WorldWideScience

Sample records for program cost analysis

  1. 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...

  2. 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

  3. [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.

  4. 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 ...

  5. 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...

  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. 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...

  8. [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.

  9. 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…

  10. 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…

  11. 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...

  12. 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 ...

  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. 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...

  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. 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…

  18. 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

  19. 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

  20. 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.

  1. 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

  2. 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.

  3. [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

  4. 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...

  5. 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...

  6. 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...

  7. 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...

  8. 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…

  9. 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.

  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. 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.

  12. 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

  13. 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

  14. 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).

  15. 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

  16. 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

  17. 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.

  18. 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…

  19. 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

  20. 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.

  1. 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,...

  2. 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

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  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. 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…

  9. 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....

  10. 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.

  11. 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

  12. Employer Benefits From an Early Intervention Program for Depression: A Cost-Benefit Analysis.

    Science.gov (United States)

    Callander, Emily J; Lindsay, Daniel B; Scuffham, Paul A

    2017-03-01

    The Work Outcomes Research Cost-benefit (WORC) project aimed to determine if early intervention for depression influenced workforce productivity in full-time employees. The current study aims to examine whether this intervention is cost-effective. A cost-benefit analysis of the WORC project from the employer's perspective was undertaken, taking into account intervention costs and associated gains due to increased workforce productivity from baseline to 12-month follow-up. Both the single intervention and case management groups were found to have a decrease in time lost at work due to presenteeism. This contributed to net gains resulting from increased workforce productivity in both intervention groups. The results suggest that the WORC intervention was cost-effective. A similar intervention to that described here may be beneficial to employers who are seeking to increase workforce productivity.

  13. Cost-effectiveness and budget impact analysis of a population-based screening program for colorectal cancer.

    Science.gov (United States)

    Pil, L; Fobelets, M; Putman, K; Trybou, J; Annemans, L

    2016-07-01

    Colorectal cancer (CRC) is one of the leading causes of cancer mortality in Belgium. In Flanders (Belgium), a population-based screening program with a biennial immunochemical faecal occult blood test (iFOBT) in women and men aged 56-74 has been organised since 2013. This study assessed the cost-effectiveness and budget impact of the colorectal population-based screening program in Flanders (Belgium). A health economic model was conducted, consisting of a decision tree simulating the screening process and a Markov model, with a time horizon of 20years, simulating natural progression. Predicted mortality and incidence, total costs, and quality-adjusted life-years (QALYs) with and without the screening program were calculated in order to determine the incremental cost-effectiveness ratio of CRC screening. Deterministic and probabilistic sensitivity analyses were conducted, taking into account uncertainty of the model parameters. Mortality and incidence were predicted to decrease over 20years. The colorectal screening program in Flanders is found to be cost-effective with an ICER of 1681/QALY (95% CI -1317 to 6601) in males and €4,484/QALY (95% CI -3254 to 18,163). The probability of being cost-effective given a threshold of €35,000/QALY was 100% and 97.3%, respectively. The budget impact analysis showed the extra cost for the health care payer to be limited. This health economic analysis has shown that despite the possible adverse effects of screening and the extra costs for the health care payer and the patient, the population-based screening program for CRC in Flanders is cost-effective and should therefore be maintained. Copyright © 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  14. 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…

  15. Educational Impacts and Cost-Effectiveness of Conditional Cash Transfer Programs in Developing Countries: A Meta-Analysis

    Science.gov (United States)

    García, Sandra; Saavedra, Juan E.

    2017-01-01

    We meta-analyze for impact and cost-effectiveness 94 studies from 47 conditional cash transfer programs in low- and middle-income countries worldwide, focusing on educational outcomes that include enrollment, attendance, dropout, and school completion. To conceptually guide and interpret the empirical findings of our meta-analysis, we present a…

  16. Benefit-cost analysis of Uganda's clonal coffee replanting program: An ex-ante analysis

    OpenAIRE

    Benin, Samuel; You, Liangzhi

    2007-01-01

    "The Ugandan coffee industry is facing some serious challenges, including low international prices in the international coffee market, aging coffee trees and declining productivity, and, more recently, the appearance of coffee-wilt disease, which have all contributed to the decline in both the quantity and value of coffee exports. The government of Uganda, through the Uganda Coffee Development Authority (UCDA), in 1993/94 started a coffee-replanting program to both replace coffee trees that w...

  17. A cost-benefit analysis of Wisconsin's screening, brief intervention, and referral to treatment program: adding the employer's perspective.

    Science.gov (United States)

    Quanbeck, Andrew; Lang, Katharine; Enami, Kohei; Brown, Richard L

    2010-02-01

    A previous cost-benefit analysis found Screening, Brief Intervention, and Referral to Treatment (SBIRT) to be cost-beneficial from a societal perspective. This paper develops a cost-benefit model that includes the employer's perspective by considering the costs of absenteeism and impaired presenteeism due to problem drinking. We developed a Monte Carlo simulation model to estimate the costs and benefits of SBIRT implementation to an employer. We first presented the likely costs of problem drinking to a theoretical Wisconsin firm that does not currently provide SBIRT services. We then constructed a cost-benefit model in which the firm funds SBIRT for its employees. The net present value of SBIRT adoption was computed by comparing costs due to problem drinking both with and without the program. When absenteeism and impaired presenteeism costs were considered from the employer's perspective, the net present value of SBIRT adoption was $771 per employee. We concluded that implementing SBIRT is cost-beneficial from the employer's perspective and recommend that Wisconsin employers consider covering SBIRT services for their employees.

  18. Cost analysis of integrated renal replacement therapy program in the province of Toledo (2012-2013).

    Science.gov (United States)

    Conde Olasagasti, José L; Garcia Diaz, José Eugenio; Carrasco Benitez, Pilar; Mareque Ruiz, Miguel Ángel; Parras Partido, María Pilar; Moreno Alia, Inmaculada; Jimenez Lopez, Laura; Cia Lecumberri, Juan José; Araque, Pilar; Fernandez, María Luisa

    Renal replacement therapy (RRT) is the object of constant analysis in the search for efficiency and sustainability. To calculate the direct cost of healthcare for the prevalent RRT population in the province of Toledo (2012/2013). a) Population: All prevalent patients at some point in RRT in 2012 (669) and in 2013 (682). b) Costs included (€): 1) dialysis procedure; 2) inpatient, outpatient and emergency care, dialysis and non-dialysis related; 3) drug consumption; 4) medical transport. c) Calculation and analysis: The aggregate localized or reconstructed cost of each item was calculated from the individual cost of each patient. Annual cost and cost per patient/year was calculated for the whole RRT and for its subprograms (€). a) Aggregate costs: The total cost of RRT amounted to 15.84 and 15.77 million euros (2012/2013). Dialysis procedures account for 40.2% of the total while the sum of hospital care and drug consumption represents 41.5%. Healthcare for patients on hospital haemodialysis (HHD) and combined haemodialysis (CHD), peritoneal dialysis (PD) and transplant (Tx) accounts for 70.0, 5.0 and 25.0% of the total respectively. b) Patient/year cost: From the number of patients/year provided by each subprogramme, the following values were obtained in 2012/2013: All RRT 26,130/25,379; HHD 49,167/53,289; CHD 44,657/44,971; PD 45,538/51,869 and Tx 10,909/10,984. Our results are consistent with others published, although our patient/year values are slightly higher, probably because they include elements such as outpatient pharmacy, hospital and medical transport cargo. The growing contribution of Tx to the survival of the whole RRT population contains the overall costs and reduces the patient/year cost, making RRT sustainable. Copyright © 2017 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  19. DVT surveillance program in the ICU: analysis of cost-effectiveness.

    Directory of Open Access Journals (Sweden)

    Ajai K Malhotra

    Full Text Available BACKGROUND: Venous Thrombo-embolism (VTE--Deep venous thrombosis (DVT and/or pulmonary embolism (PE--in traumatized patients causes significant morbidity and mortality. The current study evaluates the effectiveness of DVT surveillance in reducing PE, and performs a cost-effectiveness analysis. METHODS: All traumatized patients admitted to the adult ICU underwent twice weekly DVT surveillance by bilateral lower extremity venous Duplex examination (48-month surveillance period--SP. The rates of DVT and PE were recorded and compared to the rates observed in the 36-month pre-surveillance period (PSP. All patients in both periods received mechanical and pharmacologic prophylaxis unless contraindicated. Total costs--diagnostic, therapeutic and surveillance--for both periods were recorded and the incremental cost for each Quality Adjusted Life Year (QALY gained was calculated. RESULTS: 4234 patients were eligible (PSP--1422 and SP--2812. Rate of DVT in SP (2.8% was significantly higher than in PSP (1.3% - p<0.05, and rate of PE in SP (0.7% was significantly lower than that in PSP (1.5% - p<0.05. Logistic regression demonstrated that surveillance was an independent predictor of increased DVT detection (OR: 2.53 - CI: 1.462-4.378 and decreased PE incidence (OR: 0.487 - CI: 0.262-0.904. The incremental cost was $509,091/life saved in the base case, translating to $29,102/QALY gained. A sensitivity analysis over four of the parameters used in the model indicated that the incremental cost ranged from $18,661 to $48,821/QALY gained. CONCLUSIONS: Surveillance of traumatized ICU patients increases DVT detection and reduces PE incidence. Costs in terms of QALY gained compares favorably with other interventions accepted by society.

  20. Do Health Benefits Outweigh the Costs of Mass Recreational Programs? An Economic Analysis of Four Ciclovía Programs

    OpenAIRE

    Montes, Felipe; Sarmiento, Olga L.; Zarama, Roberto; Pratt, Michael; Wang, Guijing; Jacoby, Enrique; Schmid, Thomas L.; Ramos, Mauricio; Ruiz, Oscar; Vargas, Olga; Michel, Gabriel; Zieff, Susan G.; Valdivia, Juan Alejandro; Cavill, Nick; Kahlmeier, Sonja

    2011-01-01

    One promising public health intervention for promoting physical activity is the Ciclovía program. The Ciclovía is a regular multisectorial community-based program in which streets are temporarily closed for motorized transport, allowing exclusive access to individuals for recreational activities and physical activity. The objective of this study was to conduct an analysis of the cost–benefit ratios of physical activity of the Ciclovía programs of Bogotá and Medellín in Colombia, Guadalajara i...

  1. Tools for Economic Analysis of Patient Management Interventions in Heart Failure 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

    2015-11-01

    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. We developed the Tools for Economic Analysis of Patient Management Interventions in Heart Failure 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. Projections of resource use and quality of life are modeled using relationships with time-varying Seattle Heart Failure Model scores. The model can be used to evaluate parallel-group and single-cohort study 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. 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. The Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model provides researchers and providers with a tool for conducting long-term cost-effectiveness analyses of disease management programs in heart failure. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. An analysis of the costs of Uganda's Child Days Plus: do low costs reveal an efficient program or an underfinanced one?

    Science.gov (United States)

    Fiedler, John L; Semakula, Richard

    2014-03-01

    Twice annually, Uganda implements Child Days Plus (CDP), a month-long outreach activity that distributes vitamin A capsules to preschool children and deworms children 6 months to 14 years old. Introduced initially as a temporary, interim strategy, CDP is now a decade old. To assess how well CDP is implemented using an activity-based cost analysis. In the absence of a cost-accounting system for CDP, we defined the six major CDP activities as cost centers and identified five important subactivities required to implement a round of CDP. Based on a purposive sample, we conducted a structured interview survey of 59 Ministry of Health facilities, 9 district offices, and national-level CDP staff. Only one-third of the facilities implemented all 11 CDP core activities. The survey revealed that Ministry of Health staff and volunteers are frequently paid substantially less in allowances than they are entitled to for their CDP outreach activities. Viewing these two practices--nonimplementation and less-than-full-reimbursement--as indicators of CDP's underfinancing, we estimate the program is underfinanced by the equivalent of 37% of its 'full implementation" costs. Two-thirds of underfinancing is manifested in nonimplementation and one-third as less-than full-reimbursement. CDP exploits economies of scale and scope and has an average cost per child served of US$0.22. We estimate that it annually saves 367,000 disability-adjusted life-years (DALYs) at an average cost of US$12.5, making it--despite its underfinancing--highly cost-effective. Increased CDP funding would enable its vitamin A coverage rate of 58% and its deworming coverage rate of 62% to be increased, thereby increasing its effectiveness and efficiency. CDP should be "relaunched," as part of an effort to improve the structure of the program, set expectations about it, and earmark a minimum of resources for CDP. The Ministry of Health should demonstrate its new, greater commitment to CDP by introducing a program

  3. A Comprehensive Mathematical Programming Model for Minimizing Costs in A Multiple-Item Reverse Supply Chain with Sensitivity Analysis

    Directory of Open Access Journals (Sweden)

    Mahmoudi Hoda

    2014-09-01

    Full Text Available These instructions give you guidelines for preparing papers for IFAC conferences. A reverse supply chain is configured by a sequence of elements forming a continuous process to treat return-products until they are properly recovered or disposed. The activities in a reverse supply chain include collection, cleaning, disassembly, test and sorting, storage, transport, and recovery operations. This paper presents a mathematical programming model with the objective of minimizing the total costs of reverse supply chain including transportation, fixed opening, operation, maintenance and remanufacturing costs of centers. The proposed model considers the design of a multi-layer, multi-product reverse supply chain that consists of returning, disassembly, processing, recycling, remanufacturing, materials and distribution centers. This integer linear programming model is solved by using Lingo 9 software and the results are reported. Finally, a sensitivity analysis of the proposed model is also presented.

  4. Cost-effectiveness analysis for a tele-based health coaching program for chronic disease in primary care.

    Science.gov (United States)

    Oksman, Erja; Linna, Miika; Hörhammer, Iiris; Lammintakanen, Johanna; Talja, Martti

    2017-02-15

    The burden of chronic disease and multimorbidity is rapidly increasing. Self-management support interventions are effective in reduce cost, especially when targeted at a single disease group; however, economical evidence of such complex interventions remains scarce. The objective of this study was to evaluate a cost-effectiveness analysis of a tele-based health-coaching intervention among patients with type 2 diabetes (T2D), coronary artery disease (CAD) and congestive heart failure (CHF). A total of 1570 patients were blindly randomized to intervention (n = 970) and control (n = 470) groups. The intervention group received monthly individual health coaching by telephone from a specially trained nurse for 12-months in addition to routine social and healthcare. Patients in the control group received routine social and health care. Quality of life was assessed at the beginning of the intervention and follow-up measurements were made after 12 months health coaching. The cost included all direct health-care costs supplemented with home care and nursing home-care costs in social care. Utility was based on a Health Related Quality of Life (HRQoL) measurement (15D instrument), and cost effectiveness was assessed using incremental cost-effectiveness ratios (ICERs). The cost-effectiveness of health coaching was highest in the T2D group (ICER €20,000 per Quality-Adjusted Life Years [QALY]). The ICER for the CAD group was more modest (€40,278 per QALY), and in the CHF group, costs increased with no marked effect on QoL. Probabilistic sensitivity analysis indicated that at the societal willingness to pay threshold of €50,000 per QALY, the probability of health coaching being cost effective was 55% in the whole study group. The cost effectiveness of health coaching may vary substantially across patient groups, and thus interventions should be targeted at selected subgroups of chronically ill. Based on the results of this study, health coaching improved the QoL of

  5. Operating cost analysis of anaesthesia: Activity based costing (ABC analysis

    Directory of Open Access Journals (Sweden)

    Majstorović Branislava M.

    2011-01-01

    Full Text Available Introduction. Cost of anaesthesiology represent defined measures to determine a precise profile of expenditure estimation of surgical treatment, which is important regarding planning of healthcare activities, prices and budget. Objective. In order to determine the actual value of anaestesiological services, we started with the analysis of activity based costing (ABC analysis. Methods. Retrospectively, in 2005 and 2006, we estimated the direct costs of anestesiological services (salaries, drugs, supplying materials and other: analyses and equipment. of the Institute of Anaesthesia and Resuscitation of the Clinical Centre of Serbia. The group included all anesthetized patients of both sexes and all ages. We compared direct costs with direct expenditure, “each cost object (service or unit” of the Republican Health-care Insurance. The Summary data of the Departments of Anaesthesia documented in the database of the Clinical Centre of Serbia. Numerical data were utilized and the numerical data were estimated and analyzed by computer programs Microsoft Office Excel 2003 and SPSS for Windows. We compared using the linear model of direct costs and unit costs of anaesthesiological services from the Costs List of the Republican Health-care Insurance. Results. Direct costs showed 40% of costs were spent on salaries, (32% on drugs and supplies, and 28% on other costs, such as analyses and equipment. The correlation of the direct costs of anaestesiological services showed a linear correlation with the unit costs of the Republican Healthcare Insurance. Conclusion. During surgery, costs of anaesthesia would increase by 10% the surgical treatment cost of patients. Regarding the actual costs of drugs and supplies, we do not see any possibility of costs reduction. Fixed elements of direct costs provide the possibility of rationalization of resources in anaesthesia.

  6. [Operating cost analysis of anaesthesia: activity based costing (ABC analysis)].

    Science.gov (United States)

    Majstorović, Branislava M; Kastratović, Dragana A; Vučović, Dragan S; Milaković, Branko D; Miličić, Biljana R

    2011-01-01

    Cost of anaesthesiology represent defined measures to determine a precise profile of expenditure estimation of surgical treatment, which is important regarding planning of healthcare activities, prices and budget. In order to determine the actual value of anaestesiological services, we started with the analysis of activity based costing (ABC) analysis. Retrospectively, in 2005 and 2006, we estimated the direct costs of anestesiological services (salaries, drugs, supplying materials and other: analyses and equipment.) of the Institute of Anaesthesia and Resuscitation of the Clinical Centre of Serbia. The group included all anesthetized patients of both sexes and all ages. We compared direct costs with direct expenditure, "each cost object (service or unit)" of the Republican Healthcare Insurance. The Summary data of the Departments of Anaesthesia documented in the database of the Clinical Centre of Serbia. Numerical data were utilized and the numerical data were estimated and analyzed by computer programs Microsoft Office Excel 2003 and SPSS for Windows. We compared using the linear model of direct costs and unit costs of anaesthesiological services from the Costs List of the Republican Healthcare Insurance. Direct costs showed 40% of costs were spent on salaries, (32% on drugs and supplies, and 28% on other costs, such as analyses and equipment. The correlation of the direct costs of anaestesiological services showed a linear correlation with the unit costs of the Republican Healthcare Insurance. During surgery, costs of anaesthesia would increase by 10% the surgical treatment cost of patients. Regarding the actual costs of drugs and supplies, we do not see any possibility of costs reduction. Fixed elements of direct costs provide the possibility of rationalization of resources in anaesthesia.

  7. Worker replacement and cost-benefit analysis of life-saving health care programs, a precautionary note.

    Science.gov (United States)

    Tessier, Philippe; Sultan-Taïeb, Hélène; Barnay, Thomas

    2014-04-01

    The assumption according to which ill individuals can be replaced at work that underpins the 'friction cost method' (FCM) to value productivity costs has been primarily discussed within the framework of cost-utility analysis. This paper investigates the consequences of this assumption for cost-benefit analysis (CBA). It makes three contributions. First, it provides the first analytical account of the overall consequences of ill worker replacement on social welfare and it analyzes the associated compensation effects within a CBA framework. Second, it highlights a double counting problem that arises when ill worker replacement is assumed in the CBA of life-saving health care programs. To the best of our knowledge, no satisfactory solution to this problem has yet been provided in the literature. Third, this paper suggests and discusses two original ways to address this double counting issue. One consists in adjusting value of a statistical life estimations for the well-being provided by future incomes. Another possibility lies in the estimation of marginal rates of substitution between health and wealth so as to directly monetize the value of life over and above consumption. We show that both solutions raise unresolved questions that should be addressed in future research to enable appropriate use of the FCM in CBA.

  8. Cost-effectiveness analysis of basixilimab induction and calcineurin-sparing protocols in "old to old" programs using Markov models.

    Science.gov (United States)

    Emparan, C; Wolters, H; Laukötter, M; Dame, C; Senninger, N

    2003-06-01

    Markov models are employed in economic analyses to evaluate all possible expectations in a dilemna. The introduction of a new clinical protocol (basiliximab induction with calcineurin-sparing protocols) for a group of kidney transplant recipients receiving organs from marginal donors was validated with a Markov simulation model. Calcineurin-sparing protocols using anti-IL-2/antibody induction (Simulect) show a beneficial effect on initial kidney function, reducing transplantation costs reception based upon mean length of stay, mean admission cost, and incidences of delayed graft function and complications during the first month after transplant. A Markov simulation model was established following three different chains. A calcineurin-free regimen with basiliximab induction (chain A), a calcineurin-sparing protocol with basiliximab induction (chain B), and a conventional immunosuppressive regimen (chain C). After designing the Markov chain and cohorts, 31 patients from the "old to old" program were assigned to each chain eight to chain A, (eight to chain B, and 15 to chain C). A month after transplantation a cost-benefit study was performed guided by the three branches of the Markov model. The Markov model showed a benefit of induction therapies in elderly patients. A cost-benefit model showed that after a month there was a clear benefit from Calcineurin=free plus basiliximab induction therapies, with a slight benefit from calcineurin-sparing protocols. Markov models are extremely useful when introducing new clinical therapies. In our transplant program, a cost-effective analysis of outcomes in old patients using the Markov model showed a clear benefit of calcineurin-sparing protocols with basixilimab induction.

  9. A cost-effectiveness analysis of a program to control rheumatic fever and rheumatic heart disease in Pinar del Rio, Cuba.

    Science.gov (United States)

    Watkins, David A; Mvundura, Mercy; Nordet, Porfirio; Mayosi, Bongani M

    2015-01-01

    Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) persist in many low- and middle-income countries. To date, the cost-effectiveness of population-based, combined primary and secondary prevention strategies has not been assessed. In the Pinar del Rio province of Cuba, a comprehensive ARF/RHD control program was undertaken over 1986-1996. The present study analyzes the cost-effectiveness of this Cuban program. We developed a decision tree model based on the natural history of ARF/RHD, comparing the costs and effectiveness of the 10-year Cuban program to a "do nothing" approach. Our population of interest was the cohort of children aged 5-24 years resident in Pinar del Rio in 1986. We assessed costs and health outcomes over a lifetime horizon, and we took the healthcare system perspective on costs but did not apply a discount rate. We used epidemiologic, clinical, and direct medical cost inputs that were previously collected for publications on the Cuban program. We estimated health gains as disability-adjusted life years (DALYs) averted using standard approaches developed for the Global Burden of Disease studies. Cost-effectiveness acceptability thresholds were defined by one and three times per capita gross domestic product per DALY averted. We also conducted an uncertainty analysis using Monte Carlo simulations and several scenario analyses exploring the impact of alternative assumptions about the program's effects and costs. We found that, compared to doing nothing, the Cuban program averted 5051 DALYs (1844 per 100,000 school-aged children) and saved $7,848,590 (2010 USD) despite a total program cost of $202,890 over 10 years. In the scenario analyses, the program remained cost saving when a lower level of effectiveness and a reduction in averted years of life lost were assumed. In a worst-case scenario including 20-fold higher costs, the program still had a 100% of being cost-effective and an 85% chance of being cost saving. A 10-year program to

  10. Cost Analysis of Maintenance Programs for Pre-Positioned War Reserve Material Stock (PWRMS)

    National Research Council Canada - National Science Library

    Cyr, Phillip

    2002-01-01

    ...) for that maintenance. The objective is to provide DoD, the Navy, and the Civil Engineer Corps a guideline and possible benchmark for maintenance costs required to maintain the CESE War Reserves in a Cl condition of readiness...

  11. Life cycle cost analysis rehabilitation costs.

    Science.gov (United States)

    2015-07-01

    This study evaluates data from CDOTs Cost Data books and Pavement Management Program. Cost : indices were used to normalize project data to year 2014. Data analyzed in the study was obtained from : the CDOTs Cost Data books and the Pavement Man...

  12. A Cost-Benefit Analysis of the National Guard Youth ChalleNGe Program. Technical Report

    Science.gov (United States)

    Perez-Arce, Francisco; Constant, Louay; Loughran, David S.; Karoly, Lynn A.

    2012-01-01

    Decades of research show that high school dropouts are more likely than graduates to commit crimes, abuse drugs and alcohol, have children out of wedlock, earn low wages, be unemployed, and suffer from poor health. The ChalleNGe program, currently operating in 27 states, is a residential program coupled with post-residential mentoring that seeks…

  13. Cost/Schedule Uncertainty Analysis of the XM1/Alternative Armament Programs

    Science.gov (United States)

    1976-04-01

    120mm system; expected cost incurred is about $ 55M with either system. These delays and costs are caused by the additional redesign activities and...Tank Armament Study indicated a 1-1/2 year delay to full production at an expected cost increase of $ 55M (FY74) (measured from October 75 to...4-1 1-1 to U cfl 4J 1-1 T\\ H 4-1 rj M CJ CO td c 4-1 C8 sf 3 0) M CO c •H •H M CX •H IT) u ~~ U u CO U •H •H E M »-i o; o 4-1 •H

  14. Benefit Cost Analysis for Surface Engineering Solutions Funded by SERDP/ESTCP Weapons, Systems & Platforms Program Area

    Science.gov (United States)

    2014-11-01

    costs from manufacturing to ultimate disposal o ENVIRONMENTAL RISK : Reduced environmental risks in manufacturing and maintenance depot...further DOD deployments and benefits? • Identify DOD benefits in cost savings, environmental risk reduction, and readiness. Quantify these benefits...Missile (ESSM), ATFLIR and Test Range Metrology 8 If you have questions, comments or suggestions for WP Benefit Cost Analysis project, please

  15. 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.

  16. A Cost Analysis Model for Army Sponsored Graduate Dental Education Programs.

    Science.gov (United States)

    1997-04-01

    Surgery Pediatric Dentistry Oral Pathology Prosthodontics Comprehensive Dentistry Orthodontics Public Health Dentistry Table 1: Army and...remaining pediatric dentistry and orthodontic training programs at Ft. Meade in 1995. In FY 98, however, in a partnership with the US Air Force at... pediatric dentistry , orthodontics, oral pathology, and public health dentistry. The ADCS now obtains this low density required specialty training by

  17. Consolidation of Military Voluntary Education Program: Feasibility and Cost Benefit Analysis

    Science.gov (United States)

    1993-12-01

    ashore and afloat, to help service members improve their writing, mathematics, and reading skils . The course is offered free to the service member...college programs, atai, f career p iomotions, achievement of full workplace literacy , and completion of requirements for certificates and degrees. The...counseled concerning the requirements for earning an apprenticeship certification in their skil !. The service mewrber tabulates his daily production hours

  18. Cost-Utility Analysis of Three U.S. HIV Linkage and Re-engagement in Care Programs from Positive Charge.

    Science.gov (United States)

    Jain, Kriti M; Zulliger, Rose; Maulsby, Cathy; Kim, Jeeyon Janet; Charles, Vignetta; Riordan, Maura; Holtgrave, David

    2016-05-01

    Linking and retaining people living with HIV in ongoing, HIV medical care is vital for ending the U.S. HIV epidemic. Yet, 41-44 % of HIV+ individuals are out of care. In response, AIDS United initiated Positive Charge, a series of five HIV linkage and re-engagement projects around the U.S. This paper investigates whether three Positive Charge programs were cost effective and calculates a return on investment for each program. It uses standard methods of cost utility analysis and WHO-CHOICE thresholds. All three projects were found to be cost effective, and two were highly cost effective. Cost utility ratios ranged from $4439 to $137,271. These results suggest that HIV linkage to care programs are a productive and efficient use of public health funds.

  19. Cost analysis of a school-based comprehensive malaria program in primary schools in Sikasso region, Mali

    Directory of Open Access Journals (Sweden)

    Roberta Maccario

    2017-06-01

    Full Text Available Abstract Background The expansion of malaria prevention and control to school-aged children is receiving increasing attention, but there are still limited data on the costs of intervention. This paper analyses the costs of a comprehensive school-based intervention strategy, delivered by teachers, that included participatory malaria educational activities, distribution of long lasting insecticide-treated nets (LLIN, and Intermittent Parasite Clearance in schools (IPCs in southern Mali. Methods Costs were collected alongside a randomised controlled trial conducted in 80 primary schools in Sikasso Region in Mali in 2010-2012. Cost data were compiled between November 2011 and March 2012 for the 40 intervention schools (6413 children. A provider perspective was adopted. Using an ingredients approach, costs were classified by cost category and by activity. Total costs and cost per child were estimated for the actual intervention, as well as for a simpler version of the programme more suited for scale-up by the government. Univariate sensitivity analysis was performed. Results The economic cost of the comprehensive intervention was estimated to $10.38 per child (financial cost $8.41 with malaria education, LLIN distribution and IPCs costing $2.13 (20.5%, $5.53 (53.3% and $2.72 (26.2% per child respectively. Human resources were found to be the key cost driver, and training costs were the greatest contributor to overall programme costs. Sensitivity analysis showed that an adapted intervention delivering one LLIN instead of two would lower the economic cost to $8.66 per child; and that excluding LLIN distribution in schools altogether, for example in settings where malaria control already includes universal distribution of LLINs at community-level, would reduce costs to $4.89 per child. Conclusions A comprehensive school-based control strategy may be a feasible and affordable way to address the burden of malaria among schoolchildren in the Sahel.

  20. Cost analysis of a school-based comprehensive malaria program in primary schools in Sikasso region, Mali.

    Science.gov (United States)

    Maccario, Roberta; Rouhani, Saba; Drake, Tom; Nagy, Annie; Bamadio, Modibo; Diarra, Seybou; Djanken, Souleymane; Roschnik, Natalie; Clarke, Siân E; Sacko, Moussa; Brooker, Simon; Thuilliez, Josselin

    2017-06-12

    The expansion of malaria prevention and control to school-aged children is receiving increasing attention, but there are still limited data on the costs of intervention. This paper analyses the costs of a comprehensive school-based intervention strategy, delivered by teachers, that included participatory malaria educational activities, distribution of long lasting insecticide-treated nets (LLIN), and Intermittent Parasite Clearance in schools (IPCs) in southern Mali. Costs were collected alongside a randomised controlled trial conducted in 80 primary schools in Sikasso Region in Mali in 2010-2012. Cost data were compiled between November 2011 and March 2012 for the 40 intervention schools (6413 children). A provider perspective was adopted. Using an ingredients approach, costs were classified by cost category and by activity. Total costs and cost per child were estimated for the actual intervention, as well as for a simpler version of the programme more suited for scale-up by the government. Univariate sensitivity analysis was performed. The economic cost of the comprehensive intervention was estimated to $10.38 per child (financial cost $8.41) with malaria education, LLIN distribution and IPCs costing $2.13 (20.5%), $5.53 (53.3%) and $2.72 (26.2%) per child respectively. Human resources were found to be the key cost driver, and training costs were the greatest contributor to overall programme costs. Sensitivity analysis showed that an adapted intervention delivering one LLIN instead of two would lower the economic cost to $8.66 per child; and that excluding LLIN distribution in schools altogether, for example in settings where malaria control already includes universal distribution of LLINs at community-level, would reduce costs to $4.89 per child. A comprehensive school-based control strategy may be a feasible and affordable way to address the burden of malaria among schoolchildren in the Sahel.

  1. A screening program to test and treat for Helicobacter pylori infection: Cost-utility analysis by age, sex and ethnicity.

    Science.gov (United States)

    Teng, Andrea M; Kvizhinadze, Giorgi; Nair, Nisha; McLeod, Melissa; Wilson, Nick; Blakely, Tony

    2017-02-20

    The World Health Organization recommends all countries consider screening for H. pylori to prevent gastric cancer. We therefore aimed to estimate the cost-effectiveness of a H. pylori serology-based screening program in New Zealand, a country that includes population groups with relatively high gastric cancer rates. A Markov model was developed using life-tables and morbidity data from a national burden of disease study. The modelled screening program reduced the incidence of non-cardia gastric cancer attributable to H. pylori, if infection was identified by serology screening, and for the population expected to be reached by the screening program. A health system perspective was taken and detailed individual-level costing data was used. For adults aged 25-69 years old, nation-wide screening for H. pylori was found to have an incremental cost of US$196 million (95% uncertainty interval [95% UI]: $182-$211 million) with health gains of 14,200 QALYs (95% UI: 5,100-26,300). Cost per QALY gained was US$16,500 ($7,600-$38,400) in the total population and 17% (6%-29%) of future gastric cancer cases could be averted with lifetime follow-up. A targeted screening program for Māori only (indigenous population), was more cost-effective at US$8,000 ($3,800-$18,500) per QALY. This modeling study found that H. pylori screening was likely to be cost-effective in this high-income country, particularly for the indigenous population. While further research is needed to help clarify the precise benefits, costs and adverse effects of such screening programs, there seems a reasonable case for policy-makers to give pilot programs consideration, particularly for any population groups with relatively elevated rates of gastric cancer.

  2. An Analysis of Cost Growth in the F/A-18 Airplane Acquisition Program

    Science.gov (United States)

    1981-12-01

    Chapter Two provides the reader with the background needed to understand the analysis presented in Chapter Three. Re~ders who are thoroughly familia ~r with...priorities arc recognized, met and maintained by the Services and ltne orga;znations. Examples include our nuclear forces, C11, 00D-wjdu manpower

  3. Descriptive Cost Analysis of Special Education.

    Science.gov (United States)

    Slobojan, Alan

    1987-01-01

    Presents a study of cost analysis of the Frederick County Public Schools (Maryland) special education programs and services. The Larson IPSEC Model was used as the basis for the cost analysis. The modified Larson model provides a valuable tool to determine the per pupil cost of special education. (Author/MD)

  4. An Econometric Analysis of Volunteer Enlistments of Service and Cost Effectiveness Comparison of Service Incentive Programs

    Science.gov (United States)

    1974-10-01

    The analysis was also aimed at deter- mining the effects of changes in youth unemployment rates, college entrance patterns and various Service...determining the effects of changes in youth unemployment rates, college entrance patterns and various Service manpower policies on volunteer...including the number of recruiters, youth unemployment rate, military/civilian wage and college entrance rates was used with 1972 and 1973 enlistment

  5. Cost-Effectiveness Analysis Comparing Pre-Diagnosis Autism Spectrum Disorder (ASD)-Targeted Intervention with Ontario's Autism Intervention Program

    Science.gov (United States)

    Penner, Melanie; Rayar, Meera; Bashir, Naazish; Roberts, S. Wendy; Hancock-Howard, Rebecca L.; Coyte, Peter C.

    2015-01-01

    Novel management strategies for autism spectrum disorder (ASD) propose providing interventions before diagnosis. We performed a cost-effectiveness analysis comparing the costs and dependency-free life years (DFLYs) generated by pre-diagnosis intensive Early Start Denver Model (ESDM-I); pre-diagnosis parent-delivered ESDM (ESDM-PD); and the Ontario…

  6. 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.

  7. 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

  8. Evaluation of a Stratified National Breast Screening Program in the United Kingdom: An Early Model-Based Cost-Effectiveness Analysis.

    Science.gov (United States)

    Gray, Ewan; Donten, Anna; Karssemeijer, Nico; van Gils, Carla; Evans, D Gareth; Astley, Sue; Payne, Katherine

    2017-09-01

    To identify the incremental costs and consequences of stratified national breast screening programs (stratified NBSPs) and drivers of relative cost-effectiveness. A decision-analytic model (discrete event simulation) was conceptualized to represent four stratified NBSPs (risk 1, risk 2, masking [supplemental screening for women with higher breast density], and masking and risk 1) compared with the current UK NBSP and no screening. The model assumed a lifetime horizon, the health service perspective to identify costs (£, 2015), and measured consequences in quality-adjusted life-years (QALYs). Multiple data sources were used: systematic reviews of effectiveness and utility, published studies reporting costs, and cohort studies embedded in existing NBSPs. Model parameter uncertainty was assessed using probabilistic sensitivity analysis and one-way sensitivity analysis. The base-case analysis, supported by probabilistic sensitivity analysis, suggested that the risk stratified NBSPs (risk 1 and risk-2) were relatively cost-effective when compared with the current UK NBSP, with incremental cost-effectiveness ratios of £16,689 per QALY and £23,924 per QALY, respectively. Stratified NBSP including masking approaches (supplemental screening for women with higher breast density) was not a cost-effective alternative, with incremental cost-effectiveness ratios of £212,947 per QALY (masking) and £75,254 per QALY (risk 1 and masking). When compared with no screening, all stratified NBSPs could be considered cost-effective. Key drivers of cost-effectiveness were discount rate, natural history model parameters, mammographic sensitivity, and biopsy rates for recalled cases. A key assumption was that the risk model used in the stratification process was perfectly calibrated to the population. This early model-based cost-effectiveness analysis provides indicative evidence for decision makers to understand the key drivers of costs and QALYs for exemplar stratified NBSP. Copyright

  9. Análisis de coste-beneficio de un programa de prevención del tabaquismo en escolares Cost-benefit analysis of a school-based smoking prevention program

    Directory of Open Access Journals (Sweden)

    Jordi Hormigo Amaro

    2009-08-01

    Full Text Available Objetivo: Analizar la eficiencia de un programa de prevención del tabaquismo en escolares de Barcelona (programa PASE.bcn. Métodos: Se realizó un análisis de coste-beneficio. Como costes se incluyeron los derivados del diseño y la ejecución del programa. Como beneficios se contabilizaron los costes sanitarios y las pérdidas de productividad evitados. La perspectiva de análisis es la social y el año de referencia es 2005. Resultados: Estimando una efectividad del 1%, el programa PASE.bcn lograría un beneficio anual de 1.558.311,46 €. Los beneficios sanitarios por fumador evitado son de 1997,57 €, mientras que los beneficios indirectos por fumador evitado son de 21.260,80 €. Dado que el coste del programa es de 68.526,03 €, la razón beneficio-coste del programa es de 22,74. Conclusiones: Los programas de prevención del tabaquismo en escolares generan un beneficio para la sociedad muy superior a sus costes. Los resultados justifican la aplicación universal de este tipo de programas.Objective: To analyze the efficiency of a school-based smoking prevention program in Barcelona (PASE.bcn program. Methods: A cost-benefit analysis was performed. As costs we included those corresponding to the design and implementation of the program. As benefits we considered healthcare costs and the productivity losses avoided. This study was conducted from a societal perspective, and the estimations of costs and benefits related to 2005. Results: Assuming an effectiveness of 1%, the PASE.bcn program would achieve a total benefit of 1,558,311.46 €. The healthcare benefits per prevented smoker were 1997.57 €, and the indirect benefits per prevented smoker were 21,260.80 €. Given the total cost of the school-based program (68,526.03 €, the cost-benefit ratio was 22.74. Conclusions: From a societal perspective, the benefits of school-based tobacco prevention programs, in terms of healthcare costs and productivity losses avoided, are far

  10. Implementation Costs of an Enhanced Recovery After Surgery Program in the United States: A Financial Model and Sensitivity Analysis Based on Experiences at a Quaternary Academic Medical Center.

