WorldWideScience

Sample records for program administrative costs

  1. 20 CFR 641.859 - What other special rules govern the classification of costs as administrative costs or program...

    Science.gov (United States)

    2010-04-01

    ... documented distributions of actual time worked or other equitable cost allocation methods. (d) Specific costs charged to an overhead or indirect cost pool that can be identified directly as a program cost must be... classification of costs as administrative costs or program costs? 641.859 Section 641.859 Employees' Benefits...

  2. The Program Administrator Cost of Saved Energy for Utility Customer-Funded Energy Efficiency Programs

    Energy Technology Data Exchange (ETDEWEB)

    Billingsley, Megan A.; Hoffman, Ian M.; Stuart, Elizabeth; Schiller, Steven R.; Goldman, Charles A.; LaCommare, Kristina

    2014-03-19

    End-use energy efficiency is increasingly being relied upon as a resource for meeting electricity and natural gas utility system needs within the United States. There is a direct connection between the maturation of energy efficiency as a resource and the need for consistent, high-quality data and reporting of efficiency program costs and impacts. To support this effort, LBNL initiated the Cost of Saved Energy Project (CSE Project) and created a Demand-Side Management (DSM) Program Impacts Database to provide a resource for policy makers, regulators, and the efficiency industry as a whole. This study is the first technical report of the LBNL CSE Project and provides an overview of the project scope, approach, and initial findings, including: • Providing a proof of concept that the program-level cost and savings data can be collected, organized, and analyzed in a systematic fashion; • Presenting initial program, sector, and portfolio level results for the program administrator CSE for a recent time period (2009-2011); and • Encouraging state and regional entities to establish common reporting definitions and formats that would make the collection and comparison of CSE data more reliable. The LBNL DSM Program Impacts Database includes the program results reported to state regulators by more than 100 program administrators in 31 states, primarily for the years 2009–2011. In total, we have compiled cost and energy savings data on more than 1,700 programs over one or more program-years for a total of more than 4,000 program-years’ worth of data, providing a rich dataset for analyses. We use the information to report costs-per-unit of electricity and natural gas savings for utility customer-funded, end-use energy efficiency programs. The program administrator CSE values are presented at national, state, and regional levels by market sector (e.g., commercial, industrial, residential) and by program type (e.g., residential whole home programs, commercial new

  3. 45 CFR 96.88 - Administrative costs.

    Science.gov (United States)

    2010-10-01

    ... Assistance Program § 96.88 Administrative costs. (a) Costs of planning and administration. Any expenditure... 45 Public Welfare 1 2010-10-01 2010-10-01 false Administrative costs. 96.88 Section 96.88 Public... be included in determining administrative costs subject to the statutory limitation on administrative...

  4. 20 CFR 632.263 - Administrative costs.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Administrative costs. 632.263 Section 632.263 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR INDIAN AND NATIVE AMERICAN EMPLOYMENT AND TRAINING PROGRAMS Summer Youth Employment and Training Programs § 632.263 Administrative costs...

  5. 45 CFR 1301.32 - Limitations on costs of development and administration of a Head Start program.

    Science.gov (United States)

    2010-10-01

    .../property clerk, janitor for administrative office space, and costs associated with volunteers carrying out... 45 Public Welfare 4 2010-10-01 2010-10-01 false Limitations on costs of development and... and General Administration § 1301.32 Limitations on costs of development and administration of a Head...

  6. 24 CFR 511.71 - Administrative costs.

    Science.gov (United States)

    2010-04-01

    ... cost-sharing agreement with a State grantee (see § 511.51(b)), in carrying out the Rental... costs in carrying out the Rental Rehabilitation Program, whether the unit of general local government... 24 Housing and Urban Development 3 2010-04-01 2010-04-01 false Administrative costs. 511.71...

  7. Low-Cost Generic Program Use by Medicare Beneficiaries: Implications for Medication Exposure Misclassification in Administrative Claims Data.

    Science.gov (United States)

    Pauly, Nathan J; Talbert, Jeffery C; Brown, Joshua

    2016-06-01

    Administrative claims data are used for a wide variety of research and quality assurance purposes; however, they are prone to medication exposure misclassification if medications are purchased without using an insurance benefit. Low-cost generic drug programs (LCGPs) offered at major chain pharmacies are a relatively new and sparsely investigated source of exposure misclassification. LCGP medications are often purchased out of pocket; thus, a pharmacy claim may never be submitted, and the exposure may go unobserved in claims data. As heavy users of medications, Medicare beneficiaries have much to gain from the affordable medications offered through LCGPs. This use may put them at increased risk of exposure misclassification in claims data. Many high-risk medications (HRMs) and medications tracked for adherence and utilization quality metrics are available through LCGPs, and exposure misclassification of these medications may impact the quality assurance efforts reliant on administrative claims data. Presently, there is little information regarding the use of these programs among a geriatric population. To (a) quantify the prevalence of LCGP users in a nationally representative population of Medicare beneficiaries; (b) compare clinical and demographic characteristics of LCGP users and nonusers; (c) assess determinants of LCGP use and medications acquired through these programs; and (d) analyze patterns of LCGP use during the years 2007-2012. This study relied on data from the Medical Expenditure Panel Survey (MEPS) from 2007 to 2012. The first 3 objectives were completed with a cohort of individuals in the most recent MEPS panel, while the fourth objective was completed with a separate cohort composed of individuals who participated in MEPS from 2007 to 2012. Inclusion in either study cohort required that individuals were Medicare beneficiaries aged 65 years or greater, used at least 1 prescription drug during their 2-year panel period, and participated in all 5

  8. 34 CFR 673.7 - Administrative cost allowance.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false Administrative cost allowance. 673.7 Section 673.7... Federal Perkins Loan, FWS, and FSEOG Programs § 673.7 Administrative cost allowance. (a) An institution... allowance for an award year if it advances funds under the Federal Perkins Loan Program, provides FWS...

  9. Cost-Estimation Program

    Science.gov (United States)

    Cox, Brian

    1995-01-01

    COSTIT computer program estimates cost of electronic design by reading item-list file and file containing cost for each item. Accuracy of cost estimate based on accuracy of cost-list file. Written by use of AWK utility for Sun4-series computers running SunOS 4.x and IBM PC-series and compatible computers running MS-DOS. The Sun version (NPO-19587). PC version (NPO-19157).

  10. Child Nutrition Programs. Administrative Manual.

    Science.gov (United States)

    Utah State Office of Education, Salt Lake City.

    Recognizing the importance of efficient and effective program administration for the success of Utah's Child Nutrition Programs, the State Office of Education developed a manual to assist local program administrators in using the U.S. Department of Agriculture's (USDA's) programs. This document contains Part 1 of the manual's four interrelated…

  11. Investigating Cost Implications of Incorporating Level III At-Home Testing into a Polysomnography Based Sleep Medicine Program Using Administrative Data

    Directory of Open Access Journals (Sweden)

    Samuel Alan Stewart

    2017-01-01

    Full Text Available Objective. Obstructive sleep apnea is a common problem, requiring expensive in-lab polysomnography for proper diagnosis. Home monitoring can provide an alternative to in-lab testing for a subset of OSA patients. The objective of this project was to investigate the effect of incorporating home testing into an OSA program at a large, tertiary sleep disorders centre. Methods. The Sleep Disorders Centre in Saskatoon, Canada, has been incorporating at-home testing into their diagnostic pathways since 2006. Administrative data from 2007 to 2013 were extracted (10030 patients and the flow of patients through the program was followed from diagnosis to treatment. Costs were estimated using 2014 pricing and were stratified by disease attributes and sensitivity analysis was applied. Results. The overall costs per patient were $627.40, with $419.20 for at-home testing and $746.20 for in-lab testing. The cost of home management would rise to $515 if all negative tests were required to be confirmed by an in-lab PSG. Discussion. Our review suggests that at-home testing can be cost-effective alternative to in-lab testing when applied to the correct population, specifically, those with a high pretest probability of obstructive sleep apnea and an absence of significant comorbidities.

  12. 24 CFR 92.207 - Eligible administrative and planning costs.

    Science.gov (United States)

    2010-04-01

    ... assistance programs. (b) Staff and overhead. Staff and overhead costs directly related to carrying out the... planning costs. 92.207 Section 92.207 Housing and Urban Development Office of the Secretary, Department of... Prohibited Activities § 92.207 Eligible administrative and planning costs. A participating jurisdiction may...

  13. 24 CFR 583.135 - Administrative costs.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 3 2010-04-01 2010-04-01 false Administrative costs. 583.135... (Continued) OFFICE OF ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT, DEPARTMENT OF HOUSING AND... Administrative costs. (a) General. Up to five percent of any grant awarded under this part may be used for the...

  14. Monthly Program Cost Report (MPCR)

    Data.gov (United States)

    Department of Veterans Affairs — The Monthly Program Cost Report (MPCR) replaces the Cost Distribution Report (CDR). The MPCR provides summary information about Veterans Affairs operational costs,...

  15. Efficiency and administrative costs in primary care.

    Science.gov (United States)

    Giuffrida, A; Gravelle, H; Sutton, M

    2000-11-01

    We use a formal model to examine the implications of endogenous managerial effort for the interpretation and estimation of efficiency in health care organisations. The model is applied to investigate the doubling of the cost of administering primary care in England in real terms between 1989/1990 and 1994/1995. The main cost determinant was the number of general practitioners (GPs), and there were economies of scale but not of scope. Fund-holding had a positive but small effect on administrative costs, so that the recent abolition of fund-holding may do little to reduce primary care administrative costs. After allowing for changes in the numbers of primary care practitioners, the quality of primary care and the extent of fund-holding, most of the increase in costs was unexplained, and may reflect additional but unmeasured increases in the administrative burden associated with the 1990 reforms. There was little variation in relative efficiency across areas.

  16. 7 CFR Appendix A to Part 277 - Principles for Determining Costs Applicable to Administration of the Food Stamp Program by State...

    Science.gov (United States)

    2010-01-01

    ... allowable. (2) Advertising. Advertising media includes newspapers, magazines, radio and television programs, direct mail, trade papers, and the like. The advertising costs allowable are those which are solely for...

  17. 45 CFR 152.6 - Program administration.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Program administration. 152.6 Section 152.6 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS PRE-EXISTING CONDITION INSURANCE PLAN PROGRAM PCIP Program Administration § 152.6 Program administration. (a) General rule. Section 1101(b)(1) of the...

  18. 5 CFR 179.214 - Interest, penalties and administrative costs.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Interest, penalties and administrative costs. 179.214 Section 179.214 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS CLAIMS COLLECTION STANDARDS Salary Offset § 179.214 Interest, penalties and administrative costs...

  19. Administration: Army Congressional Fellowship Program

    National Research Council Canada - National Science Library

    2000-01-01

    This printing publishes a new Army Regulation. This regulation presents the policies and procedures under which the Army manages the Army Congressional Fellowship Program and supplements applicable Department...

  20. 7 CFR 277.9 - Administrative costs principles.

    Science.gov (United States)

    2010-01-01

    ...) Indirect cost. Allowable indirect costs may also be claimed at the 50 percent or higher reimbursement funding level as specified in this part and appendix A. (3) Direct and indirect costs claimed for program... the rates are approved by FNS. (d) All State agency Cost Allocation Plans for determining the costs of...

  1. 45 CFR 607.12 - Interest, penalties, and administrative costs.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Interest, penalties, and administrative costs. 607.12 Section 607.12 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION SALARY OFFSET § 607.12 Interest, penalties, and administrative costs. Charges may be assessed on a...

  2. 24 CFR 1006.230 - Administrative and planning costs.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Administrative and planning costs... Administrative and planning costs. Up to such amount as HUD may authorize, or such other limit as may be... planning expenses of the DHHL relating to carrying out the Act and this part and activities assisted with...

  3. 78 FR 54862 - Information Collection; General Program Administration

    Science.gov (United States)

    2013-09-06

    ... Farm Service Agency Information Collection; General Program Administration AGENCY: Farm Service Agency... Programs (FLP) General Program Administration. The information collected is used to ensure that applicants... INFORMATION: ] Title: Farm Loan Programs, General Program Administration. OMB Control Number: 0560-0238...

  4. 42 CFR 432.55 - Reporting training and administrative costs.

    Science.gov (United States)

    2010-10-01

    .... Costs for staff spending less than full time on training for the Medicaid program must be allocated...); and (2) Cost of employing students on a temporary basis, for instance, during summer vacation. ...

  5. Brazilian residential sector demand administration programs: opportunities, costs and barriers; Programas de administracao da demanda para o setor residencial brasileiro: oportunidades, custos e barreiras

    Energy Technology Data Exchange (ETDEWEB)

    Jannuzzi, Gilberto de Martino [Universidade Estadual de Campinas, SP (Brazil). Faculdade de Engenharia Mecanica; Santos, Vanice Ferreira dos; Ugaya, Cassia Maria Lie; Madureira, Ronaldo Goncalves; Salcedo, Marco Vinicio Yanez [Universidade Estadual de Campinas, SP (Brazil)

    1995-12-31

    This work aims to present some results and discussions concerning the implementation of demand side management projects for the Brazilian residential sector. The economic advantages of these programs for the electric power utilities is presented as well as the barriers and problems. The opportunities for the application of such programs in a national level are presented and the expected difficulties discussed. A case study is presented 3 tabs., 3 refs.

  6. School Administrator's Guide to Implementing Language Programming

    Science.gov (United States)

    Alberta Education, 2007

    2007-01-01

    The "School Administrator's Guide to Implementing Language Programming" serves as a starting point to plan for and implement language programming. It provides a general overview; suggests practical strategies for working with students, parents, teachers and the surrounding community; and includes details on areas to address in selecting…

  7. Cost-minimization of mabthera intravenous versus subcutaneous administration

    NARCIS (Netherlands)

    Bax, P.; Postma, M.J.

    2013-01-01

    Objectives: To identify and compare all costs related to preparing and administrating MabThera for the intravenous and subcutaneous formulations in Dutch hematological patients. The a priori notion is that the costs of subcutaneous MabThera injections are lower compared to intravenous infusion due

  8. Recasting Educational Administration Programs as Learning Organizations.

    Science.gov (United States)

    Calabrese, Raymond L.; Shoho, Alan

    2000-01-01

    Presents a model for overcoming traditional, culturally rooted resistance to change in educational administration programs. The systems model offered proceeds from the premise that reflective awareness is the starting point for change. Aligning the operator, engineer, and executive cultures within a university enables the development of a…

  9. Corporation Income Tax and Administrative Costs of the Public Sector

    Directory of Open Access Journals (Sweden)

    Břetislav Andrlík

    2015-01-01

    Full Text Available This contribution examines the issues of measurement of corporate income tax effectiveness in the circumstances of the Czech Republic, referred to as the tax on income of legal persons. The tax on income of legal persons represents a significant part of the public budget revenue, with the volume of collection of CZK 128,002 million in 2012. The theoretical basis for this contribution is the principle of tax system effectiveness, which is one of the principles characterizing a good tax system and is related to costs inherent in a tax system. The contribution defines two existing types of costs expended on the collection of taxes, i. e. administrative costs (direct or indirect and in theory describes excessive tax burden. In this contribution we shall focus on the measurement of direct administrative costs. The measurement of effectiveness of corporation income tax is performed with the use of the full-time equivalent (FTE method, which is based on the classification of revenue authorities’ staff according to their jobs and on the determination of conversion coefficients in order to identify costs related to the collection of a particular tax.A separate part of the article deals with measurement of administrative costs performed by the Organisation for Economic Co-operation and Development on the timeline ranging from year 2009 to 2011. The author of this article performed his own measurements concerning the direct administrative costs related to the collection of tax on income of legal persons in the Czech Republic. Results achieved in the respective monitored years are lower by the average (in the Czech Republic 2 percentage of ca 1.66 percentage points in relation to the average value of direct administrative costs of the Czech tax system.

  10. Product costing program for wood component manufacturers

    Science.gov (United States)

    Adrienn Andersch; Urs Buehlmann; Jeff Palmer; Janice K Wiedenbeck; Steve. Lawser

    2013-01-01

    Accurate and timely product costing information is critically important for companies in planning the optimal utilization of company resources. While an overestimation of product costs can lead to loss of potential business and market share, underestimation of product costs can result in financial losses to the company. This article introduces a product costing program...

  11. 78 FR 13675 - Federal Acquisition Regulation; Submission for OMB Review; Cost Accounting Standards Administration

    Science.gov (United States)

    2013-02-28

    ... Regulation; Submission for OMB Review; Cost Accounting Standards Administration AGENCY: Department of Defense... approved information collection requirement concerning cost accounting standards administration. A notice... Information Collection 9000- 0129, Cost Accounting Standards Administration by any of the following methods...

  12. 77 FR 69441 - Federal Acquisition Regulation; Information Collection; Cost Accounting Standards Administration

    Science.gov (United States)

    2012-11-19

    ... Regulation; Information Collection; Cost Accounting Standards Administration AGENCY: Department of Defense... approved information collection requirement concerning cost accounting standards administration. Public... comments identified by Information Collection 9000- 0129, Cost Accounting Standards Administration by any...

  13. A weatherization manual for LIHEAP policy makers and program administrators

    Energy Technology Data Exchange (ETDEWEB)

    Witherspoon, M.J.; Marabate, R.; Weinhaus, M. [National Association for State Community Service Programs, Washington, DC (United States); Eisenberg, J.F. [Economic Opportunity Research Inst., Arlington, VA (United States)

    1993-09-01

    This manual is designed to provide Low-Income Home Energy Assistance Program (LIHEAP) directors with information about weatherization and innovative ways they can utilize LIHEAP funds for weatherization activities. It contains a description of innovative weatherization programs which demonstrate creative uses of LIHEAP funds in weatherization activities. In many of the innovative examples, state and local administrators are coordinating their LIHEAP funds with the US Department of Energy (DOE) Low-Income Weatherization Assistance Program`s funding and with a variety of other federal, state and utility company resources. The innovative programs demonstrate how LIHEAP funds can be used in client education, targeting high energy users, staff training, assessment and audits for weatherization services. The reader will find in the appendices lists of contact persons and further descriptions of the programs highlighted. Although designed with LIHEAP directors in mind, the practices and programs highlighted in this manual are of practical use to any state, local or utility weatherization program administrator. The glossary at the end of the descriptive chapters will assist readers with the terminology used throughout the manual. This manual and the many resource entities cited in its appendices provide ready access to a wealth of state-of-the-art information which could lead to a more cost-effective expenditure of LIBEAP weatherization dollars.

  14. Tax-tariff reform with costs of tax administration

    DEFF Research Database (Denmark)

    Munk, Knud Jørgen

    As is broadly recognized, the straightforward application of the Diamond-Mirrlees (1971) production efficiency theorem implies that when lump-sum taxation is not available, then it is optimal for the government in a small open economy to rely on taxes on the net demand of ouseholds rather than...... on border taxes to finance its resource requirements. However, the theorem does not hold when taxation is associated with administrative costs. The present paper explores the implications of taking into account the costs of tax administration for optimal taxation and for desirable directions of tax......-tariff reform in countries at different levels of economic development. The paper clarifies the reasons for, and lends support to, the criticism by Stiglitz (2003) of the IMF and the World Bank's recommendation to developing countries to adopt VAT to replace border taxes....

  15. Federal Aviation Administration retained savings program proposal

    Energy Technology Data Exchange (ETDEWEB)

    Hostick, D.J.; Larson, L.L. [Pacific Northwest National Lab., Richland, WA (United States); Hostick, C.J. [IBP, Inc., Pasco, WA (United States)

    1998-03-01

    Federal legislation allows federal agencies to retain up to 50% of the savings associated with implementing energy efficiency and water conservation measures and practices. Given budget pressures to reduce expenditures, the use of retained savings to fund additional projects represents a source of funds outside of the traditional budget cycle. The Southwest Region Federal Aviation Administration (FAA) has tasked Pacific Northwest National Laboratory (PNNL) to develop a model retained savings program for Southwest Region FAA use and as a prototype for consideration by the FAA. PNNL recommends the following steps be taken in developing a Southwest Region FAA retained savings program: Establish a retained savings mechanism. Determine the level at which the retained savings should be consolidated into a fund. The preliminary recommendation is to establish a revolving efficiency loan fund at the regional level. Such a mechanism allows some consolidation of savings to fund larger projects, while maintaining a sense of facility ownership in that the funds will remain within the region.

  16. 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.

  17. 34 CFR 363.51 - What are the allowable administrative costs?

    Science.gov (United States)

    2010-07-01

    ... than five percent of a State's allotment may be expended for administrative costs for carrying out this... 34 Education 2 2010-07-01 2010-07-01 false What are the allowable administrative costs? 363.51... administrative costs? (a) Administrative costs—general. Expenditures are allowable for the following...

  18. School District Program Cost Accounting: An Alternative Approach

    Science.gov (United States)

    Hentschke, Guilbert C.

    1975-01-01

    Discusses the value for school districts of a program cost accounting system and examines different approaches to generating program cost data, with particular emphasis on the "cost allocation to program system" (CAPS) and the traditional "transaction-based system." (JG)

  19. 45 CFR 286.55 - What types of costs are subject to the administrative cost limit on Tribal Family Assistance...

    Science.gov (United States)

    2010-10-01

    ... computerization and, thus, costs associated with these tasks must be considered administrative costs. (d) Indirect Costs negotiated by BIA, the Department's Division of Cost Allocation, or another federal agency must be... 45 Public Welfare 2 2010-10-01 2010-10-01 false What types of costs are subject to the...

  20. Administrators' Roles in Training Programs and Training Transfer

    Science.gov (United States)

    Ismail, Azman; Hua, Ng Kueh; Ismail, Yusof; Samah, Ainon Jauhariah Abu; Bakar, Rixal Abu; Ibrahim, Nurshahira

    2015-01-01

    An administrator plays a vital role in the growth and development of his/her subordinates. Despite this notion, the role of an administrator in the context of training programs and transfer of training is not well studied. Therefore, this study is set to examine the relationship between administrator's role in training programs and training…

  1. Costs of Integrated Mass Drug Administration for Neglected Tropical Diseases in Haiti

    Science.gov (United States)

    Goldman, Ann S.; Brady, Molly A.; Direny, Abdel; Desir, Luccene; Oscard, Roland; Vely, Jean-Francois; Linehan, Mary; Baker, Margaret

    2011-01-01

    We conducted a cost analysis of Haiti's Ministry of Public Health and Population neglected tropical disease program, Projet des Maladies Tropicales Negligées and collected data for 9 of 55 communes participating in the May 2008–April 2009 mass drug administration (MDA). The Projet des Maladies Tropicales Negligées Program partnered with IMA World Health and Hôpital Ste. Croix to implement MDA for treatment of lymphatic filariasis and soil-transmitted helminthiasis by using once a year treatment with albendazole and diethylcarbamazine in a population of approximately 8 million persons. Methods included analyzing partner financial records and conducting retrospective surveys of personnel. In the nine communes, 633,261 persons were treated at a cost of U.S. $0.64 per person, which included the cost of donated drugs, and at a cost of U.S. $0.42 per person treated, when excluding donated drug costs. The MDA for lymphatic filariasis in Haiti began in 2000, with the treatment of 105,750 persons at a cost per person of U.S. $2.23. The decrease in cost per person treated is the result of cumulative implementation experience and economies of scale. PMID:22049035

  2. Costs of subcutaneous and intravenous administration of trastuzumab for patients with HER2-positive breast cancer

    DEFF Research Database (Denmark)

    Olsen, Jens; Jensen, Kenneth Forsstrøm; Olesen, Daniel Sloth

    2018-01-01

    . administration. The outcome was time estimates. To estimate the administration costs, the time estimates were valued by average gross wages. RESULTS: The iv. administration takes longer time as infusion time is longer (25 or 85 min). The iv. administration is associated with higher cost for 17 cycles; €971...

  3. 7 CFR 246.14 - Program costs.

    Science.gov (United States)

    2010-01-01

    ... the fulfillment of Program objectives are to be considered allowable costs. The two types of nutrition... to two hematological tests for anemia per individual per certification period. The first test shall be to determine anemia status. The second test may be performed only in follow up to a finding of...

  4. Mission possible: creating a technology infrastructure to help reduce administrative costs.

    Science.gov (United States)

    Alper, Michael

    2003-01-01

    Controlling administrative costs associated with managed care benefits has traditionally been considered a "mission impossible" in healthcare, with the unreasonably high cost of paperwork and administration pushing past the $420 billion mark. Why administrative costs remain a critical problem in healthcare while other industries have alleviated their administrative burdens must be carefully examined. This article looks at the key factors contributing to high administrative costs and how these costs can be controlled in the future with "mission possible" tools, including business process outsourcing, IT outsourcing, technology that helps to bring "consumerism" to managed care, and an IT infrastructure that improves quality and outcomes.

  5. 75 FR 78798 - Airport Improvement Program: Proposed Changes to Benefit Cost Analysis (BCA) Threshold

    Science.gov (United States)

    2010-12-16

    ... Federal Aviation Administration Airport Improvement Program: Proposed Changes to Benefit Cost Analysis... requiring benefit cost analyses (BCA) for capacity projects when applying for Airport Improvement Program... Friday, except Federal holidays. Privacy: We will post all comments we receive, without change, to http...

  6. 22 CFR 62.10 - Program administration.

    Science.gov (United States)

    2010-04-01

    ... into the United States; (4) Housing; (5) Fees payable to the sponsor; (6) Other costs that the exchange... community resources (e.g., public transportation, medical centers, schools, libraries, recreation centers...

  7. 42 CFR 457.910 - State program administration.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false State program administration. 457.910 Section 457.910 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES Program Integrity § 457.910 State program...

  8. Cost Functions for Airframe Production Programs.

    Science.gov (United States)

    1982-07-01

    were the foundation for the present study. D. Aproach Our goal of unifying the previously separate methods of describing program costs led us to adopt...and procedures on other program data. 4. Write the final report. The first task was to conduct a detailed residual analysis and sensitivity analysis...variables in (3.104), it is possible to write Q as a function of Z. Q(Z) = k1 [-AOZ’(T)/-Il/0 z(t) 1-6 ) Z"[I-Z-1(T)Z" I-I/dZ. (3.105) This integral

  9. 34 CFR 461.40 - What are the State and local administrative costs requirements?

    Science.gov (United States)

    2010-07-01

    ... remainder may be used for local administrative costs—noninstructional expenses, including planning... administrative cost limits under paragraph (b)(2) of this section are insufficient for adequate planning... 34 Education 3 2010-07-01 2010-07-01 false What are the State and local administrative costs...

  10. Cost savings associated with using immunization information systems for Vaccines for Children administrative tasks.

    Science.gov (United States)

    Bartlett, Diana L; Washington, Michael L; Bryant, Amanda; Thurston, Norman; Perfili, Christine A

    2007-01-01

    Our objective was to investigate the potential cost savings of immunization information systems (IIS) in performing some administrative tasks associated with the federal Vaccines for Children (VFC) program at the state and practice levels. VFC is an entitlement program providing free vaccine to eligible children. We timed the staff of the Utah Department of Health (UDOH) and 72 private VFC practices for administrative VFC-related tasks from September 2003 through March 2004. Time measurements included time for practices to produce VFC reports and for UDOH staff to assess practice coverage levels and process VFC reports manually or via the Utah Statewide Immunization Information System (USIIS). Median cost savings to the state health department could be as much as $11 740 annually. Utah VFC practices could save up to a maximum of $446 annually per practice by using USIIS for VFC tasks. If applied to the 218 enrolled private practices statewide, this would result in a median total cost savings of $17,615 ($15,519 for reports and $2,096 for pulling medical charts).

  11. 48 CFR 52.230-6 - Administration of Cost Accounting Standards.

    Science.gov (United States)

    2010-10-01

    ... Clauses 52.230-6 Administration of Cost Accounting Standards. As prescribed in 30.201-4(d)(1), insert the following clause: Administration of Cost Accounting Standards (JUN 2010) For the purpose of administering the Cost Accounting Standards (CAS) requirements under this contract, the Contractor shall take the...

  12. 75 FR 3236 - Federal Acquisition Regulation; Submission for OMB Review; Cost Accounting Standards Administration

    Science.gov (United States)

    2010-01-20

    ... Regulation; Submission for OMB Review; Cost Accounting Standards Administration AGENCIES: Department of... requirement concerning cost accounting standards administration. A request for public comments was published... and the provision at 52.230-5 include pertinent rules and regulations related to the Cost Accounting...

  13. 76 FR 65769 - Airport Improvement Program: Modifications to Benefit Cost Analysis (BCA) Threshold

    Science.gov (United States)

    2011-10-24

    ... Federal Aviation Administration Airport Improvement Program: Modifications to Benefit Cost Analysis (BCA... Airport Improvement Program (AIP) discretionary funds. On December 16, 2010, the FAA issued a Notice of... which BCAs are required from $5 million to $10 million in Airport Improvement Program (AIP...

  14. Program Administration | Division of Cancer Prevention

    Science.gov (United States)

    Governance Structure Recognizing the importance of an integrated approach to preventative drug development, there is a unified Governance Structure for the PREVENT Program responsible for coordinating and integrating available resources. With the goal of reaching go/no-go decisions as efficiently as possible, the purpose is to ensure a pragmatic approach to drug development and a clear path to market. |

  15. Developing Program of Creative Leadership for School Administrators

    Directory of Open Access Journals (Sweden)

    Wattana Pakika

    2017-11-01

    Full Text Available The purposes of the research were 1 to investigate components and indicators for creating creative leadership of school administrators, 2 to analyze current conditions, strategies and needs for creating the leadership,3 to develop a program for fostering creative leadership for school administrators and 4 to evaluate results of the program implementation. The research methodology was divided into 4 phases: 1 study of components and indicators for creative leadership from seven experts, 2 analysis of current situation and strategies for developing creative leadership program based on the data collected from 1,225 sample subjects, 3 design of a creative leadership program for school administrators assessed by seven experts, and 4 implementation of the program to ten school administrators. The thirty key informants for the leadership development program consisted of school administrators, academicians, and chairmen of the basic education committee. The statistics using for data analysis included the percentage, mean, standard deviation, modified priority needs index (PNImodified, and t-test. The results of the research were as follows: 1 The findings indicted that there were four key components, each comprising several indicators. These components and indicators for creative leadership consisted of imagination with three indicators: creative ideas, humor and a problem-solving, flexibility with three indicators: independent thinking ability, adaptability, and modernization/ acceptance of new ideas ; vision with three indicators: creation, promotion and implementation and trustworthiness with three indicators: extroversion, confidence and support for others.2 the overall condition of the creative leadership of school administrators was at a high level, and the overall need of the school administrators for creating creative leadership was at the highest level. Four strategies regarding of creating creative leadership were training, self study, field

  16. 31 CFR 205.18 - Are administrative costs subject to this part?

    Science.gov (United States)

    2010-07-01

    ... payroll is monthly, or one-sixth of its quarterly administrative costs if payroll is semi-monthly. (2) If... or other system under an approved cost allocation plan, the State will draw down funds to meet cash...

  17. Good agreement between questionnaire and administrative databases for health care use and costs in patients with osteoarthritis

    Directory of Open Access Journals (Sweden)

    Robertson M Clare

    2011-04-01

    Full Text Available Abstract Background Estimating costs is essential to the economic analysis of health care programs. Health care costs are often captured from administrative databases or by patient report. Administrative records only provide a partial representation of health care costs and have additional limitations. Patient-completed questionnaires may allow a broader representation of health care costs; however the validity and feasibility of such methods have not been firmly established. This study was conducted to assess the validity and feasibility of using a patient-completed questionnaire to capture health care use and costs for patients with osteoarthritis, and to compare the research costs of the data-capture methods. Methods We designed a patient questionnaire and applied it in a clinical trial. We captured equivalent data from four administrative databases. We evaluated aspects of the questionnaire's validity using sensitivity and specificity, Lin's concordance correlation coefficient (ρc, and Bland-Altman comparisons. Results The questionnaire's response rate was 89%. Acceptable sensitivity and specificity levels were found for all types of health care use. The numbers of visits and the majority of medications reported by patients were in agreement with the database-derived estimates (ρc > 0.40. Total cost estimates from the questionnaire agreed with those from the databases. Patient-reported co-payments agreed with administrative records with respect to GP office transactions, but not pharmaceutical co-payments. Research costs for the questionnaire-based method were less than one-third of the costs for the databases method. Conclusion A patient-completed questionnaire is feasible for capturing health care use and costs for patients with osteoarthritis, and data collected using it mostly agree with administrative databases. Caution should be exercised when applying unit costs and collecting co-payment data.

  18. Social Security Administration Data for Extra Help with Medicare Prescription Drug Plan Cost

    Data.gov (United States)

    Social Security Administration — This file contains information about Social Security determinations of eligibility for Extra Help with Medicare Prescription Drug Plan Costs. Specific data elements...

  19. 42 CFR 417.564 - Apportionment and allocation of administrative and general costs.

    Science.gov (United States)

    2010-10-01

    ... providing medical care. Enrollment, marketing, and other administrative and general costs that benefit the...) Political and lobbying activities. (4) Charity or courtesy allowances. (5) Spousal education. (6...

  20. 36 CFR 1206.45 - What rules govern subgrant distribution, cost sharing, grant administration, and reporting?

    Science.gov (United States)

    2010-07-01

    ... Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION GENERAL RULES NATIONAL HISTORICAL... funds; (2) Cost sharing and matching requirements; and (3) Reporting. (b) Each participating state is...

  1. The Vital Role of Administrative Cost Allowances to Student Financial Aid Offices: Key Findings from NASFAA's Administrative Cost Allowance Survey, July 2011

    Science.gov (United States)

    National Association of Student Financial Aid Administrators (NJ1), 2011

    2011-01-01

    The National Association of Student Financial Aid Administrators (NASFAA) recently conducted a survey on the 2009-10 award year Administrative Cost Allowances (ACA), which are funds used by colleges and universities to support operations and professional development. Specifically, ACA is often used in essential areas that support the day-to-day…

  2. A calculation program for electricity generation costs using LOTUS

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sung Ki; Lee, Man Ki [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    1994-12-01

    This program is designed in order to calculate electricity generation cost by different energy sources, and menu type is adopted for user convenience. This program also graphically shows the share of capital investment cost, O and M cost, and fuel cost. Sensitivity analysis about discount rate can also be carried out by this program, taking into consideration the important role of the discount rate in the generation costs calculation. (Author) 7 refs., 1 fig., 3 tabs.

  3. The curriculum success of business administration education programs

    NARCIS (Netherlands)

    Bijker, Monique; Van der Klink, Marcel; Boshuizen, Els

    2012-01-01

    Bijker, M. M., Van der Klink, M. R., & Boshuizen, H. P. A. (2011, 8 September). The curriculum success of business administration education programs. Presentation for the visit of KU Leuven, Open Universiteit, Heerlen, The Netherlands.

  4. Women's Perceptions of Graduate Level Educational Administration Programs.

    Science.gov (United States)

    Epp, Juanita Ross

    1994-01-01

    A survey of 123 women enrolled in Canadian graduate programs in educational administration found that, although some found a relatively warm professional climate for women, for many the experience was not positive. Devaluation of female faculty, counseling of women out of administration, sexist language, and other evidence of sexism were found.…

  5. Program for advanced study in public science policy and administration

    Science.gov (United States)

    Rosenthal, A. H.

    1976-01-01

    The results and conclusions of the six-year effort concerned with the development and implementation of a university educational program intended to prepare scientists and engineers for upper-level management and administrative positions (as distinct from senior technical positions) were presented. This interdisciplinary program is at the graduate level, leading to a Master of Arts degree, and is given within a Division of Public Administration.

  6. U.S. Army Central did not Implement Controls to Effectively Manage the Shared Cost of Administrative Support Functions in Iraq

    Science.gov (United States)

    2016-02-17

    develop controls to effectively manage the shared cost of administrative support functions in Iraq after FY 2016. During the audit we notified officials...effectiveness of the controls . We identified internal control weaknesses in ARCENT’s management of the shared costs of administrative support...DoD Instruction 5010.40,“Managers’ Internal Control Program Procedures,” May 30, 2013. 7 DoS 6 FAH-5, “ International Cooperative Administrative

  7. 75 FR 21292 - Proposed CERCLA Administrative Cost Recovery Settlement Agreement; AVX Corporation

    Science.gov (United States)

    2010-04-23

    ... AGENCY Proposed CERCLA Administrative Cost Recovery Settlement Agreement; AVX Corporation AGENCY... administrative settlement for recovery of projected future response oversight costs and performance of work... with AVX Corporation. The settlement provides for the performance of a portion of a non-time critical...

  8. 77 FR 9652 - Proposed CERCLA Administrative Cost Recovery Settlement; Lake Linden Superfund Site in Lake...

    Science.gov (United States)

    2012-02-17

    ... AGENCY Proposed CERCLA Administrative Cost Recovery Settlement; Lake Linden Superfund Site in Lake Linden... administrative settlement for recovery of past response costs concerning the Lake Linden Superfund Site in Lake... settling party to pay $357,149.47 to the Hazardous Substance Superfund. The settlement includes a covenant...

  9. 25 CFR 122.8 - Administrative costs for management of the fund.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Administrative costs for management of the fund. 122.8 Section 122.8 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR FINANCIAL ACTIVITIES MANAGEMENT OF OSAGE JUDGMENT FUNDS FOR EDUCATION § 122.8 Administrative costs for management of the fund. Funds...

  10. 42 CFR 457.40 - State program administration.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false State program administration. 457.40 Section 457.40 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES Introduction; State Plans for Child Health Insurance...

  11. The cost of first-ever stroke in Valle d’Aosta, Italy: linking clinical registries and administrative data

    Directory of Open Access Journals (Sweden)

    Bottacchi Edo

    2012-10-01

    Full Text Available Abstract Background Stroke is one of the most relevant reasons of death and disability worldwide. Many cost of illness studies have been performed to evaluate direct and indirect costs of ischaemic stroke, especially within the first year after the acute episode, using different methodologies. Methods We conducted a longitudinal, retrospective, bottom-up cost of illness study, to evaluate clinical and economic outcomes of a cohort of patients affected by a first cerebrovascular event, including subjects with ischaemic, haemorrhagic or transient episodes. The analysis intended to detect direct costs, within 1, 2 and 3 years from the index event. Clinical patient data collected in regional disease registry were integrated and linked to regional administrative databases to perform the analysis. Results The analysis of costs within the first year from the index event included 800 patients. The majority of patients (71.5% were affected by ischaemic stroke. Overall, per patient costs were €7,079. Overall costs significantly differ according to the type of stroke, with costs for haemorrhagic stroke and ischaemic stroke amounting to €9,044 and €7,289. Hospital costs, including inpatient rehabilitation, were driver of expenditure, accounting for 89.5% of total costs. The multiple regression model showed that sex, level of physical disability and level of neurological deficit predict direct healthcare costs within 1 year. The analysis at 2 and 3 years (per patient costs: €7,901 and €8,874, respectively showed that majority of costs are concentrated in the first months after the acute event. Conclusions This cost analysis highlights the importance to set up significant prevention programs to reduce the economic burden of stroke, which is mostly attributable to hospital and inpatient rehabilitation costs immediately after the acute episode. Although some limitation typical of retrospective analyses the approach of linking clinical and

  12. Cost-effective management of the hospital-based hospice program.

    Science.gov (United States)

    Baker, M

    1992-01-01

    As hospital-based hospice programs proliferate across the country, most are under the leadership of a nurse administrator. Nurse administrators must be prepared to manage the many components that constitute the broad scope of this role. Cost-effective management is the greatest challenge. The author explores this management role, including a discussion of hospice-program reimbursement, hospital-based program advantages, options to increase staff productivity, management of drugs and durable medical equipment, inpatient admissions, volunteer services, and fund-raising. Cost-effective measures are explored throughout the discussion, along with a history and explanation of the hospice concept of care.

  13. 45 CFR 30.18 - Interest, penalties, and administrative costs.

    Science.gov (United States)

    2010-10-01

    ... from the date of delinquency. (e) Cost of living adjustment. When there is a legitimate reason to do so... statutory authority. The Department may impose and waive interest and related charges on debts not subject to 31 U.S.C. 3717 in accordance with the common law or other statutory authority. ...

  14. STEM Faculty and Indirect Costs: What Administrators Need to Know

    Science.gov (United States)

    Gossman, Susan

    2016-01-01

    The focus of this single site, qualitative case study was on public research university STEM (science, technology, engineering and mathematics) faculty and their perspectives on, and behavior towards, indirect cost recovery. The explanatory scheme was derived from anthropological theory and incorporated organizational culture, resource dependency…

  15. Multisite Cost Analysis of a School-Based Voluntary Alcohol and Drug Prevention Program*

    Science.gov (United States)

    Kilmer, Beau; Burgdorf, James R.; D'amico, Elizabeth J.; Miles, Jeremy; Tucker, Joan

    2011-01-01

    Objective: This article estimates the societal costs of Project CHOICE, a voluntary after-school alcohol and other drug prevention program for adolescents. To our knowledge, this is the first cost analysis of an after-school program specifically focused on reducing alcohol and other drug use. Method: The article uses microcosting methods based on the societal perspective and includes a number of sensitivity analyses to assess how the results change with alternative assumptions. Cost data were obtained from surveys of participants, facilitators, and school administrators; insights from program staff members; program expenditures; school budgets; the Bureau of Labor Statistics; and the National Center for Education Statistics. Results: From the societal perspective, the cost of implementing Project CHOICE in eight California schools ranged from $121 to $305 per participant (Mdn = $238). The major cost drivers included labor costs associated with facilitating Project CHOICE, opportunity costs of displaced class time (because of in-class promotions for Project CHOICE and consent obtainment), and other efforts to increase participation. Substituting nationally representative cost information for wages and space reduced the range to $100–$206 (Mdn = $182), which is lower than the Substance Abuse and Mental Health Services Administration's estimate of $262 per pupil for the "average effective school-based program in 2002." Denominating national Project CHOICE costs by enrolled students instead of participants generates a median per-pupil cost of $21 (range: $14—$28). Conclusions: Estimating the societal costs of school-based prevention programs is crucial for efficiently allocating resources to reduce alcohol and other drug use. The large variation in Project CHOICE costs across schools highlights the importance of collecting program cost information from multiple sites. PMID:21906509

  16. Multisite cost analysis of a school-based voluntary alcohol and drug prevention program.

    Science.gov (United States)

    Kilmer, Beau; Burgdorf, James R; D'Amico, Elizabeth J; Miles, Jeremy; Tucker, Joan

    2011-09-01

    This article estimates the societal costs of Project CHOICE, a voluntary after-school alcohol and other drug prevention program for adolescents. To our knowledge, this is the first cost analysis of an after-school program specifically focused on reducing alcohol and other drug use. The article uses microcosting methods based on the societal perspective and includes a number of sensitivity analyses to assess how the results change with alternative assumptions. Cost data were obtained from surveys of participants, facilitators, and school administrators; insights from program staff members; program expenditures; school budgets; the Bureau of Labor Statistics; and the National Center for Education Statistics. From the societal perspective, the cost of implementing Project CHOICE in eight California schools ranged from $121 to $305 per participant (Mdn = $238). The major cost drivers included labor costs associated with facilitating Project CHOICE, opportunity costs of displaced class time (because of in-class promotions for Project CHOICE and consent obtainment), and other efforts to increase participation. Substituting nationally representative cost information for wages and space reduced the range to $100-$206 (Mdn = $182), which is lower than the Substance Abuse and Mental Health Services Administration's estimate of $262 per pupil for the "average effective school-based program in 2002." Denominating national Project CHOICE costs by enrolled students instead of participants generates a median per-pupil cost of $21 (range: $14-$28). Estimating the societal costs of school-based prevention programs is crucial for efficiently allocating resources to reduce alcohol and other drug use. The large variation in Project CHOICE costs across schools highlights the importance of collecting program cost information from multiple sites.

  17. 42 CFR 409.46 - Allowable administrative costs.

    Science.gov (United States)

    2010-10-01

    ... MEDICARE PROGRAM HOSPITAL INSURANCE BENEFITS Home Health Services Under Hospital Insurance § 409.46... that constitute skilled care may be separately billed as skilled visits. (d) Dietary and nutrition...

  18. Cost estimation for unmanned lunar and planetary programs

    Science.gov (United States)

    Dunkin, J. H.; Pekar, P. R.; Spadoni, D. J.; Stone, C. A.

    1973-01-01

    A basic model is presented for estimating the cost of unmanned lunar and planetary programs. Cost data were collected and analyzed for eight lunar and planetary programs. Total cost was separated into the following components: labor, overhead, materials, and technical support. The study determined that direct labor cost of unmanned lunar and planetary programs comprises 30 percent of the total program cost. Twelve program categories were defined for modeling: six spacecraft subsystem categories (science, structure, propulsion, electrical power, communications, and guidance and integration, test and quality assurance, launch and flight operations, ground equipment, systems analysis and engineering, and program management). An analysis showed that on a percentage basis, direct labor cost and direct labor manhours compare on a one-to-one ratio. Therefore, direct labor hours is used as the parameter for predicting cost, with the advantage of eliminating the effect of inflation on the analysis.

  19. 78 FR 956 - National Vaccine Injury Compensation Program: Revised Amount of the Average Cost of a Health...

    Science.gov (United States)

    2013-01-07

    ... HUMAN SERVICES Health Resources and Services Administration National Vaccine Injury Compensation Program: Revised Amount of the Average Cost of a Health Insurance Policy The Health Resources and Services Administration (HRSA) is publishing an updated monetary amount of the average cost of a health insurance policy...

  20. Cost and cost threshold analyses for 12 innovative US HIV linkage and retention in care programs.

    Science.gov (United States)

    Jain, Kriti M; Maulsby, Catherine; Brantley, Meredith; Kim, Jeeyon Janet; Zulliger, Rose; Riordan, Maura; Charles, Vignetta; Holtgrave, David R

    2016-09-01

    Out of >1,000,000 people living with HIV in the USA, an estimated 60% were not adequately engaged in medical care in 2011. In response, AIDS United spearheaded 12 HIV linkage and retention in care programs. These programs were supported by the Social Innovation Fund, a White House initiative. Each program reflected the needs of its local population living with HIV. Economic analyses of such programs, such as cost and cost threshold analyses, provide important information for policy-makers and others allocating resources or planning programs. Implementation costs were examined from societal and payer perspectives. This paper presents the results of cost threshold analyses, which provide an estimated number of HIV transmissions that would have to be averted for each program to be considered cost-saving and cost-effective. The methods were adapted from the US Panel on Cost-effectiveness in Health and Medicine. Per client program costs ranged from $1109.45 to $7602.54 from a societal perspective. The cost-saving thresholds ranged from 0.32 to 1.19 infections averted, and the cost-effectiveness thresholds ranged from 0.11 to 0.43 infections averted by the programs. These results suggest that such programs are a sound and efficient investment towards supporting goals set by US HIV policy-makers. Cost-utility data are pending.

  1. Costs of cardiac rehabilitation and enhanced lifestyle modification programs.

    Science.gov (United States)

    Lee, A James; Shepard, Donald S

    2009-01-01

    Inadequate payment to providers for traditional cardiac rehabilitation (CR) and lifestyle modification programs may contribute to low utilization, but little systematic evidence exists. This article estimates and compares the per-patient costs and revenues for 3 types of secondary prevention programs: the Dr Dean Ornish Program for Reversing Heart Disease (Ornish), the Benson-Henry Mind/Body Medical Institute's Cardiac Wellness Program (M/BMI), and CR. The authors developed an Excel spreadsheet template for the costs of a secondary prevention program and calibrated it to 7 programs that provided the necessary data. The calibration was based on budgets, cost accounting, statistical reports, and structured interviews (in person or by telephone). The 4 lifestyle programs (2 Ornish and 2 M/BMI) cost almost 4 times as much per patient as the 3 traditional CR programs (means of $7,176 and $1,828, respectively; difference P costs averaged more than twice those of M/BMI ($9,895 and $4,458, respectively; difference P costs per patient by carefully matching program capacity to demand. In none of the programs did net revenues cover costs. The findings suggest that 4 patients could attend a traditional CR program for the cost of 1 patient in an enhanced program.

  2. The Cost of Quality Out-of-School-Time Programs

    Science.gov (United States)

    Grossman, Jean Baldwin; Lind, Christianne; Hayes, Cheryl; McMaken, Jennifer; Gersick, Andrew

    2009-01-01

    Funders and program planners want to know: What does it cost to operate a high-quality after-school or summer program? This study answers that question, discovering that there is no "right" number. Cost varies substantially, depending on the characteristics of the participants, the goals of the program, who operates it and where it is located.…

  3. Basic health program: state administration of basic health programs; eligibility and enrollment in standard health plans; essential health benefits in standard health plans; performance standards for basic health programs; premium and cost sharing for basic health programs; federal funding process; trust fund and financial integrity. Final rule.

    Science.gov (United States)

    2014-03-12

    This final rule establishes the Basic Health Program (BHP), as required by section 1331 of the Affordable Care Act. The BHP provides states the flexibility to establish a health benefits coverage program for low-income individuals who would otherwise be eligible to purchase coverage through the Affordable Insurance Exchange (Exchange, also called Health Insurance Marketplace). The BHP complements and coordinates with enrollment in a QHP through the Exchange, as well as with enrollment in Medicaid and the Children's Health Insurance Program (CHIP). This final rule also sets forth a framework for BHP eligibility and enrollment, benefits, delivery of health care services, transfer of funds to participating states, and federal oversight. Additionally, this final rule amends another rule issued by the Secretary of the Department of Health and Human Services (Secretary) in order to clarify the applicability of that rule to the BHP.

  4. The Stickiness of Selling, General, and Administrative Costs in the Indonesian Companies

    Directory of Open Access Journals (Sweden)

    Benny Armanto

    2014-04-01

    Full Text Available Selling, general and administration costs are the main components in the Income Statement. A large number of permanent staff in sales and marketing department will make the company dominated by the fixed costs. This fact could lead to sticky cost behavior. In addition, role of the manager can also cause the cost stickiness. When the company’s revenue decreases, manager may delay to decrease the cost or not even decrease cost at all. The objective of the study is to determine whether cost stickiness of selling, general and administrative in the Indonesian listed companies. This study applied log-linear data panel regression with 3605 firm years that is listed in Indonesian Stock Exchange (BEI from 1993 – 2013. This study finds that selling, general, and administrative costs are sticky only for the manufacturing companies. Furthermore, the results show that adjustment of sales, general, and administrative costs delayed by the manager when revenue decreases, yet the cost stickiness will be reduced in the next period.

  5. Transaction Costs from a Program Manager’s Perspective

    Science.gov (United States)

    2009-09-28

    for the governments of Mexico and the Czech Republic on achieving excellence in the public sector. As an adjunct professor for the University of...we attempted to directly measure transactions costs for defense acquisition programs using the expenditures of the Program Management Office ( PMO ...as an approximate measure of the amount of transaction costs present in an acquisition program. We found that DoD does not track PMO costs

  6. VENVAL : a plywood mill cost accounting program

    Science.gov (United States)

    Henry Spelter

    1991-01-01

    This report documents a package of computer programs called VENVAL. These programs prepare plywood mill data for a linear programming (LP) model that, in turn, calculates the optimum mix of products to make, given a set of technologies and market prices. (The software to solve a linear program is not provided and must be obtained separately.) Linear programming finds...

  7. Examining Community-Engaged Scholarship in Public Administration Programs

    Science.gov (United States)

    Norvell, Katrina Herndon

    2010-01-01

    This study sought to broaden the understanding of the role that academic professions play in shaping the values and attitudes of faculty toward CES. This study explored faculty perceptions regarding the factors that encourage or dissuade them in the pursuit of CES within public administration programs. As a framework for research, a conceptual…

  8. 76 FR 27002 - Information Collection; National Recreation Program Administration

    Science.gov (United States)

    2011-05-10

    ...-6814) authorizes the Forest Service to issue permits and charge fees for recreation uses of Federal... authorized to collect recreation fees and/or issue recreation permits. Name and contact information will be... Forest Service Information Collection; National Recreation Program Administration AGENCY: Forest Service...

  9. 77 FR 44238 - Proposed Administrative Cost Recovery Settlement Under the Comprehensive Environmental Response...

    Science.gov (United States)

    2012-07-27

    ... From the Federal Register Online via the Government Publishing Office ENVIRONMENTAL PROTECTION AGENCY Proposed Administrative Cost Recovery Settlement Under the Comprehensive Environmental Response Compensation and Liability Act, as Amended, Big River Mine Tailings Superfund Site, St. Francois County, MO...

  10. 76 FR 14968 - Proposed CERCLA Administrative Cost Recovery Settlement; Eugenio Painting Company

    Science.gov (United States)

    2011-03-18

    ... From the Federal Register Online via the Government Publishing Office ENVIRONMENTAL PROTECTION AGENCY Proposed CERCLA Administrative Cost Recovery Settlement; Eugenio Painting Company AGENCY... following settling party: Eugenio Painting Company. The settlement requires the settling party to pay $20...

  11. Costs of the multimicronutrient supplementation program in Chiclayo, Peru.

    Science.gov (United States)

    Lechtig, Aarón; Gross, Rainer; Paulini, Javier; de Romaã, Daniel López

    2006-01-01

    There is little information on the cost parameters of weekly multimicronutrient supplementation programs. To assess the cost parameters and cost-effectiveness of a weekly multimicronutrient supplementation program in an urban population of Peru. Data from the Integrated Food Security Program (Programa Integrado de Seguridad Alimentaria [PISA]), which distributed capsules and foodlets to women and adolescent girls and to children under five, were extrapolated to a population of 100,000 inhabitants. The annual cost per community member was US$1.51. The cost-effectiveness ratio was US$0.12 per 1% of prevented anemia per community member. These costs are in the upper margin of iron supplementation alone. They will decrease notably when weekly multimicronutrient supplementation programs are integrated into health packages and participation by women increases. Focusing on micronutrient deficiencies would prevent these problems, and food-distribution programs would be effectively targeted to food-deficient populations.

