kim, Yong-wan

2014-01-01

Contemporary hydrogen is production is primarily based on fossil fuels, which is not considered as environments friendly and economically efficient. To achieve the hydrogen economy, it is very important to produce a massive amount of hydrogen in a clean, safe and efficient way. Nuclear production of hydrogen would allow massive production of hydrogen at economic prices while avoiding environments pollution reducing the release of carbon dioxide. Nuclear production of hydrogen could thus become the enabling technology for the hydrogen economy. The economic assessment was performed for nuclear hydrogen production plant consisting of VHTR coupled with SI cycle. For the study, G4-ECONS developed by EMWG of GIF was appropriately modified to calculate the LUHC, assuming 36 months of plant construction time, 5 % of annual interest rate and 12.6 % of fixed charge rate. In G4-ECONS program, LUHC is calculated by the following formula; LUHC = (Annualized TCIC + Annualized O-M Cost + Annualized Fuel Cycle Cost + Annualized D-D Cost) / Annual Hydrogen Production Rate

A Response Surface-Based Cost Model for Wind Farm Design

International Nuclear Information System (INIS)

Zhang Jie; Chowdhury, Souma; Messac, Achille; Castillo, Luciano

2012-01-01

A Response Surface-Based Wind Farm Cost (RS-WFC) model is developed for the engineering planning of wind farms. The RS-WFC model is developed using Extended Radial Basis Functions (E-RBF) for onshore wind farms in the U.S. This model is then used to explore the influences of different design and economic parameters, including number of turbines, rotor diameter and labor cost, on the cost of a wind farm. The RS-WFC model is composed of three components that estimate the effects of engineering and economic factors on (i) the installation cost, (ii) the annual Operation and Maintenance (O and M) cost, and (iii) the total annual cost of a wind farm. The accuracy of the cost model is favorably established through comparison with pertinent commercial data. The final RS-WFC model provided interesting insights into cost variation with respect to critical engineering and economic parameters. In addition, a newly developed analytical wind farm engineering model is used to determine the power generated by the farm, and the subsequent Cost of Energy (COE). This COE is optimized for a unidirectional uniform “incoming wind speed” scenario using Particle Swarm Optimization (PSO). We found that the COE could be appreciably minimized through layout optimization, thereby yielding significant cost savings. - Highlights: ► We present a Response Surface-Based Wind Farm Cost (RS-WFC) model for wind farm design. ► The model could estimate installation cost, Operation and Maintenance cost, and total annual cost of a wind farm. ► The Cost of Energy is optimized using Particle Swarm Optimization. ► Layout optimization could yield significant cost savings.

Patient-level costs of major cardiovascular conditions: a review of the international literature.

Science.gov (United States)

Nicholson, Gina; Gandra, Shravanthi R; Halbert, Ronald J; Richhariya, Akshara; Nordyke, Robert J

2016-01-01

Robust cost estimates of cardiovascular (CV) events are required for assessing health care interventions aimed at reducing the economic burden of major adverse CV events. This review synthesizes international cost estimates of CV events. MEDLINE database was searched electronically for English language studies published during 2007-2012, with cost estimates for CV events of interest - unstable angina, myocardial infarction, heart failure, stroke, and CV revascularization. Included studies provided at least one estimate of patient-level direct costs in adults for any identified country. Information on study characteristics and cost estimates were collected. All costs were adjusted for inflation to 2013 values. Across the 114 studies included, the average cost was US $6,466 for unstable angina, $11,664 for acute myocardial infarction, $11,686 for acute heart failure, $11,635 for acute ischemic stroke, $37,611 for coronary artery bypass graft, and $13,501 for percutaneous coronary intervention. The ranges for cost estimates varied widely across countries with US cost estimate being at least twice as high as European Union costs for some conditions. Few studies were found on populations outside the US and European Union. This review showed wide variation in the cost of CV events within and across countries, while showcasing the continuing economic burden of CV disease. The variability in costs was primarily attributable to differences in study population, costing methodologies, and reporting differences. Reliable cost estimates for assessing economic value of interventions in CV disease are needed.

Comparative life-cycle cost analysis for low-level mixed waste remediation alternatives

International Nuclear Information System (INIS)

Jackson, J.A.; White, T.P.; Kloeber, J.M.; Toland, R.J.; Cain, J.P.; Buitrago, D.Y.