    Science.gov (United States)

    Stone, Alexander B; Grant, Michael C; Pio Roda, Claro; Hobson, Deborah; Pawlik, Timothy; Wu, Christopher L; Wick, Elizabeth C

    2016-03-01

    Despite positive results from several international Enhanced Recovery After Surgery (ERAS) protocols, the United States has been slow to adopt ERAS protocols, in part due to concern regarding the expenses of such a program. We sought to evaluate the potential annual net cost savings of implementing a US-based ERAS program. Using data from existing publications and experience with an ERAS program, a model of net financial costs was developed for surgical groups of escalating numbers of annual cases. Our example scenario provided a financial analysis of the implementation of an ERAS program at a United States academic institution based on data from the ERAS Program for Colorectal Surgery at The Johns Hopkins Hospital. Based on available data from the United States, ERAS programs lead to reductions in lengths of hospital stay that range from 0.7 to 2.7 days and substantial direct cost savings. Using example data from a quaternary hospital, the considerable cost of $552,783 associated with implementation of an ERAS program was offset by even greater savings in the first year of nearly $948,500, yielding a net savings of $395,717. Sensitivity analysis across several caseload and direct cost scenarios yielded similar savings in 20 of the 27 projections. Enhanced Recovery After Surgery protocols have repeatedly led to reduction in length of hospital stay and improved surgical outcomes. A financial model, based on published data and experience, projects that investment in an ERAS program can also lead to net financial savings for US hospitals. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  11. Nationwide expansion of a financial incentive program on fruit and vegetable purchases among Supplemental Nutrition Assistance Program participants: A cost-effectiveness analysis.

    Science.gov (United States)

    An, Ruopeng

    2015-12-01

    High prices remain a formidable barrier for many people, especially those of low socioeconomic status, to adopt a healthier diet. The Food, Conservation, and Energy Act of 2008 mandated the U.S. Department of Agriculture (USDA) to conduct a pilot study to assess the impact of making fruits and vegetables more affordable for households in the Supplemental Nutrition Assistance Program (SNAP). Based on the USDA final report of the Healthy Incentives Pilot (HIP), a large-scale randomized trial in 2011-2012 that provided 30% rebate on targeted fruits and vegetables to 7500 study participants enrolled in the SNAP, we constructed a decision model to evaluate the cost-effectiveness of an expansion of the HIP to all SNAP households nationwide. The estimated life-time per capita costs of the HIP to the Federal government is $1323 in 2012 U.S. dollars, and the average gains in quality-adjusted life expectancy to a SNAP participant is 0.082 quality-adjusted life year (QALY), resulting in an incremental cost-effectiveness ratio (ICER) of $16,172 per QALY gained. Sensitivity analysis using Monte Carlo simulations indicates a 94.4% and 99.6% probability that the estimated ICER would be lower than the cost-effective threshold of $50,000 and $100,000 per QALY gained, respectively. Moreover, the estimated ICER of the HIP expansion tends to be competitive in comparison to other interventions that aimed at promoting fruit/vegetable intake among adult population. Findings from this study suggest that a nationwide expansion of the HIP is likely to nudge SNAP households towards purchasing and consuming more targeted fruits and vegetables. However, diet behavior modification is proportional to price change. When people's actual eating behaviors and what dietary guidelines recommend differ by several folds, even a 30% rebate closes just a small fraction of that gap and has limited beneficial impact on participants' weight management, disease prevention, and health-related quality of life

  12. HEDL contribution to SRL fuel recycle program. Quarterly report, January--March 1977. [Sensitivity analysis of LMFBR fuel fabrication cost

    Energy Technology Data Exchange (ETDEWEB)

    Fletcher, J.F.

    1977-08-01

    Research on LWR fuel cycle is being done in the following categories: economic studies (sensitivity analysis of LMFBR fuel fabrication costs), spent fuel receipt and storage (failure of PWR and BWR fuel assemblies), fuel materials preparation or finishing processes, reduction of TRU waste generation, and environmental impacts. 12 tables. (DLC)

  13. Cost-benefit analysis of an area-wide pest management program to control Asian tiger mosquito in New Jersey

    Science.gov (United States)

    Area-wide pest management (AWPM) is recommended to control urban mosquitoes, such as Aedes albopictus (Asian tiger mosquito), which limit outdoor activities. We conducted a cost-benefit analysis for an AWPM in Mercer and Monmouth counties, New Jersey, as part of a controlled design with matched area...

  14. 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...

  15. Assessment of the routine, occupation-based gonorrhea and syphilis screening program in Moscow, Russia: an analysis of sexually transmitted infection prevalence and cost-effectiveness.

    Science.gov (United States)

    Kourbatova, Ekaterina V; Akovbyan, Vagan A; Chesson, Harrell W; Lytkina, Irina N; Dmitriev, Georgyi A; Tikhonova, Lilia I; Koubanova, Anna A; Petukhova, Irina I; Latypova, Munira F; Aboymova, Olga A; Lewis, Joel S; Ryan, Caroline A; Shakarishvili, Anna

    2008-05-01

    In the Russian Federation, large sectors of the population regularly undergo mandatory occupational screening for sexually transmitted infections (STIs). Objectives of our study were to determine the prevalence of syphilis and gonorrhea in the screened occupational groups in Moscow and to conduct a cost-effectiveness evaluation of the occupational screening program. Serum samples from 4 main occupational groups (food handlers and other food industry workers, market salespersons, education and health care providers, and hotel and other public utility workers) were tested for syphilis and gonorrhea. We conducted a cost-effectiveness analysis (in 2003 rubles) of the screening program using decision analysis models. In the total sample of 1000 study participants, overall prevalence for syphilis was 1.2% with the highest rate in market salespersons (4.4%) and for gonorrhea 0.3%. The incremental cost per case of STI treated was 8409 rubles ($252) for syphilis screening (compared with no screening) with higher incremental costs associated with expanding the program to include gonorrhea screening. The relatively low STI prevalence in the screened groups and the poor performance of the diagnostic tests used were important factors in the estimated cost-effectiveness of occupation-based screening. Modifications to occupation-based screening, including an increased focus on higher risk population and the adoption of more current diagnostic technologies, could help to use prevention resources more effectively.

  16. Impact of preparing for OSHA local emphasis program inspections of New York dairy farms: Case studies and financial cost analysis.

    Science.gov (United States)

    Gadomski, Anne M; Vargha, Marybeth; Tallman, Nancy; Scribani, Melissa B; Kelsey, Timothy W

    2016-03-01

    OSHA inspection of dairy farms began in July 1, 2014 in New York State. As of September 2014, a total of eight farms were randomly selected for inspection. This case study addresses how dairy farm managers prepared for these inspections, and identifies farm level costs preparing for inspection and/or being inspected. Four farms that were OSHA inspected and 12 farms that were not inspected were included in this mixed method evaluation using a multimodal (telephone, email, or mail) survey. Descriptive analysis was carried out using frequencies, proportions, means, and medians. Overall, the impact of OSHA inspections was positive, leading to improved safety management and physical changes on the farm and worker trainings, although the farmers' perspectives about OSHA inspection were mixed. The cost of compliance was low relative to estimated overall production costs. Clarifications and engineering solutions for specific dairy farm hazard exposures are needed to facilitate compliance with OSHA regulations. © 2015 Wiley Periodicals, Inc.

  17. PROBABILISTIC COST ANALYSIS OF LOGIC PROGRAMS ANÁLISIS DE COSTO PROBABILÍSTICO DE PROGRAMAS LÓGICOS

    Directory of Open Access Journals (Sweden)

    Héctor Juan Soza Pollman

    2009-08-01

    Full Text Available Cost analyses of logic programs have been developed which make it possible to obtain automatically lower and upper bounds of runtime cost of computations. This information is very useful for a variety of purposes, including granularity control, query optimization in databases, and program transformation and synthesis. However, current techniques suffer a loss of accuracy in some cases which are quite representative (i.e., some divide-and-conquer programs as QuickSort. This paper describes an alternative probabilistic approach which makes it possible to figure out an estimate of the execution cost. One of its advantages is that it needs only a few changes over previously proposed schemes.Se han desarrollado análisis de costos de programas lógicos para obtener automáticamente cotas superiores e inferiores del costo del tiempo de ejecución de dicho tipo de programas. Esta información es muy útil para una variedad de propósitos, incluyendo control de granularidad, optimización de consultas en bases de datos, y transformación de programas y síntesis. Sin embargo, las técnicas actuales carecen de exactitud en algunos casos que son bastante representativos (por ejemplo, algunos programas de dividir para reinar como Quicksort. Este artículo describe un enfoque probabilístico alternativo que hace posible obtener una estimación más precisa del costo de ejecución. Una de sus ventajas es que plantea sólo unos pocos cambios sobre los esquemas propuestos previamente.

  18. 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

  19. Cost-effectiveness analysis of introducing universal human papillomavirus vaccination of girls aged 11 years into the National Immunization Program in Brazil.

    Science.gov (United States)

    Novaes, Hillegonda Maria Dutilh; de Soárez, Patrícia Coelho; Silva, Gulnar Azevedo; Ayres, Andreia; Itria, Alexander; Rama, Cristina Helena; Sartori, Ana Marli Christovam; Clark, Andrew D; Resch, Stephen

    2015-05-07

    To evaluate the impact and cost-effectiveness of introducing universal human papillomavirus (HPV) vaccination into the National Immunization Program (NIP) in Brazil. The Excel-based CERVIVAC decision support model was used to compare two strategies: (1) status quo (with current screening program) and (2) vaccination of a cohort of 11-year-old girls. National parameters for the epidemiology and costs of cervical cancer were estimated in depth. The estimates were based on data from the health information systems of the public health system, the PNAD 2008 national household survey, and relevant scientific literature on Brazil. Costs are expressed in 2008 United States dollars (US$), and a 5% discount rate is applied to both future costs and future health benefits. Introducing the HPV vaccine would reduce the burden of disease. The model estimated there would be 229 deaths avoided and 6677 disability-adjusted life years (DALYs) averted in the vaccinated cohort. The incremental cost-effectiveness ratios (ICERs) per DALY averted from the perspectives of the government (US$ 7663), health system (US$ 7412), and society (US$ 7298) would be considered cost-effective, according to the parameters adopted by the World Health Organization. In the sensitivity analysis, the ICERs were most sensitive to variations in discount rate, disease burden, vaccine efficacy, and proportion of cervical cancer caused by types 16 and 18. However, universal HPV vaccination remained a cost-effective strategy in most variations of the key estimates. Vaccine introduction could contribute additional benefits in controlling cervical cancer, but it requires large investments by the NIP. Among the essential conditions for attaining the expected favorable results are immunization program sustainability, equity in a population perspective, improvement of the screening program, and development of a surveillance system. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. 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…

  1. Cost-benefit analysis for biological control programs that target insects pests of eucalypts in urban landscapes of California

    Science.gov (United States)

    T.D. Paine; J.G. Millar; L.M. Hanks; J. Gould; Q. Wang; K. Daane; D.L. Dahlsten; E.G. McPherson

    2015-01-01

    As well as being planted for wind breaks, landscape trees, and fuel wood, eucalypts are also widely used as urban street trees in California. They now are besieged by exotic insect herbivores of four different feeding guilds. The objective of the current analysis was to determine the return on investment from biological control programs that have targeted these pests....

  2. Break-even analysis of costs for controlling Toxoplasma gondii infections in slaughter pigs via a serological surveillance program in the Netherlands.

    Science.gov (United States)

    van Asseldonk, M; van Wagenberg, C P A; Wisselink, H J

    2017-03-01

    Toxoplasma gondii (T. gondii) is a food safety hazard which causes a substantial human disease burden and cost-of-illness. Infected pig meat is a common source of toxoplasmosis. A break-even analysis was conducted to estimate the point for which the intervention cost at fattening pig farms equaled the cost of averted human disease burden and cost-of-illness minus the costs of a T. gondii surveillance program. The surveillance program comprised serological testing of blood samples taken at slaughter. Break-even points were determined given alternative levels of the effectiveness of the intervention program (10% up to 90% in steps of 10%), the value of an averted DALY (20,000, 50,000 and 80,000 Euro), and threshold of sample prevalence for a farm to be under intervention (5% up to 50% out of 20 samples in steps of 5%). Since test characteristics are a determining factor in the break-even analysis, and literature is inconclusive concerning sensitivity (se) and specificity (sp) of the serological test kit used, two alternative sets of assumptions were analysed. The estimated maximum costs of an intervention if only benefits for domestic consumers were accounted amounted approximately 2981 Euro (se=98.9% and sp=92.7%) versus 4389 Euro (se=65.2% and sp=97.4%) per year per fattening pig farm under intervention assuming an effectiveness of 50%, 50,000 Euro per averted DALY and threshold T. gondii sample prevalence of 5% for a farm to be under intervention. Since almost 80% of the gross domestic production is exported corresponding break-even values increased up to 12,034 Euro and 18,366 Euro if benefits for consumers abroad were included as well. Empirical research to strengthen the knowledge about the efficacy of a farm intervention measures is recommended. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Cost Utility Analysis Applied to Library Budgeting.

    Science.gov (United States)

    Stitleman, Leonard

    Cost Utility Analysis (CUA) is, basically, an administrative tool to be used in situations where making a choice among meaningful programs is necessary. It does not replace the administrator, but can provide a significant source of data for the decision maker. CUA can be a guide to the selection of an optimal program in terms of available funds,…

  4. Strengthening cost-effectiveness analysis in Thailand through the establishment of the health intervention and technology assessment program.

    Science.gov (United States)

    Tantivess, Sripen; Teerawattananon, Yot; Mills, Anne

    2009-01-01

    Capacity is limited in the developing world to conduct cost-effectiveness analysis (CEA) of health interventions. In Thailand, there have been concerted efforts to promote evidence-based policy making, including the introduction of economic appraisals within health technology assessment (HTA). This paper reviews the experience of this lower middle-income country, with an emphasis on the creation of the Health Intervention and Technology Assessment Program (HITAP), including its mission, management structures and activities. Over the past 3 decades, several HTA programmes were implemented in Thailand but not sustained or developed further into a national institute. As a response to increasing demands for HTA evidence including CEA information, the HITAP was created in 2007 as an affiliate unit of a semi-autonomous research arm of the Ministry of Public Health. An advantage of this HTA programme over previous initiatives was that it was hosted by a research institute with long-term experience in conducting health systems and policy research and capacity building of its research staff, and excellent research and policy networks. To deal with existing impediments to conducting health economics research, the main strategies of the HITAP were carefully devised to include not only capacity strengthening of its researchers and administrative staff, but also the development of essential elements for the country's health economic evaluation methodology. These included, for example, methodological guidelines, standard protocols and benchmarks for resource allocation, many of which have been adopted by national policy-making bodies including the three major public health insurance plans. Networks and collaborations with domestic and foreign institutes have been sought as a means of resource mobilization and exchange. Although the HITAP is well financed by a number of government agencies and international organizations, the programme is vulnerable to shortages of qualified

  5. Cost-effectiveness analysis of the introduction of the pneumococcal conjugate vaccine (PCV-13) in the Egyptian national immunization program, 2013.

    Science.gov (United States)

    Sibak, Mohammed; Moussa, Ibrahim; El-Tantawy, Nasr; Badr, Shaza; Chaudhri, Irtaza; Allam, Essam; Baxter, Louise; Abo Freikha, Saiyed; Hoestlandt, Céline; Lara, Carlos; Hajjeh, Rana; Munier, Aline

    2015-05-07

    Pneumonia is one of the most important causes of morbidity and mortality in children under 5 in Egypt, and the Ministry of Health of Egypt is considering introducing pneumococcal conjugate vaccine (PCV) in its national immunization program. We performed an economic analysis to evaluate the cost-effectiveness of this vaccine in Egypt and to provide the decision-makers with needed evidence. The analysis was done using the TRIVAC model. Data included demographic characteristics, burden of disease, coverage and efficacy of the vaccine, health resource utilization, and costs of pneumococcal disease vaccination and treatment. Whenever possible, we used national or regional data. Two alternatives were compared: (1) general vaccination of children younger than 5 years with the 13-valent pneumococcal conjugate vaccine (PCV13), using a three-dose schedule without booster, and (2) no vaccination. Outcomes of 10 cohorts from birth to 5 years were analyzed. The study was performed from the governmental perspective and selected public health providers. In comparison to no vaccine, the introduction of PCV13 would be cost-effective, with an incremental cost-effectiveness ratio of US$ 3916 per disability-adjusted life-year (DALY) averted (government perspective). The total incremental cost of the PCV vaccination program (10 cohorts) would be approximately US$ 1.09 billion. Over the 10 cohorts, the program would avert 8583 pneumococcal deaths - 42% of all pneumococcal-related deaths. The introduction of PCV13 would be a good value for money from the government perspective. It would represent a high-impact public health intervention for Egypt and respond to the National Immunization Technical Advisory Group (NITAG) resolution on reducing pneumonia burden and overall child mortality. Strengthening surveillance will be critical to generating high-quality national data, improving future economic analyses that support evidence-based decisions for introducing vaccines and public health

  6. An introduction to cost analysis.

    Science.gov (United States)

    Camponovo, Ernest

    2015-04-01

    This article describes the basics of cost accounting for healthcare providers and how these concepts relate to decision making in medical practice. By understanding cost accounting and cost analysis, providers can be better prepared to compete and survive in a changing healthcare environment.

  7. Summit Station Skiway Cost Analysis

    Science.gov (United States)

    2016-07-01

    ER D C/ CR RE L TR -1 6- 9 Engineering for Polar Operations, Logistics , and Research (EPOLAR) Summit Station Skiway Cost Analysis Co ld...and Research (EPOLAR) ERDC/CRREL TR-16-9 July 2016 Summit Station Skiway Cost Analysis Terry D. Melendy Cold Regions Research and Engineering...snapshot at the current operating costs . We collected alternative skiway concepts, such as those at the NEEM camp, from the NEEM logistics and project

  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

    2016-01-01

    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

  9. 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.

  10. Analysis of Direct Costs

    OpenAIRE

    Terri W. Thomas

    2017-01-01

    DroTech and VectorCal are both operating in drone navigation system industry. Both DroTech and VectorCal are proficient organizations, equipped with adequate resources to enhance the value of services which are offered in relevance to drone technology, ranging from, leisure travel expeditions, construction zoning, and requirements for military applications. This paper discusses the main production costs which incur in production of VectorCal’s drone navigation system, the direct and indirect ...

  11. 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

  12. The cost-effectiveness of basiliximab induction in "old-to-old" kidney transplant programs: Bayesian estimation, simulation, and uncertainty analysis.

    Science.gov (United States)

    Emparan, C; Wolters, H; Laukötte, M; Senninger, N

    2005-06-01

    Markov models are employed in economic analyses to evaluate all possible expectations in a dilemna. The introduction of a new clinical protocol (Basiliximab induction with calcineurin-sparing protocols) for a group of kidney transplant recipients receiving organs from marginal donors was validated with a Markov simulation model, demonstrating the usefulness of combining simulation with Bayesian estimation methods for analysis of cost-effectiveness data collected alongside a clinical trial. We sought to determine whether calcineurin-sparing protocols using anti-interleukin-2/antibody induction (Simulect) would show a beneficial effect on initial kidney function and reduce transplantation costs upon admission, clinical incidences, graft function, and complications during the first month after transplant. A Markov Chain Monte Carlo (MCMC) was used to estimate a system of generalized linear models relating costs and outcomes to a kidney transplant process affected by treatment under alternative therapies. The Markov simulation model was established following three chains: a calcineurin-free regimen with Basiliximab induction (chain A); a calcineurin-sparing protocol with Basiliximab induction (chain B); and a conventional immunosuppressive regimen (chain C). The MCMC draws were used as parameters in simulations that yielded inferences about the relative cost-effectiveness of the novel therapy under a variety of scenarios. After designing the Markov chain and cohorts, 31 patients from the "old-to-old" program were assigned; eight to chain A; eight to chain B; and 15 to chain C. A year after transplantation a cost-benefit study was performed guided by the three branches of the Markov model. The Markov model showed a benefit of induction therapies in elderly patients. A cost-benefit model showed that after a year, there was a clear benefit from calcineurin-free plus Basiliximab induction therapies, with a slight benefit from calcineurin-sparing protocols. Markov models

  13. Analysis of Unit Costs in a University. The Fribourg Example. Program on Institutional Management in Higher Education.

    Science.gov (United States)

    Pasquier, Jacques; Sachse, Matthias

    Costing principles are applied to a university by estimating unit costs and their component factors for the university's different inputs, activities, and outputs. The information system used is designed for Fribourg University but could be applicable to other Swiss universities and could serve Switzerland's universities policy. In general, it…

  14. 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)

  15. 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.

  16. [Multidisciplinary outpatient care program vs. usual care : Cost-benefit analysis in patients with chronic low back pain].

    Science.gov (United States)

    Brömme, J; Mohokum, M; Disch, A C; Marnitz, U

    2015-04-01

    Chronic low back pain (CLBP) is a major health problem in industrialized nations and is associated with very high total costs. These costs are split between direct costs brought about by the utilization of health care services and indirect costs due to back pain-related loss of productivity. Despite the existence of some evidence about the effectiveness of a multidisciplinary outpatient care programmes in Germany, the economic benefit of these programmes has not yet been studied in detail. To provide an economic evaluation of the cost benefits of a multidisciplinary outpatient care programme for patients with chronic low back pain (CLBP) compared to those undergoing conventional care. An economic evaluation was performed in 514 patients who have been diagnosed with LBP. Two interventions will be compared: (1) a multidisciplinary outpatient care programme consisting of education, activity programmes, cognitive behavioural therapy, work hardening and functional restoration and (2) the usual noninvasive care provided by medical specialists and health care professionals. In all, 257 patients were involved in a 4 week multidisciplinary outpatient care programme, while the other 257 were subject to conventional care. The total costs per patient were estimated to be 10,584.14 (± 9,730.87) after 1 year in the group with the multidisciplinary care programme. The results show a significant reduction in the total amount of costs 3,161.63 (range 2,845.30-3,477.96) compared to the usual care group. However, the direct costs are minor (6-12%) compared to the indirect costs (80-93%). This study provides important information which is of value for decision-making and making an adequate allocation of medical resources for patients with CLBP. A multidisciplinary outpatient care programme can facilitate rapid return to work.

  17. Cost-benefit analysis on the use of telemedicine program of Kosova for continuous medical education: a sustainable and efficient model to rebuild medical systems in developing countries.

    Science.gov (United States)

    Latifi, Kalterina; Lecaj, Ismet; Bekteshi, Flamur; Dasho, Erion; Doarn, Charles R; Merrell, Ronald C; Latifi, Rifat

    2011-12-01

    The Ministry of Health of Kosova has recently announced the Telemedicine Program of Kosova (TMPK) as the official institution responsible for managing and coordinating the nation's Long-Distance Continuous Medical Education (CME) program. There are a lack of studies on cost-benefit analysis (CBA) and other economic evaluations of telemedicine programs (TMP), in particular the financial value of CME offered through such a service. In addition, there is lack of prospective studies on Monitoring & Evaluation (M&E) of TMP. The goal of this study was to conduct a retrospective CBA of prospective data collected at TMPK over a 5-year period (2005-2010) in order to determine the cost benefit as opposed to the alternative method of delivery of this model for developing countries whose healthcare systems are in disarray. We reviewed data on the number of participants in virtual lectures both at the Telemedicine Center of Kosova (TCK) as well as the number of participants at six Regional Telemedicine Centers throughout Kosova, the number of lectures broadcasted, the clinical cases reviewed and transmitted for international consultation, and other quantitative data. Only in 2009, approximately 2,000 CME certificates were awarded to physicians and nurses of Kosova, 18 international teleconsultations were conducted, 138 videoconferences, lectures, and seminars were held, and there were over 9,000 visitors at the TCK e-library. Data analysis shows that the TMPK has been an efficient mechanism for CME and sustainable model for rebuilding the medical system. TMPK has been successful in offering physicians, nurses, and other medical professions access to electronic information. TMP is an efficient mechanism to ensure CME and rebuilding medical systems in developing countries. There is a need for prospective CBA of any TMP and the establishment of M&E programs in any future telemedicine initiatives in developing countries.

  18. A cost-benefit analysis of a proposed overseas refugee latent tuberculosis infection screening and treatment program

    National Research Council Canada - National Science Library

    Wingate, La'Marcus T; Coleman, Margaret S; de la Motte Hurst, Christopher; Semple, Marie; Zhou, Weigong; Cetron, Martin S; Painter, John A

    2015-01-01

    ...) before entrance to the United States as a strategy for reducing active tuberculosis (TB). The purpose of this study was to estimate the costs and benefits of LTBI screening and treatment in United States bound refugees prior to arrival...

  19. Chemical exchange program analysis.

    Energy Technology Data Exchange (ETDEWEB)

    Waffelaert, Pascale

    2007-09-01

    As part of its EMS, Sandia performs an annual environmental aspects/impacts analysis. The purpose of this analysis is to identify the environmental aspects associated with Sandia's activities, products, and services and the potential environmental impacts associated with those aspects. Division and environmental programs established objectives and targets based on the environmental aspects associated with their operations. In 2007 the most significant aspect identified was Hazardous Materials (Use and Storage). The objective for Hazardous Materials (Use and Storage) was to improve chemical handling, storage, and on-site movement of hazardous materials. One of the targets supporting this objective was to develop an effective chemical exchange program, making a business case for it in FY07, and fully implementing a comprehensive chemical exchange program in FY08. A Chemical Exchange Program (CEP) team was formed to implement this target. The team consists of representatives from the Chemical Information System (CIS), Pollution Prevention (P2), the HWMF, Procurement and the Environmental Management System (EMS). The CEP Team performed benchmarking and conducted a life-cycle analysis of the current management of chemicals at SNL/NM and compared it to Chemical Exchange alternatives. Those alternatives are as follows: (1) Revive the 'Virtual' Chemical Exchange Program; (2) Re-implement a 'Physical' Chemical Exchange Program using a Chemical Information System; and (3) Transition to a Chemical Management Services System. The analysis and benchmarking study shows that the present management of chemicals at SNL/NM is significantly disjointed and a life-cycle or 'Cradle-to-Grave' approach to chemical management is needed. This approach must consider the purchasing and maintenance costs as well as the cost of ultimate disposal of the chemicals and materials. A chemical exchange is needed as a mechanism to re-apply chemicals on site. This

  20. 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...

  1. 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.

  2. Evaluation of a Stratified National Breast Screening Program in the United Kingdom : An Early Model-Based Cost-Effectiveness Analysis

    NARCIS (Netherlands)

    Gray, Ewan; Donten, Anna; Karssemeijer, Nico; van Gils, Carla|info:eu-repo/dai/nl/17443068X; Evans, D. Gareth R.; Astley, Sue; Payne, Katherine

    Objectives: To identify the incremental costs and consequences of stratified national breast screening programs (stratified NBSPs) and drivers of relative cost-effectiveness. Methods: A decision-analytic model (discrete event simulation) was conceptualized to represent four stratified NBSPs (risk 1,

  3. 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.

  4. Cost-Effectiveness Analysis in Markets with High Fixed Costs

    OpenAIRE

    David M. Cutler; Marzilli Ericson, Keith M.

    2010-01-01

    We consider how to conduct cost-effectiveness analysis when the social cost of a resource differs from the posted price. From the social perspective, the true cost of a medical intervention is the marginal cost of delivering another unit of a treatment, plus the social cost (deadweight loss) of raising the revenue to fund the treatment. We focus on pharmaceutical prices, which have high markups over marginal cost due to the monopoly power granted to pharmaceutical companies when drugs are und...

  5. Energy and cost savings analysis of Wood Burning Boiler Plant, Fort Stewart, Georgia: Final report, Validation of ECIP Project No. 193: DOD, Energy Conservation Investment Program (ECIP)

    Energy Technology Data Exchange (ETDEWEB)

    Broders, M.A.; Miller, D.R.

    1987-08-01

    An Energy Conservation Investment Program (ECIP) project to install a 94,900 lb steam per hour wood burning boiler in the Fort Stewart Central Energy Plant was selected by the US Army for validation by the Oak Ridge National Laboratory. This ECIP project was justified on the basis of fuel cost savings and the use of a renewable energy source: wood waste, which is abundantly available at Fort Stewart, Georgia. This report documents the results of a 1-year postretrofit study designed to validate the energy and cost savings attributed to the installation of the new wood burning boiler. During the postretrofit validation study period (FY 1986), the new wood burning boiler produced approximately 90% of the steam required by the Central Energy Plant to meet the seasonal heating and cooling demands of Fort Stewart. In doing so, over 2,880,000 gal of No. 5 fuel oil (a nonrenewable energy source) was conserved. With full consideration given to the increase in electrical energy required to operate the new Wood Burning Boiler Plant addition, an annual nonrenewable energy savings of over 400,000 MBtu is projected. Based on the results of a life cycle cost analysis performed on this ECIP project, a first-year savings of over $1,200,000 is estimated. The resultant discounted savings ratio is 3.36, and the estimated simple payback period is 6.7 years. It was concluded that installation and operation of a wood burning boiler at a military installation such as Fort Stewart can result in significant cost and nonrenewable energy savings.

  6. A critical cost benefit analysis of oilseed biodiesel in Canada : a BIOCAP research integration program synthesis paper

    Energy Technology Data Exchange (ETDEWEB)

    Reaney, M.J.T.; Hartley Furtan, W. [Saskatchewan Univ., Regina, SK (Canada); Loutas, P. [Northstar Engineering, Chico, CA (United States)

    2006-03-15

    This paper investigated resources in Canada with the potential for conversion to biodiesel and analyzed strategies for the development of a biodiesel economy in Saskatchewan. Costs and benefits of biodiesel production were investigated. Producer margins for growing biodiesel crops were examined. Grain transportation and storage methods for various feed materials were discussed, as well as oil extraction and refining strategies that influence non-oil co-products. Biodiesel production technologies were also evaluated, and various distribution methods were discussed. The study determined that the costs and benefits of a biodiesel economy would accrue to many different sectors and sub-sectors, including seed production; farming; agricultural chemicals; fertilizers; grain storage and transportation; biodiesel manufacture and distribution; and petroleum manufacture and distribution. Outlines of impacts on each sector were examined under various scenarios. Results of the study demonstrated that the quantity of low-priced canola that is available in a given year has a significant impact on the profitability of a biodiesel industry in Saskatchewan. 16 refs., 13 tabs., 2 figs.

  7. 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.

  8. Cost analysis of emergency department.

    Science.gov (United States)

    Cremonesi, P; Di Bella, E; Montefiori, M

    2010-12-01

    This paper is intended to examine both clinical and economic data concerning the activity of an emergency department of an Italian primary Hospital. Real data referring to arrivals, waiting times, service times, severity (according to triage classification) of patients' condition collected along the whole 2009 are matched up with the relevant accounting and economic information concerning the costs faced. A new methodological approach is implemented in order to identify a "standard production cost" and its variability. We believe that this kind of analysis well fits the federalizing process that Italy is experiencing. In fact the federal reform is driving our Country toward a decentralized provision and funding of local public services. The health care services are "fundamental" under the provisions of the law that in turn implies that a standard cost has to be defined for its funding. The standard cost (as it is defined by the law) relies on the concepts of appropriateness and efficiency in the production of the health care service, assuming a standard quality level as target. The identification and measurement of health care costs is therefore a crucial task propaedeutic to health services economic evaluation. Various guidelines with different amount of details have been set up for costing methods which, however, are defined in simplified frameworks and using fictious data. This study is a first attempt to proceed in the direction of a precise definition of the costs inherent to the emergency department activity.

  9. Extensive analysis of hydrogen costs

    Energy Technology Data Exchange (ETDEWEB)

    Guinea, D.M.; Martin, D.; Garcia-Alegre, M.C.; Guinea, D. [Consejo Superior de Investigaciones Cientificas, Arganda, Madrid (Spain). Inst. de Automatica Industrial; Agila, W.E. [Acciona Infraestructuras, Alcobendas, Madrid (Spain). Dept. I+D+i

    2010-07-01

    Cost is a key issue in the spreading of any technology. In this work, the cost of hydrogen is analyzed and determined, for hydrogen obtained by electrolysis. Different contributing partial costs are taken into account to calculate the hydrogen final cost, such as energy and electrolyzers taxes. Energy cost data is taken from official URLs, while electrolyzer costs are obtained from commercial companies. The analysis is accomplished under different hypothesis, and for different countries: Germany, France, Austria, Switzerland, Spain and the Canadian region of Ontario. Finally, the obtained costs are compared to those of the most used fossil fuels, both in the automotive industry (gasoline and diesel) and in the residential sector (butane, coal, town gas and wood), and the possibilities of hydrogen competing against fuels are discussed. According to this work, in the automotive industry, even neglecting subsidies, hydrogen can compete with fossil fuels. Hydrogen can also compete with gaseous domestic fuels. Electrolyzer prices were found to have the highest influence on hydrogen prices. (orig.)

  10. 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.

  11. Probabilistic Structural Analysis Program

    Science.gov (United States)

    Pai, Shantaram S.; Chamis, Christos C.; Murthy, Pappu L. N.; Stefko, George L.; Riha, David S.; Thacker, Ben H.; Nagpal, Vinod K.; Mital, Subodh K.

    2010-01-01

    NASA/NESSUS 6.2c is a general-purpose, probabilistic analysis program that computes probability of failure and probabilistic sensitivity measures of engineered systems. Because NASA/NESSUS uses highly computationally efficient and accurate analysis techniques, probabilistic solutions can be obtained even for extremely large and complex models. Once the probabilistic response is quantified, the results can be used to support risk-informed decisions regarding reliability for safety-critical and one-of-a-kind systems, as well as for maintaining a level of quality while reducing manufacturing costs for larger-quantity products. NASA/NESSUS has been successfully applied to a diverse range of problems in aerospace, gas turbine engines, biomechanics, pipelines, defense, weaponry, and infrastructure. This program combines state-of-the-art probabilistic algorithms with general-purpose structural analysis and lifting methods to compute the probabilistic response and reliability of engineered structures. Uncertainties in load, material properties, geometry, boundary conditions, and initial conditions can be simulated. The structural analysis methods include non-linear finite-element methods, heat-transfer analysis, polymer/ceramic matrix composite analysis, monolithic (conventional metallic) materials life-prediction methodologies, boundary element methods, and user-written subroutines. Several probabilistic algorithms are available such as the advanced mean value method and the adaptive importance sampling method. NASA/NESSUS 6.2c is structured in a modular format with 15 elements.

  12. Livestock Gross Margin Insurance for Dairy Cattle: An Analysis of Program Performance and Cost under Alternative Policy Configurations

    OpenAIRE

    Cabrera, Victor E.; Brian W. GOULD; Valvekar, Mayuri

    2009-01-01

    Livestock Gross Margin insurance for dairy cattle (LGM-Dairy) is a risk management tool that can be used to insure a lower bound on a dairy producer’s gross margin. In this paper we (1) review the basic structure of LGM-Dairy (2) examine the sensitivity of Gross Margin Guarantee (GMG) and premium to changes in feeding regimes and (3) quantify impacts of changes in deductible level on important program characteristics.

  13. 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.

  14. 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

  15. 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.

  16. A Cost-Benefit Analysis of the LAV Mobility and Obsolescence Program by Using U.S. Army Stryker Suspensions

    Science.gov (United States)

    2015-06-01

    9 1. Inspect Repair Only as Necessary Process ........................................9 2. Economic Analysis Tools...Manual GCE Ground Combat Element GDLS-C General Dynamics Land Systems-Canada HF High Frequency IROAN Inspect/Repair Only as Necessary LAR Light...the collective knowledge of each service in such a way that it benefits the warfighter down to the lowest level . Many thanks are also due to PM-LAV

  17. Prevalence and inheritance of and selection for elbow arthrosis in Bernese mountain dogs and Rottweilers in Sweden and benefit: cost analysis of a screening and control program.

    Science.gov (United States)

    Swenson, L; Audell, L; Hedhammar, A

    1997-01-15

    To determine the prevalence and charges over time in the prevalence of elbow arthrosis in Bernese Mountain Dogs and Rottweilers, to ascertain whether prevalence or severity of elbow arthrosis was associated with sex of the dogs, age at the time of elbow joint examination, or ancestral background, to determine the effects of selective breeding, and to conduct an economic evaluation of the elbow arthrosis program operated by the Swedish Kennel Club. Analysis of radiographic evaluations of elbow joint conformity. 4,515 dogs from 2 breeds registered by the Swedish Kennel Club. All radiographs were scrutinized by a single radiologist (LA), and elbow joint conformation was classified as normal or arthrotic, with the degree of arthrosis classified as 1, 2, or 3. Decreasing prevalence of elbow arthrosis corresponding to selection of breeding stock and high heritabilities was found. Sex differences were documented in both breeds, but with contradictory directions. This was interpreted as breed differences in the distribution of genes related to elbow arthrosis. Economic analyses showed that costs of screening and registration of elbow joints was less than the value of dogs estimated to have been saved from moderate and severe elbow arthrosis in both breeds. Documented effects of age suggest that all dogs should be screened at the same age, rather than screening a few dogs at an older, more revealing age. In screening and control programs based on an open registry with access to family records, decreasing prevalence of elbow arthrosis can be expected, and related to selection of breeding stock.

  18. Break-even analysis of costs for controlling Toxoplasma gondii infections in slaughter pigs via a serological surveillance program in the Netherlands

    NARCIS (Netherlands)

    Asseldonk, van M.; Wagenberg, van C.P.A.; Wisselink, H.J.

    2017-01-01

    Toxoplasma gondii (T. gondii) is a food safety hazard which causes a substantial human disease burden and cost-of-illness. Infected pig meat is a common source of toxoplasmosis. A break-even analysis was conducted to estimate the point for which the intervention cost at fattening pig farms

  19. Cost-Benefit Analysis of Employee Training: A Literature Review.

    Science.gov (United States)

    Blomberg, Robert

    1989-01-01

    The author reviews current literature related to cost-benefit analysis of employee training programs. After the necessary concepts are defined, methodologies for measuring costs and benefits, and problems related to this process are discussed. Concluding comments focus on the need for practical applications of cost-benefit research. (Author/CH)

  20. Low cost real time interactive analysis system

    Science.gov (United States)

    Stetina, F.

    1988-01-01

    Efforts continue to develop a low cost real time interactive analysis system for the reception of satellite data. A multi-purpose ingest hardware software frame formatter was demonstrated for GOES and TIROS data and work is proceeding on extending the capability to receive GMS data. A similar system was proposed as an archival and analysis system for use with INSAT data and studies are underway to modify the system to receive the planned SeaWiFS (ocean color) data. This system was proposed as the core of a number of international programs in support of U.S. AID activities. Systems delivered or nearing final testing are listed.

  1. Long- vs. short-term energy storage technologies analysis : a life-cycle cost study : a study for the DOE energy storage systems program.

    Energy Technology Data Exchange (ETDEWEB)

    Schoenung, Susan M.; Hassenzahl, William V. (, - Advanced Energy Analysis, Piedmont, CA)

    2003-08-01

    This report extends an earlier characterization of long-duration and short-duration energy storage technologies to include life-cycle cost analysis. Energy storage technologies were examined for three application categories--bulk energy storage, distributed generation, and power quality--with significant variations in discharge time and storage capacity. More than 20 different technologies were considered and figures of merit were investigated including capital cost, operation and maintenance, efficiency, parasitic losses, and replacement costs. Results are presented in terms of levelized annual cost, $/kW-yr. The cost of delivered energy, cents/kWh, is also presented for some cases. The major study variable was the duration of storage available for discharge.