  12. Optimal administrative scale for planning public services: a social cost model applied to Flemish hospital care.

    Science.gov (United States)

    Blank, Jos L T; van Hulst, Bart

    2015-01-01

    In choosing the scale of public services, such as hospitals, both economic and public administrative considerations play important roles. The scale and the corresponding spatial distribution of public institutions have consequences for social costs, defined as the institutions' operating costs and the users' travel costs (which include the money and time costs). Insight into the relationship between scale and spatial distribution and social costs provides a practical guide for the best possible administrative planning level. This article presents a purely economic model that is suitable for deriving the optimal scale for public services. The model also reveals the corresponding optimal administrative planning level from an economic perspective. We applied this model to hospital care in Flanders for three different types of care. For its application, we examined the social costs of hospital services at different levels of administrative planning. The outcomes show that the social costs of rehabilitation in Flanders with planning at the urban level (38 areas) are 11% higher than those at the provincial level (five provinces). At the regional level (18 areas), the social costs of rehabilitation are virtually equal to those at the provincial level. For radiotherapy, there is a difference of 88% in the social costs between the urban and the provincial level. For general care, there are hardly any cost differences between the three administrative levels. Thus, purely from the perspective of social costs, rehabilitation should preferably be planned at the regional level, general services at the urban level and radiotherapy at the provincial level. Copyright © 2014 John Wiley & Sons, Ltd.

  13. Development and Implementation of An Administrative Internship Program

    Directory of Open Access Journals (Sweden)

    Esther Wermuth

    2017-04-01

    Full Text Available This article describes the development and implementation of a pilot program to prepare teachers seeking New York state certification as school district administrators, by assigning them as administrative interns to a school district. The superintendent of a large urban school district and the director of a college program to prepare school district administrators partnered to design a pilot experiential course in which candidates for a master’s degree and state certificate would have an opportunity to develop skills and learn by experiencing situations that support new learning (Kolb, 1984, to take the place of an existing internship course for eight candidates. The dual purpose was to provide an authentic learning experience for the candidates and to provide actionable information for the superintendent for improvement of the district instructional program. To identify areas of academic concern, the candidates reviewed the New York State District Report Card1, conducted research, and interviewed district personnel in order to be able tomake actionable suggestions and recommendations to the superintendent that might result in academic improvement. Findings and recommendations to inform district improvement efforts and for improvement of the existing course were presented to the superintendent and his administrative staff. Recommendations are included.

  14. Technology Transfer Program (TTP) Cost Accounting Final Report

    National Research Council Canada - National Science Library

    1980-01-01

    .... Shipbuilding Maritime Administration. The material contained herein was developed from the study of the Cost Accounting systems presently in operation in the shipyards of Ishikawajima-Harima Heavy Industries (IHI) of Japan...

  15. Cost Estimation Lessons Learned for Future Submarine Acquisition Programs

    Science.gov (United States)

    2010-02-17

    North Carolina and New Mexico 30 General Dynamics Electric Boat “U.S. Navy Awards General Dynamics $14 Billion Contract for Eight Virginia- Class...NAVSEA Program Executive officer, Submarines PMO 450, June 1995. “New SSN Program Life Cycle Cost Estimate.” Naval Center for Cost Analysis: GE-1300

  16. An empirical analysis of fiscal federalism implementation and of cost accounting in Italian public administrations

    Directory of Open Access Journals (Sweden)

    Pina Puntillo

    2012-09-01

    Full Text Available The concept of cost has been introduced in Italian Administration since the early nineties. There is a copious legislation referring directly or indirectly, to the need, as well as to the utility of measuring the costs of public administration, in deference, to a renewed interpretation of the constitutional principle of Good Performance in pursuance of Article. 97 of the Italian Constitution. The most recent and probably the most significant intervention at institutional level, is the implementation of fiscal federalism as provided by Law. 42, 2009. The core features of fiscal federalism are the transition from historical expenditure to standard costs as a criterion for determining financial needs of public bodies, together with the attempt to establish more meaningful accountability mechanisms, both to policy makers and to public management. The measurement of standard costs represents one of the pillars of fiscal federalism and it will be pursued using the mechanism of "best practice". Full implementation of fiscal federalism, therefore, requires the verification of the operating costs of all public administrations. According to statutory law, regions are also required to provide verification of operating costs, for the successful pursuing of fiscal federalism. The present research is going to assess the level of diffusion of cost accounting in Italian regional public administrations. The methodology used for this paper includes the analysis of regional law as well as interviews to the officials of accounting and auditing offices

  17. Study on Cost of Nursing Education. Part 1: Cost of Basic Diploma Programs.

    Science.gov (United States)

    Rowe, Harold R.; Flitter, Hessel H.

    The cost analysis method developed in a National League for Nursing-Public Health Service study was adapted to determine the cost of nursing education in the sample of 126 hospital-supported programs in this study. Some of the findings were: (1) The median gross cost per student-year for educational functions was $1,100 and the median net cost…

  18. 77 FR 57074 - Indirect Cost Rates for the Damage Assessment, Remediation, and Restoration Program for Fiscal...

    Science.gov (United States)

    2012-09-17

    ... resolved matters for the purpose of applying the revised rates in this policy for these fiscal years. For..., costs will be recalculated using the revised rates in this policy for these fiscal years. Where a..., and Restoration Program for Fiscal Year 2011 AGENCY: National Oceanic and Atmospheric Administration...

  19. Economic Appraisal of Ontario's Universal Influenza Immunization Program: A Cost-Utility Analysis

    Science.gov (United States)

    Sander, Beate; Kwong, Jeffrey C.; Bauch, Chris T.; Maetzel, Andreas; McGeer, Allison; Raboud, Janet M.; Krahn, Murray

    2010-01-01

    Background In July 2000, the province of Ontario, Canada, initiated a universal influenza immunization program (UIIP) to provide free seasonal influenza vaccines for the entire population. This is the first large-scale program of its kind worldwide. The objective of this study was to conduct an economic appraisal of Ontario's UIIP compared to a targeted influenza immunization program (TIIP). Methods and Findings A cost-utility analysis using Ontario health administrative data was performed. The study was informed by a companion ecological study comparing physician visits, emergency department visits, hospitalizations, and deaths between 1997 and 2004 in Ontario and nine other Canadian provinces offering targeted immunization programs. The relative change estimates from pre-2000 to post-2000 as observed in other provinces were applied to pre-UIIP Ontario event rates to calculate the expected number of events had Ontario continued to offer targeted immunization. Main outcome measures were quality-adjusted life years (QALYs), costs in 2006 Canadian dollars, and incremental cost-utility ratios (incremental cost per QALY gained). Program and other costs were drawn from Ontario sources. Utility weights were obtained from the literature. The incremental cost of the program per QALY gained was calculated from the health care payer perspective. Ontario's UIIP costs approximately twice as much as a targeted program but reduces influenza cases by 61% and mortality by 28%, saving an estimated 1,134 QALYs per season overall. Reducing influenza cases decreases health care services cost by 52%. Most cost savings can be attributed to hospitalizations avoided. The incremental cost-effectiveness ratio is Can$10,797/QALY gained. Results are most sensitive to immunization cost and number of deaths averted. Conclusions Universal immunization against seasonal influenza was estimated to be an economically attractive intervention. Please see later in the article for the Editors' Summary

  20. Small Business Administration (SBA) Loan Program Performance- Post-Charge Off Recovery Rates by Program

    Data.gov (United States)

    Small Business Administration — Reflects total post-charge off recovery rates, as a percent of the amounts charged off by charge off year, for the major loan programs and aggregate totals by charge...

  1. Grande Ronde Model Watershed Program Administration and Habitat Projects, Annual Progress Report, Project Period: Program Administration: January 1, 1997 - December 31, 1997 Habitat Projects: January 1, 1997 - March 31, 1998.

    Energy Technology Data Exchange (ETDEWEB)

    Noyes, Cecilia; Kuchenbecker, Lyle; Perry, Patty

    1998-10-28

    This agreement provided funding for operation and administration of the Grande Ronde Model Watershed Program including staffing of an Executive Director, Program Planner, and clerical personnel. The contract covers maintaining program services, project planning, subwatershed plans (CRMP's), public involvement and education, interagency coordination/clearing house, monitoring, and technical support activities that have taken place in the Grande Ronde basin. Cost-share has been received from the Bureau of Reclamation and the Governor's Watershed Enhancement Board.

  2. 24 CFR 570.206 - Program administrative costs.

    Science.gov (United States)

    2010-04-01

    ... services performed under third party contracts or agreements, including such services as general legal..., religion, sex, national origin, familial status or handicap, aware of the range of housing opportunities...

  3. 24 CFR 1003.206 - Program administration costs.

    Science.gov (United States)

    2010-04-01

    ... Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT COMMUNITY DEVELOPMENT BLOCK GRANTS FOR INDIAN TRIBES AND ALASKA NATIVE VILLAGES... achieve its community development objectives. ...

  4. Costs of the Smoking Cessation Program in Brazil

    Science.gov (United States)

    Mendes, Andréa Cristina Rosa; Toscano, Cristiana Maria; Barcellos, Rosilene Marques de Souza; Ribeiro, Alvaro Luis Pereira; Ritzel, Jonas Bohn; Cunha, Valéria de Souza; Duncan, Bruce Bartholow

    2016-01-01

    ABSTRACT OBJECTIVE To assess the costs of the Smoking Cessation Program in the Brazilian Unified Health System and estimate the cost of its full implementation in a Brazilian municipality. METHODS The intensive behavioral therapy and treatment for smoking cessation includes consultations, cognitive-behavioral group therapy sessions, and use of medicines. The costs of care and management of the program were estimated using micro-costing methods. The full implementation of the program in the municipality of Goiania, Goias was set as its expansion to meet the demand of all smokers motivated to quit in the municipality that would seek care at Brazilian Unified Health System. We considered direct medical and non-medical costs: human resources, medicines, consumables, general expenses, transport, travels, events, and capital costs. We included costs of federal, state, and municipal levels. The perspective of the analysis was that from the Brazilian Unified Health System. Sensitivity analysis was performed by varying parameters concerning the amount of activities and resources used. Data sources included a sample of primary care health units, municipal and state secretariats of health, and the Brazilian Ministry of Health. The costs were estimated in Brazilian Real (R$) for the year of 2010. RESULTS The cost of the program in Goiania was R$429,079, with 78.0% regarding behavioral therapy and treatment of smoking. The cost per patient was R$534, and, per quitter, R$1,435. The full implementation of the program in the municipality of Goiania would generate a cost of R$20.28 million to attend 35,323 smokers. CONCLUSIONS The Smoking Cessation Program has good performance in terms of cost per patient that quit smoking. In view of the burden of smoking in Brazil, the treatment for smoking cessation must be considered as a priority in allocating health resources. PMID:27849293

  5. Cost-Effectiveness Analysis of a Military Hearing Conservation Program.

    Science.gov (United States)

    Garcia, Seth L; Smith, Kenneth J; Palmer, Catherine

    2018-02-07

    Occupational noise threatens U.S. worker health and safety and commands a significant financial burden on state and federal government worker compensation programs. Previous studies suggest that hearing conservation programs have contributed to reduced occupational hearing loss for noise-exposed workers. Many military personnel are overexposed to noise and are provided hearing conservation services. Select military branches require all active duty personnel to follow hearing conservation program guidelines, regardless of individual noise exposure. We evaluated the cost-effectiveness of a military hearing conservation program, relative to no intervention, in relation to cases of hearing loss prevented. We employed cost-effectiveness analytic methods to compare the costs and effectiveness, in terms of hearing loss cases prevented, of a military hearing conservation program relative to no program. We used costs and probability estimates available in the literature and publicly available sources. The effectiveness of the interventions was analyzed based on whether hearing loss occurred over a 20-yr time frame. The incremental cost-effectiveness ratio of the hearing conservation program compared with no intervention was $10,657 per case of hearing loss prevented. Workers were 28% less likely to sustain hearing loss in our model when they received the hearing conservation program compared with no intervention, which reflected the greater effectiveness of the hearing conservation program. Cost-effectiveness results were sensitive to estimated values for the probability of acquiring hearing loss from both interventions and the cost of hearing protection. We performed a Monte Carlo probabilistic sensitivity analysis where we simultaneously varied all the model parameters to their extreme plausible bounds. When we ran 10,000 Monte Carlo iterations, we observed that the hearing conservation program was more cost-effective in 99% of cases when decision makers were willing to

  6. Cost effectiveness of two army physical fitness programs.

    Science.gov (United States)

    Talbot, Laura A; Metter, E Jeffrey; Fleg, Jerome L; Weinstein, Ali A; Frick, Kevin D

    2013-12-01

    Repeated failure in the Army Physical Fitness Test (APFT) is associated with lower fitness level, premature discharge, and significant career disruption, at high economic and health costs to the individual soldier and the U.S. Army. We used cost-effectiveness analysis to estimate the health and economic implications of two exercise interventions for Army National Guard (ARNG) soldiers who had failed the APFT, a traditional remediation program and a new pedometer-based program called Fitness for Life, involving individual counseling and follow-up telephone calls. Effectiveness of the interventions was analyzed in terms of APFT pass rates and calculated 10-year coronary heart disease risk. Costs were calculated based on tracking of resources used in the programs. APFT pass rates were 54.3% and 47.9%, respectively, for traditional and Fitness for Life programs, p = not significant. Neither program affected 10-year coronary heart disease risk. For assumed APFT pass rates up to 40% without any formal remediation, both the traditional remediation program and the ARNG Fitness for Life intervention had cost savings without significant group differences. Depending on the ARNG unit and personnel preference, although the Fitness for Life Program was more expensive and thus less cost-effective, either program could be cost-effective and of benefit to the military. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

  7. Administrative organization in diagnostic radiology residency program leadership.

    Science.gov (United States)

    Webber, Grant R; Mullins, Mark E; Chen, Zhengjia; Meltzer, Carolyn C

    2012-04-01

    The aim of this study was to document the current state of administrative structure in US diagnostic radiology (DR) residency program leadership. A secondary objective was to assess for correlation(s), if any, with DR residency programs that equipped positions such as assistant, associate, and emeritus program director (PD) with respect to residency size and region of the country. The Fellowship and Residency Electronic Interactive Database, as well as direct communication and programmatic Web site searches, were used to gather data regarding current US DR residency leadership. Data collected included the presence of additional leadership titles, including assistant PD, associate PD, and PD emeritus, and how many faculty members currently held each position. Programs were excluded if results could not be identified. Analysis of variance and t tests were used to estimate the correlations of the size of a residency with having additional or shared PD positions and the types of positions, respectively. Chi-square tests were used to assess for any regional differences. As of the time of this project, the Fellowship and Residency Electronic Interactive Database defined 186 US DR residency programs. A total of 173 programs (93%) were included in the analysis; the remainder were excluded because of unavailability of relevant data. Seventy-two percent (124 of 173) of programs had additional DR leadership positions. Of these, 30 programs (17%) had more than one such position. There were no significant differences in the sizes of the programs that used these additional positions (mean, 25 ± 12; range, 6-72) compared with those that did not (mean, 24 ± 12; range, 7-51). There were no significant differences between programs that had additional positions with respect to region of the country. The majority of US DR residency programs used some form of additional DR leadership position. In the majority of cases, this was in the form of an assistant or associate PD. Nearly one

  8. Promoting career mobility of women faculty in health administration programs.

    Science.gov (United States)

    Pohl, C M

    1999-01-01

    Faculty women have encountered the same glass ceiling in their pursuit of better paying, higher level positions that other women have experienced in the work world. Numerous factors have contributed to the continued inequality of salary and rank within the academic community. In order to overcome these barriers, faculty women and women executives in health administration have identified and implemented successful strategies. This article describes these barriers and discusses their impact on the career paths of faculty women and women graduate students in health administration programs. The strategies of role modeling, mentoring, and networking were examined in terms of their benefits, problems, and related gender factors. Finally, recommendations that will complement these strategies were determined and discussed.

  9. Measuring Patient Satisfaction's Relationship to Hospital Cost Efficiency: Can Administrators Make a Difference?

    Science.gov (United States)

    Huerta, Timothy R; Harle, Christopher A; Ford, Eric W; Diana, Mark L; Menachemi, Nir

    2016-01-01

    The aim of this study was to assess the ability and means by which hospital administrators can influence patient satisfaction and its impact on costs. Data are drawn from the American Hospital Association's Annual Survey of Hospitals, federally collected Hospital Cost Reports, and Medicare's Hospital Compare. Stochastic frontier analyses (SFA) are used to test the hypothesis that the patient satisfaction-hospital cost relationship is primarily a latent "management effect." The null hypothesis is that patient satisfaction measures are main effects under the control of care providers rather than administrators. Both SFA models were superior to the standard regression analysis when measuring patient satisfaction's relationship to hospitals' cost efficiency. The SFA model with patient satisfaction measures treated as main effects, rather than "latent, management effects," was significantly better comparing the log-likelihood statistics. Higher patient satisfaction scores on the environmental quality and provider communication dimensions were related to lower facility costs. Higher facility costs were positively associated with patients' overall impressions (willingness to recommend and overall satisfaction), assessments of medication and discharge instructions, and ratings of caregiver responsiveness (pain control and help when called). In the short term, managers have a limited ability to influence patient satisfaction scores, and it appears that working through frontline providers (doctors and nurses) is critical to success. In addition, results indicate that not all patient satisfaction gains are cost neutral and there may be added costs to some forms of quality. Therefore, quality is not costless as is often argued.

  10. Emergency management program operational responses to weapons of mass destruction: Veterans Health Administration, 2001-2004.

    Science.gov (United States)

    Hodgson, Michael J; Bierenbaum, Arnold; Mather, Susan; Brown, Mark A; Beatty, John; Scott, Margie; Brewster, Peter

    2004-11-01

    Despite the recognition of chemical emergencies, terrorist events, and ongoing threats, little practical guidance exists for healthcare facilities. An approach and materials developed by the Veterans Health Administration in a five-element program over the last 2 years to enhance the existing emergency management program is outlined. Nine steps to the development of a comprehensive all-hazards, emergency plan and program, with auditing and improvement tools are offered. Cognitive aids for clinical use are available on-line and in hard copy. A hazard assessment modeled patients as emission sources documenting the operations strategies under which level C personal protective equipment will protect healthcare workers. The development of this response program appears to support a broader, long-standing VHA approach to problem solving. This involves bringing together individual talented field staff, representing specific skills, geographic regions, and work styles; investing in face-to-face consensus development; and developing programs with extensive internal peer-review ("field-based," "bottom-up and top-down," and external reviews). Comprehensive and effective programs can be constructed at low cost with reasonable speed within large systems with a public mandate, leading to responsible use of public funds internally, and as models for private sector programs. It is the long-term operational cost implications, under budget constraints in health care, which often present the true challenge. Copyright 2004 Wiley-Liss, Inc.

  11. Analysis of Defense Industry Consolidation Effects on Program Acquisition Costs

    National Research Council Canada - National Science Library

    Hoff, Russell V

    2007-01-01

    .... This thesis examines whether cost changes are evident following consolidation within the defense industry by conducting a regression analysis of Major Defense Acquisition Programs across 13 broad defense market sectors...

  12. Cost estimation model for advanced planetary programs, fourth edition

    Science.gov (United States)

    Spadoni, D. J.

    1983-01-01

    The development of the planetary program cost model is discussed. The Model was updated to incorporate cost data from the most recent US planetary flight projects and extensively revised to more accurately capture the information in the historical cost data base. This data base is comprised of the historical cost data for 13 unmanned lunar and planetary flight programs. The revision was made with a two fold objective: to increase the flexibility of the model in its ability to deal with the broad scope of scenarios under consideration for future missions, and to maintain and possibly improve upon the confidence in the model's capabilities with an expected accuracy of 20%. The Model development included a labor/cost proxy analysis, selection of the functional forms of the estimating relationships, and test statistics. An analysis of the Model is discussed and two sample applications of the cost model are presented.

  13. National Aeronautics and Space Administration Science and Engineering Apprentice Program

    Science.gov (United States)

    1997-01-01

    The National Aeronautics and Space Administration's Science and Engineering Apprentice Program for high school students is one of NASA's many efforts toward a goal of scientific literacy. It embraces science, mathematics, and technology as keys to purposeful and sustained progress and security for our nation and its people. It serves as a model for helping reform education by striving to address mechanisms to influence the knowledge, skills, and attitudes of our students. It focuses on what to do today to meet the challenges of tomorrow.

  14. GPACC program cost work breakdown structure-dictionary. General purpose aft cargo carrier study, volume 3

    Science.gov (United States)

    1985-01-01

    The results of detailed cost estimates and economic analysis performed on the updated Model 101 configuration of the general purpose Aft Cargo Carrier (ACC) are given. The objective of this economic analysis is to provide the National Aeronautics and Space Administration (NASA) with information on the economics of using the ACC on the Space Transportation System (STS). The detailed cost estimates for the ACC are presented by a work breakdown structure (WBS) to ensure that all elements of cost are considered in the economic analysis and related subsystem trades. Costs reported by WBS provide NASA with a basis for comparing competing designs and provide detailed cost information that can be used to forecast phase C/D planning for new projects or programs derived from preliminary conceptual design studies. The scope covers all STS and STS/ACC launch vehicle cost impacts for delivering payloads to a 160 NM low Earth orbit (LEO).

  15. A computer program for analysis of fuelwood harvesting costs

    Science.gov (United States)

    George B. Harpole; Giuseppe Rensi

    1985-01-01

    The fuelwood harvesting computer program (FHP) is written in FORTRAN 60 and designed to select a collection of harvest units and systems from among alternatives to satisfy specified energy requirements at a lowest cost per million Btu's as recovered in a boiler, or thousand pounds of H2O evaporative capacity kiln drying. Computed energy costs are used as a...

  16. Ethical Climate In Vocational Program Administrative Sciences Department: Student Perception

    Directory of Open Access Journals (Sweden)

    Retno Kusumastuti

    2013-12-01

    Full Text Available The existence of ethics course in the designed curriculum given, expected to shape morale and develop ethic awareness between student in their study environment. This thing will be a primary asset for graduate  candidates in the future. This research is an effort to make an image about study environment climate, that occur in Vocational Program generally, and in Administration Science particularly. The aim of this study is to describe students’ perceptions of their institution’s ethical environment. The Ethical Climate Questionnaires were completed by fifty two final-year vocational program students. The result showed that the type of consensual morality is the most dominant factor that forms ethical environment in campus.

  17. [Cost analysis of the colorectal neoplasm screen program in Beijing].

    Science.gov (United States)

    Mao, Ayan; Dong, Pei; Yan, Xiaoling; Hu, Guangyu; Chen, Qingkun; Qiu, Wuqi

    2015-05-01

    To conduct with a cost analysis of the colorectal neoplasm screening program in Beijing, and provide data evidence for decision making. Based on stratified cluster sampling method, we carried out a 2-stage colorectal neoplasm screening program within 6 districts, Dongcheng, Xicheng, Chaoyang, Haidian, Fengtai and Shijingshan, of Beijing city between October, 2012 to May. 2013. The first stage of the program was to conducting a cancer risk level evaluation for community residents who were forty years older and the second stage's task was to providing clinical exam for those high risk people who were selected from the first stage. There were about 12 953 residents were involved in this program. We calculated the main cost of the colorectal neoplasm screen program in Beijing. Then estimate the cost of detecting one Colorectal Neoplasm patient of this program and compare it with the total treatment cost for a patient. 2 487 high risk residents were selected by the first stage and 1 055 of them made appointment for the colonoscopy exam but only 375 accepted the exam, participate rate was 35.5%. 9 neoplasm cancer patients and 71 pre-cancer patient were found at the second stage, the detection rate were 69.2/100 000 and 546/100 000, respectively. The direct input for this neoplasm screening program was 227 100 CNY and the transport expense was 4 200 CNY in the calculations. The cost for detecting one cancer patient was about 19 900 CNY. Comparing with the total medical care cost of a cancer patient (1 282 800 CNY), especially for those have been diagnosed as middle to end stage cancer, the screening program (cost 842 800 CNY) might help to reduce the total health expenditure about 128 700 CNY, based on 12 953 local residents age above 40 years old. An colonoscopy based colorectal neoplasm screening program showed its function on medical expenditure saving and might have advantage on health social labor creating.

  18. New York City Program Administrators Perceptions of the Helpfulness of Outside Mandated Evaluations on Administrative Decision-Making in ESEA Programs.

    Science.gov (United States)

    Goldberg, Melvin

    Program administrators for 64 Elementary Secondary Education Act (ESEA) programs in New York City were asked to respond to a questionnaire rating scale concerning the helpfulness and quantity of information that had been provided to them by the program evaluators. The rating scale categorized areas of administrative decision making in five…

  19. 15 CFR 40.4 - Administrative provisions on selection of participants and funding of costs.

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Administrative provisions on selection of participants and funding of costs. 40.4 Section 40.4 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade BUREAU OF THE CENSUS, DEPARTMENT OF COMMERCE TRAINING OF FOREIGN...

  20. 78 FR 13056 - Proposed CERCLA Administrative Cost Recovery Settlement; in re: Factory H Superfund Site, Meriden...

    Science.gov (United States)

    2013-02-26

    ... AGENCY Proposed CERCLA Administrative Cost Recovery Settlement; in re: Factory H Superfund Site, Meriden...)(1) concerning the Factory H Superfund Site in Meriden, Connecticut (``Site'') with the following... the Hazardous Substance Superfund. The settlement includes a covenant not to sue the settling party...

  1. 77 FR 19425 - Prescription Drugs Not Administered During Treatment; Update to Administrative Cost for Calendar...

    Science.gov (United States)

    2012-03-30

    ... AFFAIRS Prescription Drugs Not Administered During Treatment; Update to Administrative Cost for Calendar... purposes of calculating VA's charges for prescription drugs that were not administered during treatment but....101 of title 38, Code of Federal Regulations, sets forth VA's medical regulations concerning the...

  2. 76 FR 79678 - Proposed CERCLA Administrative Cost Recovery Settlement; North Hollywood Operable Unit of the San...

    Science.gov (United States)

    2011-12-22

    ... given of a proposed administrative settlement for recovery of response costs concerning the North... response to any comments received will be available for public inspection at the City of Los Angeles Central Library, Science and Technology Department, 630 West 5th Street, Los Angeles, CA 90071 and at the...

  3. 76 FR 77528 - Proposed CERCLA Administrative Cost Recovery Settlement; North Hollywood Operable Unit of the San...

    Science.gov (United States)

    2011-12-13

    ... given of a proposed administrative settlement for recovery of response costs concerning the North... response to any comments received will be available for public inspection at the City of Los Angeles Central Library, Science and Technology Department, 630 West 5th Street, Los Angeles, CA 90071 and at the...

  4. 77 FR 123 - Proposed CERCLA Administrative Cost Recovery Settlement; North Hollywood Operable Unit of the San...

    Science.gov (United States)

    2012-01-03

    ... proposed administrative settlement for recovery of response costs concerning the North Hollywood Operable.... The Agency's response to any comments received will be available for public inspection at the City of Los Angeles Central Library, Science and Technology Department, 630 West 5th Street, Los Angeles CA...

  5. 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.

  6. Low Cost Motor Demonstration Program. Volume 1

    Science.gov (United States)

    1977-02-01

    Ib/cu ft foam mandrel (S/N 24) and Motor T-640-2 employed a 17.5 Ib/cu ft mandrel (S/N 28). The change in igniter charge makeup from all size 3A...8217:f ;r.ii ■: rr ■ - — l| fX »-j 4 ’_;:_ ’d/ — t; ■ (’ : ’ -- (;-,’,: f 1 ■ 1 :rL /J :rj _" £ •tit Fpi :t"j .r f. •;.:.l..: ■ ■^i.v \\ Si / fei Wt_...not include cutting or finishing costs. t Si 455 ^mtämim^^^’^*^mM^» fx >imr Arnim ,. ffmß:: -»•«■ ••**r**f F«! iltaWHiMiUiMi ’mm HM m—mm~m mmm

  7. Boston children's hospital community asthma initiative: Five-year cost analyses of a home visiting program.

    Science.gov (United States)

    Bhaumik, Urmi; Sommer, Susan J; Giller-Leinwohl, Judith; Norris, Kerri; Tsopelas, Lindsay; Nethersole, Shari; Woods, Elizabeth R

    2017-03-01

    To evaluate the costs and benefits of the Boston Children's Hospital Community Asthma Initiative (CAI) through reduction of Emergency Department (ED) visits and hospitalizations for the full pilot-phase program participants. A cost-benefit analyses was conducted using hospital administrative data to determine an adjusted Return on Investment (ROI): on all 268 patients enrolled in the CAI program during the 33-month pilot program phase of CAI intervention between October 1, 2005 and June 30, 2008 using a comparison group of 818 patients from a similar cohort in neighboring ZIP codes without CAI intervention. Cost data through June 30, 2013 were used to examine cost changes and calculate an adjusted ROI over a 5-year post-intervention period. CAI patients had a cost reduction greater than the comparison group of $1,216 in Year 1 (P = 0.001), $1,320 in Year 2 (P management programs can decrease the incidence of costly hospitalizations and ED visits from asthma. An ROI of greater than one, as found in this cost analysis, supports the business case for the provision of community-based asthma services as part of patient-centered medical homes and Accountable Care Organizations.

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

    Science.gov (United States)

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

    2013-03-01

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

  9. Emissions Scenarios, Costs, and Implementation Considerations of REDD Programs

    Energy Technology Data Exchange (ETDEWEB)

    Sathaye, Jayant; Andrasko, Ken; Chan, Peter

    2011-04-11

    Greenhouse gas emissions from the forestry sector are estimated to be 8.4 GtCO2-eq./year or about 17percent of the global emissions. We estimate that the cost forreducing deforestation is low in Africa and several times higher in Latin America and Southeast Asia. These cost estimates are sensitive to the uncertainties of how muchunsustainable high-revenue logging occurs, little understood transaction and program implementation costs, and barriers to implementation including governance issues. Due to lack of capacity in the affected countries, achieving reduction or avoidance of carbon emissions will require extensive REDD-plus programs. Preliminary REDD-plus Readiness cost estimates and program descriptions for Indonesia, Democratic Republic of the Congo, Ghana, Guyana and Mexico show that roughly one-third of potential REDD-plus mitigation benefits might come from avoided deforestation and the rest from avoided forest degradation and other REDD-plus activities.

  10. Low-cost flywheel demonstration program. Final report

    Energy Technology Data Exchange (ETDEWEB)

    None

    1980-04-01

    The Applied Physics Laboratory/Department of Energy Low Cost Flywheel Demonstration Program was initiated on 1 October 1977 and was successfully concluded on 31 December 19'9. The total cost of this program was $355,190. All primary objectives were successfully achieved as follows: demonstration of a full-size, 1)kWh flywheel having an estimated cost in large-volume production of approximately $50/kWh; developmeNt of a ball-bearing system having losses comparable to the losses in a totally magnetic suspension system; successful and repeated demonstration of the low-cost flywheel in a complete flywheel energy-storage system based on the use of ordinary house voltage and frequency; and application of the experience gained in the hardware program to project the system design into a complete, full-scale, 30-kWh home-type flywheel energy-storage system.

  11. Planning influenza vaccination programs: a cost benefit model

    Directory of Open Access Journals (Sweden)

    Duncan Ian G

    2012-07-01

    Full Text Available Abstract Background Although annual influenza vaccination could decrease the significant economic and humanistic burden of influenza in the United States, immunization rates are below recommended levels, and concerns remain whether immunization programs can be cost beneficial. The research objective was to compare cost benefit of various immunization strategies from employer, employee, and societal perspectives. Methods An actuarial model was developed based on the published literature to estimate the costs and benefits of influenza immunization programs. Useful features of the model included customization by population age and risk-level, potential pandemic risk, and projection year. Various immunization strategies were modelled for an average U.S. population of 15,000 persons vaccinated in pharmacies or doctor’s office during the 2011/12 season. The primary outcome measure reported net cost savings per vaccinated (PV from the perspective of various stakeholders. Results Given a typical U.S. population, an influenza immunization program will be cost beneficial for employers when more than 37% of individuals receive vaccine in non-traditional settings such as pharmacies. The baseline scenario, where 50% of persons would be vaccinated in non-traditional settings, estimated net savings of $6 PV. Programs that limited to pharmacy setting ($31 PV or targeted persons with high-risk comorbidities ($83 PV or seniors ($107 PV were found to increase cost benefit. Sensitivity analysis confirmed the scenario-based findings. Conclusions Both universal and targeted vaccination programs can be cost beneficial. Proper planning with cost models can help employers and policy makers develop strategies to improve the impact of immunization programs.

  12. Individual social security accounts: issues in assessing administrative feasibility and costs.

    Science.gov (United States)

    Olsen, K A; Salisbury, D L

    1998-11-01

    Whether to add individual accounts (IAs) to the Social Security system is a highly political issue. But almost lost in the debate so far have been any practical considerations about how to administer such accounts. Any discussion of whether to create individual accounts must also address the basic but critical questions of how they would work: Who would run them? What would they cost? Logistically, are they even possible? This EBRI Issue Brief provides an overview of the most salient administrative issues facing the current Social Security reform debate--issues that challenge proponents to carefully think through how their proposals could be implemented so as to achieve their policy goals. The options and difficulties in administering IAs raise concerns that cut across ideology. The object of this report is neither to dissuade the advocates nor support the critics of individual accounts. Rather, it is to bring practical considerations to a political debate that has largely ignored the pragmatic challenges of whether IAs would be too complex for participants to understand or too difficult for record keepers to administer. The major findings in this analysis include: Adding individual accounts to Social Security could be the largest undertaking in the history of the U.S. financial market, and no system to date has the capacity to administer such a system. The number of workers currently covered by Social Security--the largest single entitlement program in the nation--is at least four times higher than the combined number of all tax-favored employment-based retirement accounts in the United States, which are administered by hundreds of entities. Direct comparisons between employment-based retirement savings plans and Social Security reform are tenuous at best. Social Security covers workers and businesses that are disproportionately excluded from employment-based plans. Because of these differences, a system of individual Social Security accounts would be more

  13. Impact of a Novel Cost-Saving Pharmacy Program on Pregabalin Use and Health Care Costs.

    Science.gov (United States)

    Martin, Carolyn; Odell, Kevin; Cappelleri, Joseph C; Bancroft, Tim; Halpern, Rachel; Sadosky, Alesia

    2016-02-01

    Pharmacy cost-saving programs often aim to reduce costs for members and payers by encouraging use of lower-tier or generic medications and lower-cost sales channels. In 2010, a national U.S. health plan began a novel pharmacy program directed at reducing pharmacy expenditures for targeted medications, including pregabalin. The program provided multiple options to avoid higher cost sharing: use mail order pharmacy or switch to a lower-cost alternative medication via mail order or retail. Members who did not choose any option eventually paid the full retail cost of pregabalin. To evaluate the impact of the pharmacy program on pregabalin and alternative medication use, health care costs, and health care utilization. This retrospective analysis of claims data included adult commercial health plan members with a retail claim for pregabalin in the first 13 months of the pharmacy program (identification [ID] period: February 1, 2010-February 28, 2011). Members whose benefit plan included the pharmacy program were assigned to the program cohort; all others were assigned to the nonprogram cohort. The program cohort index date was the first retail pregabalin claim during the ID period and after the program start; the nonprogram cohort index date was the first retail pregabalin claim during the ID period. All members were continuously enrolled for 12 months pre- and post-index and had at least 1 inpatient claim or ≥ 2 ambulatory visit claims for a pregabalin-indicated condition. Cohorts were propensity score matched (PSM) 1:1 with logistic regression on demographic and pre-index characteristics, including mail order and pregabalin use, comorbidity, health care costs, and health care utilization. Pregabalin, gabapentin and other alternative medication use, health care costs, and health care utilization were measured. The program cohort was also divided into 2 groups: members who changed to gabapentin post-index and those who did not. A difference-in-differences (Di

  14. 48 CFR 19.707 - The Small Business Administration's role in carrying out the program.

    Science.gov (United States)

    2010-10-01

    ... Administration's role in carrying out the program. 19.707 Section 19.707 Federal Acquisition Regulations System... Subcontracting Program 19.707 The Small Business Administration's role in carrying out the program. (a) Under the... administration of individual prime contracts or subcontracts. ...

  15. 48 CFR 9904.410 - Allocation of business unit general and administrative expenses to final cost objectives.

    Science.gov (United States)

    2010-10-01

    ... unit general and administrative expenses to final cost objectives. 9904.410 Section 9904.410 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING...

  16. Costs Associated with Intravenous Cancer Therapy Administration in Patients with Metastatic Soft Tissue Sarcoma in a US Population

    Directory of Open Access Journals (Sweden)

    Mei Sheng Duh

    2013-01-01

    Full Text Available Background. The most common chemotherapies in metastatic soft tissue sarcoma (mSTS require intravenous (IV administration. This often requires patients to make multiple outpatient visits per chemotherapy cycle, possibly impeding patients’ daily activities and increasing caregiver burden and medical costs. This study investigated costs associated with IV cancer therapy administration in mSTS from the payer perspective of the health care system. Patients and Methods. From the Experian Healthcare database, 1,228 mSTS patients were selected. Data were analyzed on outpatient visits during 2005–2012 involving IV cancer therapy administration. Costs were estimated on a per patient per visit (PPPV and per patient per month (PPPM basis. Results. The mean (median cost of IV therapy was $2,427 ($1,532 PPPV and $5,468 ($4,310 PPPM, of which approximately 60% was IV drug costs. IV administration costs averaged $399 PPPV and $900 PPPM, representing 16.5% of total visit costs. Anthracycline and alkylating-agents-based therapies had the highest PPPV and PPPM IV administration costs, respectively (mean $479 and $1,336, resp.. Patients with managed care insurance had the highest IV administration costs (mean $504 PPPV; $1,120 PPPM. Conclusions. IV administration costs constitute a considerable proportion of the total costs of receiving an IV cancer therapy to treat mSTS.

  17. Applied Research of Enterprise Cost Control Based on Linear Programming

    Directory of Open Access Journals (Sweden)

    Yu Shuo

    2015-01-01

    This paper researches the enterprise cost control through the linear programming model, and analyzes the restriction factors of the labor of enterprise production, raw materials, processing equipment, sales price, and other factors affecting the enterprise income, so as to obtain an enterprise cost control model based on the linear programming. This model can calculate rational production mode in the case of limited resources, and acquire optimal enterprise income. The production guiding program and scheduling arrangement of the enterprise can be obtained through calculation results, so as to provide scientific and effective guidance for the enterprise production. This paper adds the sensitivity analysis in the linear programming model, so as to learn about the stability of the enterprise cost control model based on linear programming through the sensitivity analysis, and verify the rationality of the model, and indicate the direction for the enterprise cost control. The calculation results of the model can provide a certain reference for the enterprise planning in the market economy environment, which have strong reference and practical significance in terms of the enterprise cost control.

  18. A Needs Assessment of Aquaculture Extension Agents, Specialists, and Program Administrators in Extension Programming

    Science.gov (United States)

    Schwarz, Michael H.; Gibson, Jerry

    2010-01-01

    The study reported here identified continuing education and training needs of aquaculture Extension agents, specialists, and program administrators in 10 competency areas relating to the need for continuing education or training. Fourteen resources on the AquaNIC Web site were also evaluated, as was the efficacy of the AQUA-EXT listserv. Data were…

  19. Planning influenza vaccination programs: a cost benefit model

    OpenAIRE

    Duncan Ian G; Taitel Michael S; Zhang Junjie; Kirkham Heather S

    2012-01-01

    Abstract Background Although annual influenza vaccination could decrease the significant economic and humanistic burden of influenza in the United States, immunization rates are below recommended levels, and concerns remain whether immunization programs can be cost beneficial. The research objective was to compare cost benefit of various immunization strategies from employer, employee, and societal perspectives. Methods An actuarial model was developed based on the published literature to est...

  20. Valuation of selected environmental impacts associated with Bonneville Power Administration Resource Program alternatives

    Energy Technology Data Exchange (ETDEWEB)

    Englin, J E; Gygi, K F

    1992-03-01

    This report documents work undertaken by the Pacific Northwest Laboratory (PNL) and its contractors to assist the Bonneville Power Administration (Bonneville) in assessing the potential environmental consequences of new power resources. A major purpose of this effort is to describe and evaluate the techniques available for economic valuation of environmental costs. Another is to provide estimates of the environmental costs associated with specific power resources called for under Bonneville's Resource Programs. Bonneville's efforts to extend valuation techniques to as many impacts as can be reliably assessed represents a substantial advance in the application of state-of-the-art economic techniques to environmental assessments. This economic analysis evaluates effects on human health, wildlife, crops, and visibility impacts associated with air pollution. This report also discusses river recreation (primarily fishing) which may be affected by fluctuations in water levels. 70 refs.

  1. The Social Value Of Vaccination Programs: Beyond Cost-Effectiveness.

    Science.gov (United States)

    Luyten, Jeroen; Beutels, Philippe

    2016-02-01

    In the current global environment of increased strain on health care budgets, all medical interventions have to compete for funding. Cost-effectiveness analysis has become a standard method to use in estimating how much value an intervention offers relative to its costs, and it has become an influential element in decision making. However, the application of cost-effectiveness analysis to vaccination programs fails to capture the full contribution such a program offers to the community. Recent literature has highlighted how cost-effectiveness analysis can neglect the broader economic impact of vaccines. In this article we also argue that socioethical contributions such as effects on health equity, sustaining the public good of herd immunity, and social integration of minority groups are neglected in cost-effectiveness analysis. Evaluations of vaccination programs require broad and multidimensional perspectives that can account for their social, ethical, and economic impact as well as their cost-effectiveness. Project HOPE—The People-to-People Health Foundation, Inc.

  2. 24 CFR 984.302 - Administrative fees.

    Science.gov (United States)

    2010-04-01

    ... costs incurred by PHAs in carrying out the public housing FSS programs. These costs are subject to... program. The administrative fees paid to PHAs for HUD-approved costs associated with operation of an FSS...

  3. 77 FR 46433 - Proposed CERCLA Administrative Cost Recovery Settlements for the Buckbee-Mears Co. Superfund Site...

    Science.gov (United States)

    2012-08-03

    ... AGENCY Proposed CERCLA Administrative Cost Recovery Settlements for the Buckbee-Mears Co. Superfund Site... administrative settlements for recovery ] of past response costs concerning the Buckbee-Mears Co. Superfund Site.... Superfund Site located in Cortland, New York, Cortland County, EPA Region II Docket No.'s CERCLA-02-2012...

  4. 31 CFR 5.5 - How will Treasury entities add interest, penalty charges, and administrative costs to a Treasury...

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false How will Treasury entities add interest, penalty charges, and administrative costs to a Treasury debt? 5.5 Section 5.5 Money and Finance... Debts § 5.5 How will Treasury entities add interest, penalty charges, and administrative costs to a...

  5. 36 CFR 1011.5 - What interest, penalty charges and administrative costs will the Presidio Trust add to a debt?

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false What interest, penalty charges and administrative costs will the Presidio Trust add to a debt? 1011.5 Section 1011.5 Parks... § 1011.5 What interest, penalty charges and administrative costs will the Presidio Trust add to a debt...

  6. 20 CFR 669.555 - Do the WIA administrative cost limits for States and local areas apply to NFJP grants?

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Do the WIA administrative cost limits for... WORKFORCE INVESTMENT ACT Performance Accountability, Planning and Waiver Provision § 669.555 Do the WIA administrative cost limits for States and local areas apply to NFJP grants? No, under 20 CFR 667.210(b), limits...

  7. Cost and Time Overruns in Major Defense Acquisition Programs

    OpenAIRE

    Berteau, David; Hofbauer, Joachim; Sanders, Gregory; Ari, Guy Ben

    2010-01-01

    Proceedings Paper (for Acquisition Research Program) Approved for public release; distribution unlimited. Cost and time overruns in Major Defense Acquisition Programs (MDAPs) have become a high-profile problem attracting the interest of Congress, government and watchdog groups. According to the GAO, the 96 MDAPs from FY2008 collectively ran $296 billion over budget and were an average of 22 months behind schedule. President Obama''s memo on government contracting of 4 March 2009 also h...

  8. The Cost of Commonality: Assessing Value in Joint Programs

    Science.gov (United States)

    2015-12-01

    interdependent networks using game theory . Stakeholders in such networks share a common but not identical range of objectives. Parochial interests prevent...network are often undertaken irrespective of common goals. This consequence is a social dilemma known as the tragedy of the commons . The program...transaction cost theories only partially explain the program dynamics that erode joint commonality . Conceptual designs for complex systems in

  9. Risk-adjusted impact of administrative costs on the distribution of terminal wealth for long-term investment.

    Science.gov (United States)

    Guillén, Montserrat; Jarner, Søren Fiig; Nielsen, Jens Perch; Pérez-Marín, Ana M

    2014-01-01

    The impact of administrative costs on the distribution of terminal wealth is approximated using a simple formula applicable to many investment situations. We show that the reduction in median returns attributable to administrative fees is usually at least twice the amount of the administrative costs charged for most investment funds, when considering a risk-adjustment correction over a reasonably long-term time horizon. The example we present covers a number of standard cases and can be applied to passive investments, mutual funds, and hedge funds. Our results show investors the potential losses they face in performance due to administrative costs.

  10. Risk-Adjusted Impact of Administrative Costs on the Distribution of Terminal Wealth for Long-Term Investment

    Science.gov (United States)

    Guillén, Montserrat; Jarner, Søren Fiig; Pérez-Marín, Ana M.

    2014-01-01

    The impact of administrative costs on the distribution of terminal wealth is approximated using a simple formula applicable to many investment situations. We show that the reduction in median returns attributable to administrative fees is usually at least twice the amount of the administrative costs charged for most investment funds, when considering a risk-adjustment correction over a reasonably long-term time horizon. The example we present covers a number of standard cases and can be applied to passive investments, mutual funds, and hedge funds. Our results show investors the potential losses they face in performance due to administrative costs. PMID:25180200

  11. Risk-Adjusted Impact of Administrative Costs on the Distribution of Terminal Wealth for Long-Term Investment

    Directory of Open Access Journals (Sweden)

    Montserrat Guillén

    2014-01-01

    Full Text Available The impact of administrative costs on the distribution of terminal wealth is approximated using a simple formula applicable to many investment situations. We show that the reduction in median returns attributable to administrative fees is usually at least twice the amount of the administrative costs charged for most investment funds, when considering a risk-adjustment correction over a reasonably long-term time horizon. The example we present covers a number of standard cases and can be applied to passive investments, mutual funds, and hedge funds. Our results show investors the potential losses they face in performance due to administrative costs.

  12. 20 CFR 422.501 - Applications and other forms used in Social Security Administration programs.

    Science.gov (United States)

    2010-04-01

    ... Security Administration programs. 422.501 Section 422.501 Employees' Benefits SOCIAL SECURITY... used in Social Security Administration programs. This subpart lists the applications and some of the related forms prescribed by the Social Security Administration for use by the public in applying for...

  13. Cost-Effectiveness of Multidisciplinary Management Program and Exercise Training Program in Heart Failure.

    Science.gov (United States)

    Dang, Weixiong; Yi, Anji; Jhamnani, Sunny; Wang, Shi-Yi

    2017-10-15

    Heart failure causes significant health and financial burdens for patients and society. Multidisciplinary management program (MMP) and exercise training program (ETP) have been reported as cost-effective in improving health outcomes, yet no study has compared the 2 programs. We constructed a Markov model to simulate life year (LY) gained and total costs in usual care (UC), MMP, and ETP. The probability of transitions between states and healthcare costs were extracted from previous literature. We calculated the incremental cost-effectiveness ratio (ICER) over a 10-year horizon. Model robustness was assessed through 1-way and probabilistic sensitivity analyses. The expected LY for patients treated with UC, MMP, and ETP was 7.6, 8.2, and 8.4 years, respectively. From a societal perspective, the expected cost of MMP was $20,695, slightly higher than the cost of UC ($20,092). The cost of ETP was much higher ($48,378) because of its high implementation expense and the wage loss it incurred. The ICER of MMP versus UC was $976 per LY gained, and the ICER of ETP versus MMP was $165,702 per LY gained. The results indicated that, under current cost-effectiveness threshold, MMP is cost-effective compared with UC, and ETP is not cost-effective compared with MMP. However, ETP is cost-effective compared with MMP from a healthcare payer's perspective. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Potential Cost Savings and Cost Avoidances Associated With Security Cooperation Training Programs

    Science.gov (United States)

    2015-12-01

    Joint Combined Exchange Trainings MBA Masters of Business Administration MERHC Medicare-eligible retiree health care MODA Ministry of Defense...Related Construction (ERC) Title 10 Ministry of Defense Advisors ( MODA ) Program Title 10 Coalition Support Funds (CSF), including Coalition Readiness

  15. 5 CFR 930.208 - Administrative Law Judge Loan Program-detail to other agencies.

    Science.gov (United States)

    2010-01-01

    ...-detail to other agencies. 930.208 Section 930.208 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT... (MISCELLANEOUS) Administrative Law Judge Program § 930.208 Administrative Law Judge Loan Program—detail to other... that coordinates the loan/detail of an administrative law judge from one agency to another. An agency...

  16. Cost-Effectiveness of Dengue Vaccination Programs in Brazil.

    Science.gov (United States)

    Shim, Eunha

    2017-05-01

    AbstractThe first approved dengue vaccine, CYD-TDV, a chimeric, live-attenuated, tetravalent dengue virus vaccine, was recently licensed in 13 countries, including Brazil. In light of recent vaccine approval, we modeled the cost-effectiveness of potential vaccination policies mathematically based on data from recent vaccine efficacy trials that indicated that vaccine efficacy was lower in seronegative individuals than in seropositive individuals. In our analysis, we investigated several vaccination programs, including routine vaccination, with various vaccine coverage levels and those with and without large catch-up campaigns. As it is unclear whether the vaccine protects against infection or just against disease, our model incorporated both direct and indirect effects of vaccination. We found that in the presence of vaccine-induced indirect protection, the cost-effectiveness of dengue vaccination decreased with increasing vaccine coverage levels because the marginal returns of herd immunity decreases with vaccine coverage. All routine dengue vaccination programs that we considered were cost-effective, reducing dengue incidence significantly. Specifically, a routine dengue vaccination of 9-year-olds would be cost-effective when the cost of vaccination per individual is less than $262. Furthermore, the combination of routine vaccination and large catch-up campaigns resulted in a greater reduction of dengue burden (by up to 93%) than routine vaccination alone, making it a cost-effective intervention as long as the cost per course of vaccination is $255 or less. Our results show that dengue vaccination would be cost-effective in Brazil even with a relatively low vaccine efficacy in seronegative individuals.

  17. The costs of transit fare prepayment programs : a parametric cost analysis.

    Science.gov (United States)

    Despite the renewed interest in transit fare prepayment plans over the past : 10 years, few transit managers have a clear idea of how much it costs to operate : and maintain a fare prepayment program. This report provides transit managers : with the ...

  18. Processes and outcomes of the veterans health administration safe patient handling program: study protocol.

    Science.gov (United States)

    Rugs, Deborah; Toyinbo, Peter; Patel, Nitin; Powell-Cope, Gail; Hahm, Bridget; Elnitsky, Christine; Besterman-Dahan, Karen; Campbell, Robert; Sutton, Bryce

    2013-11-18

    Health care workers, such as nurses, nursing aides, orderlies, and attendants, who manually move patients, are consistently listed in the top professions for musculoskeletal injuries (MSIs) by the Bureau of Labor Statistics. These MSIs are typically caused by high-risk patient caregiving activities. In 2008, a safe patient handling (SPH) program was implemented in all 153 Veterans Administration Medical Centers (VAMCs) throughout the United States to reduce patient handling injuries. The goal of the present study is to evaluate the effects associated with the national implementation of a comprehensive SPH program. The primary objectives of the research were to determine the effectiveness of the SPH program in improving direct care nursing outcomes and to provide a context for understanding variations in program results across sites over time. Secondary objectives of the present research were to evaluate the effectiveness of the program in reducing direct and indirect costs associated with patient handling, to explore the potential mediating and moderating mechanisms, and to identify unintended consequences of implementing the program. This 3-year longitudinal study used mixed methods of data collection at 6- to 9-month intervals. The analyses will include data from surveys, administrative databases, individual and focus group interviews, and nonparticipant observations. For this study, a 3-tiered measurement plan was used. For Tier 1, the unit of analysis was the facility, the data source was the facility coordinator or administrative data, and all 153 VAMCs participated. For Tier 2, frontline caregivers and program peer leaders at 17 facilities each completed different surveys. For Tier 3, six facilities completed qualitative site visits, which included individual interviews, focus groups, and nonparticipant observations. Multiple regression models were proposed to test the effects of SPH components on nursing outcomes related to patient handling. Content analysis

  19. Introduction to Administrative Programs that Mitigate the Insider Threat

    Energy Technology Data Exchange (ETDEWEB)

    Gerke, Gretchen K.; Rogers, Erin; Landers, John; DeCastro, Kara

    2012-09-01

    This presentation begins with the reality of the insider threat, then elaborates on these tools to mitigate the insider threat: Human Reliability Program (HRP); Nuclear Security Culture (NSC) Program; Employee Assistance Program (EAP).

  20. Predicting Future High-Cost Schizophrenia Patients Using High-Dimensional Administrative Data

    Directory of Open Access Journals (Sweden)

    Yajuan Wang

    2017-06-01

    Full Text Available BackgroundThe burden of serious and persistent mental illness such as schizophrenia is substantial and requires health-care organizations to have adequate risk adjustment models to effectively allocate their resources to managing patients who are at the greatest risk. Currently available models underestimate health-care costs for those with mental or behavioral health conditions.ObjectivesThe study aimed to develop and evaluate predictive models for identification of future high-cost schizophrenia patients using advanced supervised machine learning methods.MethodsThis was a retrospective study using a payer administrative database. The study cohort consisted of 97,862 patients diagnosed with schizophrenia (ICD9 code 295.* from January 2009 to June 2014. Training (n = 34,510 and study evaluation (n = 30,077 cohorts were derived based on 12-month observation and prediction windows (PWs. The target was average total cost/patient/month in the PW. Three models (baseline, intermediate, final were developed to assess the value of different variable categories for cost prediction (demographics, coverage, cost, health-care utilization, antipsychotic medication usage, and clinical conditions. Scalable orthogonal regression, significant attribute selection in high dimensions method, and random forests regression were used to develop the models. The trained models were assessed in the evaluation cohort using the regression R2, patient classification accuracy (PCA, and cost accuracy (CA. The model performance was compared to the Centers for Medicare & Medicaid Services Hierarchical Condition Categories (CMS-HCC model.ResultsAt top 10% cost cutoff, the final model achieved 0.23 R2, 43% PCA, and 63% CA; in contrast, the CMS-HCC model achieved 0.09 R2, 27% PCA with 45% CA. The final model and the CMS-HCC model identified 33 and 22%, respectively, of total cost at the top 10% cost cutoff.ConclusionUsing advanced feature selection leveraging detailed

  1. Accessing Secondary Markets as a Capital Source for Energy Efficiency Finance Programs: Program Design Considerations for Policymakers and Administrators

    Energy Technology Data Exchange (ETDEWEB)

    Kramer, C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Martin, E. Fadrhonc [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Thompson, P. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Goldman, C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2015-02-01

    Estimates of the total opportunity for investment in cost-effective energy efficiency in the United States are typically in the range of several hundred billion dollars (Choi Granade, et al., 2009 and Fulton & Brandenburg, 2012).1,2 To access this potential, many state policymakers and utility regulators have established aggressive energy efficiency savings targets. Current levels of taxpayer and utility bill-payer funding for energy efficiency is only a small fraction of the total investment needed to meet these targets (SEE Action Financing Solutions Working Group, 2013). Given this challenge, some energy efficiency program administrators are working to access private capital sources with the aim of amplifying the funds available for investment. In this context, efficient access to secondary market capital has been advanced as one important enabler of the energy efficiency industry “at scale.”3 The question of what role secondary markets can play in bringing energy efficiency to scale is largely untested despite extensive attention from media, technical publications, advocates, and others. Only a handful of transactions of energy efficiency loan products have been executed to date, and it is too soon to draw robust conclusions from these deals. At the same time, energy efficiency program administrators and policymakers face very real decisions regarding whether and how to access secondary markets as part of their energy efficiency deployment strategy.