1995-03-01

The purpose of this study is two-fold: (1) to develop a generic, life-cycle cost model for evaluating low-level, mixed waste remediation alternatives, and (2) to apply the model specifically, to estimate remediation costs for a site similar to the Fernald Environmental Management Project near Cincinnati, OH. Life-cycle costs for vitrification, cementation, and dry removal process technologies are estimated. Since vitrification is in a conceptual phase, computer simulation is used to help characterize the support infrastructure of a large scale vitrification plant. Cost estimating relationships obtained from the simulation data, previous cost estimates, available process data, engineering judgment, and expert opinion all provide input to an Excel based spreadsheet for generating cash flow streams. Crystal Ball, an Excel add-on, was used for discounting cash flows for net present value analysis. The resulting LCC data was then analyzed using multi-attribute decision analysis techniques with cost and remediation time as criteria. The analytical framework presented allows alternatives to be evaluated in the context of budgetary, social, and political considerations. In general, the longer the remediation takes, the lower the net present value of the process. This is true because of the time value of money and large percentage of the costs attributed to storage or disposal

School lunch waste among middle school students: nutrients consumed and costs.

Science.gov (United States)

Cohen, Juliana F W; Richardson, Scott; Austin, S Bryn; Economos, Christina D; Rimm, Eric B

2013-02-01

The National School Lunch Program has been guided by modest nutrient standards, and the palatability of meals, which drives consumption, receives inadequate attention. School food waste can have important nutritional and cost implications for policymakers, students, and their families. Nutrient losses and economic costs associated with school meal waste were examined. The study also assessed if school foods served were valid proxies for foods consumed by students. Plate waste measurements were collected from middle school students in Boston attending two Chef Initiative schools (n=1609) and two control schools (n=1440) during a 2-year pilot study (2007-2009) in which a professional chef trained cafeteria staff to make healthier school meals. The costs associated with food waste were calculated and the percentage of foods consumed was compared with a gold standard of 85% consumption. Analyses were conducted in 2010-2011. Overall, students consumed less than the required/recommended levels of nutrients. An estimated $432,349 of food (26.1% of the total food budget) was discarded by middle school students annually at lunch in these Boston middle schools. For most meal components, substantially less than 85% was consumed. There is substantial food waste among middle school students in Boston. Overall, students' nutrient consumption levels were below school meal standards, and foods served were not valid proxies for foods consumed. The costs associated with discarded foods are high; if translated nationally for school lunches, roughly $1,238,846,400 annually is wasted. Students might benefit if additional focus were given to the quality and palatability of school meals. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

SunShot solar power reduces costs and uncertainty in future low-carbon electricity systems.

Science.gov (United States)

Mileva, Ana; Nelson, James H; Johnston, Josiah; Kammen, Daniel M

2013-08-20

The United States Department of Energy's SunShot Initiative has set cost-reduction targets of $1/watt for central-station solar technologies. We use SWITCH, a high-resolution electricity system planning model, to study the implications of achieving these targets for technology deployment and electricity costs in western North America, focusing on scenarios limiting carbon emissions to 80% below 1990 levels by 2050. We find that achieving the SunShot target for solar photovoltaics would allow this technology to provide more than a third of electric power in the region, displacing natural gas in the medium term and reducing the need for nuclear and carbon capture and sequestration (CCS) technologies, which face technological and cost uncertainties, by 2050. We demonstrate that a diverse portfolio of technological options can help integrate high levels of solar generation successfully and cost-effectively. The deployment of GW-scale storage plays a central role in facilitating solar deployment and the availability of flexible loads could increase the solar penetration level further. In the scenarios investigated, achieving the SunShot target can substantially mitigate the cost of implementing a carbon cap, decreasing power costs by up to 14% and saving up to $20 billion ($2010) annually by 2050 relative to scenarios with Reference solar costs.

Smoking Cessation Is Associated With Lower Indirect Costs.

Science.gov (United States)

Baker, Christine L; Bruno, Marianna; Emir, Birol; Li, Vicky W; Goren, Amir

2018-06-01

This study quantified differences in indirect costs due to decreased work productivity between current and former smokers. Former smokers were further categorized by number of years since quitting to assess corresponding differences. Data on employed individuals were obtained from the 2013 US National Health and Wellness Survey (NHWS; N = 75,000). Indirect costs were calculated for current smokers and former smokers from weekly wages based on age and sex. The annual total indirect costs for current smokers were $1327.53, $1560.18, and $1839.87 higher than for those who quit 0 to 4 years, 5 to 10 years, and more than or equal to 11 years prior, respectively. There were no significant differences in mean total indirect costs between the former smoker groups. Current smokers showed significantly higher total annual indirect costs compared with former smokers, independently of the number of years since quitting smoking.