  2. A cost constraint alone has adverse effects on food selection and nutrient density: an analysis of human diets by linear programming.

    Science.gov (United States)

    Darmon, Nicole; Ferguson, Elaine L; Briend, André

    2002-12-01

    Economic constraints may contribute to the unhealthy food choices observed among low socioeconomic groups in industrialized countries. The objective of the present study was to predict the food choices a rational individual would make to reduce his or her food budget, while retaining a diet as close as possible to the average population diet. Isoenergetic diets were modeled by linear programming. To ensure these diets were consistent with habitual food consumption patterns, departure from the average French diet was minimized and constraints that limited portion size and the amount of energy from food groups were introduced into the models. A cost constraint was introduced and progressively strengthened to assess the effect of cost on the selection of foods by the program. Strengthening the cost constraint reduced the proportion of energy contributed by fruits and vegetables, meat and dairy products and increased the proportion from cereals, sweets and added fats, a pattern similar to that observed among low socioeconomic groups. This decreased the nutritional quality of modeled diets, notably the lowest cost linear programming diets had lower vitamin C and beta-carotene densities than the mean French adult diet (i.e., diets and influence food selection in ways that reproduce the food intake patterns observed among low socioeconomic groups. They suggest that economic measures will be needed to effectively improve the nutritional quality of diets consumed by these populations.

  3. 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

  4. Instructional Cost Analysis: History and Present Inadequacies.

    Science.gov (United States)

    Humphrey, David A.

    The cost analysis of instruction is conducted according to principles of teaching and learning that have often become historically dated. Using today's costing systems prevents determination of whether cost effectiveness actually exists. The patterns of instruction in higher education and the systems employed for instructional cost analysis are…

  5. Análisis costo beneficio del Programa de Detección Oportuna del Cáncer Cervicouterino Cost benefit analysis of the Cervical Cancer Screening Program

    Directory of Open Access Journals (Sweden)

    PATRICIA HERNÁNDEZ-PEÑA

    1997-07-01

    Full Text Available Objetivo. Determinar el costo beneficio de la reorganización del Programa de Detección Oportuna del Cáncer Cervicouterino (PDOC mediante intervenciones de garantía de calidad. Material y métodos. Se siguieron tres etapas: a identificación y cuantificación de costos; b identificación y cuantificación de beneficios, y c evaluación económica del costo beneficio. Resultados. El costo unitario de operación por citología -obtención, fijación, el traslado al centro de lectura, su tinción e interpretación y la notificación de resultados- se estimó en USD$ 11.6. En conjunto, las intervenciones en calidad al PDOC elevarían el costo de cada citología en 32.7%. Sin embargo, la nueva organización generaría una razón beneficio/costo de 2 y un beneficio neto de 88 millones de dólares para los próximos cinco años. Conclusiones. La operación del programa propuesto resulta socialmente deseable, siempre y cuando las modificaciones se lleven a cabo, particularmente la capacitación, la notificación personalizada de los casos positivos, el incremento de cobertura, la introducción de mecanismos de control de calidad, el monitoreo contínuo y el tratamiento en mujeres con anormalidades detectadas.Objective. Previous researches pointed out the critical changes needed to increase the efficiency of the National Screening Programme of Cervical Cancer in Mexico. These changes were assessed through a cost-benefit analysis. This paper presents the results of that appraisal. Figures are presented as USDollars of 1996 valued as 7.5 pesos for each dollar. Results. The operational unitary cost of the integral process of the cytology –the obtention of the Pap smear, its transportation to the interpretation centre, its analysis, and the notification of results to users– was estimated in US$ 11.6. If the proposed changes are operated, the cost of each citology would increase by 32.7%. The benefit/cost ratio would be 2 and the net benefit of 88

  6. Space construction system analysis. Part 2: Cost and programmatics

    Science.gov (United States)

    Vonflue, F. W.; Cooper, W.

    1980-01-01

    Cost and programmatic elements of the space construction systems analysis study are discussed. The programmatic aspects of the ETVP program define a comprehensive plan for the development of a space platform, the construction system, and the space shuttle operations/logistics requirements. The cost analysis identified significant items of cost on ETVP development, ground, and flight segments, and detailed the items of space construction equipment and operations.

  7. Estimating Cost-effectiveness of a Multimodal Ovarian Cancer Screening Program in The United States: Secondary Analysis of the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS).

    Science.gov (United States)

    Moss, Haley A; Berchuck, Andrew; Neely, Megan L; Myers, Evan R; Havrilesky, Laura J

    2017-12-07

    The United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) is the largest randomized clinical trial to evaluate screening's impact on ovarian cancer mortality, assigning women to multimodal screening (MMS) with serum cancer antigen 125 (CA-125) interpreted using a risk algorithm. If the MMS screening method is eventually shown to reduce mortality and be cost-effective, then it may be accepted by the medical community as a feasible screening tool. To estimate the cost-effectiveness of an MMS screening program in the United States. A Markov simulation model was constructed using data from UKCTOCS to compare MMS with no screening in the United States. Screening would begin at the age of 50 years for women in the general population. Published estimates of the long-term effect of MMS screening on ovarian cancer mortality and the trial's published hazard ratios were used to simulate mortality estimates up to 40 years from start of screening. Base-case costs included CA-125, ultrasound, and false-positive work-up results, in addition to a risk algorithm cost estimate of $100. The utility and costs of ovarian cancer treatment were incorporated into the model. Screening strategies varied by costs of the algorithm and treatment for advanced ovarian cancer, rates of screening compliance, ovarian cancer incidence, and extrapolation of ovarian cancer mortality. Costs, quality-adjusted life-years (QALYs), and mortality reduction of ovarian cancer screening. Multimodal screening is both more expensive and more effective in reducing ovarian cancer mortality over a lifetime than no screening. After accounting for uncertainty in the underlying parameters, screening women starting at age 50 years with MMS is cost-effective 70% of the time, when decision makers are willing to pay $150 000 per QALY. Screening reduced mortality by 15%, with an incremental cost-effectiveness ratio (ICER) ranging from $106 187 (95% CI, $97 496-$127 793) to $155 256 (95% CI

  8. Cost-utility analysis of bilateral cochlear implantation in adults: a health economic assessment from the perspective of a publicly funded program.

    Science.gov (United States)

    Chen, Joseph M; Amoodi, Hossam; Mittmann, Nicole

    2014-06-01

    To determine the cost-effectiveness of bilateral cochlear implantation (CI) in deaf adults. Cost-utility analysis. Ninety patients and 52 health professionals served as proxies to estimate the benefit of bilateral cochlear implantation, utilizing the Health Utility Index. Three scenarios were created to reflect 1) deafness without intervention, 2) unilateral CI, and 3) bilateral CI. Cost evaluation reflected the burden on a publicly funded healthcare system. The base case included 25 years of service provision, processor upgrades every 5 years, 50% price reduction for second side, and 15% failure rate. Discounting and sensitivity analyses were applied. Costs were $63,632 (unilateral CI), $111,764 (bilateral CI), and $48,132 (incremental cost of second CI). The health preference gained from no intervention to unilateral CI, and to bilateral CI were 0.270 and 0.305. Incremental utility gained by the second implant was 11.5% of total. The incremental cost-utility ratio (ICUR) was $14,658/quality-adjusted life year (QALY) for bilateral CI compared to no intervention. It was stable regardless of discounting or sensitivity analyses. ICUR was $55,020/QALY from unilateral to bilateral CI with higher uncertainties. It improved with differential discounting, further second-side price reduction, and reduced frequency of processor upgrades. ICUR worsened with reduced length of use and higher failure rates. Sequential bilateral CI was cost-effective when compared to no intervention, although gains were made mostly by the first implant. Cost-effectiveness compared to unilateral implantation was borderline but improved through base case variations to reflect long-term gains or cost-saving measures. 2C. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

  9. SOLIDWORKS COSTING ANALYSYS ON A DESIGNED PART

    Directory of Open Access Journals (Sweden)

    Catalin IANCU

    2016-05-01

    Full Text Available In this paperwork are presented the SolidWorks analysis steps taken for costing study of a designed part, using Costing module. There are presented the settings that have to be done for such analysis and the results shown by this software module. The costing elements that are taken into account are specific to default costing templates in SolidWorks, but can be adjusted (edited to costs specific to a given enterprise.

  10. 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.

  11. Cost-utility analysis of a medication review with follow-up service for older adults with polypharmacy in community pharmacies in Spain: the conSIGUE program.

    Science.gov (United States)

    Jódar-Sánchez, Francisco; Malet-Larrea, Amaia; Martín, José J; García-Mochón, Leticia; López Del Amo, M Puerto; Martínez-Martínez, Fernando; Gastelurrutia-Garralda, Miguel A; García-Cárdenas, Victoria; Sabater-Hernández, Daniel; Sáez-Benito, Loreto; Benrimoj, Shalom I

    2015-06-01

    The concept of pharmaceutical care is operationalized through pharmaceutical professional services, which are patient-oriented to optimize their pharmacotherapy and to improve clinical outcomes. The objective of this study was to estimate the incremental cost-effectiveness ratio (ICER) of a medication review with follow-up (MRF) service for older adults with polypharmacy in Spanish community pharmacies against the alternative of having their medication dispensed normally. The study was designed as a cluster randomized controlled trial, and was carried out over a time horizon of 6 months. The target population was older adults with polypharmacy, defined as individuals taking five or more medicines per day. The study was conducted in 178 community pharmacies in Spain. Cost-utility analysis adopted a health service perspective. Costs were in euros at 2014 prices and the effectiveness of the intervention was estimated as quality-adjusted life-years (QALYs). In order to analyze the uncertainty of ICER results, we performed a non-parametric bootstrapping with 5000 replications. A total of 1403 older adults, aged between 65 and 94 years, were enrolled in the study: 688 in the intervention group (IG) and 715 in the control group (CG). By the end of the follow-up, both groups had reduced the mean number of prescribed medications they took, although this reduction was greater in the IG (0.28 ± 1.25 drugs; p cost was 977.57 ± 1455.88 for the IG and 1173.44 ± 3671.65 for the CG. In order to estimate the ICER, we used the costs adjusted for baseline medications and QALYs adjusted for baseline utility score, resulting in a mean incremental total cost of -250.51 ± 148.61 (95 % CI -541.79 to 40.76) and a mean incremental QALY of 0.0156 ± 0.004 (95 % CI 0.008-0.023). Regarding the results from the cost-utility analysis, the MRF service emerged as the dominant strategy. The MRF service is an effective intervention for optimizing prescribed medication and

  12. Cost-effectiveness analysis in markets with high fixed costs.

    Science.gov (United States)

    Cutler, David M; Ericson, Keith M Marzilli

    2010-01-01

    We consider how to conduct cost-effectiveness analysis when the social cost of a resource differs from the posted price. From the social perspective, the true cost of a medical intervention is the marginal cost of delivering another unit of a treatment, plus the social cost (deadweight loss) of raising the revenue to fund the treatment. We focus on pharmaceutical prices, which have high markups over marginal cost due to the monopoly power granted to pharmaceutical companies when drugs are under patent. We find that the social cost of a branded drug is approximately one-half the market price when the treatment is paid for by a public insurance plan and one-third the market price for mandated coverage by private insurance. We illustrate the importance of correctly accounting for social costs using two examples: coverage for statin drugs and approval for a drug to treat kidney cancer (sorafenib). In each case, we show that the correct social perspective for cost-effectiveness analysis would be more lenient than researcher recommendations.

  13. 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.

  14. 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.

  15. 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.…

  16. Improving The Discipline of Cost Estimation and Analysis

    Science.gov (United States)

    Piland, William M.; Pine, David J.; Wilson, Delano M.

    2000-01-01

    The need to improve the quality and accuracy of cost estimates of proposed new aerospace systems has been widely recognized. The industry has done the best job of maintaining related capability with improvements in estimation methods and giving appropriate priority to the hiring and training of qualified analysts. Some parts of Government, and National Aeronautics and Space Administration (NASA) in particular, continue to need major improvements in this area. Recently, NASA recognized that its cost estimation and analysis capabilities had eroded to the point that the ability to provide timely, reliable estimates was impacting the confidence in planning many program activities. As a result, this year the Agency established a lead role for cost estimation and analysis. The Independent Program Assessment Office located at the Langley Research Center was given this responsibility. This paper presents the plans for the newly established role. Described is how the Independent Program Assessment Office, working with all NASA Centers, NASA Headquarters, other Government agencies, and industry, is focused on creating cost estimation and analysis as a professional discipline that will be recognized equally with the technical disciplines needed to design new space and aeronautics activities. Investments in selected, new analysis tools, creating advanced training opportunities for analysts, and developing career paths for future analysts engaged in the discipline are all elements of the plan. Plans also include increasing the human resources available to conduct independent cost analysis of Agency programs during their formulation, to improve near-term capability to conduct economic cost-benefit assessments, to support NASA management's decision process, and to provide cost analysis results emphasizing "full-cost" and "full-life cycle" considerations. The Agency cost analysis improvement plan has been approved for implementation starting this calendar year. Adequate financial

  17. Life-Cycle Cost-Benefit Analysis

    DEFF Research Database (Denmark)

    Thoft-Christensen, Palle

    2010-01-01

    The future use of Life-Cycle Cost-Benefit (LCCB) analysis is discussed in this paper. A more complete analysis including not only the traditional factors and user costs, but also factors which are difficult to include in the analysis is needed in the future.......The future use of Life-Cycle Cost-Benefit (LCCB) analysis is discussed in this paper. A more complete analysis including not only the traditional factors and user costs, but also factors which are difficult to include in the analysis is needed in the future....

  18. Incorporating psychological influences in probabilistic cost analysis

    Energy Technology Data Exchange (ETDEWEB)

    Kujawski, Edouard; Alvaro, Mariana; Edwards, William

    2004-01-08

    Today's typical probabilistic cost analysis assumes an ''ideal'' project that is devoid of the human and organizational considerations that heavily influence the success and cost of real-world projects. In the real world ''Money Allocated Is Money Spent'' (MAIMS principle); cost underruns are rarely available to protect against cost overruns while task overruns are passed on to the total project cost. Realistic cost estimates therefore require a modified probabilistic cost analysis that simultaneously models the cost management strategy including budget allocation. Psychological influences such as overconfidence in assessing uncertainties and dependencies among cost elements and risks are other important considerations that are generally not addressed. It should then be no surprise that actual project costs often exceed the initial estimates and are delivered late and/or with a reduced scope. This paper presents a practical probabilistic cost analysis model that incorporates recent findings in human behavior and judgment under uncertainty, dependencies among cost elements, the MAIMS principle, and project management practices. Uncertain cost elements are elicited from experts using the direct fractile assessment method and fitted with three-parameter Weibull distributions. The full correlation matrix is specified in terms of two parameters that characterize correlations among cost elements in the same and in different subsystems. The analysis is readily implemented using standard Monte Carlo simulation tools such as {at}Risk and Crystal Ball{reg_sign}. The analysis of a representative design and engineering project substantiates that today's typical probabilistic cost analysis is likely to severely underestimate project cost for probability of success values of importance to contractors and procuring activities. The proposed approach provides a framework for developing a viable cost management strategy for

  19. 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.

  20. A cost-effectiveness analysis of using TheraBite in a preventive exercise program for patients with advanced head and neck cancer treated with concomitant chemo-radiotherapy.

    Science.gov (United States)

    Retèl, Valesca P; van der Molen, Lisette; Steuten, Lotte M G; van den Brekel, Michiel W; Hilgers, Frans J M

    2016-03-01

    Previous studies have shown that a "Preventive Exercise Program" (PREP) is cost-effective compared to the standard exercise program provided in "Usual Care" (UC) in patients with advanced head and neck cancer. The current paper specifically estimates the cost-effectiveness of the TheraBite jaw rehabilitation device (TB) which is used as part of the PREP, compared to Speech Language Pathology (SLP) sessions as part of UC, and herewith intents to inform reimbursement discussions regarding the TheraBite device. Costs and outcomes [quality-adjusted life-years (QALYs)] of the TB compared to SLP were estimated using a Markov model of advanced head and neck cancer patients. Secondary outcome variables were trismus, feeding substitutes, facial pain, and pneumonia. The incremental cost-effectiveness ratio (ICER) was estimated from a health care perspective of the Netherlands, with a time horizon of 2 years. The total health care costs per patient were estimated to amount to €5,129 for the TB strategy and €6,915 for the SLP strategy. Based on the current data, the TB strategy yielded more quality-adjusted life-years (1.28) compared to the SLP strategy (1.24). Thus, the TB strategy seems more effective (+0.04) and less costly (-€1,786) than the SLP only strategy. At the prevailing threshold of €20,000/QALY the probability for the TB strategy being cost-effective compared to SLP was 70 %. To conclude, analysis of presently available data indicates that TB is expected to be cost-effective compared to SLP in a preventive exercise program for concomitant chemo-radiotherapy for advanced head and neck cancer patients.

  1. 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

  2. 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...

  3. RECTIFIED ETHANOL PRODUCTION COST ANALYSIS

    Directory of Open Access Journals (Sweden)

    Nikola J Budimir

    2011-01-01

    Full Text Available This paper deals with the impact of the most important factors of the total production costs in bioethanol production. The most influential factors are: total investment costs, price of raw materials (price of biomass, enzymes, yeast, and energy costs. Taking into account these factors, a procedure for estimation total production costs was establish. In order to gain insight into the relationship of production and selling price of bioethanol, price of bioethanol for some countries of the European Union and the United States are given.

  4. The increased cost of ventral hernia recurrence: a cost analysis.

    Science.gov (United States)

    Davila, D G; Parikh, N; Frelich, M J; Goldblatt, M I

    2016-12-01

    Over 300,000 ventral hernia repairs (VHRs) are performed each year in the US. We sought to assess the economic burden related to ventral hernia recurrences with a focused comparison of those with the initial open versus laparoscopic surgery. The Premier Alliance database from 2009 to 2014 was utilized to obtain patient demographics and comorbid indices, including the Charlson comorbidity index (CCI). Total hospital cost and resource expenses during index laparoscopic and open VHRs and subsequent recurrent repairs were also obtained. The sample was separated into laparoscopic and open repair groups from the initial operation. Adjusted and propensity score matched cost outcome data were then compared amongst groups. One thousand and seventy-seven patients were used for the analysis with a recurrence rate of 3.78 %. For the combined sample, costs were significantly higher during recurrent hernia repair hospitalization ($21,726 versus $19,484, p cost and department level costs were similar during the index and the recurrent visit. The costs and resource utilization did not go up due to recurrence, even though these patients had greater severity during the recurrent visit (CCI score 0.92 versus 1.06; p = 0.0092). Using a matched sample, the total hospital recurrence cost was higher for the initial open group compared to laparoscopic group ($14,520 versus $12,649; p = 0.0454). Based on our analysis, need for recurrent VHR adds substantially to total hospital costs and resource utilization. Following initial laparoscopic repair, however, the total cost of recurrent repair is not significantly increased, as it is following initial open repair. When comparing the initial laparoscopic repair versus open, the cost of recurrence was higher for the prior open repair group.

  5. 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…

  6. Analysis of the performance and cost effectiveness of nine small wind energy conversion systems funded by the DOE small grants program

    Energy Technology Data Exchange (ETDEWEB)

    Kay, Joshua [Univ. of California, Berkeley, CA (United States)

    1982-04-01

    This report presents an analysis of the technical performance and cost effectiveness of nine small wind energy conversion systems (SWECS) funded during FY 1979 by the U.S. Department of Energy. Chapter 1 gives an analytic framework with which to evaluate the systems. Chapter 2 consists of a review of each of the nine projects, including project technical overviews, estimates of energy savings, and results of economic analysis. Chapter 3 summarizes technical, economic, and institutional barriers that are likely to inhibit widespread dissemination of SWECS technology.

  7. 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

  8. 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.

  9. Biodiesel Emissions Analysis Program

    Science.gov (United States)

    Using existing data, the EPA's biodiesel emissions analysis program sought to quantify the air pollution emission effects of biodiesel for diesel engines that have not been specifically modified to operate on biodiesel.

  10. Ethics and Cost-Benefit Analysis

    DEFF Research Database (Denmark)

    Arler, Finn

    The purpose of this research report is threefold. Firstly, the author traces the origins and justification of cost-benefit analysis in moral and political philosophy. Secondly, he explain some of the basic features of cost-benefit analysis as a planning tool in a step-bystep presentation. Thirdly......, he presents and discusses some of the main ethical difficulties related to the use of cost-benefit analysis as a planning tool....

  11. Cost-benefit considerations in regulatory analysis

    Energy Technology Data Exchange (ETDEWEB)

    Mubayi, V.; Sailor, V.; Anandalingam, G.

    1995-10-01

    Justification for safety enhancements at nuclear facilities, e.g., a compulsory backfit to nuclear power plants, requires a value-impact analysis of the increase in overall public protection versus the cost of implementation. It has been customary to assess the benefits in terms of radiation dose to the public averted by the introduction of the safety enhancement. Comparison of such benefits with the costs of the enhancement then requires an estimate of the monetary value of averted dose (dollars/person rem). This report reviews available information on a variety of factors that affect this valuation and assesses the continuing validity of the figure of $1000/person-rem averted, which has been widely used as a guideline in performing value-impact analyses. Factors that bear on this valuation include the health risks of radiation doses, especially the higher risk estimates of the BEIR V committee, recent calculations of doses and offsite costs by consequence codes for hypothesized severe accidents at U.S. nuclear power plants under the NUREG-1150 program, and recent information on the economic consequences of the Chernobyl accident in the Soviet Union and estimates of risk avoidance based on the willingness-to-pay criterion. The report analyzes these factors and presents results on the dollars/person-rem ratio arising from different assumptions on the values of these factors.

  12. 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...

  13. A Cost-Benefit Analysis of Prenatal Screening for Toxoplasmosis

    Directory of Open Access Journals (Sweden)

    Vic S Sahai

    1996-01-01

    Full Text Available The objective of this study was to examine critically the validity of a toxoplasma prenatal screening program, in the context of a cost-benefit analysis, as it relates to the Canadian experience. Recently, studies have suggested that early treatment of infected infants with a combination of pyrimethamine and sulfadiazine is effective in reducing the sequelae of toxoplasmosis. It was concluded that a carefully planned screening program for detecting and treating infants infected with Toxoplasma gondii during pregnancy is cost beneficial. The cost of delivering a screening and treatment program is less than half of what it would cost to provide comprehensive long term medical, educational and other social services for the estimated 1000 children born each year with congenital toxoplasmosis. Even if an incidence as low as two infected infants per 1000 pregnancies is assumed and only 400 children were affected, the screening and preventive therapy program would be justified.

  14. Program risk analysis handbook

    Science.gov (United States)

    Batson, R. G.

    1987-01-01

    NASA regulations specify that formal risk analysis be performed on a program at each of several milestones. Program risk analysis is discussed as a systems analysis approach, an iterative process (identification, assessment, management), and a collection of techniques. These techniques, which range from extremely simple to complex network-based simulation, are described in this handbook in order to provide both analyst and manager with a guide for selection of the most appropriate technique. All program risk assessment techniques are shown to be based on elicitation and encoding of subjective probability estimates from the various area experts on a program. Techniques to encode the five most common distribution types are given. Then, a total of twelve distinct approaches to risk assessment are given. Steps involved, good and bad points, time involved, and degree of computer support needed are listed. Why risk analysis should be used by all NASA program managers is discussed. Tools available at NASA-MSFC are identified, along with commercially available software. Bibliography (150 entries) and a program risk analysis check-list are provided.

  15. Reducing hospital expenditures with the COPE (Creating Opportunities for Parent Empowerment) program for parents and premature infants: an analysis of direct healthcare neonatal intensive care unit costs and savings.

    Science.gov (United States)

    Melnyk, Bernadette Mazurek; Feinstein, Nancy Fischbeck

    2009-01-01

    More than 500,000 premature infants are born in the United States every year. Preterm birth results in a multitude of negative adverse outcomes for children, including extended stays in the neonatal intensive care unit (NICU), developmental delays, physical and mental health/behavioral problems, increased medical utilization, and poor academic performance. In addition, parents of preterms experience a higher incidence of depression and anxiety disorders along with altered parent-infant interactions and overprotective parenting, which negatively impact their children. The costs associated with preterm birth are exorbitant. In 2005, it is estimated that preterm birth cost the United States $26.2 billion. The purpose of this study was to perform a cost analysis of the Creating Opportunities for Parent Empowerment (COPE) program for parents of premature infants, a manualized educational-behavioral intervention program comprising audiotaped information and an activity workbook that is administered to parents in 4 phases, the first phase commencing 2 to 4 days after admission to the NICU. Findings indicated that the COPE program resulted in cost savings of at least $4864 per infant. In addition to improving parent and child outcomes, routine implementation of COPE in NICUs across the United States could save the healthcare system more than $2 billion per year.

  16. Reducing Transaction Costs for Energy Efficiency Investments and Analysis of Economic Risk Associated With Building Performance Uncertainties: Small Buildings and Small Portfolios Program

    Energy Technology Data Exchange (ETDEWEB)

    Langner, R.; Hendron, B.; Bonnema, E.

    2014-08-01

    The small buildings and small portfolios (SBSP) sector face a number of barriers that inhibit SBSP owners from adopting energy efficiency solutions. This pilot project focused on overcoming two of the largest barriers to financing energy efficiency in small buildings: disproportionately high transaction costs and unknown or unacceptable risk. Solutions to these barriers can often be at odds, because inexpensive turnkey solutions are often not sufficiently tailored to the unique circumstances of each building, reducing confidence that the expected energy savings will be achieved. To address these barriers, NREL worked with two innovative, forward-thinking lead partners, Michigan Saves and Energi, to develop technical solutions that provide a quick and easy process to encourage energy efficiency investments while managing risk. The pilot project was broken into two stages: the first stage focused on reducing transaction costs, and the second stage focused on reducing performance risk. In the first stage, NREL worked with the non-profit organization, Michigan Saves, to analyze the effects of 8 energy efficiency measures (EEMs) on 81 different baseline small office building models in Holland, Michigan (climate zone 5A). The results of this analysis (totaling over 30,000 cases) are summarized in a simple spreadsheet tool that enables users to easily sort through the results and find appropriate small office EEM packages that meet a particular energy savings threshold and are likely to be cost-effective.

  17. Cost Effectiveness Analysis of Knee Osteoarthritis Treatment.

    Science.gov (United States)

    Stan, G; Orban, H; Orban, C

    2015-01-01

    Resource allocation is challenging in times of economic restraint and cannot be based only on clinical judgments, but must also take into account economic aspects. A method for assessing patient outcome is to estimate the quality-adjusted life years (QALYs). These will quantify the benefit gained by a certain treatment by measuring the change in health-related quality of life with time. This study will assess the cost effectiveness of conservative management, consisting in rehabilitation program, and compare the cost effectiveness of total knee arthroplasty when implanted to a non operated arthritic knee with cost effectiveness of the same procedure following high tibial osteotomy. This study reviewed 30 patients who were treated for knee osteoarthritis with rehabilitation care (group 1-G1), 30 patients who underwent unilateral TKA to an non-operated knee (group 2-G2) and 30 patients who underwent TKA following HTO for degenerative arthritis of the knee (group 3-G3). The economical endpoint were the total direct costs (Euro), based on DRG rates for procedures. The cost effectiveness analysis was assessed by the ratio between direct costs as assessed by the economical endpoint and the associated patient benefit as assessed by the clinical endpoint (EUR/QALY). No statistically significant differences was found between G2 and G3 regarding clinical or radiological outcomes of this study. Yet the patients who did not previously suffered a HTO procedure showed lower mean values of KSS, ROM and femurotibial angle. A significant benefit is observed for G2 and G3 towards G1 patients. Neither a clinically relevant nor a statistically significant association between groups is observed in G2 and G3 (median benefit estimates 2.5 versus 2.6 QALYs). Median benefit estimate for patients who did not previously suffered a HTO procedure was though smaller then benefit for those who did. A median cost effectiveness ratio of 1800 EUR/QALY (450 - 2000 EUR / QALY) was found based on the

  18. Cost-Causation and Integration Cost Analysis for Variable Generation

    Energy Technology Data Exchange (ETDEWEB)

    Milligan, M.; Ela, E.; Hodge, B. M.; Kirby, B.; Lew, D.; Clark, C.; DeCesaro, J.; Lynn, K.

    2011-06-01

    This report examines how wind and solar integration studies have evolved, what analysis techniques work, what common mistakes are still made, what improvements are likely to be made in the near future, and why calculating integration costs is such a difficult problem and should be undertaken carefully, if at all.

  19. 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.

  20. 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.

  1. 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...

  2. 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.

  3. Cost Analysis for Large Civil Transport Rotorcraft

    Science.gov (United States)

    Coy, John J.

    2006-01-01

    This paper presents cost analysis of purchase price and DOC+I (direct operating cost plus interest) that supports NASA s study of three advanced rotorcraft concepts that could enter commercial transport service within 10 to 15 years. The components of DOC+I are maintenance, flight crew, fuel, depreciation, insurance, and finance. The cost analysis aims at VTOL (vertical takeoff and landing) and CTOL (conventional takeoff and landing) aircraft suitable for regional transport service. The resulting spreadsheet-implemented cost models are semi-empirical and based on Department of Transportation and Army data from actual operations of such aircraft. This paper describes a rationale for selecting cost tech factors without which VTOL is more costly than CTOL by a factor of 10 for maintenance cost and a factor of two for purchase price. The three VTOL designs selected for cost comparisons meet the mission requirement to fly 1,200 nautical miles at 350 knots and 30,000 ft carrying 120 passengers. The lowest cost VTOL design is a large civil tilt rotor (LCTR) aircraft. With cost tech factors applied, the LCTR is reasonably competitive with the Boeing 737-700 when operated in economy regional service following the business model of the selected baseline operation, that of Southwest Airlines.

  4. 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

  5. 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

  6. 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.

  7. 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.

  8. Cost Savings and Patient Experiences of a Clinic-Based, Wide-Awake Hand Surgery Program at a Military Medical Center: A Critical Analysis of the First 100 Procedures.

    Science.gov (United States)

    Rhee, Peter C; Fischer, Michelle M; Rhee, Laura S; McMillan, Ha; Johnson, Anthony E

    2017-03-01

    Wide-awake, local anesthesia, no tourniquet (WALANT) hand surgery was developed to improve access to hand surgery care while optimizing medical resources. Hand surgery in the clinic setting may result in substantial cost savings for the United States Military Health Care System (MHS) and provide a safe alternative to performing similar procedures in the operating room. A prospective cohort study was performed on the first 100 consecutive clinic-based WALANT hand surgery procedures performed at a military medical center from January 2014 to September 2015 by a single hand surgeon. Cost savings analysis was performed by using the Medical Expense and Performance Reporting System, the standard cost accounting system for the MHS, to compare procedures performed in the clinic versus the operating room during the study period. A study specific questionnaire was obtained for 66 procedures to evaluate the patient's experience. For carpal tunnel release (n = 34) and A1 pulley release (n = 33), there were 85% and 70% cost savings by having the procedures performed in clinic under WALANT compared with the main operating room, respectively. During the study period, carpal tunnel release, A1 pulley release, and de Quervain release performed in the clinic instead of the operating room amounted to $393,100 in cost savings for the MHS. There were no adverse events during the WALANT procedure. A clinic-based WALANT hand surgery program at a military medical center results in considerable cost savings for the MHS. Economic/Decision Analysis IV. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  9. Green Infrastructure Siting and Cost Effectiveness Analysis

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — Parcel scale green infrastructure siting and cost effectiveness analysis. You can find more details at the project's website.

  10. 76 FR 64931 - Building Energy Codes Cost Analysis

    Science.gov (United States)

    2011-10-19

    ... of Energy Efficiency and Renewable Energy Building Energy Codes Cost Analysis AGENCY: Office of Energy Efficiency and Renewable Energy, Department of Energy. ACTION: Notice of reopening the public... Energy, Office of Energy Efficiency and Renewable Energy, Building Technologies Program, EE-2J, 1000...

  11. A Cost-Effectiveness Analysis of Early Literacy Interventions

    Science.gov (United States)

    Simon, Jessica

    2011-01-01

    Success in early literacy activities is associated with improved educational outcomes, including reduced dropout risk, in-grade retention, and special education referrals. When considering programs that will work for a particular school and context; cost-effectiveness analysis may provide useful information for decision makers. The study…

  12. Naval new ship construction cost analysis and trends

    OpenAIRE

    Holmgren, David J.

    2012-01-01

    Approved for public release; distribution is unlimited This thesis presents an analysis of the Ship Construction and Conversion, Navy, Appropriation cost estimates for the ship construction during the period 1960-1992. Emphasis is placed on four specific shipbuilding programs: Guided Missile Destroyer (DDG-51), Fleet Ballistic Submarine (Trident), Attack Submarine (SSN-688), and Guided Missile Cruiser (CG-47). These programs are analyzed to determine how competition/dual sourcing, contrac...

  13. 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

  14. Life-cycle cost analysis of advanced design mixer pump

    Energy Technology Data Exchange (ETDEWEB)

    Hall, M.N., Westinghouse Hanford

    1996-07-23

    This analysis provides cost justification for the Advanced Design Mixer Pump program based on the cost benefit to the Hanford Site of 4 mixer pump systems defined in terms of the life-cycle cost.A computer model is used to estimate the total number of service hours necessary for each mixer pump to operate over the 20-year retrieval sequence period for single-shell tank waste. This study also considered the double-shell tank waste retrieved prior to the single-shell tank waste which is considered the initial retrieval.

  15. 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

  16. 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.

  17. Cost analysis of robotic versus laparoscopic general surgery procedures.

    Science.gov (United States)

    Higgins, Rana M; Frelich, Matthew J; Bosler, Matthew E; Gould, Jon C

    2017-01-01

    Robotic surgical systems have been used at a rapidly increasing rate in general surgery. Many of these procedures have been performed laparoscopically for years. In a surgical encounter, a significant portion of the total costs is associated with consumable supplies. Our hospital system has invested in a software program that can track the costs of consumable surgical supplies. We sought to determine the differences in cost of consumables with elective laparoscopic and robotic procedures for our health care organization. De-identified procedural cost and equipment utilization data were collected from the Surgical Profitability Compass Procedure Cost Manager System (The Advisory Board Company, Washington, DC) for our health care system for laparoscopic and robotic cholecystectomy, fundoplication, and inguinal hernia between the years 2013 and 2015. Outcomes were length of stay, case duration, and supply cost. Statistical analysis was performed using a t-test for continuous variables, and statistical significance was defined as p surgery procedures for our health care system when cases commonly performed laparoscopically are instead performed robotically. Our analysis is limited by the fact that we only included costs associated with consumable surgical supplies. The initial acquisition cost (over $1 million for robotic surgical system), depreciation, and service contract for the robotic and laparoscopic systems were not included in this analysis.

  18. 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.

  19. 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.

  20. Cost analysis and estimating tools and techniques

    CERN Document Server

    Nussbaum, Daniel

    1990-01-01

    Changes in production processes reflect the technological advances permeat­ ing our products and services. U. S. industry is modernizing and automating. In parallel, direct labor is fading as the primary cost driver while engineering and technology related cost elements loom ever larger. Traditional, labor-based ap­ proaches to estimating costs are losing their relevance. Old methods require aug­ mentation with new estimating tools and techniques that capture the emerging environment. This volume represents one of many responses to this challenge by the cost analysis profession. The Institute of Cost Analysis (lCA) is dedicated to improving the effective­ ness of cost and price analysis and enhancing the professional competence of its members. We encourage and promote exchange of research findings and appli­ cations between the academic community and cost professionals in industry and government. The 1990 National Meeting in Los Angeles, jointly spo~sored by ICA and the National Estimating Society (NES),...

  1. Improving the Discipline of Cost Estimation and Analysis

    Science.gov (United States)

    Piland, William M.; Pine, David J.; Wilson, Delano M.

    2000-01-01

    The need to improve the quality and accuracy of cost estimates of proposed new aerospace systems has been widely recognized. The industry has done the best job of maintaining related capability with improvements in estimation methods and giving appropriate priority to the hiring and training of qualified analysts. Some parts of Government, and National Aeronautics and Space Administration (NASA) in particular, continue to need major improvements in this area. Recently, NASA recognized that its cost estimation and analysis capabilities had eroded to the point that the ability to provide timely, reliable estimates was impacting the confidence in planning man), program activities. As a result, this year the Agency established a lead role for cost estimation and analysis. The Independent Program Assessment Office located at the Langley Research Center was given this responsibility.

  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. 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

  4. 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...

  5. 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).

  6. A Cost Analysis of Kidney Replacement Therapy Options in Palestine

    Directory of Open Access Journals (Sweden)

    Mustafa Younis Ph.D.

    2015-03-01

    Full Text Available This study provides a cost analysis of kidney replacement therapy options in Palestine. It informs evidence-based resource allocation decisions for government-funded kidney disease services where transplant donors are limited, and some of the common modalities, i.e., peritoneal dialysis (PD and home hemodialysis (HD, are not widely available due to shortages of qualified staff, specialists, and centers to follow the patient cases, provide training, make home visits, or provide educational programs for patients. The average cost of kidney transplant was US$16 277 for the first year; the estimated cost of HD per patient averaged US$16 085 per year—nearly as much as a transplant. Consistent with prior literature and experience, while live, related kidney donors are scarce, we found that kidney transplant was more adequate and less expensive than HD. These results have direct resource allocation implications for government-funded kidney disease services under Palestinian Ministry of Health. Our findings strongly suggest that investing in sufficient qualified staff, equipment, and clinical infrastructure to replace HD services with transplantation whenever medically indicated and suitable kidney donors are available, as well as deploying PD programs and Home HD programs, will result in major overall cost savings. Our results provide a better understanding of the costs of kidney disease and will help to inform Ministry of Health and related policy makers as they develop short- and long-term strategies for the population, in terms of both cost savings and enhanced quality of life.

  7. Heliostat manufacturing cost analysis. Volume 1

    Energy Technology Data Exchange (ETDEWEB)

    Drumheller, K; Schulte, S C; Dilbeck, R A; Long, L W

    1979-10-01

    This study has two primary objectives. The first is to provide a detailed cost evaluation of the second generation of DOE heliostats, from which repowering heliostat designs are likely to be derived. A second objective is to provide an analytical foundation for the evaluation of futue heliostat designs. The approach taken for this study was to produce a cost estimate for the production of the McDonnell Douglas prototype design by generating estimates of the materials, labor, overhead, and facilities costs for two different production scenarios, 25,000 heliostats per year and 250,000 heliostats per year. The primary conclusion of this study is that the second generation of heliostat designs should cost approximately $100/m/sup 2/ at volumes of 25,000 units/year. This price falls to approximately $80/m/sup 2/ at volumes of 250,000 units/year. A second conclusion is that cost reduction begins at relatively low production volumes and that many production benefits can be obtained at production rates of 5,000 to 15,000 units/year. A third conclusion is that the SAMICS model and the SAMIS III program can be useful tools in heliostat manufacturing, costing, and economic studies.

  8. [Cost of a renal transplant: medico-economic analysis of the amount reimbursed by the French national health program to finance renal transplantation].