  2. Administrator Perspectives of Ohio's Teacher Evaluation System: Implications for Educational Administration Programs in Higher Education

    Science.gov (United States)

    Williams, Nicole V.; Crates, Kathleen

    2015-01-01

    The purpose of this study was to elicit elementary and middle school administrators' perceptions of the Ohio Teacher Evaluation System (OTES). The researchers created a questionnaire to learn administrators' experiences with and attitudes, opinions, beliefs, and knowledge of OTES thus far. The questionnaire consisted of twenty-five Likert-based…

  3. How to think clearly about Medicare administrative costs: data sources and measurement.

    Science.gov (United States)

    Sullivan, Kip

    2013-06-01

    The Centers for Medicare and Medicaid Services (CMS) annually publishes two measures of Medicare's administrative expenditures. One of these appears in the reports of the Medicare Boards of Trustees and the other in the National Health Expenditure Accounts (NHEA). The latest trustees' report indicates Medicare's administrative expenditures are 1 percent of total Medicare spending, while the latest NHEA indicates the figure is 6 percent. The debate about Medicare's administrative expenditures, which emerged several years ago, reflects widespread confusion about these data. Critics of Medicare argue that the official reports on Medicare's overhead ignore or hide numerous types of administrative spending, such as the cost of collecting taxes and Part B premiums. Defenders of Medicare claim the official statistics are accurate. But participants on both sides of this debate fail to cite the official documents and do not analyze CMS's methodology. This article examines the controversy over the methodology CMS uses to calculate the trustees' and NHEA's measures and the sources of confusion and ignorance about them. It concludes with a discussion of how the two measures should be used.

  4. 75 FR 32341 - Import Administration IA ACCESS Pilot Program

    Science.gov (United States)

    2010-06-08

    ... from Mexico-- Administrative Review 07/01/08-06/30/09; A-201-836: Light-Walled Rectangular Pipe and... the People's Republic of China-- Administrative Review 01/31/08-07/31/09; A-570-922: Raw Flexible Magnets from the People's Republic of China-- New Shipper Review (Jingzhou Meihou Flexible Magnet Company...

  5. 77 FR 50903 - Food Distribution Program on Indian Reservations: Administrative Funding Allocations

    Science.gov (United States)

    2012-08-23

    ... food, including fresh produce, in FDPIR, and (4) making all Social Security recipients categorically... lifestyle changes. These funds are allocated separately from program administrative funds. D. Regulatory...

  6. Cost-Utility Analysis of a Cardiac Telerehabilitation Program

    DEFF Research Database (Denmark)

    Kidholm, Kristian; Rasmussen, Maja Kjær; Andreasen, Jan Jesper

    2016-01-01

    and Methods: The analysis was carried out together with a randomized controlled trial with 151 patients during 2012-2014. Costs of the intervention were estimated with a health sector perspective following international guidelines for CU. Quality of life was assessed using the 36-Item Short Form Health Survey......Background: Cardiac rehabilitation can reduce mortality of patients with cardiovascular disease, but a frequently low participation rate in rehabilitation programs has been found globally. The objective of the Teledialog study was to assess the cost-utility (CU) of a cardiac telerehabilitation (CTR....... Results: The rehabilitation activities were approximately the same in the two groups, but the number of contacts with the physiotherapist was higher among the intervention group. The mean total cost per patient was (sic)1,700 higher in the intervention group. The quality-adjusted life-years (QALYs) gain...

  7. Administration

    DEFF Research Database (Denmark)

    Bogen handler om den praksis, vi kalder administration. Vi er i den offentlige sektor i Danmark hos kontorfolkene med deres sagsmapper, computere, telefoner,, lovsamlinger,, retningslinier og regneark. I bogen udfoldes en mangfoldighed af konkrete historier om det administrative arbejde fra...... forskellige områder i den offentlige sektor. Hensigten er at forstå den praksis og faglighed der knytter sig til det administrative arbejde...

  8. 36 CFR 230.4 - State program administration.

    Science.gov (United States)

    2010-07-01

    ... composition meets the requirements of section 19(b) of the Act. The Committee shall be chaired by the State... cost for practice components; (7) The distribution mechanism for the allocation of cost-share funds...; and make planning recommendations for Federal, State, and local implementation of the Act. (1) The...

  9. [Cost-effectiveness analysis on colorectal cancer screening program].

    Science.gov (United States)

    Huang, Q C; Ye, D; Jiang, X Y; Li, Q L; Yao, K Y; Wang, J B; Jin, M J; Chen, K

    2017-01-10

    Objective: To evaluate the cost-effectiveness of colorectal cancer screening program in different age groups from the view of health economics. Methods: The screening compliance rates, detection rates in different age groups were calculated by using the data from colorectal cancer screening program in Jiashan county, Zhejiang province. The differences in indicator among age groups were analyzed with χ(2) test or trend χ(2) test. The ratios of cost to the number of case were calculated according to cost statistics. Results: The detection rates of immunochemical fecal occult blood test (iFOBT) positivity, advanced adenoma and colorectal cancer and early stage cancer increased with age, while the early diagnosis rates were negatively associated with age. After exclusion the younger counterpart, the cost-effectiveness of individuals aged >50 years could be reduced by 15%-30%. Conclusion: From health economic perspective, it is beneficial to start colorectal cancer screening at age of 50 years to improve the efficiency of the screening.

  10. 34 CFR 263.4 - What training costs may a Professional Development program include?

    Science.gov (United States)

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false What training costs may a Professional Development... GRANT PROGRAMS Professional Development Program § 263.4 What training costs may a Professional Development program include? (a) A Professional Development program may include, as training costs, assistance...

  11. Administration

    OpenAIRE

    2009-01-01

    Cet imposant volume constitue un registre des cours magistraux tenus par l’auteur à l’École supérieure allemande des sciences administratives de Spire, enrichis des résultats de travaux scientifiques menés principalement à l'Institut Allemand de Recherche en Administration Publique (Deutsches Forschungsinstitut für öffentliche Verwaltung Speyer, FÖV). Il s’agit donc d’une entreprise au long cours, destinée à apporter un nouvel éclairage (quasi ?) exhaustif sur l’administration publique : son ...

  12. Development of Program to Enhance Strategic Leadership of Secondary School Administrators

    Science.gov (United States)

    Chatchawaphun, Pimpisa; Julsuwan, Suwat; Srisa-ard, Boonchom

    2016-01-01

    This research aimed to 1) study principles, attributes and skills needed for secondary school administrators, 2) investigate current situations, desirable conditions and needs for strategic secondary school administrators, 3) develop a strategic secondary school administrator enhancement program, and 4) explore the efficiency level of the…

  13. "Living on Barbed Wire": Resilient Women Administrators in Educational Leadership Programs

    Science.gov (United States)

    Christman, Dana; McClellan, Rhonda

    2008-01-01

    Background: Despite access for women administrators in educational leadership departments, the longevity of their service within them is tenuous. Women administrators are caught in the social constructions of gender and leadership. Purpose: To explore how some women administrators in educational leadership programs have sustained their…

  14. 77 FR 74913 - Privacy Act of 1974, as Amended; Computer Matching Program (Social Security Administration (SSA...

    Science.gov (United States)

    2012-12-18

    ... From the Federal Register Online via the Government Publishing Office SOCIAL SECURITY ADMINISTRATION Privacy Act of 1974, as Amended; Computer Matching Program (Social Security Administration (SSA)/Office of Personnel Management (OPM))--Match Number 1307 AGENCY: Social Security Administration. ACTION...

  15. 75 FR 57233 - 340B Drug Pricing Program Administrative Dispute Resolution Process

    Science.gov (United States)

    2010-09-20

    ... HUMAN SERVICES 42 CFR Chapter I 340B Drug Pricing Program Administrative Dispute Resolution Process... regulations to establish and implement an administrative dispute resolution process for the 340B Drug Pricing... should be marked ``Comments on Administrative Dispute Resolution Process'' and sent to Ms. Dorcas Ann...

  16. 77 FR 43639 - Privacy Act of 1974, as Amended; Computer Matching Program (Social Security Administration (SSA...

    Science.gov (United States)

    2012-07-25

    ...)/Department of Veterans Affairs (VA), Veterans Benefits Administration (VBA))--Match Number 1008 AGENCY: SSA... of an existing computer matching program that we are currently conducting with VA/VBA. DATES: We will... Benefits Administration (VBA) A. Participating Agencies SSA and VA/VBA. B. Purpose of the Matching Program...

  17. 77 FR 54943 - Privacy Act of 1974, as Amended; Computer Matching Program (Social Security Administration (SSA...

    Science.gov (United States)

    2012-09-06

    ...)/Department of Veterans Affairs (VA), Veterans Benefits Administration (VBA))--Match Number 1309 AGENCY: SSA... of an existing computer matching program that we are currently conducting with VA/VBA. DATES: We will... Benefits Administration (VBA). A. Participating Agencies SSA and VA/VBA. B. Purpose of the Matching Program...

  18. The Effects of Peer Coaching on the Evaluation Knowledge, Skills, and Concerns of Gifted Program Administrators

    Science.gov (United States)

    Cotabish, Alicia; Robinson, Ann

    2012-01-01

    To increase knowledge and skills in program evaluation, a peer-coaching intervention provided one-on-one professional development to gifted program administrators. This randomized field study examined the effects of peer coaching on evaluation knowledge and skills and on administrators' concerns about implementing more rigorous program…

  19. 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...

  20. Medicaid service use and program costs for pregnant teens.

    Science.gov (United States)

    Gavin, Norma I; Kuo, May; Adams, E Kathleen; Ayadi, M Femi; Gilbert, Brenda Colley

    2005-12-01

    Teen pregnancy is an important public health issue for all teens, but particularly for low-income teens who rely on the public health safety net for services. Medicaid pays for more than two-thirds of deliveries among teenagers in the USA. To discern how this public program serves pregnant teens (aged 11-19 years), the authors used Medicaid enrollment and claims data for Florida, Georgia and New Jersey in 1995 to examine teens' enrollment duration, service use and average payments relative to 20-24-year-olds on Medicaid. Teens were more likely than the older women to have been enrolled in Medicaid before pregnancy and to have maintained coverage through the third month following delivery. If not enrolled prepregnancy, teens were more likely than older women to enroll later in pregnancy. Teens were less likely to receive early prenatal care and more likely to be hospitalized during pregnancy, usually for preterm labor. While total Medicaid payments for routine prenatal and delivery-related care were equivalent between teens and older women, payments for nonroutine care during pregnancy were modestly higher for teens in Florida and Georgia. Thus, only modest cost savings can accrue from lower average costs per pregnancy and delivery among teens who delay pregnancy. Additional and larger cost savings to the Medicaid program from preventing teen pregnancy would accrue from the expected lower enrollment in Medicaid among the teens as they age.

  1. 40 CFR 172.25 - Administration of State programs.

    Science.gov (United States)

    2010-07-01

    ... upon the nature of the pest problem and the requirements of the testing program submitted. The... pesticides and pesticide containers, whether disposed of during the course of a State permit or remaining at... approved as part of the experimental program; or (2) Returned to the permittee for storage or disposal in...

  2. Administrators' Descriptions of Their Leadership Roles in a Precollege Program

    Science.gov (United States)

    Owens, Michael A.

    2010-01-01

    The purpose of this work is to describe how leaders of the Upward Bound (UB) program at a university in the western United States described their leadership roles in the program. It is a qualitative study based on data drawn from interviews, observations, written material, and field observations conducted over two years. Participants described…

  3. The School Administrator and the Food Service Program.

    Science.gov (United States)

    Perryman, John N.

    The aim of this publication is to offer information that will assist the elementary school principal in the establishment or improvement of a school lunch program. The material focuses on the necessary ingredients of an effective school food service, the necessity of nutrition education as a part of a food service program, and the importance of…

  4. Best Practices in Administration of K-12 Dance Programs

    Science.gov (United States)

    Henneman, Suzanne E.

    2013-01-01

    The role of administering K-12 dance education programs is both exciting and invigorating. Being part of the decision-making process, problem solving with teams of colleagues, establishing routines and initiatives, creating "something from nothing," and watching programs grow is appealing to dance teachers as creative and critical…

  5. Cost estimate for a proposed GDF Suez LNG testing program

    Energy Technology Data Exchange (ETDEWEB)

    Blanchat, Thomas K.; Brady, Patrick Dennis; Jernigan, Dann A.; Luketa, Anay Josephine; Nissen, Mark R.; Lopez, Carlos; Vermillion, Nancy; Hightower, Marion Michael

    2014-02-01

    At the request of GDF Suez, a Rough Order of Magnitude (ROM) cost estimate was prepared for the design, construction, testing, and data analysis for an experimental series of large-scale (Liquefied Natural Gas) LNG spills on land and water that would result in the largest pool fires and vapor dispersion events ever conducted. Due to the expected cost of this large, multi-year program, the authors utilized Sandia's structured cost estimating methodology. This methodology insures that the efforts identified can be performed for the cost proposed at a plus or minus 30 percent confidence. The scale of the LNG spill, fire, and vapor dispersion tests proposed by GDF could produce hazard distances and testing safety issues that need to be fully explored. Based on our evaluations, Sandia can utilize much of our existing fire testing infrastructure for the large fire tests and some small dispersion tests (with some modifications) in Albuquerque, but we propose to develop a new dispersion testing site at our remote test area in Nevada because of the large hazard distances. While this might impact some testing logistics, the safety aspects warrant this approach. In addition, we have included a proposal to study cryogenic liquid spills on water and subsequent vaporization in the presence of waves. Sandia is working with DOE on applications that provide infrastructure pertinent to wave production. We present an approach to conduct repeatable wave/spill interaction testing that could utilize such infrastructure.

  6. Administrator Responses to Financial Incentives: Insights from a TIF Program

    Science.gov (United States)

    King Rice, Jennifer; Malen, Betty; Jackson, Cara; Hoyer, Kathleen Mulvaney

    2017-01-01

    This article provides evidence and generates insights about the power of financial rewards to motivate school administrators and the design features that influence their motivational potency. The multi-year mixed-methods study is grounded in expectancy and goal setting theories that suggest (a) awards must be salient and sizable enough to appeal…

  7. Mentors for Women Entering Administration: A Program That Works.

    Science.gov (United States)

    Luebkemann, Heinz; Clemens, Jacqueline

    1994-01-01

    Describes a Florida State University study of six women principals to determine specific influences in their emerging development as successful leaders. Although women can advance without mentors, having mentors can definitely advance the timetable for entering the administrative ranks. Since mentoring efforts are not always successful, careful…

  8. Costs of the Smoking Cessation Program in Brazil.

    Science.gov (United States)

    Mendes, Andréa Cristina Rosa; Toscano, Cristiana Maria; Barcellos, Rosilene Marques de Souza; Ribeiro, Alvaro Luis Pereira; Ritzel, Jonas Bohn; Cunha, Valéria de Souza; Duncan, Bruce Bartholow

    2016-11-10

    To assess the costs of the Smoking Cessation Program in the Brazilian Unified Health System and estimate the cost of its full implementation in a Brazilian municipality. The intensive behavioral therapy and treatment for smoking cessation includes consultations, cognitive-behavioral group therapy sessions, and use of medicines. The costs of care and management of the program were estimated using micro-costing methods. The full implementation of the program in the municipality of Goiania, Goias was set as its expansion to meet the demand of all smokers motivated to quit in the municipality that would seek care at Brazilian Unified Health System. We considered direct medical and non-medical costs: human resources, medicines, consumables, general expenses, transport, travels, events, and capital costs. We included costs of federal, state, and municipal levels. The perspective of the analysis was that from the Brazilian Unified Health System. Sensitivity analysis was performed by varying parameters concerning the amount of activities and resources used. Data sources included a sample of primary care health units, municipal and state secretariats of health, and the Brazilian Ministry of Health. The costs were estimated in Brazilian Real (R$) for the year of 2010. The cost of the program in Goiania was R$429,079, with 78.0% regarding behavioral therapy and treatment of smoking. The cost per patient was R$534, and, per quitter, R$1,435. The full implementation of the program in the municipality of Goiania would generate a cost of R$20.28 million to attend 35,323 smokers. The Smoking Cessation Program has good performance in terms of cost per patient that quit smoking. In view of the burden of smoking in Brazil, the treatment for smoking cessation must be considered as a priority in allocating health resources. Analisar os custos do Programa de Tratamento do Tabagismo no Sistema Único de Saúde e estimar o custo de sua implementação plena em um município brasileiro. A

  9. DACC program cost and work breakdown structure-dictionary. General purpose aft cargo carrier study, volume 2

    Science.gov (United States)

    1985-01-01

    Results of detailed cost estimates and economic analysis performed on the updated 201 configuration of the dedicated Aft Cargo Carrier (DACC) are given. The objective of this economic analysis is to provide the National Aeronautics and Space Administration (NASA) with information on the economics of using the DACC on the Space Transportation System (STS). The detailed cost estimates for the DACC are presented by a work breakdown structure (WBS) to ensure that all elements of cost are considered in the economic analysis and related subsystem trades. Costs reported by WBS provide NASA with a basis for comparing competing designs and provide detailed cost information that can be used to forecast phase C/D planning for new projects or programs derived from preliminary conceptual design studies. The scope covers all STS and STS/DACC launch vehicle cost impacts for delivering an orbital transfer vehicle to a 120 NM low Earth orbit (LEO).

  10. Cost Effectiveness Ratio: Evaluation Tool for Comparing the Effectiveness of Similar Extension Programs

    Science.gov (United States)

    Jayaratne, K. S. U.

    2015-01-01

    Extension educators have been challenged to be cost effective in their educational programming. The cost effectiveness ratio is a versatile evaluation indicator for Extension educators to compare the cost of achieving a unit of outcomes or educating a client in similar educational programs. This article describes the cost effectiveness ratio and…

  11. Academic Executive Programs in Public Administration and Management: Some Variety across Europe

    Science.gov (United States)

    Reichard, Christoph

    2017-01-01

    Universities and other higher education institutions in Europe offer a vast and increasing number of academic degree programs in the broad field of Public Administration. A subset of these programs is those offering postgraduate degrees to experienced students being already employed by public or private organisations. These executive programs are…

  12. The role of risk and cost benefit in program budgeting

    Energy Technology Data Exchange (ETDEWEB)

    Henry, C.J.; Alchowiak, J. [Dept. of Energy, Washington, DC (United States)

    1995-12-31

    The primary Environmental Management (EM) program mission is protecting human health and the environment. EM is currently facing a decreasing budget while still having to deal with competing requirements and risks to workers, public, and environment. There has been no consistent framework for considering in an integrated fashion the multiple types of risks and hazards present in the nuclear weapons complex. Therefore, to allocate resources during the budget process, EM is using risk, long term costs, mortgage reduction, compliance issues, and stakeholders concerns to prioritize the funding of activities. Risk and cost-benefit analysis are valuable tools to help make decisions to reduce risks to health, safety, and the environment in a sensible and cost-effective manner. Principles for priority setting using risk analysis are to seek to compare risks by grouping them into broad categories of concern (e.g., high, medium, and low); to set priorities in managing risks to account for relevant management and social considerations; to inform priorities by as broad a range of views as possible, ideally with consensus; and, to try to coordinate risk reduction efforts among programs. The Draft Risk Report to Congress, Risks and the Risk Debate: Searching for Common Ground {open_quote}The First Step,{close_quote} provides the first link between budget, compliance requirements, and risk reduction/pollution prevention activities. The process used for the report provides an initial framework to capture the spectrum of risks associated with environmental management activities and to link these risks in a qualitative fashion to compliance and the budget.

  13. Program Evaluation for School Improvement: Guidelines for School Administrators.

    Science.gov (United States)

    Gillies, Warna D.

    1995-01-01

    Fourth-generation program evaluation is a collaborative, responsive approach that attaches great importance to the claims, concerns, and issues set forth by various stakeholders. This model stresses value pluralism and has several community-involvement phases: planning, data collection, results, final evaluation report, and follow-up. (20…

  14. 24 CFR 570.489 - Program administrative requirements.

    Science.gov (United States)

    2010-04-01

    ... procedures for units of general local government, based on full and open competition. Methods of procurement... aggregate of the state's annual grant, program income received by units of general local government (whether retained by the unit of general local government or paid to the State) and funds reallocated by HUD to the...

  15. Human Service Administrator Perceptions of Online MSW Degree Programs

    Science.gov (United States)

    Curran, Laura; Sanchez Mayers, Ray; Fulghum, Fontaine

    2017-01-01

    Online programs have proliferated rapidly in higher education, and this reality holds true for social work education as well. Employing a mixed methods design, this study looked at employer perceptions of online degrees compared to traditional degrees. Data was collected through an online survey that included Likert type and open-ended questions…

  16. Professional Student Exchange Program (PSEP) Administrative Manual. Revised

    Science.gov (United States)

    Western Interstate Commission for Higher Education, 2012

    2012-01-01

    WICHE (the Western Interstate Commission for Higher Education) is a regional, nonprofit organization. WICHE and its 15 member states work to improve access to higher education and ensure student success. Its student exchange programs, regional initiatives, and its research and policy work allow it to assist constituents throughout the West and…

  17. Proposed framework for the Western Area Power Administration Environmental Risk Management Program

    Energy Technology Data Exchange (ETDEWEB)

    Glantz, C.S.; DiMassa, F.V.; Pelto, P.J.; Brothers, A.J. [Pacific Northwest Lab., Richland, WA (United States); Roybal, A.L. [Western Area Power Administration, Golden, CO (United States)

    1994-12-01

    The Western Area Power Administration (Western) views environmental protection and compliance as a top priority as it manages the construction, operation, and maintenance of its vast network of transmission lines, substations, and other facilities. A recent Department of Energy audit of Western`s environmental management activities recommends that Western adopt a formal environmental risk program. To accomplish this goal, Western, in conjunction with Pacific Northwest Laboratory, is in the process of developing a centrally coordinated environmental risk program. This report presents the results of this design effort, and indicates the direction in which Western`s environmental risk program is heading. Western`s environmental risk program will consist of three main components: risk communication, risk assessment, and risk management/decision making. Risk communication is defined as an exchange of information on the potential for threats to human health, public safety, or the environment. This information exchange provides a mechanism for public involvement, and also for the participation in the risk assessment and management process by diverse groups or offices within Western. The objective of risk assessment is to evaluate and rank the relative magnitude of risks associated with specific environmental issues that are facing Western. The evaluation and ranking is based on the best available scientific information and judgment and serves as input to the risk management process. Risk management takes risk information and combines it with relevant non-risk factors (e.g., legal mandates, public opinion, costs) to generate risk management options. A risk management tool, such as decision analysis, can be used to help make risk management choices.

  18. Review of demand-side bidding programs: Impacts, costs, and cost-effectiveness

    Energy Technology Data Exchange (ETDEWEB)

    Goldman, C.A.; Kito, M.S. [Lawrence Berkeley Lab., CA (United States). Energy and Environment Div.

    1994-05-01

    In December 1987, Central Maine Power (CMP) instituted the first competitive bidding program that allowed developers to propose installation of conservation measures. Since then, about 30 utilities in 14 states have solicited bids from energy service companies (ESCOs) and customers to reduce energy demand in residential homes and in commercial and industrial facilities. Interest in the use of competitive procurement mechanisms for demand-side resources continues to grow. In this study, the authors build upon earlier work conducted by LBL in collaboration with others (Goldman and Busch 1992; Wolcott and Goldman 1992). They have developed methods to compare bid prices and program costs among utilities. They also characterize approaches used by utilities and developers to allocate risks associated with DSM resources based on their review of a large sample of signed contracts. These contracts are analyzed in some detail because they provide insights into the evolving roles and responsibilities of utilities, customers, and third party contractors in providing demand-side management (DSM) services. The analysis also highlights differences in the allocation of risks between traditional utility rebate programs and DSM bidding programs.

  19. Cost analysis of large-scale implementation of the 'Helping Babies Breathe' newborn resuscitation-training program in Tanzania.

    Science.gov (United States)

    Chaudhury, Sumona; Arlington, Lauren; Brenan, Shelby; Kairuki, Allan Kaijunga; Meda, Amunga Robson; Isangula, Kahabi G; Mponzi, Victor; Bishanga, Dunstan; Thomas, Erica; Msemo, Georgina; Azayo, Mary; Molinier, Alice; Nelson, Brett D

    2016-12-01

    Helping Babies Breathe (HBB) has become the gold standard globally for training birth-attendants in neonatal resuscitation in low-resource settings in efforts to reduce early newborn asphyxia and mortality. The purpose of this study was to do a first-ever activity-based cost-analysis of at-scale HBB program implementation and initial follow-up in a large region of Tanzania and evaluate costs of national scale-up as one component of a multi-method external evaluation of the implementation of HBB at scale in Tanzania. We used activity-based costing to examine budget expense data during the two-month implementation and follow-up of HBB in one of the target regions. Activity-cost centers included administrative, initial training (including resuscitation equipment), and follow-up training expenses. Sensitivity analysis was utilized to project cost scenarios incurred to achieve countrywide expansion of the program across all mainland regions of Tanzania and to model costs of program maintenance over one and five years following initiation. Total costs for the Mbeya Region were $202,240, with the highest proportion due to initial training and equipment (45.2%), followed by central program administration (37.2%), and follow-up visits (17.6%). Within Mbeya, 49 training sessions were undertaken, involving the training of 1,341 health providers from 336 health facilities in eight districts. To similarly expand the HBB program across the 25 regions of mainland Tanzania, the total economic cost is projected to be around $4,000,000 (around $600 per facility). Following sensitivity analyses, the estimated total for all Tanzania initial rollout lies between $2,934,793 to $4,309,595. In order to maintain the program nationally under the current model, it is estimated it would cost $2,019,115 for a further one year and $5,640,794 for a further five years of ongoing program support. HBB implementation is a relatively low-cost intervention with potential for high impact on perinatal

  20. Endoscopist-directed propofol administration versus anesthesiologist assistance for colorectal cancer screening: a cost-effectiveness analysis.

    Science.gov (United States)

    Hassan, C; Rex, D K; Cooper, G S; Benamouzig, R

    2012-05-01

    Propofol for colonoscopy is largely administered by anesthesiologists or anesthesiology nurses in the United States (US) and Europe. Endoscopist-directed administration of propofol (EDP) by nonanesthesiologists has recently been proposed, with potential savings of anesthetist reimbursement costs. We aimed to assess potential EDP-related benefit in a screening setting. In a Markov model the total number of screening and follow-up colonoscopies in a cohort of 100 000 US subjects were estimated. Anesthetist-assisted colonoscopy was compared with an EDP strategy. Model outputs were projected onto the 50 - 80-year-old US population, assuming 27 % as the current uptake for colonoscopy screening. Anesthetist costs were estimated using the mean reimbursement for the corresponding Medicare code (≥ 65-year-olds) and from commercial insurance information (50 - 64-year-olds). The proportion of colonoscopies with anesthesiologist assistance was estimated from the Medicare database. Mean nurse salary was used to estimate the cost of a 2-week EDP training. The absolute number of US endoscopists was estimated by inflating by 33 % the number of board-certified gastroenterologists. No EDP mortality was assumed in the reference scenario, and 0.0008 % mortality in the sensitivity analysis. US census data were adopted. Analogous inputs were used for France to assess EDP-related benefit in a European country. EDP training for 17 166 nurses (one for each US endoscopist) showed a cost of $ 47 million. Cost estimates for anesthesiologist assistance for colonoscopy were $ 95 (Medicare) and $ 450 (non-Medicare commercial insurance), with 34.8 % of colonoscopies requiring anesthesiologist assistance. US implementation of an EDP policy showed a 10-year saving of $ 3.2 billion (Monte Carlo analysis 5 - 95 % percentiles $ 2.7 - $ 11.9 billion). In the sensitivity analysis, assuming 50 % of colonoscopies were anesthetist-assisted showed an EDP benefit of $ 4.6 billion. Assuming a 0

  1. Materials Development Program, Ceramic Technology Project addendum to program plan: Cost effective ceramics for heat engines

    Energy Technology Data Exchange (ETDEWEB)

    1992-08-01

    This is a new thrust in the Ceramic Technology project. This effort represents an expansion of the program and an extension through FY 1997. Moderate temperature applications in conventional automobile and truck engines will be included along with high-temp. gas turbine and low heat rejection diesel engines. The reliability goals are expected to be met on schedule by end of FY 1993. Ceramic turbine rotors have been run (in DOE's ATTAP program) for 1000 h at 1370C and full speed. However, the cost of ceramic components is a deterrrent to near-term commercialization. A systematic approach to reducing this cost includes the following elements: economic cost modeling, ceramic machining, powder synthesis, alternative forming and densification processes, yield improvement, system design studies, standards development, and testing and data base development. A draft funding plan is outlined. 6 figs, 1 tab.

  2. Materials Development Program, Ceramic Technology Project addendum to program plan: Cost effective ceramics for heat engines

    Energy Technology Data Exchange (ETDEWEB)

    1992-08-01

    This is a new thrust in the Ceramic Technology project. This effort represents an expansion of the program and an extension through FY 1997. Moderate temperature applications in conventional automobile and truck engines will be included along with high-temp. gas turbine and low heat rejection diesel engines. The reliability goals are expected to be met on schedule by end of FY 1993. Ceramic turbine rotors have been run (in DOE`s ATTAP program) for 1000 h at 1370C and full speed. However, the cost of ceramic components is a deterrrent to near-term commercialization. A systematic approach to reducing this cost includes the following elements: economic cost modeling, ceramic machining, powder synthesis, alternative forming and densification processes, yield improvement, system design studies, standards development, and testing and data base development. A draft funding plan is outlined. 6 figs, 1 tab.

  3. Compendium of Administrators of Land Use and Related Programs. Revision

    Science.gov (United States)

    1982-09-01

    Regions. Ten Regions A4 U.S. Forest Service. Regional Boundaries A5 Regional Action Planning Commission A6 Bureau of Indian Affairs . Area Offices...Resources-Land. Foren , and WHalife Manage- ..xitt, DA PAM 420-7 (Department oi the Army, 1C May 1377) Bwmusi policies which thay have initiated in...August 1976j, pp 140-145. Iowa Office for Planning and Programming, Division of Municipal Affairs , Directory, Areawide Planning Organizations

  4. The impact of patient assistance programs and the 340B Drug Pricing Program on medication cost.

    Science.gov (United States)

    Castellon, Yelba M; Bazargan-Hejazi, Shahrzad; Masatsugu, Miles; Contreras, Roberto

    2014-02-01

    Patient assistance programs and the 340B Drug Pricing Program promise to improve the financial stability, better serve vulnerable patients, and decrease the burden of cost for uninsured patients. Our objective is to examine the financial impact that PAPs and the 340B Program have on improving medication cost. Retrospective analysis of medication dispensary data. Dispensary data for uninsured patients obtaining medications at 2 community health centers were collected from February 1 to February 29, 2012. Uninsured patients were divided into 2 samples: (1) patients receiving PAP medications and (2) patients receiving 340B medications. The main outcome measured was the patient's cost savings. Cost savings were calculated based on the amount a medication would have cost had it been purchased by patients at prices found on Epocrates software (drugstore.com). A paired sample t test model using continuous variables was utilized to calculate confidence intervals. A total of 1420 PAP and 2772 340B individual medications were dispensed to uninsured patients in February 2012. For patients receiving PAP medications the mean ± standard deviation (SD) for age = 52 ± 10. Average cost was $0.11 (95% CI, $0.04-$0.17) and average savings was $617.36 (95% Cl, $581.32-$653.40). For patients receiving 340B medications the mean ±SD for age = 50 ± 14. Average cost was $11.50 (95% CI, $10.55-$12.45). Average saving was $62.31 (95% CI, $57.99-$66.63). PAPs and 340B provide significant medication savings for uninsured patient. More research is needed to establish "best practices" for the successful integration of PAPs.

  5. New benchmarks for costs and cost-efficiency of school-based feeding programs in food-insecure areas.

    Science.gov (United States)

    Gelli, Aulo; Cavallero, Andrea; Minervini, Licia; Mirabile, Mariana; Molinas, Luca; de la Mothe, Marc Regnault

    2011-12-01

    School feeding is a popular intervention that has been used to support the education, health and nutrition of school children. Although the benefits of school feeding are well documented, the evidence on the costs of such programs is remarkably thin. Address the need for systematic estimates of the cost of different school feeding modalities, and of the determinants of the considerable cost variation among countries. WFP project data, including expenditures and number of schoolchildren covered, were collected for 78 projects in 62 countries through project reports and validated through WFP Country Office records. Yearly project costs per schoolchild were standardized over a set number of feeding days and the amount of energy provided by the average ration. Output metrics, such as tonnage, calories, and micronutrient content, were used to assess the cost-efficiency of the different delivery mechanisms. The standardized yearly average school feeding cost per child, not including school-level costs, was US$48. The yearly costs per child were lowest at US$23 for biscuit programs reaching school-going children and highest at US$75 for take-home rations programs reaching families of schoolgoing children. The average cost of programs combining on-site meals with extra take-home rations for children from vulnerable households was US$61. Commodity costs were on average 58% of total costs and were highest for biscuit and take-home rations programs (71% and 68%, respectively). Fortified biscuits provided the most cost-efficient option in terms of micronutrient delivery, whereas take-home rations were more cost-efficient in terms of food quantities delivered. Both costs and effects should be considered carefully when designing school feeding interventions. The average costs of school feeding estimated here are higher than those found in earlier studies but fall within the range of costs previously reported. Because this analysis does not include school-level costs, these

  6. Cost Effectiveness of Iran National Plasma Contract Fractionation Program

    Directory of Open Access Journals (Sweden)

    Abdol Majid Cheraghali

    2012-10-01

    Full Text Available Plasma derived medicines (PDM including immunoglobulins, clotting factors and albumin are life saving medicines which due to their high costs are inaccessible for many patients living in developing countries. By contrary substantial volume of plasma as raw materials for production of these medicines are discarded worldwide. Good quality recovered plasma, as a result of separation of donated blood into its components, could be used for production of PDM. In 2011 Iranian donors donated about 2 million units of blood. A shift fromadministration of whole blood to components therapy has resulted in the generation of over 250,000 liters of surplus of recovered plasma. This created a good opportunity for Iran’s health care system to use this plasma for production of PDM. Therefore Iran national transfusion service has started a contract fractionation program for converting recovered plasma into PDM. This program not only provided essential PDM for Iran pharmaceutical market but also has created a direct saving of about 8.5 million Euros in 2011 for national health sector. In addition this program has drastically contributed to improvement of overall quality of working procedures and services provided by Iran national blood transfusion organization.

  7. Cost benefit analysis of the California HVS program

    CSIR Research Space (South Africa)

    Du Plessis, L

    2008-10-01

    Full Text Available ); • Compile a set of assumptions required for a benefit/cost analysis including analysis period, initial construction costs, routine maintenance costs, rehabilitation timing and costs, discount rate etc.; • Conduct initial benefit/cost analyses based... Pf Ca Cb Cc Concrete Base Pavement Notation: Pi = Probability that option I would be implemented Ci = Discounted life cycle cost for each alternative Asphalt Base Pavement G1 Base Pavement Effective cost for each alternative = (P i ) x (C i...

  8. Two Computer Programs for Equipment Cost Estimation and Economic Evaluation of Chemical Processes.

    Science.gov (United States)

    Kuri, Carlos J.; Corripio, Armando B.

    1984-01-01

    Describes two computer programs for use in process design courses: an easy-to-use equipment cost estimation program based on latest cost correlations available and an economic evaluation program which calculates two profitability indices. Comparisons between programed and hand-calculated results are included. (JM)

  9. UMTRA Project Administrative Files Collection Records Management Program

    Energy Technology Data Exchange (ETDEWEB)

    1994-09-01

    The UPAFC Records Management Plan is based on the life cycle of a record - the evolution of a record from creation until final disposition. There are three major phases in the life cycle of a record: (1) creation and receipt, (2) maintenance and use, and (3) disposition. Accordingly, the Records Management Plan is structured to follow each of those phases. During each of the three phases, some kind of control is mandatory. The Records Management Plan establishes appropriate standards, policies, and procedures to ensure adequate control is always maintained. It includes a plan for records management, a plan for records management training activities, and a plan for auditing and appraising the program.

  10. 78 FR 64598 - Bank Enterprise Award (BEA) Program; Programmatic and Administrative Aspects; Public Comment Request

    Science.gov (United States)

    2013-10-29

    ... Community Development Financial Institutions Fund Bank Enterprise Award (BEA) Program; Programmatic and Administrative Aspects; Public Comment Request AGENCY: Community Development Financial Institutions Fund, Department of the Treasury. ACTION: Request for public comment. SUMMARY: This notice invites comments from...

  11. Establishing a Competency Field-Based Program of Reading Education: Essential Elements of Administrative Planning.

    Science.gov (United States)

    Blair, Charles W.

    1979-01-01

    Identifies essential aspects of administrative planning that must be considered when moving from a traditional reading preservice education program to a competency, field-based model of instruction. (TJ)

  12. Cost analysis of school-based sexuality education programs in six countries

    Science.gov (United States)

    2013-01-01

    Background Policy-makers who are making decisions on sexuality education programs face important economic questions: what are the costs of developing sexuality education programs; and what are the costs of implementing and scaling them up? This study responds to these questions by assessing the costs of six school-based sexuality education programs (Nigeria, Kenya, Indonesia, India, Estonia and the Netherlands). Methods Cost analyses were carried out in schools that were fully implementing a SE program, as this best reflects the resources needed to run an effective program. The costs were analyzed from the program perspective, meaning that all costs borne by the governmental and (international) non-governmental organizations supporting the program were included. Cost analyses were based on financial records, interviews and school surveys. We distinguished costs in three consecutive program phases: development, update and implementation. Recommendations on the most efficient program characteristics and scale-up pathways were drawn from results of three fully scaled up programs (Estonia, Nigeria and the Netherlands), scale-up scenarios of two pilot programs (Kenya and Indonesia), and an implementation plan (India), The costs of the programs were compared by converting cost per student reached in US dollars (US$) to international dollars (I$). Results Findings revealed a range of costs and coverage of sexuality education programs. Costs per student reached were; US$7 in Nigeria, US$13.50 in India, US$33 in Estonia and the Netherlands, US$50 in Kenya, and US$160 in Indonesia. Conclusions Intra-curricular sexuality education programs have, because of their compulsory nature, the most potential to be scaled up and are therefore most efficient. Extra-curricular sexuality education programs have lower potential to be scaled up and are therefore less efficient. In terms of class size and number of lessons, countries need to strike a balance between the quality (demanding

  13. Cost analysis of school-based sexuality education programs in six countries.

    Science.gov (United States)

    Kivela, Jari; Ketting, Evert; Baltussen, Rob

    2013-08-01

    Policy-makers who are making decisions on sexuality education programs face important economic questions: what are the costs of developing sexuality education programs; and what are the costs of implementing and scaling them up? This study responds to these questions by assessing the costs of six school-based sexuality education programs (Nigeria, Kenya, Indonesia, India, Estonia and the Netherlands). Cost analyses were carried out in schools that were fully implementing a SE program, as this best reflects the resources needed to run an effective program. The costs were analyzed from the program perspective, meaning that all costs borne by the governmental and (international) non-governmental organizations supporting the program were included. Cost analyses were based on financial records, interviews and school surveys.We distinguished costs in three consecutive program phases: development, update and implementation. Recommendations on the most efficient program characteristics and scale-up pathways were drawn from results of three fully scaled up programs (Estonia, Nigeria and the Netherlands), scale-up scenarios of two pilot programs (Kenya and Indonesia), and an implementation plan (India), The costs of the programs were compared by converting cost per student reached in US dollars (US$) to international dollars (I$). Findings revealed a range of costs and coverage of sexuality education programs. Costs per student reached were; US$7 in Nigeria, US$13.50 in India, US$33 in Estonia and the Netherlands, US$50 in Kenya, and US$160 in Indonesia. Intra-curricular sexuality education programs have, because of their compulsory nature, the most potential to be scaled up and are therefore most efficient. Extra-curricular sexuality education programs have lower potential to be scaled up and are therefore less efficient. In terms of class size and number of lessons, countries need to strike a balance between the quality (demanding smaller classes and many lessons) and the

  14. Perceived Value of University-Based Continuing Education Leadership Development Programs for Administrators

    Science.gov (United States)

    Stone, Geri L.; Major, Claire H.

    2014-01-01

    This quantitative study, which involved development of a Value Creation Survey, examined the perceived value of leadership development programs (LDPs) provided by continuing higher education for administrators in colleges and universities. Participants were administrators at Association for Continuing Higher Education (ACHE) member institutions.…

  15. An Instrumental Case Study of Administrative Smart Practices for Fully Online Programs and Degrees

    Science.gov (United States)

    Gregory, Charles V.

    2017-01-01

    The purpose of this instrumental case study was to explore administrators' responses to significant administrative challenges of fully online programs and degrees. The case was a single public community college located in the Integrated Postsecondary Education Data System Plains Region. In this study Bardach's (1994) method to identify and…

  16. Diffusion of Courses with World Wide Web Features: Perceptions of Journalism and Mass Communication Program Administrators.

    Science.gov (United States)

    Sutherland, Patrick J.

    2003-01-01

    Examines perceptions of top administrators concerning courses with Web features at Association of Schools of Journalism and Mass Communication (ASJMC) programs. Studies the imperatives and pressures to implement courses with Web features as well as resistances to implementation. Suggests that administrators perceive an extensive set of needs and…

  17. A Case Study of Dual Language Program Administrators: The Teachers We Need

    Science.gov (United States)

    Lachance, Joan R.

    2017-01-01

    In support of growing numbers of dual language programs nation-wide, dual language school administrators seek to find teachers who are specifically prepared to work with dual language learners for additive biliteracy. For this research the author utilized a case study design to explore practicing dual language administrators' perspectives…

  18. 76 FR 35318 - Competitive and Noncompetitive Nonformula Federal Assistance Programs-Administrative Provisions...

    Science.gov (United States)

    2011-06-17

    ... Agriculture and the Secretary of Energy, to establish and carry out a joint Biomass Research and Development... Federal Assistance Programs--Administrative Provisions for Biomass Research and Development Initiative... containing a set of specific administrative requirements for the Biomass Research and Development Initiative...

  19. Bonneville Power Administration Wildlife Mitigation Program : Draft Environmental Impact Statement.

    Energy Technology Data Exchange (ETDEWEB)

    United States. Bonneville Power Administration.

    1996-08-01

    Bonneville Power Administration (BPA) is responsible for mitigating the loss of wildlife habitat caused by the development of the Federal Columbia River Power System. BPA accomplishes this mitigation by funding projects consistent with those recommended by the Northwest Power Planning Council (Council). The projects are submitted to the Council from Indian Tribes, state agencies, property owners, private conservation groups, and other Federal agencies. Future wildlife mitigation actions with potential environmental impacts are expected to include land acquisition and management, water rights acquisition and management, habitat restoration and enhancement, installation of watering devices, riparian fencing, and similar wildlife conservation actions. BPA needs to ensure that individual wildlife mitigation projects are planned and managed with appropriate consistency across projects, jurisdictions, and ecosystems, as well as across time. BPA proposes to standardize the planning and implementation of individual wildlife mitigation projects funded by BPA. Alternative 1 is the No Action alternative. Five standardizing alternatives are identified to represent the range of possible strategies, goals, and procedural requirements reasonably applicable to BPA-funded projects under a standardized approach to project planning and implementation. All action alternatives are based on a single project planning process designed to resolve site-specific issues in an ecosystem context and to adapt to changing conditions and information.

  20. Medicaid: Determining Cost-Effectiveness of Home and Community-Based Services. Report to the Administrator, Health Care Financing Administration, Department of Health and Human Services.

    Science.gov (United States)

    General Accounting Office, Washington, DC.

    To examine alternatives to nursing home care, states have been testing home and community-based services under the Medicaid program. Information on the operations of the state projects will be vital to designing cost-effective alternative services in the future. The General Accounting Office (GAO) reviewed state reports to see if accurate,…

  1. Model-based evaluation of cost-effectiveness of nerve growth factor inhibitors in knee osteoarthritis: impact of drug cost, toxicity, and means of administration.

    Science.gov (United States)

    Losina, E; Michl, G; Collins, J E; Hunter, D J; Jordan, J M; Yelin, E; Paltiel, A D; Katz, J N

    2016-05-01

    Studies suggest nerve growth factor inhibitors (NGFi) relieve pain but may accelerate disease progression in some patients with osteoarthritis (OA). We sought cost and toxicity thresholds that would make NGFi a cost-effective treatment for moderate-to-severe knee OA. We used the Osteoarthritis Policy (OAPol) model to estimate the cost-effectiveness of NGFi compared to standard of care (SOC) in OA, using Tanezumab as an example. Efficacy and rates of accelerated OA progression were based on published studies. We varied the price/dose from $200 to $1000. We considered self-administered subcutaneous (SC) injections (no administration cost) vs provider-administered intravenous (IV) infusion ($69-$433/dose). Strategies were defined as cost-effective if their incremental cost-effectiveness ratio (ICER) was less than $100,000/quality-adjusted life year (QALY). In sensitivity analyses we varied efficacy, toxicity, and costs. SOC in patients with high levels of pain led to an average discounted quality-adjusted life expectancy of 11.15 QALYs, a lifetime risk of total knee replacement surgery (TKR) of 74%, and cumulative discounted direct medical costs of $148,700. Adding Tanezumab increased QALYs to 11.42, reduced primary TKR utilization to 63%, and increased costs to between $155,400 and $199,500. In the base-case analysis, Tanezumab at $600/dose was cost-effective when delivered outside of a hospital. At $1000/dose, Tanezumab was not cost-effective in all but the most optimistic scenario. Only at rates of accelerated OA progression of 10% or more (10-fold higher than reported values) did Tanezumab decrease QALYs and fail to represent a viable option. At $100,000/QALY, Tanezumab would be cost effective if priced ≤$400/dose in all settings except IV hospital delivery. Copyright © 2016 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  2. Administrative databases as a tool for identifying healthcare demand and costs in an over-one million population

    Directory of Open Access Journals (Sweden)

    Fabiana Madotto

    2013-06-01

    Full Text Available Background: the aim of this study was to assess healthcare demand of specific groups of population and their costs borne by Italian Health System, using healthcare administrative databases.Methods: demographic, clinical and economic data were obtained from datasets available at the Regional Health System, combined into a data warehouse (DENALI, using a probabilistic record linkage to optimize the data matching process. The study population consisted of more than 1 million people registered in 2005 at one Local Healthcare Unit of Lombardy. Eight different segments were identified. Costs occurring in 2005 for hospital admissions, drug prescriptions, outpatient medical specialist visits were quantified in each segment.Results: healthy people accounted for 53% of the population and cost € 180 per-capita. Subjects with only one chronic disease made up 16% of the population and cost € 916 per-capita, those affected by several chronic diseases accounted for 13% and cost € 3 457 per-capita. Hospitalizations were the cost driver in five segments, ranging from 42% to 89% of total expenditures. Outpatient visits were the cost driver among healthy subjects (54% and those with a possible chronic disease (42%, while drug costs ranged between 4% (“acute event” and 32% (“one chronic disease”. Overall, healthcare cost was € 809 per-capita.Conclusions: healthcare costs were mainly determined by people affected by chronic conditions, even if “healthy people” ranked third for total expenditure. These costs need an appropriate identification of healthcare demand, that could be efficiently monitored through the use of administrative databases.

  3. 76 FR 54999 - Notice of 2011 National Organic Certification Cost-Share Program

    Science.gov (United States)

    2011-09-06

    ... Agricultural Marketing Service Notice of 2011 National Organic Certification Cost-Share Program AGENCY... Departments of Agriculture for the National Organic Certification Cost- Share Program. SUMMARY: This Notice... Service (AMS) for the allocation of National Organic Certification Cost-Share Funds. Beginning in Fiscal...

  4. 75 FR 54590 - Notice of 2010 National Organic Certification Cost-Share Program

    Science.gov (United States)

    2010-09-08

    ... Agricultural Marketing Service Notice of 2010 National Organic Certification Cost-Share Program AGENCY... National Organic Certification Cost-Share Program. SUMMARY: This Notice invites all States of the United... allocation of National Organic Certification Cost-Share Funds. The AMS has allocated $22.0 million for this...

  5. 75 FR 54591 - Notice of Agricultural Management Assistance Organic Certification Cost-Share Program

    Science.gov (United States)

    2010-09-08

    ... Agricultural Marketing Service Notice of Agricultural Management Assistance Organic Certification Cost-Share... Applications for the Agricultural Management Assistance Organic Certification Cost-Share Program. SUMMARY: This... the Agricultural Management Assistance (AMA) Program. Total amount of cost-share payments provided to...

  6. Organizational Change Efforts: Methodologies for Assessing Organizational Effectiveness and Program Costs versus Benefits.

    Science.gov (United States)

    Macy, Barry A.; Mirvis, Philip H.

    1982-01-01

    A standardized methodology for identifying, defining, and measuring work behavior and performance rather than production, and a methodology that estimates the costs and benefits of work innovation are presented for assessing organizational effectiveness and program costs versus benefits in organizational change programs. Factors in a cost-benefit…

  7. 42 CFR 137.301 - How are project and program environmental review costs identified?

    Science.gov (United States)

    2010-10-01

    ... development to identify program and project related costs associated with carrying out environmental... costs identified? 137.301 Section 137.301 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND... Construction Nepa Process § 137.301 How are project and program environmental review costs identified? (a) The...

  8. What Are the Perceptions of Administrators and Clinicians on an Effective Anti-Bully Prevention Program?

    Science.gov (United States)

    Bringas, Mary Elizabeth

    2017-01-01

    This qualitative case study examined the effective elements of a successful anti-bullying program through clinician and administrator perceptions. Previous studies have examined resources and interventions as curricular strategies, with some studies reflecting interventions as comprehensive programs; however, most studies do not provide…

  9. 15 CFR 19.5 - How will Commerce entities add interest, penalty charges, and administrative costs to a Commerce...

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false How will Commerce entities add interest, penalty charges, and administrative costs to a Commerce debt? 19.5 Section 19.5 Commerce and Foreign Trade Office of the Secretary of Commerce COMMERCE DEBT COLLECTION Procedures To Collect Commerce...

  10. 77 FR 58989 - Proposed CERCLA Administrative Cost Recovery Settlement for the Buckbee-Mears Co. Superfund Site...

    Science.gov (United States)

    2012-09-25

    ... AGENCY Proposed CERCLA Administrative Cost Recovery Settlement for the Buckbee-Mears Co. Superfund Site.... Superfund Site located in Cortland, Cortland County, New York, (the ``Site'') with the State Bank of India... the Buckbee- Mears Co. Superfund Site located in Cortland, New York, Cortland County, EPA Region II...

  11. Updating Linear Schedules with Lowest Cost: a Linear Programming Model

    Science.gov (United States)

    Biruk, Sławomir; Jaśkowski, Piotr; Czarnigowska, Agata

    2017-10-01

    Many civil engineering projects involve sets of tasks repeated in a predefined sequence in a number of work areas along a particular route. A useful graphical representation of schedules of such projects is time-distance diagrams that clearly show what process is conducted at a particular point of time and in particular location. With repetitive tasks, the quality of project performance is conditioned by the ability of the planner to optimize workflow by synchronizing the works and resources, which usually means that resources are planned to be continuously utilized. However, construction processes are prone to risks, and a fully synchronized schedule may expire if a disturbance (bad weather, machine failure etc.) affects even one task. In such cases, works need to be rescheduled, and another optimal schedule should be built for the changed circumstances. This typically means that, to meet the fixed completion date, durations of operations have to be reduced. A number of measures are possible to achieve such reduction: working overtime, employing more resources or relocating resources from less to more critical tasks, but they all come at a considerable cost and affect the whole project. The paper investigates the problem of selecting the measures that reduce durations of tasks of a linear project so that the cost of these measures is kept to the minimum and proposes an algorithm that could be applied to find optimal solutions as the need to reschedule arises. Considering that civil engineering projects, such as road building, usually involve less process types than construction projects, the complexity of scheduling problems is lower, and precise optimization algorithms can be applied. Therefore, the authors put forward a linear programming model of the problem and illustrate its principle of operation with an example.

  12. Major Management Challenges and Program Risks National Aeronautics and Space Administration

    National Research Council Canada - National Science Library

    1999-01-01

    .... These problems are the results of serious deficiencies in financial management systems, continuing threats to the International Space Station Program that translate into higher program costs, and a lack of closure in the implementation of cooperative efforts with the Department of Defense regarding aerospace test facilities.

  13. 75 FR 54530 - Food Distribution Program on Indian Reservations: Administrative Funding Allocations

    Science.gov (United States)

    2010-09-08

    ... conducting data collection and analysis for several months, the work group completed a preliminary proposal... warehousing and transporting USDA foods to both the independent programs and those programs that they... FNS, the work group recommended that Montana's and North Dakota's warehousing and transportation costs...

  14. Department of Energy Environmental Management cost infrastructure development program: Cost analysis requirements

    Energy Technology Data Exchange (ETDEWEB)

    Custer, W.R. Jr.; Messick, C.D.