Proceedings of the seventh annual participants' information meeting. DOE Low-Level Waste Management Program

International Nuclear Information System (INIS)

1986-02-01

The Seventh Annual Department of Energy (DOE) Low-Level Waste Management Program (LLWMP) Participants' Information Meeting was held September 10-13, 1985 in Las Vegas, Nevada. The purpose of the meeting was to provide a forum for exchange of information on low-level radioactive waste management activities, requirements, and plans. Attendees included representatives from the DOE Nuclear Energy and Defense Low-Level Waste Management Programs, interim operations offices and their contractor operators; representatives from the US Nuclear Regulatory Commission, US Environmental Protection Agency, US Geological Survey, and their contractors; representatives of states and regions responsible for development of new commercial low-level waste disposal facilities; representatives of Great Britain, France, and Canada; representatives of utilities, private contractors, and parties concerned with low-level waste management issues. The meeting was organized by topical areas to allow for the exchange of information and the promotion of discussion on specific aspects of low-level waste management. Plenary sessions were held at the start and conclusion of the meeting while seven concurrent topical sessions were held during the intervening day and a half. Session chairmen from each of these concurrent sessions presented a summary of the discussion and conclusions resulting from their respective sessions at the final plenary session

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

International Nuclear Information System (INIS)

Kemp, A.G.; MacDonald, Bruce

1995-01-01

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

Cost-effectiveness optimization of a solar hot water heater with integrated storage system

International Nuclear Information System (INIS)

Kamaruzzaman Sopian; Syahri, M.; Shahrir, A.; Mohd Yusof Othman; Baharuddin Yatim

2006-01-01

Solar processes are generally characterized by high first cost and low operating costs. Therefore, the basic economic problem is one of comparing an initial known investment with estimated future operating cost. This paper present the cost-benefit ratio of solar collector with integrated storage system. Evaluation of the annual cost (AC) and the annual energy gain (AEG) of the collector are performed and the ratio of AC/AEG or the cost benefit ratio is presented for difference combination of mass flow rate, solar collector length and channel depth. Using these cost-effectiveness curves, the user can select optimum design features, which correspond to minimum AC/AEG

Economic evaluation comparing intraoperative cone beam CT-based navigation and conventional fluoroscopy for the placement of spinal pedicle screws: a patient-level data cost-effectiveness analysis.

Science.gov (United States)

Dea, Nicolas; Fisher, Charles G; Batke, Juliet; Strelzow, Jason; Mendelsohn, Daniel; Paquette, Scott J; Kwon, Brian K; Boyd, Michael D; Dvorak, Marcel F S; Street, John T

2016-01-01

Pedicle screws are routinely used in contemporary spinal surgery. Screw misplacement may be asymptomatic but is also correlated with potential adverse events. Computer-assisted surgery (CAS) has been associated with improved screw placement accuracy rates. However, this technology has substantial acquisition and maintenance costs. Despite its increasing usage, no rigorous full economic evaluation comparing this technology to current standard of care has been reported. Medical costs are exploding in an unsustainable way. Health economic theory requires that medical equipment costs be compared with expected benefits. To answer this question for computer-assisted spinal surgery, we present an economic evaluation looking specifically at symptomatic misplaced screws leading to reoperation secondary to neurologic deficits or biomechanical concerns. The study design was an observational case-control study from prospectively collected data of consecutive patients treated with the aid of CAS (treatment group) compared with a matched historical cohort of patients treated with conventional fluoroscopy (control group). The patient sample consisted of consecutive patients treated surgically at a quaternary academic center. The primary effectiveness measure studied was the number of reoperations for misplaced screws within 1 year of the index surgery. Secondary outcome measures included were total adverse event rate and postoperative computed tomography usage for pedicle screw examination. A patient-level data cost-effectiveness analysis from the hospital perspective was conducted to determine the value of a navigation system coupled with intraoperative 3-D imaging (O-arm Imaging and the StealthStation S7 Navigation Systems, Medtronic, Louisville, CO, USA) in adult spinal surgery. The capital costs for both alternatives were reported as equivalent annual costs based on the annuitization of capital expenditures method using a 3% discount rate and a 7-year amortization period

Cost effectiveness of tobacco control policies in Vietnam: the case of population-level interventions.

Science.gov (United States)

Higashi, Hideki; Truong, Khoa D; Barendregt, Jan J; Nguyen, Phuong K; Vuong, Mai L; Nguyen, Thuy T; Hoang, Phuong T; Wallace, Angela L; Tran, Tien V; Le, Cuong Q; Doran, Christopher M