    Science.gov (United States)

    Sainsaulieu, Yoël; Sambuc, Cléa; Logerot, Hélène; Bongiovanni, Isabelle; Couchoud, Cécile

    2014-07-01

    Successful organ transplantation relies on several ancillary activities such as the identification of a compatible donor, organ allocation and procurement and the coordination of the transplant process. No existing study of the overall costs, in France, of these additional transplantation activities could be identified. This study determines the total additional costs of ancillary transplantation activities by comparing the costs of kidney transplantations with living donors against those using deceased donors. The data used are drawn from the 2013 public healthcare tariff calculations, PMSI recorded activity and transplant activity in 2012 as assessed and reported by the Agence de la biomédecine. The results show that, in 2012, additional transplant costs varied from 13835.44 € to 20050.67 € for a deceased donor and were 13601.66 € for a living donor. In conclusion, this study demonstrates that all the costs covered by National Health Insurance need to be taken into account in the economic impact evaluation of renal transplantation and during the development of this national priority activity. Copyright © 2014 Association Société de néphrologie. Published by Elsevier SAS. All rights reserved.

  9. SNAP - Program for Symbolic Analysis

    Directory of Open Access Journals (Sweden)

    Z. Kolka

    1999-04-01

    Full Text Available The paper deals with a program SNAP for symbolic analysis of linear circuits in frequency domain. The program is suitable for analysis of circuits with ideal network elements to explore basic principles of their operation. Besides graphical presentation the analysis results can be exported to popular mathematical programs for further processing. Currently, an algorithm for exact symbolic analysis is implemented. Therefore the program is suitable for relatively small circuits.

  10. 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...

  11. Utility green pricing programs: A statistical analysis of program effectiveness

    Energy Technology Data Exchange (ETDEWEB)

    Wiser, Ryan; Olson, Scott; Bird, Lori; Swezey, Blair

    2004-02-01

    Development of renewable energy. Such programs have grown in number in recent years. The design features and effectiveness of these programs varies considerably, however, leading a variety of stakeholders to suggest specific marketing and program design features that might improve customer response and renewable energy sales. This report analyzes actual utility green pricing program data to provide further insight into which program features might help maximize both customer participation in green pricing programs and the amount of renewable energy purchased by customers in those programs. Statistical analysis is performed on both the residential and non-residential customer segments. Data comes from information gathered through a questionnaire completed for 66 utility green pricing programs in early 2003. The questionnaire specifically gathered data on residential and non-residential participation, amount of renewable energy sold, program length, the type of renewable supply used, program price/cost premiums, types of consumer research and program evaluation performed, different sign-up options available, program marketing efforts, and ancillary benefits offered to participants.

  12. High efficiency lighting: Cost benefit analysis

    Energy Technology Data Exchange (ETDEWEB)

    Di Franco, N. (ENEA, Rome (Italy))

    1992-12-01

    Analysis of the incandescent and fluorescent lamp market in Italy reveals that, by the substitution of conventional equipment with high efficiency lamps, energy savings of up to 3.5 billion kWh could be realized. However, the proper selection of these highly efficient lamps, e.g., compact fluorescent, fluorescent systems using electronic reactors, outdoor systems using sodium or metal iodides, etc., requires a thorough and accurate cost benefit analysis. This article suggests a calculation model for a cost evaluation beginning from the technical and economic aspects of alternative appliances.

  13. 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.

  14. Making choices in health: WHO guide to cost effectiveness analysis

    National Research Council Canada - National Science Library

    Tan Torres Edejer, Tessa

    2003-01-01

    ... . . . . . . . . . . . . . . . . . . . . . . . XXI PART ONE: METHODS COST-EFFECTIVENESS FOR GENERALIZED ANALYSIS 1. 2. What is Generalized Cost-Effectiveness Analysis? . . . . . . . . . . . . 3 Undertaking...

  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. 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

  17. 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...

  18. 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

  19. Life Cycle Cost Analysis Handbook. First Edition.

    Science.gov (United States)

    Alaska State Dept. of Education and Early Development, Juneau.

    This handbook presents guidelines on the Life Cycle Cost Analysis (LCCA) of building operations over the life of a building to assist school districts and consultants with evaluating proposed educational facility construction projects. It defines the terminology found in an LCCA, such as initial and future expenses, residual value, real discount…

  20. Costs Analysis of Iron Casts Manufacturing

    Directory of Open Access Journals (Sweden)

    S. Kukla

    2012-04-01

    Full Text Available The article presents the issues of costs analysis of iron casts manufacturing using automated foundry lines. Particular attention was paid to departmental costs, conversion costs and costs of in-plant transport. After the Pareto analysis had been carried out, it was possible to set the model area of the process and focus on improving activities related to finishing of a chosen group of casts. In order to eliminate losses, the activities realised in this domain were divided into activities with added value, activities with partially added value and activities without added value. To streamline the production flow, it was proposed to change the location of workstations related to grinding, control and machining of casts. Within the process of constant improvement of manufacturing processes, the aspect of work ergonomics at a workstation was taken into account. As a result of the undertaken actions, some activities without added value were eliminated, efficiency was increased and prime costs of manufacturing casts with regard to finishing treatment were lowered.

  1. Benefit-cost analysis of addiction treatment: methodological guidelines and empirical application using the DATCAP and ASI

    National Research Council Canada - National Science Library

    French, Michael T; Salomé, Helena J; Sindelar, Jody L; McLellan, A Thomas

    2002-01-01

    ...) and Addiction Severity Index (ASI) in a benefit-cost analysis of addiction treatment. A representative benefit-cost analysis of three outpatient programs was conducted to demonstrate the feasibility and value of the methodological guidelines...

  2. 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.

  3. Nonlinear programming analysis and methods

    CERN Document Server

    Avriel, Mordecai

    2012-01-01

    This text provides an excellent bridge between principal theories and concepts and their practical implementation. Topics include convex programming, duality, generalized convexity, analysis of selected nonlinear programs, techniques for numerical solutions, and unconstrained optimization methods.

  4. Making choices in health: WHO guide to cost effectiveness analysis

    National Research Council Canada - National Science Library

    Tan Torres Edejer, Tessa

    2003-01-01

    ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 6. Uncertainty in cost-effectiveness analysis . . . . . . . . . . . . . . . . . . 73 7. 8. Policy uses of Generalized CEA...

  5. 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.

  6. Final Report: Hydrogen Storage System Cost Analysis

    Energy Technology Data Exchange (ETDEWEB)

    James, Brian David [Strategic Analysis Inc., Arlington, VA (United States); Houchins, Cassidy [Strategic Analysis Inc., Arlington, VA (United States); Huya-Kouadio, Jennie Moton [Strategic Analysis Inc., Arlington, VA (United States); DeSantis, Daniel A. [Strategic Analysis Inc., Arlington, VA (United States)

    2016-09-30

    The Fuel Cell Technologies Office (FCTO) has identified hydrogen storage as a key enabling technology for advancing hydrogen and fuel cell power technologies in transportation, stationary, and portable applications. Consequently, FCTO has established targets to chart the progress of developing and demonstrating viable hydrogen storage technologies for transportation and stationary applications. This cost assessment project supports the overall FCTO goals by identifying the current technology system components, performance levels, and manufacturing/assembly techniques most likely to lead to the lowest system storage cost. Furthermore, the project forecasts the cost of these systems at a variety of annual manufacturing rates to allow comparison to the overall 2017 and “Ultimate” DOE cost targets. The cost breakdown of the system components and manufacturing steps can then be used to guide future research and development (R&D) decisions. The project was led by Strategic Analysis Inc. (SA) and aided by Rajesh Ahluwalia and Thanh Hua from Argonne National Laboratory (ANL) and Lin Simpson at the National Renewable Energy Laboratory (NREL). Since SA coordinated the project activities of all three organizations, this report includes a technical description of all project activity. This report represents a summary of contract activities and findings under SA’s five year contract to the US Department of Energy (Award No. DE-EE0005253) and constitutes the “Final Scientific Report” deliverable. Project publications and presentations are listed in the Appendix.

  7. (Correcting misdiagnoses of asthma: a cost effectiveness analysis

    Directory of Open Access Journals (Sweden)

    Vandemheen Katherine

    2011-05-01

    Full Text Available Abstract Background The prevalence of physician-diagnosed-asthma has risen over the past three decades and misdiagnosis of asthma is potentially common. Objective: to determine whether a secondary-screening-program to establish a correct diagnosis of asthma in those who report a physician diagnosis of asthma is cost effective. Method Randomly selected physician-diagnosed-asthmatic subjects from 8 Canadian cities were studied with an extensive diagnostic algorithm to rule-in, or rule-out, a correct diagnosis of asthma. Subjects in whom the diagnosis of asthma was excluded were followed up for 6-months and data on asthma medications and heath care utilization was obtained. Economic analysis was performed to estimate the incremental lifetime costs associated with secondary screening of previously diagnosed asthmatic subjects. Analysis was from the perspective of the Canadian healthcare system and is reported in Canadian dollars. Results Of 540 randomly selected patients with physician diagnosed asthma 150 (28%; 95%CI 19-37% did not have asthma when objectively studied. 71% of these misdiagnosed patients were on some asthma medications. Incorporating the incremental cost of secondary-screening for the diagnosis of asthma, we found that the average cost savings per 100 individuals screened was $35,141 (95%CI $4,588-$69,278. Conclusion Cost savings primarily resulted from lifetime costs of medication use averted in those who had been misdiagnosed.

  8. Army Initial Acquisition Training: An Analysis of Costs and Benefits

    Science.gov (United States)

    2015-12-01

    civilian university and the vast differences in Graduate Management Admission Test ( GMAT ) scores, total program cost, total credit hours, and cost per...on location Average GMAT Score Program Tuition in State Total Credit Hours Total Cost In State Total Cost Per Credit Hour Cost Per Credit...common qualitative measure of student aptitude. The GMAT 38 is the most readily available measure most business schools use as a qualitative predictor

  9. 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)

  10. 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.

  11. Using Cost-Effectiveness Analysis to Address Health Equity Concerns.

    Science.gov (United States)

    Cookson, Richard; Mirelman, Andrew J; Griffin, Susan; Asaria, Miqdad; Dawkins, Bryony; Norheim, Ole Frithjof; Verguet, Stéphane; J Culyer, Anthony

    2017-02-01

    This articles serves as a guide to using cost-effectiveness analysis (CEA) to address health equity concerns. We first introduce the "equity impact plane," a tool for considering trade-offs between improving total health-the objective underpinning conventional CEA-and equity objectives, such as reducing social inequality in health or prioritizing the severely ill. Improving total health may clash with reducing social inequality in health, for example, when effective delivery of services to disadvantaged communities requires additional costs. Who gains and who loses from a cost-increasing health program depends on differences among people in terms of health risks, uptake, quality, adherence, capacity to benefit, and-crucially-who bears the opportunity costs of diverting scarce resources from other uses. We describe two main ways of using CEA to address health equity concerns: 1) equity impact analysis, which quantifies the distribution of costs and effects by equity-relevant variables, such as socioeconomic status, location, ethnicity, sex, and severity of illness; and 2) equity trade-off analysis, which quantifies trade-offs between improving total health and other equity objectives. One way to analyze equity trade-offs is to count the cost of fairer but less cost-effective options in terms of health forgone. Another method is to explore how much concern for equity is required to choose fairer but less cost-effective options using equity weights or parameters. We hope this article will help the health technology assessment community navigate the practical options now available for conducting equity-informative CEA that gives policymakers a better understanding of equity impacts and trade-offs. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  12. A Comparative Cost and Utility Analysis of Three Models of Service Delivery for Special Needs Students.

    Science.gov (United States)

    Pruslow, John T.

    2001-01-01

    Discusses available data on special-education costs, reviews New York State's initiative to document educational outcomes for special-needs students, and summarizes three service-delivery models. A cost-analysis of one district's program shows a model's cost is related to the identified number of special-needs students and their needs. (Contains…

  13. Cost-Effectiveness Analysis in Practice: Interventions to Improve High School Completion

    Science.gov (United States)

    Hollands, Fiona; Bowden, A. Brooks; Belfield, Clive; Levin, Henry M.; Cheng, Henan; Shand, Robert; Pan, Yilin; Hanisch-Cerda, Barbara

    2014-01-01

    In this article, we perform cost-effectiveness analysis on interventions that improve the rate of high school completion. Using the What Works Clearinghouse to select effective interventions, we calculate cost-effectiveness ratios for five youth interventions. We document wide variation in cost-effectiveness ratios between programs and between…

  14. Planetary Protection Bioburden Analysis Program

    Science.gov (United States)

    Beaudet, Robert A.

    2013-01-01

    is programmed in Visual Basic for Applications for installation as a simple add-in for Microsoft Excel. The user is directed to a graphical user interface (GUI) that requires user inputs and provides solutions directly in Microsoft Excel workbooks. This work was done by Shannon Ryan of the USRA Lunar and Planetary Institute for Johnson Space Center. Further information is contained in a TSP (see page 1). MSC- 24582-1 Micrometeoroid and Orbital Debris (MMOD) Shield Ballistic Limit Analysis Program Lyndon B. Johnson Space Center, Houston, Texas Commercially, because it is so generic, Enigma can be used for almost any project that requires engineering visualization, model building, or animation. Models in Enigma can be exported to many other formats for use in other applications as well. Educationally, Enigma is being used to allow university students to visualize robotic algorithms in a simulation mode before using them with actual hardware. This work was done by David Shores and Sharon P. Goza of Johnson Space Center; Cheyenne McKeegan, Rick Easley, Janet Way, and Shonn Everett of MEI Technologies; Mark Manning of PTI; and Mark Guerra, Ray Kraesig, and William Leu of Tietronix Software, Inc. For further information, contact the JSC Innovation Partnerships Office at (281) 483-3809. MSC-24211-1 Spitzer Telemetry Processing System NASA's Jet Propulsion Laboratory, Pasadena, California The Spitzer Telemetry Processing System (SirtfTlmProc) was designed to address objectives of JPL's Multi-mission Image Processing Lab (MIPL) in processing spacecraft telemetry and distributing the resulting data to the science community. To minimize costs and maximize operability, the software design focused on automated error recovery, performance, and information management. The system processes telemetry from the Spitzer spacecraft and delivers Level 0 products to the Spitzer Science Center. SirtfTlmProc is a unique system with automated error notification and recovery, with a real

  15. [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

  16. Analysis of the Costs of a Backlog Project in Response to Recommendation 2 of the 2004 Archives and History Office Program Review Committee Report

    Energy Technology Data Exchange (ETDEWEB)

    O' Hara, Laura; /SLAC

    2007-12-21

    SLAC Archives and History Office (AHO) backlog of unprocessed material is over 3,000 cubic feet and growing. Because much of this material was directly transferred to off-site storage, the provenance and contents are a mystery. The costs of off-site storage, lack of knowledge of the contents, and the impending federal regulations in 2009 concerning storage facilities all suggest the need for a long-term plan for the backlog. AHO presents these options to SLAC management: (1) Continue with the status quo, adding new accessions to OffSite Records Management, LLC (hereinafter referred to as OffSite) storage; (2) Pull the backlog back a segment at a time for box-level processing, determine what is in each box, get rid of extraneous material, and return what is left to OffSite storage; (3) Gradually retrieve the backlog for thorough, folder-level processing and then transfer to the Federal Records Center in San Bruno (hereinafter referred to as FRC) or the Archives side of the operations at the National Archives and Records Administration in San Bruno (hereinafter referred to as NARA); and (4) Gradually retrieve the backlog for a combination of box-level processing with return to OffSite storage and thorough folder-level processing with transfer to FRC or NARA.

  17. Food Irradiation Update and Cost Analysis

    Science.gov (United States)

    1991-11-01

    spices in the United States. In Japan, 10,000 tons of potatoes are irradiated each year to prevent sprouting (chemical treatments to inhibit potato... irradiation can extend the shelf life of refrigerated products, which reduces losses due to spoilage. It can also greatly reduce the pathogens in foods...AD-A273 506 ýil il lit i i1 ii , TECHNICAL REPORT AD NATICK /TR-92 / 002 FOOD IRRADIATION UPDATE-,. .•0 , AND COST ANALYSIS f. .• By Robert T

  18. Analysis of nuclear power plant construction costs

    Energy Technology Data Exchange (ETDEWEB)

    1986-01-01

    The objective of this report is to present the results of a statistical analysis of nuclear power plant construction costs and lead-times (where lead-time is defined as the duration of the construction period), using a sample of units that entered construction during the 1966-1977 period. For more than a decade, analysts have been attempting to understand the reasons for the divergence between predicted and actual construction costs and lead-times. More importantly, it is rapidly being recognized that the future of the nuclear power industry rests precariously on an improvement in the cost and lead-time situation. Thus, it is important to study the historical information on completed plants, not only to understand what has occurred to also to improve the ability to evaluate the economics of future plants. This requires an examination of the factors that have affected both the realized costs and lead-times and the expectations about these factors that have been formed during the construction process. 5 figs., 22 tabs.

  19. 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.

  20. A cost analysis of kidney replacement therapy options in Palestine.

    Science.gov (United States)

    Younis, Mustafa; Jabr, Samer; Al-Khatib, Abdallah; Forgione, Dana; Hartmann, Michael; Kisa, Adnan

    2015-01-01

    This study provides a cost analysis of kidney replacement therapy options in Palestine. It informs evidence-based resource allocation decisions for government-funded kidney disease services where transplant donors are limited, and some of the common modalities, i.e., peritoneal dialysis (PD) and home hemodialysis (HD), are not widely available due to shortages of qualified staff, specialists, and centers to follow the patient cases, provide training, make home visits, or provide educational programs for patients. The average cost of kidney transplant was US$16,277 for the first year; the estimated cost of HD per patient averaged US$16,085 per year--nearly as much as a transplant. Consistent with prior literature and experience, while live, related kidney donors are scarce, we found that kidney transplant was more adequate and less expensive than HD. These results have direct resource allocation implications for government-funded kidney disease services under Palestinian Ministry of Health. Our findings strongly suggest that investing in sufficient qualified staff, equipment, and clinical infrastructure to replace HD services with transplantation whenever medically indicated and suitable kidney donors are available, as well as deploying PD programs and Home HD programs, will result in major overall cost savings. Our results provide a better understanding of the costs of kidney disease and will help to inform Ministry of Health and related policy makers as they develop short- and long-term strategies for the population, in terms of both cost savings and enhanced quality of life. © The Author(s) 2015.

  1. Terrorism risks and cost-benefit analysis of aviation security.

    Science.gov (United States)

    Stewart, Mark G; Mueller, John

    2013-05-01

    We evaluate, for the U.S. case, the costs and benefits of three security measures designed to reduce the likelihood of a direct replication of the 9/11 terrorist attacks. To do so, we assess risk reduction, losses, and security costs in the context of the full set of security layers. The three measures evaluated are installed physical secondary barriers (IPSB) to restrict access to the hardened cockpit door during door transitions, the Federal Air Marshal Service (FAMS), and the Federal Flight Deck Officer (FFDO) Program. In the process, we examine an alternate policy measure: doubling the budget of the FFDO program to $44 million per year, installing IPSBs in all U.S. aircraft at a cost of $13.5 million per year, and reducing funding for FAMS by 75% to $300 million per year. A break-even cost-benefit analysis then finds the minimum probability of an otherwise successful attack required for the benefit of each security measures to equal its cost. We find that the IPSB is costeffective if the annual attack probability of an otherwise successful attack exceeds 0.5% or one attack every 200 years. The FFDO program is costeffective if the annual attack probability exceeds 2%. On the other hand, more than two otherwise successful attacks per year are required for FAMS to be costeffective. A policy that includes IPSBs, an increased budget for FFDOs, and a reduced budget for FAMS may be a viable policy alternative, potentially saving hundreds of millions of dollars per year with consequences for security that are, at most, negligible. © 2012 Society for Risk Analysis.

  2. SSL Pricing and Efficacy Trend Analysis for Utility Program Planning

    Energy Technology Data Exchange (ETDEWEB)

    Tuenge, J. R. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2013-10-01

    Report to help utilities and energy efficiency organizations forecast the order in which important SSL applications will become cost-effective and estimate when each "tipping point" will be reached. Includes performance trend analysis from DOE's LED Lighting Facts® and CALiPER programs plus cost analysis from various sources.

  3. 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.

  4. Nuclear Power Plant Module, NPP-1: Nuclear Power Cost Analysis.

    Science.gov (United States)

    Whitelaw, Robert L.

    The purpose of the Nuclear Power Plant Modules, NPP-1, is to determine the total cost of electricity from a nuclear power plant in terms of all the components contributing to cost. The plan of analysis is in five parts: (1) general formulation of the cost equation; (2) capital cost and fixed charges thereon; (3) operational cost for labor,…

  5. 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.

  6. Japanese Cost Accounting Systems - analysis of the cost accounting systems of the Japanese cost accounting standard

    OpenAIRE

    Peter, Winter

    2005-01-01

    This paper aims at providing an insight into Japanese cost accounting. Firstly, the development of cost accounting in Japan is delineated. Subsequently, the cost accounting systems codified in the Japanese cost accounting standard are analysed based on the classification according to Hoitsch/Schmitz. Lastly, a critical appraisal of the cost accounting systems of the Japanese cost accounting standard as well as a comparison to German and American cost accounting systems are conducted.

  7. 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...

  8. Cost-benefit analysis of screening for esophageal and gastric cardiac cancer.

    Science.gov (United States)

    Wei, Wen-Qiang; Yang, Chun-Xia; Lu, Si-Han; Yang, Juan; Li, Bian-Yun; Lian, Shi-Yong; Qiao, You-Lin

    2011-03-01

    In 2005, a program named "Early Detection and Early Treatment of Esophageal and Cardiac Cancer" (EDETEC) was initiated in China. A total of 8279 residents aged 40-69 years old were recruited into the EDETEC program in Linzhou of Henan Province between 2005 and 2008. Howerer, the cost-benefit of the EDETEC program is not very clear yet. We conducted herein a cost-benefit analysis of screening for esophageal and cardiac cancer. The assessed costs of the EDETEC program included screening costs for each subject, as well as direct and indirect treatment costs for esophageal and cardiac severe dysplasia and cancer detected by screening. The assessed benefits of this program included the saved treatment costs, both direct and indirect, on esophageal and cardiac cancer, as well as the value of prolonged life due to screening, as determined by the human capital approach. The results showed the screening cost of finding esophageal and cardiac severe dysplasia or cancer ranged from RMB 2707 to RMB 4512, and the total cost on screening and treatment was RMB 13 115-14 920. The cost benefit was RMB 58 944-155 110 (the saved treatment cost, RMB 17 730, plus the value of prolonged life, RMB 41 214-137 380). The ratio of benefit-to-cost (BCR) was 3.95-11.83. Our results suggest that EDETEC has a high benefit-to-cost ratio in China and could be instituted into high risk areas of China.

  9. Hybrid energy system cost analysis: San Nicolas Island, California

    Energy Technology Data Exchange (ETDEWEB)

    Olsen, T.L.; McKenna, E.

    1996-07-01

    This report analyzes the local wind resource and evaluates the costs and benefits of supplementing the current diesel-powered energy system on San Nicolas Island, California (SNI), with wind turbines. In Section 2.0 the SNI site, naval operations, and current energy system are described, as are the data collection and analysis procedures. Section 3.0 summarizes the wind resource data and analyses that were presented in NREL/TP 442-20231. Sections 4.0 and 5.0 present the conceptual design and cost analysis of a hybrid wind and diesel energy system on SNI, with conclusions following in Section 6. Appendix A presents summary pages of the hybrid system spreadsheet model, and Appendix B contains input and output files for the HYBRID2 program.

  10. Heliostat production evaluation and cost analysis

    Energy Technology Data Exchange (ETDEWEB)

    Britt, J. F.; Shulte, C. W.; Davey, H. L.

    1979-12-01

    The primary objective of this study is to provide a factory cost for the production of heliostats in terms of 1979 dollars. Factory cost is defined as the sum of all direct labor, direct material and burden expenses that are incurred in the manufacture of a heliostat, and its packaging for shipment. Transportation, installation, taxes other than plant real taxes, profit, selling expenses, and all other profit and loss items are not included. Two production volumes are considered, 25,000 heliostat units per year and 250,000 heliostat units per year. The study concluded that the factory cost to manufacture heliostats is $95.99/m/sup 2/ at 25,000 units per year and $67.95/m/sup 2/ at 250,000 units per year. The Policy Analysis Branch of the Solar Energy Research Institute estimates that this implies an installed price of $122.12/m/sup 2/ at the 25,000 unit-per-year volume.

  11. 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...

  12. 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.

  13. Energy Analysis Program 1990 annual report

    Energy Technology Data Exchange (ETDEWEB)

    1992-01-01

    The Energy Analysis Program has played an active role in the analysis and discussion of energy and environmental issues at several levels. (1) at the international level, with programs as developing scenarios for long-term energy demand in developing countries and organizing leading an analytic effort, ``Energy Efficiency, Developing Countries, and Eastern Europe,`` part of a major effort to increase support for energy efficiency programs worldwide; (2) at national level, the Program has been responsible for assessing energy forecasts and policies affecting energy use (e.g., appliance standards, National Energy Strategy scenarios); and (3) at the state and utility levels, the Program has been a leader in promoting integrated resource utility planning; the collaborative process has led to agreement on a new generation of utility demand-site programs in California, providing an opportunity to use knowledge and analytic techniques of the Program`s researchers. We continue to place highest on analyzing energy efficiency, with particular attention given to energy use in buildings. The Program continues its active analysis of international energy issues in Asia (including China), the Soviet Union, South America, and Western Europe. Analyzing the costs and benefits of different levels of standards for residential appliances continues to be the largest single area of research within the Program. The group has developed and applied techniques for forecasting energy demand (or constructing scenarios) for the United States. We have built a new model of industrial energy demand, are in the process of making major changes in our tools for forecasting residential energy demand, have built an extensive and documented energy conservation supply curve of residential energy use, and are beginning an analysis of energy-demand forecasting for commercial buildings.

  14. 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.

  15. Cost Effectiveness Analysis of Optimal Malaria Control Strategies in Kenya

    Directory of Open Access Journals (Sweden)

    Gabriel Otieno

    2016-03-01

    Full Text Available Malaria remains a leading cause of mortality and morbidity among the children under five and pregnant women in sub-Saharan Africa, but it is preventable and controllable provided current recommended interventions are properly implemented. Better utilization of malaria intervention strategies will ensure the gain for the value for money and producing health improvements in the most cost effective way. The purpose of the value for money drive is to develop a better understanding (and better articulation of costs and results so that more informed, evidence-based choices could be made. Cost effectiveness analysis is carried out to inform decision makers on how to determine where to allocate resources for malaria interventions. This study carries out cost effective analysis of one or all possible combinations of the optimal malaria control strategies (Insecticide Treated Bednets—ITNs, Treatment, Indoor Residual Spray—IRS and Intermittent Preventive Treatment for Pregnant Women—IPTp for the four different transmission settings in order to assess the extent to which the intervention strategies are beneficial and cost effective. For the four different transmission settings in Kenya the optimal solution for the 15 strategies and their associated effectiveness are computed. Cost-effective analysis using Incremental Cost Effectiveness Ratio (ICER was done after ranking the strategies in order of the increasing effectiveness (total infections averted. The findings shows that for the endemic regions the combination of ITNs, IRS, and IPTp was the most cost-effective of all the combined strategies developed in this study for malaria disease control and prevention; for the epidemic prone areas is the combination of the treatment and IRS; for seasonal areas is the use of ITNs plus treatment; and for the low risk areas is the use of treatment only. Malaria transmission in Kenya can be minimized through tailor-made intervention strategies for malaria control

  16. 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

  17. 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.

  18. GAP Analysis Program (GAP)

    Data.gov (United States)

    Kansas Data Access and Support Center — The Kansas GAP Analysis Land Cover database depicts 43 land cover classes for the state of Kansas. The database was generated using a two-stage hybrid classification...

  19. Medicare Part D Program Analysis

    Data.gov (United States)

    U.S. Department of Health & Human Services — This page contains information on Part D program analysis performed by CMS. These reports will also be used to better identify, evaluate and measure the effects of...

  20. On the transition to sustainability: an analysis of the costs of school feeding compared with the costs of primary education.

    Science.gov (United States)

    Bundy, Donald; Burbano, Carmen; Gelli, Aulo; Risley, Claire; Neeser, Kristie

    2011-09-01

    The current food, fuel, and financial crises have highlighted the importance of school feeding programs both as a social safety net for children living in poverty and food insecurity, and as part of national educational policies and plans. To examine the costs of school feeding, in terms of both the absolute cost per child and the cost per child relative to overall education expenditure and gross domestic product (GDP) in low-, middle-, and high-income countries. Data on the costs of school feeding in different countries were collected from multiple sources, including World Food Programme project data, reports from government ministries, and, where such searches failed, newspaper articles and other literature obtained from internet searches. Regression models were then used to analyze the relationships between school feeding costs, the per capita costs of primary education and GDP per capita. School feeding programs in low-income countries exhibit large variations in cost, with concomitant opportunities for cost containment. As countries get richer, however, school feeding costs become a much smaller proportion of the investment in education. The per capita costs of feeding relative to education decline nonlinearly with increasing GDP. These analyses suggest that the main reason for this decline in the relative cost of school feeding versus primary education is a greatly increased investment per child in primary education as GDP rises, but a fairly flat investment in food. The analyses also show that there appears to be a transitional discontinuity at the interface between the lower- and middle-income countries, which tends to coincide with changes in the capacity of governments to take over the management and funding of programs. Further analysis is required to define these relationships, but an initial conclusion is that supporting countries to maintain an investment in school feeding through this transition may emerge as a key role for development partners.

  1. 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.

  2. 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

  3. [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.

  4. Energy Analysis Program 1990 annual report

    Energy Technology Data Exchange (ETDEWEB)

    1992-01-01

    The Energy Analysis Program has played an active role in the analysis and discussion of energy and environmental issues at several levels. (1) at the international level, with programs as developing scenarios for long-term energy demand in developing countries and organizing leading an analytic effort, Energy Efficiency, Developing Countries, and Eastern Europe,'' part of a major effort to increase support for energy efficiency programs worldwide; (2) at national level, the Program has been responsible for assessing energy forecasts and policies affecting energy use (e.g., appliance standards, National Energy Strategy scenarios); and (3) at the state and utility levels, the Program has been a leader in promoting integrated resource utility planning; the collaborative process has led to agreement on a new generation of utility demand-site programs in California, providing an opportunity to use knowledge and analytic techniques of the Program's researchers. We continue to place highest on analyzing energy efficiency, with particular attention given to energy use in buildings. The Program continues its active analysis of international energy issues in Asia (including China), the Soviet Union, South America, and Western Europe. Analyzing the costs and benefits of different levels of standards for residential appliances continues to be the largest single area of research within the Program. The group has developed and applied techniques for forecasting energy demand (or constructing scenarios) for the United States. We have built a new model of industrial energy demand, are in the process of making major changes in our tools for forecasting residential energy demand, have built an extensive and documented energy conservation supply curve of residential energy use, and are beginning an analysis of energy-demand forecasting for commercial buildings.

  5. 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…

  6. XML Graphs in Program Analysis

    DEFF Research Database (Denmark)

    Møller, Anders; Schwartzbach, Michael I.

    2011-01-01

    XML graphs have shown to be a simple and effective formalism for representing sets of XML documents in program analysis. It has evolved through a six year period with variants tailored for a range of applications. We present a unified definition, outline the key properties including validation...... of XML graphs against different XML schema languages, and provide a software package that enables others to make use of these ideas. We also survey the use of XML graphs for program analysis with four very different languages: XACT (XML in Java), Java Servlets (Web application programming), XSugar...... (transformations between XML and non-XML data), and XSLT (stylesheets for transforming XML documents)....

  7. Strategic cost-benefit analysis of energy policies: detailed projections

    Energy Technology Data Exchange (ETDEWEB)

    Davitian, H.; Groncki, P.J.; Kleeman, P.; Lukachinski, J.

    1979-10-01

    Current US energy policy includes many programs directed toward restructuring the energy system in order to decrease US dependence on foreign supplies and to increase our reliance on plentiful and environmentally benign energy forms. However, recent events have led to renewed concern over the direction of current energy policy. This study describes three possible energy strategies and analyzes each in terms of its economic, environmental, and national security benefits and costs. Each strategy is represented by a specific policy. In the first, no additional programs or policies are initiated beyond those currently in effect or announced. The second is directed toward reducing the growth in energy demand, i.e., energy conservation. The third promotes increased domestic supply through accelerated development of synthetic and unconventional fuels. The analysis focuses on the evaluation and comparison of these strategy alternatives with respect to their energy, economic, and environmental consequences. Results indicate that conservation can substantially reduce import dependence and slow the growth of energy demand, with only a small macroeconomic cost and with substantial environmental benefits; the synfuels policy reduces imports by a smaller amount, does not reduce the growth in energy demand, involves substantial environmental costs and slows the rate of economic growth. These relationships could be different if the energy savings per unit cost for conservation are less than anticipated, or if the costs of synthetic fuels can be significantly lowered. Given these uncertainties, both conservation and RD and D support for synfuels should be included in future energy policy. However, between these policy alternatives, conservation appears to be the preferred strategy. The results of this study are presented in three reports (see also BNL--51105 and BNL--51128). 11 references, 3 figures, 61 tables.

  8. Distributional Cost-Effectiveness Analysis: A Tutorial.

    Science.gov (United States)

    Asaria, Miqdad; Griffin, Susan; Cookson, Richard

    2016-01-01

    Distributional cost-effectiveness analysis (DCEA) is a framework for incorporating health inequality concerns into the economic evaluation of health sector interventions. In this tutorial, we describe the technical details of how to conduct DCEA, using an illustrative example comparing alternative ways of implementing the National Health Service (NHS) Bowel Cancer Screening Programme (BCSP). The 2 key stages in DCEA are 1) modeling social distributions of health associated with different interventions, and 2) evaluating social distributions of health with respect to the dual objectives of improving total population health and reducing unfair health inequality. As well as describing the technical methods used, we also identify the data requirements and the social value judgments that have to be made. Finally, we demonstrate the use of sensitivity analyses to explore the impacts of alternative modeling assumptions and social value judgments. © The Author(s) 2015.

  9. An analysis of rising health care costs.

    Science.gov (United States)

    Thorne, L M

    1992-02-01

    Why are medical costs rising so rapidly? What are the factors involved that influence those costs? Does inflation affect health care costs? Can anything be done? The solutions to these complex issues are not clearly understood. It is clear, however, that the resolutions to these questions must be found quickly. If the causes of rising medical care costs are not promptly diagnosed and treated, we may find our economic health to be in critical condition. This paper attempts to better understand the reasons for increasing health care costs. The role that inflation plays relative to health care costs is investigated.

  10. The JPL Cost Risk Analysis Approach that Incorporates Engineering Realism

    Science.gov (United States)

    Harmon, Corey C.; Warfield, Keith R.; Rosenberg, Leigh S.

    2006-01-01

    This paper discusses the JPL Cost Engineering Group (CEG) cost risk analysis approach that accounts for all three types of cost risk. It will also describe the evaluation of historical cost data upon which this method is based. This investigation is essential in developing a method that is rooted in engineering realism and produces credible, dependable results to aid decision makers.

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

    Science.gov (United States)

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

    1984-01-01

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

  12. 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.

  13. Real Cost-Benefit Analysis Is Needed in American Public Education

    Directory of Open Access Journals (Sweden)

    Bert D. Stoneberg

    2015-07-01

    Full Text Available Public school critics often point to rising expenditures and relatively flat test scores to justify their school reform agendas. The claims are flawed because their analyses fail to account for the difference in data types between dollars (ratio and test scores (interval. A cost-benefit analysis using dollars as a common metric for both costs and benefits can provide a good estimate of their relationship. It also acknowledges that costs and benefits are both subject to inflation. The National Center for Education Research administers a methods training program for researchers who want to know more about cost-benefit analyses on education policies and programs.

  14. 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.

  15. 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.

  16. Cost analysis of a novel interdisciplinary model for advanced illness management.

    Science.gov (United States)

    Hopp, Faith P; Trzcinski, Eileen; Roth, Roxanne; Deremo, Dorothy; Fonger, Evan; Chiv, Sokchay; Paletta, Michael

    2015-05-01

    This research project evaluated cost outcomes for patients in the @HOMe Support program, a novel interdisciplinary home-based program for patients and caregivers facing advanced illness drawing on the Chronic Care Model. Cost analysis involved paired sample t-tests to examine pre-post differences in health care expenditures obtained from Health Maintenance Organization (HMO) claims data for program participants. Average 6-month costs per month significantly declined for patients older than 65 years of age from 1 HMO (US$9300-US$5900, P = .001). Evaluation of the second HMO showed that patients less than 65 years of age with lower preentry costs (costs (US$18 787-US$13 781, P = .08). Study findings suggest @HOMe Support is associated with reductions in the use and cost for most health services over time. © The Author(s) 2014.

  17. METHODOLOGICAL APPROACHES IN REALIZING AND APPLYING COST-BENEFIT ANALYSIS FOR THE INVESTMENT PROJECTS

    Directory of Open Access Journals (Sweden)

    Pelin Andrei

    2009-05-01

    Full Text Available Cost-benefit analysis represents the most frequent technique used for a rational allocation of resources. This modality of evaluating the expenditure programs is an attempt to measure the costs and gains of a community as a result of running the evaluated

  18. Cost analysis of the treatment of severe acute malnutrition in West Africa.

    Science.gov (United States)

    Isanaka, Sheila; Menzies, Nicolas A; Sayyad, Jessica; Ayoola, Mudasiru; Grais, Rebecca F; Doyon, Stéphane

    2017-10-01

    We present an updated cost analysis to provide new estimates of the cost of providing community-based treatment for severe acute malnutrition, including expenditure shares for major cost categories. We calculated total and per child costs from a provider perspective. We categorized costs into three main activities (outpatient treatment, inpatient treatment, and management/administration) and four cost categories within each activity (personnel; therapeutic food; medical supplies; and infrastructure and logistical support). For each category, total costs were calculated by multiplying input quantities expended in the Médecins Sans Frontières nutrition program in Niger during a 12-month study period by 2015 input prices. All children received outpatient treatment, with 43% also receiving inpatient treatment. In this large, well-established program, the average cost per child treated was €148.86, with outpatient and inpatient treatment costs of €75.50 and €134.57 per child, respectively. Therapeutic food (44%, €32.98 per child) and personnel (35%, €26.70 per child) dominated outpatient costs, while personnel (56%, €75.47 per child) dominated in the cost of inpatient care. Sensitivity analyses suggested lowering prices of medical treatments, and therapeutic food had limited effect on total costs per child, while increasing program size and decreasing use of expatriate staff support reduced total costs per child substantially. Updated estimates of severe acute malnutrition treatment cost are substantially lower than previously published values, and important cost savings may be possible with increases in coverage/program size and integration into national health programs. These updated estimates can be used to suggest approaches to improve efficiency and inform national-level resource allocation. © 2016 John Wiley & Sons Ltd.

  19. 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.

  20. 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.

  1. [Cost Analysis of Cochlear Implantation in Adults].