    1996-03-31

    This report was prepared to support development of the Department of Energy Environmental Management cost infrastructure -- a new capability to independently estimate and analyze costs. Currently, the cost data are reported according to a structure that blends level of effort tasks with product and process oriented tasks. Also. the budgetary inputs are developed from prior year funding authorizations and from contractor-developed parametric estimates that have been adjusted to planned funding levels or appropriations. Consequently, it is difficult for headquarters and field-level activities to use actual cost data and technical requirements to independently assess the costs generated and identify trends, potential cost savings from process improvements, and cost reduction strategies.

  15. The Opportunity Cost of Study Abroad Programs: An Economics-Based Analysis

    Science.gov (United States)

    Heitmann, George

    2008-01-01

    Most colleges and universities offer study abroad programs, and an increasing number of students participate in such programs. The cost of offering and promoting study abroad programs is often misunderstood and incorrectly assessed. This paper provides an analysis of study abroad costs that will be of general interest, but will be especially…

  16. Evaluating Intangible Outcomes: Using Multiattribute Utility Analysis to Compare the Benefits and Costs of Social Programs

    Science.gov (United States)

    Selameab, Tehout; Yeh, Stuart S.

    2008-01-01

    Increasingly, program managers are required to evaluate programs with multiple outcomes against costs. This is difficult when program outcomes are not easily translated into a common metric. This article compares cost benefit analysis with Multiple Attribute Utility Technology and discusses the application of judgment in both analytical…

  17. A Cost Model for Air Force Institute of Technology Programs.

    Science.gov (United States)

    1979-09-01

    specific Air Force require- ments in science, engineering management, medicine, and the social sciences. The peograms administered by CI include officer...Difference Direct Costs: $ 73.11 $ 67.77 $ 5.34 Indirect Costs: AFIT Indirect Costs 19.31 22.51 (3.20) Base Sico =rt Costs .97 1.01 (.04) Crmand Overhead...cost model’s forecast potential. A final determination regarding the quantification of the risk involved in using the AFIT cost model as a forecast

  18. 78 FR 5164 - Notice of Agricultural Management Assistance Organic Certification Cost-Share Program

    Science.gov (United States)

    2013-01-24

    ... Agricultural Marketing Service Notice of Agricultural Management Assistance Organic Certification Cost-Share... Applications From State Departments of Agriculture for the Agricultural Management Assistance Organic Certification Cost-Share Program. SUMMARY: This notice invites the following eligible States: Connecticut...

  19. 76 FR 55000 - Notice of Agricultural Management Assistance Organic Certification Cost-Share Program

    Science.gov (United States)

    2011-09-06

    ... Agricultural Marketing Service Notice of Agricultural Management Assistance Organic Certification Cost-Share... INFORMATION: This Organic Certification Cost-Share Program is part of the Agricultural Management Assistance... Applications from State Departments of Agriculture for the Agricultural Management Assistance Organic...

  20. 20 CFR 645.235 - What types of activities are subject to the administrative cost limit on Welfare-to-Work grants?

    Science.gov (United States)

    2010-04-01

    ...) Although administrative in nature, costs of information technology—computer hardware and software—needed... WtW including: (i) Accounting, budgeting, financial and cash management functions; (ii) Procurement... administrative functions (for example, personnel, procurement, purchasing, property management, accounting and...

  1. Cost of the Cervical Cancer Screening Program at the Mexican Social Security Institute

    Directory of Open Access Journals (Sweden)

    Víctor Granados-García

    2014-09-01

    Full Text Available Objective. To estimate the annual cost of the National Cervical Cancer Screening Program (CCSP of the Mexican Institute of Social Security (IMSS. Materials and methods. This cost analysis examined regional coverage rates reported by IMSS. We estimated the number of cytology, colposcopy, biopsy and pathology evaluations, as well as the diagnostic test and treatment costs for cervical intraepithelial neoplasia grade II and III (CIN 2/3 and cervical cancer. Diagnostic test costs were estimated using a micro-costing technique. Sensitivity analyses were performed. Results. The cost to perform 2.7 million cytology tests was nearly 38 million dollars, which represents 26.1% of the total program cost (145.4 million. False negatives account for nearly 43% of the program costs. Conclusion. The low sensitivity of the cytology test generates high rates of false negatives, which results in high institutional costs from the treatment of undetected cervical cancer cases.

  2. Evaluation of the Super Efficient Refrigerator Program (SERP) in the Bonneville Power Administration service territory

    Energy Technology Data Exchange (ETDEWEB)

    Lee, A.D.; Conger, R.L.

    1996-06-01

    The Super Efficient Refrigerator Program (SERP) is a collaborative utility program intended to transform the market for energy-efficient and environmentally friendly refrigerators. it is one of the first examples of large-scale {open_quotes}market transformation{close_quotes} energy efficiency program. This report documents the evaluation of SERP ({open_quotes}the Program{close_quotes}) in the Bonneville Power Administration`s (Bonneville`s) service territory. Pacific Northwest National Laboratory (PNNL) conducted this evaluation for Bonneville. This study includes the process evaluation, preliminary impact evaluation, and market transformation assessment. It is based on site visits and interviews with refrigerator dealers and manufacturers, industry data, and Bonneville information. Results from this study are compared with those from a parallel study that examines the Program across the 24 participating utilities.

  3. Quality management and federal workers' compensation: the Veterans Health Administration workers' compensation program model.

    Science.gov (United States)

    Hodgson, Michael J; Mohr, David C; Lipkowitz-Eaton, Jennifer; Rodrigues, Dianne; Moreau, Sarah; McPhaul, Kate

    2015-03-01

    The federal workers' compensation program includes under a single employer five commonly encountered roles and responsibilities-injured patient, clinical provider, third-party administrator, adjudicator, and insurer. Data within the Veterans Health Administration (VHA) provide a unique opportunity to apply a simple model of health care quality improvement, exploring interactions between structures, processes, and outcomes. A facility survey identified reporting structures, levels of education and training, policies and processes, tool availability and use, and perceptions of role adherence. Administrative data included process and outcome metrics, including short-term disability, long-term disability, and lost time cases. Improved collaboration between clinical and administrative staff within VHA and with the Department of Labor was associated with improved performance. Applying a clinical quality improvement model clarifies roles, expectations, and likely relationships for improved program management.

  4. When pharmacodynamics trump costs: an antimicrobial stewardship program's approach to selecting optimal antimicrobial agents

    National Research Council Canada - National Science Library

    Goff, Debra A; Nicolau, David P

    2013-01-01

    .... Antimicrobial stewardship programs provide guidance for clinicians regarding use of the most appropriate antimicrobial at the right dose, duration, and route in addition to being cost-effective...

  5. Survey of academic pediatric hospitalist programs in the US: organizational, administrative, and financial factors.

    Science.gov (United States)

    Gosdin, Craig; Simmons, Jeffrey; Yau, Connie; Sucharew, Heidi; Carlson, Douglas; Paciorkowski, Natalia

    2013-06-01

    Many pediatric academic centers have hospital medicine programs. Anecdotal data suggest that variability exists in program structure. To provide a description of the organizational, administrative, and financial structures of academic pediatric hospital medicine (PHM). This online survey focused on the organizational, administrative, and financial aspects of academic PHM programs, which were defined as hospitalist programs at US institutions associated with accredited pediatric residency program (n = 246) and identified using the Accreditation Council for Graduate Medical Education (ACGME) Fellowship and Residency Electronic Interactive Database. PHM directors and/or residency directors were targeted by both mail and the American Academy of Pediatrics Section on Hospital Medicine LISTSERV. The overall response rate was 48.8% (120/246). 81.7% (98/120) of hospitals reported having an academic PHM program, and 9.1% (2/22) of hospitals without a program reported plans to start a program in the next 3 years. Over a quarter of programs provide coverage at multiple sites. Variability was identified in many program factors, including hospitalist workload and in-house coverage provided. Respondents reported planning increased in-house hospitalist coverage coinciding with the 2011 ACGME work-hour restrictions. Few programs reported having revenues greater than expenses (26% single site, 4% multiple site). PHM programs exist in the majority of academic centers, and there appears to be variability in many program factors. This study provides the most comprehensive data on academic PHM programs and can be used for benchmarking as well as program development. Copyright © 2013 Society of Hospital Medicine.

  6. The cost and performance of utility commercial lighting programs. A report from the Database on Energy Efficiency Programs (DEEP) project

    Energy Technology Data Exchange (ETDEWEB)

    Eto, J.; Vine, E.; Shown, L.; Sonnenblick, R.; Payne, C. [Lawrence Berkeley Lab., CA (United States). Energy and Environment Div.

    1994-05-01

    The objective of the Database on Energy Efficiency Programs (DEEP) is to document the measured cost and performance of utility-sponsored, energy-efficiency, demand-side management (DSM) programs. Consistent documentation of DSM programs is a challenging goal because of problems with data consistency, evaluation methodologies, and data reporting formats that continue to limit the usefulness and comparability of individual program results. This first DEEP report investigates the results of 20 recent commercial lighting DSM programs. The report, unlike previous reports of its kind, compares the DSM definitions and methodologies that each utility uses to compute costs and energy savings and then makes adjustments to standardize reported program results. All 20 programs were judged cost-effective when compared to avoided costs in their local areas. At an average cost of 3.9{cents}/kWh, however, utility-sponsored energy efficiency programs are not ``too cheap to meter.`` While it is generally agreed upon that utilities must take active measures to minimize the costs and rate impacts of DSM programs, the authors believe that these activities will be facilitated by industry adoption of standard definitions and reporting formats, so that the best program designs can be readily identified and adopted.

  7. PROPOSAL FOR NEURAL-LINGUISTIC PROGRAMMING (N.L.P. INTHE ADMINISTRATIVE DEVELOPMENT OF LEADERSHIP SPORTS

    Directory of Open Access Journals (Sweden)

    Khalil Samira

    2010-08-01

    Full Text Available Neural-linguistic programming is an organised method to know the human self construction and dealing with it in fixed means and styles so as to decesisively affect the processes of perception, thinking, imaging, ideas,feeling and also in behavior, skills and the human body and mental performance (1 Neural-linguistic programming has a private nature because it is a group of mechanisms and practicaltechniques far from likeliness, so it enters in the circle of application and employment of the human abilities and possibilities. (9 Al Fiky (2001 points out that neural linguistic programming created the favourable environment to help individuals to get rid of their diseased fears and controlling in their negative reactions and thus improving communication with themselves and with others. He shows it took its way into the human life fields because itsways and strategies are used in the sectors of health, education, marketing and administration(2. The modern administration embarks on the human element that represents the most valuable elementsof administration and is the most effective on the productivity and with the increasing the effect of the human element in the efficacy of the administrative organizations, the need increased to consider the management of the human resources as an independent function of administrative functions that cancers the human element and onwhose efficiency, abilities, experience and zeal for work, the administration efficacy depends.

  8. A Sensitivity Analysis of the Rigid Pavement Life-Cycle Cost Analysis Program

    Science.gov (United States)

    2000-12-01

    Original Report Date: September 1999. This report describes the sensitivity analysis performed on the Rigid Pavement Life-Cycle Cost Analysis program, a computer program developed by the Center for Transportation Research for the Texas Department of ...

  9. A Practical Methodology for Disaggregating the Drivers of Drug Costs Using Administrative Data.

    Science.gov (United States)

    Lungu, Elena R; Manti, Orlando J; Levine, Mitchell A H; Clark, Douglas A; Potashnik, Tanya M; McKinley, Carol I

    2017-09-01

    Prescription drug expenditures represent a significant component of health care costs in Canada, with estimates of $28.8 billion spent in 2014. Identifying the major cost drivers and the effect they have on prescription drug expenditures allows policy makers and researchers to interpret current cost pressures and anticipate future expenditure levels. To identify the major drivers of prescription drug costs and to develop a methodology to disaggregate the impact of each of the individual drivers. The methodology proposed in this study uses the Laspeyres approach for cost decomposition. This approach isolates the effect of the change in a specific factor (e.g., price) by holding the other factor(s) (e.g., quantity) constant at the base-period value. The Laspeyres approach is expanded to a multi-factorial framework to isolate and quantify several factors that drive prescription drug cost. Three broad categories of effects are considered: volume, price and drug-mix effects. For each category, important sub-effects are quantified. This study presents a new and comprehensive methodology for decomposing the change in prescription drug costs over time including step-by-step demonstrations of how the formulas were derived. This methodology has practical applications for health policy decision makers and can aid researchers in conducting cost driver analyses. The methodology can be adjusted depending on the purpose and analytical depth of the research and data availability.

  10. Availability and Perceived Value of Masters of Business Administration Degree Programs in Pharmaceutical Marketing and Management

    Science.gov (United States)

    Clauson, Kevin A.; Latif, David A.

    2012-01-01

    Objectives. To examine pharmacist-targeted master of business administration (MBA) degree programs and investigate pharmacists’ perceptions regarding them. Methods. Specialized MBA programs in pharmaceutical marketing and management offered at US colleges and schools of pharmacy were identified in the literature and compared. Pharmacists’ perceptions of MBA programs were evaluated through a survey of clinical preceptors affiliated with a school of pharmacy. Results. Seven US universities that offer an MBA program in pharmaceutical marketing and management were identified. Thirty-three percent of the 57 pharmacist preceptors who responded to the survey reported plans to pursue an MBA degree program. Respondents preferred MBA programs related to healthcare or pharmacy (66%) over general MBA programs (33%). Conclusion. An MBA in pharmaceutical marketing and management could provide pharmacists with advanced knowledge of the operational and strategic business aspects of pharmacy practice and give pharmacy graduates an advantage in an increasingly competitive job market. PMID:22611273

  11. Availability and perceived value of masters of business administration degree programs in pharmaceutical marketing and management.

    Science.gov (United States)

    Alkhateeb, Fadi M; Clauson, Kevin A; Latif, David A

    2012-05-10

    To examine pharmacist-targeted master of business administration (MBA) degree programs and investigate pharmacists' perceptions regarding them. Specialized MBA programs in pharmaceutical marketing and management offered at US colleges and schools of pharmacy were identified in the literature and compared. Pharmacists' perceptions of MBA programs were evaluated through a survey of clinical preceptors affiliated with a school of pharmacy. Seven US universities that offer an MBA program in pharmaceutical marketing and management were identified. Thirty-three percent of the 57 pharmacist preceptors who responded to the survey reported plans to pursue an MBA degree program. Respondents preferred MBA programs related to healthcare or pharmacy (66%) over general MBA programs (33%). An MBA in pharmaceutical marketing and management could provide pharmacists with advanced knowledge of the operational and strategic business aspects of pharmacy practice and give pharmacy graduates an advantage in an increasingly competitive job market.

  12. A model to predict the cost-effectiveness of disease management programs.

    Science.gov (United States)

    Gandjour, Afschin

    2010-06-01

    High costs and deficits in the care of patients with chronic diseases have triggered numerous programs to improve the quality and efficiency of treatment of chronic diseases. Decision makers need to estimate the impact of a disease management program (DMP) on long-term costs and cost-effectiveness in order to decide which programs to introduce. This prediction, however, requires formalizing the relations between a variety of variables. The purpose of this paper is to formalize these relations and develop a model that enhances the quality of predictions of the costs and cost-effectiveness of a DMP. The model's cost function is able to portray a reduction both of treatment overuse and underuse by improving both physician and patient compliance. The model's applicability is demonstrated by a simulated DMP for patients with hypertension. The application example shows that implementation costs may have a larger financial impact than downstream costs.

  13. Implementing Suicide Prevention Programs: Costs and Potential Life Years Saved in Canada.

    Science.gov (United States)

    Vasiliadis, Helen-Maria; Lesage, Alain; Latimer, Eric; Seguin, Monique

    2015-09-01

    Little is known about the costs and effects of suicide prevention programs at the population level. We aimed to determine (i) the costs associated with a suicide death and using prospective values (ii) the costs and effects of transferring, into a Canadian context, the results of the European Nuremberg Alliance against Depression (NAD) trial with the addition of 4 community-based suicide prevention strategies. These included the training of family physicians in the detection and treatment of depression, population campaigns aimed at increasing awareness about depression, the training of community leaders among first responders and follow-up of individuals who attempted suicide. This study includes a prospective value implementation study design. Using published data and information from interviews with Canadian decision makers, we assessed the costs of a suicide death in the province of Quebec and the costs of potentially implementing the NAD multi-modal suicide prevention programs, and the incremental cost-effectiveness ratio (ICER), from a health care system and societal perspective, associated with the NAD program while considering the friction cost method (FCM) and human capital approach (HCA) (discounted at 3%.) The costs considered included those incurred for the suicide prevention program and direct medical and non-medical costs as well as those related to a police investigation and funeral costs. Indirect costs associated with loss of productivity and short term disability were also considered. Sensitivity analyses were also carried out. Costs presented were in 2010 dollars. The annual total cost of implementing the suicide prevention programs in Quebec reached CAD23,982,293. The most expensive components of the program included the follow-up of individuals who had attempted suicide and psychotherapy for bereaved individuals. These accounted for 39% and 34% of total costs. The ICER associated with the implementation of the programs reached on average CAD3

  14. Cost analysis of an exercise program for older women with respect to social welfare and healthcare costs: a pilot study.

    Science.gov (United States)

    Timonen, L; Rantanen, T; Mäkinen, E; Timonen, T E; Törmäkangas, T; Sulkava, R

    2008-12-01

    The aim of this study was to analyze social welfare and healthcare costs and fall-related healthcare costs after a group-based exercise program. The 10-week exercise program, which started after discharge from the hospital, was designed to improve physical fitness, mood, and functional abilities in frail elderly women. Sixty-eight acutely hospitalized and mobility-impaired women (mean age 83.0, SD 3.9 years) were randomized into either group-based (intervention) or home exercise (control) groups. Information on costs was collected during 1 year after hospital discharge. There were no differences between the intervention and control groups in the mean individual healthcare costs: 4381 euros (SD 3829 euros) vs 3539 euros (SD 3967 euros), P=0.477, in the social welfare costs: 3336 euros (SD 4418 euros) vs 4073 euros (SD 5973 euros), P=0.770, or in the fall-related healthcare costs: 996 euros (SD 2612 euros) vs 306 euros (SD 915), P=0.314, respectively. This exercise intervention, which has earlier proved to be effective in improving physical fitness and mood, did not result in any financial savings in municipal costs. These results serve as a pilot study and further studies are needed to establish the cost-effectiveness of this exercise intervention for elderly people.

  15. From Compassionate Conservatism to Obamacare: Funding for the Ryan White Program During the Obama Administration.

    Science.gov (United States)

    Hatcher, William; Pund, Britten; Khatiashvili, Giorgi

    2016-11-01

    To examine President Obama's fiscal commitment to the Ryan White Program (formerly Ryan White Comprehensive AIDS Resource Emergency Act), which provides funding for economically disadvantaged people and families affected by HIV. We analyzed budgetary request and congressional appropriation data from 2009 to 2016. The data are available from the Health Resources and Services Administration and the Henry J. Kaiser Family Foundation. Increased coverage for people living with HIV/AIDS provided by the Affordable Care Act most likely led the Obama administration to request small increases and at times decreases in funding for the Ryan White Program. Congress passed either small increases or decreases in appropriations for the Ryan White Program. Decreases or small increases in the Ryan White Program funding risk progress made in treating HIV among economically disadvantaged patients.

  16. Evaluation of the Super ESPC Program: Level 2 -- Recalculated Cost Savings

    Energy Technology Data Exchange (ETDEWEB)

    Shonder, John A [ORNL; Hughes, Patrick [ORNL

    2009-04-01

    particular validity criteria, is described in Shonder and Florita (2003) and Shonder and Hughes (2005). To address the first objective of the Level 2 analysis, we first assembled all the necessary information, and then repeated the ESCOs' calculations of reported annual cost savings. Only minor errors were encountered, the most common being the use of incorrect escalation rates to calculate utility prices or O&M savings. Altogether, our corrected calculations of the ESCO's reported cost savings were within 0.6% of the ESCOs' reported cost savings, and errors found were as likely to favor the government as they were the ESCO. To address the second objective, we gathered data on utility use and cost from central databases maintained by the Department of Defense and the General Services Administration, and directly from some of the sites, to determine the prices of natural gas and electricity actually paid at the sites during the periods addressed by the annual reports. We used these data to compare the actual utility costs at the sites to the contract utility prices. For natural gas, as expected, we found that prices had risen much faster than had been anticipated in the contracts. In 17 of the 18 projects for which the comparison was possible, contract gas prices were found to be lower than the average actual prices being paid. We conclude that overall in the program, the estimates of gas prices and gas price escalation rates used in the Super ESPC projects have been conservative. For electricity, it was possible to compare contract prices with the actual (estimated) marginal prices of electricity in 20 projects. In 14 of these projects, the overall contract electricity price was found to be lower than the marginal price of electricity paid to the serving utility. Thus it appears that conservative estimates of electricity prices and escalation rates have been used in the program as well. Finally we calculated the value of the reported energy savings using the

  17. An Assessment of Cost Improvements in the NASA COTS - CRS Program and Implications for Future NASA Missions

    Science.gov (United States)

    Zapata, Edgar

    2017-01-01

    This review brings rigorous life cycle cost (LCC) analysis into discussions about COTS program costs. We gather publicly available cost data, review the data for credibility, check for consistency among sources, and rigorously define and analyze specific cost metrics.

  18. A Qualitative Approach to Examining Knowledge Sharing in Iran Tax Administration Reform Program

    Directory of Open Access Journals (Sweden)

    Mehdi Shami Zanjanie

    2012-02-01

    Full Text Available The paper aims to examine knowledge sharing infrastructure of "Iran Tax Administration Reform Program". The qualitative approach by using case study method was applied in this research. In order to meet the research goal, four infrastructural dimensions of knowledge sharing were studied: leadership & strategy, culture, structure, and information technology. To the authors’ knowledge, this was maybe the first paper which examined knowledge sharing infrastructure in programs environment

  19. Maternal influenza immunization in Malawi: Piloting a maternal influenza immunization program costing tool by examining a prospective program.

    Directory of Open Access Journals (Sweden)

    Clint Pecenka

    Full Text Available This costing study in Malawi is a first evaluation of a Maternal Influenza Immunization Program Costing Tool (Costing Tool for maternal immunization. The tool was designed to help low- and middle-income countries plan for maternal influenza immunization programs that differ from infant vaccination programs because of differences in the target population and potential differences in delivery strategy or venue.This analysis examines the incremental costs of a prospective seasonal maternal influenza immunization program that is added to a successful routine childhood immunization and antenatal care program. The Costing Tool estimates financial and economic costs for different vaccine delivery scenarios for each of the major components of the expanded immunization program.In our base scenario, which specifies a donated single dose pre-filled vaccine formulation, the total financial cost of a program that would reach 2.3 million women is approximately $1.2 million over five years. The economic cost of the program, including the donated vaccine, is $10.4 million over the same period. The financial and economic costs per immunized pregnancy are $0.52 and $4.58, respectively. Other scenarios examine lower vaccine uptake, reaching 1.2 million women, and a vaccine purchased at $2.80 per dose with an alternative presentation.This study estimates the financial and economic costs associated with a prospective maternal influenza immunization program in a low-income country. In some scenarios, the incremental delivery cost of a maternal influenza immunization program may be as low as some estimates of childhood vaccination programs, assuming the routine childhood immunization and antenatal care systems are capable of serving as the platform for an additional vaccination program. However, purchasing influenza vaccines at the prices assumed in this analysis, instead of having them donated, is likely to be challenging for lower-income countries. This result

  20. Cost and quality planning for large NASA programs

    Science.gov (United States)

    Rone, Kyle Y.

    1990-01-01

    The Software Cost and Quality Engineering methodology developed over the last two decades at IBM Federal Sector Div. is used to plan the NASA Space Station Data Management System (DMS). An ongoing project to capture this methodology, which is built on a foundation of experiences and lessons learned, has resulted in the development of a PC-based tool that integrates cost and quality forecasting methodologies and data in a consistent manner. This tool, Software Cost and Quality Engineering Starter Set (SCQESS), is being used to assist in the DMS costing exercises. At the same time, DMS planning serves as a forcing function and provides a platform for the continuing, iterative development, calibration, and validation and verification of SCQESS. The data that forms the cost and quality engineering data base is derived from more than 17 years of development of NASA Space Shuttle software, ranging from low criticality, low complexity support tools to highly complex and highly critical onboard software.

  1. Safety and quality management and administration Fiscal Year 1995 site support program plan WBS 6.7.2.6

    Energy Technology Data Exchange (ETDEWEB)

    Hagan, J.W.

    1994-09-01

    The mission of the Emergency, Safety, and Quality Services (ESQ) management and Program Integration is to provide leadership for the ESQ Department, coordinate business management activities of the ESQ department, and the programs it supports, as well as to plan organize, direct, and control other activities that require department-wide coordination. Primary activities include providing strategic and business planning and reporting support to ESQ management; developing and documenting ESQ management systems and procedures; coordinating ESQ`s self-assessment and Award Fee self evaluation efforts; coordinating the ESQ departments`s communication, total quality, cost savings, and productivity efforts; and tracking ESQ commitments and staffing data. This program element also provides program direction and performance assessment for the ESH&Q division of ICF KH. The ESH&Q Division educates ICF KH management and employees to protect personnel and the environment; identifies, interprets and inspects to requirements; provides administrative and field support; performs final acceptance of construction; assesses effectiveness of ICF KH programs and processes, and performs baseline ESH&Q assessments.

  2. TEAM-HF Cost-Effectiveness Model: A Web-Based Program Designed to Evaluate the Cost-Effectiveness of Disease Management Programs in Heart Failure

    Science.gov (United States)

    Reed, Shelby D.; Neilson, Matthew P.; Gardner, Matthew; Li, Yanhong; Briggs, Andrew H.; Polsky, Daniel E.; Graham, Felicia L.; Bowers, Margaret T.; Paul, Sara C.; Granger, Bradi B.; Schulman, Kevin A.; Whellan, David J.; Riegel, Barbara; Levy, Wayne C.

    2015-01-01

    Background Heart failure disease management programs can influence medical resource use and quality-adjusted survival. Because projecting long-term costs and survival is challenging, a consistent and valid approach to extrapolating short-term outcomes would be valuable. Methods We developed the Tools for Economic Analysis of Patient Management Interventions in Heart Failure (TEAM-HF) Cost-Effectiveness Model, a Web-based simulation tool designed to integrate data on demographic, clinical, and laboratory characteristics, use of evidence-based medications, and costs to generate predicted outcomes. Survival projections are based on a modified Seattle Heart Failure Model (SHFM). Projections of resource use and quality of life are modeled using relationships with time-varying SHFM scores. The model can be used to evaluate parallel-group and single-cohort designs and hypothetical programs. Simulations consist of 10,000 pairs of virtual cohorts used to generate estimates of resource use, costs, survival, and incremental cost-effectiveness ratios from user inputs. Results The model demonstrated acceptable internal and external validity in replicating resource use, costs, and survival estimates from 3 clinical trials. Simulations to evaluate the cost-effectiveness of heart failure disease management programs across 3 scenarios demonstrate how the model can be used to design a program in which short-term improvements in functioning and use of evidence-based treatments are sufficient to demonstrate good long-term value to the health care system. Conclusion The TEAM-HF Cost-Effectiveness Model provides researchers and providers with a tool for conducting long-term cost-effectiveness analyses of disease management programs in heart failure. PMID:26542504

  3. Cost analysis of school-based sexuality education programs in six countries

    NARCIS (Netherlands)

    Kivela, J.; Ketting, E.; Baltussen, R.M.P.M.

    2013-01-01

    BACKGROUND: Policy-makers who are making decisions on sexuality education programs face important economic questions: what are the costs of developing sexuality education programs; and what are the costs of implementing and scaling them up? This study responds to these questions by assessing the

  4. A Cost-Benefit Study of a Breaking the Cycle Program for Juveniles

    Science.gov (United States)

    Cowell, Alexander J.; Lattimore, Pamela K.; Krebs, Christopher P.

    2010-01-01

    The authors present a cost-benefit analysis of a Juvenile Breaking the Cycle (JBTC) program in Oregon designed to provide juvenile justice system monitoring and coordinated treatment and services to youth who are assessed as at high risk for recidivism and substance use. Detailed cost analyses are presented for youth in the JBTC program and a…

  5. Identifying potentially cost effective chronic care programs for people with COPD

    NARCIS (Netherlands)

    L.M.G. Steuten (Lotte); K.M.M. Lemmens (Karin); A.P. Nieboer (Anna); H.J.M. Vrijhoef (Hubertus)

    2009-01-01

    textabstractObjective: To review published evidence regarding the cost effectiveness of multi-component COPD programs and to illustrate how potentially cost effective programs can be identified. Methods: Systematic search of Medline and Cochrane databases for evaluations of multicomponent disease

  6. Cost-Benefit Considerations of New Careers Programs. Career Options Research and Development.

    Science.gov (United States)

    Soong, Robert K.; And Others

    Since the early 1960's, new programs have been developed to prepare poor people for jobs in hospitals, schools, social agencies, and community centers offering human services. To ascertain the cost effectiveness of these programs the Career Options Research and Development (CORD) Project focused on the need for cost and benefit studies that…

  7. 78 FR 53425 - Indirect Cost Rates for the Damage Assessment, Remediation, and Restoration Program for Fiscal...

    Science.gov (United States)

    2013-08-29

    ... policy for these fiscal years. For cases not settled and cost claims not paid prior to the effective date of the fiscal year in question, costs will be recalculated using the revised rates in this policy for... Indirect Cost Rates for the Damage Assessment, Remediation, and Restoration Program for Fiscal Year 2012...

  8. Preventing errors in administration of parenteral drugs: the results of a four-year national patient safety program.

    NARCIS (Netherlands)

    Blok, C. de; Schilp, J.; Wagner, C.

    2013-01-01

    Objectives: To evaluate the implementation of a four-year national patient safety program concerning the parenteral drug administration process in the Netherlands. Methods: Structuring the preparation and administration process of parenteral drugs reduces the number of medication errors. A

  9. Weighing the Issues and Consequences of Federal Program Termination: Administration on Aging Support for Career Preparation.

    Science.gov (United States)

    Craig, Bruce M.

    1982-01-01

    Describes policy decisions that have acted upon the 1982 Fiscal Year budget and funding priorities of the Administration on Aging's Gerontology Career Preparation Program, and projects the probable consequences of the policy option now being weighed to eliminate all future funding. (University of Texas Press, Box 7819, Austin, TX 78712). (NJ)

  10. Objectives, Priorities, and Activities of the Administration on Aging's Research and Development Grants Program.

    Science.gov (United States)

    Administration on Aging (DHEW), Washington, DC.

    Development, demonstration, and research projects, supported by the Administration on Aging's Research and Development Grants Program, have two major objectives: to stimulate community efforts in behalf of the elderly, and to develop solutions to many social and economic problems of the elderly. As of September 1, 1969, 117 projects had been…

  11. 78 FR 8329 - Federal Housing Administration (FHA): Hospital Mortgage Insurance Program-Refinancing Hospital Loans

    Science.gov (United States)

    2013-02-05

    ...) refinancing. III. Overview of Key Changes Made at Final Rule Stage HUD is making several changes to the... rule. Definitions (Section 242.1) The proposed rule added the following three definitions to 24 CFR... Administration (FHA): Hospital Mortgage Insurance Program--Refinancing Hospital Loans; Final Rule #0;#0;Federal...

  12. 77 FR 28854 - Proposed Information Collection; Comment Request; Coastal Zone Management Program Administration

    Science.gov (United States)

    2012-05-16

    ... importance of U.S. coastal areas, the U.S. Congress passed the Coastal Zone Management Act of 1972 (CZMA), 16... approve amendments or program changes; and report on the states' coastal nonpoint source pollution... National Oceanic and Atmospheric Administration Proposed Information Collection; Comment Request; Coastal...

  13. A Guide for Implementing Project DEEP (Diversified Educational Experiences Program). Administrator's Guide.

    Science.gov (United States)

    Connett, Jane; Swanson, Monty

    The guide is designed to provide the building level administrator a step by step model for implementing Project DEEP's (Diversified Educational Experiences Program) alternative classroom management system for secondary academic classrooms with disaffected (attendance problems, discipline problems, potential dropouts), average, and gifted and…

  14. The School Librarian as Program Administrator: Just-in-Time Librarianship

    Science.gov (United States)

    Yates, Steven D.

    2011-01-01

    By applying just-in-time philosophy to today's school libraries, librarians can fulfill the role of program administrator by continuing to provide the resources students and faculty deserve, exactly at their individual points of need. Just-in-time librarianship is a mindset that could prove unsettling for some school librarians. The main facets of…

  15. Limitations on Change: Current Conditions Influencing Academic Intransigence in Educational Administration Programs.

    Science.gov (United States)

    Logan, Connie Stokes; Pounder, Diana G.

    An analysis of academic intransigence (resistance to change) in educational administrative preparation programs is presented in this paper. Drawing upon two conceptual frameworks, the stakeholder perspective and Porter's (1980) five-force model of industry structure and competitive influence, two factors contributing to academic intransigence are…

  16. Adult Literacy Education Program Administrators' Perceptions of Occupational Stress and Coping Mechanisms

    Science.gov (United States)

    Engelmann, Stephanie

    2014-01-01

    Job performance may be adversely affected by stress. Job stress is a primary contributor to serious physical and emotional health consequences. This quantitative study examined adult literacy program administrator perceptions of occupational stress and coping mechanisms related to job satisfaction, job efficacy, career longevity, and overall…

  17. Handbook for Teachers and Administrators of Occupational Orientation Programs in Mississippi. Revised.

    Science.gov (United States)

    Mississippi State Dept. of Education, Jackson. Div. of Vocational and Technical Education.

    The handbook was prepared as a guide for school administrators and teachers of occupational orientation in secondary schools to help them develop an occupational orientation program which will meet the needs of their students. Topics discussed are: a definition and philosophy of occupational orientation; general objectives; course structure and…

  18. Cost Management Competencies for Department of Defense Program Managers

    Science.gov (United States)

    1994-09-01

    Posner .................................................................................................... 22 Cadbury -Schweppes...Posner’s Problems and Skills .............................................................................. . 23 8. Cadbury -Schweppes Model...goals make organizational skills critical. Cadbury -Schweppes Cadbury -Schweppes conducted an extensive research program involving program manager

  19. Cost effectiveness of the MDOT preventive maintenance program.

    Science.gov (United States)

    2013-04-01

    The Michigan Department of Transportations (MDOT) pavement preservation program dates back to 1992. MDOTs pavement preservation strategy is primarily implemented through its capital preventive maintenance (CPM) program, in which preventive main...

  20. Transfer Guide for BCcampus Online Courses and College/University Onsite Courses in Applied Business Technology/Office Administration Legal Administrative Assistant Programs

    Science.gov (United States)

    Haythorne, Marion

    2008-01-01

    This Transfer Guide provides students in Legal Administrative Assistant programs in any of the public post-secondary institutions in British Columbia the information they need to transfer credit acquired in onsite and/or online courses between institutions.

  1. Cost-effectiveness of the Norwegian breast cancer screening program.

    Science.gov (United States)

    van Luijt, P A; Heijnsdijk, E A M; de Koning, H J

    2017-02-15

    The Norwegian Breast Cancer Screening Programme (NBCSP) has a nation-wide coverage since 2005. All women aged 50-69 years are invited biennially for mammography screening. We evaluated breast cancer mortality reduction and performed a cost-effectiveness analysis, using our microsimulation model, calibrated to most recent data. The microsimulation model allows for the comparison of mortality and costs between a (hypothetical) situation without screening and a situation with screening. Breast cancer incidence in Norway had a steep increase in the early 1990s. We calibrated the model to simulate this increase and included recent costs for screening, diagnosis and treatment of breast cancer and travel and productivity loss. We estimate a 16% breast cancer mortality reduction for a cohort of women, invited to screening, followed over their complete lifetime. Cost-effectiveness is estimated at NOK 112,162 per QALY gained, when taking only direct medical costs into account (the cost of the buses, examinations, and invitations). We used a 3.5% annual discount rate. Cost-effectiveness estimates are substantially below the threshold of NOK 1,926,366 as recommended by the WHO guidelines. For the Norwegian population, which has been gradually exposed to screening, breast cancer mortality reduction for women exposed to screening is increasing and is estimated to rise to ∼30% in 2020 for women aged 55-80 years. The NBCSP is a highly cost-effective measure to reduce breast cancer specific mortality. We estimate a breast cancer specific mortality reduction of 16-30%, at the cost of 112,162 NOK per QALY gained. © 2016 UICC.

  2. Collecting costs of community prevention programs: communities putting prevention to work initiative.

    Science.gov (United States)

    Khavjou, Olga A; Honeycutt, Amanda A; Hoerger, Thomas J; Trogdon, Justin G; Cash, Amanda J

    2014-08-01

    Community-based programs require substantial investments of resources; however, evaluations of these programs usually lack analyses of program costs. Costs of community-based programs reported in previous literature are limited and have been estimated retrospectively. To describe a prospective cost data collection approach developed for the Communities Putting Prevention to Work (CPPW) program capturing costs for community-based tobacco use and obesity prevention strategies. A web-based cost data collection instrument was developed using an activity-based costing approach. Respondents reported quarterly expenditures on labor; consultants; materials, travel, and services; overhead; partner efforts; and in-kind contributions. Costs were allocated across CPPW objectives and strategies organized around five categories: media, access, point of decision/promotion, price, and social support and services. The instrument was developed in 2010, quarterly data collections took place in 2011-2013, and preliminary analysis was conducted in 2013. Preliminary descriptive statistics are presented for the cost data collected from 51 respondents. More than 50% of program costs were for partner organizations, and over 20% of costs were for labor hours. Tobacco communities devoted the majority of their efforts to media strategies. Obesity communities spent more than half of their resources on access strategies. Collecting accurate cost information on health promotion and disease prevention programs presents many challenges. The approach presented in this paper is one of the first efforts successfully collecting these types of data and can be replicated for collecting costs from other programs. Copyright © 2014 American Journal of Preventive Medicine. All rights reserved.

  3. Implications of Cost Effectiveness Screening Practices in a Low Natural Gas Price Environment: Case Study of a Midwestern Residential Energy Upgrade Program

    Energy Technology Data Exchange (ETDEWEB)

    Hoffman, Ian M. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Borgeson, Merrian Goggio [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Zimring, Mark [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2013-04-12

    With the proliferation of statewide energy savings targets and other policies favorable to energy efficiency, savings from utility customer-funded energy efficiency programs could rise to offset much of annual load growth by 2025 (Barbose et al 2013). For these increased savings to occur, however, nearly all of these programs must pass screening for cost effectiveness. Some program administrators and state regulators are finding that conventional analyses, which only consider a narrow set of energy-savings related efficiency program benefits, are now resulting in some natural gas efficiency programs failing their cost-effectiveness criteria in the new low natural gas price environment. Regulators are considering whether to scale back or terminate gas portfolios in at least four states (WA, OR, ID, NM) because of cost-effectiveness concerns. Stakeholders in several regions of the country have asked LBNL to help assess alternatives to reducing the pursuit of energy savings in their regions. We address these requests by producing two working papers: one exploring cost-effectiveness screening policy implications of low to moderate natural gas prices, and a second assessing some of the values that policymakers may take into account in weighing the pros and cons of ending natural gas efficiency programs. In this policy brief, we lay out the challenges that low gas prices pose for cost effectiveness of an electric-gas efficiency program and portfolio. We then quantify options available to regulators and administrators who want to evaluate the tradeoffs among multiple policy objectives. A multi-measure, residential energy upgrade program in the Midwest is used as a lens to explore the implications of common and emerging cost-effectiveness policies in the context of low prices for natural gas. We illustrate the results across a range of cost-effectiveness screening options, including different discount rates, levels of test application, various benefit-cost tests, and the

  4. Program Cost Allocation and the Validation of Faculty Activity Involvement

    Science.gov (United States)

    Hilles, William C.

    1973-01-01

    The author reviews the historical use of effort measure in cost allocation studies, examines criticism of the effort technique, and reports on several recent attempts by academic health centers to achieve a more valid measure of faculty activities. (Editor)

  5. Cost-benefit analysis of childhood asthma management through school-based clinic programs.

    Science.gov (United States)

    Tai, Teresa; Bame, Sherry I

    2011-04-01

    Asthma is a leading chronic illness among American children. School-based health clinics (SBHCs) reduced expensive ER visits and hospitalizations through better healthcare access and monitoring in select case studies. The purpose of this study was to examine the cost-benefit of SBHC programs in managing childhood asthma nationwide for reduction in medical costs of ER, hospital and outpatient physician care and savings in opportunity social costs of lowing absenteeism and work loss and of future earnings due to premature deaths. Eight public data sources were used to compare costs of delivering primary and preventive care for childhood asthma in the US via SBHC programs, including direct medical and indirect opportunity costs for children and their parents. The costs of nurse staffing for a nationwide SBHC program were estimated at $4.55 billion compared to the estimated medical savings of $1.69 billion, including ER, hospital, and outpatient care. In contrast, estimated total savings for opportunity costs of work loss and premature death were $23.13 billion. Medical savings alone would not offset the expense of implementing a SBHC program for prevention and monitoring childhood asthma. However, even modest estimates of reducing opportunity costs of parents' work loss would be far greater than the expense of this program. Although SBHC programs would not be expected to affect the increasing prevalence of childhood asthma, these programs would be designed to reduce the severity of asthma condition with ongoing monitoring, disease prevention and patient compliance.

  6. [Relationship between community-based dental health programs and health care costs for the metabolic syndrome].

    Science.gov (United States)

    Takeuchi, Noriko; Yamamoto, Tatsuo; Hirai, Aya; Morita, Manabu; Kodera, Ryousei

    2010-11-01

    Health care costs have been increasing year by year and health programs are needed which will allow reduction in the burden. The present community-based ecological study examined the relationship between implementation of dental health care programs and health care costs for the metabolic syndrome. We calculated the monthly health care cost for the metabolic syndrome per capita for each municipality in Okayama Prefecture (n = 27) using the national health insurance receipts for 1997 and 2007 for diabetes mellitus, hypertension, cardiovascular disorder, cerebral vascular disorder, and atherosclerosis as principal diseases. Information was obtained from each municipality on the implementation of public dental health services consisting of 10 programs, including visits for oral hygiene guidance, health consultation for periodontal disease, preventive long-term care, participation of dental hygienists in public health service, programs for improving oral function in the aged, and etc. The municipalities were divided into two groups based on the implementation/non-implementation of each dental health program. Then, the change in health care cost for metabolic syndrome per capita between 1997 and 2007 was compared between the two groups according to each dental health program. RESULTS Health care costs for metabolic syndrome were reduced in decade in the municipalities which executed dental health care programs such as 'preventive long-term care' or 'health consultation for periodontal disease', being greater in the municipalities which did not. More decrease in health care costs was further observed in the municipalities where the other seven programs were also implemented. Any direct relationship between dental health programs and health care costs for the metabolic syndrome remains unclear. However, our data suggests that costs might be decreased in municipalities which can afford to implement dental health programs. Health care costs for the metabolic syndrome in

  7. 78 FR 78589 - Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards

    Science.gov (United States)

    2013-12-26

    ... waste, fraud and abuse. This final guidance supersedes and streamlines requirements from OMB Circulars A... otherwise based on any existing statute. This guidance does not supersede any existing or future authority... administrative burden and (2) strengthen oversight over Federal funds to reduce risks of waste, fraud, and abuse...

  8. Is expanding HPV vaccination programs to include school-aged boys likely to be value-for-money: a cost-utility analysis in a country with an existing school-girl program.

    Science.gov (United States)

    Pearson, Amber L; Kvizhinadze, Giorgi; Wilson, Nick; Smith, Megan; Canfell, Karen; Blakely, Tony

    2014-06-26

    Similar to many developed countries, vaccination against human papillomavirus (HPV) is provided only to girls in New Zealand and coverage is relatively low (47% in school-aged girls for dose 3). Some jurisdictions have already extended HPV vaccination to school-aged boys. Thus, exploration of the cost-utility of adding boys' vaccination is relevant. We modeled the incremental health gain and costs for extending the current girls-only program to boys, intensifying the current girls-only program to achieve 73% coverage, and extension of the intensive program to boys. A Markov macro-simulation model, which accounted for herd immunity, was developed for an annual cohort of 12-year-olds in 2011 and included the future health states of: cervical cancer, pre-cancer (CIN I to III), genital warts, and three other HPV-related cancers. In each state, health sector costs, including additional health costs from extra life, and quality-adjusted life-years (QALYs) were accumulated. The model included New Zealand data on cancer incidence and survival, and other cause mortality (all by sex, age, ethnicity and deprivation). At an assumed local willingness-to-pay threshold of US$29,600, vaccination of 12-year-old boys to achieve the current coverage for girls would not be cost-effective, at US$61,400/QALY gained (95% UI $29,700 to $112,000; OECD purchasing power parities) compared to the current girls-only program, with an assumed vaccine cost of US$59 (NZ$113). This was dominated though by the intensified girls-only program; US$17,400/QALY gained (95% UI: dominant to $46,100). Adding boys to this intensified program was also not cost-effective; US$128,000/QALY gained, 95% UI: $61,900 to $247,000).Vaccination of boys was not found to be cost-effective, even for additional scenarios with very low vaccine or program administration costs - only when combined vaccine and administration costs were NZ$125 or lower per dose was vaccination of boys cost-effective. These results suggest that

  9. 78 FR 18429 - Cost Recovery for Permit Processing, Administration, and Enforcement

    Science.gov (United States)

    2013-03-26

    ... as bureau support functions such as human resource services, finance, and management. We used the... bureau support functions such as human resource services, finance, and management. OSM used a cost... similar geography require approximately the same amount of time to complete a particular type of...

  10. 78 FR 20393 - Cost Recovery for Permit Processing, Administration, and Enforcement

    Science.gov (United States)

    2013-04-04

    ... as bureau support functions such as human resource services, finance, and management. We used the... bureau support functions such as human resource services, finance, and management. OSM used a cost... similar geography require approximately the same amount of time to complete a particular type of...

  11. Federal workers' compensation programs: Department of Defense and Veterans Health Administration experiences.

    Science.gov (United States)

    Mallon, Timothy M; Grizzell, Tifani L; Hodgson, Michael J

    2015-03-01

    The objective of this article is to introduce the reader to this special supplement to the Journal of Occupational and Environmental Medicine regarding Federal Workers' Compensation Programs. The short history of both the VHA and DoD Federal Workers' Compensation Programs are provided and a short synopsis of each author's article is provided. The lessons learned from the articles in the supplement are summarized in this article and 6 key findings are highlighted. Cooperation between human resources workers' compensation personnel, safety and occupational health personnel is a must for successful management of the WC program. Information and data sharing are critical for root cause and injury prevention, case management, and cost containment efforts. Enhancing efforts in these areas will save an estimated $100 million through cost avoidance efforts.

  12. The impact of the NASA Administrator's Fellowship Program on fellows' career choices

    Science.gov (United States)

    Graham, Eva M.

    Maintaining diversity in the technical workforce and in higher education has been identified as one way to increase the outreach, recruitment and retention of students and other faculty from underrepresented, underserved and minority populations, especially in Science, Technology, Engineering and Mathematics (STEM) courses of study and careers. The National Aeronautics and Space Administration (NASA) Administrator's Fellowship Program (NAFP) is a professional development program targeting faculty at Minority Serving Institutions and NASA civil servant employees for a two year work-based professional development experience toward increasing the likelihood of retaining them in STEM careers and supporting the recruitment and retention of minority students in STEM courses of study. This evaluation links the activities of the fellowship program to the impact on fellows' career choices as a result of participation through a series of surveys and interviews. Fellows' personal and professional perceptions of themselves and colleagues' and administrators' beliefs about their professional capabilities as a result of selection and participation were also addressed as they related to career outcomes. The findings indicated that while there was no direct impact on fellows' choice of careers, the exposure, direction and focus offered through travel, mentoring, research and teaching had an impact their perceptions of their own capabilities and, their colleagues' and administrators' beliefs about them as professionals and researchers. The career outcomes reported were an increase in the number publications, promotions, change in career and an increased awareness of the culture of science and engineering.

  13. Program-specific cost-effectiveness analysis: breast cancer screening policies for a safety-net program.

    Science.gov (United States)

    Melnikow, Joy; Tancredi, Daniel J; Yang, Zhuo; Ritley, Dominique; Jiang, Yun; Slee, Christina; Popova, Svetlana; Rylett, Phillip; Knutson, Kirsten; Smalley, Sherie

    2013-01-01

    Every Woman Counts (EWC), a California breast cancer screening program, faced challenging budget cutbacks and policy choices. A microsimulation model evaluated costs, outcomes, and cost-effectiveness of EWC program mammography policy options on coverage for digital mammography (which has a higher cost than film mammography but recent legislation allowed reimbursement at the lower film rate); screening eligibility age; and screening frequency. Model inputs were based on analyses of program claims data linked to California Cancer Registry data, Surveillance, Epidemiology, and End Results data, and the Medi-Cal literature. Outcomes included number of procedures, cancers, cancer deaths, costs, and incremental cost per life-year. Projected model outcomes matched program data closely. With restrictions on the number of clients screened, strategies starting screening at age 40 years were dominated (not cost-effective). This finding was highly robust in sensitivity analyses. Compared with no screening, biennial film mammography for women aged 50 to 64 years was projected to reduce 15-year breast cancer mortality by nearly 7.8% at $18,999 per additional life-year, annual film mammography was $106,428 per additional life-year, and digital mammography $180,333 per additional life-year. This more effective, more expensive strategy was projected to reduce breast cancer mortality by 8.6%. Under equal mammography reimbursement, biennial digital mammography beginning at age 50 years was projected to decrease 15-year breast cancer mortality by 8.6% at an incremental cost per additional life-year of $17,050. For the EWC program, biennial screening mammography starting at age 50 years was the most cost-effective strategy. The impact of digital mammography on life expectancy was small. Program-specific cost-effectiveness analysis can be completed in a policy-relevant time frame to assist policymakers faced with difficult program choices. Copyright © 2013, International Society for

  14. Evaluation and recommendations for the Department of Energy-Farmers Home Administration small-town energy-planning grant program

    Energy Technology Data Exchange (ETDEWEB)

    Cannon, T.; Kron, N. Jr.

    1980-10-01

    DOE funded several small-town energy planning projects, through the Farmer's Home Administration (FmHA) Area Development Assistance Planning Grant Program. DOE intended that this program should: (1) encourage community energy planning and the development of Integrated Community Energy Systems (ICES) and (2) provide a testing ground for the technologies and planning methods developed by its Buildings and Community Systems Division. FmHA intended that the joint program should further the development of rural areas and make DOE expertise available to grant recipients doing energy planning. All grantees under this joint program endeavored to define their local energy problems and to find local solutions. However, the resulting energy cost savings were not always impressive, and generally they were not very well documented. Lack of implementation power, lack of focus, and inability to generate local financial support for projects and further planning were the main reasons for this performance. The lack of sufficient documentation could be the result of DOE's failure to require a standardized and systematic accounting of grantees' accomplishments. The recommended changes in the scope-of-work requirements suggested in this report would cause grantees to focus their energy-planning activities so as to increase local financial support. The appendixes give a standardized format by which grantees would account for the energy savings and production made possible by their planning efforts.

  15. Resource consumption and healthcare costs of acute coronary syndrome: a retrospective observational administrative database analysis.

    Science.gov (United States)

    Roggeri, Alessandro; Gnavi, Roberto; Dalmasso, Marco; Rusciani, Raffaella; Giammaria, Massimo; Anselmino, Monica; Roggeri, Daniela Paola

    2013-12-01

    The objective of this study was to estimate resource consumption and direct healthcare costs of patients with a first hospitalization for acute coronary syndrome (ACS) in 2008 in the Piedmont Region, Italy. Subjects hospitalized with a first episode of ACS in 2008 were selected from the regional hospital discharge database. All hospitalizations, drug prescriptions, and outpatient episodes of care in the 12 months following discharge were considered to estimate resource consumption and direct healthcare costs from the Piedmont Regional Health Service perspective. The analysis was carried out separately for ST-elevation myocardial infarction (STEMI), non-ST-elevation myocardial infarction (NSTEMI), and unstable angina (UA) populations. In the accrual period, 7765 subjects (1.75‰ of the total population) were hospitalized for ACS (64.2% men). The average age was 66.5 for men and 75.4 for women. The average in-hospital mortality was 6.5% (n = 508). The total ACS population was classified as: STEMI 45.2%, NSTEMI 29.4%, and UA 25.4%. The average yearly costs per patient alive at the end of follow-up (n = 6851) were 14,160.8&OV0556; (18,678.7 USD): 83.9% for inpatient admissions [11,881.2&OV0556; (15,671.8 USD)], 9.3% for drugs [1311.6&OV0556; (1730.1 USD)], 5.0% for diagnostic and therapeutic procedures and outpatient visits [708.2&OV0556; (934.1 USD)], and 1.8% for 1-day hospital stays [259.8&OV0556; (342.7 USD)]. The average yearly direct healthcare costs by ACS event were 14,984.5&OV0556; (19,765.2 USD) for STEMI, 14,554.1&OV0556; (19,197.4 USD) for NSTEMI, and 12,481.5&OV0556; (16,463.6 USD) for UA. In each subpopulation, costs were significantly higher for men than for women. ACS imposes a significant burden in terms of morbidity and mortality and generates major public health service costs.