2011-05-01

Tobacco smoking is one of the leading public health problems in the world. It is also possible to prevent and/or reduce the harm from tobacco use through the use of cost-effective tobacco control measures. However, most of this evidence comes from developed countries and little research has been conducted on this issue in developing countries. The objective of this study was to analyse the cost effectiveness of four population-level tobacco control interventions in Vietnam. Four tobacco control interventions were evaluated: excise tax increase; graphic warning labels on cigarette packs; mass media campaigns; and smoking bans (in public or in work places). A multi-state life table model was constructed in Microsoft® Excel to examine the cost effectiveness of the tobacco control intervention options. A government perspective was adopted, with costing conducted using a bottom-up approach. Health improvement was considered in terms of disability-adjusted life-years (DALYs) averted. All assumptions were subject to sensitivity and uncertainty analysis. All the interventions fell within the definition of being very cost effective according to the threshold level suggested by the WHO (i.e. place smoking bans. If the cost offset was included in the analysis, all interventions would provide cost savings to the government health sector. All four interventions to reduce the harm from tobacco use appear to be highly cost effective and should be considered as priorities in the context of Vietnam. The government may initially consider graphic warning labels and tax increase, followed by other interventions.

Economic Cost of Breast Cancer in Ghana: The Komfo Anokye ...

African Journals Online (AJOL)

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 ...

Is there an optimum level for renewable energy?

International Nuclear Information System (INIS)

Moriarty, Patrick; Honnery, Damon

2011-01-01

Because continued heavy use of fossil fuel will lead to both global climate change and resource depletion of easily accessible fuels, many researchers advocate a rapid transition to renewable energy (RE) sources. In this paper we examine whether RE can provide anywhere near the levels of primary energy forecast by various official organisations in a business-as-usual world. We find that the energy costs of energy will rise in a non-linear manner as total annual primary RE output increases. In addition, increasing levels of RE will lead to increasing levels of ecosystem maintenance energy costs per unit of primary energy output. The result is that there is an optimum level of primary energy output, in the sense that the sustainable level of energy available to the economy is maximised at that level. We further argue that this optimum occurs at levels well below the energy consumption forecasts for a few decades hence. - Highlights: → We need to shift to renewable energy for climate change and fuel depletion reasons. → We examine whether renewable energy can provide the primary energy levels forecast. → The energy costs of energy rise non-linearly with renewable energy output. → There is thus an optimum level of primary energy output. → This optimum occurs at levels well below future official energy use forecasts.

Understanding cost of care for patients on renal replacement therapy: looking beyond fixed tariffs.

Science.gov (United States)

Li, Bernadette; Cairns, John A; Fotheringham, James; Tomson, Charles R; Forsythe, John L; Watson, Christopher; Metcalfe, Wendy; Fogarty, Damian G; Draper, Heather; Oniscu, Gabriel C; Dudley, Christopher; Johnson, Rachel J; Roderick, Paul; Leydon, Geraldine; Bradley, J Andrew; Ravanan, Rommel

2015-10-01

In a number of countries, reimbursement to hospitals providing renal dialysis services is set according to a fixed tariff. While the cost of maintenance dialysis and transplant surgery are amenable to a system of fixed tariffs, patients with established renal failure commonly present with comorbid conditions that can lead to variations in the need for hospitalization beyond the provision of renal replacement therapy. Patient-level cost data for incident renal replacement therapy patients in England were obtained as a result of linkage of the Hospital Episodes Statistics dataset to UK Renal Registry data. Regression models were developed to explore variations in hospital costs in relation to treatment modality, number of years on treatment and factors such as age and comorbidities. The final models were then used to predict annual costs for patients with different sets of characteristics. Excluding the cost of renal replacement therapy itself, inpatient costs generally decreased with number of years on treatment for haemodialysis and transplant patients, whereas costs for patients receiving peritoneal dialysis remained constant. Diabetes was associated with higher mean annual costs for all patients irrespective of treatment modality and hospital setting. Age did not have a consistent effect on costs. Combining predicted hospital costs with the fixed costs of renal replacement therapy showed that the total cost differential for a patient continuing on dialysis rather than receiving a transplant is considerable following the first year of renal replacement therapy, thus reinforcing the longer-term economic advantage of transplantation over dialysis for the health service. © The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

The cost and benefit analysis of a contaminated area remediation: case study of dose level selection

Energy Technology Data Exchange (ETDEWEB)

Lauria, D.C. [Instituto de Radioproteccion e Dosimetria- IRD/CNEN, Av. Salvador Allende s/n, Barra de Tijuca, Rio de Janeiro- RJ (Brazil)]. e-mail: dejanira@ird.gov.br