    Science.gov (United States)

    Raths, S; Lenarz, T; Lesinski-Schiedat, A; Flessa, S

    2016-04-01

    The number of implantation of cochlear implants has steadily risen in recent years. Reasons for this are an extension of indication criteria, demographic change, increased quality of life needs and greater acceptance. The consequences are rising expenditure for statutory health insurance (SHI) for cochlear implantation. A detailed calculation of lifetime costs from SHI's perspective for postlingually deafened adolescents and adults is essential in estimating future cost developments. Calculations are based on accounting data from the Hannover Medical School. With regard to further life expectancy, average costs of preoperative diagnosis, surgery, rehabilitation, follow-ups, processor upgrades and electrical maintenance were discounted to their present value at age of implantation. There is an inverse relation between cost of unilateral cochlear implantation and age of initial implantation. From SHI's perspective, the intervention costs between 36,001 and 68,970 € ($ 42,504-$ 81,429). The largest cost components are initial implantation and processor upgrades. Compared to the UK the cost of cochlear implantation in Germany seems to be significantly lower. In particular the costs of, rehabilitation and maintenance in Germany cause only a small percentage of total costs. Also, the costs during the first year of treatment seem comparatively low. With regard to future spending of SHI due to implant innovations and associated extension of indication, increasing cost may be suspected. © Georg Thieme Verlag KG Stuttgart · New York.

  2. 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.

  3. Modelling User-Costs in Life Cycle Cost-Benefit (LCCB) analysis

    DEFF Research Database (Denmark)

    Thoft-Christensen, Palle

    2008-01-01

    The importance of including user's costs in Life-Cycle Cost-Benefit analysis of structures is discussed in this paper. This is especially for bridges of great importance. Repair or/and failure of a bridge will usually result in user costs greater than the repair or replacement costs of the bridge....... For the society (and the user's) it is therefore of great importance that maintenance or replacement of a bridge is performed in such a way that all costs are minimized - not only the owners cost....

  4. Primary Prevention of Pediatric Abusive Head Trauma: A Cost Audit and Cost-Utility Analysis

    Science.gov (United States)

    Friedman, Joshua; Reed, Peter; Sharplin, Peter; Kelly, Patrick

    2012-01-01

    Objectives: To obtain comprehensive, reliable data on the direct cost of pediatric abusive head trauma in New Zealand, and to use this data to evaluate the possible cost-benefit of a national primary prevention program. Methods: A 5 year cohort of infants with abusive head trauma admitted to hospital in Auckland, New Zealand was reviewed. We…

  5. 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.

  6. Program Analysis as Model Checking

    DEFF Research Database (Denmark)

    Olesen, Mads Chr.

    Software programs are proliferating throughout modern life, to a point where even the simplest appliances such as lightbulbs contain software, in addition to the software embedded in cars and airplanes. The correct functioning of these programs is therefore of the utmost importance, for the quality...... and sustenance of life. Due to the complexity inherent in the software it can be very difficult for the software developer to guarantee the absence of errors; automated support in the form of automated program analysis is therefore essential. Two methods have traditionally been proposed: model checking...... and abstract interpretation. Model checking views the program as a finite automaton and tries to prove logical properties over the automaton model, or present a counter-example if not possible — with a focus on precision. Abstract interpretation translates the program semantics into abstract semantics...

  7. 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)

  8. The LTS timing analysis program :

    Energy Technology Data Exchange (ETDEWEB)

    Armstrong, Darrell Jewell; Schwarz, Jens

    2013-08-01

    The LTS Timing Analysis program described in this report uses signals from the Tempest Lasers, Pulse Forming Lines, and Laser Spark Detectors to carry out calculations to quantify and monitor the performance of the the Z-Accelerators laser triggered SF6 switches. The program analyzes Z-shots beginning with Z2457, when Laser Spark Detector data became available for all lines.

  9. 48 CFR 3046.792 - Cost benefit analysis (USCG).

    Science.gov (United States)

    2010-10-01

    ..., HOMELAND SECURITY ACQUISITION REGULATION (HSAR) CONTRACT MANAGEMENT QUALITY ASSURANCE Warranties 3046.792 Cost benefit analysis (USCG). If a specific warranty is considered not to be cost beneficial by the...

  10. Cost-benefit analysis and health care evaluations

    National Research Council Canada - National Science Library

    Brent, Robert J

    2003-01-01

    ... Cataloguing in Publication Data Brent, Robert J., 1946- Cost-benefit analysis and health care evaluations / Robert J. Brent. p. cm. Includes index. 1. Medical care - Cost effectiveness - Researc...

  11. 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

  12. 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

  13. Matlab programming for numerical analysis

    CERN Document Server

    Lopez, Cesar

    2014-01-01

    MATLAB is a high-level language and environment for numerical computation, visualization, and programming. Using MATLAB, you can analyze data, develop algorithms, and create models and applications. The language, tools, and built-in math functions enable you to explore multiple approaches and reach a solution faster than with spreadsheets or traditional programming languages, such as C/C++ or Java. Programming MATLAB for Numerical Analysis introduces you to the MATLAB language with practical hands-on instructions and results, allowing you to quickly achieve your goals. You will first become

  14. R data analysis without programming

    CERN Document Server

    Gerbing, David W

    2013-01-01

    This book prepares readers to analyze data and interpret statistical results using R more quickly than other texts. R is a challenging program to learn because code must be created to get started. To alleviate that challenge, Professor Gerbing developed lessR. LessR extensions remove the need to program. By introducing R through less R, readers learn how to organize data for analysis, read the data into R, and produce output without performing numerous functions and programming exercises first. With lessR, readers can select the necessary procedure and change the relevant variables without pro

  15. Cost analysis of energy storage systems for electric utility applications

    Energy Technology Data Exchange (ETDEWEB)

    Akhil, A. [Sandia National Lab., Albuquerque, NM (United States); Swaminathan, S.; Sen, R.K. [R.K. Sen & Associates, Inc., Bethesda, MD (United States)

    1997-02-01

    Under the sponsorship of the Department of Energy, Office of Utility Technologies, the Energy Storage System Analysis and Development Department at Sandia National Laboratories (SNL) conducted a cost analysis of energy storage systems for electric utility applications. The scope of the study included the analysis of costs for existing and planned battery, SMES, and flywheel energy storage systems. The analysis also identified the potential for cost reduction of key components.

  16. 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

  17. 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

  18. 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).

  19. Risk analysis of poultry feed costs

    Science.gov (United States)

    Introduction and Aims. Poultry feed continues to be a significant expense in poultry production as the cost of corn and soybean meals remain elevated. Alternative meals are under investigation to reduce production costs while maintaining high feed conversion rates and body weight gain. Two promising...

  20. Cost-benefit analysis of wetland restoration

    DEFF Research Database (Denmark)

    Dubgaard, Alex

    2004-01-01

    of environmental services. Costs typically depend on the level of ambitions regarding the magnitude and multitude of benefits. Decision makers are therefore confronted with the questions: how can generically different benefits be measured in comparable terms and how should different levels of project costs...

  1. [Cost analysis of a bone bank].

    Science.gov (United States)

    Torwesten, G; Braun, M

    1993-01-01

    The costs of a bone-bank working in accordance with the guidelines of the german federal chamber of physicians are described. Establishing a bone-bank storing deep-frozen bone is not very expensive. The main costs are due to laboratory costs for excluding HIV, hepatitis, syphilis and bacterial contamination of bone grafts. In our experience with 206 bone grafts about 20% of them are to be discharged because of positive laboratory tests. The costs of each bone graft are DM 327. A second HIV-Test of the donor 3 months after explantation of a bone graft will cause rising of costs up to 47%. About 20-30% of bone graft donors will probably not carry out this test. In this case discharging of the bone graft is necessary.

  2. 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...

  3. 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...

  4. 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...

  5. 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…

  6. 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...

  7. Brain network analysis: separating cost from topology using cost-integration.

    Directory of Open Access Journals (Sweden)

    Cedric E Ginestet

    Full Text Available A statistically principled way of conducting brain network analysis is still lacking. Comparison of different populations of brain networks is hard because topology is inherently dependent on wiring cost, where cost is defined as the number of edges in an unweighted graph. In this paper, we evaluate the benefits and limitations associated with using cost-integrated topological metrics. Our focus is on comparing populations of weighted undirected graphs that differ in mean association weight, using global efficiency. Our key result shows that integrating over cost is equivalent to controlling for any monotonic transformation of the weight set of a weighted graph. That is, when integrating over cost, we eliminate the differences in topology that may be due to a monotonic transformation of the weight set. Our result holds for any unweighted topological measure, and for any choice of distribution over cost levels. Cost-integration is therefore helpful in disentangling differences in cost from differences in topology. By contrast, we show that the use of the weighted version of a topological metric is generally not a valid approach to this problem. Indeed, we prove that, under weak conditions, the use of the weighted version of global efficiency is equivalent to simply comparing weighted costs. Thus, we recommend the reporting of (i differences in weighted costs and (ii differences in cost-integrated topological measures with respect to different distributions over the cost domain. We demonstrate the application of these techniques in a re-analysis of an fMRI working memory task. We also provide a Monte Carlo method for approximating cost-integrated topological measures. Finally, we discuss the limitations of integrating topology over cost, which may pose problems when some weights are zero, when multiplicities exist in the ranks of the weights, and when one expects subtle cost-dependent topological differences, which could be masked by cost-integration.

  8. Brain network analysis: separating cost from topology using cost-integration.

    Science.gov (United States)

    Ginestet, Cedric E; Nichols, Thomas E; Bullmore, Ed T; Simmons, Andrew

    2011-01-01

    A statistically principled way of conducting brain network analysis is still lacking. Comparison of different populations of brain networks is hard because topology is inherently dependent on wiring cost, where cost is defined as the number of edges in an unweighted graph. In this paper, we evaluate the benefits and limitations associated with using cost-integrated topological metrics. Our focus is on comparing populations of weighted undirected graphs that differ in mean association weight, using global efficiency. Our key result shows that integrating over cost is equivalent to controlling for any monotonic transformation of the weight set of a weighted graph. That is, when integrating over cost, we eliminate the differences in topology that may be due to a monotonic transformation of the weight set. Our result holds for any unweighted topological measure, and for any choice of distribution over cost levels. Cost-integration is therefore helpful in disentangling differences in cost from differences in topology. By contrast, we show that the use of the weighted version of a topological metric is generally not a valid approach to this problem. Indeed, we prove that, under weak conditions, the use of the weighted version of global efficiency is equivalent to simply comparing weighted costs. Thus, we recommend the reporting of (i) differences in weighted costs and (ii) differences in cost-integrated topological measures with respect to different distributions over the cost domain. We demonstrate the application of these techniques in a re-analysis of an fMRI working memory task. We also provide a Monte Carlo method for approximating cost-integrated topological measures. Finally, we discuss the limitations of integrating topology over cost, which may pose problems when some weights are zero, when multiplicities exist in the ranks of the weights, and when one expects subtle cost-dependent topological differences, which could be masked by cost-integration.

  9. Cost analysis of carbon dioxide concentrators

    Science.gov (United States)

    Yakut, M. M.

    1973-01-01

    Methodology and cost estimating relationships, for flight-type and prototype CO2 concentrators, have been developed and presented. A validity check was made by comparing the molecular sieves system considered here and that developed for Skylab. The system evaluated here is twice the size of the Skylab system and is also more complex as it desorbs CO2 thermally and stores it in an accumulator. The cost estimates developed were found to be approximately 50 to 70% higher than the actual cost of the Skylab unit.

  10. Capital Cost Optimization for Prefabrication: A Factor Analysis Evaluation Model

    Directory of Open Access Journals (Sweden)

    Hong Xue

    2018-01-01

    Full Text Available High capital cost is a significant hindrance to the promotion of prefabrication. In order to optimize cost management and reduce capital cost, this study aims to explore the latent factors and factor analysis evaluation model. Semi-structured interviews were conducted to explore potential variables and then questionnaire survey was employed to collect professionals’ views on their effects. After data collection, exploratory factor analysis was adopted to explore the latent factors. Seven latent factors were identified, including “Management Index”, “Construction Dissipation Index”, “Productivity Index”, “Design Efficiency Index”, “Transport Dissipation Index”, “Material increment Index” and “Depreciation amortization Index”. With these latent factors, a factor analysis evaluation model (FAEM, divided into factor analysis model (FAM and comprehensive evaluation model (CEM, was established. The FAM was used to explore the effect of observed variables on the high capital cost of prefabrication, while the CEM was used to evaluate comprehensive cost management level on prefabrication projects. Case studies were conducted to verify the models. The results revealed that collaborative management had a positive effect on capital cost of prefabrication. Material increment costs and labor costs had significant impacts on production cost. This study demonstrated the potential of on-site management and standardization design to reduce capital cost. Hence, collaborative management is necessary for cost management of prefabrication. Innovation and detailed design were needed to improve cost performance. The new form of precast component factories can be explored to reduce transportation cost. Meanwhile, targeted strategies can be adopted for different prefabrication projects. The findings optimized the capital cost and improved the cost performance through providing an evaluation and optimization model, which helps managers to

  11. 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.

  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. Consortium Purchases: Case Study for a Cost-Benefit Analysis.

    Science.gov (United States)

    Scigliano, Marisa

    2002-01-01

    Discusses library cooperation and academic library consortia and presents a case study of a Canadian consortia that conducted a cost-benefit analysis for purchasing an electronic resource. Reports on member library subscription costs, external economic factors, value of patron time saved, costs and benefits for patrons, and net savings. (LRW)

  14. comparative cost and strength analysis of cement and aggregate

    African Journals Online (AJOL)

    2012-07-02

    Jul 2, 2012 ... Abstract. This research presents a comparative cost and strength analysis of cement and aggregate replace- ment materials which is aimed at reducing the cost of concrete production. Tests were performed to compare the strength and cost of seven various cement replacement materials(rice husk ash,.

  15. Cost-Effectiveness Analysis of Family Planning Services Offered by ...

    African Journals Online (AJOL)

    Incremental cost-effectiveness ratios (ICER) and sensitivity analyses were calculated. Mobile clinics cost more per facility, produced more CYPs but had fewer FP visits. Sensitivity analysis was done using: total costs, CYP and FP visits of mobile and static clinics and showed that variations in CYP of mobile and static clinics ...

  16. Comparative Cost and Strength Analysis of Cement and Aggregate ...

    African Journals Online (AJOL)

    This research presents a comparative cost and strength analysis of cement and aggregate replacement materials which is aimed at reducing the cost of concrete production. Tests were performed to compare the strength and cost of seven various cement replacement materials(rice husk ash, groundnut husk ash, palm oil ...

  17. Systems engineering and integration: Cost estimation and benefits analysis

    Science.gov (United States)

    Dean, ED; Fridge, Ernie; Hamaker, Joe

    1990-01-01

    Space Transportation Avionics hardware and software cost has traditionally been estimated in Phase A and B using cost techniques which predict cost as a function of various cost predictive variables such as weight, lines of code, functions to be performed, quantities of test hardware, quantities of flight hardware, design and development heritage, complexity, etc. The output of such analyses has been life cycle costs, economic benefits and related data. The major objectives of Cost Estimation and Benefits analysis are twofold: (1) to play a role in the evaluation of potential new space transportation avionics technologies, and (2) to benefit from emerging technological innovations. Both aspects of cost estimation and technology are discussed here. The role of cost analysis in the evaluation of potential technologies should be one of offering additional quantitative and qualitative information to aid decision-making. The cost analyses process needs to be fully integrated into the design process in such a way that cost trades, optimizations and sensitivities are understood. Current hardware cost models tend to primarily use weights, functional specifications, quantities, design heritage and complexity as metrics to predict cost. Software models mostly use functionality, volume of code, heritage and complexity as cost descriptive variables. Basic research needs to be initiated to develop metrics more responsive to the trades which are required for future launch vehicle avionics systems. These would include cost estimating capabilities that are sensitive to technological innovations such as improved materials and fabrication processes, computer aided design and manufacturing, self checkout and many others. In addition to basic cost estimating improvements, the process must be sensitive to the fact that no cost estimate can be quoted without also quoting a confidence associated with the estimate. In order to achieve this, better cost risk evaluation techniques are

  18. Cost Analysis in Shoulder Arthroplasty Surgery

    Directory of Open Access Journals (Sweden)

    Matthew J. Teusink

    2012-01-01

    Full Text Available Cost in shoulder surgery has taken on a new focus with passage of the Patient Protection and Affordable Care Act. As part of this law, there is a provision for Accountable Care Organizations (ACOs and the bundled payment initiative. In this model, one entity would receive a single payment for an episode of care and distribute funds to all other parties involved. Given its reproducible nature, shoulder arthroplasty is ideally situated to become a model for an episode of care. Currently, there is little research into cost in shoulder arthroplasty surgery. The current analyses do not provide surgeons with a method for determining the cost and outcomes of their interventions, which is necessary to the success of bundled payment. Surgeons are ideally positioned to become leaders in ACOs, but in order for them to do so a methodology must be developed where accurate costs and outcomes can be determined for the episode of care.

  19. Infrastructures and Life-Cycle Cost-Benefit Analysis

    DEFF Research Database (Denmark)

    Thoft-Christensen, Palle

    2012-01-01

    Design and maintenance of infrastructures using Life-Cycle Cost-Benefit analysis is discussed in this paper with special emphasis on users costs. This is for several infrastructures such as bridges, highways etc. of great importance. Repair or/and failure of infrastructures will usually result...... in user costs greater than the repair or replacement costs of the infrastructure. For the society (and the users) it is therefore of great importance that maintenance or replacement of an infrastructure is performed in such a way that all costs are minimized - not only the owners cost....

  20. 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.

  1. Program Instrumentation and Trace Analysis

    Science.gov (United States)

    Havelund, Klaus; Goldberg, Allen; Filman, Robert; Rosu, Grigore; Koga, Dennis (Technical Monitor)

    2002-01-01

    Several attempts have been made recently to apply techniques such as model checking and theorem proving to the analysis of programs. This shall be seen as a current trend to analyze real software systems instead of just their designs. This includes our own effort to develop a model checker for Java, the Java PathFinder 1, one of the very first of its kind in 1998. However, model checking cannot handle very large programs without some kind of abstraction of the program. This paper describes a complementary scalable technique to handle such large programs. Our interest is turned on the observation part of the equation: How much information can be extracted about a program from observing a single execution trace? It is our intention to develop a technology that can be applied automatically and to large full-size applications, with minimal modification to the code. We present a tool, Java PathExplorer (JPaX), for exploring execution traces of Java programs. The tool prioritizes scalability for completeness, and is directed towards detecting errors in programs, not to prove correctness. One core element in JPaX is an instrumentation package that allows to instrument Java byte code files to log various events when executed. The instrumentation is driven by a user provided script that specifies what information to log. Examples of instructions that such a script can contain are: 'report name and arguments of all called methods defined in class C, together with a timestamp'; 'report all updates to all variables'; and 'report all acquisitions and releases of locks'. In more complex instructions one can specify that certain expressions should be evaluated and even that certain code should be executed under various conditions. The instrumentation package can hence be seen as implementing Aspect Oriented Programming for Java in the sense that one can add functionality to a Java program without explicitly changing the code of the original program, but one rather writes an

  2. 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.

  3. 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

  4. Cost analysis, cost recovery, marketing and fee-based services a guide for the health sciences librarian

    CERN Document Server

    Wood, M Sandra

    2013-01-01

    This outstanding volume won the 1986 Ida and George Eliot Prize--awarded by the Medical Library Association for the work judged most effective in furthering medical librarianship. Library professionals review the controversy behind fee-for-service programs and provide a rationale for incorporating them into contemporary library philosophies of service. Some fee-based services are necessary for survival in a society that treats information as a marketable commodity; this comprehensive book gives practical advice on cost analysis, cost recovery and marketing of reference services, and presents i

  5. 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.

  6. Analysis of Logistics Costs of the Ukrainian Semiconductor Industry

    OpenAIRE

    Popova Viktoriya D.

    2014-01-01

    The goal of the article is analysis of logistics costs in production of semiconductor materials using example of two Ukrainian enterprises. The article studies influence of logistics management and logistics costs upon formation of the final cost value (price) of a commodity (service). It gives an assessment of logistics costs of Ukrainian semiconductor enterprises and establishes its structure by types of main expenditure items: material, transport, production and storehouse. It establishes ...

  7. 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

  8. 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...

  9. 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...

  10. Management of End-Stage Ankle Arthritis: Cost-Utility Analysis Using Direct and Indirect Costs.

    Science.gov (United States)

    Nwachukwu, Benedict U; McLawhorn, Alexander S; Simon, Matthew S; Hamid, Kamran S; Demetracopoulos, Constantine A; Deland, Jonathan T; Ellis, Scott J

    2015-07-15

    Total ankle replacement and ankle fusion are costly but clinically effective treatments for ankle arthritis. Prior cost-effectiveness analyses for the management of ankle arthritis have been limited by a lack of consideration of indirect costs and nonoperative management. The purpose of this study was to compare the cost-effectiveness of operative and nonoperative treatments for ankle arthritis with inclusion of direct and indirect costs in the analysis. Markov model analysis was conducted from a health-systems perspective with use of direct costs and from a societal perspective with use of direct and indirect costs. Costs were derived from the 2012 Nationwide Inpatient Sample (NIS) and expressed in 2013 U.S. dollars; effectiveness was expressed in quality-adjusted life years (QALYs). Model transition probabilities were derived from the available literature. The principal outcome measure was the incremental cost-effectiveness ratio (ICER). In the direct-cost analysis for the base case, total ankle replacement was associated with an ICER of $14,500/QALY compared with nonoperative management. When indirect costs were included, total ankle replacement was both more effective and resulted in $5900 and $800 in lifetime cost savings compared with the lifetime costs following nonoperative management and ankle fusion, respectively. At a $100,000/QALY threshold, surgical management of ankle arthritis was preferred for patients younger than ninety-six years and total ankle replacement was increasingly more cost-effective in younger patients. Total ankle replacement, ankle fusion, and nonoperative management were the preferred strategy in 83%, 12%, and 5% of the analyses, respectively; however, our model was sensitive to patient age, the direct costs of total ankle replacement, the failure rate of total ankle replacement, and the probability of arthritis after ankle fusion. Compared with nonoperative treatment for the management of end-stage ankle arthritis, total ankle

  11. Methodology of technical analysis to reduce cost in the planning of the works of 'Energy for All' program in Sao Paulo, Brazil; Metodologia de analise tecnica para reducao de custo no planejamento das obras do programa 'Luz para Todos' em Sao Paulo

    Energy Technology Data Exchange (ETDEWEB)

    Betiol Junior, Genesio; Strazzi, Paulo Ernesto; Carmo, Jose R. do; Ribeiro, Fernando Selles [Comissao de Eletrificacao Rural do Estado de Sao Paulo (CERESP), SP (Brazil)

    2006-07-01

    This article relates the development of a research about low cost for rural electrification projects, which have been used like a base to develop a technical analysis in whole projects of the program 'Luz para Todos'. This program was made in 2002 with the purpose to offer electricity for whole people in Brazilian rural area. This method was developed seeking in to achieve cost reduction in the planning made by electric companies in Sao Paulo state. At first, were analyzed the rural electric projects made by electricity companies in the program 'Luz da Terra', in front of to the commitment in achieving cost reduction in the rural electric projects. The program 'Luz da Terra' was made whit a social purpose and it was developed in the whole Sao Paulo state, during 1996 until 2004. One of the main demands to achieve reasonable costs and to allow the program's viability was the previous analyses of rural distribution projects, before them changing to work of electricity, checking out if they had well defined. social, technical and economics methods. For that, were chosen quantitative and non-quantitative indicators, agreement whit a comparative analysis of each company performance in the program 'Luz da Terra', in agreement whit historical series, based on the group of the final result of each distribution electricity project. In a second moment, the same methodology was adjusted to confront the plans data of each company's future works in the program 'Luz para Todos', using the results of the first program. The research allowed the identification of some planner's tendencies when developing from a more rigorous model of low cost, like was the program 'Luz da Terra', to the actual program 'Luz para Todos'. Applied to all companies in the Sao Paulo state, the study served as a support to renegotiate budgets, what provided savings of more than US$ 10,000.000 in a total of 42

  12. 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.

  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. Cost-Effectiveness Analysis of Morcellation Hysterectomy for Myomas.

    Science.gov (United States)

    Bortoletto, Pietro; Einerson, Brett D; Miller, Emily S; Milad, Magdy P

    2015-01-01

    To estimate the cost-effectiveness of eliminating morcellation in the surgical treatment of leiomyomas from a societal perspective. Cost-effectiveness analysis. Not applicable. A theoretical cohort of women undergoing hysterectomy for myoma disease large enough to require morcellation. None. None. A decision analysis model was constructed using probabilities, costs, and utility data from published sources. A cost-effectiveness analysis analyzing both quality-adjusted life years (QALYs) and cases of disseminated cancer was performed to determine the incremental cost-effectiveness ratio (ICER) of eliminating morcellation as a tool in the surgical treatment of leiomyomas. Costs and utilities were discounted using standard methodology. The base case included health care system costs and costs incurred by the patient for surgery-related disability. One-way sensitivity analyses were performed to assess the effect of various assumptions. The cost to prevent 1 case of disseminated cancer was $10 540 832. A strategy of nonmorcellation hysterectomy via laparotomy costed more ($30 359.92 vs $20 853.15) and yielded more QALYs (21.284 vs 21.280) relative to morcellation hysterectomy. The ICER for nonmorcellation hysterectomy compared with morcellation hysterectomy was $2 184 172 per QALY. Health care costs (prolonged hospitalizations) and costs to patients of prolonged time away from work were the primary drivers of cost differential between the 2 strategies. Even when the incidence of occult sarcoma in leiomyoma surgery was ranged to twice that reported in the literature (.98%), the ICER for nonmorcellation hysterectomy was $644 393.30. Eliminating morcellation hysterectomy as a treatment for myomas is not cost-effective under a wide variety of probability and cost assumptions. Performing laparotomy for all patients who might otherwise be candidates for morcellation hysterectomy is a costly policy from a societal perspective. Copyright © 2015 AAGL. Published by Elsevier Inc

  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.

    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

  16. Cost-effectiveness Analysis of Health Care Interventions in ...

    African Journals Online (AJOL)

    Background: Decisions concerning the implementation of health programs are usually made on the basis of descriptive assessment. There are only few attempts to review whether returns from investment on these programs worth the effort. Objectives: To analyze and evaluate the cost-effectiveness of health care ...

  17. Cost Analysis and Performance Assessment of Partner Services for Human Immunodeficiency Virus and Sexually Transmitted Diseases, New York State, 2014.

    Science.gov (United States)

    Johnson, Britney L; Tesoriero, James; Feng, Wenhui; Qian, Feng; Martin, Erika G

    2017-12-01

    To estimate the programmatic costs of partner services for HIV, syphilis, gonorrhea, and chlamydial infection. New York State and local health departments conducting partner services activities in 2014. A cost analysis estimated, from the state perspective, total program costs and cost per case assignment, patient interview, partner notification, and disease-specific key performance indicator. Data came from contracts, a time study of staff effort, and statewide surveillance systems. Disease-specific costs per case assignment (mean: $580; range: $502-$1,111), patient interview ($703; $608-$1,609), partner notification ($1,169; $950-$1,936), and key performance indicator ($2,697; $1,666-$20,255) varied across diseases. Most costs (79 percent) were devoted to gonorrhea and chlamydial infection investigations. Cost analysis complements cost-effectiveness analysis in evaluating program performance and guiding improvements. © Health Research and Educational Trust.

  18. Cost Benefit Analysis of Consumer Product Safety Standards

    Science.gov (United States)

    Smith, Betty F.; Dardis, Rachel

    1977-01-01

    This paper investigates the role of cost-benefit analysis in evaluating consumer product safety standards and applys such analysis to an evaluation of flammability standards for children's sleepwear. (Editor)

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

    Directory of Open Access Journals (Sweden)

    Syed Shahid Abbas

    2014-02-01

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

  20. Cost Analysis of Medications Used in Upper Respiratory Tract ...

    African Journals Online (AJOL)

    Purpose: To conduct a cost analysis, a narrow cost-utility study, for upper respiratory tract infection medications in University Sans Malaysia's clinics. Methods: Retrospective analysis was done for all medical claims of upper respiratory tract infections in the period 2008 - 2009. The study was done in the clinics under ...

  1. Impossible Certainty: Cost Risk Analysis for Air Force Systems

    Science.gov (United States)

    2006-01-01

    7 For more detailed information, see, for example, Henrici (1964). 52 Impossible Certainty: Cost Risk Analysis for Air Force Systems... Henrici , Peter, Elements of Numerical Analysis, New York: John Wiley, 1964. Hess, Ronald W., and H. P. Romanoff, Aircraft Airframe Cost Estimating

  2. sensitivity analysis on flexible road pavement life cycle cost model

    African Journals Online (AJOL)

    user

    8. REFERENCES. [1] Asta, G. “Life Cycle Cost Analysis of Asphalt and. Concrete Pavements” Thesis submitted to the School of Science and Engineering at Reykjavík University in impartial fulfillment of the requirements for the degree of Master of Science, Iceland. 2011. [2] Walls, J. I., & Smith, M. “Life-Cycle Cost Analysis in.

  3. Comparative Cost-Effectiveness Analysis Of Streptomycin And ...

    African Journals Online (AJOL)

    Ethambutol tablet therefore appears to be more cost effective than streptomycin injection. Subjecting the cost and effectiveness to sensitivity analysis did not change this conclusion. Statistical analysis shows that there is a statistically significant difference in the effectiveness (outcome) of ethambutol (95%) and streptomycin ...

  4. Burden of disease calculation, cost of illness analysis and demand ...

    African Journals Online (AJOL)

    Burden of disease calculation, cost of illness analysis and demand for death: a theoretical review. ... International Journal of Development and Management Review ... The works of Murray and co-workers on calculating Burden of Disease (BoD), and even the analysis of Cost of Illness (CoI), to fully understand the priority ...

  5. Cost-effectiveness analysis of Mectizan treatment Programmes for ...

    African Journals Online (AJOL)

    Objectives: This study analyzed the operational costs of two Mectizan treatment strategies in relation to their effectiveness. Methods: The study was conducted in 24 communities located in Irewole and Egbeda districts of Osun and Oyo State, Nigeria respectively. Cost-effectiveness analysis included retrospective analysis of ...

  6. Cost analysis for the implementation of a medication review with follow-up service in Spain.

    Science.gov (United States)

    Noain, Aranzazu; Garcia-Cardenas, Victoria; Gastelurrutia, Miguel Angel; Malet-Larrea, Amaia; Martinez-Martinez, Fernando; Sabater-Hernandez, Daniel; Benrimoj, Shalom I

    2017-08-01

    Background Medication review with follow-up (MRF) is a professional pharmacy service proven to be cost-effective. Its broader implementation is limited, mainly due to the lack of evidence-based implementation programs that include economic and financial analysis. Objective To analyse the costs and estimate the price of providing and implementing MRF. Setting Community pharmacy in Spain. Method Elderly patients using poly-pharmacy received a community pharmacist-led MRF for 6 months. The cost analysis was based on the time-driven activity based costing model and included the provider costs, initial investment costs and maintenance expenses. The service price was estimated using the labour costs, costs associated with service provision, potential number of patients receiving the service and mark-up. Main outcome measures Costs and potential price of MRF. Results A mean time of 404.4 (SD 232.2) was spent on service provision and was extrapolated to annual costs. Service provider cost per patient ranged from €196 (SD 90.5) to €310 (SD 164.4). The mean initial investment per pharmacy was €4594 and the mean annual maintenance costs €3,068. Largest items contributing to cost were initial staff training, continuing education and renting of the patient counselling area. The potential service price ranged from €237 to €628 per patient a year. Conclusion Time spent by the service provider accounted for 75-95% of the final cost, followed by initial investment costs and maintenance costs. Remuneration for professional pharmacy services provision must cover service costs and appropriate profit, allowing for their long-term sustainability.

  7. An Analysis of Aviation Maintenance Operations and Supporting Costs, and Cost Capturing Systems

    Science.gov (United States)

    2012-12-04

    also contains military personnel databases composed of personnel costs and has recently added databases covering DoN civilian personnel and Navy...host.uniroma3.it/facolta/economia/db/ materiali /insegnamenti/588_3930.pdf Cost Analysis Improvement Group (CAIG). (2007). Office of the Secretary of

  8. Cost Analysis for Dual Source Weapon Procurement

    Science.gov (United States)

    1983-10-01

    report was prepared by: Willis R. Greer, Jr., Profesor ’- S. iao, 4ssociate Frofessor Department of Administrative Sciences Department of...performanac. Extra loqis- tics cost is inevitable if there is a differanca betveen !h, two end iPeas. Some analysts also ar;ue that the TOP ninlz to be

  9. Economic cost analysis in cancer management and its relevance today.

    Science.gov (United States)

    Sharma, K; Das, S; Mukhopadhyay, A; Rath, G K; Mohanti, B K

    2009-01-01

    The global cancer burden has shown a distinct shift in the last two decades and its financial impact can be large, even among patients living in high resource countries, with comprehensive health insurance policies. It is hard to imagine its impact on patients of developing countries where insurance policies exist infrequently and often cost becomes the greatest barrier in availing cancer treatment. It is recognized that these costs include the direct cost of disease treatment and care, indirect costs accrued by the patient and the family, and economic losses to the society as a whole. Economic cost analysis or cost-effectiveness analysis has emerged as a basic tool in the evaluation of health-care practices. To date, these cost data have been collected only sporadically, even in the most developed countries, and there is a great need for incorporating economic cost assessment practices in developing countries, so that patients and their families can access the care adequately. The current review has been done using PubMed and MEDLINE search with keywords like cancer, cost-analysis, cost-effectiveness, economic burden, medical cost, etc.

  10. Life cycle cost analysis of aging aircraft airframe maintenance

    Science.gov (United States)

    Sperry, Kenneth Robert

    Scope and method of study. The purpose of this study was to examine the relationship between an aircraft's age and its annual airframe maintenance costs. Common life cycle costing methodology has previously not recognized the existence of this cost growth potential, and has therefor not determined the magnitude nor significance of this cost element. This study analyzed twenty-five years of DOT Form 41-airframe maintenance cost data for the Boeing 727, 737, 747 and McDonnell Douglas DC9 and DC-10 aircraft. Statistical analysis included regression analysis, Pearson's r, and t-tests to test the null hypothesis. Findings and conclusion. Airframe maintenance cost growth was confirmed to be increasing after an aircraft's age exceeded its designed service objective of approximately twenty-years. Annual airframe maintenance cost growth increases were measured ranging from 3.5% annually for a DC-9, to approximately 9% annually for a DC-10 aircraft. Average measured coefficient of determination between age and airframe maintenance, exceeded .80, confirming a strong relationship between cost: and age. The statistical significance of the difference between airframe costs sampled in 1985, compared to airframe costs sampled in 1998 was confirmed by t-tests performed on each subject aircraft group. Future cost forecasts involving aging aircraft subjects must address cost growth due to aging when attempting to model an aircraft's economic service life.

  11. 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...

  12. Processing Cost Analysis for Biomass Feedstocks

    Energy Technology Data Exchange (ETDEWEB)

    Badger, P.C.

    2002-11-20

    The receiving, handling, storing, and processing of woody biomass feedstocks is an overlooked component of biopower systems. The purpose of this study was twofold: (1) to identify and characterize all the receiving, handling, storing, and processing steps required to make woody biomass feedstocks suitable for use in direct combustion and gasification applications, including small modular biopower (SMB) systems, and (2) to estimate the capital and operating costs at each step. Since biopower applications can be varied, a number of conversion systems and feedstocks required evaluation. In addition to limiting this study to woody biomass feedstocks, the boundaries of this study were from the power plant gate to the feedstock entry point into the conversion device. Although some power plants are sited at a source of wood waste fuel, it was assumed for this study that all wood waste would be brought to the power plant site. This study was also confined to the following three feedstocks (1) forest residues, (2) industrial mill residues, and (3) urban wood residues. Additionally, the study was confined to grate, suspension, and fluidized bed direct combustion systems; gasification systems; and SMB conversion systems. Since scale can play an important role in types of equipment, operational requirements, and capital and operational costs, this study examined these factors for the following direct combustion and gasification system size ranges: 50, 20, 5, and 1 MWe. The scope of the study also included: Specific operational issues associated with specific feedstocks (e.g., bark and problems with bridging); Opportunities for reducing handling, storage, and processing costs; How environmental restrictions can affect handling and processing costs (e.g., noise, commingling of treated wood or non-wood materials, emissions, and runoff); and Feedstock quality issues and/or requirements (e.g., moisture, particle size, presence of non-wood materials). The study found that over the

  13. Analysis of the Aircraft Flying Hour Program at the Pacific Missile Test Center.

    Science.gov (United States)

    1987-12-01

    David R. Whipple, hai artment of Adinst<t’e c2e ABSTRACT "Yhis thesis is an analysis of the flight hour cost program at the Pacific Missile Test Center...LEVEL 2 TRAIN COSTS TO BE COSTS COSTS COSTS COSTS NOIA LIZED A-3 A-6 CIVILIANS 87 306,000 A-7 CONTRCTOR F-4 STSI 81 620,325 F-14 SAC 33 568,750 F-18 HIC 5

  14. 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.

  15. Cost-Effectiveness of the “Helping Babies Breathe” Program in a Missionary Hospital in Rural Tanzania

    Science.gov (United States)

    Vossius, Corinna; Lotto, Editha; Lyanga, Sara; Mduma, Estomih; Msemo, Georgina; Perlman, Jeffrey; Ersdal, Hege L.

    2014-01-01

    Objective 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. Methods 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. Findings 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. Conclusion 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. PMID:25006802

  16. Satellite Power Systems (SPS) space transportation cost analysis and evaluation

    Energy Technology Data Exchange (ETDEWEB)

    None

    1980-11-01

    The objective of this study is to provide a clear picture of SPS space transportation costs at the present time with respect to their accuracy as stated, the reasonableness of the methods used, the assumptions made, and the uncertainty associated with the estimates. The approach used consists of examining space transportation costs from several perspectives - to perform a variety of sensitivity analyses or reviews and examine the findings in terms of internal consistency and external comparison with analogous systems. These approaches are summarized as a theoretical and historical review including a review of stated and unstated assumptions used to derive the costs, and a performance or technical review. These reviews cover the overall transportation program as well as the individual vehicles proposed. The review of overall cost assumptions is the principal means used for estimating the cost uncertainty derived. The cost estimates used as the best current estimate are included.

  17. 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.

  18. Systematic review of incremental non-vaccine cost estimates used in cost-effectiveness analysis on the introduction of rotavirus and pneumococcal vaccines.