  16. Nullius in verba: The University of Minnesota Social and Administrative Pharmacy Program proposed Guidelines for Formulary Evaluations

    Directory of Open Access Journals (Sweden)

    Paul C Langley

    2016-07-01

    Full Text Available The University of Minnesota Social and Administrative Pharmacy Program proposed Guidelines for Formulary Evaluations (GFE are designed to focus on the credibility of clinical and cost-outcomes claims in formulary decision making. The last few years have witnessed increasing concern over the credibility of trial based efficacy claims, with a surprisingly high proportion of claims falling short. At the same time cost-outcomes claims, where comparative clinical claims are a key input, have been presented where the claims made are not open to experimental or observational assessment. This follows from standards recommended for modeled and simulated claims. In the absence of cost-outcomes claims being presented in an evaluable form, it is impossible not only to replicate the claim or to judge whether or not it is credible. Claims for product value based on such claims are unacceptable. The guidelines proposed here are designed to overcome these limitations and support an evidence base that is both credible and replicable for formulary decisions. This is achieved by focusing on short-term modeled or simulated claims for cost-effectiveness. The requirement for modeled or simulated claims that are evaluable within a time frame that is meaningful for formulary decisions marks a major departure from format submissions already in play, not only in the US but in other developed economies. Rather than subscribing to the gold standard of long term or lifetime cost-per-QALY claims a short-term time horizon of no more than 2-years is recommended. This allows products to be provisionally placed on formulary but subject to a protocol that supports an evaluation to be reported back to a formulary committee as part of ongoing disease area or therapeutic class reviews. The place of the product and its contracted price can then be reviewed. Conflict of Interest None Type: Commentary

  17. The cost of policy simplification in conservation incentive programs

    DEFF Research Database (Denmark)

    Armsworth, Paul R.; Acs, Szvetlana; Dallimer, Martin

    2012-01-01

    of biodiversity. Common policy simplifications result in a 49100% loss in biodiversity benefits depending on the conservation target chosen. Failure to differentiate prices for conservation improvements in space is particularly problematic. Additional implementation costs that accompany more complicated policies......Incentive payments to private landowners provide a common strategy to conserve biodiversity and enhance the supply of goods and services from ecosystems. To deliver cost-effective improvements in biodiversity, payment schemes must trade-off inefficiencies that result from over-simplified policies...

  18. The changing cost to prevent diabetes: A retrospective analysis of the Diabetes Prevention Program.

    Science.gov (United States)

    Carris, Nicholas W; Cheng, Feng; Kelly, William N

    Diabetes prevention interventions are poorly implemented. While health care costs generally increase, 2 factors affect the relative cost of diabetes prevention interventions: the declining cost of metformin (even without insurance) and the new recommendation for vitamin B12 monitoring during metformin treatment. The study's objective was to update the relative health system cost estimate of metformin for diabetes prevention by incorporating the current health system cost of metformin and the cost of addressing potential metformin-associated vitamin B12 deficiency. The study was designed to assess whether metformin with vitamin B12 supplementation is a cost-saving measure for diabetes prevention and for the updated cost estimate to be useful in assessing future implementation studies. In 2012, the Diabetes Prevention Program Research Group published detailed per capita total direct health system costs for the Diabetes Prevention Program (DPP) and the Diabetes Prevention Program Outcomes Study (DPPOS). The present analysis incorporated the declining cost of metformin and the increasing cost of metformin monitoring into the detailed per capita health system costs found in the DPP and DPPOS. The updated costs were used to assess the total cost of metformin use for diabetes prevention relative to placebo and lifestyle intervention. The current health system cost to acquire metformin ranges from $0 to $72 per year. The estimated health system cost to address potential metformin-associated vitamin B12 deficiency is $28 per metformin-treated patient per year. The 10-year total health system cost for metformin in diabetes prevention can decrease by $329 or increase by $21 depending on the cost to acquire metformin. Compared with placebo, the unadjusted cost savings of metformin is generally maintained, although it may double or quadruple depending on how metformin is acquired by patients. Metformin with vitamin B12 supplementation remained less costly and less effective

  19. Cost Study of the Saint Paul Early Childhood Scholarship Program. Technical Report

    Science.gov (United States)

    Schwartz, Heather L.; Karoly, Lynn A.

    2011-01-01

    In 2008, the Minnesota Early Learning Foundation created the Saint Paul Early Childhood Scholarship Program, a pilot program to provide families with scholarships to cover the cost of high-quality early childhood education (ECE) programs. Although there is a large body of research about the benefits of preschool specifically and early learning…

  20. Very Low-Cost Nutritious Diet Plans Designed by Linear Programming.

    Science.gov (United States)

    Foytik, Jerry

    1981-01-01

    Provides procedural details of Linear Programing, developed by the U.S. Department of Agriculture to devise a dietary guide for consumers that minimizes food costs without sacrificing nutritional quality. Compares Linear Programming with the Thrifty Food Plan, which has been a basis for allocating coupons under the Food Stamp Program. (CS)

  1. Cost-utility analysis of neonatal screening program, shiraz university of medical sciences, shiraz, iran, 2010.

    Science.gov (United States)

    Hatam, Nahid; Shirvani, Samad; Javanbakht, Mehdi; Askarian, Mehrdad; Rastegar, Mohsen

    2013-10-01

    The most important cause of infant mortality during the first month of life is related to congenital abnormalities. Nevertheless, timely diagnosis of these diseases can reduce the severity of their effects. The present study aimed to investigate the cost-effectiveness of the neonatal screening program in Fars Province, Iran. In this study, costs of executing the screening programs, treatment of the diagnosed cases, treatment of affected, non-screened individuals, quality of life, and incremental cost-effectiveness ratios were measured in two study groups. Performing the screening programs for phenylketonuria, congenital hypothyroidism, galactosemia, and favism resulted in respectively $3386, $13078, $19641, and $1088 saving per patient. Overall, the study results revealed the cost-effectiveness of execution of the neonatal screening program. Neonatal screening program is one of the health interventions which lead to long-term beneficial outcome for the patients, financial saving for the society, and improvement of the patients' quantity as well as quality of life.

  2. The Cost of Commonality: Assessing Value in Joint Programs

    Science.gov (United States)

    2015-12-01

    dire consequences for the survival and performance of the network as a whole ( Emerson , 1976). Military services are independent stakeholders who join...maximize provincial outcomes at the expense of collective optimization. Thus, rational actions within the network are often undertaken irrespective of...incentives for opportunistic behavior at the expense of collective optimization. The associated transaction costs and suboptimal performance can have

  3. Health care utilization and costs after entry into an outreach program for homeless mentally ill veterans.

    Science.gov (United States)

    Rosenheck, R; Gallup, P; Frisman, L K

    1993-12-01

    This study evaluated the impact of a Department of Veterans Affairs outreach and residential treatment program for homeless mentally ill veterans on utilization and cost of health care services provided by the VA. Veterans at nine program sites (N = 1,748) were assessed with a standard intake instrument. Services provided by the outreach program were documented in quarterly clinical reports and in residential treatment discharge summaries. Data on nonprogram VA health service utilization and health care costs were obtained from national VA data bases. Changes in use of services and cost of services from the year before initial contact with the program to the year after were analyzed by t test. Multivariate analyses were used to examine the relationship of these changes to indicators of clinical need and to participation in the outreach program. Although utilization of inpatient service did not increase after veterans' initial contact with the program, use of domiciliary and outpatient services increased substantially. Total annual costs to the VA also increased by 35 percent, from $6,414 to $8,699 per veteran per year. Both clinical need and participation in the program were associated with increased use of health services and increased cost. Veterans with concomitant psychiatric and substance abuse problems used fewer health care services than others. Specialized programs to improve the access of homeless mentally ill persons to health care services appear to be effective, but costly. Dually diagnosed persons seem especially difficult to engage in treatment.

  4. Risk Management for Study Abroad Programs: Issues and Resources to Inform Program Development, Administration, and Training

    Science.gov (United States)

    Rhodes, Gary

    2014-01-01

    This chapter provides a practical background to the health and safety risks and challenges for U.S. colleges and universities and other program providers. Potential risks, field-based guidelines, good practices, and resources to support the management of risks by study abroad offices will be covered.

  5. 78 FR 59121 - Basic Health Program: State Administration of Basic Health Programs; Eligibility and Enrollment...

    Science.gov (United States)

    2013-09-25

    ... applicability (Sec. 600.700) 2. BHP trust fund (Sec. 600.705) 3. Fiscal policies and accountability (Sec. 600... proposed Sec. 600.200, or from evidence of beneficiary harm, financial malfeasance or fraud. We propose... state's BHP. This report is both a mechanism to report state knowledge of any program fraud, waste or...

  6. National Nuclear Security Administration Nonproliferation Graduate Fellowship Program Annual Report in Brief: October 2007 - May 2008

    Energy Technology Data Exchange (ETDEWEB)

    Berkman, Clarissa O.; Fankhauser, Jana G.; Sandusky, Jessica A.

    2009-05-01

    This abbreviated Annual Report covers program activities of the National Nuclear Security Administration (NNSA) Nonproliferation Graduate Fellowship Program (NGFP) from October 2007 through May 2008--the timeframe between the last Annual Report (which covered activities through September 2007) and the next report (which will begin with June 2008 activities). In that timeframe, the NGFP continued building a solid foundation as the program began reaping the benefits of recently implemented changes. This report is organized by Fellowship class and the pertinent program activities for each, including: October 2007 Recruiting events and final applications (Class of 2008) Winter 2007 Selection and hiring (Class of 2008) Spring 2008 Career development roundtables (Class of 2007) Orientation planning (Class of 2008) Recruitment planning and university outreach (Class of 2009) May 2008 Closing ceremony (Class of 2007)

  7. Diabetes Affects Length of Stay and Hospital Costs for Elderly Patients with Pneumonia: An Analysis of a Hospital Administrative Database.

    Science.gov (United States)

    Kabeya, Yusuke; Shimada, Akira; Tsukada, Nobuhiro; Atsumi, Yoshihito; Higaki, Megumu

    2016-12-20

    The present study investigated the association of having diabetes with length of stay and hospital costs for elderly patients with pneumonia who were admitted to an acute-care hospital in Japan. Based on the inpatient administrative claims database of an acute-care hospital in central Tokyo between 2010 and 2013, 753 patients aged ≥ 65 years who were admitted to the hospital presenting with pneumonia and discharged alive were analyzed. The association was analyzed using a negative binomial model, having adjusted for age, sex, body mass index, dyspnea grade, functional evaluation of feeding, use of mechanical ventilation, and use of renal replacement therapy. A log-linear regression model adjusted for the same variables was used in the analysis of hospital costs. Of the 753 patients (mean age, 82.5 years; men, 58.2%), 225 patients had diabetes. The negative binomial regression revealed that those with diabetes had a 1.19 times longer length of stay (95% CI = 1.06-1.33) compared to those without. The log-linear regression revealed that hospital costs were 1.14 times higher (95% CI = 1.04-1.25) in patients with diabetes. The presence of diabetes significantly correlated with longer length of stay and higher hospital costs for elderly patients with pneumonia.

  8. Same-day bidirectional endoscopy with nonanesthesiologist administration of propofol: safety and cost-effectiveness compared with separated exams.

    Science.gov (United States)

    Lucendo, Alfredo J; Arias, Ángel; González-Castillo, Sonia; Angueira, Teresa; Guagnozzi, Danila; Fernández-Fuente, Mariluz; Serrano-Valverde, Mercedes; Sánchez-Cazalilla, Marta; Chumillas, Oliver; Fernández-Ordóñez, Maruja; Tenías, José M

    2014-03-01

    The safety and cost-effectiveness of a combination of esophagogastroduodenoscopy (EGD) and colonoscopy [or bidirectional endoscopy (BDE)] versus alternative-day EGD and colonoscopy when using nonanesthesiologist administration of propofol have never been evaluated. This was a single-center prospective registry of consecutive American Society of Anaesthesiology class I-III outpatients undergoing EGD, colonoscopy, and BDE. Propofol was the sole sedative used. Adverse events, recovery time, and procedure-related costs were analyzed. Among the 1500 study participants (51.5% women), EGD, colonoscopy, and BDE were carried out on 449, 702, and 349 patients, respectively. All patients were discharged directly from the endoscopy unit. No sex differences were found with respect to age (mean 54.4, range 18-96 years), BMI, or procedure type. Propofol doses for BDE were 25.9% less than when EGD and colonoscopy were performed separately (P<0.001). Adverse events, including transient O2 saturation less than 90%, systolic blood pressure less than 90 mmHg, and bradycardia (<50 bpm), appeared in 10.7% of single EGD and 8.6% of EGD within BDE; for colonoscopies, the figures were 8.6 and 9.5%, respectively (P=NS). Recovery time to discharge after BDE was 47.9% shorter than when EGD and colonoscopy were performed separately (P<0.001). The cost of same-day BDE was 28.1% lower than that of EGD and colonoscopy performed as separated procedures (P<0.001). Same-day BDE with nonanesthesiologist administration of propofol resulted in reductions in propofol doses, recovery time, and procedure-related costs as compared with carrying out EGD and colonoscopy separately, without an increase in adverse events.

  9. Microsurgical vs. Endoscopic Excision of Colloid Cysts: An Analysis of Complications and Costs Using a Longitudinal Administrative Database.

    Science.gov (United States)

    Connolly, Ian David; Johnson, Eli; Lamsam, Layton; Veeravagu, Anand; Ratliff, John; Li, Gordon

    2017-01-01

    Open microsurgical and endoscopic approaches are the two main surgical options for excision of colloid cysts. Controversy remains as to which is superior. Previous studies consist of small cohort sizes. This topic has not been investigated using national administrative claims data which benefits from larger patient numbers. Current Procedural Terminology (CPT) and International Classification of Disease version 9 (ICD-9) coding at inpatient visit was used to select for index surgical procedures corresponding to microsurgical or endoscopic excision of colloid cysts. Comorbidities, costs, and complications were collected. We identified a total of 483 patients. In all, 240 were from the microsurgical cohort and 243 were from the endoscopic cohort. The two groups displayed similar demographic and comorbidity profiles. Thirty-day post-operative complications were also similar between groups with the exception of seizures and thirty-day readmissions, both higher in the open surgical cohort. The seizure rates were 14.7 and 5.4% in the microsurgical and endoscopic cohorts, respectively (p = 0.0011). The thirty-day readmission rates were 17.3 and 9.6% in the microsurgical and endoscopic cohorts, respectively (p = 0.0149). Index admission costs and 90-day post discharge payments were higher in patients receiving microsurgical excision. An analysis of administrative claims data revealed few differences in surgical complications following colloid cyst excision via microsurgical and endoscopic approaches. Post-operative seizures and thirty-day readmissions were seen at higher frequency in patients who underwent microsurgical resection. Despite similar complication profiles, patients undergoing microsurgical excision experienced higher index admission costs and 90-day aggregated costs suggesting that complications may have been more severe in this group.

  10. Follow-up process evaluation of Bonneville Power Administration's energy savings plan program

    Energy Technology Data Exchange (ETDEWEB)

    Jennings, J.G.; Peters, J.S. (ERC International, Albuquerque, NM (USA))

    1990-01-01

    The Energy $avings Plan (E$P) program has been operated by the Bonneville Power Administration (Bonneville) since late fall 1987. The program is designed to build capability in the acquisition of conservation resources in the non-aluminum industrial sector in the Pacific Northwest. According to the Northwest Power Planning Council, the non-aluminum industrial sector accounts for about 23% of the total regional electricity consumption. Five non-aluminum industries consume 85% of this total. Three major industries --- chemical producers, pulp and paper plants, and lumber mills --- account for around 68% of non-aluminum industrial consumption (i.e., 16% of the total regional electricity consumption). 1 ref.

  11. Cost-effectiveness of a disease management program for early childhood caries.

    Science.gov (United States)

    Samnaliev, Mihail; Wijeratne, Rashmi; Kwon, Eunhae Grace; Ohiomoba, Henry; Ng, Man Wai

    2015-01-01

    To assess the cost-effectiveness of a pilot disease management (DM) program aimed at preventing early childhood caries among children younger than 5 years. The DM program was implemented in the Boston Children's Hospital-based dental practice in 2008. Health care costs were obtained from the hospital finance department and non-health care costs were estimated through a parent survey. The measure of effectiveness was avoided hospital-based visits for restorative treatment or extractions. Incremental costs (2011 US$) and effectiveness were estimated from a health care system, societal, and public payer perspectives over 3, 6, and 12 months, by comparing DM participants (n = 395) to a historical comparison group (n = 123) using generalized linear models. Bootstrapping and other sensitivity analyses were used to incorporate uncertainty in the analyses. The DM program was associated with a reduction in societal costs of $20 (p = 0.85), $215 (p = 0.24), and $669 (p costly and more effective was 61.5 percent, 81.9 percent, and 98.6 percent over 3, 6, and 12 months, respectively. Consistent results were observed from a health care system and public payer perspectives. The DM program appears cost-effective and has the potential to reduce health care costs. Our results justify a multicenter trial to evaluate the DM program on a larger scale. © 2014 American Association of Public Health Dentistry.

  12. 43 CFR 404.51 - Are proposed projects under the Rural Water Supply Program reviewed by the Administration?

    Science.gov (United States)

    2010-10-01

    ... Water Supply Program reviewed by the Administration? 404.51 Section 404.51 Public Lands: Interior... SUPPLY PROGRAM Feasibility Studies § 404.51 Are proposed projects under the Rural Water Supply Program... the Reclamation's Rural Water Supply Program. This includes review under Executive Order 12322 to...

  13. Variation in average costs among federally sponsored state-organized cancer detection programs: economies of scale?

    Science.gov (United States)

    Mansley, Edward C; Duñet, Diane O; May, Daniel S; Chattopadhyay, Sajal K; McKenna, Matthew T

    2002-01-01

    Societal cost-effectiveness analysis and its variants help decision makers achieve an efficient allocation of resources across the set of all possible health interventions. Sometimes, however, decision makers are focused instead on the efficient allocation of resources within a particular intervention program that has already been implemented. This is especially true when the intervention is being delivered at several different sites. An analysis of average cost across program sites may help program officials to maximize the health benefits that can be achieved with limited resources. In this article, the authors present such an analysis, with special attention paid to the possible existence and implications of economies of scale. Focusing on federally sponsored, state-organized cancer detection programs, the authors modeled 19 state programs as productive processes and examined their average costs over a 2- to 5-year period of operation. They considered 3 alternative definitions of output: women served, screens performed, and conditions detected. Average federal costs and average total costs were estimated for each grant period. Multivariate regression analysis was used to help explain the variation in average costs. The average cost estimates were distributed in a skewed pattern with the majority of observations falling close to the median and substantially below the mean. For all measures considered, average cost decreased as output expanded. This inverse relationship between average cost and output level persisted even after controlling for the effects of other predictors, suggesting the possible existence of economies of scale. The potential existence of economies of scale calls into question the assumption of a constant average cost frequently made in economic analyses of proposed public health programs. It also implies that a) differences in output level should be taken into account when comparing operating efficiency across program sites; b) conclusions

  14. Private Administration – Favorable Environment for Implementing Programs and Campaigns of Public Relations?

    Directory of Open Access Journals (Sweden)

    Simona HAIDAU

    2012-11-01

    Full Text Available This paper refer to decision of the private administration organizations from the region northeast of Romania to implement programs and public relations campaigns from the socio-economic context in the current period. This decision of organizations above mentioned is strongly influenced by nature non-profit purposes they have, more precisely, to be involved in carrying out the public interest or community.

  15. Personnel Medical Listing and Administrative Tickler Program for Independent Duty Corpsmen

    OpenAIRE

    Allen, Daniel R.

    1981-01-01

    The Tektronics 4051 Desk Top Calculator is utilized to meet the medical/dental administrative requirements of the Pacific submarine force and to provide a quick recall of information required on a periodic basis or prior to an extended deployment. The program enables the user to store, update, and recall information for crew immunizations, weight control, dental check-ups, exposure to occupational hazards, e.g., noise, compression-decompression, welding, asbestos, radiation, and sonar, and to...

  16. Cost-Effectiveness of a Community Exercise and Nutrition Program for Older Adults: Texercise Select

    Directory of Open Access Journals (Sweden)

    Olufolake (Odufuwa Akanni

    2017-05-01

    Full Text Available The wide-spread dissemination of evidence-based programs that can improve health outcomes among older populations often requires an understanding of factors influencing community adoption of such programs. One such program is Texercise Select, a community-based health promotion program previously shown to improve functional health, physical activity, nutritional habits and quality of the life among older adults. This paper assesses the cost-effectiveness of Texercise Select in the context of supportive environments to facilitate its delivery and statewide sustainability. Participants were surveyed using self-reported instruments distributed at program baseline and conclusion. Program costs were based on actual direct costs of program implementation and included costs of recruitment and outreach, personnel costs and participant incentives. Program effectiveness was measured using quality-adjusted life year (QALY gained, as well as health outcomes, such as healthy days, weekly physical activity and Timed Up-and-Go (TUG test scores. Preference-based EuroQol (EQ-5D scores were estimated from the number of healthy days reported by participants and converted into QALYs. There was a significant increase in the number of healthy days (p < 0.05 over the 12-week program. Cost-effectiveness ratios ranged from $1374 to $1452 per QALY gained. The reported cost-effective ratios are well within the common cost-effectiveness threshold of $50,000 for a gained QALY. Some sociodemographic differences were also observed in program impact and cost. Non-Hispanic whites experienced significant improvements in healthy days from baseline to the follow-up period and had higher cost-effectiveness ratios. Results indicate that the Texercise Select program is a cost-effective strategy for increasing physical activity and improving healthy dietary practices among older adults as compared to similar health promotion interventions. In line with the significant improvement in

  17. Use of linear programming to estimate impact of changes in a hospital's operating room time allocation on perioperative variable costs.

    Science.gov (United States)

    Dexter, Franklin; Blake, John T; Penning, Donald H; Sloan, Brian; Chung, Patricia; Lubarsky, David A

    2002-03-01

    Administrators at hospitals with a fixed annual budget may want to focus surgical services on priority areas to ensure its community receives the best health services possible. However, many hospitals lack the detailed managerial accounting data needed to ensure that such a change does not increase operating costs. The authors used a detailed hospital cost database to investigate by how much a change in allocations of operating room (OR) time among surgeons can increase perioperative variable costs. The authors obtained financial data for all patients who underwent outpatient or same-day admit surgery during a year. Linear programming was used to determine by how much changing the mix of surgeons can increase total variable costs while maintaining the same total hours of OR time for elective cases. Changing OR allocations among surgeons without changing total OR hours allocated will likely increase perioperative variable costs by less than 34%. If, in addition, intensive care unit hours for elective surgical cases are not increased, hospital ward occupancy is capped, and implant use is tracked and capped, perioperative costs will likely increase by less than 10%. These four variables predict 97% of the variance in total variable costs. The authors showed that changing OR allocations among surgeons without changing total OR hours allocated can increase hospital perioperative variable costs by up to approximately one third. Thus, at hospitals with fixed or nearly fixed annual budgets, allocating OR time based on an OR-based statistic such as utilization can adversely affect the hospital financially. The OR manager can reduce the potential increase in costs by considering not just OR time, but also the resulting use of hospital beds and implants.

  18. 78 FR 102 - Guidance for Industry and Food and Drug Administration Staff; eCopy Program for Medical Device...

    Science.gov (United States)

    2013-01-02

    ... HUMAN SERVICES Food and Drug Administration Guidance for Industry and Food and Drug Administration Staff... implemented the eCopy Program under the Federal Food, Drug, and Cosmetic Act (the FD&C Act). This guidance... announcing the availability of a final guidance for industry and FDA staff entitled ``eCopy Program for...

  19. Healthcare costs of the progression of chronic kidney disease and different dialysis techniques estimated through administrative database analysis.

    Science.gov (United States)

    Roggeri, Alessandro; Roggeri, Daniela Paola; Zocchetti, Carlo; Bersani, Maurizio; Conte, Ferruccio

    2017-04-01

    Chronic kidney disease (CKD) progression is associated with significant comorbidities and costs. In Italy, limited evidence of healthcare resource consumption and costs is available. We therefore aimed to investigate the direct healthcare costs in charge to the Lombardy Regional Health Service (RHS) for the treatment of CKD patients in the first year after starting hemodialysis and in the 2 years prior to dialysis. Citizens resident in the Lombardy Region (Italy) who initiated dialysis in the year 2011 (Jan 1 to Dec 31) were selected and data were extracted from Lombardy Regional databases on their direct healthcare costs in the first year after starting dialysis and in the 2 years prior to it was analyzed. Drugs, hospitalizations, diagnostic procedures and outpatient costs covered by RHS were estimated. Patients treated for acute kidney injury, or who died or stopped dialysis during the observational period were excluded. From the regional population (>9,700,000 inhabitants), 1067 patients (34.3 % females) initiating dialysis were identified, of whom 82 % underwent only hemodialysis (HD), 13 % only peritoneal dialysis (PD) and the remaining 5 % both treatments. Direct healthcare costs/patient were € 5239, € 12,303 and € 38,821 (€ 40,132 for HD vs. € 30,444 for PD patients) for the periods 24-12 months pre-dialysis, 12-0 months pre-dialysis, and in the first year of dialysis, respectively. This study highlights a significant economic burden related to CKD and an increase in direct healthcare costs associated with the start of dialysis, pointing to the importance of prevention programs and early diagnosis.

  20. Cost of providing injectable contraceptives through a community-based social marketing program in Tigray, Ethiopia.

    Science.gov (United States)

    Prata, Ndola; Downing, Janelle; Bell, Suzanne; Weidert, Karen; Godefay, Hagos; Gessessew, Amanuel

    2016-06-01

    To provide a cost analysis of an injectable contraceptive program combining community-based distribution and social marketing in Tigray, Ethiopia. We conducted a cost analysis, modeling the costs and programmatic outcomes of the program's initial implementation in 3 districts of Tigray, Ethiopia. Costs were estimated from a review of program expense records, invoices, and interviews with health workers. Programmatic outcomes include number of injections and couple-year of protection (CYP) provided. We performed a sensitivity analysis on the average number of injections provided per month by community health workers (CHWs), the cost of the commodity, and the number of CHWs trained. The average programmatic CYP was US $17.91 for all districts with a substantial range from US $15.48-38.09 per CYP across districts. Direct service cost was estimated at US $2.96 per CYP. The cost per CYP was slightly sensitive to the commodity cost of the injectable contraceptives and the number of CHWs. The capacity of each CHW, measured by the number of injections sold, was a key input that drove the cost per CYP of this model. With a direct service cost of US $2.96 per CYP, this study demonstrates the potential cost of community-based social marketing programs of injectable contraceptives. The findings suggest that the cost of social marketing of contraceptives in rural communities is comparable to other delivery mechanisms with regards to CYP, but further research is needed to determine the full impact and cost-effectiveness for women and communities beyond what is measured in CYP. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Increasing compliance with mass drug administration programs for lymphatic filariasis in India through education and lymphedema management programs.

    Science.gov (United States)

    Cantey, Paul T; Rout, Jonathan; Rao, Grace; Williamson, John; Fox, LeAnne M

    2010-06-29

    Nearly 45% of people living at risk for lymphatic filariasis (LF) worldwide live in India. India has faced challenges obtaining the needed levels of compliance with its mass drug administration (MDA) program to interrupt LF transmission, which utilizes diethylcarbamazine (DEC) or DEC plus albendazole. Previously identified predictors of and barriers to compliance with the MDA program were used to refine a pre-MDA educational campaign. The objectives of this study were to assess the impact of these refinements and of a lymphedema morbidity management program on MDA compliance. A randomized, 30-cluster survey was performed in each of 3 areas: the community-based pre-MDA education plus community-based lymphedema management education (Com-MDA+LM) area, the community-based pre-MDA education (Com-MDA) area, and the Indian standard pre-MDA education (MDA-only) area. Compliance with the MDA program was 90.2% in Com-MDA+LM, 75.0% in Com-MDA, and 52.9% in the MDA-only areas (peducational intervention were: 1) knowing about the MDA in advance of its occurrence, 2) knowing everyone is at risk for LF, 3) knowing that the MDA was for LF, and 4) knowing at least one component of the lymphedema management techniques taught in the lymphedema management program. This study confirmed previously identified predictors of and barriers to compliance with India's MDA program for LF. More importantly, it showed that targeting these predictors and barriers in a timely and clear pre-MDA educational campaign can increase compliance with MDA programs, and it demonstrated, for the first time, that lymphedema management programs may also increase compliance with MDA programs.

  2. Increasing compliance with mass drug administration programs for lymphatic filariasis in India through education and lymphedema management programs.

    Directory of Open Access Journals (Sweden)

    Paul T Cantey

    2010-06-01

    Full Text Available Nearly 45% of people living at risk for lymphatic filariasis (LF worldwide live in India. India has faced challenges obtaining the needed levels of compliance with its mass drug administration (MDA program to interrupt LF transmission, which utilizes diethylcarbamazine (DEC or DEC plus albendazole. Previously identified predictors of and barriers to compliance with the MDA program were used to refine a pre-MDA educational campaign. The objectives of this study were to assess the impact of these refinements and of a lymphedema morbidity management program on MDA compliance.A randomized, 30-cluster survey was performed in each of 3 areas: the community-based pre-MDA education plus community-based lymphedema management education (Com-MDA+LM area, the community-based pre-MDA education (Com-MDA area, and the Indian standard pre-MDA education (MDA-only area. Compliance with the MDA program was 90.2% in Com-MDA+LM, 75.0% in Com-MDA, and 52.9% in the MDA-only areas (p<0.0001. Identified barriers to adherence included: 1 fear of side effects and 2 lack of recognition of one's personal benefit from adherence. Multivariable predictors of adherence amenable to educational intervention were: 1 knowing about the MDA in advance of its occurrence, 2 knowing everyone is at risk for LF, 3 knowing that the MDA was for LF, and 4 knowing at least one component of the lymphedema management techniques taught in the lymphedema management program.This study confirmed previously identified predictors of and barriers to compliance with India's MDA program for LF. More importantly, it showed that targeting these predictors and barriers in a timely and clear pre-MDA educational campaign can increase compliance with MDA programs, and it demonstrated, for the first time, that lymphedema management programs may also increase compliance with MDA programs.

  3. Economic Modeling of Heart Failure Telehealth Programs: When Do They Become Cost Saving?

    Directory of Open Access Journals (Sweden)

    Sheena Xin Liu

    2016-01-01

    Full Text Available Telehealth programs for congestive heart failure have been shown to be clinically effective. This study assesses clinical and economic consequences of providing telehealth programs for CHF patients. A Markov model was developed and presented in the context of a home-based telehealth program on CHF. Incremental life expectancy, hospital admissions, and total healthcare costs were examined at periods ranging up to five years. One-way and two-way sensitivity analyses were also conducted on clinical performance parameters. The base case analysis yielded cost savings ranging from $2832 to $5499 and 0.03 to 0.04 life year gain per patient over a 1-year period. Applying telehealth solution to a low-risk cohort with no prior admission history would result in $2502 cost increase per person over the 1-year time frame with 0.01 life year gain. Sensitivity analyses demonstrated that the cost savings were most sensitive to patient risk, baseline cost of hospital admission, and the length-of-stay reduction ratio affected by the telehealth programs. In sum, telehealth programs can be cost saving for intermediate and high risk patients over a 1- to 5-year window. The results suggested the economic viability of telehealth programs for managing CHF patients and illustrated the importance of risk stratification in such programs.

  4. Costs of vaccine programs across 94 low- and middle-income countries.

    Science.gov (United States)

    Portnoy, Allison; Ozawa, Sachiko; Grewal, Simrun; Norman, Bryan A; Rajgopal, Jayant; Gorham, Katrin M; Haidari, Leila A; Brown, Shawn T; Lee, Bruce Y

    2015-05-07

    While new mechanisms such as advance market commitments and co-financing policies of the GAVI Alliance are allowing low- and middle-income countries to gain access to vaccines faster than ever, understanding the full scope of vaccine program costs is essential to ensure adequate resource mobilization. This costing analysis examines the vaccine costs, supply chain costs, and service delivery costs of immunization programs for routine immunization and for supplemental immunization activities (SIAs) for vaccines related to 18 antigens in 94 countries across the decade, 2011-2020. Vaccine costs were calculated using GAVI price forecasts for GAVI-eligible countries, and assumptions from the PAHO Revolving Fund and UNICEF for middle-income countries not supported by the GAVI Alliance. Vaccine introductions and coverage levels were projected primarily based on GAVI's Adjusted Demand Forecast. Supply chain costs including costs of transportation, storage, and labor were estimated by developing a mechanistic model using data generated by the HERMES discrete event simulation models. Service delivery costs were abstracted from comprehensive multi-year plans for the majority of GAVI-eligible countries and regression analysis was conducted to extrapolate costs to additional countries. The analysis shows that the delivery of the full vaccination program across 94 countries would cost a total of $62 billion (95% uncertainty range: $43-$87 billion) over the decade, including $51 billion ($34-$73 billion) for routine immunization and $11 billion ($7-$17 billion) for SIAs. More than half of these costs stem from service delivery at $34 billion ($21-$51 billion)-with an additional $24 billion ($13-$41 billion) in vaccine costs and $4 billion ($3-$5 billion) in supply chain costs. The findings present the global costs to attain the goals envisioned during the Decade of Vaccines to prevent millions of deaths by 2020 through more equitable access to existing vaccines for people in all

  5. Calculation of Complexity Costs – An Approach for Rationalizing a Product Program

    DEFF Research Database (Denmark)

    Hansen, Christian Lindschou; Mortensen, Niels Henrik; Hvam, Lars

    2012-01-01

    of suggested Life Cycle Complexity Factors (LCCFs). The suggested method has been tested in an action based research study with promising results. The case study shows how the allocation of complexity costs on individual product variants provides previously unknown insights into the true cost structure......This paper proposes an operational method for rationalizing a product program based on the calculation of complexity costs. The method takes its starting point in the calculation of complexity costs on a product program level. This is done throughout the value chain ranging from component...... inventories at the factory sites, all the way to the distribution of finished goods from distribution centers to the customers. The method proposes a step-wise approach including the analysis, quantification and allocation of product program complexity costs by the means of identifying of a number...

  6. Cost-analysis of an oral health outreach program for preschool children in a low socioeconomic multicultural area in Sweden

    DEFF Research Database (Denmark)

    Wennhall, Inger; Norlund, Anders; Matsson, Lars

    2010-01-01

    of materials, rental facilities and equipment based on accounting data. The cost for fillings was extracted from a specified per diem list. Overhead costs were assumed to correspond to 50% of salaries and all costs were calculated as net present value per participating child in the program and expressed...... in Euro. The results revealed an estimated total cost of 310 Euro per included child (net present value) in the 3-year program. Half of the costs were attributed to the first year of the program and the costs of manpower constituted 45% of the total costs. When the total cost was reduced with the cost......The aim was to calculate the total and the net costs per child included in a 3-year caries preventive program for preschool children and to make estimates of expected lowest and highest costs in a sensitivity analysis. The direct costs for prevention and dental care were applied retrospectively...

  7. Streamlined library programming how to improve services and cut costs

    CERN Document Server

    Porter-Reynolds, Daisy

    2014-01-01

    In their roles as community centers, public libraries offer many innovative and appealing programs; but under current budget cuts, library resources are stretched thin. With slashed budgets and limited staff hours, what can libraries do to best serve their publics? This how-to guide provides strategies for streamlining library programming in public libraries while simultaneously maintaining-or even improving-quality delivery. The wide variety of principles and techniques described can be applied on a selective basis to libraries of all sizes. Based upon the author's own extensive experience as

  8. Economic Values for Evaluation of Federal Aviation Administration Investment and Regulatory Programs

    Science.gov (United States)

    1989-10-01

    185.60 Maintenance 645.83 Turboprop, 2-Engine, 20+ Seats ATR42 Crew 176.21 Fuel & Oil 100.70 Maintenance 114.81 C-6 rew 69.41 Fuel & Oil 58.49 Maintenance... ATR42 8 $6850 $7400 $7125 $57000 CV580 58 1000 750 875 50750 CV600/640 31 625 500 562.5 17437.5 IW-6 68 575 575 575 39100 L8W-7 38 3500 3250 3375...Administration, 1984. 84. Miller, T., S. Luchter and C. P. Brinkman, " Crash Costs and Safety Investment," unpublished paper to be presented at, Association for

  9. The National Shipbuilding Research Program: Producibility Cost Reductions through Alternative Materials and Processes

    National Research Council Canada - National Science Library

    Horsmon, Jr., Albert W; Johnson, Karl; Gans-Devney, Barbara

    1999-01-01

    .... The research, sponsored by the National Shipbuilding Research Program (NSRP), looks specifically at increased use of fiberglass and plastic pipe, adhesives, and flexible and rubber hose as areas where cost and producibility gains may be found...

  10. National Nuclear Security Administration International Safeguards Education & Training Program(s)

    Energy Technology Data Exchange (ETDEWEB)

    Frazar, Sarah L.; McClelland-Kerr, John

    2009-10-06

    The introduction of nuclear power is a challenging, time-consuming and complex endeavor. After lengthy deliberations and research, some discover they are not prepared to take on the responsibilities or make the necessary investments to pursue nuclear power at this time. In particular, as countries begin to study their education systems with a critical eye, they discover they are unlikely to produce the requisite people to support the new plant they had hoped to introduce in the next ten to fifteen years. Without experienced personnel who can manage, operate, regulate and inspect the new plant, there is no point to building a plant in the first place. This paper will begin with an overview of various challenges associated with establishing and implementing a safe, secure and sustainable nuclear program and describe the some of the key issues that need to be addressed while planning to introduce nuclear power into an energy portfolio. Subsequent sections will describe how the United States is assisting countries in this planning process and in developing an effective workforce capable of supporting the nuclear program. Next, the paper will look at the key documents countries need to prepare in order to develop an effective workforce. The final section will offer some potential measures for success to ensure the long-term viability of the education system.

  11. Do volunteers reduce the costs of parent training programs?

    DEFF Research Database (Denmark)

    Scavenius Sonne-Schmidt, Christoffer; Amilon, Anna; Schultz, Esben Anton

    ADHD in children has considerable negative consequences for both affected individuals and their families. One way to milden these negative consequences is by offering parents training in how to handle the child’s difficulties. However, running parent training programs is associated with substantial...

  12. Plenary III–04: Responses to Drug Costs: Year Three of the Medicare Part D Program

    OpenAIRE

    Fung, Vicki; Reed, Mary; Hsu, John

    2010-01-01

    Background/Aims: Many Medicare Part D beneficiaries face substantial prescription drug cost-sharing. In the first year of the program, many beneficiaries reported substantial drug use changes in response to the coverage gap. In response, an increasing number of plans offer generic drug coverage during the gap. We compared responses to Part D costs among beneficiaries with generic-only gap coverage and full gap coverage in 2008, the third year of the Part D program.

  13. Cost-Effectiveness Analysis of Early Reading Programs: A Demonstration with Recommendations for Future Research

    Science.gov (United States)

    Hollands, Fiona M.; Kieffer, Michael J.; Shand, Robert; Pan, Yilin; Cheng, Henan; Levin, Henry M.

    2016-01-01

    We review the value of cost-effectiveness analysis for evaluation and decision making with respect to educational programs and discuss its application to early reading interventions. We describe the conditions for a rigorous cost-effectiveness analysis and illustrate the challenges of applying the method in practice, providing examples of programs…

  14. The growing importance of costs and ways to maintain cost control on a large program in today's competitive environment

    Science.gov (United States)

    Newman, J. J.; Grimes, D. W.; Gaetano, F. W.

    1973-01-01

    Discussion of management techniques that make it possible to overcome inflationary and developmental cost rises while holding schedule and performance fixed in scientific space programs. The techniques reviewed pertain to high personnel motivation, continual review of contract rigidity for de facto modification by senior judgment, standardization vs design innovation, cooperative customer/contractor goal orientation vs task orientation, and deep real-time management visibility.

  15. Costs to Automate Demand Response - Taxonomy and Results from Field Studies and Programs

    Energy Technology Data Exchange (ETDEWEB)

    Piette, Mary A. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Schetrit, Oren [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Kiliccote, Sila [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Cheung, Iris [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Li, Becky Z [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2017-07-31

    During the past decade, the technology to automate demand response (DR) in buildings and industrial facilities has advanced significantly. Automation allows rapid, repeatable, reliable operation. This study focuses on costs for DR automation in commercial buildings with some discussion on residential buildings and industrial facilities. DR automation technology relies on numerous components, including communication systems, hardware and software gateways, standards-based messaging protocols, controls and integration platforms, and measurement and telemetry systems. This report compares cost data from several DR automation programs and pilot projects, evaluates trends in the cost per unit of DR and kilowatts (kW) available from automated systems, and applies a standard naming convention and classification or taxonomy for system elements. Median costs for the 56 installed automated DR systems studied here are about $200/kW. The deviation around this median is large with costs in some cases being an order of magnitude great or less than the median. This wide range is a result of variations in system age, size of load reduction, sophistication, and type of equipment included in cost analysis. The costs to automate fast DR systems for ancillary services are not fully analyzed in this report because additional research is needed to determine the total cost to install, operate, and maintain these systems. However, recent research suggests that they could be developed at costs similar to those of existing hot-summer DR automation systems. This report considers installation and configuration costs and does include the costs of owning and operating DR automation systems. Future analysis of the latter costs should include the costs to the building or facility manager costs as well as utility or third party program manager cost.

  16. Intraoperative waste in spine surgery: incidence, cost, and effectiveness of an educational program.

    Science.gov (United States)

    Soroceanu, Alex; Canacari, Elena; Brown, Eric; Robinson, Adam; McGuire, Kevin J

    2011-09-01

    Prospective observational study. This study aims to quantify the incidence of intraoperative waste in spine surgery and to examine the efficacy of an educational program directed at surgeons to induce a reduction in the intraoperative waste. Spine procedures are associated with high costs. Implants are a main contributor of these costs. Intraoperative waste further exacerbates the high cost of surgery. Data were collected during a 25-month period from one academic medical center (15-month observational period, 10-month post-awareness program). The total number of spine procedures and the incidence of intraoperative waste were recorded prospectively. Other variables recorded included the type of product wasted, cost associated with the product or implant wasted, and reason for the waste. Intraoperative waste occurred in 20.2% of the procedures prior to the educational program and in 10.3% of the procedures after the implementation of the program (P spine budget. After the awareness program this proportion decrease to an average of 1.2% (P = 0.003). Intraoperative waste in spine surgery exacerbates the already costly procedures. Extrapolation of this data to the national level leads to an annual estimate of $126,722,000 attributable to intraoperative spine waste. A simple educational program proved to be and continues to be effective in making surgeons aware of the import of their choices and the costs related to surgical waste.

  17. A cost effectiveness study of integrated care in health services delivery: a diabetes program in Australia

    Directory of Open Access Journals (Sweden)

    Snow Jill

    2008-10-01

    Full Text Available Abstract Background Type 2 diabetes is rapidly growing as a proportion of the disease burden in Australia as elsewhere. This study addresses the cost effectiveness of an integrated approach to assisting general practitioners (GPs with diabetes management. This approach uses a centralized database of clinical data of an Australian Division of General Practice (a network of GPs to co-ordinate care according to national guidelines. Methods Long term outcomes for patients in the program were derived using clinical parameters after 5 years of program participation, and the United Kingdom Prospective Diabetes Study (UKPDS Outcomes Model, to project outcomes for 40 years from the time of diagnosis and from 5 years post-diagnosis. Cost information was obtained from a range of sources. While program costs are directly available, and costs of complications can be estimated from the UKPDS model, other costs are estimated by comparing costs in the Division with average costs across the state or the nation. The outcome and cost measures are used derive incremental cost-effectiveness ratios. Results The clinical data show that the program is effective in the short term, with improvement or no statistical difference in most clinical measures over 5 years. Average HbA1c levels increased by less than expected over the 5 year period. While the program is estimated to generate treatment cost savings, overall net costs are positive. However, the program led to projected improvements in expected life years and Quality Adjusted Life Expectancy (QALE, with incremental cost effectiveness ratios of $A8,106 per life-year saved and $A9,730 per year of QALE gained. Conclusions The combination of an established model of diabetes progression and generally available data has provided an opportunity to establish robust methods of testing the cost effectiveness of a program for which a formal control group was not available. Based on this methodology, integrated health care

  18. International Acquisition Programs: Variables Beyond Cost, Schedule and Performance

    Science.gov (United States)

    2015-02-17

    US defense budget and often run on a different budgeting timeline.25 For example, the Norwegian defense budget is approximately 1 percent of the US...Defense Acquisition System, 5. 12 Wood , International Military Aerospace Collaboration Case Studies in Domestic and Intergovernmental Politics, 3. 13...Financial Impacts on Foreign Suppliers, 8. 35 Ibid., 55. 36 Hoff, “The F-16 Coproduction Program – An Analysis,” 21. 37 Ibid., 15. 38 Wood

  19. Virtualization for cost-effective teaching of assembly language programming

    OpenAIRE

    Cadenas, Jose O.; Sherratt, Simon; Howlett, Des; Guy, Chris; Lundqvist, Karsten

    2015-01-01

    A virtual system that emulates an ARM-based processor machine has been created to replace a traditional hardware-based system for teaching assembly language. The proposed virtual system integrates, in a single environment, all the development tools necessary to deliver introductory or advanced courses on modern assembly language programming. The virtual system runs a Linux operating system in either a graphical or console mode on a Windows or Linux host machine. No software licenses or extra ...

  20. 20 CFR 671.170 - What are the program and administrative requirements that apply to national emergency grants?

    Science.gov (United States)

    2010-04-01

    ... be used for temporary job creation in areas declared eligible for public assistance by FEMA, subject... costs based on the design and complexity of the project. We will negotiate administration costs with the.... (5) We may negotiate and fund projects under terms other than those specified in this part where it...

  1. Hyperuricemia is associated with increased hospitalization risk and healthcare costs: Evidence from an administrative database in Italy.

    Science.gov (United States)

    Degli Esposti, L; Desideri, G; Saragoni, S; Buda, S; Pontremoli, R; Borghi, C

    2016-10-01

    Chronic hyperuricemia is responsible for a relevant burden of articular diseases and cardio-nephrometabolic disorders. We evaluated the effect of high serum uric acid (SUA) levels on hospitalization risk and mortality and on healthcare costs in a real-life setting. We conducted a retrospective analysis using a large administrative database and a clinical registry among 112,170 subjects from three Italian local health units. Individuals were divided into four groups according to their SUA levels: 6 mg/dL and ≤7 mg/dL (19.3%), >7 mg/dL and ≤8 mg/dL (8.7%), and >8 mg/dL (5.5%). Compared to those with SUA level of 8 mg/dL). Increased SUA levels are associated with an increased risk of hospitalizations related to hyperuricemia, CKD, and CVDs and total mortality, and consequently with higher total healthcare costs and hospitalization costs per patient. Copyright © 2016 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

  2. 40 CFR 147.650 - State-administrative program-Class I, II, III, IV, and V wells.

    Science.gov (United States)

    2010-07-01

    ... CONTROL PROGRAMS Idaho § 147.650 State-administrative program—Class I, II, III, IV, and V wells. The UIC program for Class I, II, III, IV, and V wells in the State of Idaho, other than those on Indian lands, is... 40 Protection of Environment 22 2010-07-01 2010-07-01 false State-administrative program-Class I...

  3. Gender and the use of Veterans Health Administration homeless services programs among Iraq/Afghanistan veterans.

    Science.gov (United States)

    Blackstock, Oni J; Haskell, Sally G; Brandt, Cynthia A; Desai, Rani A

    2012-04-01

    Female Veterans comprise 12% of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Veterans, the largest proportion of women to serve of any prior cohort. We sought to determine the sex-specific risk of using a Veterans Health Administration (VHA) homeless program among OEF/OIF Veterans and to identify factors associated with increased risk of program use for women compared with men. We included OEF/OIF Veterans with at least 1 VHA clinical visit between October 1, 2001, and September 30, 2009. The study's outcome was the time to first use of a VHA homeless program. Cox proportional-hazards regression was used to estimate the relative risk of using a homeless program by sex, adjusting for relevant sociodemographic and clinical variables. Exploratory analyses examined interactions between sex and all covariates. Of 445,319 Veterans, 7431 (1.7%) used a VHA homeless program, of which 961 were females (1.8%), and 6470 were males (1.7%) during a median follow-up period of 3.20 years. Women were as likely as men to use a homeless program (adjusted hazard ratio, 1.02; 95% confidence interval, 0.95-1.09); median time to first use was similar for female and male Veterans (1.88 vs. 1.88 y, respectively, P=0.53). In exploratory analyses, we found increased risk of program use for women compared with men for the following subgroups: ages 26-35 years, 100% service-connected disability rating, posttraumatic stress disorder diagnosis, and northeast location. Overall, there was no substantial difference in the sex-specific risk of using a VHA homeless program. In light of this finding, VHA homeless programs must be prepared to recognize and address the unique needs of female OEF/OIF Veterans.

  4. Study of the environmental costs to nuclear power plants using the SIMPACTS program

    Energy Technology Data Exchange (ETDEWEB)

    Menzel, Francine; Sabundjian, Gaiane; Mutarelli, Rita de Cassia, E-mail: fmenzel@ipen.b, E-mail: gdjian@ipen.b [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2011-07-01

    The nuclear energy presents advantages in comparison with other kinds of energy sources, when their externalities are evaluated. Externality is a term that represents the side effects of production of goods or services on other people not directly involved in the activity. The externalities can be identified and related to the term environmental cost. The environmental cost is a externality that somehow affects the environment, converted into economic terms, to then be compared with other costs of an action or enterprise. The environmental cost can be calculated through programs for that purpose, however for the nuclear area is the most used SIMPACTS, developed by the International Atomic Energy Agency (IAEA). The motivation for this work arose from the need to have a complete assessment of environmental costs from nuclear power reactors, although it is known that this kind of form of energy generation show an advantage over others with regard to externalities. This work is the first step in implementing the program SIMPACTS in plant Angra 2 in order to calculate the environmental cost of their operation. The objective is to develop a methodology for calculating environmental cost for nuclear power reactors. SIMPACTS program will be used to identify the advantages and disadvantages of a cost analysis of environmental and perform the calculation of environmental costs for Angra 2, with the aim of minimizing the environmental impacts of its operation. From an extensive literature search, is presented in this paper the methodology for calculating the environmental cost of the program SIMPACTS and some results of calculations with the environmental cost in international power reactors other power generation plants. (author)

  5. [Cost-benefit analysis of primary prevention programs for mental health at the workplace in Japan].

    Science.gov (United States)

    Yoshimura, Kensuke; Kawakami, Norito; Tsusumi, Akizumi; Inoue, Akiomi; Kobayashi, Yuka; Takeuchi, Ayano; Fukuda, Takashi

    2013-01-01

    To determine the cost-benefits of primary prevention programs for mental health at the workplace, we conducted a meta-analysis of published studies in Japan. We searched the literature, published as of 16 November 2011, using the Pubmed database and relevant key words. The inclusion criteria were: conducted in the workplace in Japan; primary prevention focus; quasi-experimental studies or controlled trials; and outcomes including absenteeism or presenteeism. Four studies were identified: one participatory work environment improvement, one individual-oriented stress management, and two supervisor education programs. Costs and benefits in yen were estimated for each program, based on the description of the programs in the literature, and additional information from the authors. The benefits were estimated based on each program's effect on work performance (measured using the WHO Health and Work Performance Questionnaire in all studies), as well as sick leave days, if available. The estimated relative increase in work performance (%) in the intervention group compared to the control group was converted into labor cost using the average bonus (18% of the total annual salary) awarded to employees in Japan as a base. Sensitive analyses were conducted using different models of time-trend of intervention effects and 95% confidence limits of the relative increase in work performance. For the participatory work environment improvement program, the cost was estimated as 7,660 yen per employee, and the benefit was 15,200-22,800 yen per employee. For the individual-oriented stress management program, the cost was 9,708 yen per employee, and the benefit was 15,200-22,920 yen per employee. For supervisor education programs, the costs and benefits were respectively 5,209 and 4,400-6,600 yen per employee, in one study, 2,949 and zero yen per employee in the other study. The 95% confidence intervals were wide for all these studies. For the point estimates based on these cases, the

  6. Post Milestone B Funding Climate and Cost Growth in Major Defense Acquisition Programs

    Science.gov (United States)

    2017-03-01

    I N S T I T U T E F O R D E F E N S E A N A L Y S E S IDA Paper P-8091 March 2017 Post-Milestone B Funding Climate and Cost Growth in Major...Jun 2013]. Post-Milestone B Funding Climate and Cost Growth in Major Defense Acquisition Programs David L. McNicol I N S T I T U T E F O R D E F...entered a boom climate for procurement funding some time after passing Milestone (MS) B on average had higher unit cost growth than programs whose

  7. The Economics of Perception: Potential Effect regarding Institutional Uses of Recovered Facilities and Administrative Costs upon a Faculty Member's Decision to Engage in Sponsored Research Activity

    Science.gov (United States)

    Hatfield, Anne Elizabeth

    2012-01-01

    There is one aspect of sponsored research associated with higher education's research enterprise that often places the institution's research administrators and the institution's faculty members in conflict with each other; the recovery of Facilities and Administrative (F&A) costs associated with sponsored research projects (Sedwick, 2009;…

  8. Cost-utility of a disease management program for patients with asthma.

    Science.gov (United States)

    Steuten, Lotte; Palmer, Stephen; Vrijhoef, Bert; van Merode, Frits; Spreeuwenberg, Cor; Severens, Hans

    2007-01-01

    The long-term cost-utility of a disease management program (DMP) for adults with asthma was assessed compared to usual care. A DMP for patients with asthma has been developed and implemented in the region of Maastricht (The Netherlands). By integrating care, the program aims to continuously improve quality of care within existing budgets. A clinical trial was performed over a period of 15 months to collect data on costs and effects of the program and usual care. These data were used to inform a probabilistic decision-analytic model to estimate the 5-year impact of the program beyond follow-up. A societal perspective was adopted, with outcomes assessed in terms of costs per quality-adjusted life-year (QALY). The DMP is associated with a gain in QALYs compared to usual care (2.7+/-.2 versus 3.4+/-.8), at lower costs (3,302+/-314 euro versus 2,973+/-304 euro), thus leading to dominance. The probability that disease management is the more cost-effective strategy is 76 percent at a societal willingness to pay (WTP) for an additional QALY of 0 euro, reaching 95 percent probability at a WTP of 1,000 euro per additional QALY. Organizing health care according to the principles of disease management for adults with asthma has a high probability of being cost-effective and is associated with a gain in QALYs at lower costs.

  9. Alvimopan reduces length of stay and costs in patients undergoing segmental colonic resections: results from multicenter national administrative database.