2006-07-01

In recent years there has been an increasing awareness of the radiological impact of non-nuclear industries that extract and/or process ores and minerals containing naturally occurring radioactive material (NORM). Without radiological rules, these industrial activities may result in significant radioactive contamination of installations and sites. Depending on the potential hazardous to the environment and public health, the radioactive contaminated sites may require remediation. The extent of the site cleanup is a function of the size, localization, complexity, potential risks and on possible future uses envisioned for the site. Since worker and public health, public anxiety and economics factors are involved; the selection of an appropriate dose level can be quite complicated. This paper discusses the selection of a dose level criterion to remedy a site, which was contaminated by wastes from monazite processing. The site is located in the Sao Paulo city; the most densely populated Brazilian City. In its 60,000 square meters of area, a preliminary survey showed contaminated zones covering an area of 6,500 square meters. In some places, contamination was found below the superficial layer of the soil, being the radionuclide vertical distribution not uniform. The {sup 228} Ra soil activity concentration reached values up to 33,000 Bq/kg while those for {sup 226} Ra reached values up to 6,700 Bq/kg. Based on pathway analysis model and considering both the current land use and a hypothetical residential scenario, the residual contamination levels of radionuclides in soil have been derived for dose values of 10 mSv/y (dose level for intervention), 5 mSv/y, 3 mSv/y, 1 mSv/y (dose limit for practices) and 0.3 mSv/y (dose constraint for practices). An optimized value o f annual dose of about 5 mSv/y would be a good option for intervention level, but taking into account the public concern and anxiety, the site location and size, and the remediation costs, it is suggested

The cost and benefit analysis of a contaminated area remediation: case study of dose level selection

International Nuclear Information System (INIS)

Lauria, D.C.

2006-01-01

In recent years there has been an increasing awareness of the radiological impact of non-nuclear industries that extract and/or process ores and minerals containing naturally occurring radioactive material (NORM). Without radiological rules, these industrial activities may result in significant radioactive contamination of installations and sites. Depending on the potential hazardous to the environment and public health, the radioactive contaminated sites may require remediation. The extent of the site cleanup is a function of the size, localization, complexity, potential risks and on possible future uses envisioned for the site. Since worker and public health, public anxiety and economics factors are involved; the selection of an appropriate dose level can be quite complicated. This paper discusses the selection of a dose level criterion to remedy a site, which was contaminated by wastes from monazite processing. The site is located in the Sao Paulo city; the most densely populated Brazilian City. In its 60,000 square meters of area, a preliminary survey showed contaminated zones covering an area of 6,500 square meters. In some places, contamination was found below the superficial layer of the soil, being the radionuclide vertical distribution not uniform. The 228 Ra soil activity concentration reached values up to 33,000 Bq/kg while those for 226 Ra reached values up to 6,700 Bq/kg. Based on pathway analysis model and considering both the current land use and a hypothetical residential scenario, the residual contamination levels of radionuclides in soil have been derived for dose values of 10 mSv/y (dose level for intervention), 5 mSv/y, 3 mSv/y, 1 mSv/y (dose limit for practices) and 0.3 mSv/y (dose constraint for practices). An optimized value o f annual dose of about 5 mSv/y would be a good option for intervention level, but taking into account the public concern and anxiety, the site location and size, and the remediation costs, it is suggested the

Comparison of costs for solidification of high-level radioactive waste solutions: glass monoliths vs metal matrices

International Nuclear Information System (INIS)

Jardine, L.J.; Carlton, R.E.; Steindler, M.J.

1981-05-01

A comparative economic analysis was made of four solidification processes for liquid high-level radioactive waste. Two processes produced borosilicate glass monoliths and two others produced metal matrix composites of lead and borosilicate glass beads and lead and supercalcine pellets. Within the uncertainties of the cost (1979 dollars) estimates, the cost of the four processes was about the same, with the major cost component being the cost of the primary building structure. Equipment costs and operating and maintenance costs formed only a small portion of the building structure costs for all processes

An Alternative Method for Computing Unit Costs and Productivity Ratios. AIR 1984 Annual Forum Paper.

Science.gov (United States)

Winstead, Wayland H.; And Others

An alternative measure for evaluating the performance of academic departments was studied. A comparison was made with the traditional manner for computing unit costs and productivity ratios: prorating the salary and effort of each faculty member to each course level based on the personal mix of course taught. The alternative method used averaging…

Hardwood sawmill downtime costs

Science.gov (United States)

Jan Wiedenbeck; Kyle Blackwell

2003-01-01

How time flies when you don't pay attention to it. With hardwood sawmill operating costs ranging from $4 to $25 per operating minute ($95/MBF to $335/MBF) and gross profit margins ranging from $0.10/BF to $0.35/BF, five extra minutes of downtime per day will cost a sawmill that produces an average of 20,000 BF per day (5 MMBF annually) between $21 and $73 per day...

Moderation of the Relation of County-Level Cost of Living to Nutrition by the Supplemental Nutrition Assistance Program.