    Science.gov (United States)

    De la Hoz-Restrepo, Fernando; Castañeda-Orjuela, Carlos; Paternina, Angel; Alvis-Guzman, Nelson

    2013-07-02

    To review the approaches used in the cost-effectiveness analysis (CEAs) literature to estimate the cost of expanded program on immunization (EPI) activities, other than vaccine purchase, for rotavirus and pneumococcal vaccines. A systematic review in PubMed and NHS EED databases of rotavirus and pneumococcal vaccines CEAs was done. Selected articles were read and information on how EPI costs were calculated was extracted. EPI costing approaches were classified according to the method or assumption used for estimation. Seventy-nine studies that evaluated cost effectiveness of rotavirus (n=43) or pneumococcal (n=36) vaccines were identified. In general, there are few details on how EPI costs other than vaccine procurement were estimated. While 30 studies used some measurement of that cost, only one study on pneumococcal vaccine used a primary cost evaluation (bottom-up costing analysis) and one study used a costing tool. Twenty-seven studies (17 on rotavirus and 10 on pneumococcal vaccine) assumed the non-vaccine costs. Five studies made no reference to additional costs. Fourteen studies (9 rotavirus and 5 pneumococcal) did not consider any additional EPI cost beyond vaccine procurement. For rotavirus studies, the median for non-vaccine cost per dose was US$0.74 in developing countries and US$6.39 in developed countries. For pneumococcal vaccines, the median for non-vaccine cost per dose was US$1.27 in developing countries and US$8.71 in developed countries. Many pneumococcal (52.8%) and rotavirus (60.4%) cost-effectiveness analyses did not consider additional EPI costs or used poorly supported assumptions. Ignoring EPI costs in addition to those for vaccine procurement in CEA analysis of new vaccines may lead to significant errors in the estimations of ICERs since several factors like personnel, cold chain, or social mobilization can be substantially affected by the introduction of new vaccines. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. Association of antipsychotic polypharmacy with health service cost: a register-based cost analysis

    DEFF Research Database (Denmark)

    Baandrup, Lone; Sørensen, Jan; Lublin, Henrik Kai Francis

    2012-01-01

    OBJECTIVE: To investigate the association of antipsychotic polypharmacy in schizophrenia with cost of primary and secondary health service use. METHOD: Comparative analysis of health service cost for patients prescribed antipsychotic polypharmacy versus antipsychotic monotherapy. Resource utilisa...... demonstrate that antipsychotic co-prescribing is associated with increased use of health care services, even though no causal relations can be inferred from an observational study.......OBJECTIVE: To investigate the association of antipsychotic polypharmacy in schizophrenia with cost of primary and secondary health service use. METHOD: Comparative analysis of health service cost for patients prescribed antipsychotic polypharmacy versus antipsychotic monotherapy. Resource...... at the two cross-sectional dates was recorded and used as proxy of polypharmacy exposure during the preceding year. A multivariate generalised linear model was fitted with total costs of primary and secondary health service use as dependent variable, and antipsychotic polypharmacy, diagnosis, age, gender...

  20. 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

  1. Cost Benefit Analysis: Bypass of Prešov city

    Directory of Open Access Journals (Sweden)

    Margorínová Martina

    2017-01-01

    Full Text Available The paper describes decision making process based on economic evaluation, i.e. Cost Benefit Analysis for motorway bypass of the Prešov city. Three variants were evaluated by means of the Highway Development and Management Tool (HDM-4. HDM-4 is a software system for evaluating options for investing in road transport infrastructure. Vehicle operating costs and travel time costs were monetized with the use of the software. The investment opportunities were evaluated in terms of Cost Benefit Analysis results, i.e. economic indicators.

  2. Cost Analysis of an Intervention to Prevent Methicillin-Resistant Staphylococcus Aureus (MRSA Transmission.

    Directory of Open Access Journals (Sweden)

    Michal Chowers

    Full Text Available Our objective was to assess the cost implications of a vertical MRSA prevention program that led to a reduction in MRSA bacteremia.We performed a matched historical cohort study and cost analysis in a single hospital in Israel for the years 2005-2011. The cost of MRSA bacteremia was calculated as total hospital cost for patients admitted with bacteremia and for patients with hospital-acquired bacteremia, the difference in cost compared to matched controls. The cost of prevention was calculated as the sum of the cost of microbiology tests, single-use equipment used for patients in isolation, and infection control personnel.An average of 20,000 patients were screened yearly. The cost of prevention was $208,100 per year, with the major contributor being laboratory cost. We calculated that our intervention averted 34 cases of bacteremia yearly: 17 presenting on admission and 17 acquired in the hospital. The average cost of a case admitted with bacteremia was $14,500, and the net cost attributable to nosocomial bacteremia was $9,400. Antibiotics contributed only 0.4% of the total disease management cost. When the annual cost of averted cases of bacteremia and that of prevention were compared, the intervention resulted in annual cost savings of $199,600.A vertical MRSA prevention program targeted at high-risk patients, which was highly effective in preventing bacteremia, is cost saving. These results suggest that allocating resources to targeted prevention efforts might be beneficial even in a single institution in a high incidence country.

  3. Vehicle Lightweighting: Mass Reduction Spectrum Analysis and Process Cost Modeling

    Energy Technology Data Exchange (ETDEWEB)

    Mascarin, Anthony [IBIS Associates, Inc., Waltham, MA (United States); Hannibal, Ted [IBIS Associates, Inc., Waltham, MA (United States); Raghunathan, Anand [Energetics Inc., Columbia, MD (United States); Ivanic, Ziga [Energetics Inc., Columbia, MD (United States); Clark, Michael [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2016-03-01

    The U.S. Department of Energy’s Vehicle Technologies Office, Materials area commissioned a study to model and assess manufacturing economics of alternative design and production strategies for a series of lightweight vehicle concepts. In the first two phases of this effort examined combinations of strategies aimed at achieving strategic targets of 40% and a 45% mass reduction relative to a standard North American midsize passenger sedan at an effective cost of $3.42 per pound (lb) saved. These results have been reported in the Idaho National Laboratory report INL/EXT-14-33863 entitled Vehicle Lightweighting: 40% and 45% Weight Savings Analysis: Technical Cost Modeling for Vehicle Lightweighting published in March 2015. The data for these strategies were drawn from many sources, including Lotus Engineering Limited and FEV, Inc. lightweighting studies, U.S. Department of Energy-funded Vehma International of America, Inc./Ford Motor Company Multi-Material Lightweight Prototype Vehicle Demonstration Project, the Aluminum Association Transportation Group, many United States Council for Automotive Research’s/United States Automotive Materials Partnership LLC lightweight materials programs, and IBIS Associates, Inc.’s decades of experience in automotive lightweighting and materials substitution analyses.

  4. 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

    This report presents the results of Level 2 of a three-tiered evaluation of the U.S. Department of Energy Federal Energy Management Program's Super Energy Savings Performance Contract (Super ESPC) Program. Level 1 of the analysis studied all of the Super ESPC projects for which at least one Annual Measurement & Verification (M&V) Report had been produced by April 2006. For those 102 projects in aggregate, we found that the value of cost savings reported by the energy service company (ESCO) in the Annual M&V Reports was 108% of the cost savings guaranteed in the contracts. We also compared estimated energy savings (which are not guaranteed, but are the basis for the guaranteed cost savings) to the energy savings reported by the ESCO in the Annual M&V Report. In aggregate, reported energy savings were 99.8% of estimated energy savings on the basis of site energy, or 102% of estimated energy savings based on source energy. Level 2 focused on a random sample of 27 projects taken from the 102 Super ESPC projects studied in Level 1. The objectives were, for each project in the sample, to: repeat the calculations of the annual energy and cost savings in the most recent Annual M&V Report to validate the ESCO's results or correct any errors, and recalculate the value of the reported energy, water, and operations and maintenance (O&M) savings using actual utility prices paid at the project site instead of the 'contract' energy prices - the prices that are established in the project contract as those to be used by the ESCO to calculate the annual cost savings, which determine whether the guarantee has been met. Level 3 analysis will be conducted on three to five projects from the Level 2 sample that meet validity criteria for whole-building or whole-facility data analysis. This effort will verify energy and cost savings using statistical analysis of actual utility use, cost, and weather data. This approach, which can only be used for projects meeting

  5. Cost-effectiveness of a transitional home-based palliative care program for patients with end-stage heart failure.

    Science.gov (United States)

    Wong, Frances Kam Yuet; So, Ching; Ng, Alina Yee Man; Lam, Po-Tin; Ng, Jeffrey Sheung Ching; Ng, Nancy Hiu Yim; Chau, June; Sham, Michael Mau Kwong

    2018-02-01

    Studies have shown positive clinical outcomes of specialist palliative care for end-stage heart failure patients, but cost-effectiveness evaluation is lacking. To examine the cost-effectiveness of a transitional home-based palliative care program for patients with end-stage heart failure patients as compared to the customary palliative care service. A cost-effectiveness analysis was conducted alongside a randomized controlled trial (Trial number: NCT02086305). The costs included pre-program training, intervention, and hospital use. Quality of life was measured using SF-6D. The study took place in three hospitals in Hong Kong. The inclusion criteria were meeting clinical indicators for end-stage heart failure patients including clinician-judged last year of life, discharged to home within the service area, and palliative care referral accepted. A total of 84 subjects (study = 43, control = 41) were recruited. When the study group was compared to the control group, the net incremental quality-adjusted life years gain was 0.0012 (28 days)/0.0077 (84 days) and the net incremental costs per case was -HK$7935 (28 days)/-HK$26,084 (84 days). The probability of being cost-effective was 85% (28 days)/100% (84 days) based on the cost-effectiveness thresholds recommended both by National Institute for Health and Clinical Excellence (£20,000/quality-adjusted life years) and World Health Organization (Hong Kong gross domestic product/capita in 2015, HK$328117). Results suggest that a transitional home-based palliative care program is more cost-effective than customary palliative care service. Limitations of the study include small sample size, study confined to one city, clinic consultation costs, and societal costs including patient costs and unpaid care-giving costs were not included.

  6. Cost savings associated with improving appropriate and reducing inappropriate preventive care: cost-consequences analysis

    Directory of Open Access Journals (Sweden)

    Baskerville Neill

    2005-03-01

    Full Text Available Abstract Background Outreach facilitation has been proven successful in improving the adoption of clinical preventive care guidelines in primary care practice. The net costs and savings of delivering such an intensive intervention need to be understood. We wanted to estimate the proportion of a facilitation intervention cost that is offset and the potential for savings by reducing inappropriate screening tests and increasing appropriate screening tests in 22 intervention primary care practices affecting a population of 90,283 patients. Methods A cost-consequences analysis of one successful outreach facilitation intervention was done, taking into account the estimated cost savings to the health system of reducing five inappropriate tests and increasing seven appropriate tests. Multiple data sources were used to calculate costs and cost savings to the government. The cost of the intervention and costs of performing appropriate testing were calculated. Costs averted were calculated by multiplying the number of tests not performed as a result of the intervention. Further downstream cost savings were determined by calculating the direct costs associated with the number of false positive test follow-ups avoided. Treatment costs averted as a result of increasing appropriate testing were similarly calculated. Results The total cost of the intervention over 12 months was $238,388 and the cost of increasing the delivery of appropriate care was $192,912 for a total cost of $431,300. The savings from reduction in inappropriate testing were $148,568 and from avoiding treatment costs as a result of appropriate testing were $455,464 for a total savings of $604,032. On a yearly basis the net cost saving to the government is $191,733 per year (2003 $Can equating to $3,687 per physician or $63,911 per facilitator, an estimated return on intervention investment and delivery of appropriate preventive care of 40%. Conclusion Outreach facilitation is more expensive

  7. Concentrated photovoltaics system costs and learning curve analysis

    Science.gov (United States)

    Haysom, Joan E.; Jafarieh, Omid; Anis, Hanan; Hinzer, Karin

    2013-09-01

    An extensive set of costs in /W for the installed costs of CPV systems has been amassed from a range of public sources, including both individual company prices and market reports. Cost reductions over time are very evident, with current prices for 2012 in the range of 3.0 ± 0.7 /W and a predicted cost of 1.5 /W for 2020. Cost data is combined with deployment volumes in a learning curve analysis, providing a fitted learning rate of either 18.5% or 22.3% depending on the methodology. This learning rate is compared to that of PV modules and PV installed systems, and the influence of soft costs is discussed. Finally, if an annual growth rate of 39% is assumed for deployed volumes, then, using the learning rate of 20%, this would predict the achievement of a cost point of 1.5 /W by 2016.

  8. The Michigan Surgical Home and Optimization Program is a scalable model to improve care and reduce costs.

    Science.gov (United States)

    Englesbe, Michael J; Grenda, Dane R; Sullivan, June A; Derstine, Brian A; Kenney, Brooke N; Sheetz, Kyle H; Palazzolo, William C; Wang, Nicholas C; Goulson, Rebecca L; Lee, Jay S; Wang, Stewart C

    2017-06-01

    The Michigan Surgical Home and Optimization Program is a structured, home-based, preoperative training program targeting physical, nutritional, and psychological guidance. The purpose of this study was to determine if participation in this program was associated with reduced hospital duration of stay and health care costs. We conducted a retrospective, single center, cohort study evaluating patients who participated in the Michigan Surgical Home and Optimization Program and subsequently underwent major elective general and thoracic operative care between June 2014 and December 2015. Propensity score matching was used to match program participants to a control group who underwent operative care prior to program implementation. Primary outcome measures were hospital duration of stay and payer costs. Multivariate regression was used to determine the covariate-adjusted effect of program participation. A total of 641 patients participated in the program; 82% were actively engaged in the program, recording physical activity at least 3 times per week for the majority of the program; 182 patients were propensity matched to patients who underwent operative care prior to program implementation. Multivariate analysis demonstrated that participation in the Michigan Surgical Home and Optimization Program was associated with a 31% reduction in hospital duration of stay (P < .001) and 28% lower total costs (P < .001) after adjusting for covariates. A home-based, preoperative training program decreased hospital duration of stay, lowered costs of care, and was well accepted by patients. Further efforts will focus on broader implementation and linking participation to postoperative complications and rigorous patient-reported outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Cost Effectiveness Analysis, A DTIC Bibliography.

    Science.gov (United States)

    1980-07-01

    Xeches.Thoma$ MI. : Benner . REPT. NO. AG-PR-AlOI-Voi-5 Lynne E. CONTRACT: N00014-7C-C-0465 REPT. NO. AG-PR-AIOI-vOL-2 CONTRACT: N000Z4-78-C-C465...Theory Achvancea Co"poite Cost Estimating BENNER , LYNNE E. and Application. Volume IV. Case Manual. Volume II. Appendix. * *Studies. AD-A041 496...Requisition Size- DEY. PATRICIA KONOS4E CDEARMON, IRA A.. JR AD-A046 249 C a.. * * CAn Appraisal 0f Loistics Sup~port The Magnitude of Variability in On

  10. Nurse manager succession planning: A cost-benefit analysis.

    Science.gov (United States)

    Phillips, Tracy; Evans, Jennifer L; Tooley, Stephanie; Shirey, Maria R

    2017-12-12

    This commentary presents a cost-benefit analysis to advocate for the use of succession planning to mitigate the problems ensuing from nurse manager turnover. An estimated 75% of nurse managers will leave the workforce by 2020. Many benefits are associated with proactively identifying and developing internal candidates. Fewer than 7% of health care organisations have implemented formal leadership succession planning programmes. A cost-benefit analysis of a formal succession-planning programme from one hospital illustrates the benefits of the programme in their organisation and can be replicated easily. Assumptions of nursing manager succession planning cost-benefit analysis are identified and discussed. The succession planning exemplar demonstrates the integration of cost-benefit analysis principles. Comparing the costs of a formal nurse manager succession planning strategy with the status quo results in a positive cost-benefit ratio. The implementation of a formal nurse manager succession planning programme effectively reduces replacement costs and time to transition into the new role. This programme provides an internal pipeline of future leaders who will be more successful than external candidates. Using an actual cost-benefit analysis equips nurse managers with valuable evidence depicting succession planning as a viable business strategy. © 2017 John Wiley & Sons Ltd.

  11. Conducting a SWOT Analysis for Program Improvement

    Science.gov (United States)

    Orr, Betsy

    2013-01-01

    A SWOT (strengths, weaknesses, opportunities, and threats) analysis of a teacher education program, or any program, can be the driving force for implementing change. A SWOT analysis is used to assist faculty in initiating meaningful change in a program and to use the data for program improvement. This tool is useful in any undergraduate or degree…

  12. Hospital pharmacy decisions, cost containment, and the use of cost-effectiveness analysis.

    Science.gov (United States)

    Sloan, F A; Whetten-Goldstein, K; Wilson, A

    1997-08-01

    The key hypothesis of the study was that hospital pharmacies under the pressure of managed care would be more likely to adopt process innovations to assure less costly and more cost-effective provision of care. We conducted a survey of 103 hospitals and analyzed secondary data on cost and staffing. Compared to the size of the reduction in length of stay, changes in the way that a day of care is delivered appear to be minor, even in areas with substantial managed care share. The vast majority of hospitals surveyed had implemented some form of therapeutic interchange and generic substitution. Most hospitals used some drug utilization guidelines, but as of mid 1995 these were not yet important management tools for hospital pharmacies. To our knowledge, ours was the first survey to investigate the link between hospital formularies and use of cost-effectiveness analysis. At most cost-effectiveness was a minor tool in pharmaceutical decision making in hospitals at present. We could determine no differences in use of such analyses by managed care market share in the hospital's market share. One impediment to the use of cost-effectiveness studies was the lack of timeliness of studies. Other stated reasons for not using cost-effectiveness analysis more often were: lack of information on hospitalized patients and hence on the potential cost offsets accruing to the hospital: lack of independent sponsorship, and inadequate expertise in economic evaluation.

  13. Can Additional Homeopathic Treatment Save Costs? A Retrospective Cost-Analysis Based on 44500 Insured Persons.

    Directory of Open Access Journals (Sweden)

    Julia K Ostermann

    Full Text Available The aim of this study was to compare the health care costs for patients using additional homeopathic treatment (homeopathy group with the costs for those receiving usual care (control group.Cost data provided by a large German statutory health insurance company were retrospectively analysed from the societal perspective (primary outcome and from the statutory health insurance perspective. Patients in both groups were matched using a propensity score matching procedure based on socio-demographic variables as well as costs, number of hospital stays and sick leave days in the previous 12 months. Total cumulative costs over 18 months were compared between the groups with an analysis of covariance (adjusted for baseline costs across diagnoses and for six specific diagnoses (depression, migraine, allergic rhinitis, asthma, atopic dermatitis, and headache.Data from 44,550 patients (67.3% females were available for analysis. From the societal perspective, total costs after 18 months were higher in the homeopathy group (adj. mean: EUR 7,207.72 [95% CI 7,001.14-7,414.29] than in the control group (EUR 5,857.56 [5,650.98-6,064.13]; p<0.0001 with the largest differences between groups for productivity loss (homeopathy EUR 3,698.00 [3,586.48-3,809.53] vs. control EUR 3,092.84 [2,981.31-3,204.37] and outpatient care costs (homeopathy EUR 1,088.25 [1,073.90-1,102.59] vs. control EUR 867.87 [853.52-882.21]. Group differences decreased over time. For all diagnoses, costs were higher in the homeopathy group than in the control group, although this difference was not always statistically significant.Compared with usual care, additional homeopathic treatment was associated with significantly higher costs. These analyses did not confirm previously observed cost savings resulting from the use of homeopathy in the health care system.

  14. Sources and Nature of Cost Analysis Data Base Reference Manual.

    Science.gov (United States)

    1983-07-01

    Personnel Office; Contractual Procurement Office CPR - Cost Performance Report CPU - Control Processing Unit CRT - Cathode Ray Tube C/SCSC - Cost...Gust and Load Alleviation System GLLD - Ground Laser Locator Designator GNIF - Gross National Product CPU - Ground Power Unit GS - General Support...I.OSSARY OF (u:Yl ANALYSIS T LRNS* I. AELRONAUTICAL MANUFA . .I t.R’ PLANNINGR(EPORT (AMPR) WEIGHT. See Airframe We 0,it . Soirce: Cost nforrnatiom

  15. Cost-effectiveness analysis of sandhill crane habitat management

    Science.gov (United States)

    Kessler, Andrew C.; Merchant, James W.; Shultz, Steven D.; Allen, Craig R.

    2013-01-01

    Invasive species often threaten native wildlife populations and strain the budgets of agencies charged with wildlife management. We demonstrate the potential of cost-effectiveness analysis to improve the efficiency and value of efforts to enhance sandhill crane (Grus canadensis) roosting habitat. We focus on the central Platte River in Nebraska (USA), a region of international ecological importance for migrating avian species including sandhill cranes. Cost-effectiveness analysis is a valuation process designed to compare alternative actions based on the cost of achieving a pre-determined objective. We estimated costs for removal of invasive vegetation using geographic information system simulations and calculated benefits as the increase in area of sandhill crane roosting habitat. We generated cost effectiveness values for removing invasive vegetation on 7 land parcels and for the entire central Platte River to compare the cost-effectiveness of management at specific sites and for the central Platte River landscape. Median cost effectiveness values for the 7 land parcels evaluated suggest that costs for creating 1 additional hectare of sandhill crane roosting habitat totaled US $1,595. By contrast, we found that creating an additional hectare of sandhill crane roosting habitat could cost as much as US $12,010 for some areas in the central Platte River, indicating substantial cost savings can be achieved by using a cost effectiveness analysis to target specific land parcels for management. Cost-effectiveness analysis, used in conjunction with geographic information systems, can provide decision-makers with a new tool for identifying the most economically efficient allocation of resources to achieve habitat management goals.

  16. XML Graphs in Program Analysis

    DEFF Research Database (Denmark)

    Møller, Anders; Schwartzbach, Michael Ignatieff

    2007-01-01

    XML graphs have shown to be a simple and effective formalism for representing sets of XML documents in program analysis. It has evolved through a six year period with variants tailored for a range of applications. We present a unified definition, outline the key properties including validation...... of XML graphs against different XML schema languages, and provide a software package that enables others to make use of these ideas. We also survey four very different applications: XML in Java, Java Servlets and JSP, transformations between XML and non-XML data, and XSLT....

  17. 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.

  18. Cost analysis of hospitalized Clostridium difficile-associated diarrhea (CDAD

    Directory of Open Access Journals (Sweden)

    Hübner, Claudia

    2015-10-01

    Full Text Available Aim: -associated diarrhea (CDAD causes heavy financial burden on healthcare systems worldwide. As with all hospital-acquired infections, prolonged hospital stays are the main cost driver. Previous cost studies only include hospital billing data and compare the length of stay in contrast to non-infected patients. To date, a survey of actual cost has not yet been conducted.Method: A retrospective analysis of data for patients with nosocomial CDAD was carried out over a 1-year period at the University Hospital of Greifswald. Based on identification of CDAD related treatment processes, cost of hygienic measures, antibiotics and laboratory as well as revenue losses due to bed blockage and increased length of stay were calculated.Results: 19 patients were included in the analysis. On average, a CDAD patient causes additional costs of € 5,262.96. Revenue losses due to extended length of stay take the highest proportion with € 2,555.59 per case, followed by loss in revenue due to bed blockage during isolation with € 2,413.08 per case. Overall, these opportunity costs accounted for 94.41% of total costs. In contrast, costs for hygienic measures (€ 253.98, pharmaceuticals (€ 22.88 and laboratory (€ 17.44 are quite low.Conclusion: CDAD results in significant additional costs for the hospital. This survey of actual costs confirms previous study results.

  19. 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

  20. 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…

  1. 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...

  2. Access Based Cost Estimation for Beddown Analysis

    Science.gov (United States)

    2006-03-23

    everyone in Air Mobility Command Planning and Programs Requirements Division that contributed to this effort: especially Major Brad Buckman and...investigate available on-line sources of data and other existing databases. The necessary protocols and network access authorizations must be...System (C2IPS), and Standard Base Supply System (SBSS), etc. Figure 2 outlines the basic architecture and interface protocols . The system provides

  3. 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

  4. 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...

  5. 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.

  6. Analysis of Cost and Returns Among Women Food Crop Marketers ...

    African Journals Online (AJOL)

    The study was on the analysis of costs and returns in women participation in food crop marketing in Abia State. The objectives of the study were to describe the socio-economic characteristics of the respondents, describe the types of crops marketed by the women, determine the costs and returns of the enterprise and make ...

  7. Analysis of cost efficiency in small scale irrigated tomato production ...

    African Journals Online (AJOL)

    The result showed that there was relative presence of economies of scale among the farmers meaning that average farm in the study area produced at a minimum cost considering the size of the farm indicating that they operated in stage II of production surface. The mean cost efficiency of 1.09 obtained from the analysis ...

  8. A Comparative Cost Analysis of Picture Archiving and ...

    African Journals Online (AJOL)

    Method: An incremental cost analysis for chest radiographs,, computed tomography and magnetic resonance imaging brain scans with and without contrast were performed. The overall incremental cost for PACS in comparison with a conventional radiology site was determined. The net present value was also determined to ...

  9. HYBRID SULFUR PROCESS REFERENCE DESIGN AND COST ANALYSIS

    Energy Technology Data Exchange (ETDEWEB)

    Gorensek, M.; Summers, W.; Boltrunis, C.; Lahoda, E.; Allen, D.; Greyvenstein, R.

    2009-05-12

    This report documents a detailed study to determine the expected efficiency and product costs for producing hydrogen via water-splitting using energy from an advanced nuclear reactor. It was determined that the overall efficiency from nuclear heat to hydrogen is high, and the cost of hydrogen is competitive under a high energy cost scenario. It would require over 40% more nuclear energy to generate an equivalent amount of hydrogen using conventional water-cooled nuclear reactors combined with water electrolysis compared to the proposed plant design described herein. There is a great deal of interest worldwide in reducing dependence on fossil fuels, while also minimizing the impact of the energy sector on global climate change. One potential opportunity to contribute to this effort is to replace the use of fossil fuels for hydrogen production by the use of water-splitting powered by nuclear energy. Hydrogen production is required for fertilizer (e.g. ammonia) production, oil refining, synfuels production, and other important industrial applications. It is typically produced by reacting natural gas, naphtha or coal with steam, which consumes significant amounts of energy and produces carbon dioxide as a byproduct. In the future, hydrogen could also be used as a transportation fuel, replacing petroleum. New processes are being developed that would permit hydrogen to be produced from water using only heat or a combination of heat and electricity produced by advanced, high temperature nuclear reactors. The U.S. Department of Energy (DOE) is developing these processes under a program known as the Nuclear Hydrogen Initiative (NHI). The Republic of South Africa (RSA) also is interested in developing advanced high temperature nuclear reactors and related chemical processes that could produce hydrogen fuel via water-splitting. This report focuses on the analysis of a nuclear hydrogen production system that combines the Pebble Bed Modular Reactor (PBMR), under development by

  10. Personal Computer Transport Analysis Program

    Science.gov (United States)

    DiStefano, Frank, III; Wobick, Craig; Chapman, Kirt; McCloud, Peter

    2012-01-01

    The Personal Computer Transport Analysis Program (PCTAP) is C++ software used for analysis of thermal fluid systems. The program predicts thermal fluid system and component transients. The output consists of temperatures, flow rates, pressures, delta pressures, tank quantities, and gas quantities in the air, along with air scrubbing component performance. PCTAP s solution process assumes that the tubes in the system are well insulated so that only the heat transfer between fluid and tube wall and between adjacent tubes is modeled. The system described in the model file is broken down into its individual components; i.e., tubes, cold plates, heat exchangers, etc. A solution vector is built from the components and a flow is then simulated with fluid being transferred from one component to the next. The solution vector of components in the model file is built at the initiation of the run. This solution vector is simply a list of components in the order of their inlet dependency on other components. The component parameters are updated in the order in which they appear in the list at every time step. Once the solution vectors have been determined, PCTAP cycles through the components in the solution vector, executing their outlet function for each time-step increment.

  11. Aagesta-BR3 Decommissioning Cost. Comparison and Benchmarking Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Varley, Geoff [NAC International, Henley on Thames (United Kingdom)

    2002-11-01

    This report presents the results of decommissioning cost analyses focusing on discrete working packages within the decommissioning program of the BR3 reactor in Mol, Belgium and comparison of them with cost estimate data for the Aagesta research reactor in Sweden. The specific BR3 work packages analysed were: Primary coolant piping decontamination; Primary coolant piping dismantling; Vulcain reactor internals dismantling; Westinghouse reactor internals dismantling; Reactor vessel dismantling. The main conclusions to be drawn from the analyses are that: The fixed costs related to decontamination and dismantling activities generally are a very important part of the overall resources needed to execute the work, with the Reactor Pressure Vessel (RPV) seemingly being significantly more demanding than other major components. Cutting activities tend to need something like 150 to 200 labour hours per m{sup 2} of reactor equipment dismantled. Fixed investment costs to set up the equipment needed to cut up major vessels or internals appear to be in the range of MSEK 4 to 8. Consumables costs vary according to the nature of the equipment being dismantled. The thicker the metal being cut, the higher the attrition rate for things such as cutting blades. The range of consumables costs at BR3 have been in the range of MSEK 0.1 to 0.2/m{sup 2} dismantled. The extent of detailed information available in the 1996 Aagesta estimate is not sufficient to enable a full comparison with the BR3 decommissioning results. A global first comparison has been attempted by summing the resources expended on the BR3 work packages described in this report with the combined dismantling data presented in the 1996 Aagesta cost estimate report. Very broadly the cost of decontamination plus dismantling of the main process equipment at Aagesta appears to be in the order of MSEK 70, of which MSEK 4 is labour on preparatory/planning work, MSEK 40 is labour on actual decontamination and dismantling and MSEK

  12. Cost analysis in health centers using 'Step Down' methodology

    Directory of Open Access Journals (Sweden)

    Matejić S.

    2015-01-01

    Full Text Available Health care reform aims to improve Health System performance by achievement of one of the four objectives: reducing costs by increasing the efficiency of health care provision. Performance improvement implies acceptance of innovations in all Health care activities including health care financial management. Successful implementation of health care financing reform requires previous costs and activities analysis in health institutions. In the work we performed comparative analysis of the costs of 27 health institutions by applying innovative system for health care services costs analysis and control. Initialy spreadsheet system was made, by using internationaly recognised 'Step Down' methodology, for cost control and analisys in the hospitals and was adapted for Primary health care institutions. Results achieved: The dominant cost for employees salaries, on average around 80%, does not depend on the size of Primary health institution (Dom zdravlja; Significant differences in the percentage values of the cost of medicines, medical supplies, diagnostic services; There is an obvious difference percentage values of technical maintenance costs as a result of uneven percentage of the number of non-medical employees, differences in infrastructure organization, the difference in the condition and type of equipment, the difference in the type of space heating and type of fuel for heating, patients transportation obligations especialy of home treatment services and polyvalent patronage. There is a big difference in average cost per outpatient examination, as a consequence of uneven number of services performed, especialy in the dentistry services. There is a significant difference in the number of preventive health examinations performed which has a direct impact on the cost of these inspections. The main conclusion of the analysis done indicates that in the actual situation of disparities, in terms of costs, can joperdize implementation of Primary health

  13. A MANAGERIAL AND COST ACCOUNTING APPROACH OF CUSTOMER PROFITABILITY ANALYSIS

    Directory of Open Access Journals (Sweden)

    CARDOS Ildiko Reka

    2010-07-01

    Full Text Available In the last years many organizations realized that market orientation is essential to their success. Satisfying the needs of customers, offering them products and services which meet their desires and demands, customer loyalty can increase profitability for long term. After analyzing the existing journal literature in this field we would like to emphasize that managerial accounting, cost calculation methods and techniques, the analysis of costs provides relevant information when analyzing the customer’s profitability. We pay special attention on cost systems. An activity based costing approach takes customer profitability to new levels of accuracy and usefulness, provides the basis for creating, communicating and delivering value to the customers.

  14. Identifying airline cost economies: An econometric analysis of the factors affecting aircraft opeerating costs

    NARCIS (Netherlands)

    Zuidberg, J.

    2014-01-01

    This paper provides the results of an econometric analysis of the influences of airline characteristics on the average operating costs per aircraft movement. The analysis combines a comprehensive selection of airline-output variables, airline-fleet variables, and airline-market variables. The

  15. 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)

  16. 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...

  17. Learning Together; part 2: training costs and health gain - a cost analysis.

    Science.gov (United States)

    Cullen, Katherine; Riches, Wendy; Macaulay, Chloe; Spicer, John

    2017-01-01

    Learning Together is a complex educational intervention aimed at improving health outcomes for children and young people. There is an additional cost as two doctors are seeing patients together for a longer appointment than a standard general practice (GP) appointment. Our approach combines the impact of the training clinics on activity in South London in 2014-15 with health gain, using NICE guidance and standards to allow comparison of training options. Activity data was collected from Training Practices hosting Learning Together. A computer based model was developed to analyse the costs of the Learning Together intervention compared to usual training in a partial economic evaluation. The results of the model were used to value the health gain required to make the intervention cost effective. Data were returned for 363 patients booked into 61 clinics across 16 Training Practices. Learning Together clinics resulted in an increase in costs of £37 per clinic. Threshold analysis illustrated one child with a common illness like constipation needs to be well for two weeks, in one Practice hosting four training clinics for the clinics to be considered cost effective. Learning Together is of minimal training cost. Our threshold analysis produced a rubric that can be used locally to test cost effectiveness at a Practice or Programme level.

  18. [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

  19. Electric vehicle life cycle cost analysis : final research project report.

    Science.gov (United States)

    2017-02-01

    This project compared total life cycle costs of battery electric vehicles (BEV), plug-in hybrid electric vehicles (PHEV), hybrid electric vehicles (HEV), and vehicles with internal combustion engines (ICE). The analysis considered capital and operati...

  20. Portfolios of biomedical HIV interventions in South Africa: a cost-effectiveness analysis.

    Science.gov (United States)

    Long, Elisa F; Stavert, Robert R

    2013-10-01

    Recent clinical trials of male circumcision, oral pre-exposure prophylaxis (PrEP), and a vaginal microbicide gel have shown partial effectiveness at reducing HIV transmission, stimulating interest in implementing portfolios of biomedical prevention programs. To evaluate the effectiveness and cost-effectiveness of combination biomedical HIV prevention and treatment scale-up in South Africa, given uncertainty in program effectiveness. Dynamic HIV transmission and disease progression model with Monte Carlo simulation and cost-effectiveness analysis. Men and women aged 15 to 49 years in South Africa. HIV screening and counseling, antiretroviral therapy (ART), male circumcision, PrEP, microbicide, and select combinations. HIV incidence, prevalence, discounted costs, discounted quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios. Providing half of all uninfected persons with PrEP averts 28 % of future HIV infections for $9,000/QALY gained, but the affordability of such a program is questionable. Given limited resources, annual HIV screening and ART utilization by 75 % of eligible infected persons could avert one-third of new HIV infections, for approximately $1,000/QALY gained. Male circumcision is more cost-effective, but disproportionately benefits men. A comprehensive portfolio of expanded screening, ART, male circumcision, microbicides, and PrEP could avert 62 % of new HIV infections, reducing HIV prevalence from a projected 14 % to 10 % after 10 years. This strategy doubles treatment initiation and adds 31 million QALYs to the population. Despite uncertainty in program effectiveness, a comprehensive portfolio costs less than $10,000/QALY gained in 33 % of simulation iterations and less than $30,000/QALY gained in 90 % of iterations, assuming an annual microbicide cost of $100. A portfolio of modestly-effective biomedical HIV prevention programs, including male circumcision, vaginal microbicides, and oral PrEP, could substantially reduce

  1. Costs and benefits of railway urban logistics: a prospective social cost benefit analysis

    OpenAIRE

    Gonzalez-Feliu, Jesus

    2014-01-01

    This paper presents a general framework to assess urban rail logistics suitability via a socio-economic cost benefit analysis. Firstly, we propose an overview on the basic notions of CBA and SCBA. Secondly, we identify and present the main types of costs and benefits or railway urban logistics services and the related final delivery services using low emission road vehicles to serve customers where the rail systems cannot. Thirdly, as an example of application, we propose to assess a scenario...

  2. Analysis of Logistics Costs of the Ukrainian Semiconductor Industry

    Directory of Open Access Journals (Sweden)

    Popova Viktoriya D.

    2014-01-01

    Full Text Available The goal of the article is analysis of logistics costs in production of semiconductor materials using example of two Ukrainian enterprises. The article studies influence of logistics management and logistics costs upon formation of the final cost value (price of a commodity (service. It gives an assessment of logistics costs of Ukrainian semiconductor enterprises and establishes its structure by types of main expenditure items: material, transport, production and storehouse. It establishes the generalised quantitative structure of logistics costs of Ukrainian semiconductor enterprises with various forms of ownership under conditions of a situational growth of cost value of products and reduction of profitability of production, caused by common crisis tendencies in economy. Prospects of further studies in this direction are analysis of costs in production of semiconductor products and establishment of the specific feature of their grouping and classifying from the point of view of logistics and justification of the model of assessment of cost value of products, which takes into account mutually contradictory influence of direct logistics costs and logistics management upon the final result.

  3. Cost and cost-effectiveness of a school-based education program to reduce salt intake in children and their families in China.

    Directory of Open Access Journals (Sweden)

    Xian Li

    Full Text Available The School-based Education Program to Reduce Salt Intake in Children and Their Families study was a cluster randomized control trial among grade five students in 28 primary schools and their families in Changzhi, China. It achieved a significant effect in lowering systolic blood pressure (SBP in all family adults by 2.3 mmHg and in elderlies (aged > = 60 years by 9.5 mmHg. The aim of this study was to assess the cost-effectiveness of this salt reduction program.Costs of the intervention were assessed using an ingredients approach to identify resource use. A trial-based incremental cost-effectiveness ratio (ICER was estimated based on the observed effectiveness in lowering SBP. A Markov model was used to estimate the long-term cost-effectiveness of the intervention, and then based on population data, extrapolated to a scenario where the program is scaled up nationwide. Findings were presented in terms of an incremental cost per quality-adjusted life year (QALY. The perspective was that of the health sector.The intervention cost Int$19.04 per family and yielded an ICER of Int$2.74 (90% CI: 1.17-12.30 per mmHg reduction of SBP in all participants (combining children and adult participants together compared with control group. If scaled up nationwide for 10 years and assumed deterioration in treatment effect of 50% over this period, it would reach 165 million families and estimated to avert 42,720 acute myocardial infarction deaths and 107,512 stroke deaths in China. This would represent a gain of 635,816 QALYs over 10-year time frame, translating into Int$1,358 per QALY gained.Based on WHO-CHOICE criteria, our analysis demonstrated that the proposed salt reduction strategy is highly cost-effective, and if scaled up nationwide, the benefits could be substantial.ClinicalTrials.gov NCT01821144.

  4. Cost-effectiveness of new-generation oral cholera vaccines: a multisite analysis.

    Science.gov (United States)

    Jeuland, Marc; Cook, Joseph; Poulos, Christine; Clemens, John; Whittington, Dale

    2009-09-01

    We evaluated the cost-effectiveness of a low-cost cholera vaccine licensed and used in Vietnam, using recently collected data from four developing countries where cholera is endemic. Our analysis incorporated new findings on vaccine herd protective effects. Using data from Matlab, Bangladesh, Kolkata, India, North Jakarta, Indonesia, and Beira, Mozambique, we calculated the net public cost per disability-adjusted life year avoided for three immunization strategies: 1) school-based vaccination of children 5 to 14 years of age; 2) school-based vaccination of school children plus use of the schools to vaccinate children aged 1 to 4 years; and 3) community-based vaccination of persons aged 1 year and older. We determined cost-effectiveness when vaccine herd protection was or was not considered, and compared this with commonly accepted cutoffs of gross domestic product (GDP) per person to classify interventions as cost-effective or very-cost effective. Without including herd protective effects, deployment of this vaccine would be cost-effective only in school-based programs in Kolkata and Beira. In contrast, after considering vaccine herd protection, all three programs were judged very cost-effective in Kolkata and Beira. Because these cost-effectiveness calculations include herd protection, the results are dependent on assumed vaccination coverage rates. Ignoring the indirect effects of cholera vaccination has led to underestimation of the cost-effectiveness of vaccination programs with oral cholera vaccines. Once these effects are included, use of the oral killed whole cell vaccine in programs to control endemic cholera meets the per capita GDP criterion in several developing country settings.