    Science.gov (United States)

    Simorov, Anton; Thompson, Jon; Oleynikov, Dmitry

    2014-12-01

    Alvimopan (Entereg), a peripherally acting mu-opioid receptor antagonist, has been shown to expedite recovery of bowel function after colon resection surgery. Most data are available from industry-sponsored trials. This study aims to evaluate the clinical impact of this drug on perioperative outcomes and costs in patients undergoing segmental colonic resection for diverticular disease. A large administrative database maintained by the University Health System Consortium, an alliance of over 200 academic and affiliate hospitals, was queried from 2008 to 2011. International Classification of Diseases, 9th Revision, Clinical Modification codes for segmental colon resection because of diverticular disease were used to identify 2 matched cohorts of adult patients. University Health System Consortium's clinical resource manager was used to access pharmacy data and compare it with patient outcomes. Five thousand two hundred ninety-nine patients met the above criteria. Four hundred thirty-eight patients received alvimopan and 4,861 did not. Regardless of laparoscopic or open approach, alvimopan significantly improved the postoperative length of stay (4.43 ± 2.02 vs 5.92 ± 3.79, P < .0001), cost (9,974 ± 4,077 vs 11,303 ± 6,968, P < .0001), and intensive care unit admission rate (1.83% vs 7.20%, P < .05), with no significant difference in mortality (.0% vs .19%, P = 1.000), morbidity (5.93% vs 8.39%, P = .08), or 30-day readmission rate (4.40% vs 4.63%, P = .90). Alvimopan significantly reduced length of stay, days in the intensive care unit, and hospital cost for patients undergoing colonic segmental resections. Unlike some previously reported studies, we also observed a significant reduction in the length of stay in patients undergoing laparoscopic colectomies who received the drug. Alvimopan may reduce total healthcare costs if used as part of a best care practice model for colon resections. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. DEP : a computer program for evaluating lumber drying costs and investments

    Science.gov (United States)

    Stewart Holmes; George B. Harpole; Edward Bilek

    1983-01-01

    The DEP computer program is a modified discounted cash flow computer program designed for analysis of problems involving economic analysis of wood drying processes. Wood drying processes are different from other processes because of the large amounts of working capital required to finance inventories, and because of relatively large shares of costs charged to inventory...

  11. Recidivism, Costs, and Psychosocial Outcomes for a Post-Arrest Juvenile Diversion Program

    Science.gov (United States)

    Hodges, Kay; Martin, Lisa A.; Smith, Cynthia; Cooper, Shaun

    2011-01-01

    Recidivism, costs, and psychosocial outcomes are reported for a post-arrest diversion program in Wayne County (Detroit), MI. Program features included: rapid, standardized assessment of psychosocial functioning with the Juvenile Inventory For Functioning[R], an individualized plan for addressing needs, engagement of caregivers, service provision…

  12. 76 FR 61089 - Indirect Cost Rates for the Damage Assessment, Remediation, and Restoration Program for Fiscal...

    Science.gov (United States)

    2011-10-03

    ... fiscal year in question, costs will be recalculated using the revised rates in this policy for these..., and Restoration Program for Fiscal Years 2009 and 2010 AGENCY: National Oceanic and Atmospheric..., and Restoration Program for Fiscal Years 2009 and 2010. SUMMARY: The National Oceanic and Atmospheric...

  13. A Cost-Savings Analysis of a Statewide Parenting Education Program in Child Welfare

    Science.gov (United States)

    Maher, Erin J.; Corwin, Tyler W.; Hodnett, Rhenda; Faulk, Karen

    2012-01-01

    Objectives: This article presents a cost-savings analysis of the statewide implementation of an evidence-informed parenting education program. Methods: Between the years 2005 and 2008, the state of Louisiana used the Nurturing Parenting Program (NPP) to impart parenting skills to child welfare-involved families. Following these families' outcomes…

  14. Lowering employee health care costs through the Healthy Lifestyle Incentive Program.

    Science.gov (United States)

    Merrill, Ray M; Hyatt, Beverly; Aldana, Steven G; Kinnersley, Dan

    2011-01-01

    To evaluate the impact of the Healthy Lifestyle Incentive Program (HLIP), a worksite health program, on lowering prescription drug and medical costs. Health care cost data for Salt Lake County employees during 2004 through 2008 were linked with HLIP enrollment status. Additional program information was obtained from a cross-sectional survey administered in 2008. The program includes free annual screenings, tailored feedback on screening results, financial incentives for maintaining and modifying certain behaviors, and periodic educational programs and promotions to raise awareness of health topics. Frequency and cost of prescription drug and medical claims. Participation increased from 16% to 23% in men and 34% to 45% in women over the 5-year study period and was associated with a significantly greater level of physical activity and improved general health. Participants were generally satisfied with the HLIP (43% were very satisfied, 51% satisfied, 5% dissatisfied, and 1% very dissatisfied). The primary factors contributing to participation were financial incentives (more so among younger employees), followed by a desire to improve health (more so among older employees). Over the study period, the cost savings in lower prescription drug and medical costs was $3,568,837. For every dollar spent on the HLIP the county saved $3.85. Financial incentives and then a desire for better health were the primary reasons for participation. The HLIP resulted in substantial health care cost savings for Salt Lake County Government.

  15. Low-cost flywheel demonstration program. Final report, 1 October 1977-31 December 1979

    Energy Technology Data Exchange (ETDEWEB)

    Rabenhorst, D.W.; Small, T.R.; Wilkinson, W.O.

    1980-04-01

    The Applied Physics Laboratory/Department of Energy Low Cost Flywheel Demonstration Program was initiated on 1 October 1977 and was successfully concluded on 31 December 1979. The total cost of this program was $355,190. All primary objectives were successfully achieved as follows: demonstration of a full-size, 1-kWh flywheel having an estimated cost in large-volume production of approximately $50/kWh; development of a ball-bearing system having losses comparable to the losses in a totally magnetic suspension system; successful and repeated demonstration of the low-cost flywheel in a complete flywheel energy-storage system based on the use of ordinary house voltage and frequency; and application of the experience gained in the hardware program to project the system design into a complete, full-scale, 30-kWh home-type flywheel energy-storage system.

  16. Use of Linear Programming to Develop Cost-Minimized Nutritionally Adequate Health Promoting Food Baskets

    DEFF Research Database (Denmark)

    Parlesak, A.; Tetens, Inge; Dejgård Jensen, Jørgen

    2016-01-01

    variety of foods contained from 70 (CAN) to 134 (DGN) foods and cost between DKK 60 (€ 8.1, N) and DKK 125 (€ 16.8, DGN). Ensuring that the food baskets cover both dietary guidelines and nutrient recommendations doubled the cost while cultural acceptability (CAN) tripled it. Use of linear programming...... both micronutrient inadequacy and diet-related non-communicable diseases at lowest cost. Average prices for 312 foods were collected within the Greater Copenhagen area. The cost and nutrient content of five different cost-minimized FBs for a family of four were calculated per day using linear...... programming. The FBs were defined using five different constraints: cultural acceptability (CA), or dietary guidelines (DG), or nutrient recommendations (N), or cultural acceptability and nutrient recommendations (CAN), or dietary guidelines and nutrient recommendations (DGN). The variety and number of foods...

  17. What Do Schools Want? Assessing Elementary School Administrator and Teacher Preferences Related to Nutrition Education Program Scheduling

    Science.gov (United States)

    Hermann, Janice; Parker, Stephany; Phelps, Josh; Brown, Barbara

    2011-01-01

    Extension is positioned to provide school-based nutrition education programs as required by the 2004 Child Nutrition and WIC Reauthorization Act. To enhance program acceptance and sustainability, it is important to consider school administrators' and teachers' interests and preferences regarding nutrition education programming. The project…

  18. Investigation of administrative obstacles to family physician program in urban areas of Iran

    Directory of Open Access Journals (Sweden)

    Javad Javan noughabi

    2017-06-01

    Full Text Available Health is regarded as one of the basic rights of each person in society; so governments are obligated to provide it equally for everyone. The best way to achieve this goal is the establishment of health insurance with the orientation of family physician and the strategic referral system. Yet, such programs will not be successful without encouraging people to participate and changing social behaviors. The aim of the present study was to investigate the administrative obstacles and problems to family physician program in urban areas of Iran. This study was a qualitative research conducted. A purposive sampling method was employed and the data were gathered via semi-structured interview with open-ended questions and document examination. All the interviews were recorded digitally and immediately transcribed verbatim. They were finally analyzed based on framework analysis. The participants' detailed descriptions showed that systemic, environmental, and human related factors were the main obstacles to the implementation of family physician plan. Since the success and performance of each program effectively cannot be obtained without people’s acceptance and collaboration, the necessity of training and giving information rapidly and timely to the residents in urban areas is felt more than ever. Also, making authorities aware of the obstacles expressed by people can be helpful in harmonizing the program with people’s requests; and can result in overcoming the challenges and obstacles facing the program.

  19. Application of a strategic planning model in a stricto sensu postgraduate program in business administration

    Directory of Open Access Journals (Sweden)

    Emerson Antonio Maccari

    2006-07-01

    Full Text Available Since the 1996 the Educational Directives and Bases Law, the Brazilian educational sector has been going through a revolution in the flexibility and extension of the supply of higher education (Brasil 1996. This can also be seen in stricto sensu postgraduate programs (which require dissertation, due to the increase in the number of new courses which have been offered by higher educational institutions, and because of the quality requirements which these courses are expected to fulfill by the Brazilian Ministry of Education, specifically Coordenação de Aperfeiçoamento Pessoal de Nível Superior – CAPES. The demands imposed by CAPES have forced the higher educational institutions and their postgraduate programs to plan and manage in a more professional way. The aim of this paper is to show the importance of strategic planning as a managerial tool for graduate Programs in Business Administration. To do this we designed the research as an action-research, using Almeida’s (2003 Strategic Planning Model to frame the research process. The main results indicate that the combination of CAPES’ quality parameters used in a systemic way, according to the selected strategic planning model, allow Graduate Program Chairmen to reach pursued vision. In the case studied, the action-research method induced the Program Chairmanship to change the Program’s status from business orientation to academic orientation, targeting to its new strategic trajectory.

  20. The impact of an online disease management program on medical costs among health plan members.

    Science.gov (United States)

    Schwartz, Steven M; Day, Brian; Wildenhaus, Kevin; Silberman, Anna; Wang, Chun; Silberman, Jordan

    2010-01-01

    This study evaluated the economic impact of an online disease management program within a broader population health management strategy. A retrospective, quasi-experimental, cohort design evaluated program participants and a matched cohort of nonparticipants on 2003-2007 claims data in a mixed model. The study was conducted through Highmark Inc, Blue Cross Blue Shield, covering 4.8 million members in five regions of Pennsylvania. Overall, 413 online self-management program participants were compared with a matched cohort of 360 nonparticipants. The costs and claims data were measured per person per calendar year. Total payments were aggregated from inpatient, outpatient, professional services, and pharmacy payments. The costs of the online program were estimated on a per-participant basis. All dollars were adjusted to 2008 values. The online intervention, implemented in 2006, was a commercially available, tailored program for chronic condition self management, nested within the Blues on Call(SM) condition management strategy. General linear modeling (with covariate adjustment) was used. Data trends were also explored using second-order polynomial regressions. Health care costs per person per year were $757 less than predicted for participants relative to matched nonparticipants, yielding a return on investment of $9.89 for every dollar spent on the program. This online intervention showed a favorable and cost-effective impact on health care cost.

  1. [Costs of population cervical cancer screening program in Poland between 2007-2009].

    Science.gov (United States)

    Spaczyński, Marek; Karowicz-Bilinska, Agata; Kedzia, Witold; Molińska-Glura, Marta; Seroczyński, Przemysław; Januszek-Michalecka, Lucyna; Rokita, Wojciech; Nowak-Markwitz, Ewa

    2010-10-01

    Screening programs may contribute to decreasing the mortality rate in a given population and their main target, in case of cervical cancer; is to find and to cure preclinical stages of this malignancy. Regularly repeated tests in defined time intervals can diagnose the illness at its early stages but the results come with a high cost. Population program of early detection of cervical cancer has been conducted since 2007 and is run by the Central Coordinating Center and 16 regional centers. Funds for promotional, educational, monitoring and medical activities are obtained from the National Health Service. The aim of this study was to present the cost-effectiveness of the Program between 2007 and 2009. The material for the analysis was obtained from the SIMP system, where all the data about women participating in the Program are implemented. The analysis of the cervical carcinoma treatment and procedure costs was made on the basis of the National Health Service estimates. The number of new cervical carcinoma cases was calculated with the help of the newly introduced system code--C53. Between 2007 and 2009 the cost of one cytological smear was similar in all regions (about 10 PLN). The highest costs were noted in Lubuski and Swietokrzyski regions. The costs of promotional and educational activities amounted up to 4.5 million PLN. A single cervical smear test cost for one woman has increased in the analyzed years from 3.95 up to 7.34 PLN. The total cost of one woman cytological examination--medical and non-medical elements--was more than 60 PLN. In 2009, 622 new cases of cervical cancer were found thanks to the Program. The cost of one case of cervical cancer diagnosis was 15 000 PLN. The total costs of all cases of cervical cancer in 2009 was 45.5 million PLN. The situation calls for creating new and effective tools for monitoring medical, epidemiological and financial parameters of the Program. Otherwise, the estimates of the health and social impact of the Program

  2. Cost-effectiveness of the "helping babies breathe" program in a missionary hospital in rural Tanzania.

    Directory of Open Access Journals (Sweden)

    Corinna Vossius

    Full Text Available The Helping Babies Breathe" (HBB program is an evidence-based curriculum in basic neonatal care and resuscitation, utilizing simulation-based training to educate large numbers of birth attendants in low-resource countries. We analyzed its cost-effectiveness at a faith-based Haydom Lutheran Hospital (HLH in rural Tanzania.Data about early neonatal mortality and fresh stillbirth rates were drawn from a linked observational study during one year before and one year after full implementation of the HBB program. Cost data were provided by the Tanzanian Ministry of Health and Social Welfare (MOHSW, the research department at HLH, and the manufacturer of the training material Lærdal Global Health.Costs per life saved were USD 233, while they were USD 4.21 per life year gained. Costs for maintaining the program were USD 80 per life saved and USD 1.44 per life year gained. Costs per disease adjusted life year (DALY averted ranged from International Dollars (ID; a virtual valuta corrected for purchasing power world-wide 12 to 23, according to how DALYs were calculated.The HBB program is a low-cost intervention. Implementation in a very rural faith-based hospital like HLH has been highly cost-effective. To facilitate further global implementation of HBB a cost-effectiveness analysis including government owned institutions, urban hospitals and district facilities is desirable for a more diverse analysis to explore cost-driving factors and predictors of enhanced cost-effectiveness.

  3. Costs of Development and Maintenance of an Internet Program for Teens with Type 1 Diabetes.

    Science.gov (United States)

    Grey, Margaret; Liberti, Lauren; Whittemore, Robin

    2015-07-01

    Many adolescents with type 1 diabetes (T1D) have difficulty completing self-management tasks within the context of their social environments. Group-based approaches to psycho-educational support have been shown to prevent declines in glucose control, but are challenging to implement due to youths' many activities and costs. A novel solution is providing psycho-educational support via the internet. The purpose of this study is to describe the cost of developing and maintaining two internet psycho-educational programs, both of which have been shown to improve health outcomes in adolescents with T1D. We calculated actual costs of personnel and programming in the development of TEENCOPE(™) and Managing Diabetes, two highly interactive programs that were evaluated in a multi-site clinical trial (n=320). Cost calculations were set at U.S. dollars and converted to value for 2013 as expenses were incurred over 6 years. Development costs over 1.5 years totaled $324,609, with the majority of costs being for personnel to develop and write content in a creative and engaging format, to get feedback from teens on content and a prototype, and IT programming. Maintenance of the program, including IT support, a part-time moderator to assure safety of the discussion board (0.5-1 hour/week), and yearly update of content was $43,845/year, or $137.00 per youth over 4.5 years. Overall, program and site development were relatively expensive, but the program reach was high, including non-white youth from 4 geographically distinct regions. Once developed, maintenance was minimal. With greater dissemination, cost-per-youth would decrease markedly, beginning to offset the high development expense.

  4. Life prolonging of disease management programs in patients with type 2 diabetes is cost-effective.

    Science.gov (United States)

    Drabik, A; Büscher, G; Sawicki, P T; Thomas, K; Graf, C; Müller, D; Stock, S

    2012-02-01

    Our objective was to examine the cost-effectiveness of disease management programs (DMPs) for type 2 diabetes mellitus (T2DM) taking into account their life prolonging effect. We compared real life costs in 19,888 propensity score matched pairs of T2DM DMP participants and T2DM patients in routine care (RC) according to sickness funds data. We estimated mean annual costs for survivors, last year of life costs for decedents, the influence of ageing on costs, incremental cost-effectiveness ratio and effects on hospitalization. Annual costs for survivors were 3,318€ (DMP) and 3,570€ (RC). The mean costs in the last year of life were 16,911€ (DMP) and 15,763€ (RC). Ageing had a cost triggering effect for survivors (30€/36€ per year in DMP-/RC-group; pcost decreasing effect in the last year of life (546€/483€ per year in DMP-/RC-group; pcost-effectiveness ratio of the DMP vs. RC was -1396€ per life-year gained. Hospitalizations increased with age in case of survival and decreased with age in case of death but were always lower in the DMP-group. Despite increase in costs due to longer life DMPs are cost-effective. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  5. Identifying potentially cost effective chronic care programs for people with COPD

    Directory of Open Access Journals (Sweden)

    L M G Steuten

    2008-12-01

    Full Text Available L M G Steuten1, K M M Lemmens2, A P Nieboer2, H JM Vrijhoef31Maastricht University Medical Centre, School for Care and Public Health Research, Department of Health, Organisation, Policy and Economics, Maastricht, The Netherlands; 2Erasmus University Medical Centre, Institute of Health Policy and Management, Rotterdam, The Netherlands; 3Maastricht University Medical Centre, School for Care and Public Health Research, Department of Integrated Care, Maastricht, The NetherlandsObjective: To review published evidence regarding the cost effectiveness of multi-component COPD programs and to illustrate how potentially cost effective programs can be identified.Methods: Systematic search of Medline and Cochrane databases for evaluations of multi-component disease management or chronic care programs for adults with COPD, describing process, intermediate, and end results of care. Data were independently extracted by two reviewers and descriptively summarized.Results: Twenty articles describing 17 unique COPD programs were included. There is little evidence for significant improvements in process and intermediate outcomes, except for increased provision of patient self-management education and improved disease-specific knowledge. Overall, the COPD programs generate end results equivalent to usual care, but programs containing ≥3 components show lower relative risks for hospitalization. There is limited scope for programs to break-even or save money.Conclusion: Identifying cost effective multi-component COPD programs remains a challenge due to scarce methodologically sound studies that demonstrate significant improvements on process, intermediate and end results of care. Estimations of potential cost effectiveness of specific programs illustrated in this paper can, in the absence of ‘perfect data’, support timely decision-making regarding these programs. Nevertheless, well-designed health economic studies are needed to decrease the current decision

  6. Stochastic Funding of a Defined Contribution Pension Plan with Proportional Administrative Costs and Taxation under Mean-Variance Optimization Approach

    Directory of Open Access Journals (Sweden)

    Charles I Nkeki

    2014-11-01

    Full Text Available This paper aim at studying a mean-variance portfolio selection problem with stochastic salary, proportional administrative costs and taxation in the accumulation phase of a defined contribution (DC pension scheme. The fund process is subjected to taxation while the contribution of the pension plan member (PPM is tax exempt. It is assumed that the flow of contributions of a PPM are invested into a market that is characterized by a cash account and a stock. The optimal portfolio processes and expected wealth for the PPM are established. The efficient and parabolic frontiers of a PPM portfolios in mean-variance are obtained. It was found that capital market line can be attained when initial fund and the contribution rate are zero. It was also found that the optimal portfolio process involved an inter-temporal hedging term that will offset any shocks to the stochastic salary of the PPM.

  7. A cost-effectiveness analysis of a multimedia learning education program for stoma patients.

    Science.gov (United States)

    Lo, Shu-Fen; Wang, Yun-Tung; Wu, Li-Yue; Hsu, Mei-Yu; Chang, Shu-Chuan; Hayter, Mark

    2010-07-01

    The purpose of this study was to compare the costs and effectiveness of enterostomal education using a multimedia learning education program (MLEP) and a conventional education service program (CESP). Multimedia health education programs not only provide patients with useful information in the absence of health professionals, but can also augment information provided in traditional clinical practice. However, the literature on the cost-effectiveness of different approaches to stoma education is limited. This study used a randomised experimental design. A total of 54 stoma patients were randomly assigned to MLEP or CESP nursing care with a follow-up of one week. Effectiveness measures were knowledge of self-care (KSC), attitude of self-care (ASC) and behavior of self-care (BSC). The costs measures for each patient were: health care costs, MLEP cost and family costs. Subjects in the MLEP group demonstrated significantly better outcomes in the effectiveness measures of KSC, ASC and BSC. Additionally, the total social costs for each MLEP patient and CESP patient were US$7396·90 and US$8570·54, respectively. The cost-effectiveness ratios in these two groups showed that the MLEP model was better than the CESP model after one intervention cycle. In addition, the Incremental Cost Effectiveness Ratio was -20·99. This research provides useful information for those who would like to improve the self-care capacity of stoma patients. Due to the better cost-effectiveness ratio of MLEP, hospital policy-makers may consider these results when choosing to allocate resources and develop care and educational interventions. This study provides a cost effective way of addressing stoma care in the post-operative period that could be usefully transferred to stoma care settings internationally. © 2009 The Authors. Journal compilation © 2009 Blackwell Publishing Ltd.

  8. Low-income DSM Programs: Methodological approach to determining the cost-effectiveness of coordinated partnerships

    Energy Technology Data Exchange (ETDEWEB)

    Brown, M.A.; Hill, L.J.

    1994-05-01

    As governments at all levels become increasingly budget-conscious, expenditures on low-income, demand-side management (DSM) programs are being evaluated more on the basis of efficiency at the expense of equity considerations. Budgetary pressures have also caused government agencies to emphasize resource leveraging and coordination with electric and gas utilities as a means of sharing the expenses of low-income programs. The increased involvement of electric and gas utilities in coordinated low-income DSM programs, in turn, has resulted in greater emphasis on estimating program cost-effectiveness. The objective of this study is to develop a methodological approach to estimate the cost- effectiveness of coordinated low-income DSM programs, given the special features that distinguish these programs from other utility-operated DSM programs. The general approach used in this study was to (1) select six coordinated low-income DSM programs from among those currently operating across the United States, (2) examine the main features of these programs, and (3) determine the conceptual and pragmatic problems associated with estimating their cost-effectiveness. Three types of coordination between government and utility cosponsors were identified. At one extreme, local agencies operate {open_quotes}parallel{close_quotes} programs, each of which is fully funded by a single sponsor (e.g., one funded by the U.S. Department of Energy and the other by a utility). At the other extreme are highly {open_quotes}coupled{close_quotes} programs that capitalize on the unique capabilities and resources offered by each cosponsor. In these programs, agencies employ a combination of utility and government funds to deliver weatherization services as part of an integrated effort. In between are {open_quotes}supplemental{close_quotes} programs that utilize resources to supplement the agency`s government-funded weatherization, with no changes to the operation of that program.

  9. Cost-effectiveness analysis of family planning programs in rural Bangladesh: evidence from Matlab.

    Science.gov (United States)

    Simmons, G B; Balk, D; Faiz, K K

    1991-01-01

    The Family Planning Health Services Project in Matlab is often seen as more expensive than similar activities carried out by the government of Bangladesh. At the same time, it as been observed that the project is much more effective. The alleged high cost of the project is said to make it difficult to replicate throughout the nation. Previously, the true costs of the project had not been documented. This study systemically examines the cost of the project and assesses its cost-effectiveness. An experimental design framework is used as a basis for understanding the cost-effectiveness of the project, although a sensitivity analysis lends further support to the relative efficiency of the approach undertaken in Matlab. Although in the aggregate, the Matlab Project is more expensive than the government's family planning program, it is also more effective, generating enough output to offset the extra costs of the intensified delivery system.

  10. Energy storage systems cost update : a study for the DOE Energy Storage Systems Program.

    Energy Technology Data Exchange (ETDEWEB)

    Schoenung, Susan M. (Longitude 122 West, Menlo Park, CA)

    2011-04-01

    This paper reports the methodology for calculating present worth of system and operating costs for a number of energy storage technologies for representative electric utility applications. The values are an update from earlier reports, categorized by application use parameters. This work presents an update of energy storage system costs assessed previously and separately by the U.S. Department of Energy (DOE) Energy Storage Systems Program. The primary objective of the series of studies has been to express electricity storage benefits and costs using consistent assumptions, so that helpful benefit/cost comparisons can be made. Costs of energy storage systems depend not only on the type of technology, but also on the planned operation and especially the hours of storage needed. Calculating the present worth of life-cycle costs makes it possible to compare benefit values estimated on the same basis.

  11. 43 CFR 12.62 - Allowable costs.

    Science.gov (United States)

    2010-10-01

    ... uniform cost accounting standards that comply with cost principles acceptable to the Federal agency. ... COST PRINCIPLES FOR ASSISTANCE PROGRAMS Uniform Administrative Requirements for Grants and Cooperative... increment above allowable costs) to the grantee or subgrantee. (b) Applicable cost principles. For each kind...

  12. Experience of health-system pharmacy administration residents in a longitudinal human resource management program.

    Science.gov (United States)

    Amerine, Lindsey B Poppe; Granko, Robert P; Savage, Scott W; Daniels, Rowell; Eckel, Stephen F

    2014-12-15

    The experience of health-system pharmacy administration (HSPA) residents in a longitudinal human resource (HR) management program is described. The subsequent benefits to the residents, department, and profession are also discussed. Postgraduate year 2 HSPA residents at an academic medical center desired more responsibility for managing an operational area. To this end, a program was created in which these residents directly manage a small group of pharmacy technicians and report to a clinical manager or assistant director with oversight responsibility. These "resident managers" are responsible, under the direction of the area's clinical manager, for the personnel, schedule, time and attendance, and HR activities of the area. Resident managers have led and sustained operational improvement projects in their areas. In addition to providing learning experiences to residents, the HSPA residency program has also improved the operations of the areas in which these residents work. Benefits to the residents include conducting annual performance evaluations for employees with whom they have a relationship as it is a task every administrator completes. Resident managers at UNC have consistently stated that this longitudinal HR experience is one of the most rewarding and most challenging experiences offered in the two-year HSPA residency. The involvement of HSPA residents in longitudinal management responsibilities furthers residents' leadership success by providing trained managers who are ready to immerse themselves into practice postresidency, having employee engagement and HR skills as well as experiences with leading operational improvements. A longitudinal HR management experience was successfully incorporated into an HSPA residency combined Master of Science degree program. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  13. Purposive facebook recruitment endows cost-effective nutrition education program evaluation.

    Science.gov (United States)

    Lohse, Barbara; Wamboldt, Patricia

    2013-08-15

    Recent legislation established a requirement for nutrition education in federal assistance programs to be evidence-based. Recruitment of low-income persons to participate and evaluate nutrition education activities can be challenging and costly. Facebook has been shown to be a cost-effective strategy to recruit this target audience to a nutrition program. The purpose of our study was to examine Facebook as a strategy to recruit participants, especially Supplemental Nutrition Assistance Program Education (SNAP-Ed) eligible persons, to view and evaluate an online nutrition education program intended to be offered as having some evidence base for SNAP-Ed programming. English-speaking, low-income Pennsylvania residents, 18-55 years with key profile words (eg, Supplemental Nutrition Assistance Program, Food bank), responded to a Facebook ad inviting participation in either Eating Together as a Family is Worth It (WI) or Everyone Needs Folic Acid (FA). Participants completed an online survey on food-related behaviors, viewed a nutrition education program, and completed a program evaluation. Facebook set-up functions considered were costing action, daily spending cap, and population reach. Respondents for both WI and FA evaluations were similar; the majority were white, Cost per completed evaluation was US $25.48; cost per low-income completer was US $39.92. Results were similar for the FA evaluation; 795 Facebook users clicked on the ad with 110 unique site visitors, and 73 completing the evaluation (ie, 73/795, 9.2% of ad clickers and 73/110, 66% of site visitors completed the evaluation). Cost per valid completed survey with program evaluation was US $18.88; cost per low-income completer was US $27.53. With Facebook we successfully recruited low-income Pennsylvanians to online nutrition program evaluations. Benefits using Facebook as a recruitment strategy included real-time recruitment management with lower costs and more efficiency compared to previous data from

  14. Evaluation of mass drug administration in the program to control imported lymphatic filariasis in Thailand.

    Science.gov (United States)

    Toothong, Tanaporn; Tipayamongkholgul, Mathuros; Suwannapong, Nawarat; Suvannadabba, Saravudh

    2015-09-28

    Migration plays a major role in the emergence and resurgence of lymphatic filariasis (LF) in many countries. Because of the high prevalence of Imported Bancroftian Filariasis (IBF) caused by nocturnally periodic Wuchereria bancrofti and the intensive movement of immigrant workers from endemic areas, Thailand has implemented two doses of 6 mg/kg diethylcarbamazine (DEC) with interval of 6 months to prevent IBF. In areas where immigrants are very mobile, the administration of DEC may be compromised. This study aimed to evaluate DEC administration and its barriers in such areas. A cross-sectional study with two-stage stratified cluster sampling was conducted. We selected Myanmar immigrants aged >18 years from factory and fishery areas of Samut Sakhon Province for interview with a structured questionnaire. We also interviewed health personnel regarding the functions of the LF program and practice of DEC delivery among immigrants. Associations were measured by multiple logistic regression, at P Incorrect perceptions about the side-effects of DEC also obstructed DEC access for Myanmar immigrants. All positive LF antigenic immigrants reported visiting and emigrating from LF-endemic areas. Hospital-based DEC administration was an inappropriate approach to DEC delivery in areas with highly mobile Myanmar immigrants. Incorporating health-center personnel in DEC delivery twice yearly and improving the perceptions of DEC side effects would likely increase DEC coverage among Myanmar immigrants.

  15. Extreme Cost Growth: Themes from Six U.S. Air Force Major Defense Acquisition Programs

    Science.gov (United States)

    2015-01-01

    Aeronautics and Space Administration NOAA National Oceanic and Atmospheric Administration NPOESS National Polar-Orbiting Operational Environmental...high frequency phased array antennas of a type never before used in this capacity; and a major new encryption and secure communications requirement of...Studies, National Research Council, Division on Engineering and Physical Sciences, The Role of Small Satellites in NASA and NOAA Earth Observation Programs

  16. Severe Obesity In Adults Cost State Medicaid Programs Nearly $8 Billion In 2013.

    Science.gov (United States)

    Wang, Y Claire; Pamplin, John; Long, Michael W; Ward, Zachary J; Gortmaker, Steven L; Andreyeva, Tatiana

    2015-11-01

    Efforts to expand Medicaid while controlling spending must be informed by a deeper understanding of the extent to which the high medical costs associated with severe obesity (having a body mass index of [Formula: see text] or higher) determine spending at the state level. Our analysis of population-representative data indicates that in 2013, severe obesity cost the nation approximately $69 billion, which accounted for 60 percent of total obesity-related costs. Approximately 11 percent of the cost of severe obesity was paid for by Medicaid, 30 percent by Medicare and other federal health programs, 27 percent by private health plans, and 30 percent out of pocket. Overall, severe obesity cost state Medicaid programs almost $8 billion a year, ranging from $5 million in Wyoming to $1.3 billion in California. These costs are likely to increase following Medicaid expansion and enhanced coverage of weight loss therapies in the form of nutrition consultation, drug therapy, and bariatric surgery. Ensuring and expanding Medicaid-eligible populations' access to cost-effective treatment for severe obesity should be part of each state's strategy to mitigate rising obesity-related health care costs. Project HOPE—The People-to-People Health Foundation, Inc.

  17. Confinement of Military Prisoners and Administration of Military Correctional Programs and Facilities, Directive No. 1325.4

    National Research Council Canada - National Science Library

    2001-01-01

    This directive reissues DoD Directive 1325.4, dated 28 September 1999 (hereby cancelled) to update policy and responsibilities for the administration and operation of military correctional programs and facilities under Title 10, USC...

  18. Cost-effectiveness of national health insurance programs in high-income countries: A systematic review.

    Directory of Open Access Journals (Sweden)

    Son Nghiem

    Full Text Available National health insurance is now common in most developed countries. This study reviews the evidence and synthesizes the cost-effectiveness information for national health insurance or disability insurance programs across high-income countries.A literature search using health, economics and systematic review electronic databases (PubMed, Embase, Medline, Econlit, RepEc, Cochrane library and Campbell library, was conducted from April to October 2015.Two reviewers independently selected relevant studies by applying screening criteria to the title and keywords fields, followed by a detailed examination of abstracts.Studies were selected for data extraction using a quality assessment form consisting of five questions. Only studies with positive answers to all five screening questions were selected for data extraction. Data were entered into a data extraction form by one reviewer and verified by another.Data on costs and quality of life in control and treatment groups were used to draw distributions for synthesis. We chose the log-normal distribution for both cost and quality-of-life data to reflect non-negative value and high skew. The results were synthesized using a Monte Carlo simulation, with 10,000 repetitions, to estimate the overall cost-effectiveness of national health insurance programs.Four studies from the United States that examined the cost-effectiveness of national health insurance were included in the review. One study examined the effects of medical expenditure, and the remaining studies examined the cost-effectiveness of health insurance reforms. The incremental cost-effectiveness ratio (ICER ranged from US$23,000 to US$64,000 per QALY. The combined results showed that national health insurance is associated with an average incremental cost-effectiveness ratio of US$51,300 per quality-adjusted life year (QALY. Based on the standard threshold for cost-effectiveness, national insurance programs are cost-effective interventions

  19. Implementation findings from a hybrid III implementation-effectiveness trial of the Diabetes Prevention Program (DPP) in the Veterans Health Administration (VHA).

    Science.gov (United States)

    Damschroder, Laura J; Reardon, Caitlin M; AuYoung, Mona; Moin, Tannaz; Datta, Santanu K; Sparks, Jordan B; Maciejewski, Matthew L; Steinle, Nanette I; Weinreb, Jane E; Hughes, Maria; Pinault, Lillian F; Xiang, Xinran M; Billington, Charles; Richardson, Caroline R

    2017-07-26

    The Diabetes Prevention Program (DPP) is an effective lifestyle intervention to reduce incidence of type 2 diabetes. However, there are gaps in knowledge about how to implement DPP. The aim of this study was to evaluate implementation of DPP via assessment of a clinical demonstration in the Veterans Health Administration (VHA). A 12-month pragmatic clinical trial compared weight outcomes between the Veterans Affairs Diabetes Prevention Program (VA-DPP) and the usual care MOVE!® weight management program (MOVE!). Eligible participants had a body mass index (BMI) ≥30 kg/m2 (or BMI ≥ 25 kg/m2 with one obesity-related condition), prediabetes (glycosylated hemoglobin (HbA1c) 5.7-6.5% or fasting plasma glucose (FPG) 100-125 mg/dL), lived within 60 min of their VA site, and had not participated in a weight management program within the last year. Established evaluation and implementation frameworks were used to guide the implementation evaluation. Implementation barriers and facilitators, delivery fidelity, participant satisfaction, and implementation costs were assessed. Using micro-costing methods, costs for assessment of eligibility and scheduling and maintaining adherence per participant, as well as cost of delivery per session, were also assessed. Several barriers and facilitators to Reach, Adoption, Implementation, Effectiveness and Maintenance were identified; barriers related to Reach were the largest challenge encountered by site teams. Fidelity was higher for VA-DPP delivery compared to MOVE! for five of seven domains assessed. Participant satisfaction was high in both programs, but higher in VA-DPP for most items. Based on micro-costing methods, cost of assessment for eligibility was $68/individual assessed, cost of scheduling and maintaining adherence was $328/participant, and cost of delivery was $101/session. Multi-faceted strategies are needed to reach targeted participants and successfully implement DPP. Costs for assessing patients for

  20. 77 FR 63837 - Draft Guidance for Industry and Food and Drug Administration Staff; eCopy Program for Medical...

    Science.gov (United States)

    2012-10-17

    ... HUMAN SERVICES Food and Drug Administration Draft Guidance for Industry and Food and Drug Administration... guidance describes how FDA plans to implement the eCopy Program under the Federal Food, Drug, and Cosmetic... FDA is announcing the availability of a draft guidance for industry and FDA staff entitled ``eCopy...

  1. Predicting Cost Growth Using Programs Reviews and Milestones for DoD Aircraft

    Science.gov (United States)

    2016-03-24

    growth, percent of programs with cost growth, mean, median, standard deviation, interquartile range, minimum, and maximum. We used Microsoft Excel to...rc en t t ot al  c os t g ro w th Percent Program Completion Mean: % Complete vs % Total Cost  Growth Development Procurement Total 0% 20% 40% 60% 80...100% 120% 0% 20% 40% 60% 80% 100% Pe rc en t t ot al  c os t g ro w th Percent Program Completion Median: % Complete vs % Total Cost  Growth

  2. Cost-effectiveness of SHINE: A Telephone Translation of the Diabetes Prevention Program

    Directory of Open Access Journals (Sweden)

    Christopher S. Hollenbeak

    2016-01-01

    Full Text Available Background The Support, Health Information, Nutrition, and Exercise (SHINE trial recently showed that a telephone adaptation of the Diabetes Prevention Program (DPP lifestyle intervention was effective in reducing weight among patients with metabolic syndrome. The aim of this study is to determine whether a conference call (CC adaptation was cost effective relative to an individual call (IC adaptation of the DPP lifestyle intervention in the primary care setting. Methods We performed a stochastic cost-effectiveness analysis alongside a clinical trial comparing two telephone adaptations of the DPP lifestyle intervention. The primary outcomes were incremental cost-effectiveness ratios estimated for weight loss, body mass index (BMI, waist circumference, and quality-adjusted life years (QALYs. Costs were estimated from the perspective of society and included direct medical costs, indirect costs, and intervention costs. Results After one year, participants receiving the CC intervention accumulated fewer costs ($2,831 vs. $2,933 than the IC group, lost more weight (6.2 kg vs. 5.1 kg, had greater reduction in BMI (2.1 vs. 1.9, and had greater reduction in waist circumference (6.5 cm vs. 5.9 cm. However, participants in the CC group had fewer QALYs than those in the IC group (0.635 vs. 0.646. The incremental cost-effectiveness ratio for CC vs. IC was $9,250/QALY, with a 48% probability of being cost-effective at a willingness-to-pay of $100,000/QALY. Conclusions CC delivery of the DPP was cost effective relative to IC delivery in the first year in terms of cost per clinical measure (weight lost, BMI, and waist circumference but not in terms of cost per QALY, most likely because of the short time horizon.

  3. 25 CFR 170.607 - Can a tribe use its allocation of IRR Program funds for contract support costs?

    Science.gov (United States)

    2010-04-01

    ... costs? Yes. Contract support costs are an eligible item out of a tribe's IRR Program allocation and need... 25 Indians 1 2010-04-01 2010-04-01 false Can a tribe use its allocation of IRR Program funds for contract support costs? 170.607 Section 170.607 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE...

  4. Cost-Utility Analysis of a Cardiac Telerehabilitation Program: The Teledialog Project.

    Science.gov (United States)

    Kidholm, Kristian; Rasmussen, Maja Kjær; Andreasen, Jan Jesper; Hansen, John; Nielsen, Gitte; Spindler, Helle; Dinesen, Birthe

    2016-07-01

    Cardiac rehabilitation can reduce mortality of patients with cardiovascular disease, but a frequently low participation rate in rehabilitation programs has been found globally. The objective of the Teledialog study was to assess the cost-utility (CU) of a cardiac telerehabilitation (CTR) program. The aim of the intervention was to increase the patients' participation in the CTR program. At discharge, an individualized 3-month rehabilitation plan was formulated for each patient. At home, the patients measured their own blood pressure, pulse, weight, and steps taken for 3 months. The analysis was carried out together with a randomized controlled trial with 151 patients during 2012-2014. Costs of the intervention were estimated with a health sector perspective following international guidelines for CU. Quality of life was assessed using the 36-Item Short Form Health Survey. The rehabilitation activities were approximately the same in the two groups, but the number of contacts with the physiotherapist was higher among the intervention group. The mean total cost per patient was €1,700 higher in the intervention group. The quality-adjusted life-years (QALYs) gain was higher in the intervention group, but the difference was not statistically significant. The incremental CU ratio was more than €400,000 per QALY gained. Even though the rehabilitation activities increased, the program does not appear to be cost-effective. The intervention itself was not costly (less than €500), and increasing the number of patients may show reduced costs of the devices and make the CTR more cost-effective. Telerehabilitation can increase participation, but the intervention, in its current form, does not appear to be cost-effective.

  5. Small Business Administration (SBA) Loan Program Performance- Charge Off Rates as a Percent of Unpaid Principal Balance (UPB) Amount by Program

    Data.gov (United States)

    Small Business Administration — Reflects charge off rates, as a percent of the UPB amounts, at the end of the fiscal year for the major loan programs and aggregate totals for the small direct and...

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

    Science.gov (United States)

    Prada, Sergio I

    2017-12-01

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

  7. The cost-effectiveness of a successful community-based obesity prevention program: the be active eat well program.

    Science.gov (United States)

    Moodie, Marjory L; Herbert, Jessica K; de Silva-Sanigorski, Andrea M; Mavoa, Helen M; Keating, Catherine L; Carter, Robert C; Waters, Elizabeth; Gibbs, Lisa; Swinburn, Boyd A

    2013-10-01

    To examine the cost-effectiveness of Be Active Eat Well (BAEW), a large, multifaceted, community-based capacity-building demonstration program that promoted healthy eating and physical activity for Australian children aged 4-12 years between 2003 and 2006. A quasi-experimental, longitudinal design was used with anthropometric data collected at baseline (1001 children-intervention; 1183-comparator) and follow-up. A societal perspective was employed, with intervention resource use measured retrospectively based on process evaluation reports, school newsletters, reports, and key stakeholder interviews, and valued in 2006 Australian dollars (AUD). Outcomes were measured as Body Mass Index (BMI) units saved and Disability Adjusted Life Years (DALYs) averted over the predicted cohort lifetime, and reported as incremental cost-effectiveness ratios (with 95% uncertainty intervals). The intervention cost AUD0.34M ($0.31M; $0.38M) annually, and resulted in savings of 547 (-104; 1209) BMI units and 10.2 (-0.19; 21.6) DALYs. This translated to modest cost offsets of AUD27 311 (-$1803; $58 242) and a net cost per DALY saved of AUD29 798 (dominated; $0.26M). BAEW was affordable and cost-effective, and generated substantial spin-offs in terms of activity beyond funding levels. Elements fundamental to its success and any potential cost efficiencies associated with scaling-up now require identification. Copyright © 2013 The Obesity Society.

  8. A Comparison of Four Software Programs for Implementing Decision Analytic Cost-Effectiveness Models.

    Science.gov (United States)

    Hollman, Chase; Paulden, Mike; Pechlivanoglou, Petros; McCabe, Christopher

    2017-08-01

    The volume and technical complexity of both academic and commercial research using decision analytic modelling has increased rapidly over the last two decades. The range of software programs used for their implementation has also increased, but it remains true that a small number of programs account for the vast majority of cost-effectiveness modelling work. We report a comparison of four software programs: TreeAge Pro, Microsoft Excel, R and MATLAB. Our focus is on software commonly used for building Markov models and decision trees to conduct cohort simulations, given their predominance in the published literature around cost-effectiveness modelling. Our comparison uses three qualitative criteria as proposed by Eddy et al.: "transparency and validation", "learning curve" and "capability". In addition, we introduce the quantitative criterion of processing speed. We also consider the cost of each program to academic users and commercial users. We rank the programs based on each of these criteria. We find that, whilst Microsoft Excel and TreeAge Pro are good programs for educational purposes and for producing the types of analyses typically required by health technology assessment agencies, the efficiency and transparency advantages of programming languages such as MATLAB and R become increasingly valuable when more complex analyses are required.

  9. A calculation program for harvesting and transportation costs of energy wood; Energiapuun korjuun ja kuljetuksen kustannuslaskentaohjelmisto

    Energy Technology Data Exchange (ETDEWEB)

    Kuitto, P.J.

    1996-12-31

    VTT Energy is compiling a large and versatile calculation program for harvesting and transportation costs of energy wood. The work has been designed and will be carried out in cooperation with Metsaeteho and Finntech Ltd. The program has been realised in Windows surroundings using SQLWindows graphical database application development system, using the SQLBase relational database management system. The objective of the research is to intensify and create new possibilities for comparison of the utilization costs and the profitability of integrated energy wood production chains with each other inside the chains

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

    Directory of Open Access Journals (Sweden)

    Szkultecka-Debek Monika

    2014-06-01

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

  11. Effect of Medicaid disease management programs on emergency admissions and inpatient costs.

    Science.gov (United States)

    Conti, Matthew S

    2013-08-01

    To determine the impact of state Medicaid diabetes disease management programs on emergency admissions and inpatient costs. National InPatient Sample sponsored by the Agency for Healthcare Research and Quality Project for the years from 2000 to 2008 using 18 states. A difference-in-difference methodology compares costs and number of emergency admissions for Washington, Texas, and Georgia, which implemented disease management programs between 2000 and 2008, to states that did not undergo the transition to managed care (N = 103). Costs and emergency admissions were extracted for diabetic Medicaid enrollees diagnosed in the reform and non-reform states and collapsed into state and year cells. In the three treatment states, the implementation of disease management programs did not have statistically significant impacts on the outcome variables when compared to the control states. States that implemented disease management programs did not achieve improvements in costs or the number of emergency of admissions; thus, these programs do not appear to be an effective way to reduce the burden of this chronic disease. © Health Research and Educational Trust.

  12. Guide for Conducting Benefit-Cost Evaluation of Realized Impacts of Public R&D Programs

    Energy Technology Data Exchange (ETDEWEB)

    Ruegg, Rosalie [TIA Consulting, Inc., Emerald Isle, NC (United States); Jordan, Gretchen B. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2011-08-01

    This document provides guidance for evaluators who conduct impact assessments to determine the “realized” economic benefits and costs, energy, environmental benefits, and other impacts of the Office of Energy Efficiency and Renewable Energy’s (EERE) R&D programs. The focus of this Guide is on realized outcomes or impacts of R&D programs actually experienced by American citizens, industry, and others. Retrospective evaluations may be contrasted to prospective evaluations that reflect expected or potential outcomes only if assumptions hold. The retrospective approach described in this Guide is based on realized results only and the extent they can be attributed to the efforts of an R&D program. While it has been prepared specifically to guide retrospective benefit-cost analysis of EERE R&D Programs, this report may be used for similar analysis of other public R&D organizations.

  13. Cost-Effectiveness of Elderly Health Examination Program: The Example of Hypertension Screening

    Directory of Open Access Journals (Sweden)

    Bing-Hwa Deng

    2007-01-01

    Full Text Available The National Health Insurance (NHI and social welfare agencies have implemented the Elderly Health Examination Program (EHEP for years. No study has ever attempted to evaluate whether this program is cost-effective. The purposes of this study were, firstly, to understand the prevalence and incidence rates of hypertension and, secondly, to estimate the cost and effectiveness of the EHEP, focusing on hypertension screening. The data sources were: (1 hypertension and clinical information derived from the 1996 and 1997 EHEP, which was used to generate prevalence and incidence rates of hypertension; and (2 claim data of the NHI that included treatment costs of stroke patients (in-and outpatients. Hypothetical models were used to evaluate the cost-effectiveness of the hypertension screening program in various conditions. Sensitivity analysis was also employed to evaluate the effect of each estimation indicator on the cost and effectiveness of the hypertension screening program. A total of 28.3% of the elderly population in Kaohsiung (25,174 of 88,812 participated in the 1996 EHEP; 14,915 of them participated in the following 1997 EHEP, with a retention rate of 59.3%. Criteria from the Sixth Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI (systolic blood pressure/diastolic blood pressure ≥ 160/95mmHg or taking antihypertensive drugs were used; we found that prevalence and incidence rates of hypertension were 24.6% and 6.6%, respectively. Hypertension rates are increasing in the aging process as shown in both prevalence and incidence models. In comparison with non-participants, the prevalence model indicates that each hypertension patient who had attended the EHEP not only saved NT$34,570–34,890 in medical and associated costs, but also increased their lifespan by 128 days. The present findings suggest that the EHEP is a cost-effective program with health and social welfare policy

  14. Cost and Time Overruns for Major Defense Acquisition Programs: An Annotated Brief

    OpenAIRE

    Berteau, David; Ben-Ari, Guy; Hofbauer, Joachim; Sanders, Gregory; Ellman, Jesse; Morrow, David

    2011-01-01

    Proceedings Paper (for Acquisition Research Program) Cost and time overruns in Major Defense Acquisition Programs (MDAPs) have become a high-profile problem attracting the interest of Congress, government, and watchdog groups. According to the GAO, the 98 MDAPs from FY2010 collectively ran $402 billion over budget and were an average of 22 months behind schedule since their first full estimate. President Obama''s memorandum on government contracting of 4 March 2009 also highlighted this i...

  15. Cost-effectiveness analysis of neonatal hearing screening program in China: should universal screening be prioritized?

    Science.gov (United States)

    Huang, Li-Hui; Zhang, Luo; Tobe, Ruo-Yan Gai; Qi, Fang-Hua; Sun, Long; Teng, Yue; Ke, Qing-Lin; Mai, Fei; Zhang, Xue-Feng; Zhang, Mei; Yang, Ru-Lan; Tu, Lin; Li, Hong-Hui; Gu, Yan-Qing; Xu, Sai-Nan; Yue, Xiao-Yan; Li, Xiao-Dong; Qi, Bei-Er; Cheng, Xiao-Huan; Tang, Wei; Xu, Ling-Zhong; Han, De-Min

    2012-04-17

    Neonatal hearing screening (NHS) has been routinely offered as a vital component of early childhood care in developed countries, whereas such a screening program is still at the pilot or preliminary stage as regards its nationwide implementation in developing countries. To provide significant evidence for health policy making in China, this study aims to determine the cost-effectiveness of NHS program implementation in case of eight provinces of China. A cost-effectiveness model was conducted and all neonates annually born from 2007 to 2009 in eight provinces of China were simulated in this model. The model parameters were estimated from the established databases in the general hospitals or maternal and child health hospitals of these eight provinces, supplemented from the published literature. The model estimated changes in program implementation costs, disability-adjusted life years (DALYs), average cost-effectiveness ratio (ACER), and incremental cost-effectiveness ratio (ICER) for universal screening compared to targeted screening in eight provinces. A multivariate sensitivity analysis was performed to determine uncertainty in health effect estimates and cost-effectiveness ratios using a probabilistic modeling technique. Targeted strategy trended to be cost-effective in Guangxi, Jiangxi, Henan, Guangdong, Zhejiang, Hebei, Shandong, and Beijing from the level of 9%, 9%, 8%, 4%, 3%, 7%, 5%, and 2%, respectively; while universal strategy trended to be cost-effective in those provinces from the level of 70%, 70%, 48%, 10%, 8%, 28%, 15%, 4%, respectively. This study showed although there was a huge disparity in the implementation of the NHS program in the surveyed provinces, both universal strategy and targeted strategy showed cost-effectiveness in those relatively developed provinces, while neither of the screening strategy showed cost-effectiveness in those relatively developing provinces. This study also showed that both strategies especially universal strategy

  16. Cost-effectiveness analysis of neonatal hearing screening program in china: should universal screening be prioritized?

    Directory of Open Access Journals (Sweden)

    Huang Li-Hui

    2012-04-01

    Full Text Available Abstract Background Neonatal hearing screening (NHS has been routinely offered as a vital component of early childhood care in developed countries, whereas such a screening program is still at the pilot or preliminary stage as regards its nationwide implementation in developing countries. To provide significant evidence for health policy making in China, this study aims to determine the cost-effectiveness of NHS program implementation in case of eight provinces of China. Methods A cost-effectiveness model was conducted and all neonates annually born from 2007 to 2009 in eight provinces of China were simulated in this model. The model parameters were estimated from the established databases in the general hospitals or maternal and child health hospitals of these eight provinces, supplemented from the published literature. The model estimated changes in program implementation costs, disability-adjusted life years (DALYs, average cost-effectiveness ratio (ACER, and incremental cost-effectiveness ratio (ICER for universal screening compared to targeted screening in eight provinces. Results and discussion A multivariate sensitivity analysis was performed to determine uncertainty in health effect estimates and cost-effectiveness ratios using a probabilistic modeling technique. Targeted strategy trended to be cost-effective in Guangxi, Jiangxi, Henan, Guangdong, Zhejiang, Hebei, Shandong, and Beijing from the level of 9%, 9%, 8%, 4%, 3%, 7%, 5%, and 2%, respectively; while universal strategy trended to be cost-effective in those provinces from the level of 70%, 70%, 48%, 10%, 8%, 28%, 15%, 4%, respectively. This study showed although there was a huge disparity in the implementation of the NHS program in the surveyed provinces, both universal strategy and targeted strategy showed cost-effectiveness in those relatively developed provinces, while neither of the screening strategy showed cost-effectiveness in those relatively developing provinces. This

  17. A cost-reducing extracorporeal membrane oxygenation (ECMO) program model: a single institution experience.

    Science.gov (United States)

    Cavarocchi, N C; Wallace, S; Hong, E Y; Tropea, A; Byrne, J; Pitcher, H T; Hirose, H

    2015-03-01

    The worldwide demand for ECMO support has grown. Its provision remains limited due to several factors (high cost, complicated technology, lack of expertise) that increase healthcare cost. Our goal was to assess if an intensive care unit (ICU)-run ECMO model without continuous bedside perfusionists would decrease costs while maintaining patient safety and outcomes. A new ECMO program was implemented in 2010, consisting of dedicated ICU multidisciplinary providers (ICU-registered nurses, mid-level providers and intensivists). In year one, we introduced an education platform, new technology and dedicated space. In year two, continuous bedside monitoring by perfusionists was removed and new management algorithms designating multidisciplinary providers as first responders were established. The patient safety and cost benefit from the removal of the continuous bedside monitoring of the perfusionists of this new ECMO program was retrospectively reviewed and compared. During the study period, 74 patients (28 patients in year 1 and 46 patients in year 2) were placed on ECMO (mean days: 8 ± 5.7). The total annual hospital expenditure for the ECMO program was significantly reduced in the new model ($234,000 in year 2 vs. $600,264 in year 1), showing a 61% decrease in cost. This cost decrease was attributed to a decreased utilization of perfusion services and the introduction of longer lasting and more efficient ECMO technology. We did not find any significant changes in registered nurse ratios or any differences in outcomes related to ICU safety events. We demonstrated that the ICU-run ECMO model managed to lower hospital cost by reducing the cost of continuous bedside perfusion support without a change in outcomes. © The Author(s) 2014.