Science.gov (United States)

Basu, Sanjay; Wimer, Christopher; Seligman, Hilary

2016-11-01

To examine the association of county-level cost of living with nutrition among low-income Americans. We used the National Household Food Acquisition and Purchase Survey (2012-2013; n = 14 313; including 5414 persons in households participating in the Supplemental Nutrition Assistance Program [SNAP]) to examine associations between county-level cost-of-living metrics and both food acquisitions and the Healthy Eating Index, with control for individual-, household-, and county-level covariates and accounting for unmeasured confounders influencing both area of living and food acquisition. Living in a higher-cost county-particularly one with high rent costs-was associated with significantly lower volume of acquired vegetables, fruits, and whole grains; greater volume of acquired refined grains, fats and oils, and added sugars; and an 11% lower Healthy Eating Index score. Participation in SNAP was associated with nutritional improvements among persons living in higher-cost counties. Living in a higher-cost county (particularly with high rent costs) is associated with poorer nutrition among low-income Americans, and SNAP may mitigate the negative nutritional impact of high cost of living.

FY 2012 Lightweight Materials Annual Report

Energy Technology Data Exchange (ETDEWEB)

None

2013-04-15

The FY 2012 Annual Progress Report for Lightweight Materials provides a detailed description of the activities and technical accomplishments which focuses on the development and validation of advanced materials and manufacturing technologies to significantly reduce light and heavy duty vehicle weight without compromising other attributes such as safety, performance, recyclability, and cost.

7 CFR 3560.308 - Annual financial reports.

Science.gov (United States)

2010-01-01

... AGRICULTURE DIRECT MULTI-FAMILY HOUSING LOANS AND GRANTS Financial Management § 3560.308 Annual financial... audit in accordance with generally accepted government auditing standards (GAGAS). Costs incurred to... requirements: (1) Borrowers must use an Agency approved engagement letter. Borrowers must submit the results of...

Cost analysis of operating an all-digital radiology department

International Nuclear Information System (INIS)

Arenson, R.L.; Soshadri, S.B.; DeSimone, D.; Hiss, S.S.

1988-01-01

Using the current film system as a baseline, this study analyzes the cost of digital acquisition, transmission, archiving, and display of all images generated in our department. Two approaches are considered: (1) conventional x-ray films are digitized with a laser scanning film digitizer; (2) images are captured with a direct digital receptor and no film is created. In both approaches, images from digital modalities are acquired directly from the scanners. The cost of equipment and its maintenance, film, supplies, storage space, operations, personnel, and so forth are analyzed for all approaches. The annual cost of operating the film system is $2.5 million. The estimated annual cost is $2.3 million for the first digital approach, $1.8 million for the second. This analysis demonstrates that these digital approaches can be cost-effective, viable alternatives to film-bases systems

A workplace physical activity program at a public university in Mexico can reduce medical costs associated with type 2 diabetes and hypertension.

Science.gov (United States)

Méndez-Hernández, Pablo; Dosamantes-Carrasco, Darina; Siani, Carole; Flores, Yvonne N; Arredondo, Armando; Lumbreras-Delgado, Irma; Granados-García, Víctor M; Denova-Gutiérrez, Edgar; Gallegos-Carrillo, Katia; Salmerón, Jorge

2012-01-01

To assess the impact of a workplace leisure physical activity program on healthcare expenditures for type 2 diabetes and hypertension treatment. We assessed a workplace program's potential to reduce costs by multiplying the annual healthcare costs of patients with type 2 diabetes and hypertension by the population attributable risk fraction of non-recommended physical activity levels. Feasibility of a physical activity program was assessed among 425 employees of a public university in Mexico. If 400 sedentary employees engaged in a physical activity program to decrease their risk of diabetes and hypertension, the potential annual healthcare cost reduction would be 138 880 US dollars. Each dollar invested in physical activity could reduce treatment costs of both diseases by 5.3 dollars. This research meets the call to use health economics methods to re-appraise health priorities, and devise strategies for optimal allocation of financial resources in the health sector.

All-Cause and Acute Pancreatitis Health Care Costs in Patients With Severe Hypertriglyceridemia.

Science.gov (United States)

Rashid, Nazia; Sharma, Puza P; Scott, Ronald D; Lin, Kathy J; Toth, Peter P

2017-01-01

The aim of this study was to assess health care utilization and costs related to acute pancreatitis (AP) in patients with severe hypertriglyceridemia (sHTG) levels. Patients with sHTG levels 1000 mg/dL or higher were identified from January 1, 2007, to June 30, 2013. The first identified incident triglyceride level was labeled as index date. All-cause, AP-related health care visits, and mean total all-cause costs in patients with and without AP were compared during 12 months postindex. A generalized linear model regression was used to compare costs while controlling for patient characteristics and comorbidities. Five thousand five hundred fifty sHTG patients were identified, and 5.4% of these patients developed AP during postindex. Patients with AP had significantly (P < 0.05) more all-cause outpatient visits, hospitalizations, longer length of stays during the hospital visits, and emergency department visits versus patients without AP. Mean (SD) unadjusted all-cause health care costs in the 12 months postindex were $25,343 ($33,139) for patients with AP compared with $15,195 ($24,040) for patients with no AP. The regression showed annual all-cause costs were 49.9% higher (P < 0.01) for patients with AP versus without AP. Patients who developed AP were associated with higher costs; managing patients with sHTG at risk of developing AP may help reduce unnecessary costs.