  5. Sealing versus Nonsealing: Cost-benefit analysis

    Directory of Open Access Journals (Sweden)

    Anshula N Deshpande

    2016-01-01

    Full Text Available Dental caries still remains the second most prevalent disease after common cold, out of which occlusal caries is the most profound one. In India, more than 40% of children are found to be affected by dental caries. Occlusal surfaces of the teeth are most susceptible sites for caries development due to their morphology. They are least benefited from fluoride application. Various efforts have been made by the preventive means to decline the rate of caries, one of which being sealant application. Sealants have come into existence long back since 1971 when first pit and fissure sealant Nuva-Caulk came into existence. There have been piles of literature stating the benefits that arrive from sealing the teeth. However, one crucial point that is being missed most of the times is the cost-effectiveness of the sealant. There are various schools of thoughts, regarding this that is controversial ones. Some of the analysts believe that always sealing may be a bit costlier, but it reduces subsequent dental treatments and hence saves money as well as time. However, some believe that why to unnecessarily seal the teeth in all cases even when the child is not at a risk to develop caries. Hence, we need to foresee both the sides of equation. For best clinical practice and decision-making, we need to have a balance of best evidence, clinical judgment, and the most important, patient needs and preferences.

  6. Cost of Cutaneous Melanoma by Tumor Stage: A Descriptive Analysis.

    Science.gov (United States)

    Serra-Arbeloa, P; Rabines-Juárez, Á O; Álvarez-Ruiz, M S; Guillén-Grima, F

    2017-04-01

    The basis for optimal resource allocation is an understanding of requirements during the diagnostic and treatment phases. Costs associated with the rising incidence of cutaneous melanoma are considerable. We undertook an up-to-date analysis of the cost of diagnosis, treatment, and follow-up according to tumor stage. We constructed descriptive tables following a theoretical model of direct costs based on amounts published in directives for the Spanish national health system and in international guidelines for managing cutaneous melanoma according to stage at diagnosis and clinical course. The tables allowed us to calculate the cost of treating individual patients as well as the expected cost for all patients with tumors in the same stage. Individual patients would generate costs ranging from €1689 (for a stage I tumor) to €88, 268 (stage IV). The largest differences were between stages IA and IB-IIA and between stages III and IV. Costs differed greatly between patients with early-stage tumors and favorable outcomes and those with recurring tumors, which cost 50-fold more in the first year and 20-fold more after 10 years of follow-up. The high cost of diagnosing advanced-stage cutaneous melanoma calls attention to the need to promote primary prevention and early detection. Our findings provide the knowledge base for cost-effectiveness studies in this disease. Copyright © 2016 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Analysis of costs structure of the industrial enterprise

    Directory of Open Access Journals (Sweden)

    Yuriy V. Kovtunenko

    2014-12-01

    Full Text Available Costs are an important factor that affects the economic activities of an industrial enterprise, because they affect the profits of the enterprise on production efficiency and competitiveness. The article aims to summarize approaches of the definition of “costs”, classification costs of the enterprise according to different characteristics and cost structure of industrial enterprises. Each scientist has his own opinion on the choice of the structure and classification of costs, which is based on his own experience and experience of other scientists. Economically justified classification of costs is an important factor for analysis and costs accounting. This paper examines the concept of “costs” in the interpretation of various authors based on research of scientists that highlight the main features of the classification of costs, give the cost structure of industrial enterprises. Based on the study it can be concluded that the standard classification of costs is not for all companies. Therefore, it is necessary to develop a classification of costs according to the main features of the company.

  8. U.S. Department of Energy Hydrogen Storage Cost Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Law, Karen; Rosenfeld, Jeffrey; Han, Vickie; Chan, Michael; Chiang, Helena; Leonard, Jon

    2013-03-11

    The overall objective of this project is to conduct cost analyses and estimate costs for on- and off-board hydrogen storage technologies under development by the U.S. Department of Energy (DOE) on a consistent, independent basis. This can help guide DOE and stakeholders toward the most-promising research, development and commercialization pathways for hydrogen-fueled vehicles. A specific focus of the project is to estimate hydrogen storage system cost in high-volume production scenarios relative to the DOE target that was in place when this cost analysis was initiated. This report and its results reflect work conducted by TIAX between 2004 and 2012, including recent refinements and updates. The report provides a system-level evaluation of costs and performance for four broad categories of on-board hydrogen storage: (1) reversible on-board metal hydrides (e.g., magnesium hydride, sodium alanate); (2) regenerable off-board chemical hydrogen storage materials(e.g., hydrolysis of sodium borohydride, ammonia borane); (3) high surface area sorbents (e.g., carbon-based materials); and 4) advanced physical storage (e.g., 700-bar compressed, cryo-compressed and liquid hydrogen). Additionally, the off-board efficiency and processing costs of several hydrogen storage systems were evaluated and reported, including: (1) liquid carrier, (2) sodium borohydride, (3) ammonia borane, and (4) magnesium hydride. TIAX applied a bottom-up costing methodology customized to analyze and quantify the processes used in the manufacture of hydrogen storage systems. This methodology, used in conjunction with ® software and other tools, developed costs for all major tank components, balance-of-tank, tank assembly, and system assembly. Based on this methodology, the figure below shows the projected on-board high-volume factory costs of the various analyzed hydrogen storage systems, as designed. Reductions in the key cost drivers may bring hydrogen storage system costs closer to this DOE target

  9. Cost-utility analysis of nonalcoholic steatohepatitis screening.

    Science.gov (United States)

    Zhang, Eric; Wartelle-Bladou, Claire; Lepanto, Luigi; Lachaine, Jean; Cloutier, Guy; Tang, An

    2015-11-01

    Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease in Western countries. No studies have examined the cost-effectiveness of screening its advanced form, nonalcoholic steatohepatitis (NASH). We performed a cost-utility analysis of annual noninvasive screening strategies using third-party payer perspective in a general population in comparison to screening a high-risk obese or diabetic population. Screening algorithms involved well-studied techniques, including NAFLD fibrosis score, transient elastography (TE), and acoustic radiation force impulse (ARFI) imaging for detecting advanced fibrosis (≥ F3); and plasma cytokeratin (CK)-18 for NASH detection. Liver biopsy and magnetic resonance elastography (MRE) were compared as confirmation methods. Canadian dollar (CAD or C$) costs were adjusted for inflation and discounted at 5%. Incremental cost-effectiveness ratio (ICER) of ≤C$ 50,000 was considered cost-effective. Compared with no screening, screening with NAFLD fibrosis score/TE/CK-18 algorithm with MRE as confirmation for advanced fibrosis had an ICER of C$ 26,143 per quality-adjusted life year (QALY) gained. Screening in high-risk obese or diabetic populations was more cost-effective, with an ICER of C$ 9,051 and C$ 7,991 per quality-adjusted life-year (QALY) gained, respectively. Liver biopsy confirmation was not found to be cost-effective. Our model suggests that annual NASH screening in high-risk obese or diabetic populations can be cost-effective. • This cost-utility analysis suggests that screening for nonalcoholic steatohepatitis may be cost-effective. • In particular, screening of high-risk obese or diabetic populations is more cost-effective. • Magnetic resonance elastography was more cost-effective to confirm disease compared to biopsy. • More studies are needed to determine quality of life in nonalcoholic steatohepatitis. • More management strategies for nonalcoholic steatohepatitis are also needed.

  10. Dancing on the Bottom Line: An Unruly Cost-Benefit Analysis of Three Academic Development Initiatives

    Science.gov (United States)

    Sword, Helen

    2014-01-01

    This article offers an unconventional cost-benefit analysis of three academic development initiatives at a large Australasian university: a three-day foundation course for new academics, a series of one-on-one teaching consultations and a two-year postgraduate certificate program. Weaving together qualitative, quantitative and arts-based…

  11. ROOT CAUSE ANALYSIS PROGRAM MANUAL

    Energy Technology Data Exchange (ETDEWEB)

    Gravois, Melanie C.

    2007-05-02

    Root Cause Analysis (RCA) identifies the cause of an adverse condition that, if corrected, will preclude recurrence or greatly reduce the probability of recurrence of the same or similar adverse conditions and thereby protect the health and safety of the public, the workers, and the environment. This procedure sets forth the requirements for management determination and the selection of RCA methods and implementation of RCAs that are a result of significant findings from Price-Anderson Amendments Act (PAAA) violations, occurrences/events, Significant Adverse Conditions, and external oversight Corrective Action Requests (CARs) generated by the Office of Enforcement (PAAA headquarters), the U.S. Environmental Protection Agency, and other oversight entities against Lawrence Berkeley National Laboratory (LBNL). Performance of an RCA may result in the identification of issues that should be reported in accordance with the Issues Management Program Manual.

  12. Estimating the effectiveness of ergonomics interventions through case studies: implications for predictive cost-benefit analysis.

    Science.gov (United States)

    Goggins, Richard W; Spielholz, Peregrin; Nothstein, Greg L

    2008-01-01

    Cost-benefit analysis (CBA) can help to justify an investment in ergonomics interventions. A predictive CBA model would allow practitioners to present a cost justification to management during the planning stages, but such a model requires reliable estimates of the benefits of ergonomics interventions. Through literature reviews and Internet searches, 250 case studies that reported the benefits of ergonomics programs and control measures were collected and summarized. Commonly reported benefits included reductions in the number of work-related musculoskeletal disorders (WMSDs) or their incidence rate, as well as related lost workdays, restricted workdays, and workers' compensation costs. Additional benefits reported were related to productivity, quality, turnover and absenteeism. Benefits reported were largely positive, and payback periods for ergonomics interventions were typically less than one year. The results of this review could be used to develop predictive CBA models for ergonomics programs and individual control measures. Cost-justifying ergonomics interventions prior to implementation may help to secure management support for proposed changes. Numbers used for the benefits side of a cost-benefit analysis (CBA) need to be based on "real world" data in order to be credible. The data presented in this paper may help in the development of simple cost-benefit models for ergonomics programs and control measures.

  13. 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...

  14. PET-CT in oncological patients: analysis of informal care costs in cost-benefit assessment.

    Science.gov (United States)

    Orlacchio, Antonio; Ciarrapico, Anna Micaela; Schillaci, Orazio; Chegai, Fabrizio; Tosti, Daniela; D'Alba, Fabrizio; Guazzaroni, Manlio; Simonetti, Giovanni

    2014-04-01

    The authors analysed the impact of nonmedical costs (travel, loss of productivity) in an economic analysis of PET-CT (positron-emission tomography-computed tomography) performed with standard contrast-enhanced CT protocols (CECT). From October to November 2009, a total of 100 patients referred to our institute were administered a questionnaire to evaluate the nonmedical costs of PET-CT. In addition, the medical costs (equipment maintenance and depreciation, consumables and staff) related to PET-CT performed with CECT and PET-CT with low-dose nonenhanced CT and separate CECT were also estimated. The medical costs were 919.3 euro for PET-CT with separate CECT, and 801.3 euro for PET-CT with CECT. Therefore, savings of approximately 13% are possible. Moreover, savings in nonmedical costs can be achieved by reducing the number of hospital visits required by patients undergoing diagnostic imaging. Nonmedical costs heavily affect patients' finances as well as having an indirect impact on national health expenditure. Our results show that PET-CT performed with standard dose CECT in a single session provides benefits in terms of both medical and nonmedical costs.

  15. Simultaneous versus sequential bilateral cochlear implants in adults: Cost analysis in a US setting.

    Science.gov (United States)

    Trinidade, Aaron; Page, Joshua C; Kennett, Sarah W; Cox, Matthew D; Dornhoffer, John L

    2017-11-01

    From a purely surgical efficiency point of view, simultaneous cochlear implantation (SimCI) is more cost-effective than sequential cochlear implantation (SeqCI) when total direct costs are considered (implant and hospital costs). However, in a setting where only SeqCI is practiced and a proportion of initially unilaterally implanted patients do not progress to a second implant, this may not be the case, especially when audiological costs are factored in. We present a cost analysis of such a scenario as would occur in our institution. Retrospective review and cost analysis. Between 2005 and 2015, 370 patients fulfilled the audiological criteria for bilateral implantation. Of those, 267 (72.1%) underwent unilateral cochlear implantation only, 101 (27.3%) progressed to SeqCI, and two underwent SimCI. The total hospital, surgical, and implant costs, and initial implant stimulation series audiological costs between August 2015 and August 2016 (29 adult patients) were used in this analysis. The total hospital, surgical, and implant costs for this period was $2,731,360.42. Based on previous local trends, if a projected eight (27.3%) of these patients decide to progress to SeqCI, this will cost an additional $750,811.04, resulting in an overall total of $3,482,171.46 for these 29 patients. Had all 29 undergone SimCI, the total projected cost would have been $3,332,991.75, representing a total potential saving of $149,179.67 (4.3%). In institutions where only SeqCI is allowed in adults, overall patient management may cost marginally more than if SimCI were practiced. This will be of interest to CI programs and health insurance companies. 4. Laryngoscope, 127:2615-2618, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  16. Cost-Utility Analysis of Cochlear Implantation in Australian Adults.

    Science.gov (United States)

    Foteff, Chris; Kennedy, Steven; Milton, Abul Hasnat; Deger, Melike; Payk, Florian; Sanderson, Georgina

    2016-06-01

    Sequential and simultaneous bilateral cochlear implants are emerging as appropriate treatment options for Australian adults with sensory deficits in both cochleae. Current funding of Australian public hospitals does not provide for simultaneous bilateral cochlear implantation (CI) as a separate surgical procedure. Previous cost-effectiveness studies of sequential and simultaneous bilateral CI assumed 100% of unilaterally treated patients' transition to a sequential bilateral CI. This assumption does not place cochlear implantation in the context of the generally treated population. When mutually exclusive treatment options exist, such as unilateral CI, sequential bilateral CI, and simultaneous bilateral CI, the mean costs of the treated populations are weighted in the calculation of incremental cost-utility ratios. The objective was to evaluate the cost-utility of bilateral hearing aids (HAs) compared with unilateral, sequential, and simultaneous bilateral CI in Australian adults with bilateral severe to profound sensorineural hearing loss. Cost-utility analysis of secondary sources input to a Markov model. Australian health care perspective, lifetime horizon with costs and outcomes discounted 5% annually. Bilateral HAs as treatment for bilateral severe to profound sensorineural hearing loss compared with unilateral, sequential, and simultaneous bilateral CI. Incremental costs per quality adjusted life year (AUD/QALY). When compared with bilateral hearing aids the incremental cost-utility ratio for the CI treatment population was AUD11,160/QALY. The incremental cost-utility ratio was weighted according to the number of patients treated unilaterally, sequentially, and simultaneously, as these were mutually exclusive treatment options. No peer-reviewed articles have reported the incremental analysis of cochlear implantation in a continuum of care for surgically treated populations with bilateral severe to profound sensorineural hearing loss. Unilateral, sequential

  17. 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…

  18. 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)

  19. Cost analysis of microtia treatment in the Netherlands.

    Science.gov (United States)

    Kolodzynski, M N; van Hövell Tot Westerflier, C V A; Kon, M; Breugem, C C

    2017-09-01

    Ear reconstruction for microtia is a challenging procedure. Although analyzing esthetic outcome is crucial, there is a paucity of information with regard to financial aspects of microtia reconstruction. This study was conducted to analyze the costs associated with ear reconstruction with costal cartilage in patients with microtia. Ten consecutive children with autologous ear reconstruction of a unilateral microtia were included in this analysis. All patients had completed their treatment protocol for ear reconstruction. Direct costs (admission to hospital, diagnostics, and surgery) and indirect cost (travel expenses and absence from work) were obtained retrospectively. The overall mean cumulative cost per patient was €14,753. Direct and indirect costs were €13,907 and €846, respectively. Hospital admission and surgery cover 55% and 32% of all the costs, respectively. This study analyzes the costs for autologous ear reconstruction. Hospital admission and surgery are the most important factors of the total costs. Total costs could be decreased by possibly decreasing admission days and surgical time. These data can be used for choosing and developing future treatment strategies. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  20. Cost of Illness and Cost Containment Analysis Using Empirical Antibiotic Therapy in Sepsis Patients in Bandung

    Directory of Open Access Journals (Sweden)

    Rano K. Sinuraya

    2012-12-01

    Full Text Available The aims of this study were to analyze cost of illness (COI and cost containment analysis using empirical antibiotic therapy in sepsis patients with respiratory infection in a hospital in Bandung. A cross sectional method was conducted retrospectively. Data were collected from medical record of inpatients sepsis patients with respiratory infections with empirical antibiotic therapy ceftazidime-levofloxacin or cefotaxime-erythromycin. Direct and indirect cost were calculated and analyzed in this study. The result showed that the average COI for patients with combination ceftazidime-levofloxaxin was 13,369,055 IDR whereas combination of cefotaxime-erythromycin was 22,250,495 IDR. In summary, the COI empirical antibiotic therapy ceftazidime-levofloxacin was lower than cefotaxime-erythromycin. Cost containment using empirical antibiotic therapy ceftazidime-levofloxacin which without reducing the service quality was 8,881,440 IDR.

  1. 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

  2. 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.

  3. A cost-minimization analysis in minimally invasive spine surgery using a national cost scale method.

    Science.gov (United States)

    Maillard, Nicolas; Buffenoir-Billet, Kevin; Hamel, Olivier; Lefranc, Benoit; Sellal, Olivier; Surer, Nathalie; Bord, Eric; Grimandi, Gael; Clouet, Johann

    2015-03-01

    The last decade has seen the emergence of minimally invasive spine surgery. However, there is still no consensus on whether percutaneous osteosynthesis (PO) or open surgery (OS) is more cost-effective in treatment of traumatic fractures and degenerative lesions. The objective of this study is to compare the clinical results and hospitalization costs of OS and PO for degenerative lesions and thoraco-lumbar fractures. This cost-minimization study was performed in patients undergoing OS or PO on a 36-month period. Patient data, surgical and clinical results, as well as cost data were collected and analyzed. The financial costs were calculated based on diagnosis related group reimbursement and the French national cost scale, enabling the evaluation of charges for each hospital stay. 46 patients were included in this cost analysis, 24 patients underwent OS and 22 underwent PO. No significant difference was found between surgical groups in terms of patient's clinical features and outcomes during the patient hospitalization. The use of PO was significantly associated with a decrease in Length Of Stay (LOS). The cost-minimization revealed that PO is associated with decreased hospital charges and shorten LOS for patients, with similar clinical outcomes and medical device cost to OS. This medico-economic study has leaded to choose preferentially the use of minimally invasive surgery techniques. This study also illustrates the discrepancy between the national health system reimbursement and real hospital charges. The medico-economic is becoming critical in the current context of sustainable health resource allocation. Copyright © 2015 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  4. Potential Cost-Effectiveness of an Influenza Vaccination Program Offering Microneedle Patch for Vaccine Delivery in Children.

    Science.gov (United States)

    Wong, Carlos; Jiang, Minghuan; You, Joyce H S

    2016-01-01

    The influenza vaccine coverage rate of children is low in Hong Kong. Microneedle patches (MNPs) is a technology under development for painless delivery of vaccines. This study aimed to examine the potential clinical outcomes and direct medical costs of an influenza program offering MNP vaccine to children who have declined intramuscular (IM) vaccine in Hong Kong. A decision model was designed to compare potential outcomes between IM vaccine program and a program offering MNP vaccine to those declined IM vaccine (IM/MNP program) in a hypothetical cohort of children over one-year time horizon. The model outcomes included direct medical cost, influenza infection rate, mortality rate, and quality-adjusted life-years (QALYs) loss. Model inputs were retrieved from published literature. Sensitivity analyses were performed to examine the robustness of model results. In base-case analysis, IM/MNP program was more costly per child (USD19.13 versus USD13.69; USD1 = HKD7.8) with lower influenza infection rate (98.9 versus 124.8 per 1,000 children), hospitalization rate (0.83 versus 1.05 per 1,000 children) and influenza-related mortality rate (0.00042 versus 0.00052 per 1,000 children) when compared to IM program. The incremental cost per QALY saved (ICER) of IM/MNP program versus IM program was 27,200 USD/QALY. Using gross domestic product (GDP) per capita of Hong Kong (USD40,594) as threshold of willingness-to-pay (WTP) per QALY, one-way sensitivity analysis found ICER of IM/MNP to exceed WTP when duration of illness in outpatient setting was 1.39-time of IM vaccine cost. In 10,000 Monte Carlo simulations, IM/MNP program was the preferred option in 57.28% and 91.68% of the time, using 1x and 3x GDP per capita as WTP threshold, respectively. Acceptance of IM/MNP program as the preferred program was subject to the WTP threshold, duration of illness in outpatient settings, and cost of MNP vaccine.

  5. Potential Cost-Effectiveness of an Influenza Vaccination Program Offering Microneedle Patch for Vaccine Delivery in Children.

    Directory of Open Access Journals (Sweden)

    Carlos Wong

    Full Text Available The influenza vaccine coverage rate of children is low in Hong Kong. Microneedle patches (MNPs is a technology under development for painless delivery of vaccines. This study aimed to examine the potential clinical outcomes and direct medical costs of an influenza program offering MNP vaccine to children who have declined intramuscular (IM vaccine in Hong Kong.A decision model was designed to compare potential outcomes between IM vaccine program and a program offering MNP vaccine to those declined IM vaccine (IM/MNP program in a hypothetical cohort of children over one-year time horizon. The model outcomes included direct medical cost, influenza infection rate, mortality rate, and quality-adjusted life-years (QALYs loss. Model inputs were retrieved from published literature. Sensitivity analyses were performed to examine the robustness of model results.In base-case analysis, IM/MNP program was more costly per child (USD19.13 versus USD13.69; USD1 = HKD7.8 with lower influenza infection rate (98.9 versus 124.8 per 1,000 children, hospitalization rate (0.83 versus 1.05 per 1,000 children and influenza-related mortality rate (0.00042 versus 0.00052 per 1,000 children when compared to IM program. The incremental cost per QALY saved (ICER of IM/MNP program versus IM program was 27,200 USD/QALY. Using gross domestic product (GDP per capita of Hong Kong (USD40,594 as threshold of willingness-to-pay (WTP per QALY, one-way sensitivity analysis found ICER of IM/MNP to exceed WTP when duration of illness in outpatient setting was 1.39-time of IM vaccine cost. In 10,000 Monte Carlo simulations, IM/MNP program was the preferred option in 57.28% and 91.68% of the time, using 1x and 3x GDP per capita as WTP threshold, respectively.Acceptance of IM/MNP program as the preferred program was subject to the WTP threshold, duration of illness in outpatient settings, and cost of MNP vaccine.

  6. Cost-effectiveness of surveillance programs for families at high and moderate risk of hereditary non-polyposis colorectal cancer

    DEFF Research Database (Denmark)

    Rose Olsen, Kim; Bojesen, Stig E; Gerdes, Anne-Marie M

    2007-01-01

    OBJECTIVES: Surveillance programs are recommended to both families at high risk (Amsterdam-positive families with known- and unknown mutation) and moderate risk (families not fulfilling all Amsterdam criteria) of colorectal cancer (CRC). Cost-effectiveness has so far only been estimated for the g......OBJECTIVES: Surveillance programs are recommended to both families at high risk (Amsterdam-positive families with known- and unknown mutation) and moderate risk (families not fulfilling all Amsterdam criteria) of colorectal cancer (CRC). Cost-effectiveness has so far only been estimated...... for the group at high risk. The aim of the present study is to determine cost-effectiveness of surveillance programs where families at both high and moderate risk of HNPCC participate. METHODS: A decision analytic model (Markov model) is developed to assess surveillance programs where families at high...... and moderate risk of HNPCC are offered surveillance from age 25 and age 45, respectively. The model includes costs for all families referred to genetic counseling, including genetic risk assessment, mutation analysis, and surveillance in relevant families with or without known mutation, plus the costs related...

  7. 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.

  8. Cost-benefit analysis of a preventive intervention for divorced families: reduction in mental health and justice system service use costs 15 years later.

    Science.gov (United States)

    Herman, Patricia M; Mahrer, Nicole E; Wolchik, Sharlene A; Porter, Michele M; Jones, Sarah; Sandler, Irwin N

    2015-05-01

    This cost-benefit analysis compared the costs of implementing the New Beginnings Program (NBP), a preventive intervention for divorced families to monetary benefits saved in mental healthcare service use and criminal justice system costs. NBP was delivered when the offspring were 9-12 years old. Benefits were assessed 15 years later when the offspring were young adults (ages 24-27). This study estimated the costs of delivering two versions of NBP, a single-component parenting-after-divorce program (Mother Program, MP) and a two-component parenting-after-divorce and child-coping program (Mother-Plus-Child Program, MPCP), to costs of a literature control (LC). Long-term monetary benefits were determined from actual expenditures from past-year mental healthcare service use for mothers and their young adult (YA) offspring and criminal justice system involvement for YAs. Data were gathered from 202 YAs and 194 mothers (75.4 % of families randomly assigned to condition). The benefits, as assessed in the 15th year after program completion, were $1630/family (discounted benefits $1077/family). These 1-year benefits, based on conservative assumptions, more than paid for the cost of MP and covered the majority of the cost of MPCP. Because the effects of MP versus MPCP on mental health and substance use problems have not been significantly different at short-term or long-term follow-up assessments, program managers would likely choose the lower-cost option. Given that this evaluation only calculated economic benefit at year 15 and not the previous 14 (nor future years), these findings suggest that, from a societal perspective, NBP more than pays for itself in future benefits.

  9. Combined multi-criteria and cost-benefit analysis

    DEFF Research Database (Denmark)

    Moshøj, Claus Rehfeld

    1996-01-01

    The paper is an introduction to both theory and application of combined Cost-Benefit and Multi-Criteria Analysis. The first section is devoted to basic utility theory and its practical application in Cost-Benefit Analysis. Based on some of the problems encountered, arguments in favour...... of the application of utility-based Multi-Criteria Analyses methods as an extension and refinement of the traditional Cost-Benefit Analysis are provided. The theory presented in this paper is closely related the methods used in the WARP software (Leleur & Jensen, 1989). The presentation is however wider in scope.......The second section introduces the stated preference methodology used in WARP to create weight profiles for project pool sensitivity analysis. This section includes a simple example. The third section discusses how decision makers can get a priori aid to make their pair-wise comparisons based on project pool...

  10. Identifying and explaining the variability in development and implementation costs of disease management programs in the Netherlands.

    Science.gov (United States)

    Tsiachristas, Apostolos; Waters, Bethany Hipple; Adams, Samantha A; Bal, Roland; Mölken, Maureen P M M Rutten-van

    2014-10-26

    In the Netherlands, disease management programs (DMPs) are used to treat chronic diseases. Their aim is to improve care and to control the rising expenditures related to chronic diseases. A bundled payment was introduced to facilitate the implementation of DMPs. This payment is an all-inclusive price per patient per year for a pre-specified care package. However, it is unclear to which extent the costs of developing and implementing DMPs are included in this price. Consequently, the organizations providing DMPs bear financial risk because the development and implementation (D&I) costs may be substantial. The aim of this paper is to investigate the variability in and drivers of D&I costs among 22 DMPs and highlight characteristics that impact these. The data was analyzed using a mixed methods approach. Descriptive statistical analysis explored the variability in D&I costs as measured by a self-developed costing instrument and investigated the drivers. In addition, qualitative research, including document analysis and interviews, was conducted to explain the possible underlying reasons of cost variability. The development costs varied from €5,891 to €274,783 and the implementation costs varied from €7,278 to €387,879 across DMPs. Personnel costs were the main component of development. Development costs were strongly correlated with the implementation costs (ρ = 0.55), development duration (ρ = 0.74), and number of FTEs dedicated DMP development. Organizations with large size and high level of care prior to the implementation of a DMP had relatively low development costs. These findings were in line with the cross-case qualitative comparison where programs with a longer history, more experienced project leadership, previously established ICT systems, and less complex patient populations had lower D&I costs. There is wide variation in D&I costs of DMPs, which is driven primarily by the duration of the development phase and the staff needed to develop and

  11. Cost-benefit analysis of the ATM automatic deposit service

    Directory of Open Access Journals (Sweden)

    Ivica Županović

    2015-03-01

    Full Text Available Bankers and other financial experts have analyzed the value of automated teller machines (ATM in terms of growing consumer demand, rising costs of technology development, decreasing profitability and market share. This paper presents a step-by-step cost-benefit analysis of the ATM automatic deposit service. The first step is to determine user attitudes towards using ATM automatic deposit service by using the Technology Acceptance Model (TAM. The second step is to determine location priorities for ATMs that provide automatic deposit services using the Analytic Hierarchy Process (AHP model. The results of the previous steps enable a highly efficient application of cost-benefit analysis for evaluating costs and benefits of automatic deposit services. To understand fully the proposed procedure outside of theoretical terms, a real-world application of a case study is conducted.

  12. 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

  13. sensitivity analysis on flexible road pavement life cycle cost model

    African Journals Online (AJOL)

    Sensitivity analysis is a tool used in the assessment of a model's performance. This study examined the application of sensitivity analysis on a developed flexible pavement life cycle cost model using varying discount rate. The study area is Effurun, Uvwie Local Government Area of Delta State of Nigeria. In order to ...

  14. Costs-Returns Analysis of Small Ruminant (Sheep) Production in ...

    African Journals Online (AJOL)

    Data collected were analyzed using descriptive statistics and costs-returns analysis. Results from the analysis revealed that a net returns of N1,942,400.00 was realized with N 33.72 made on every naira invested. Sheep production is a profitable farming business, with attractive net return on investment. This study also ...

  15. Roles of Variables and Program Analysis

    OpenAIRE

    Bishop, Craig; Johnson, Colin G.

    2005-01-01

    The idea of roles of variables is to provide a vocabulary for describing the way in which variables are used by experienced programmers. This paper presents work on a system that is designed to automatically check students' role assignments in simple procedural programming. This is achieved by applying program analysis techniques, in particular program slicing and data flow analysis, to programs that students have written and annotated with role assignments.

  16. Cost-analysis of teledentistry in residential aged care facilities.

    Science.gov (United States)

    Mariño, Rodrigo; Tonmukayakul, Utsana; Manton, David; Stranieri, Andrew; Clarke, Ken

    2016-09-01

    The purpose of this research was to conduct a cost-analysis, from a public healthcare perspective, comparing the cost and benefits of face-to-face patient examination assessments conducted by a dentist at a residential aged care facility (RACF) situated in rural areas of the Australian state of Victoria, with two teledentistry approaches utilizing virtual oral examination. The costs associated with implementing and operating the teledentistry approach were identified and measured using 2014 prices in Australian dollars. Costs were measured as direct intervention costs and programme costs. A population of 100 RACF residents was used as a basis to estimate the cost of oral examination and treatment plan development for the traditional face-to-face model vs. two teledentistry models: an asynchronous review and treatment plan preparation; and real-time communication with a remotely located oral health professional. It was estimated that if 100 residents received an asynchronous oral health assessment and treatment plan, the net cost from a healthcare perspective would be AU$32.35 (AU$27.19-AU$38.49) per resident. The total cost of the conventional face-to-face examinations by a dentist would be AU$36.59 ($30.67-AU$42.98) per resident using realistic assumptions. Meanwhile, the total cost of real-time remote oral examination would be AU$41.28 (AU$34.30-AU$48.87) per resident. Teledental asynchronous patient assessments were the lowest cost service model. Access to oral health professionals is generally low in RACFs; however, the real-time consultation could potentially achieve better outcomes due to two-way communication between the nurse and a remote oral health professional via health promotion/disease prevention delivered in conjunction with the oral examination. © The Author(s) 2015.

  17. Neuraxial blockade for external cephalic version: Cost analysis.

    Science.gov (United States)

    Yamasato, Kelly; Kaneshiro, Bliss; Salcedo, Jennifer

    2015-07-01

    Neuraxial blockade (epidural or spinal anesthesia/analgesia) with external cephalic version increases the external cephalic version success rate. Hospitals and insurers may affect access to neuraxial blockade for external cephalic version, but the costs to these institutions remain largely unstudied. The objective of this study was to perform a cost analysis of neuraxial blockade use during external cephalic version from hospital and insurance payer perspectives. Secondarily, we estimated the effect of neuraxial blockade on cesarean delivery rates. A decision-analysis model was developed using costs and probabilities occurring prenatally through the delivery hospital admission. Model inputs were derived from the literature, national databases, and local supply costs. Univariate and bivariate sensitivity analyses and Monte Carlo simulations were performed to assess model robustness. Neuraxial blockade was cost saving to both hospitals ($30 per delivery) and insurers ($539 per delivery) using baseline estimates. From both perspectives, however, the model was sensitive to multiple variables. Monte Carlo simulation indicated neuraxial blockade to be more costly in approximately 50% of scenarios. The model demonstrated that routine use of neuraxial blockade during external cephalic version, compared to no neuraxial blockade, prevented 17 cesarean deliveries for every 100 external cephalic versions attempted. Neuraxial blockade is associated with minimal hospital and insurer cost changes in the setting of external cephalic version, while reducing the cesarean delivery rate. © 2015 The Authors. Journal of Obstetrics and Gynaecology Research © 2015 Japan Society of Obstetrics and Gynecology.

  18. Cost-effectiveness analysis in minimally invasive spine surgery.

    Science.gov (United States)

    Al-Khouja, Lutfi T; Baron, Eli M; Johnson, J Patrick; Kim, Terrence T; Drazin, Doniel

    2014-06-01

    Medical care has been evolving with the increased influence of a value-based health care system. As a result, more emphasis is being placed on ensuring cost-effectiveness and utility in the services provided to patients. This study looks at this development in respect to minimally invasive spine surgery (MISS) costs. A literature review using PubMed, the Cost-Effectiveness Analysis (CEA) Registry, and the National Health Service Economic Evaluation Database (NHS EED) was performed. Papers were included in the study if they reported costs associated with minimally invasive spine surgery (MISS). If there was no mention of cost, CEA, cost-utility analysis (CUA), quality-adjusted life year (QALY), quality, or outcomes mentioned, then the article was excluded. Fourteen studies reporting costs associated with MISS in 12,425 patients (3675 undergoing minimally invasive procedures and 8750 undergoing open procedures) were identified through PubMed, the CEA Registry, and NHS EED. The percent cost difference between minimally invasive and open approaches ranged from 2.54% to 33.68%-all indicating cost saving with a minimally invasive surgical approach. Average length of stay (LOS) for minimally invasive surgery ranged from 0.93 days to 5.1 days compared with 1.53 days to 12 days for an open approach. All studies reporting EBL reported lower volume loss in an MISS approach (range 10-392.5 ml) than in an open approach (range 55-535.5 ml). There are currently an insufficient number of studies published reporting the costs of MISS. Of the studies published, none have followed a standardized method of reporting and analyzing cost data. Preliminary findings analyzing the 14 studies showed both cost saving and better outcomes in MISS compared with an open approach. However, more Level I CEA/CUA studies including cost/QALY evaluations with specifics of the techniques utilized need to be reported in a standardized manner to make more accurate conclusions on the cost effectiveness of

  19. 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

  20. Decision analysis of the Liquid Metal Fast Breeder Reactor program

    Energy Technology Data Exchange (ETDEWEB)

    Seim, E.H.

    1983-01-01

    The decision-analysis methodology is employed to develop a model to examine the Liquid Metal Fast Breeder Reactor Program to provide guidance for US decision makers. Information relative to the nuclear fuel cycle, the decision analysis technique, and the supporting economic theory is provided for background purposes. The model consists of four courses of action, three decision times, and five critical factors with either two or three paths leading to 198 possible end results. The courses of action cover a range of the possible programs to develop a commercial LMFBR including scale-up, program timing, and plant schedules. Data developed from a number of recent studies along with probability assignments from three sources are run through the model and indicate that course of action one (Compressed Full Program) produces the greatest net benefits discounted to a present value at a real rate of 5%. An analysis is included to consider the foregone costs of coal usage for electrical generation when LMFBR capacity could be available. Ranking of the courses of action does not change compared to the analysis without foregone costs. The foregone costs are approximately five times greater than the LMFBR benefits alone. Recommendations for specific actions by decision makers conclude the study.

  1. 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...

  2. Oral Cholera Vaccination Delivery Cost in Low- and Middle-Income Countries: An Analysis Based on Systematic Review.

    Science.gov (United States)

    Mogasale, Vittal; Ramani, Enusa; Wee, Hyeseung; Kim, Jerome H

    2016-12-01

    Use of the oral cholera vaccine (OCV) is a vital short-term strategy to control cholera in endemic areas with poor water and sanitation infrastructure. Identifying, estimating, and categorizing the delivery costs of OCV campaigns are useful in analyzing cost-effectiveness, understanding vaccine affordability, and in planning and decision making by program managers and policy makers. To review and re-estimate oral cholera vaccination program costs and propose a new standardized categorization that can help in collation, analysis, and comparison of delivery costs across countries. Peer reviewed publications listed in PubMed database, Google Scholar and World Health Organization (WHO) websites and unpublished data from organizations involved in oral cholera vaccination. The publications and reports containing oral cholera vaccination delivery costs, conducted in low- and middle-income countries based on World Bank Classification. Limits are humans and publication date before December 31st, 2014. No participants are involved, only costs are collected. Oral cholera vaccination and cost estimation. A systematic review was conducted using pre-defined inclusion and exclusion criteria. Cost items were categorized into four main cost groups: vaccination program preparation, vaccine administration, adverse events following immunization and vaccine procurement; the first three groups constituting the vaccine delivery costs. The costs were re-estimated in 2014 US dollars (US$) and in international dollar (I$). Ten studies were identified and included in the analysis. The vaccine delivery costs ranged from US$0.36 to US$ 6.32 (in US$2014) which was equivalent to I$ 0.99 to I$ 16.81 (in I$2014). The vaccine procurement costs ranged from US$ 0.29 to US$ 29.70 (in US$2014), which was equivalent to I$ 0.72 to I$ 78.96 (in I$2014). The delivery costs in routine immunization systems were lowest from US$ 0.36 (in US$2014) equivalent to I$ 0.99 (in I$2014). The reported cost categories

  3. Cost analysis of inpatient treatment of anorexia nervosa in adolescents: hospital and caregiver perspectives.

    Science.gov (United States)

    Toulany, Alene; Wong, Matthew; Katzman, Debra K; Akseer, Nadia; Steinegger, Cathleen; Hancock-Howard, Rebecca L; Coyte, Peter C

    2015-01-01

    Admission to hospital is the treatment of choice for anorexia nervosa in adolescent patients who are medically unstable; however, stays are often prolonged and frequently disrupt normal adolescent development, family functioning, school and work productivity. We sought to determine the costs of inpatient treatment in this population from a hospital and caregiver perspective, and to identify determinants of such costs. We used micro-costing methods for this cohort study involving all adolescent patients (age 12-18 yr) admitted for treatment of anorexia nervosa at a tertiary care child and adolescent eating disorder program in Toronto, between Sept. 1, 2011, and Mar. 31, 2013. We used hospital administrative data and Canadian census data to calculate hospital and caregiver costs. We included 73 adolescents in our cohort for cost-analysis. We determined a mean total hospital cost in 2013 Canadian dollars of $51 349 (standard deviation [SD] $26 598) and a mean total societal cost of $54 932 (SD $27 864) per admission, based on a mean length of stay of 37.9 days (SD 19.7 d). We found patient body mass index (BMI) to be the only significant negative predictor of hospital cost (p eating disorders early may preclude the need for admission to hospital altogether or result in admissions at higher BMIs, thereby potentially reducing these costs.