  18. What linear programming contributes: world food programme experience with the "cost of the diet" tool.

    Science.gov (United States)

    Frega, Romeo; Lanfranco, Jose Guerra; De Greve, Sam; Bernardini, Sara; Geniez, Perrine; Grede, Nils; Bloem, Martin; de Pee, Saskia

    2012-09-01

    Linear programming has been used for analyzing children's complementary feeding diets, for optimizing nutrient adequacy of dietary recommendations for a population, and for estimating the economic value of fortified foods. To describe and apply a linear programming tool ("Cost of the Diet") with data from Mozambique to determine what could be cost-effective fortification strategies. Based on locally assessed average household dietary needs, seasonal market prices of available food products, and food composition data, the tool estimates the lowest-cost diet that meets almost all nutrient needs. The results were compared with expenditure data from Mozambique to establish the affordability of this diet by quintiles of the population. Three different applications were illustrated: identifying likely "limiting nutrients," comparing cost effectiveness of different fortification interventions at the household level, and assessing economic access to nutritious foods. The analysis identified iron, vitamin B2, and pantothenic acid as "limiting nutrients." Under the Mozambique conditions, vegetable oil was estimated as a more cost-efficient vehicle for vitamin A fortification than sugar; maize flour may also be an effective vehicle to provide other constraining micronutrients. Multiple micronutrient fortification of maize flour could reduce the cost of the "lowest-cost nutritious diet" by 18%, but even this diet can be afforded by only 20% of the Mozambican population. Within the context of fortification, linear programming can be a useful tool for identifying likely nutrient inadequacies, for comparing fortification options in terms of cost effectiveness, and for illustrating the potential benefit of fortification for improving household access to a nutritious diet.

  19. Economic impact of dengue illness and the cost-effectiveness of future vaccination programs in Singapore.

    Directory of Open Access Journals (Sweden)

    Luis R Carrasco

    2011-12-01

    Full Text Available BACKGROUND: Dengue illness causes 50-100 million infections worldwide and threatens 2.5 billion people in the tropical and subtropical regions. Little is known about the disease burden and economic impact of dengue in higher resourced countries or the cost-effectiveness of potential dengue vaccines in such settings. METHODS AND FINDINGS: We estimate the direct and indirect costs of dengue from hospitalized and ambulatory cases in Singapore. We consider inter alia the impacts of dengue on the economy using the human-capital and the friction cost methods. Disease burden was estimated using disability-adjusted life years (DALYs and the cost-effectiveness of a potential vaccine program was evaluated. The average economic impact of dengue illness in Singapore from 2000 to 2009 in constant 2010 US$ ranged between $0.85 billion and $1.15 billion, of which control costs constitute 42%-59%. Using empirically derived disability weights, we estimated an annual average disease burden of 9-14 DALYs per 100 000 habitants, making it comparable to diseases such as hepatitis B or syphilis. The proportion of symptomatic dengue cases detected by the national surveillance system was estimated to be low, and to decrease with age. Under population projections by the United Nations, the price per dose threshold for which vaccines stop being more cost-effective than the current vector control program ranged from $50 for mass vaccination requiring 3 doses and only conferring 10 years of immunity to $300 for vaccination requiring 2 doses and conferring lifetime immunity. The thresholds for these vaccine programs to not be cost-effective for Singapore were $100 and $500 per dose respectively. CONCLUSIONS: Dengue illness presents a serious economic and disease burden in Singapore. Dengue vaccines are expected to be cost-effective if reasonably low prices are adopted and will help to reduce the economic and disease burden of dengue in Singapore substantially.

  20. Mandatory Special Education Plan for the Administration and Implementation of Public School Programs for the Hearing Impaired.

    Science.gov (United States)

    Indiana State Dept. of Public Instruction, Indianapolis. Div. of Special Education.

    Intended for public school administrators, teachers, and speech and hearing clinicians, the document contains guidelines for setting up programs to implement the statewide mandatory special education plan for hearing impaired children in Indiana. Outlined are procedures to follow in comprehensive programing for the following categories of the…

  1. Quantitative Research Methods Training in Education Leadership and Administration Preparation Programs as Disciplined Inquiry for Building School Improvement Capacity

    Science.gov (United States)

    Bowers, Alex J.

    2017-01-01

    The quantitative research methods course is a staple of graduate programs in education leadership and administration. Historically, these courses serve to train aspiring district and school leaders in fundamental statistical research topics. This article argues for programs to focus as well in these courses on helping aspiring leaders develop…

  2. 76 FR 81510 - Draft Guidance for Industry and Food and Drug Administration Staff; the 510(k) Program...

    Science.gov (United States)

    2011-12-28

    ... Staff; the 510(k) Program: Evaluating Substantial Equivalence in Premarket Notifications ; Availability... and Drug Administration Staff; The 510(k) Program: Evaluating Substantial Equivalence in Premarket... reviews premarket notification (510(k)) submissions as well as on the Special and Abbreviated 510(k...

  3. 75 FR 3197 - Notice of a Public Meeting on Administration of the Business and Industry Guaranteed Loan Program

    Science.gov (United States)

    2010-01-20

    ... Rural Business-Cooperative Service Notice of a Public Meeting on Administration of the Business and Industry Guaranteed Loan Program AGENCY: Rural Business-Cooperative Service, USDA. ACTION: Notice of public... Development Mission area, will hold a public meeting entitled ``Business and Industry Guaranteed Loan Program...

  4. Activity-Based Costing: A Cost Management Tool.

    Science.gov (United States)

    Turk, Frederick J.

    1993-01-01

    In college and university administration, overhead costs are often charged to programs indiscriminately, whereas the support activities that underlie those costs remain unanalyzed. It is time for institutions to decrease ineffective use of resources. Activity-based management attributes costs more accurately and can improve efficiency. (MSE)

  5. A Cost Analysis Study of the Radiography Program at Middlesex Hospital Using Shock's Analysis Model.

    Science.gov (United States)

    Spence, Weymouth

    Federal and state governments want to decrease payments for medical education, and other payers are trying to restrict payouts to direct and necessary patient care services. Teaching hospitals are increasing tuition and fees, reducing education budgets and, in many instances, closing education programs. Hospital administrators are examining the…

  6. Use of Linear Programming to Develop Cost-Minimized Nutritionally Adequate Health Promoting Food Baskets.

    Science.gov (United States)

    Parlesak, Alexandr; Tetens, Inge; Dejgård Jensen, Jørgen; Smed, Sinne; Gabrijelčič Blenkuš, Mojca; Rayner, Mike; Darmon, Nicole; Robertson, Aileen

    2016-01-01

    Food-Based Dietary Guidelines (FBDGs) are developed to promote healthier eating patterns, but increasing food prices may make healthy eating less affordable. The aim of this study was to design a range of cost-minimized nutritionally adequate health-promoting food baskets (FBs) that help prevent both micronutrient inadequacy and diet-related non-communicable diseases at lowest cost. Average prices for 312 foods were collected within the Greater Copenhagen area. The cost and nutrient content of five different cost-minimized FBs for a family of four were calculated per day using linear programming. The FBs were defined using five different constraints: cultural acceptability (CA), or dietary guidelines (DG), or nutrient recommendations (N), or cultural acceptability and nutrient recommendations (CAN), or dietary guidelines and nutrient recommendations (DGN). The variety and number of foods in each of the resulting five baskets was increased through limiting the relative share of individual foods. The one-day version of N contained only 12 foods at the minimum cost of DKK 27 (€ 3.6). The CA, DG, and DGN were about twice of this and the CAN cost ~DKK 81 (€ 10.8). The baskets with the greater variety of foods contained from 70 (CAN) to 134 (DGN) foods and cost between DKK 60 (€ 8.1, N) and DKK 125 (€ 16.8, DGN). Ensuring that the food baskets cover both dietary guidelines and nutrient recommendations doubled the cost while cultural acceptability (CAN) tripled it. Use of linear programming facilitates the generation of low-cost food baskets that are nutritionally adequate, health promoting, and culturally acceptable.

  7. The effect of repair costs on the profitability of a ureteroscopy program.

    Science.gov (United States)

    Tosoian, Jeffrey J; Ludwig, Wesley; Sopko, Nikolai; Mullins, Jeffrey K; Matlaga, Brian R

    2015-04-01

    Ureteroscopy (URS) is a common treatment for patients with stone disease. One of the disadvantages of this approach is the great capital expense associated with the purchase and repair of endoscopic equipment. In some cases, these costs can outpace revenues and lead to an unprofitable and unsustainable enterprise. We sought to characterize the profitability of our URS program when accounting for endoscope maintenance and repair costs. We identified all URS cases performed at a single hospital during fiscal year 2013 (FY2013). Charges, collection rates, and fixed and variable costs including annual equipment repair costs were obtained. The net margin and break-even point of URS were derived on a per-case basis. For 190 cases performed in FY2013, total endoscope repair costs totaled $115,000, resulting in an average repair cost of $605 per case. The vast majority of cases (94.2%) were conducted in the outpatient setting, which generated a net margin of $659 per case, while inpatient cases yielded a net loss of $455. URS was ultimately associated with a net positive margin approaching $600 per case. On break-even analysis, URS remained profitable until repair costs reached $1200 per case. Based on these findings, an established URS program can sustain profitability even with large equipment repair costs. Nonetheless, our findings serve to emphasize the importance of controlling costs, particularly in the current setting of decreasing reimbursement. A multifaceted approach, based on improving endoscope durability and exploring digital and disposable platforms, will be critical in maintaining the sustainability of URS.

  8. Use of Linear Programming to Develop Cost-Minimized Nutritionally Adequate Health Promoting Food Baskets.

    Directory of Open Access Journals (Sweden)

    Alexandr Parlesak

    Full Text Available Food-Based Dietary Guidelines (FBDGs are developed to promote healthier eating patterns, but increasing food prices may make healthy eating less affordable. The aim of this study was to design a range of cost-minimized nutritionally adequate health-promoting food baskets (FBs that help prevent both micronutrient inadequacy and diet-related non-communicable diseases at lowest cost.Average prices for 312 foods were collected within the Greater Copenhagen area. The cost and nutrient content of five different cost-minimized FBs for a family of four were calculated per day using linear programming. The FBs were defined using five different constraints: cultural acceptability (CA, or dietary guidelines (DG, or nutrient recommendations (N, or cultural acceptability and nutrient recommendations (CAN, or dietary guidelines and nutrient recommendations (DGN. The variety and number of foods in each of the resulting five baskets was increased through limiting the relative share of individual foods.The one-day version of N contained only 12 foods at the minimum cost of DKK 27 (€ 3.6. The CA, DG, and DGN were about twice of this and the CAN cost ~DKK 81 (€ 10.8. The baskets with the greater variety of foods contained from 70 (CAN to 134 (DGN foods and cost between DKK 60 (€ 8.1, N and DKK 125 (€ 16.8, DGN. Ensuring that the food baskets cover both dietary guidelines and nutrient recommendations doubled the cost while cultural acceptability (CAN tripled it.Use of linear programming facilitates the generation of low-cost food baskets that are nutritionally adequate, health promoting, and culturally acceptable.

  9. Community Partnership to Address Snack Quality and Cost in After-School Programs

    Science.gov (United States)

    Beets, Michael W.; Tilley, Falon; Turner-McGrievy, Gabrielle; Weaver, Robert G.; Jones, Sonya

    2014-01-01

    Background: Policies call on after-school programs (ASPs) to serve more nutritious snacks. A major barrier for improving snack quality is cost. This study describes the impact on snack quality and expenditures from a community partnership between ASPs and local grocery stores. Methods: Four large-scale ASPs (serving ~500 children, aged 6-12?years,…

  10. Analysis of the Children's Hospital Graduate Medical Education Program Fund Allocations for Indirect Medical Education Costs.

    Science.gov (United States)

    Wynn, Barbara O.; Kawata, Jennifer

    This study analyzed issues related to estimating indirect medical education costs specific to pediatric discharges. The Children's Hospital Graduate Medical Education (CHGNE) program was established to support graduate medical education in children's hospitals. This provision authorizes payments for both direct and indirect medical education…

  11. 78 FR 6140 - Discount Rates for Cost-Effectiveness Analysis of Federal Programs

    Science.gov (United States)

    2013-01-29

    ... BUDGET Discount Rates for Cost-Effectiveness Analysis of Federal Programs AGENCY: Office of Management... and Budget revised Circular A-94 in 1992. The revised Circular specified certain discount rates to be... States Government were changed. These discount rates are found in Appendix C of the revised Circular. The...

  12. 77 FR 1743 - Discount Rates for Cost-Effectiveness Analysis of Federal Programs

    Science.gov (United States)

    2012-01-11

    ... BUDGET Discount Rates for Cost-Effectiveness Analysis of Federal Programs AGENCY: Office of Management... and Budget revised Circular A-94 in 1992. The revised Circular specified certain discount rates to be... States Government were changed. These discount rates are found in Appendix C of the revised Circular. The...

  13. 76 FR 7881 - Discount Rates for Cost-Effectiveness Analysis of Federal Programs

    Science.gov (United States)

    2011-02-11

    ... BUDGET Discount Rates for Cost-Effectiveness Analysis of Federal Programs AGENCY: Office of Management... and Budget revised Circular A-94 in 1992. The revised Circular specified certain discount rates to be... States Government were changed. These discount rates are found in Appendix C of the revised Circular. The...

  14. A Fresh Look at the Benefits and Costs of the US Acid Rain Program

    Science.gov (United States)

    The US Acid Rain Program (Title IV of the 1990 Clean Air Act Amendments) has achieved substantial reductions in emissions of sulfur dioxide (SO2) and nitrogen oxides (NOx) from power plants in the United States. We compare new estimates of the benefits and costs of Title IV to th...

  15. Age 26 Cost-Benefit Analysis of the Child-Parent Center Early Education Program

    Science.gov (United States)

    Reynolds, Arthur J.; Temple, Judy A.; White, Barry A. B.; Ou, Suh-Ruu; Robertson, Dylan L.

    2011-01-01

    Using data collected up to age 26 in the Chicago Longitudinal Study, this cost-benefit analysis of the Child-Parent Centers (CPC) is the first for a sustained publicly funded early intervention. The program provides services for low-income families beginning at age 3 in 20 school sites. Kindergarten and school-age services are provided up to age 9…

  16. West Coast tree improvement programs: a break-even, cost-benefit analysis

    Science.gov (United States)

    F. Thomas Ledig; Richard L Porterfield

    1981-01-01

    Three tree improvement programs were analyzed by break-even, cost-benefit technique: one for ponderosa pine in the Pacific Northwest, and two for Douglas-fir in the Pacific Northwest-one of low intensity and the other of high intensity. A return of 8 percent on investment appears feasible by using short rotations or by accompanying tree improvement with thinning....

  17. NATIONAL STORMWATER CALCULATOR: LOW IMPACT DEVELOPMENT STORMWATER CONTROL COST ESTIMATION PROGRAMMING & FUTURE ENHANCEMENTS

    Science.gov (United States)

    National Stormwater Calculator: Low Impact Development Stormwater Control Cost Estimation Programming & Future EnhancementsJason Berner1; Michael Tryby1; Scott Struck2, Dan Pankani2, Marion Deerhake3, Michelle Simon11. USEPA2. GeoSyntec, Inc.3. RTI, Inc.The National Stormwater Ca...

  18. Hospital-centered violence intervention programs: a cost-effectiveness analysis.

    Science.gov (United States)

    Chong, Vincent E; Smith, Randi; Garcia, Arturo; Lee, Wayne S; Ashley, Linnea; Marks, Anne; Liu, Terrence H; Victorino, Gregory P

    2015-04-01

    Hospital-centered violence intervention programs (HVIPs) reduce violent injury recidivism. However, dedicated cost analyses of such programs have not yet been published. We hypothesized that the HVIP at our urban trauma center is a cost-effective means for reducing violent injury recidivism. We conducted a cost-utility analysis using a state-transition (Markov) decision model, comparing participation in our HVIP with standard risk reduction for patients injured because of firearm violence. Model inputs were derived from our trauma registry and published literature. The 1-year recidivism rate for participants in our HVIP was 2.5%, compared with 4% for those receiving standard risk reduction resources. Total per-person costs of each violence prevention arm were similar: $3,574 for our HVIP and $3,515 for standard referrals. The incremental cost effectiveness ratio for our HVIP was $2,941. Our HVIP is a cost-effective means of preventing recurrent episodes of violent injury in patients hurt by firearms. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Cost Savings From the Provision of Specific Methods of Contraception in a Publicly Funded Program

    Science.gov (United States)

    Rostovtseva, Daria P.; Brindis, Claire D.; Biggs, M. Antonia; Hulett, Denis; Darney, Philip D.

    2009-01-01

    Objectives. We examined the cost-effectiveness of contraceptive methods dispensed in 2003 to 955 000 women in Family PACT (Planning, Access, Care and Treatment), California's publicly funded family planning program. Methods. We estimated the number of pregnancies averted by each contraceptive method and compared the cost of providing each method with the savings from averted pregnancies. Results. More than half of the 178 000 averted pregnancies were attributable to oral contraceptives, one fifth to injectable methods, and one tenth each to the patch and barrier methods. The implant and intrauterine contraceptives were the most cost-effective, with cost savings of more than $7.00 for every $1.00 spent in services and supplies. Per $1.00 spent, injectable contraceptives yielded savings of $5.60; oral contraceptives, $4.07; the patch, $2.99; the vaginal ring, $2.55; barrier methods, $1.34; and emergency contraceptives, $1.43. Conclusions. All contraceptive methods were cost-effective—they saved more in public expenditures for unintended pregnancies than they cost to provide. Because no single method is clinically recommended to every woman, it is medically and fiscally advisable for public health programs to offer all contraceptive methods. PMID:18703437

  20. Fitting of full Cobb-Douglas and full VRTS cost frontiers by solving goal programming problem

    Science.gov (United States)

    Venkateswarlu, B.; Mahaboob, B.; Subbarami Reddy, C.; Madhusudhana Rao, B.

    2017-11-01

    The present research article first defines two popular production functions viz, Cobb-Douglas and VRTS production frontiers and their dual cost functions and then derives their cost limited maximal outputs. This paper tells us that the cost limited maximal output is cost efficient. Here the one side goal programming problem is proposed by which the full Cobb-Douglas cost frontier, full VRTS frontier can be fitted. This paper includes the framing of goal programming by which stochastic cost frontier and stochastic VRTS frontiers are fitted. Hasan et al. [1] used a parameter approach Stochastic Frontier Approach (SFA) to examine the technical efficiency of the Malaysian domestic banks listed in the Kuala Lumpur stock Exchange (KLSE) market over the period 2005-2010. AshkanHassani [2] exposed Cobb-Douglas Production Functions application in construction schedule crashing and project risk analysis related to the duration of construction projects. Nan Jiang [3] applied Stochastic Frontier analysis to a panel of New Zealand dairy forms in 1998/99-2006/2007.

  1. Public health sealant delivery programs: optimal delivery and the cost of practice acts.

    Science.gov (United States)

    Scherrer, Christina R; Griffin, Paul M; Swann, Julie L

    2007-01-01

    The greatest unmet health need for US children is dental care. School-based sealant programs target low-income, high-risk second graders and are effective in preventing caries for as long as the sealant material remains in place. However, it is not clear whether such programs make efficient use of available resources and staffing. The authors used discrete event simulation to determine the optimal combinations of staffing levels and sealant stations for school-based sealant programs. Using data provided by state programs and the literature, they modeled different-sized programs under different practice act constraints and determined times and associated costs. A detailed economic analysis was done for Wisconsin. For general, direct, or indirect supervision, it is optimal to have only 1 dentist or no dentists for no supervision. For general supervision, it is optimal to have the dentist and dental assistant to come on separate days to screen. The cost savings for adding an assistant and chair averaged over all of the program sizes and travel distances ranged from 4.50% (SE= 0.89) to 10.94% (SE= 0.56). Significant cost savings also result from reducing the required supervision level (8.72% [SE = 1.61] to 29.96% [SE= 1.67]). The cost of the practice act for the state of Wisconsin for 2003 was from USD 83,041 to USD 346,156, significantly more than its annual budget. States could save money by relaxing restrictions on the type of personnel who can deliver sealants in public health settings and by productivity gains through proper consideration of staffing. The savings could be used to improve access to sealant programs and further reduce disparities in oral health.

  2. Cost-Effectiveness of a Family Planning Voucher Program in Rural Pakistan

    Directory of Open Access Journals (Sweden)

    Edward Ivor Broughton

    2017-09-01

    Full Text Available IntroductionThis study reports on the effectiveness and efficiency from the program funder’s perspective of the Suraj Social Franchise (SSF voucher program in which private health-care providers in remote rural areas were identified, trained, upgraded, and certified to deliver family planning services to underserved women of reproductive age in 29 districts of Sindh and 3 districts of Punjab province, Pakistan between October 2013 and June 2016.MethodA decision tree compared the cost of implementing SSF to the program funder and its effects of providing additional couple years of protection (CYPs to targeted women, compared to business-as-usual. Costs included vouchers given to women to receive a free contraceptive method of their choice from the SSF provider. The vouchers were then reimbursed to the SSF provider by the program.ResultsA total of 168,206 married women of reproductive age (MWRA received SSF vouchers between October 2013 and June 2016, costing $3,278,000 ($19.50/recipient. The average effectiveness of the program per voucher recipient was an additional 1.66 CYPs, giving an incremental cost-effectiveness of the program of $4.28 per CYP compared to not having the program (95% CI: $3.62–5.31.ConclusionThe result compares favorably to other interventions with similar objectives and appears affordable for the Pakistan national health-care system. It is therefore recommended to help address the unmet need for contraception among MWRA in these areas of Pakistan and is worthy of trial implementation in the country more widely.

  3. Assessing Programming Costs of Explicit Memory Localization on a Large Scale Shared Memory Multiprocessor

    Directory of Open Access Journals (Sweden)

    Silvio Picano

    1992-01-01

    Full Text Available We present detailed experimental work involving a commercially available large scale shared memory multiple instruction stream-multiple data stream (MIMD parallel computer having a software controlled cache coherence mechanism. To make effective use of such an architecture, the programmer is responsible for designing the program's structure to match the underlying multiprocessors capabilities. We describe the techniques used to exploit our multiprocessor (the BBN TC2000 on a network simulation program, showing the resulting performance gains and the associated programming costs. We show that an efficient implementation relies heavily on the user's ability to explicitly manage the memory system.

  4. Individual competences acquired during the undergraduate years of students of a Business Administration program

    Directory of Open Access Journals (Sweden)

    Arilda Schmidt Godoy

    2009-01-01

    Full Text Available The aim of this study is to identify and analyze the opinions of students about the competences acquired in programs of Business Administration at a private university in São Paulo. A case study was carried out using a questionnaire – with closed and opened questions – to collect data and semi-structured interviews. The sample includes 441 students enrolled in the last semester. The factorial analysis allowed the identification of four factors corresponding to the following groups of competences: social, problem-solving, technical-professional, and communication ones. The frequency of the answers indicate that the competences which have highly agreement value concentrate on factor 1 (social competence and factor 2 (problem-solving competence. The qualitative data analysis allowed a better comprehension of the aspects involved in the identified competences. By summarizing the found results it is possible to conclude that, besides the development of an entrepreneur attitude, the program fundamentally provided the development of the social competence.

  5. U.S. Food and Drug Administration's dioxin monitoring program

    Energy Technology Data Exchange (ETDEWEB)

    South, P.; S. Kathleen Egan; Troxell, T.; P. Michael Bolger [U.S. Food and Drug Administration, Center for Food Safety and Applied Nutrition, College Park (United States)

    2004-09-15

    Dioxin-like compounds (DLCs) are a group of environmental contaminants whose primary route of human exposure occurs via the consumption of fatty foods of animal origin. Recent safety risk assessments conducted by national and international organizations broadly agree that risk management actions should be developed to decrease DLC exposure. Since the mid-1990s, the U.S. Food and Drug Administration (FDA) has tested specific foods with the goal of describing and reducing DLC exposure. In 2001, FDA developed a strategy for DLCs (http://vm.cfsan.fda.gov/{proportional_to}lrd/dioxstra.html) and substantially expanded its dioxin monitoring program to obtain more comprehensive data on background levels of DLCs in specific food and feed samples as well as to identify and reduce pathways of DLC contamination. FDA's dioxin monitoring program analyzes food collected under its Total Diet Study (TDS) and food and feed from targeted sampling. The TDS is FDA's ongoing market basket survey of approximately 280 core foods in the U.S. food supply. FDA targeted sampling collects and analyzes foods suspected of having both higher DLC levels and more variability in those levels than other foods. The contribution of dietary DLCs to overall exposure and the possible introduction of DLCs in animalbased food via the use of particular feed components was recently identified by the National Academy of Sciences Committee on the Implications of Dioxin in the Food Supply and confirmed FDA's approach articulated in its dioxin strategy.

  6. Cost analysis of a domiciliary program of supportive and palliative care for patients with hematologic malignancies.

    Science.gov (United States)

    Cartoni, Claudio; Brunetti, Gregorio Antonio; D'Elia, Gianna Maria; Breccia, Massimo; Niscola, Pasquale; Marini, Maria Giulia; Nastri, Antonio; Alimena, Giuliana; Mandelli, Franco; Foà, Robin

    2007-05-01

    The costs of home care (HC) programs may be tailored to the specific needs of patients with hematological malignancies. The aim of this study was to analyze the use of resources and the costs of a program of HC for four different prognostic groups of patients subdivided according to disease status. Over 2 years, 144 patients with hematological malignancies were assisted at home. Patients were subdivided according to disease status and life expectancy in the following groups: (i) terminal phase, with a life expectancy of 3 months or less; (ii) advanced phase, with a life expectancy of 6 months or less; (iii) chronic phase, with a life expectancy of more than 6 months; (iv) discharged early from the hospital with curable disease, following anticancer chemotherapy. Median mean monthly costs (MMC) in Euro (x) have been compared with the costs of hospitalization (DRG). Among the 4 groups of patients, those discharged early and in terminal phase required the highest mean monthly number of home visits (27.2 and 24.1), transfusions (6.1 and 6.8) and days of care (22.8 and 19.7) respectively. MMC were affected by the following variables: disease status and transfusion requirements. MMC for terminal patients (4,232.50x) and those discharged early (3,986.40x) were higher than those for advanced (2,303.80x) and chronic patients (1,488,30x). The cost of HC was lower than the corresponding DRG charges, but exceeded the district fares for HC of cancer patients. In hematological patients, the costs of HC differ according to disease status and transfusion requirements. For some categories of patients, costs of HC are lower than those of hospitalization, although higher than the current national fares for HC programs.

  7. Contract case managers prove cost effective in federal workers' compensation programs.

    Science.gov (United States)

    Mallon, Timothy Michael; Cloeren, Marianne; Firestone, Lisa Michelle; Burch, Helen Christine

    2008-03-01

    This pilot study examined whether contract case managers are cost effective in reducing workers' compensation (WC) costs and preventing injuries. We placed contract medical case managers at four installations where they employed private industry best practices. A needs assessment was performed and site-specific targeted interventions were developed. Case managers improved WC program effectiveness by ensuring command support, and strengthening the case management process. They minimized lost work time and provided the WC team resources to review the oldest cases. Case managers cost $1.25 million and they generated $4.4 million in savings for a 3.52 return on investment. Case managers removed 73 workers from long-term rolls by making use of vocational rehabilitation, finding modified duty jobs, offering workers medical retirement, and terminating benefits when workers refused to work after being offered a job. This study of medical case managers demonstrates they can reduce WC costs.

  8. Nutritional, Economic, and Environmental Costs of Milk Waste in a Classroom School Breakfast Program.

    Science.gov (United States)

    Blondin, Stacy A; Cash, Sean B; Goldberg, Jeanne P; Griffin, Timothy S; Economos, Christina D

    2017-04-01

    To measure fluid milk waste in a US School Breakfast in the Classroom Program and estimate its nutritional, economic, and environmental effects. Fluid milk waste was directly measured on 60 elementary school classroom days in a medium-sized, urban district. The US Department of Agriculture nutrition database, district cost data, and carbon dioxide equivalent (CO2e) emissions and water footprint estimates for fluid milk were used to calculate the associated nutritional, economic, and environmental costs. Of the total milk offered to School Breakfast Program participants, 45% was wasted. A considerably smaller portion of served milk was wasted (26%). The amount of milk wasted translated into 27% of vitamin D and 41% of calcium required of School Breakfast Program meals. The economic and environmental costs amounted to an estimated $274 782 (16% of the district's total annual School Breakfast Program food expenditures), 644 893 kilograms of CO2e, and 192 260 155 liters of water over the school year in the district. These substantial effects of milk waste undermine the School Breakfast Program's capacity to ensure short- and long-term food security and federal food waste reduction targets. Interventions that reduce waste are urgently needed.

  9. [Needle exchange programs are a cost-effective preventative measure against HIV in Iceland].

    Science.gov (United States)

    Eythórsson, Elías Sæbjorn; Ásgeirsdóttir, Tinna Laufey; Gottfređsson, Magnús

    2014-07-01

    In 2007 there was a sudden increase in HIV cases among intravenous drug users (IDUs) in Iceland. In 2007 - 2011 there were 34 new HIV cases among IDUs compared to four in the previous four year period. The purpose of this study was to assess whether needle exchange programs (NEPs) were cost-effective in preventing the spread of HIV among IDUs in Iceland. Cost-utility analysis was conducted from a societal perspective. Costs are presented at the 2011 price level and values were discounted using a 3% discount rate. A ten year period, 2011 - 2020 was compared with and without NEPs. The Incremental Cost-Utility Ratio (ICUR) was calculated as societal cost per quality adjusted life year (QALY). Sensitivity analysis was performed on study assumptions. The estimated societal costs associated with HIV infections among IDUs from 2011 - 2020 was 914.369.621 ISK without NEP and 947.653.758 ISK with NEP. Excess societal cost due to NEP was 33.284.137 ISK. Societal utility from NEP was 7,39 QALYs. Additionally, NEP prevented 4-5 HIV infections. The ICUR of providing NEP was 4.506.720 ISK. According to WHO an intervention is considered cost-effective if the ICUR is less than three-fold national GDP per capita. In 2011 the GDP per capita in Iceland was 15.315.000 ISK. Sensitivity analysis on study assumptions yielded a societal cost within the WHO limit. Therefore, the results indicate that NEPs are cost-effective in preventing the spread of HIV among IDUs in Iceland.

  10. Opioid overdose education and naloxone distribution: Development of the Veterans Health Administration's national program.

    Science.gov (United States)

    Oliva, Elizabeth M; Christopher, Melissa L D; Wells, Daina; Bounthavong, Mark; Harvey, Michael; Himstreet, Julianne; Emmendorfer, Thomas; Valentino, Michael; Franchi, Mariano; Goodman, Francine; Trafton, Jodie A

    To prevent opioid-related mortality, the Veterans Health Administration (VHA) developed a national Opioid Overdose Education and Naloxone Distribution (OEND) program. VHA's OEND program sought national implementation of OEND across all medical facilities (n = 142). This paper describes VHA's efforts to facilitate nationwide health care system-based OEND implementation, including the critical roles of VHA's national pharmacy services and academic detailing services. VHA is the first large health care system in the United States to implement OEND nationwide. Launching the national program required VHA to translate a primarily community-based public health approach to OEND into a health care system-based approach that distributed naloxone to patients with opioid use disorders as well as to patients prescribed opioid analgesics. Key innovations included developing steps to implement OEND, pharmacy developing standard naloxone rescue kits, adding those kits to the VHA National Formulary, centralizing kit distribution, developing clinical guidance for issuing naloxone kits, and supporting OEND as a focal campaign of academic detailing. Other innovations included the development of patient and provider education resources (e.g., brochures, videos, accredited training) and implementation and evaluation resources (e.g., technical assistance, clinical decision support tools). Clinical decision support tools that leverage VHA national data are available to clinical staff with appropriate permissions. These tools allow staff and leaders to evaluate OEND implementation and provide actionable next steps to help them identify patients who could benefit from OEND. Through fiscal year 2016, VHA dispensed 45,178 naloxone prescriptions written by 5693 prescribers to 39,328 patients who were primarily prescribed opioids or had opioid use disorder. As of February 2, 2016, there were 172 spontaneously reported opioid overdose reversals with the use of VHA naloxone prescriptions. VHA

  11. The cost-effectiveness of a school-based overweight program

    Directory of Open Access Journals (Sweden)

    Hoelscher Deanna M

    2007-10-01

    Full Text Available Abstract Background This study assesses the net benefit and the cost-effectiveness of the Coordinated Approach to Child Health (CATCH intervention program, using parameter estimates from the El Paso trial. There were two standard economic measures used. First, from a societal perspective on costs, cost-effectiveness ratios (CER were estimated, revealing the intervention costs per quality-adjusted life years (QALYs saved. QALY weights were estimated using National Health Interview Survey (NHIS data. Second, the net benefit (NB of CATCH was estimated, which compared the present value of averted future costs with the cost of the CATCH intervention. Using National Health and Nutrition Examination Survey I (NHANES and NHANES follow-up data, we predicted the number of adult obesity cases avoided for ages 40–64 with a lifetime obesity progression model. Results The results show that CATCH is cost-effective and net beneficial. The CER was US$900 (US$903 using Hispanic parameters and the NB was US$68,125 (US$43,239 using Hispanic parameters, all in 2004 dollars. This is much lower than the benchmark for CER of US$30,000 and higher than the NB of US$0. Both were robust to sensitivity analyses. Conclusion Childhood school-based programs such as CATCH are beneficial investments. Both NB and CER declined when Hispanic parameters were included, primarily due to the lower wages earned by Hispanics. However, both NB and CER for Hispanics were well within standard cost-effectiveness and net benefit thresholds.

  12. The Cost of Crime to Society: New Crime-Specific Estimates for Policy and Program Evaluation

    Science.gov (United States)

    French, Michael T.; Fang, Hai

    2010-01-01

    Estimating the cost to society of individual crimes is essential to the economic evaluation of many social programs, such as substance abuse treatment and community policing. A review of the crime-costing literature reveals multiple sources, including published articles and government reports, which collectively represent the alternative approaches for estimating the economic losses associated with criminal activity. Many of these sources are based upon data that are more than ten years old, indicating a need for updated figures. This study presents a comprehensive methodology for calculating the cost of society of various criminal acts. Tangible and intangible losses are estimated using the most current data available. The selected approach, which incorporates both the cost-of-illness and the jury compensation methods, yields cost estimates for more than a dozen major crime categories, including several categories not found in previous studies. Updated crime cost estimates can help government agencies and other organizations execute more prudent policy evaluations, particularly benefit-cost analyses of substance abuse treatment or other interventions that reduce crime. PMID:20071107

  13. Cost, utilization, and quality of care: an evaluation of illinois' medicaid primary care case management program.

    Science.gov (United States)

    Phillips, Robert L; Han, Meiying; Petterson, Stephen M; Makaroff, Laura A; Liaw, Winston R

    2014-01-01

    In 2006, Illinois established Illinois Health Connect (IHC), a primary care case management program for Medicaid that offered enhanced fee-for-service, capitation payments, performance incentives, and practice support. Illinois also implemented a complementary disease management program, Your Healthcare Plus (YHP). This external evaluation explored outcomes associated with these programs. We analyzed Medicaid claims and enrollment data from 2004 to 2010, covering both pre- and post-implementation. The base year was 2006, and 2006-2010 eligibility criteria were applied to 2004-2005 data to allow comparison. We studied costs and utilization trends, overall and by service and setting. We studied quality by incorporating Healthcare Effectiveness Data and Information Set (HEDIS) measures and IHC performance payment criteria. Illinois Medicaid expanded considerably between 2006 (2,095,699 full-year equivalents) and 2010 (2,692,123). Annual savings were 6.5% for IHC and 8.6% for YHP by the fourth year, with cumulative Medicaid savings of $1.46 billion. Per-beneficiary annual costs fell in Illinois over this period compared to those in states with similar Medicaid programs. Quality improved for nearly all metrics under IHC, and most prevention measures more than doubled in frequency. Medicaid inpatient costs fell by 30.3%, and outpatient costs rose by 24.9% to 45.7% across programs. Avoidable hospitalizations fell by 16.8% for YHP, and bed-days fell by 15.6% for IHC. Emergency department visits declined by 5% by 2010. The Illinois Medicaid IHC and YHP programs were associated with substantial savings, reductions in inpatient and emergency care, and improvements in quality measures. This experience is not typical of other states implementing some, but not all, of these same policies. Although specific features of the Illinois reforms may have accounted for its better outcomes, the limited evaluation design calls for caution in making causal inferences. © 2014 Annals of

  14. Computer programs for capital cost estimation, lifetime economic performance simulation, and computation of cost indexes for laser fusion and other advanced technology facilities

    Energy Technology Data Exchange (ETDEWEB)

    Pendergrass, J.H.

    1978-01-01

    Three FORTRAN programs, CAPITAL, VENTURE, and INDEXER, have been developed to automate computations used in assessing the economic viability of proposed or conceptual laser fusion and other advanced-technology facilities, as well as conventional projects. The types of calculations performed by these programs are, respectively, capital cost estimation, lifetime economic performance simulation, and computation of cost indexes. The codes permit these three topics to be addressed with considerable sophistication commensurate with user requirements and available data.

  15. Costs and cost-effectiveness of hypertension screening and treatment in adults with hypertension in rural Nigeria in the context of a health insurance program

    NARCIS (Netherlands)

    Rosendaal, N.T.A. (Nicole T. A.); M.E. Hendriks (Marleen); Verhagen, M.D. (Mark D.); O.A. Bolarinwa (Oladimeji Akeem); Sanya, E.O. (Emmanuel O.); Kolo, P.M. (Philip M.); P. Adenusi (Peju); K. Agbede (Kayode); Van Eck, D. (Diederik); S.S. Tan (Siok Swan); T.M. Akande (Tanimola); W.K. Redekop (Ken); C. Schultsz (Constance); Gomez, G.B. (Gabriela B.)

    2016-01-01

    textabstractBackground: High blood pressure is a leading risk factor for death and disability in sub-Saharan Africa (SSA). We evaluated the costs and cost-effectiveness of hypertension care provided within the Kwara State Health Insurance (KSHI) program in rural Nigeria. Methods: A Markov model was

  16. Local infiltration of rabies immunoglobulins without systemic intramuscular administration: An alternative cost effective approach for passive immunization against rabies.

    Science.gov (United States)

    Bharti, Omesh Kumar; Madhusudana, Shampur Narayan; Gaunta, Pyare Lal; Belludi, Ashwin Yajaman

    2016-03-03

    Presently the dose of rabies immunoglobulin (RIG) which is an integral part of rabies post exposure prophylaxis (PEP) is calculated based on body weight though the recommendation is to infiltrate the wound(s). This practice demands large quantities of RIG which may be unaffordable to many patients. In this background, we conducted this study to know if the quantity and cost of RIG can be reduced by restricting passive immunization to local infiltration alone and avoiding systemic intramuscular administration based on the available scientific evidence. Two hundred and sixty nine category III patients bitten by suspect or confirmed rabid dogs/animals were infiltrated with equine rabies immunoglobulin (ERIGs) in and around the wound. The quantity of ERIG used was proportionate to the size and number of wounds irrespective of their body weight. They were followed with a regular course of rabies vaccination by intra-dermal route. As against 363 vials of RIGs required for all these cases as per current recommendation based on body weight, they required only 42 vials of 5ml RIG. Minimum dose of RIGs given was 0.25 ml and maximum dose given was 8 ml. On an average 1.26 ml of RIGs was required per patient that costs Rs. 150 ($3). All the patients were followed for 9 months and they were healthy and normal at the end of observation period. With local infiltration, that required small quantities of RIG, the RIGs could be made available to all patients in times of short supply in the market. A total of 30 (11%) serum samples of patients were tested for rabies virus neutralizing antibodies by the rapid fluorescent focus inhibition test (RFFIT) and all showed antibody titers >0.5 IU/mL by day 14. In no case the dose was higher than that required based on body weight and no immunosuppression resulted. To conclude, this pilot study shows that local infiltration of RIG need to be considered in times of non-availability in the market or unaffordability by poor patients. This

  17. Adoption of robotics in a general surgery residency program: at what cost?

    Science.gov (United States)

    Mehaffey, J Hunter; Michaels, Alex D; Mullen, Matthew G; Yount, Kenan W; Meneveau, Max O; Smith, Philip W; Friel, Charles M; Schirmer, Bruce D

    2017-06-01

    Robotic technology is increasingly being utilized by general surgeons. However, the impact of introducing robotics to surgical residency has not been examined. This study aims to assess the financial costs and training impact of introducing robotics at an academic general surgery residency program. All patients who underwent laparoscopic or robotic cholecystectomy, ventral hernia repair (VHR), and inguinal hernia repair (IHR) at our institution from 2011-2015 were identified. The effect of robotic surgery on laparoscopic case volume was assessed with linear regression analysis. Resident participation, operative time, hospital costs, and patient charges were also evaluated. We identified 2260 laparoscopic and 139 robotic operations. As the volume of robotic cases increased, the number of laparoscopic cases steadily decreased. Residents participated in all laparoscopic cases and 70% of robotic cases but operated from the robot console in only 21% of cases. Mean operative time was increased for robotic cholecystectomy (+22%), IHR (+55%), and VHR (+61%). Financial analysis revealed higher median hospital costs per case for robotic cholecystectomy (+$411), IHR (+$887), and VHR (+$1124) as well as substantial associated fixed costs. Introduction of robotic surgery had considerable negative impact on laparoscopic case volume and significantly decreased resident participation. Increased operative time and hospital costs are substantial. An institution must be cognizant of these effects when considering implementing robotics in departments with a general surgery residency program. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. 45 CFR 2506.18 - What interest, penalty charges, and administrative costs will I have to pay on a debt owed to the...

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false What interest, penalty charges, and administrative costs will I have to pay on a debt owed to the Corporation? 2506.18 Section 2506.18 Public Welfare Regulations Relating to Public Welfare (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE COLLECTION...

  19. Cost-effectiveness outcomes of the national gastric cancer screening program in South Korea.

    Science.gov (United States)

    Cho, Eun; Kang, Moon Hae; Choi, Kui Son; Suh, Mina; Jun, Jae Kwan; Park, Eun-Cheol

    2013-01-01

    Although screening is necessary where gastric cancer is particularly common in Asia, the performance outcomes of mass screening programs have remained unclear. This study was conducted to evaluate cost-effectiveness outcomes of the national cancer screening program (NCSP) for gastric cancer in South Korea. People aged 40 years or over during 2002-2003 (baseline) were the target population. Screening recipients and patients diagnosed with gastric cancers were identified using the NCSP and Korea Central Cancer Registry databases. Clinical outcomes were measured in terms of mortality and life-years saved (LYS) of gastric cancer patients during 7 years based on merged data from the Korean National Health Insurance Corporation and National Statistical Office. We considered direct, indirect, and productivity-loss costs associated with screening attendance. Incremental cost-effectiveness ratio (ICER) estimates were produced according to screening method, sex, and age group compared to non-screening. The age-adjusted ICER for survival was 260,201,000-371,011,000 Korean Won (KW; 1USD=1,088 KW) for the upper-gastrointestinal (UGI) tract over non-screening. Endoscopy ICERs were lower (119,099,000-178,700,000 KW/survival) than UGI. To increase 1 life-year, additional costs of approximately 14,466,000-15,014,000 KW and 8,817,000-9,755,000 KW were required for UGI and endoscopy, respectively. Endoscopy was the most cost-effective strategy for males and females. With regard to sensitivity analyses varying based on the upper age limit, endoscopy NCSP was dominant for both males and females. For males, an upper limit of age 75 or 80 years could be considered. ICER estimates for LYS indicate that the gastric cancer screening program in Korea is cost-effective. Endoscopy should be recommended as a first-line method in Korea because it is beneficial among the Korean population.

  20. Telemedicine-based diabetic retinopathy screening programs: an evaluation of utility and cost-effectiveness

    Directory of Open Access Journals (Sweden)

    Cuadros JA

    2015-06-01

    Full Text Available Jorge A Cuadros Optometry/Vision Science, University of California, Berkeley, CA, USA Abstract: Diabetes is the main cause of blindness among working age adults, although treatment is highly effective in preventing vision loss. Eye examinations are recommended on a yearly basis for most patients for timely detection of retinal disease. Telemedicine-based diabetic retinopathy screening (TMDRS programs have been developed to identify patients with sight-threatening diabetic eye disease because patients are often noncompliant with recommended live eye examinations. This article reviews the cost-effectiveness of the various forms of TMDRS. A review of relevant articles, mostly published since 2008, shows that societal benefits generally outweigh the costs of TMDRS. However, advances in technology to improve efficacy, lower costs, and broaden screening to other sight-threatening conditions, such as glaucoma and refractive error, are necessary to improve the sustainability of TMDRS within health care organizations. Patient satisfaction with these telemedicine programs is generally high. New models of shared care with primary care providers and staff are emerging to improve patient engagement and follow-up care when individuals are found to have sight-threatening eye disease. TMDRS programs are growing and provide valuable clinical benefit. The cost-utility is currently well proven in locations with limited access to regular eye care services, such as rural areas, poor communities, and prison systems; however, improvements over time are necessary for these programs to be cost-effective in mainstream medical settings in the future. Keywords: telemedicine, diabetes, retinopathy, retinal imaging

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-03-01

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

  2. Cost impact of a non-invasive, portable device for patient self-administration of chronic migraine in a UK National Health Service setting.

    Science.gov (United States)

    Brüggenjürgen, B; Baker, T; Bhogal, R; Ahmed, F

    2016-01-01

    Chronic migraine (CM) is a neurological disorder associated with substantial disability. Botulinum toxin type A (Botox) is an approved and effective preventive treatment option for adult patients with CM. Transcranial magnetic stimulation (TMS) is an alternative treatment device delivering a brief pre-set magnetic pulse used for self-administration by the patient at home. Despite being available in a risk share scheme TMS is perceived to be more costly in the UK. The objective of this study was to analyse the incremental costs of TMS compared to Botox in refractory CM patients both for a UK individual funding request setting as well as for an average UK specialist center setting. Cost impact results were derived from a decision-tree model simulating treatment pathways over 1 year. Costs were applied from the most recently available UK data sources. Sensitivity analysis was performed for all variables. Based on published utilisation data 45.5 % of CM patients would continuously receive Botox over 1 year, whereas 53.7 % of TMS patients would be still on treatment at the end of year one. Total costs of Botox treatment accrue to £2923 in an individual funding request NHS cost setting, whereas TMS treatment results in £1466 in the first year. Applying a time-based NHS cost setting expenditures accrue to £1747 for the Botox treatment and to £1361 for the TMS treatment. In both cost settings variation of cost assumptions did have a minor impact on the cost increment from Botox to TMS. The current risk share based remuneration model of TMS allows the UK NHS to reimburse only the cost of those patients experiencing reduction in migraine days resulting in lower costs for treating migraine attacks. Treatment of chronic refractory migraine using TMS implies a substantial cost reduction potential for the management of chronic treatment of refractory migraine patients compared to conventional Botox treatment.

  3. Benefits and costs of intensive lifestyle modification programs for symptomatic coronary disease in Medicare beneficiaries.

    Science.gov (United States)

    Zeng, Wu; Stason, William B; Fournier, Stephen; Razavi, Moaven; Ritter, Grant; Strickler, Gail K; Bhalotra, Sarita M; Shepard, Donald S

    2013-05-01

    This study reports outcomes of a Medicare-sponsored demonstration of two intensive lifestyle modification programs (LMPs) in patients with symptomatic coronary heart disease: the Cardiac Wellness Program of the Benson-Henry Mind Body Institute (MBMI) and the Dr Dean Ornish Program for Reversing Heart Disease® (Ornish). This multisite demonstration, conducted between 2000 and 2008, enrolled Medicare beneficiaries who had had an acute myocardial infarction or a cardiac procedure within the preceding 12 months or had stable angina pectoris. Health and economic outcomes are compared with matched controls who had received either traditional or no cardiac rehabilitation following similar cardiac events. Each program included a 1-year active intervention of exercise, diet, small-group support, and stress reduction. Medicare claims were used to examine 3-year outcomes. The analysis includes 461 elderly, fee-for-service, Medicare participants and 1,795 controls. Cardiac and non-cardiac hospitalization rates were lower in participants than controls in each program and were statistically significant in MBMI (P < .01). Program costs of $3,801 and $4,441 per participant for the MBMI and Ornish Programs, respectively, were offset by reduced health care costs yielding non-significant three-year net savings per participant of about $3,500 in MBMI and $1,000 in Ornish. A trend towards lower mortality compared with controls was observed in MBMI participants (P = .07). Intensive, year-long LMPs reduced hospitalization rates and suggest reduced Medicare costs in elderly beneficiaries with symptomatic coronary heart disease. Copyright © 2013 Mosby, Inc. All rights reserved.

  4. Reported Energy and Cost Savings from the DOE ESPC Program: FY 2015

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-01-01

    The objective of this work was to determine the realization rate of energy and cost savings from the Department of Energy’s Energy Savings Performance Contract (ESPC) program based on information reported by the energy services companies (ESCOs) that are carrying out ESPC projects at federal sites. Information was extracted from 151 Measurement and Verification (M&V) reports to determine reported, estimated, and guaranteed cost savings and reported and estimated energy savings for the previous contract year. Because the quality of the reports varied, it was not possible to determine all of these parameters for each project.

  5. Cost-benefit analysis of a micronutrient supplementation and early childhood stimulation program in Nicaragua.

    Science.gov (United States)

    Lopez Boo, Florencia; Palloni, Giordano; Urzua, Sergio

    2014-01-01

    This paper estimates the cost-benefit ratio for an integrated early childhood development program in Nicaragua (PAININ). Using longitudinal data, we estimate the average treatment effects of PAININ including micronutrient sprinkles on the prevalence of anemia and hemoglobin levels among disadvantaged children aged 6-36 months. We also estimate the effects of PAININ excluding sprinkles on cognitive outcomes among children aged 2.5-5 years. In the younger age group the program reduced anemia by 4 percentage points after 8 months and nearly 6 percentage points after 1 year; the latter is a 26% decrease in anemia. In the older age group, the program improved verbal and numeric memory after a year and a half, but the effects were modest (0.13 SD). When analyzing its potential impact on earnings, we conclude that the discounted annual costs of the program per child are less than the discounted annual increase in beneficiary earnings. Specifically, we estimate a cost-benefit ratio of 1.50 from the PAININ plus sprinkles package. Our sensitivity analysis suggests a range for this ratio between 1.30 and 2.30. © 2014 New York Academy of Sciences.

  6. 78 FR 5781 - Cost-Sharing Rates for Pharmacy Benefits Program of the TRICARE Program

    Science.gov (United States)

    2013-01-28

    ... benefits program as $5 for generic medications, $17 for formulary medications and $44 for non-formulary medications for not more than a 30-day supply obtained through retail pharmacies, and $0 for generic medications, $13 for formulary medications, and $43 for non-formulary medications for not more than a 90-day...

  7. Defense Acquisitions: Better Approach Needed to Account for Number, Cost, and Performance of Non-Major Programs

    Science.gov (United States)

    2015-03-01

    and equipment. About 40 percent of that total is for major defense acquisition programs or ACAT I programs. DOD also invests in other, non-major... ACAT II and III programs that are generally less costly at the individual program level. These programs typically have fewer reporting requirements...and are overseen at lower organizational levels than ACAT I programs, although they may have annual funding needs that are just as significant

  8. The High/Scope Perry Preschool Program: Cost-Benefit Analysis Using Data from the Age-40 Followup

    Science.gov (United States)

    Belfield, Clive R.; Nores, Milagros; Barnett, Steve; Schweinhart, Lawrence

    2006-01-01

    This paper presents an updated cost-benefit analysis of the High/Scope Perry preschool Program, using data on individuals aged 40. Children were randomly assigned to a treatment or control group. Program costs are compared against treatment impacts on educational resources, earnings, criminal activity, and welfare receipt. Net present values are…

  9. A stump-to-truck cost estimating program for cable logging young-growth Douglas-fir

    Science.gov (United States)

    Chris B. LeDoux

    1989-01-01

    WCOST is a computer program designed to estimate the stump-to-truck logging cost of cable logging young-growth Douglas-fir. The program uses data from stand inventory, cruise data, and the logging plan for the tract in question to produce detailed stump-to-truck cost estimates for specific proposed timber sales. These estimates are then used, in combination with...

  10. Proposed Revenues, Financial Strategy, and Program Costs for FY 1992 and 1993 : Technical Appendix, BPA Programs in Perspective.

    Energy Technology Data Exchange (ETDEWEB)

    United States. Bonneville Power Administration.

    1990-07-01

    Programs in Perspective is the Bonneville Power Administration's public involvement process (PIP) for engaging customers and other stakeholders in a regional dialog to set strategic direction and broad program plans for BPA effort. This planning leads into a biennial rate setting cycle and offers a more accessible and flexible opportunity for dialog on broad issues than is possible under the strict administrative procedures of ratemaking. The self-financed character of BPA has made this public process a necessary and valuable one to assure that those who pay BPA's rates have a clear understanding and a strong voice in the plans for use of the resulting revenues. During 1989, the previous PIP engaged the region in discussion of major strategic, issues focussing on major areas. In 1990, BPA seeks discussion of the directions and plans specifically for fiscal years 1992 and 1993. The steps taken for those years will lay the foundation for the years beyond. Thus, we have subtitled this year's process, Staying fit for the long run.'' We have consulted extensively with customers and others in the region in developing these plans. In dozens of program--specific meetings, BPA staff have talked and listened to what others think our plans ought to be. PIP now gives us a chance to review their sum total, along with projections for revenues and our overall financial position. 8 tabs., 8 figs.