1998 annual report

International Nuclear Information System (INIS)

1999-01-01

Talisman Energy Inc. is the largest Canadian-based independent oil and gas producer. Its main business activities include exploration, development, production and marketing of natural gas, natural gas liquids and crude oil. Main operating centres are in Canada, the North Sea, Indonesia and Sudan. Talisman Energy is also pursuing a number of high potential exploration ventures in Algeria and Trinidad. The Company has experienced a 30 per cent annual production growth rate over the last five years and has consistently increased its reserve base, while maintaining competitive finding and development costs. This report contains an extensive review of activities and achievements in each of Talisman Energy Inc.'s exploration and operating areas during 1998, a consolidated financial statement, a management discussion and analysis of production and financial performance, and a review of corporate governance. Future prospects are also discussed. Continued growth of 10 to 15 per cent annually over the next two years is anticipated as a result of management's current investment program. tabs

Cost and cost-effectiveness analysis of a community mobilisation intervention to reduce intimate partner violence in Kampala, Uganda.

Science.gov (United States)

Michaels-Igbokwe, Christine; Abramsky, Tanya; Devries, Karen; Michau, Lori; Musuya, Tina; Watts, Charlotte

2016-02-29

Intimate partner violence (IPV) poses a major public health concern. To date there are few rigorous economic evaluations of interventions aimed at preventing IPV in low-income settings. This study provides a cost and cost effectiveness analysis of SASA!, a community mobilisation intervention to change social norms and prevent IPV. An economic evaluation alongside a cluster randomised controlled trial. Both financial and economic costs were collected retrospectively from the provider's perspective to generate total and unit cost estimates over four years of intervention programming. Univariate sensitivity analysis is conducted to estimate the impact of uncertainty in cost and outcome measures on results. The total cost of developing the SASA! Activist Kit is estimated as US$138,598. Total intervention costs over four years are estimated as US$553,252. The annual cost of supporting 351 activists to conduct SASA! activities was approximately US$389 per activist and the average cost per person reached in intervention communities was US$21 over the full course of the intervention, or US$5 annually. The primary trial outcome was past year experience of physical IPV with an estimated 1201 cases averted (90% CI: 97-2307 cases averted). The estimated cost per case of past year IPV averted was US$460. This study provides the first economic evaluation of a community mobilisation intervention aimed at preventing IPV. SASA! unit costs compare favourably with gender transformative interventions and support services for survivors of IPV. ClinicalTrials.gov # NCT00790959.

Pyrimethanil degradation by photo-Fenton process: Influence of iron and irradiance level on treatment cost.

Science.gov (United States)

Cabrera Reina, A; Miralles-Cuevas, S; Casas López, J L; Sánchez Pérez, J A

2017-12-15

This study evaluates the combined effect of photo-catalyst concentration and irradiance level on photo-Fenton efficiency when this treatment is applied to industrial wastewater decontamination. Three levels of irradiance (18, 32 and 46W/m 2 ) and three iron concentrations (8, 20 and 32mg/L) were selected and their influence over the process studied using a raceway pond reactor placed inside a solar box. For 8mg/L, it was found that there was a lack of catalyst to make use of all the available photons. For 20mg/L, the treatment always improved with irradiance indicating that the process was photo-limited. For 32mg/L, the excess of iron caused an excess of radicals production which proved to be counter-productive for the overall process efficiency. The economic assessment showed that acquisition and maintenance costs represent the lowest relative values. The highest cost was found to be the cost of the reagents consumed. Both sulfuric acid and sodium hydroxide are negligible in terms of costs. Iron cost percentages were also very low and never higher than 10.5% while the highest cost was always that of hydrogen peroxide, representing at least 85% of the reagent costs. Thus, the total costs were between 0.76 and 1.39€/m 3 . Copyright © 2017 Elsevier B.V. All rights reserved.

Survey of State-Level Cost and Benefit Estimates of Renewable Portfolio Standards

Energy Technology Data Exchange (ETDEWEB)

Heeter, J.; Barbose, G.; Bird, L.; Weaver, S.; Flores-Espino, F.; Kuskova-Burns, K.; Wiser, R.