  4. Identifying cost-minimizing strategies for guaranteeing target dairy income over feed cost via use of the Livestock Gross Margin dairy insurance program.

    Science.gov (United States)

    Valvekar, M; Cabrera, V E; Gould, B W

    2010-07-01

    Milk and feed price volatility are the major source of dairy farm risk. Since August 2008 a new federally reinsured insurance program has been available to many US dairy farmers to help minimize the negative effects of adverse price movements. This insurance program is referred to as Livestock Gross Margin Insurance for Dairy Cattle. Given the flexibility in contract design, the dairy farmer has to make 3 critical decisions when purchasing this insurance: 1) the percentage of monthly milk production to be covered, 3) declared feed equivalents used to produce this milk, and 3) the level of gross margin not covered by insurance (i.e., deductible). The objective of this analysis was to provide an optimal strategy of how a dairy farmer could incorporate this insurance program to help manage the variability in net farm income. In this analysis we assumed that a risk-neutral dairy farmer wants to design an insurance contract such that a target guaranteed income over feed cost is obtained at least cost. We undertook this analysis for a representative Wisconsin dairy farm (herd size: 120 cows) producing 8,873 kg (19,545 lb) of milk/cow per year. Wisconsin statistical data indicates that dairy farms of similar size must require an income over feed cost of at least $110/Mg ($5/cwt) of milk to be profitable during the coverage period. Therefore, using data for the July 2009 insurance contract to insure $110/Mg of milk, the least cost contract was found to have a premium of $1.22/Mg ($0.055/cwt) of milk produced insuring approximately 52% of the production with variable monthly production covered during the period of September 2009 to June 2010. This premium represented 1.10% of the desired IOFC. We compared the above optimal strategy with an alternative nonoptimal strategy, defined as a contract insuring the same proportion of milk as the optimal (52%) but with a constant amount insured across all contract months. The premium was found to be almost twice the level obtained

  5. 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...

  6. Cost-effectiveness analysis of ultrasonography screening for nonalcoholic fatty liver disease in metabolic syndrome patients.

    Science.gov (United States)

    Phisalprapa, Pochamana; Supakankunti, Siripen; Charatcharoenwitthaya, Phunchai; Apisarnthanarak, Piyaporn; Charoensak, Aphinya; Washirasaksiri, Chaiwat; Srivanichakorn, Weerachai; Chaiyakunapruk, Nathorn

    2017-04-01

    Nonalcoholic fatty liver disease (NAFLD) can be diagnosed early by noninvasive ultrasonography; however, the cost-effectiveness of ultrasonography screening with intensive weight reduction program in metabolic syndrome patients is not clear. This study aims to estimate economic and clinical outcomes of ultrasonography in Thailand. Cost-effectiveness analysis used decision tree and Markov models to estimate lifetime costs and health benefits from societal perspective, based on a cohort of 509 metabolic syndrome patients in Thailand. Data were obtained from published literatures and Thai database. Results were reported as incremental cost-effectiveness ratios (ICERs) in 2014 US dollars (USD) per quality-adjusted life year (QALY) gained with discount rate of 3%. Sensitivity analyses were performed to assess the influence of parameter uncertainty on the results. The ICER of ultrasonography screening of 50-year-old metabolic syndrome patients with intensive weight reduction program was 958 USD/QALY gained when compared with no screening. The probability of being cost-effective was 67% using willingness-to-pay threshold in Thailand (4848 USD/QALY gained). Screening before 45 years was cost saving while screening at 45 to 64 years was cost-effective. For patients with metabolic syndromes, ultrasonography screening for NAFLD with intensive weight reduction program is a cost-effective program in Thailand. Study can be used as part of evidence-informed decision making. Findings could contribute to changes of NAFLD diagnosis practice in settings where economic evidence is used as part of decision-making process. Furthermore, study design, model structure, and input parameters could also be used for future research addressing similar questions.

  7. A Cost-effectiveness Analysis of Early vs Late Tracheostomy.

    Science.gov (United States)

    Liu, C Carrie; Rudmik, Luke

    2016-10-01

    The timing of tracheostomy in critically ill patients requiring mechanical ventilation is controversial. An important consideration that is currently missing in the literature is an evaluation of the economic impact of an early tracheostomy strategy vs a late tracheostomy strategy. To evaluate the cost-effectiveness of the early tracheostomy strategy vs the late tracheostomy strategy. This economic analysis was performed using a decision tree model with a 90-day time horizon. The economic perspective was that of the US health care third-party payer. The primary outcome was the incremental cost per tracheostomy avoided. Probabilities were obtained from meta-analyses of randomized clinical trials. Costs were obtained from the published literature and the Healthcare Cost and Utilization Project database. A multivariate probabilistic sensitivity analysis was performed to account for uncertainty surrounding mean values used in the reference case. The reference case demonstrated that the cost of the late tracheostomy strategy was $45 943.81 for 0.36 of effectiveness. The cost of the early tracheostomy strategy was $31 979.12 for 0.19 of effectiveness. The incremental cost-effectiveness ratio for the late tracheostomy strategy compared with the early tracheostomy strategy was $82 145.24 per tracheostomy avoided. With a willingness-to-pay threshold of $50 000, the early tracheostomy strategy is cost-effective with 56% certainty. The adaptation of an early vs a late tracheostomy strategy depends on the priorities of the decision-maker. Up to a willingness-to-pay threshold of $80 000 per tracheostomy avoided, the early tracheostomy strategy has a higher probability of being the more cost-effective intervention.

  8. Cost-Effectiveness of a Collaborative Care Depression and Anxiety Treatment Program in Patients with Acute Cardiac Illness.

    Science.gov (United States)

    Celano, Christopher M; Healy, Brian; Suarez, Laura; Levy, Douglas E; Mastromauro, Carol; Januzzi, James L; Huffman, Jeff C

    2016-01-01

    To use data from a randomized trial to determine the cost-effectiveness of a collaborative care (CC) depression and anxiety treatment program and to assess effects of the CC program on health care utilization. The CC intervention's impact on health-related quality of life, depression-free days (DFDs), and anxiety-free days (AFDs) over the 24-week postdischarge period was calculated and compared with the enhanced usual care (EUC) condition using independent samples t tests and random-effects regression models. Costs for both the CC and EUC conditions were calculated on the basis of staff time, overhead expenses, and treatment materials. Using this information, incremental cost-effectiveness ratios were calculated. A cost-effectiveness acceptability plot was created using nonparametric bootstrapping with 10,000 replications, and the likelihood of the CC intervention's cost-effectiveness was assessed using standard cutoffs. As a secondary analysis, we determined whether the CC intervention led to reductions in postdischarge health care utilization and costs. The CC intervention was more costly than the EUC intervention ($209.86 vs. $34.59; z = -11.71; P < 0.001), but was associated with significantly greater increases in quality-adjusted life-years (t = -2.49; P = 0.01) and DFDs (t = -2.13; P = 0.03), but not AFDs (t = -1.92; P = 0.057). This translated into an incremental cost-effectiveness ratio of $3337.06 per quality-adjusted life-year saved, $13.36 per DFD, and $13.74 per AFD. Compared with the EUC intervention, the CC intervention was also associated with fewer emergency department visits but no differences in overall costs. This CC intervention was associated with clinically relevant improvements, was cost-effective, and was associated with fewer emergency department visits in the 24 weeks after discharge. Copyright © 2016. Published by Elsevier Inc.

  9. 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.

  10. A cost-benefit/cost-effectiveness analysis of an unsanctioned supervised smoking facility in the Downtown Eastside of Vancouver, Canada.

    Science.gov (United States)

    Jozaghi, Ehsan

    2014-11-13

    Smoking crack involves the risk of transmitting diseases such as HIV and hepatitis C (HCV). The current study determines whether the formerly unsanctioned supervised smoking facility (SSF)-operated by the grassroot organization, Vancouver Area Network of Drug Users (VANDU) for the last few years-costs less than the costs incurred for health-care services as a direct consequence of not having such a program in Vancouver, Canada. The data pertaining to the attendance at the SSF was gathered in 2012-2013 by VANDU. By relying on this data, a mathematical model was employed to estimate the number of HCV infections prevented by the former facility in Vancouver's Downtown Eastside (DTES). The DTES SSF's benefit-cost ratio was conservatively estimated at 12.1:1 due to its low operating cost. The study used 70% and 90% initial pipe-sharing rates for sensitivity analysis. At 80% sharing rate, the marginal HCV cases prevented were determined to be 55 cases. Moreover, at 80% sharing rate, the marginal cost-effectiveness ratio ranges from $1,705 to $97,203. The results from both the baseline and sensitivity analysis demonstrated that the establishment of the SSF by VANDU on average had annually saved CAD$1.8 million dollars in taxpayer's money. Funding SSFs in Vancouver is an efficient and effective use of financial resources in the public health domain; therefore, Vancouver Coastal Health should actively participate in their establishment in order to reduce HCV and other blood-borne infections such as HIV within the non-injecting drug users.

  11. Final Report: Hydrogen Production Pathways Cost Analysis (2013 – 2016)

    Energy Technology Data Exchange (ETDEWEB)

    James, Brian David [Strategic Analysis Inc., Arlington, VA (United States); DeSantis, Daniel Allan [Strategic Analysis Inc., Arlington, VA (United States); Saur, Genevieve [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2016-09-30

    This report summarizes work conducted under a three year Department of Energy (DOE) funded project to Strategic Analysis, Inc. (SA) to analyze multiple hydrogen (H2) production technologies and project their corresponding levelized production cost of H2. The analysis was conducted using the H2A Hydrogen Analysis Tool developed by the DOE and National Renewable Energy Laboratory (NREL). The project was led by SA but conducted in close collaboration with the NREL and Argonne National Laboratory (ANL). In-depth techno-economic analysis (TEA) of five different H2 production methods was conducted. These TEAs developed projections for capital costs, fuel/feedstock usage, energy usage, indirect capital costs, land usage, labor requirements, and other parameters, for each H2 production pathway, and use the resulting cost and system parameters as inputs into the H2A discounted cash flow model to project the production cost of H2 ($/kgH2). Five technologies were analyzed as part of the project and are summarized in this report: Proton Exchange Membrane technology (PEM), High temperature solid oxide electrolysis cell technology (SOEC), Dark fermentation of biomass for H2 production, H2 production via Monolithic Piston-Type Reactors with rapid swing reforming and regeneration reactions, and Reformer-Electrolyzer-Purifier (REP) technology developed by Fuel Cell Energy, Inc. (FCE).

  12. 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.

  13. Meta- and cost-effectiveness analysis of commercial weight loss strategies.

    Science.gov (United States)

    Finkelstein, Eric A; Kruger, Eliza

    2014-09-01

    To estimate the incremental cost-effectiveness of clinically proven nonsurgical commercial weight loss strategies for those with BMIs between 25 and 40. We performed a systematic literature review to identify randomized controlled trials of commercially available weight loss studies of at least 1 year in duration. Using the results of these trials and publicly available cost data, we quantified the incremental cost per kilogram of weight loss and per quality adjusted life year (QALY) gained. We then use probabilistic sensitivity analyses to quantify uncertainty in our results. Based on the literature review, two lifestyle programs (Weight Watchers and Vtrim), one meal replacement program (Jenny Craig), and three pharmaceutical products (Qsymia, Lorcaserin, and Orlistat) were included in the analysis. Average cost per kilogram of weight lost ranged from $155 (95% CI: $110-$218) for Weight Watchers to $546 (95% CI: $390-$736) for Orlistat. The incremental cost per QALY gained for Weight Watchers and Qsymia was $34,630 and $54,130, respectively. All other interventions were prohibitively expensive or inferior in that weight loss could be achieved at a lower cost through one or a combination of the other strategies. Results suggest that, in the absence of other considerations and at current market prices, Weight Watchers and Qsymia represent the two most cost-effective strategies for nonsurgical weight loss. © 2014 The Obesity Society.

  14. 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.

  15. 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

  16. System Cost Analysis for an Interior Permanent Magnet Motor

    Energy Technology Data Exchange (ETDEWEB)

    Peter Campbell

    2008-08-01

    The objective of this program is to provide an assessment of the cost structure for an interior permanent magnet ('IPM') motor which is designed to meet the 2010 FreedomCAR specification. The program is to evaluate the range of viable permanent magnet materials for an IPM motor, including sintered and bonded grades of rare earth magnets. The study considers the benefits of key processing steps, alternative magnet shapes and their assembly methods into the rotor (including magnetization), and any mechanical stress or temperature limits. The motor's costs are estimated for an annual production quantity of 200,000 units, and are broken out into such major components as magnetic raw materials, processing and manufacturing. But this is essentially a feasibility study of the motor's electromagnetic design, and is not intended to include mechanical or thermal studies as would be done to work up a selected design for production.

  17. 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 ...

  18. Cost utility analysis of endoscopic sinus surgery for chronic rhinosinusitis.

    Science.gov (United States)

    Scangas, George A; Su, Brooke M; Remenschneider, Aaron K; Shrime, Mark G; Metson, Ralph

    2016-06-01

    The purpose of this work was to evaluate the cost-effectiveness of endoscopic sinus surgery (ESS) compared to medical therapy for patients with chronic rhinosinusitis (CRS). The study design consisted of a microsimulation Markov decision-tree economic model with a 31-year time horizon. A cohort of 489 patients who underwent ESS for CRS were matched 1 to 1 with a cohort of 489 patients from the national Medical Expenditures Panel Survey database who underwent medical management for CRS. Utility scores were calculated from responses to the EuroQol 5-Dimension instrument in both cohorts. Decision-tree analysis and a subsequent 10-state Markov model utilized published event probabilities as well as primary data from a large multisurgeon prospective outcomes study to calculate long-term costs and utility. The primary outcome measure was incremental cost per quality-adjusted life year (QALY). Multiple sensitivity analyses were performed. The incremental cost-effectiveness ratio (ICER) for ESS vs medical therapy alone was $13,851.26 per QALY. The cost effectiveness acceptability curve demonstrated 85.84% and 98.69% certainty that the ESS strategy was the most cost-effective option at willingness-to-pay thresholds of $25,000 and $50,000 per QALY, respectively. This study shows ESS to be a cost-effective intervention compared to medical therapy alone for the management of patients with CRS. © 2016 ARS-AAOA, LLC.

  19. A Cost Analysis of Food Waste Composting in Taiwan

    Directory of Open Access Journals (Sweden)

    Yi-Tui Chen

    2016-11-01

    Full Text Available Taiwan’s Environmental Protection Administration (EPA has enacted a food waste recycling policy since 2003 as an alternative of landfill and incineration for the final disposal of municipal solid waste. Recycled food waste is currently seen as a valuable material, especially when appropriate technology is developed. This paper conducts a cost/benefit analysis based on six cases of food waste composting plants in Taiwan, finding that (1 the composting of food waste may yield the most net benefit compared to other applications of today; (2 the production cost of compost ranges from NT$ 2897–23,117/tonne; (3 the adoption of more automatic technology may reduce operation costs and, thus, a closed composting system with mechanical aeration may be more cost effective; (4 the output is a determinant of affecting production costs and private firms are more competitive in production costs than government-affiliated composting units; (5 all of the government-affiliated composting units face a negative profit and thus they are required to make use of the market value of the produced compost to achieve economic viability; and (6 a subsidy to the compost producer is needed to expand the market demand as the food waste recycled can save the disposal cost of municipal solid waste (MSW incineration.

  20. A novel and cost-effective monitoring approach for outcomes in an Australian biodiversity conservation incentive program.

    Directory of Open Access Journals (Sweden)

    David B Lindenmayer

    Full Text Available We report on the design and implementation of ecological monitoring for an Australian biodiversity conservation incentive scheme - the Environmental Stewardship Program. The Program uses competitive auctions to contract individual land managers for up to 15 years to conserve matters of National Environmental Significance (with an initial priority on nationally threatened ecological communities. The ecological monitoring was explicitly aligned with the Program's policy objective and desired outcomes and was applied to the Program's initial Project which targeted the critically endangered White Box-Yellow Box-Blakely's Red Gum Grassy Woodland and Derived Native Grassland ecological community in south eastern Australia. These woodlands have been reduced to <3% of their original extent and persist mostly as small remnants of variable condition on private farmland. We established monitoring sites on 153 farms located over 172,232 sq km. On each farm we established a monitoring site within the woodland patch funded for management and, wherever possible, a matched control site. The monitoring has entailed gathering data on vegetation condition, reptiles and birds. We also gathered data on the costs of experimental design, site establishment, field survey, and data analysis. The costs of monitoring are approximately 8.5% of the Program's investment in the first four years and hence are in broad accord with the general rule of thumb that 5-10% of a program's funding should be invested in monitoring. Once initial monitoring and site benchmarking are completed we propose to implement a novel rotating sampling approach that will maintain scientific integrity while achieving an annual cost-efficiency of up to 23%. We discuss useful lessons relevant to other monitoring programs where there is a need to provide managers with reliable early evidence of program effectiveness and to demonstrate opportunities for cost-efficiencies.

  1. Challenges from variation across regions in cost effectiveness analysis in multi-regional clinical trials

    Directory of Open Access Journals (Sweden)

    Yunbo Chu

    2016-10-01

    Full Text Available Economic evaluation in the form of cost-effectiveness analysis has become a popular means to inform decisions in healthcare. With multi-regional clinical trials in a global development program becoming a new venue for drug efficacy testing in recent decades, questions in methods for cost-effectiveness analysis in the multi-regional clinical trials setting also emerge. This paper addresses some challenges from variation across regions in cost effectiveness analysis in multi-regional clinical trials. Several discussion points are raised for further attention and a multi-regional clinical trial example is presented to illustrate the implications in industrial application. A general message is delivered to call for a depth discussion by all stakeholders to reach an agreement on a good practice in cost-effectiveness analysis in the multi-regional clinical trials. Meanwhile, we recommend an additional consideration of cost-effectiveness analysis results based on the clinical evidence from a certain homogeneous population as sensitivity or scenario analysis upon data availability.

  2. COST BENEFIT ANALYSIS AND ITS ROLE IN INVESTMENT PROJECTS IN AGRICULTURE

    Directory of Open Access Journals (Sweden)

    Sorina Simona BUMBESCU

    2014-12-01

    Full Text Available The investment projects have of particular importance for the development and progress of an organization. The development of investment projects involves making a decision and the existence of financial resources. The agriculture has specific features and contributes significantly to the gross domestic product, which is why channeling the investments to agriculture must be a priority. In this context, the cost-benefit analysis is a useful tool for evaluation and analysis of the investment projects, contributing significantly to the decision making regarding the choice of the optimal project. The objective of this article is to highlight the importance of cost-benefit analysis for the projects investment financed by the European Union through the Rural National Development Program 2007-2013, under axis IV LEADER. The article is structured in two parts which contains theoretical aspects and a case study. Thus it is made an overview of the investment, funding sources of the investment projects, the investment decision, the relevance of cost-benefit analysis for the investment projects. The case study aims to analyze the relationship between the results of the investment projects which include cost-benefit analysis and those that do not inlcude cost-benefit analysis.

  3. Challenges from Variation across Regions in Cost Effectiveness Analysis in Multi-Regional Clinical Trials.

    Science.gov (United States)

    Chu, Yunbo; Dai, Luyan; Qi, Sheng; Smith, Matthew Lee; Huang, Hui; Li, Yang; Shen, Ye

    2016-01-01

    Economic evaluation in the form of cost-effectiveness analysis has become a popular means to inform decisions in healthcare. With multi-regional clinical trials in a global development program becoming a new venue for drug efficacy testing in recent decades, questions in methods for cost-effectiveness analysis in the multi-regional clinical trials setting also emerge. This paper addresses some challenges from variation across regions in cost effectiveness analysis in multi-regional clinical trials. Several discussion points are raised for further attention and a multi-regional clinical trial example is presented to illustrate the implications in industrial application. A general message is delivered to call for a depth discussion by all stakeholders to reach an agreement on a good practice in cost-effectiveness analysis in the multi-regional clinical trials. Meanwhile, we recommend an additional consideration of cost-effectiveness analysis results based on the clinical evidence from a certain homogeneous population as sensitivity or scenario analysis upon data availability.

  4. 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

  5. Cost Analysis of Poor Quality Using a Software Simulation

    Directory of Open Access Journals (Sweden)

    Jana Fabianová

    2017-02-01

    Full Text Available The issues of quality, cost of poor quality and factors affecting quality are crucial to maintaining a competitiveness regarding to business activities. Use of software applications and computer simulation enables more effective quality management. Simulation tools offer incorporating the variability of more variables in experiments and evaluating their common impact on the final output. The article presents a case study focused on the possibility of using computer simulation Monte Carlo in the field of quality management. Two approaches for determining the cost of poor quality are introduced here. One from retrospective scope of view, where the cost of poor quality and production process are calculated based on historical data. The second approach uses the probabilistic characteristics of the input variables by means of simulation, and reflects as a perspective view of the costs of poor quality. Simulation output in the form of a tornado and sensitivity charts complement the risk analysis.

  6. Optimal Cost-Analysis and Design of Circular Footings

    Directory of Open Access Journals (Sweden)

    Prabir K. Basudhar

    2012-10-01

    Full Text Available The study pertains to the optimal cost-analysis and design of a circular footing subjected to generalized loadings using sequential unconstrained minimization technique (SUMT in conjunction with Powell’s conjugate direction method for multidimensional search and quadratic interpolation method for one dimensional minimization. The cost of the footing is minimized satisfying all the structural and geotechnical engineering design considerations. As extended penalty function method has been used to convert the constrained problem into an unconstrained one, the developed technique is capable of handling both feasible and infeasible initial design vector. The net saving in cost starting from the best possible manual design ranges from 10 to 20 %. For all practical purposes, the optimum cost is independent of the initial design point. It was observed that for better convergence, the transition parameter  should be chosen at least 100 times the initial penalty parameter kr .

  7. COST-BENEFIT ANALYSIS FOR MAKING DECISIONS ON INCENTIVES FOR INVESTMENTS IN PLUM TREES PLANTING

    Directory of Open Access Journals (Sweden)

    Marijan Karić

    2004-12-01

    Full Text Available In this paper we consider the application of Cost/Benefit Analysis procedure in the decision process on socialeconomic profitability of subsidy implementation for investments in agricultural production, based on newly planted plum trees. Cost/Benefit Analysis has many advantages over the other common methods. It proved to be especially useful in the agricultural production, because it is possible to estimate the profitability of investments in the special conditions of agricultural production, taking into account many factors of its economic efficiency, as well as main effects that individual producers and the whole social community can expect. The application of Cost/Benefit Analysis, based on the data gathered for Bosnia and Herzegovina, enabled insight into the profitability of the existing subsidy programs for investments in plum trees planting, that take place in the conditon of the whole economy transition and high degree of rural population unemployment.

  8. A Conceptual Cost Benefit Analysis of Tailings Matrices Use in Construction Applications

    Directory of Open Access Journals (Sweden)

    Mahmood Ali A.

    2016-01-01

    Full Text Available As part of a comprehensive research program, new tailings matrices are formulated of combinations of tailings and binder materials. The research program encompasses experimental and numerical analysis of the tailings matrices to investigate the feasibility of using them as construction materials in cold climates. This paper discusses a conceptual cost benefit analysis for the use of these new materials. It is shown here that the financial benefits of using the proposed new tailings matrices in terms of environmental sustainability are much higher when compared to normal sand matrices.

  9. 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

  10. Cost-Effectiveness Analysis of Bariatric Surgery for Morbid Obesity.

    Science.gov (United States)

    Alsumali, Adnan; Eguale, Tewodros; Bairdain, Sigrid; Samnaliev, Mihail

    2018-01-15

    In the USA, three types of bariatric surgeries are widely performed, including laparoscopic sleeve gastrectomy (LSG), laparoscopic Roux-en-Y gastric bypass (LRYGB), and laparoscopic adjustable gastric banding (LAGB). However, few economic evaluations of bariatric surgery are published. There is also scarcity of studies focusing on the LSG alone. Therefore, this study is evaluating the cost-effectiveness of bariatric surgery using LRYGB, LAGB, and LSG as treatment for morbid obesity. A microsimulation model was developed over a lifetime horizon to simulate weight change, health consequences, and costs of bariatric surgery for morbid obesity. US health care prospective was used. A model was propagated based on a report from the first report of the American College of Surgeons. Incremental cost-effectiveness ratios (ICERs) in terms of cost per quality-adjusted life-year (QALY) gained were used in the model. Model parameters were estimated from publicly available databases and published literature. LRYGB was cost-effective with higher QALYs (17.07) and cost ($138,632) than LSG (16.56 QALYs; $138,925), LAGB (16.10 QALYs; $135,923), and no surgery (15.17 QALYs; $128,284). Sensitivity analysis showed initial cost of surgery and weight regain assumption were very sensitive to the variation in overall model parameters. Across patient groups, LRYGB remained the optimal bariatric technique, except that with morbid obesity 1 (BMI 35-39.9 kg/m2) patients, LSG was the optimal choice. LRYGB is the optimal bariatric technique, being the most cost-effective compared to LSG, LAGB, and no surgery options for most subgroups. However, LSG was the most cost-effective choice when initial BMI ranged between 35 and 39.9 kg/m2.

  11. Programas de mantenimiento de metadona con servicios auxiliares: un estudio de coste-efectividad Methadone maintenance programs with supplementary services: a cost-effectiveness study

    Directory of Open Access Journals (Sweden)

    E. Puigdollers

    2003-04-01

    activity registries. Sociodemographic, health-related and toxicological data were collected through a semi-structured interview. A cost-effectiveness analysis was performed through two multiple linear regressions with the same adjusting variables. Results: The greater the number of supplementary services involved, the higher the costs. The adjusted models revealed a significant increase in health-related quality of life (an increase of 8% in the Nottingham Health Profile and in costs (17% between low- and medium-intensity programs. Conclusion: The medium-intensity program showed the best cost-effectiveness ratio. However, the study's limitations preclude categoric generalization of the data.

  12. Retrospective Benefit-Cost Evaluation of U.S. DOE Wind Energy R&D Program: Impact of Selected Energy Technology Investments

    Energy Technology Data Exchange (ETDEWEB)

    Pelsoci, Thomas M. [Delta Research Co., Evanston, IL (United States)

    2010-06-01

    This benefit-cost analysis focuses on the DOE Wind Energy Program's public sector R&D investments and returns. The analysis accounts for the program's additionality – that is, comparing what has happened as a result of the program to what would have happened without it. The analysis does not address the return on the investments of private companies ("private returns"). Public returns on the program's investments from 1976 to 2008 are identified and analyzed using retrospective analysis.

  13. ENGINEERING ECONOMIC ANALYSIS OF A PROGRAM FOR ARTIFICIAL GROUNDWATER RECHARGE.

    Science.gov (United States)

    Reichard, Eric G.; Bredehoeft, John D.

    1984-01-01

    This study describes and demonstrates two alternate methods for evaluating the relative costs and benefits of artificial groundwater recharge using percolation ponds. The first analysis considers the benefits to be the reduction of pumping lifts and land subsidence; the second considers benefits as the alternative costs of a comparable surface delivery system. Example computations are carried out for an existing artificial recharge program in Santa Clara Valley in California. A computer groundwater model is used to estimate both the average long term and the drought period effects of artificial recharge in the study area. Results indicate that the costs of artificial recharge are considerably smaller than the alternative costs of an equivalent surface system. Refs.

  14. 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.

  15. Bayesian cost-effectiveness analysis with the R package BCEA

    CERN Document Server

    Baio, Gianluca; Heath, Anna

    2017-01-01

    The book provides a description of the process of health economic evaluation and modelling for cost-effectiveness analysis, particularly from the perspective of a Bayesian statistical approach. Some relevant theory and introductory concepts are presented using practical examples and two running case studies. The book also describes in detail how to perform health economic evaluations using the R package BCEA (Bayesian Cost-Effectiveness Analysis). BCEA can be used to post-process the results of a Bayesian cost-effectiveness model and perform advanced analyses producing standardised and highly customisable outputs. It presents all the features of the package, including its many functions and their practical application, as well as its user-friendly web interface. The book is a valuable resource for statisticians and practitioners working in the field of health economics wanting to simplify and standardise their workflow, for example in the preparation of dossiers in support of marketing authorisation, or acade...

  16. COST BENEFIT ANALYSIS OF A DG INTEGRATED SYSTEM: CASE STUDY

    Directory of Open Access Journals (Sweden)

    Ch. V. S. S. SAILAJA

    2017-09-01

    Full Text Available Distributed Generation is capable of meeting the load of the consumers partially or completely. Depending on the type of DG involved it can be operated in interconnected mode and islanded mode. The availability of numerous alternatives present for the DG technologies and large initial investments necessitates a detailed cost benefit analysis for the implementation of DG technologies. In this work an attempt has been made to study the costs involved in implementing the DG technologies. A practical system having two kinds of distributed generation i.e., Diesel Generator and solar photovoltaic system for its back up purpose is considered. A detailed cost analysis of the two DG technologies is carried out.

  17. Internal Logistics System Selection with Total Cost of Ownership Analysis

    Science.gov (United States)

    Araújo, Inês; Pimentel, Carina; Godina, Radu; Matias, João C. O.

    2017-06-01

    In this paper a methodology was followed in order to support the decision-making of one industrial unit regarding its internal logistics system. The addressed factory was facing issues with their internal logistics approach. Some alternatives were pointed out and a proper total cost of ownership (TCO) analysis was developed. This analysis was taken in order to demonstrate the more cost-effective solution for the internal logistics system. This tool is more and more valued by the companies, due to their willing to reduce the costs that are associated with the way of doing business. Despite the proposal of the best choice for the internal logistics system of the enterprise, this study also intends to present some conclusions about the match between the nature of the industrial unit and the logistics systems that best fit the requirements of those.

  18. Cost-effectiveness analysis for clinical procedures in oncology.

    Science.gov (United States)

    Weinstein, M C

    1980-01-01

    The provision of medical care consumes resources, and the resources available for the provision of medical care are limited. Decisions are being made at many levels of the Health Care System, including providers and fiscal intermediaries, to allocate these resources. Such decisions, however, are often inconsistent with the objective of deriving the maximum health benefits from the resources spent. Many cost-effectiveness and benefit-cost studies have been conducted in order to guide present and future resource allocation decisions. Many analyses have not been accepted by health care decision makers because a critical factor or issue has been omitted. In the attempt to be objective, the analyst may avoid uncertainties or subjective value judgments that often dominate the thinking of the decision maker. The role of the analyst in cost-effectiveness analysis, as in decision analysis for the individual patient, is to clarify and highlight such factors not to obfuscate them.

  19. FORTRAN computer program for seismic risk analysis

    Science.gov (United States)

    McGuire, Robin K.

    1976-01-01

    A program for seismic risk analysis is described which combines generality of application, efficiency and accuracy of operation, and the advantage of small storage requirements. The theoretical basis for the program is first reviewed, and the computational algorithms used to apply this theory are described. The information required for running the program is listed. Published attenuation functions describing the variation with earthquake magnitude and distance of expected values for various ground motion parameters are summarized for reference by the program user. Finally, suggestions for use of the program are made, an example problem is described (along with example problem input and output) and the program is listed.

  20. 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…

  1. 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...

  2. Regenerative Engine Analysis Program (REAP).

    Science.gov (United States)

    1981-01-01

    weight, a formula was derived for a figure of merit (FOM) that included SFC, weight, and cost considerations as follows: FOM = K SFC + K WT + K $1 SFCBL...ferrules Side plates Bracing Mounts 83 ESTIMATED OFF-DESIGN PERFORMANCE 0.9 ___ 500 HP ENGINE RECUPERATOR NO I A DEI NEIE TV N S = 0.8 (FIXED GEO

  3. 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.

  4. 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.

  5. Cost analysis of measles in refugees arriving at Los Angeles International Airport from Malaysia.

    Science.gov (United States)

    Coleman, Margaret S; Burke, Heather M; Welstead, Bethany L; Mitchell, Tarissa; Taylor, Eboni M; Shapovalov, Dmitry; Maskery, Brian A; Joo, Heesoo; Weinberg, Michelle

    2017-05-04

    Background On August 24, 2011, 31 US-bound refugees from Kuala Lumpur, Malaysia (KL) arrived in Los Angeles. One of them was diagnosed with measles post-arrival. He exposed others during a flight, and persons in the community while disembarking and seeking medical care. As a result, 9 cases of measles were identified. Methods We estimated costs of response to this outbreak and conducted a comparative cost analysis examining what might have happened had all US-bound refugees been vaccinated before leaving Malaysia. Results State-by-state costs differed and variously included vaccination, hospitalization, medical visits, and contact tracing with costs ranging from $621 to $35,115. The total of domestic and IOM Malaysia reported costs for US-bound refugees were $137,505 [range: $134,531 - $142,777 from a sensitivity analysis]. Had all US-bound refugees been vaccinated while in Malaysia, it would have cost approximately $19,646 and could have prevented 8 measles cases. Conclusion A vaccination program for US-bound refugees, supporting a complete vaccination for US-bound refugees, could improve refugees' health, reduce importations of vaccine-preventable diseases in the United States, and avert measles response activities and costs.

  6. [Cost-effectiveness analysis on compound anti-hypertensive tablets for primary hypertension].

    Science.gov (United States)

    Wu, Yi-Qun; Hu, Yong-Hua; Ren, Tao; Wu, Tao; Tao, Qiu-Shan; Qin, Xue-Ying; Zhang, Yi; Zhan, Si-Yan; Cao, Wei-Hua; Li, Li-Ming

    2008-04-01

    To compare the cost-effectiveness of two anti-hypertensive therapy regimens, Compound anti-hypertensive tablets and other common anti-hypertensive agents, in the treatment program of Primary Hypertension. We conducted a cost-effectiveness analysis based on a community trial. Two communities' primary hypertensive patients were enrolled to receive different therapy drugs: Compound anti-hypertensive tablets (Group A) or other common anti-hypertensive agents (Group B). Blood pressure, medicine used, and adverse drug reactions were observed and recorded for one year, and then cost-effectiveness ratio of the two groups and incremental ratio were calculated. We considered a 30% drug price fluctuating load to make the sensitivity analysis. 2505 cases were enrolled with 1529 cases in group A and 976 cases in group B. The cost-effectiveness ratios were 418.1 and 1057.7 for Group A and B respectively while the incremental cost-effectiveness of Group B vs. Group A was 19 202.2. The results were insensitive to variation in the costs of drugs over clinically reasonable ranges. Compound anti-hypertensive tablets appeared to be relatively cost-effective when compared to common drugs for the treatment of primary hypertension.

  7. 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...

  8. Probabilistic Output Analysis by Program Manipulation

    DEFF Research Database (Denmark)

    Rosendahl, Mads; Kirkeby, Maja Hanne

    2015-01-01

    The aim of a probabilistic output analysis is to derive a probability distribution of possible output values for a program from a probability distribution of its input. We present a method for performing static output analysis, based on program transformation techniques. It generates a probability...

  9. Statis Program Analysis for Reliable, Trusted Apps

    Science.gov (United States)

    2017-02-01

    devices. App stores also provide a tempting vector for an attacker. An attacker can take advantage of bugdoors (software defects that permit...STATIC PROGRAM ANALYSIS FOR RELIABLE, TRUSTED APPS UNIVERSITY OF WASHINGTON FEBRUARY 2017 FINAL TECHNICAL REPORT APPROVED FOR PUBLIC RELEASE...STATIC PROGRAM ANALYSIS FOR RELIABLE, TRUSTED APPS 5a. CONTRACT NUMBER 5b. GRANT NUMBER FA8750-12-2-0107 5c. PROGRAM ELEMENT NUMBER 61101E 6. AUTHOR

  10. 76 FR 57982 - Building Energy Codes Cost Analysis

    Science.gov (United States)

    2011-09-19

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Office of Energy Efficiency and Renewable Energy Building Energy Codes Cost Analysis Correction In notice document 2011-23236 beginning on page 56413 in the issue of Tuesday, September 13, 2011 make the following...

  11. 29 CFR 95.45 - Cost and price analysis.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Cost and price analysis. 95.45 Section 95.45 Labor Office of the Secretary of Labor GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, AND... accomplished in various ways, including the comparison of price quotations submitted, market prices and similar...

  12. 45 CFR 74.45 - Cost and price analysis.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Cost and price analysis. 74.45 Section 74.45 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION UNIFORM ADMINISTRATIVE REQUIREMENTS FOR AWARDS AND SUBAWARDS TO INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, OTHER NONPROFIT ORGANIZATIONS, AND COMMERCIAL ORGANIZATIONS...

  13. Cost-minimization analysis of antimicrobial therapy in a tertiary ...

    African Journals Online (AJOL)

    Cost Minimization Analysis of antimicrobial therapy in a tertiary health care institution in a developing economy country was carried out. The most applicable tool for generic equivalent drugs was used in Ahmadu Bello University Teaching Hospital, a tertiary healthcare Institution in Nigeria, between 2005 and 2007. Relevant ...

  14. Comparative Life-Cycle Cost Analysis Of Solar Photovoltaic Power ...

    African Journals Online (AJOL)

    Many homes in Nigeria are in remote locations where grid electricity supply could not be extended. This paper attempts to present a concise life-cycle-cost comparison of diesel generator power supply system and photovoltaic power system for a remote rural application. In this comparative analysis, conceptual designs ...

  15. Cost analysis of hybrid adaptive routing protocol for heterogeneous ...

    Indian Academy of Sciences (India)

    This study provides insights into designing heterogeneous wireless sensor networks and aims atproviding the cost-benefit analysis that can be used in selecting the critical parameters of the network. ... Department of Computer Science and Engineering, National Institute of Technology Delhi, New Delhi 110040, India ...

  16. Cost analysis of tuberculosis treatment in two tertiary hospitals in ...

    African Journals Online (AJOL)

    Cost analysis of tuberculosis treatment in two tertiary hospitals in South-East Nigeria. ... Abia State University Medical Students' Association Journal ... How free is it? Several governmental and non-governmental agencies support tuberculosis treatment to make the services accessible and affordable to patients.

  17. Costs and returns analysis of improved and alternative cassava ...

    African Journals Online (AJOL)

    Costs and returns analysis of improved and alternative cassava production technologies in Enugu State, Nigeria. ... There has been scientific research into new technologies. Increased Agricultural Productivity depends on the acceptability of the innovations and the willingness to invest on them. For farmers to adopt and ...

  18. 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.

  19. 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.

  20. 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.