  11. Cost-Effectiveness of Four Parenting Programs and Bibliotherapy for Parents of Children with Conduct Problems.

    Science.gov (United States)

    Sampaio, Filipa; Enebrink, Pia; Mihalopoulos, Cathrine; Feldman, Inna

    2016-12-01

    Parenting programs and self-help parenting interventions employing written materials are effective in reducing child conduct problems (CP) in the short-term compared to control groups, however evidence on the cost-effectiveness of such interventions is insufficient. Few studies have looked at the differences in effects between interventions in the same study design. This study aimed to determine the cost-effectiveness of four parenting programs: Comet, Incredible Years (IY), Cope and Connect, and bibliotherapy, compared to a waitlist control (WC), with a time horizon of 4 months, targeting CP in children aged 3-12 years. This economic evaluation was conducted alongside an RCT of the four parenting interventions and bibliotherapy compared to a WC. The study sample consisted of 961 parents of 3-12 year-old children with CP. CP was measured by the Eyberg Child Behavior Inventory. Effectiveness was expressed as the proportion of "recovered" cases of CP. The time horizon of the study was four months with a limited health sector perspective, including parents' time costs. We performed an initial comparative cost analysis for interventions whose outcomes differed significantly from the WC, and later a cost-effectiveness analysis of interventions whose outcomes differed significantly from both the WC and each other. Secondary analyses were performed: (i) joint outcome "recovered and improved", (ii) intervention completers, (iii) exclusion of parents' time costs, (iv) exclusion of training costs. All interventions apart from Connect significantly reduced CP compared to the WC. Of the other interventions Comet resulted in a significantly higher proportion of recovered cases compared to bibliotherapy. A comparative cost analysis of the effective interventions rendered an average cost per recovered case for bibliotherapy of USD 483, Cope USD 1972, Comet USD 3741, and IY USD 6668. Furthermore, Comet had an ICER of USD 8375 compared to bibliotherapy. Secondary analyses of

  12. Cost-Effectiveness of Disease Management Programs for Cardiovascular Risk and COPD in The Netherlands.

    Science.gov (United States)

    Tsiachristas, Apostolos; Burgers, Laura; Rutten-van Mölken, Maureen P M H

    2015-12-01

    Disease management programs (DMPs) for cardiovascular risk (CVR) and chronic obstructive pulmonary disease (COPD) are increasingly implemented in The Netherlands to improve care and patient's health behavior. The aim of this study was to provide evidence about the (cost-) effectiveness of Dutch DMPs as implemented in daily practice. We compared the physical activity, smoking status, quality-adjusted life-years, and yearly costs per patient between the most and the least comprehensive DMPs in four disease categories: primary CVR prevention, secondary CVR prevention, both types of CVR prevention, and COPD (N = 1034). Propensity score matching increased comparability between DMPs. A 2-year cost-utility analysis was performed from the health care and societal perspectives. Sensitivity analysis was performed to estimate the impact of DMP development and implementation costs on cost-effectiveness. Patients in the most comprehensive DMPs increased their physical activity more (except for primary CVR prevention) and had higher smoking cessation rates. The incremental QALYs ranged from -0.032 to 0.038 across all diseases. From a societal perspective, the most comprehensive DMPs decreased costs in primary CVR prevention (certainty 57%), secondary CVR prevention (certainty 88%), and both types of CVR prevention (certainty 98%). Moreover, the implementation of comprehensive DMPs led to QALY gains in secondary CVR prevention (certainty 92%) and COPD (certainty 69%). The most comprehensive DMPs for CVR and COPD have the potential to be cost saving, effective, or cost-effective compared with the least comprehensive DMPs. The challenge for Dutch stakeholders is to find the optimal mixture of interventions that is most suited for each target group. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  13. Awareness of pharmaceutical cost-assistance programs among inner-city seniors.

    Science.gov (United States)

    Federman, Alex D; Safran, Dana Gelb; Keyhani, Salomeh; Cole, Helen; Halm, Ethan A; Siu, Albert L

    2009-04-01

    Lack of awareness may be a significant barrier to participation by low- and middle-income seniors in pharmaceutical cost-assistance programs. The goal of this study was to determine whether older adults' awareness of 2 major state and federal pharmaceutical cost-assistance programs was associated with the seniors' ability to access and process information about assistance programs. Data were gathered from a cross-sectional study of independently living, English- or Spanish-speaking adults aged > or =60 years. Participants were interviewed in 30 community-based settings (19 apartment complexes and 11 senior centers) in New York, New York. The analysis focused on adults aged > or =65 years who lacked Medicaid coverage. Multivariable logistic regression was used to model program awareness as a function of information access (family/social support, attendance at senior or community centers and places of worship, viewing of live health insurance presentations, instrumental activities of daily living, site of medical care, computer use, and having a proxy decision maker for health insurance matters) and information-processing ability (education level, English proficiency, health literacy, and cognitive function). The main outcome measure was awareness of New York's state pharmaceutical assistance program (Elderly Pharmaceutical Insurance Coverage [EPIC

  14. Relationships between Western Area Power Administration`s power marketing program and hydropower operations at Salt Lake City area integrated projects

    Energy Technology Data Exchange (ETDEWEB)

    Veselka, T.D.; Folga, S.; Poch, L.A. [and others

    1995-03-01

    This technical memorandum provides background information on the Western Area Power Administration (Western) and the physical characteristics of the Salt Lake City Area Integrated Projects (SLCA/IP) hydropower plants, which include the Colorado River Storage Project, the Rio Grande Project, and the Collbran Project. In addition, the history, electrical capacity, storage capacity, and flow restrictions at each dam are presented. An overview of Western`s current programs and services, including a review of statutory authorities, agency discretion, and obligations, is also provided. The variability of SLCA/IP hourly generation under various alternative marketing strategies and purchasing programs is discussed. The effects of Western`s services, such as area load control, outage assistance, and transmission, on SLCA/IP power plant operations are analyzed.

  15. The Trust Fund for the Administration of the Forest Development Program, and the Inventory and Monitoring of Jalisco's Natural Resources

    Science.gov (United States)

    Luis Artemio T. Alonso

    2006-01-01

    In 1966 the State Government of Jalisco conducted a review of the state’s forest sector. A new forest agenda resulted from this review, which led to a set of ground breaking actions creating a long term forest development program known as FIPRODEFO (Trust Fund for the Administration of the Forest Development Program of Jalisco). Among the relevant issues, the survey...

  16. Assessing the Costs and Benefits of the Superior Energy Performance Program

    Energy Technology Data Exchange (ETDEWEB)

    Therkelsen, Peter; McKane, Aimee; Sabouini, Ridah; Evans, Tracy

    2013-07-01

    Industrial companies are seeking to manage energy consumption and costs, mitigate risks associated with energy, and introduce transparency into reports of their energy performance achievements. Forty industrial facilities are participating in the U.S. DOE supported Superior Energy Performance (SEP) program in which facilities implement an energy management system based on the ISO 50001 standard, and pursue third-party verification of their energy performance improvements. SEP certification provides industrial facilities recognition for implementing a consistent, rigorous, internationally recognized business process for continually improving energy performance and achievement of established energy performance improvement targets. This paper focuses on the business value of SEP and ISO 50001, providing an assessment of the costs and benefits associated with SEP implementation at nine SEP-certified facilities across a variety of industrial sectors. These cost-benefit analyses are part of the U.S. DOE?s contribution to the Global Superior Energy Performance (GSEP) partnership, a multi-country effort to demonstrate, using facility data, that energy management system implementation enables companies to improve their energy performance with a greater return on investment than business-as-usual (BAU) activity. To examine the business value of SEP certification, interviews were conducted with SEP-certified facilities. The costs of implementing the SEP program, including internal facility staff time, are described and a marginal payback of SEP certification has been determined. Additionally, more qualitative factors with regard to the business value and challenges related to SEP and ISO 50001 implementation are summarized.

  17. The Cost and Threshold Analysis of Retention in Care (RiC): A Multi-Site National HIV Care Program.

    Science.gov (United States)

    Maulsby, Catherine; Jain, Kriti M; Weir, Brian W; Enobun, Blessing; Riordan, Maura; Charles, Vignetta E; Holtgrave, David R

    2017-03-01

    Persons diagnosed with HIV but not retained in HIV medical care accounted for the majority of HIV transmissions in 2009 in the United States (US). There is an urgent need to implement and disseminate HIV retention in care programs; however little is known about the costs associated with implementing retention in care programs. We assessed the costs and cost-saving thresholds for seven Retention in Care (RiC) programs implemented in the US using standard methods recommended by the US Panel on Cost-effectiveness in Health and Medicine. Data were gathered from accounting and program implementation records, entered into a standardized RiC economic analysis spreadsheet, and standardized to a 12 month time frame. Total program costs for from the societal perspective ranged from $47,919 to $423,913 per year or $146 to $2,752 per participant. Cost-saving thresholds ranged from 0.13 HIV transmissions averted to 1.18 HIV transmission averted per year. We estimated that these cost-saving thresholds could be achieved through 1 to 16 additional person-years of viral suppression. Across a range of program models, retention in care interventions had highly achievable cost-saving thresholds, suggesting that retention in care programs are a judicious use of resources.

  18. Cost-effectiveness of triple drug administration (TDA) with praziquantel, ivermectin and albendazole for the prevention of neglected tropical diseases in Nigeria.

    Science.gov (United States)

    Evans, D; McFarland, D; Adamani, W; Eigege, A; Miri, E; Schulz, J; Pede, E; Umbugadu, C; Ogbu-Pearse, P; Richards, F O

    2011-12-01

    Onchocerciasis, lymphatic filariasis (LF), schistosomiasis and soil transmitted, helminthiasis (STH) are all co-endemic in Nigeria. Annual mass drug administration (MDA) with ivermectin (for onchocerciasis), albendazole (for STH and with ivermectin for LF) and praziquantel (for schistosomiasis) is the WHO-recommended treatment strategy for preventive chemotherapy. Separate delivery rounds for distribution of these drugs have been the usual approach to MDA. All three drugs, however, have now been shown to be clinically and programmatically safe for co-administration with what has come to be known as triple drug administration (TDA). We examined the cost savings of converting from separate delivery rounds to TDA in two states in Nigeria. In 2008, eight local government areas received a single round of ivermectin with albendazole followed at least 1 week later by a single round of praziquantel to school-aged children. The following year, a single round was administered with TDA. The number of treated individuals was essentially unchanged during both years (1,301,864 in 2008 and 1,297,509 in 2009) and no change in adverse events was reported. The total programmatic costs for the MDA, not including drug and overhead costs, reduced by 41% from $123,624 to $72,870. Cost savings were limited in larger populations due to economies of scale. TDA is recommended for mature MDA.

  19. A Web-Based Computer-Tailored Alcohol Prevention Program for Adolescents: Cost-Effectiveness and Intersectoral Costs and Benefits

    National Research Council Canada - National Science Library

    st, Ruben M. W. A; Paulus, Agnes; Jander, Astrid F; Mercken, Liesbeth; de Vries, Hein; Ruwaard, Dirk; Evers, Silvia M. A. A

    2016-01-01

    .... Computer tailoring can be both effective and cost-effective for working with many lifestyle behaviors, yet the available information on the cost-effectiveness of computer tailoring for reducing...

  20. Resource and cost adjustment in the design of allocation funding formulas in public health programs.

    Science.gov (United States)

    Buehler, James W; Bernet, Patrick M; Ogden, Lydia L

    2012-01-01

    Multiple federal public health programs use funding formulas to allocate funds to states. To characterize the effects of adjusting formula-based allocations for differences among states in the cost of implementing programs, the potential for generating in-state resources, and income disparities, which might be associated with disease risk. Fifty US states and the District of Columbia. Formula-based funding allocations to states for 4 representative federal public health programs were adjusted using indicators of cost (average salaries), potential within-state revenues (per-capita income, the Federal Medical Assistance Percentage, per-capita aggregate home values), and income disparities (Theil index). Percentage of allocation shifted by adjustment, the number of states and the percentage of US population living in states with a more than 20% increase or decrease in funding, maximum percentage increase or decrease in funding. Each adjustor had a comparable impact on allocations across the 4 program allocations examined. Approximately 2% to 8% of total allocations were shifted, with adjustments for variations in income disparity and housing values having the least and greatest effects, respectively. The salary cost and per-capita income adjustors were inversely correlated and had offsetting effects on allocations. With the exception of the housing values adjustment, fewer than 10 states had more than 20% increases or decreases in allocations, and less than 10% of the US population lived in such states. Selection of adjustors for formula-based funding allocations should consider the impacts of different adjustments, correlations between adjustors and other data elements in funding formulas, and the relationship of formula inputs to program objectives.

  1. Age-26 Cost-Benefit Analysis of the Child-Parent Center Early Education Program

    Science.gov (United States)

    Reynolds, Arthur J.; Temple, Judy A.; White, Barry A.; Ou, Suh-Ruu; Robertson, Dylan L.

    2013-01-01

    We conducted a cost-benefit analysis of the Child-Parent Center (CPC) early childhood intervention. Using data collected up to age 26 on health and well-being, the study is the first adult economic analysis of a sustained large-scale and publicly-funded intervention. As part of the Chicago Longitudinal Study, a complete cohort of 900 low-income children who enrolled in 20 CPCs beginning at age 3 were compared to 500 well-matched low-income children who participated in the usual educational interventions for the economically disadvantaged in Chicago schools. School-age services were provided up to age 9 (third grade). Findings indicated that the three components of CPC had economic benefits in 2007 dollars that exceeded costs. The preschool program provided a total return to society of $10.83 per dollar invested (net benefits per participant of $83,708). Benefits to the public (other than program participants and families) were $7.20 per dollar invested. The primary sources of benefits were increased earnings and tax revenues, averted criminal justice system and victim costs, and savings for child welfare, special education, and grade retention. The school-age program had a societal return of $3.97 per dollar invested and a $2.11 public return. The extended intervention program (4 to 6 years of participation) had a societal return of $8.24 and public return of $5.21. Estimates were robust across a wide range of discount rates and alternative assumptions, and were consistent with the results of Monte Carlo simulations. Males, 1-year preschool participants, and children from higher risk families had greater economic benefits. Findings provide strong evidence that sustained early childhood programs can contribute to well-being for individuals and society. PMID:21291448

  2. The cost-effectiveness of the Olweus Bullying Prevention Program: Results from a modelling study.

    Science.gov (United States)

    Beckman, Linda; Svensson, Mikael

    2015-12-01

    Exposure to bullying affects around 3-5 percent of adolescents in secondary school and is related to various mental health problems. Many different anti-bullying programmes are currently available, but economic evaluations are lacking. The aim of this study is to identify the cost effectiveness of the Olweus Bullying Prevention Program (OBPP). We constructed a decision-tree model for a Swedish secondary school, using a public payer perspective, and retrieved data on costs and effects from the published literature. Probabilistic sensitivity analysis to reflect the uncertainty in the model was conducted. The base-case analysis showed that using the OBPP to reduce the number of victims of bullying costs 131,250 Swedish kronor (€14,470) per victim spared. Compared to a relevant threshold of the societal value of bullying reduction, this indicates that the programme is cost-effective. Using a relevant willingness-to-pay threshold shows that the OBPP is a cost-effective intervention. Copyright © 2015 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  3. Implementation of a shared-savings program for surgical supplies decreases inventory cost.

    Science.gov (United States)

    Eiferman, Daniel; Bhakta, Ankur; Khan, Safdar

    2015-10-01

    Management of operating room inventory has substantial cost-saving opportunities if surgeons agree to standardize supplies used to perform procedures; however, there is no incentive for surgeons to participate in these decisions, because the cost-savings are realized only by the hospital, not the practitioner. In an attempt to engage surgeons with the management of the operating room supply chain, a shared-savings programs was instituted that returned 50% of money saved to the surgery divisions. Opportunities for savings in the use of biologic mesh, cranial plating systems, and neurostimulators was identified. Each item was assigned a physician champion responsible for ensuring that there was clinical equipoise between the products being used. Any cost-savings realized during the fiscal year were shared 50-50 between the hospital and the surgery divisions. The total cost-savings was $893,865 with $446,932 being shared across 15 surgery divisions. Standardization of cranial plating systems ($374,805) generated the greatest amounts of savings followed by neurostimulators ($278,404) and biologic mesh ($240,655). Aligning hospital and surgeon incentives led to dramatic cost-savings and standardization of the operative inventory used. Quality of care is not compromised by this approach, and no conflicts of interest are created. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. High Level Learning by Design: The Nuts and Bolts of Assessment and Evaluation in a Doctorate of Business Administration Program

    Science.gov (United States)

    Lipu, Suzanne; Hill, Allison

    2005-01-01

    In 2003 two librarians at the University of Wollongong faced the challenge of designing and delivering a crucial subject in a pilot Doctorate of Business Administration program which sought to prepare a group of successful business leaders for the task of research. The focus was on developing the participants' information literacy skills and…

  5. From Theory to Practice: Utilizing Integrative Seminars as Bookends to the Master of Public Administration Program of Study

    Science.gov (United States)

    Stout, Margaret; Holmes, Maja Husar

    2013-01-01

    Integrative seminar style courses are most often used as an application-oriented capstone in place of a thesis or comprehensive exam requirement in Master of Public Administration (MPA) degree programs. This article describes and discusses the benefits of a unique approach of one National Association of Schools of Public Affairs and Administration…

  6. Welcome to Babylon: Junior Writing Program Administrators and Writing across Communities at the University of New Mexico

    Science.gov (United States)

    Kells, Michelle Hall

    2012-01-01

    Writing program administrators need to be as concerned about sustaining the cultural ecologies of our communities as we are about the material economies of our institutions--we need to attend to the diverse linguistic and rhetorical ecologies within which twenty-first century student writers are exercising agency. In order to respond productively,…

  7. The Virtual Classroom and Catholic School Leadership Preparation: The LMU Certificate in Catholic School Administration (CCSA) Program

    Science.gov (United States)

    Sabatino, Anthony

    2016-01-01

    Catholic Extension and Loyola Marymount University (LMU) have engaged in a partnership to offer a graduate level, virtual classroom-based Certificate in Catholic School Administration (CCSA) program for novice and prospective leaders in Catholic schools in mission dioceses throughout the United States. This synchronous online Catholic School…

  8. Sustainable Cost Models for mHealth at Scale: Modeling Program Data from m4RH Tanzania.

    Science.gov (United States)

    Mangone, Emily R; Agarwal, Smisha; L'Engle, Kelly; Lasway, Christine; Zan, Trinity; van Beijma, Hajo; Orkis, Jennifer; Karam, Robert

    2016-01-01

    There is increasing evidence that mobile phone health interventions ("mHealth") can improve health behaviors and outcomes and are critically important in low-resource, low-access settings. However, the majority of mHealth programs in developing countries fail to reach scale. One reason may be the challenge of developing financially sustainable programs. The goal of this paper is to explore strategies for mHealth program sustainability and develop cost-recovery models for program implementers using 2014 operational program data from Mobile for Reproductive Health (m4RH), a national text-message (SMS) based health communication service in Tanzania. We delineated 2014 m4RH program costs and considered three strategies for cost-recovery for the m4RH program: user pay-for-service, SMS cost reduction, and strategic partnerships. These inputs were used to develop four different cost-recovery scenarios. The four scenarios leveraged strategic partnerships to reduce per-SMS program costs and create per-SMS program revenue and varied the structure for user financial contribution. Finally, we conducted break-even and uncertainty analyses to evaluate the costs and revenues of these models at the 2014 user volume (125,320) and at any possible break-even volume. In three of four scenarios, costs exceeded revenue by $94,596, $34,443, and $84,571 at the 2014 user volume. However, these costs represented large reductions (54%, 83%, and 58%, respectively) from the 2014 program cost of $203,475. Scenario four, in which the lowest per-SMS rate ($0.01 per SMS) was negotiated and users paid for all m4RH SMS sent or received, achieved a $5,660 profit at the 2014 user volume. A Monte Carlo uncertainty analysis demonstrated that break-even points were driven by user volume rather than variations in program costs. These results reveal that breaking even was only probable when all SMS costs were transferred to users and the lowest per-SMS cost was negotiated with telecom partners. While this

  9. Sustainable Cost Models for mHealth at Scale: Modeling Program Data from m4RH Tanzania.

    Directory of Open Access Journals (Sweden)

    Emily R Mangone

    Full Text Available There is increasing evidence that mobile phone health interventions ("mHealth" can improve health behaviors and outcomes and are critically important in low-resource, low-access settings. However, the majority of mHealth programs in developing countries fail to reach scale. One reason may be the challenge of developing financially sustainable programs. The goal of this paper is to explore strategies for mHealth program sustainability and develop cost-recovery models for program implementers using 2014 operational program data from Mobile for Reproductive Health (m4RH, a national text-message (SMS based health communication service in Tanzania.We delineated 2014 m4RH program costs and considered three strategies for cost-recovery for the m4RH program: user pay-for-service, SMS cost reduction, and strategic partnerships. These inputs were used to develop four different cost-recovery scenarios. The four scenarios leveraged strategic partnerships to reduce per-SMS program costs and create per-SMS program revenue and varied the structure for user financial contribution. Finally, we conducted break-even and uncertainty analyses to evaluate the costs and revenues of these models at the 2014 user volume (125,320 and at any possible break-even volume.In three of four scenarios, costs exceeded revenue by $94,596, $34,443, and $84,571 at the 2014 user volume. However, these costs represented large reductions (54%, 83%, and 58%, respectively from the 2014 program cost of $203,475. Scenario four, in which the lowest per-SMS rate ($0.01 per SMS was negotiated and users paid for all m4RH SMS sent or received, achieved a $5,660 profit at the 2014 user volume. A Monte Carlo uncertainty analysis demonstrated that break-even points were driven by user volume rather than variations in program costs.These results reveal that breaking even was only probable when all SMS costs were transferred to users and the lowest per-SMS cost was negotiated with telecom partners

  10. The SmokingPaST Framework: illustrating the impact of quit attempts, quit methods, and new smokers on smoking prevalence, years of life saved, medical costs saved, programming costs, cost effectiveness, and return on investment.

    Science.gov (United States)

    O'Donnell, Michael P; Roizen, Michael F

    2011-01-01

    Describe the specifications of the Smoking Prevalence, Savings, and Treatment (SmokingPaST) Framework and show how it can illustrate the impact of quit attempts, quit method, number of new smokers, smoking rates of immigrants and emigrants, and death rates of smokers and nonsmokers on future smoking prevalence rates, program costs, years of life saved, medical costs saved, cost effectiveness of programs, and return on investment (ROI). FRAMEWORK SPECIFICATIONS: Mathematical relationships among factors in SmokingPaST are described. Input variables include baseline smoking rates among current adults, new adults, immigrants, and emigrants; population counts for these groups; annual quit attempts; and distribution of quit methods. Assumption variables include success rate by quit method, death rates of smokers and nonsmokers, annual medical costs of smoking, costs per person for four tobacco treatment methods, age distribution of quitters, and distribution of medical cost funding by source. Output variables include year-end adult smoking rates, successful quitters, years of life saved by quitting, medical costs saved by quitting and by not hiring smokers, total costs of smoking treatment programs, cost per quitter, cost per life-year saved, distribution of medical cost savings from quitting, and ROI of treatment costs. The Framework was applied at the employer, county, state, and national levels. The SmokingPaST Framework provides a conceptually simple framework that can be applied to any population. It illustrates that significant drops in smoking rates can be achieved and significant savings in medical costs can be captured by employers as well as state and federal governments through tobacco treatment and prevention programs. Savings are especially important for reducing state and federal government deficits and enhancing job competitiveness.

  11. The cost of a pediatric neurocritical care program for traumatic brain injury: a retrospective cohort study.

    Science.gov (United States)

    Howard, Steven W; Zhang, Zidong; Buchanan, Paula; Bernell, Stephanie L; Williams, Christine; Pearson, Lindsey; Huetsch, Michael; Gill, Jeff; Pineda, Jose A

    2018-01-12

    Inpatient care for children with severe traumatic brain injury (sTBI) is expensive, with inpatient charges averaging over $70,000 per case (Hospital Inpatient, Children Only, National Statistics. Diagnoses- clinical classification software (CCS) principal diagnosis category 85 coma, stupor, and brain damage, and 233 intracranial injury. Diagnoses by Aggregate charges [ https://hcupnet.ahrq.gov/#setup ]). This ranks sTBI in the top quartile of pediatric conditions with the greatest inpatient costs (Hospital Inpatient, Children Only, National Statistics. Diagnoses- clinical classification software (CCS) principal diagnosis category 85 coma, stupor, and brain damage, and 233 intracranial injury. Diagnoses by Aggregate charges [ https://hcupnet.ahrq.gov/#setup ]). The Brain Trauma Foundation developed sTBI intensive care guidelines in 2003, with revisions in 2012 (Kochanek, Carney, et. al. PCCM 3:S1-S2, 2012). These guidelines have been widely disseminated, and are associated with improved health outcomes (Pineda, Leonard. et. al. LN 12:45-52, 2013), yet research on the cost of associated hospital care is limited. The objective of this study was to assess the costs of providing hospital care to sTBI patients through a guideline-based Pediatric Neurocritical Care Program (PNCP) implemented at St. Louis Children's Hospital, a pediatric academic medical center in the Midwest United States. This is a retrospective cohort study. We used multi-level regression to estimate pre-/post-implementation effects of the PNCP program on inflation adjusted total cost of in-hospital sTBI care. The study population included 58 pediatric patient discharges in the pre-PNCP implementation group (July 15, 1999 - September 17, 2005), and 59 post-implementation patient discharges (September 18, 2005 - January 15, 2012). Implementation of the PNCP was associated with a non-significant difference in the cost of care between the pre- and post-implementation periods (eβ = 1.028, p = 0

  12. Is there an optimal pension fund size? A scale-economy analysis of administrative and investment costs

    NARCIS (Netherlands)

    Bikker, J.A.|info:eu-repo/dai/nl/06912261X

    2013-01-01

    This paper investigates scale economies and the optimal scale of pension funds, estimating different cost functions with varying assumptions about the shape of the underlying average cost function: Ushaped versus monotonically declining. Using unique data for Dutch pension funds over 1992-2009, we

  13. The Swift Project Contamination Control Program: A Case Study of Balancing Cost, Schedule and Risk

    Science.gov (United States)

    Hansen, Patricia A.; Day, Diane T.; Secunda, Mark S.; Rosecrans, Glenn P.

    2004-01-01

    The Swift Observatory will be launched in early 2004 to examine the dynamic process of gamma ray burst (GRB) events. The multi-wavelength Observatory will study the GRB afterglow characteristics, which will help to answer fundamental questions about both the structure and the evolution of the universe. The Swift Observatory Contamination Control Program has been developed to aid in ensuring the success of the on-orbit performance of two of the primary instruments: the Ultraviolet and Optical Telescope (UVOT) and the X-Ray Telescope (XRT). During the design phase of the Observatory, the contamination control program evolved and trade studies were performed to assess the risk of contaminating the sensitive UVOT and XRT optics during both pre-launch testing and on-orbit operations, within the constraints of the overall program cost and schedule.

  14. Cost Analysis of Physician Assistant Home Visit Program to Reduce Readmissions After Cardiac Surgery.

    Science.gov (United States)

    Nabagiez, John P; Shariff, Masood A; Molloy, William J; Demissie, Seleshi; McGinn, Joseph T

    2016-09-01

    A physician assistant home care (PAHC) program providing house calls was initiated to reduce hospital readmissions after adult cardiac surgery. The purpose of our study was to compare 30-day PAHC and pre-PAHC readmission rate, length of stay, and cost. Patients who underwent adult cardiac surgery in the 48 months from September 2008 through August 2012 were retrospectively reviewed using pre-PAHC patients as the control group. Readmission rate, length of stay, and health care cost, as measured by hospital billing, were compared between groups matched with propensity score. Of the 1,185 patients who were discharged directly home, 155 (13%) were readmitted. Total readmissions for the control group (n = 648) was 101 patients (16%) compared with the PAHC group (n = 537) total readmissions of 54 (10%), a 38% reduction in the rate of readmission (p = 0.0049). Propensity score matched groups showed a rate reduction of 41% with 17% (62 of 363) for the control compared with 10% (37 of 363) for the PAHC group (p = 0.0061). The average hospital bill per readmission was $39,100 for the control group and $56,600 for the PAHC group (p = 0.0547). The cost of providing home visits was $25,300 for 363 propensity score matched patients. The PAHC program reduced the 30-day readmission rate by 41% for propensity score matched patients. Analysis demonstrated a savings of $977,500 at a cost of $25,300 over 2 years, or $39 in health care saved, in terms of hospital billing, for every $1 spent. Therefore, a home visit by a cardiac surgical physician assistant is a cost-effective strategy to reduce readmissions after cardiac surgery. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  15. Building evidence for peer-led interventions: assessing the cost of the Adolescent Asthma Action program in Australia.

    Science.gov (United States)

    Otim, Michael E; Jayasinha, Ranmalie; Forbes, Hayley; Shah, Smita

    2015-01-01

    Asthma is the most common chronic illness among adolescents in Australia. Aboriginal and Torres Strait Islander adolescents, in particular, face substantial inequalities in asthma-related outcomes. Triple A (Adolescent Asthma Action) is a peer-led education intervention, which aims to improve asthma self-management and reduce the uptake of smoking among adolescents. The aim of this study was to determine the cost of implementing the Triple A program in Australia. Standard economic costing methods were used. It involved identifying the resources that were utilised (such as personnel and program materials), measuring them and then valuing them. We later performed sensitivity analysis so as to identify the cost drivers and a stress test to test how the intervention can perform when some inputs are lacking. Results indicate that the estimated cost of implementing the Triple A program in five schools was $41060, assuming that the opportunity cost of all the participants and venues was accounted for. This translated to $8212 per school or $50 per target student. From sensitivity analysis and a stress test, it was identified that the cost of the intervention (in practice) was $14 per student. This appears to be a modest cost, given the burden of asthma. In conclusion, the Triple A program is an affordable intervention to implement in high schools. The potential asthma cost savings due to the program are significant. If the Triple A program is implemented nation-wide, the benefits would be substantial.

  16. Improving Maternal Care through a State-Wide Health Insurance Program: A Cost and Cost-Effectiveness Study in Rural Nigeria.

    Science.gov (United States)

    Gomez, Gabriela B; Foster, Nicola; Brals, Daniella; Nelissen, Heleen E; Bolarinwa, Oladimeji A; Hendriks, Marleen E; Boers, Alexander C; van Eck, Diederik; Rosendaal, Nicole; Adenusi, Peju; Agbede, Kayode; Akande, Tanimola M; Boele van Hensbroek, Michael; Wit, Ferdinand W; Hankins, Catherine A; Schultsz, Constance

    2015-01-01

    While the Nigerian government has made progress towards the Millennium Development Goals, further investments are needed to achieve the targets of post-2015 Sustainable Development Goals, including Universal Health Coverage. Economic evaluations of innovative interventions can help inform investment decisions in resource-constrained settings. We aim to assess the cost and cost-effectiveness of maternal care provided within the new Kwara State Health Insurance program (KSHI) in rural Nigeria. We used a decision analytic model to simulate a cohort of pregnant women. The primary outcome is the incremental cost effectiveness ratio (ICER) of the KSHI scenario compared to the current standard of care. Intervention cost from a healthcare provider perspective included service delivery costs and above-service level costs; these were evaluated in a participating hospital and using financial records from the managing organisations, respectively. Standard of care costs from a provider perspective were derived from the literature using an ingredient approach. We generated 95% credibility intervals around the primary outcome through probabilistic sensitivity analysis (PSA) based on a Monte Carlo simulation. We conducted one-way sensitivity analyses across key model parameters and assessed the sensitivity of our results to the performance of the base case separately through a scenario analysis. Finally, we assessed the sustainability and feasibility of this program's scale up within the State's healthcare financing structure through a budget impact analysis. The KSHI scenario results in a health benefit to patients at a higher cost compared to the base case. The mean ICER (US$46.4/disability-adjusted life year averted) is considered very cost-effective compared to a willingness-to-pay threshold of one gross domestic product per capita (Nigeria, US$ 2012, 2,730). Our conclusion was robust to uncertainty in parameters estimates (PSA: median US$49.1, 95% credible interval 21

  17. Cost-effective early childhood development programs from preschool to third grade.

    Science.gov (United States)

    Reynolds, Arthur J; Temple, Judy A

    2008-01-01

    Although findings on the positive effects of early childhood development programs have been widely disseminated, less attention has been given to program impacts across the entire period of early childhood. This review summarizes evidence on the effects and cost-effectiveness of programs and services from ages 3 to 9. The major focus is preschool programs for 3- and 4-year-olds, full-day kindergarten, school-age programs including reduced class sizes, and preschool-to-third-grade interventions. Participation in preschool programs was found to have relatively large and enduring effects on school achievement and child well-being. High-quality programs for children at risk produce strong economic returns ranging from about $4 per dollar invested to over $10 per dollar invested. Relative to half-day kindergarten, the positive effects of full-day kindergarten have been found to be relatively small and generally do not last for more than a year. Although no formal economic analyses have been conducted, the economic return per dollar invested would be expected to be close to zero. Among early-school-age programs, preschool plus school-age interventions (PK-3) for children at risk are linked to higher levels of school performance into adolescence. The Child-Parent Center PK-3 Program shows a return of $6 to $9 per dollar invested. Class-size reductions show evidence of positive effects, with economic returns of roughly $3 per dollar invested. The causal mechanisms of long-term effects are discussed. Key principles to promote intervention effectiveness are offered.

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

    Directory of Open Access Journals (Sweden)

    Mehlika Toy

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

  19. Retrospective evaluation of the effect of antivenom administration on hospitalization duration and treatment cost for dogs envenomated by Crotalus viridis: 113 dogs (2004-2012).

    Science.gov (United States)

    Katzenbach, Julia E; Foy, Daniel S

    2015-01-01

    To compare the effect of antivenom administration on mortality, hospitalization duration, and cost of hospitalization for dogs envenomated by Crotalus viridis. Retrospective study (January 2004-December 2012). Private veterinary emergency and referral center. One hundred thirteen dogs with confirmed C. viridis envenomation. None. Dogs were divided into groups treated with either supportive care only (group 1) or supportive care plus antivenin crotalidae polyvalent (group 2). A modified snakebite severity score was used to compare patients from group 1 and group 2. Patients in group 2 received one 10 mL vial of antivenin crotalidae polyvalent over 4-6 hours. The mortality rate was 1.8% (2/113).  Group 1 had a median duration of hospitalization of 20 hours (range, 8-50 hours), while group 2 had a median duration of hospitalization of 24 hours (range, 1.5-74 hours). Group 1 had a median cost of hospitalization of 1050.00 USD (range, 423.52-2266.09 USD) while group 2 had a median cost of hospitalization of 2002.19 USD (range, 1139.91-6908.01 USD). Both the duration of hospitalization (P < 0.01) and the cost of hospitalization (P < 0.01) were significantly greater in the group of dogs receiving antivenom. Both the cost and the duration of hospitalization were significantly greater in the group of dogs that received antivenom. The difference in cost between the groups was approximately the cost of the antivenom vial and administration. Amongst the parameters evaluated, no significant benefit was associated with antivenom administered to dogs envenomated by C. viridis. © Veterinary Emergency and Critical Care Society 2015.

  20. Development of Program to Enhance Team Building Leadership Skills of Primary School Administrators

    Science.gov (United States)

    Sairam, Boonchauy; Sirisuthi, Chaiyuth; Wisetrinthong, Kanjana

    2017-01-01

    Team building leadership skills are important to understandings of how the primary school administrators might work towards creating more effective teamwork in the school. This research aimed 1) to study the components of team building leadership skills needed for primary school administrators, 2) to examine the current states and desirable…

  1. 45 CFR 1388.4 - Program criteria-governance and administration.

    Science.gov (United States)

    2010-10-01

    ... administration. (a) Introduction to governance and administration: The UAP must be associated with, or an... employment practices. (i) The management practices of the UAP, as well as the organizational structure, must... field of developmental disabilities and leadership and vision in carrying out the mission of the UAP. ...

  2. National Aeronautics and Space Administration (NASA)/American Society for Engineering Education (ASEE) Summer Faculty Fellowship Program 1988, volume 2

    Science.gov (United States)

    Bannerot, Richard B.; Goldstein, Stanley H.

    1989-01-01

    The 1988 Johnson Space Center (JSC) National Aeronautics and Space Administration (NASA)/American Society for Engineering Education (ASEE) Summer Faculty Fellowship Program was conducted by the University of Houston and JCS. The 10-week program was operated under the auspices of the ASEE. The program at JSC, as well as the programs at other NASA Centers, was funded by the Office of University Affairs, NASA Headquarters, Washington, D.C. The objectives of the program, which began in 1965 at JSC and in 1964 nationally, are: (1) to further the professional knowledge of qualified engineering and science faculty members; (2) to stimulate an exchange of ideas between participants and NASA; (3) to enrich and refresh the research and teaching activities of participants' institutions; and (4) to contribute to the research objectives of the NASA Centers.

  3. National Aeronautics and Space Administration (NASA)/American Society for Engineering Education (ASEE) Summer Faculty Fellowship Program, 1989, volume 2

    Science.gov (United States)

    Jones, William B., Jr. (Editor); Goldstein, Stanley H. (Editor)

    1989-01-01

    The 1989 Johnson Space Center (JSC) National Aeronautics and Space Administration (NASA)/American Society for Engineering Education (ASEE) Summer Faculty Fellowship Program was conducted by Texas A and M University and JSC. The 10-week program was operated under the auspices of the ASEE. The program at JSC, as well as the programs at other NASA Centers, was funded by the Office of University Affairs, NASA Headquarters, Washington, D.C. The objectives of the program, which began nationally in 1964 and at JSC in 1965, are: (1) to further the professional knowledge of qualified engineering and science faculty members; (2) to stimulate an exchange of ideas between participants and NASA; (3) to enrich and refresh the research and teaching activities of participants' institutions; and (4) to contribute to the research objective of the NASA Centers.

  4. National Aeronautics and Space Administration (NASA)/American Society for Engineering Education (ASEE) Summer Faculty Fellowship Program 1988, volume 1

    Science.gov (United States)

    Bannerot, Richard B. (Editor); Goldstein, Stanley H. (Editor)

    1989-01-01

    The 1988 Johnson Space Center (JSC) National Aeronautics and Space Administration (NASA)/American Society for Engineering Education (ASEE) Summer Faculty Fellowship Program was conducted by the University of Houston and JSC. The 10-week program was operated under the auspices of the ASEE. The program at JSC, as well as the programs at other NASA Centers, was funded by the Office of University Affairs, NASA Headquarters, Washington, D.C. The objectives of the program, which began in 1965 at JSC and in 1964 nationally, are (1) to further the professional knowledge of qualified engineering and science faculty members; (2) to stimulate an exchange of ideas between participants and NASA; (3) to enrich and refresh the research and teaching activities of participants' institutions; and (4) to contribute to the research objectives of the NASA Centers.

  5. National Aeronautics and Space Administration (NASA)/American Society for Engineering Education (ASEE) Summer Faculty Fellowship Program, 1989, volume 1

    Science.gov (United States)

    Jones, William B., Jr. (Editor); Goldstein, Stanley H. (Editor)

    1989-01-01

    The 1989 Johnson Space Center (JSC) National Aeronautics and Space Administration (NASA)/American Society for Engineering Education (ASEE) Summer Faculty Fellowship Program was conducted by Texas A and M University and JSC. The 10-week program was operated under the auspices of the ASEE. The program at JSC, as well as the programs at other NASA Centers, was funded by the Office of University Affairs, NASA Headquarters, Washington, D.C. The objectives of the program, which began nationally in 1964 and at JSC in 1965, are: (1) to further the professional knowledge of qualified engineering and science faculty members; (2) to stimulate an exchange of ideas between participants and NASA; (3) to enrich and refresh the research and teaching activities of participants' institutions; and (4) to contribute to the research objective of the NASA Centers.

  6. Integration of structural health monitoring solutions onto commercial aircraft via the Federal Aviation Administration structural health monitoring research program

    Science.gov (United States)

    Swindell, Paul; Doyle, Jon; Roach, Dennis

    2017-02-01

    The Federal Aviation Administration (FAA) started a research program in structural health monitoring (SHM) in 2011. The program's goal was to understand the technical gaps of implementing SHM on commercial aircraft and the potential effects on FAA regulations and guidance. The program evolved into a demonstration program consisting of a team from Sandia National Labs Airworthiness Assurance NDI Center (AANC), the Boeing Corporation, Delta Air Lines, Structural Monitoring Systems (SMS), Anodyne Electronics Manufacturing Corp (AEM) and the FAA. This paper will discuss the program from the selection of the inspection problem, the SHM system (Comparative Vacuum Monitoring-CVM) that was selected as the inspection solution and the testing completed to provide sufficient data to gain the first approved use of an SHM system for routine maintenance on commercial US aircraft.

  7. A fuzzy inventory model with unit production cost, time depended holding cost, with-out shortages under a space constraint: a parametric geometric programming approach

    OpenAIRE

    Sahidul Islam; Wasim Akram Mandal

    2017-01-01

    In this paper, an Inventory model with unit production cost, time depended holding cost, with-out shortages is formulated and solved. We have considered here a single objective inventory model. In most real world situation, the objective and constraint function of the decision makers are imprecise in nature, hence the coefficients, indices, the objective function and constraint goals are imposed here in fuzzy environment. Geometric programming provides a powerful tool for solving a variety of...

  8. Costs and Cost-Effectiveness of Hypertension Screening and Treatment in Adults with Hypertension in Rural Nigeria in the Context of a Health Insurance Program.

    Directory of Open Access Journals (Sweden)

    Nicole T A Rosendaal

    Full Text Available High blood pressure is a leading risk factor for death and disability in sub-Saharan Africa (SSA. We evaluated the costs and cost-effectiveness of hypertension care provided within the Kwara State Health Insurance (KSHI program in rural Nigeria.A Markov model was developed to assess the costs and cost-effectiveness of population-level hypertension screening and subsequent antihypertensive treatment for the population at-risk of cardiovascular disease (CVD within the KSHI program. The primary outcome was the incremental cost per disability-adjusted life year (DALY averted in the KSHI scenario compared to no access to hypertension care. We used setting-specific and empirically-collected data to inform the model. We defined two strategies to assess eligibility for antihypertensive treatment based on 1 presence of hypertension grade 1 and 10-year CVD risk of >20%, or grade 2 hypertension irrespective of 10-year CVD risk (hypertension and risk based strategy and 2 presence of hypertension in combination with a CVD risk of >20% (risk based strategy. We generated 95% confidence intervals around the primary outcome through probabilistic sensitivity analysis. We conducted one-way sensitivity analyses across key model parameters and assessed the sensitivity of our results to the performance of the reference scenario.Screening and treatment for hypertension was potentially cost-effective but the results were sensitive to changes in underlying assumptions with a wide range of uncertainty. The incremental cost-effectiveness ratio for the first and second strategy respectively ranged from US$ 1,406 to US$ 7,815 and US$ 732 to US$ 2,959 per DALY averted, depending on the assumptions on risk reduction after treatment and compared to no access to antihypertensive treatment.Hypertension care within a subsidized private health insurance program may be cost-effective in rural Nigeria and public-private partnerships such as the KSHI program may provide opportunities

  9. Community partnership to address snack quality and cost in after-school programs.

    Science.gov (United States)

    Beets, Michael W; Tilley, Falon; Turner-McGrievy, Gabrielle; Weaver, Robert G; Jones, Sonya

    2014-08-01

    Policies call on after-school programs (ASPs) to serve more nutritious snacks. A major barrier for improving snack quality is cost. This study describes the impact on snack quality and expenditures from a community partnership between ASPs and local grocery stores. Four large-scale ASPs (serving ˜500 children, aged 6-12 years, each day) and a single local grocery store chain participated in this study. The nutritional quality of snacks served was recorded preintervention (18 weeks spring/fall 2011) and postintervention (7 weeks spring 2012) via direct observation, along with cost/child/snack/day. Preintervention snacks were low-nutrient-density salty snacks (eg, chips, 3.0 servings/week), sugar-sweetened beverages (eg, powdered-lemonade, 1.9 servings/week), and desserts (eg, cookies, 2.1 servings/week), with only 0.4 servings/week of fruits and no vegetables. By postintervention, fruits (3.5 servings/week) and vegetables (1.2 servings/week) were increased, whereas sugar-sweetened beverages and desserts were eliminated. Snack expenditures were $0.26 versus $0.24 from preintervention to postintervention. Partnership savings versus purchasing snacks at full retail cost was 24.5% or $0.25/serving versus $0.34/serving. This innovative partnership can serve as a model in communities where ASPs seek to identify low-cost alternatives to providing nutritious snacks. © 2014, American School Health Association.

  10. [Cost-effectiveness of an organized breast cancer screening program in Southern Brazil].

    Science.gov (United States)

    Ribeiro, Rodrigo Antonini; Caleffi, Maira; Polanczyk, Carisi Anne

    2013-11-01

    The aim of this study was to evaluate the cost-effectiveness of an organized breast cancer mammographic screening program implemented in Porto Alegre (Núcleo Mama Porto Alegre - NMPOA), Rio Grande do Sul State, Brazil. A Markov model was constructed to estimate the incremental cost-effectiveness ratio of NMPOA compared to current BC diagnosis and care in the Brazilian public health system, in a hypothetical cohort of women aged 40-69 years at risk of developing breast cancer. Model parameters were collected from NMPOA and the national literature. In the NMPOA strategy, effectiveness was modeled taking into account the actual observed screening adherence. Effectiveness was measured in quality-adjusted life years (QALYs). Incremental cost-effectiveness ratio in the base case was R$ 13,426 per QALY. This result was not sensitive to variation in the main model parameters in sensitivity analyses. Considering the threshold usually suggested as highly attractive in Brazil, breast cancer screening as performed in NMPOA is cost-effective in cities with high incidence of breast cancer.

  11. Dynamic Programming and Error Estimates for Stochastic Control Problems with Maximum Cost

    Energy Technology Data Exchange (ETDEWEB)

    Bokanowski, Olivier, E-mail: boka@math.jussieu.fr [Laboratoire Jacques-Louis Lions, Université Paris-Diderot (Paris 7) UFR de Mathématiques - Bât. Sophie Germain (France); Picarelli, Athena, E-mail: athena.picarelli@inria.fr [Projet Commands, INRIA Saclay & ENSTA ParisTech (France); Zidani, Hasnaa, E-mail: hasnaa.zidani@ensta.fr [Unité de Mathématiques appliquées (UMA), ENSTA ParisTech (France)

    2015-02-15

    This work is concerned with stochastic optimal control for a running maximum cost. A direct approach based on dynamic programming techniques is studied leading to the characterization of the value function as the unique viscosity solution of a second order Hamilton–Jacobi–Bellman (HJB) equation with an oblique derivative boundary condition. A general numerical scheme is proposed and a convergence result is provided. Error estimates are obtained for the semi-Lagrangian scheme. These results can apply to the case of lookback options in finance. Moreover, optimal control problems with maximum cost arise in the characterization of the reachable sets for a system of controlled stochastic differential equations. Some numerical simulations on examples of reachable analysis are included to illustrate our approach.

  12. A systematic review of the cost-effectiveness of worksite physical activity and/or nutrition programs.

    Science.gov (United States)

    van Dongen, Johanna M; Proper, Karin I; van Wier, Marieke F; van der Beek, Allard J; Bongers, Paulien M; van Mechelen, Willem; van Tulder, Maurits W

    2012-09-01

    The aim of this study was to appraise and summarize the evidence on the cost-effectiveness of worksite physical activity and/or nutrition programs. We searched EMBASE, MEDLINE, SportDiscus, PsycInfo, NIOSHTIC-2, NHSEED, HTA, and Econlit for studies published up to 14 January 2011. Additionally, we searched for articles by reviewing references, searching authors' databases, and contacting authors of included studies. Two researchers independently selected articles. Articles had to include a cost-effectiveness and/or cost-utility analysis comparing a worksite physical activity and/or nutrition program to usual care or an abridged version of the program. Data were extracted on study characteristics and results. Two researchers independently assessed the risk of bias using the Consensus on Health Economic Criteria list (CHEC-list). Ten studies (18 programs) were included. More than 50% of the studies fulfilled 11 (58%) of the 19 CHEC-list items. From various perspectives, worksite nutrition and worksite physical activity and nutrition programs (N=6) were more costly and more effective in reducing body weight than usual care. When only intervention costs were considered, most worksite nutrition (N=4/5) and worksite physical activity and nutrition programs (N=5/6) were more costly and more effective in reducing cholesterol level and cardiovascular disease risks, respectively. The cost-effectiveness of more costly and more effective programs depends on the "willingness to pay" for their effects. It is unknown how much decision-makers are willing to pay for reductions in body weight, cholesterol level, and cardiovascular disease risks. Therefore, conclusions about the cost-effectiveness of worksite physical activity and/or nutrition programs cannot be made. There is substantial need for improvement of the methodological quality of studies and particular emphasis should be placed on the handling of uncertainty.

  13. TAX ADMINISTRATION: Impact of Compliance and Collection Program Declines on Taxpayers

    National Research Council Canada - National Science Library

    2002-01-01

    ...) compliance and collection programs. Many view these programs-such as audits to determine whether taxpayers have accurately reported the amount of taxes that they owe and collection follow-up with taxpayers who have not...

  14. 75 FR 25270 - Administration for Children and Families; Single-Source Program Expansion Supplement Grant

    Science.gov (United States)

    2010-05-07

    ...: This program is authorized by section 412 (c)(1)(A) of the Immigration and Nationality Act (INA) [8 U.S... programs and services that help newly-arrived refugees secure employment, overcome language and cultural...

  15. A Cost-Benefit Analysis on the Feasibility of Implementing A Same-Day Surgery Program at the 121ST General Hospital, Seoul, Korea

    Science.gov (United States)

    2000-04-27

    of child care when surgery is performed under an inpatient status) Some of the disadvantages of same-day surgery that Pollock report include...56.00 105.00 111.00 BEZ Chiropractic 25.00 47.00 50.00 Psychiatric and/or Mental Health Care BFA Psychiatry 124.00 230.00 243.00 BFB Psychology 93.00...U.S. Army-Baylor University Graduate Program in Health Care Administration A Cost-Benefit Analysis on the Feasibility of Implementing A Same-Day

  16. Developing a Leadership Development Program for the Veterans Benefits Administration within the Department of Veterans Affairs

    Science.gov (United States)

    2014-06-13

    8 VBA Budget ................................................................................................................ 8... VBA Leadership and Personnel .................................................................................. 9 Employee Promotion within VBA ...14 VBA Goals and Key Programs

  17. Cost-effectiveness of rapid syphilis screening in prenatal HIV testing programs in Haiti.

    Directory of Open Access Journals (Sweden)

    Bruce R Schackman

    2007-05-01

    Full Text Available New rapid syphilis tests permit simple and immediate diagnosis and treatment at a single clinic visit. We compared the cost-effectiveness, projected health outcomes, and annual cost of screening pregnant women using a rapid syphilis test as part of scaled-up prenatal testing to prevent mother-to-child HIV transmission in Haiti.A decision analytic model simulated health outcomes and costs separately for pregnant women in rural and urban areas. We compared syphilis syndromic surveillance (rural standard of care, rapid plasma reagin test with results and treatment at 1-wk follow-up (urban standard of care, and a new rapid test with immediate results and treatment. Test performance data were from a World Health Organization-Special Programme for Research and Training in Tropical Diseases field trial conducted at the GHESKIO Center Groupe Haitien d'Etude du Sarcome de Kaposi et des Infections Opportunistes in Port-au-Prince. Health outcomes were projected using historical data on prenatal syphilis treatment efficacy and included disability-adjusted life years (DALYs of newborns, congenital syphilis cases, neonatal deaths, and stillbirths. Cost-effectiveness ratios are in US dollars/DALY from a societal perspective; annual costs are in US dollars from a payer perspective. Rapid testing with immediate treatment has a cost-effectiveness ratio of $6.83/DALY in rural settings and $9.95/DALY in urban settings. Results are sensitive to regional syphilis prevalence, rapid test sensitivity, and the return rate for follow-up visits. Integrating rapid syphilis testing into a scaled-up national HIV testing and prenatal care program would prevent 1,125 congenital syphilis cases and 1,223 stillbirths or neonatal deaths annually at a cost of $525,000.In Haiti, integrating a new rapid syphilis test into prenatal care and HIV testing would prevent congenital syphilis cases and stillbirths, and is cost-effective. A similar approach may be beneficial in other resource

  18. Cost-effectiveness of rapid syphilis screening in prenatal HIV testing programs in Haiti.

    Science.gov (United States)

    Schackman, Bruce R; Neukermans, Christopher P; Fontain, Sandy N Nerette; Nolte, Claudine; Joseph, Patrice; Pape, Jean W; Fitzgerald, Daniel W

    2007-05-01

    New rapid syphilis tests permit simple and immediate diagnosis and treatment at a single clinic visit. We compared the cost-effectiveness, projected health outcomes, and annual cost of screening pregnant women using a rapid syphilis test as part of scaled-up prenatal testing to prevent mother-to-child HIV transmission in Haiti. A decision analytic model simulated health outcomes and costs separately for pregnant women in rural and urban areas. We compared syphilis syndromic surveillance (rural standard of care), rapid plasma reagin test with results and treatment at 1-wk follow-up (urban standard of care), and a new rapid test with immediate results and treatment. Test performance data were from a World Health Organization-Special Programme for Research and Training in Tropical Diseases field trial conducted at the GHESKIO Center Groupe Haitien d'Etude du Sarcome de Kaposi et des Infections Opportunistes in Port-au-Prince. Health outcomes were projected using historical data on prenatal syphilis treatment efficacy and included disability-adjusted life years (DALYs) of newborns, congenital syphilis cases, neonatal deaths, and stillbirths. Cost-effectiveness ratios are in US dollars/DALY from a societal perspective; annual costs are in US dollars from a payer perspective. Rapid testing with immediate treatment has a cost-effectiveness ratio of $6.83/DALY in rural settings and $9.95/DALY in urban settings. Results are sensitive to regional syphilis prevalence, rapid test sensitivity, and the return rate for follow-up visits. Integrating rapid syphilis testing into a scaled-up national HIV testing and prenatal care program would prevent 1,125 congenital syphilis cases and 1,223 stillbirths or neonatal deaths annually at a cost of $525,000. In Haiti, integrating a new rapid syphilis test into prenatal care and HIV testing would prevent congenital syphilis cases and stillbirths, and is cost-effective. A similar approach may be beneficial in other resource-poor countries

  19. Resolving Issues in Innovative Graduate Degree Programs: The Metropolitan State University Doctor of Business Administration Experience

    Science.gov (United States)

    Delmont, Tim

    2011-01-01

    Applied Master's Degree and doctoral programs have been criticized widely for their lack of relevance, rigor and quality. New graduate degree programs have responded to these criticisms by implementing innovative academic policies, program curriculum, and student services. A case study of the Metropolitan State University Doctor of Business…

  20. Tribal CCDF Guide to "Financial Management, Grants Administration, and Program Accountability"

    Science.gov (United States)

    Child Care Bureau, 2009

    2009-01-01

    Tribal managers and staff working with Federal grants must be fully knowledgeable of all applicable Federal requirements and skilled in applying these requirements to the daily operation of their programs, whether starting a new program or striving to maintain a quality program which meets the intent of the enacting legislation. It is the…