2014-05-01

Most renewable portfolio standards (RPS) have five or more years of implementation experience, enabling an assessment of their costs and benefits. Understanding RPS costs and benefits is essential for policymakers evaluating existing RPS policies, assessing the need for modifications, and considering new policies. This study provides an overview of methods used to estimate RPS compliance costs and benefits, based on available data and estimates issued by utilities and regulators. Over the 2010-2012 period, average incremental RPS compliance costs in the United States were equivalent to 0.8% of retail electricity rates, although substantial variation exists around this average, both from year-to-year and across states. The methods used by utilities and regulators to estimate incremental compliance costs vary considerably from state to state and a number of states are currently engaged in processes to refine and standardize their approaches to RPS cost calculation. The report finds that state assessments of RPS benefits have most commonly attempted to quantitatively assess avoided emissions and human health benefits, economic development impacts, and wholesale electricity price savings. Compared to the summary of RPS costs, the summary of RPS benefits is more limited, as relatively few states have undertaken detailed benefits estimates, and then only for a few types of potential policy impacts. In some cases, the same impacts may be captured in the assessment of incremental costs. For these reasons, and because methodologies and level of rigor vary widely, direct comparisons between the estimates of benefits and costs are challenging.

[Financial burden of hepatitis B-related diseases and factors influencing the costs in Shenzhen, China].

Science.gov (United States)

Liang, Sen; Zhang, Shun-xiang; Ma, Qi-shan; Xiao, He-wei; Lü, Qiu-ying; Xie, Xu; Mei, Shu-jiang; Hu, Dong-sheng; Zhou, Bo-ping; Li, Bing; Chen, Jing-fang; Cui, Fu-qiang; Wang, Fu-zhen; Liang, Xiao-feng

2010-12-01

To investigate the direct, indirect and intangible costs due to hepatitis B-related diseases and to explore main factors associated with the costs in Shenzhen. Cluster sampling for cases collected consecutively during the study period was administrated. Subjects were selected from eligible hepatitis B-related patients. By pre-trained professional investigators, health economics-related information was collected, using a structured questionnaire. Hospitalization expenses were obtained through hospital records after the patients were discharged from hospital. Total economic burden of hepatitis B-related patients would involve direct, indirect and intangible costs. Direct costs were further divided into direct medical costs and direct nonmedical costs. Human Capital Approach was employed to measure the indirect costs both on patients and the caregivers in 1-year time span. Willing to pay method was used to estimate the intangible costs. Multiple linear stepwise regression models were conducted to determine the factors linked to the economic burden. On average, the total annual cost of per patient with hepatitis B-related diseases was 81 590.23 RMB Yuan. Among which, direct, indirect and intangible costs were 30 914.79 Yuan (account for 37.9%), 15 258.01 Yuan (18.7%), 35 417.43 Yuan (43.4%), respectively. The total annual costs per patient for hepatocellular carcinoma, severe hepatitis B, decompensated cirrhosis, compensated cirrhosis, chronic hepatitis B and acute hepatitis B were 194 858.40 Yuan, 144 549.20 Yuan, 120 333.60 Yuan, 79 528.81 Yuan, 66 282.46 Yuan and 39 286.81 Yuan, respectively. The ratio of direct to indirect costs based on the base-case estimation foot add to 2.0:1, increased from hepato-cellular carcinoma (0.7:1) to compensated cirrhosis (3.5:1), followed by acute hepatitis B (3.3:1), severe hepatitis B (2.8:1), decompensate cirrhosis (2.3:1) and chronic hepatitis B (2.2:1). Direct medical costs were more than direct nonmedical. Ratio between the

The Societal Benefits and Costs of School Dropout Recovery

Directory of Open Access Journals (Sweden)

James S. Catterall

2011-01-01

Full Text Available This article reports an analysis of the societal benefits and costs of recovering school dropouts. Successful recovery is defined by subsequent graduation from high school. The analysis is based on established estimates of the societal costs of dropping out including reduced government tax collections and higher social costs of welfare, healthcare, and crime. These potential costs are cast as benefits when a dropout is recovered. A large dropout recovery program provides the setting for the analysis. Rigorous attention is given to accurate estimation of the number of students who would not have graduated without the program in the year assessed and to the induced public costs of their continued education. Estimated benefits are weighed against the total annual public costs of the program, which operates in 65 school centers and commands an annual budget of about $70 million. The estimated benefit-cost ratio for this program is 3 to 1, a figure comparable to benefit-cost ratio estimates reported in studies of dropout prevention. The sensitivity of this conclusion to specific assumptions within the analysis is discussed.

Cost-benefit analysis for environmental impacts and radwaste system for nuclear power plant

International Nuclear Information System (INIS)

Mun, K.N.; Yook, C.C.

1982-01-01