WorldWideScience

Sample records for program cost savings

  1. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-03-19

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

  3. Reported Energy and Cost Savings from the DOE ESPC Program: FY 2014

    Energy Technology Data Exchange (ETDEWEB)

    Slattery, Bob S. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2015-03-01

    The objective of this work was to determine the realization rate of energy and cost savings from the Department of Energy’s Energy Savings Performance Contract (ESPC) program based on information reported by the energy services companies (ESCOs) that are carrying out ESPC projects at federal sites. Information was extracted from 156 Measurement and Verification (M&V) reports to determine reported, estimated, and guaranteed cost savings and reported and estimated energy savings for the previous contract year. Because the quality of the reports varied, it was not possible to determine all of these parameters for each project. For all 156 projects, there was sufficient information to compare estimated, reported, and guaranteed cost savings. For this group, the total estimated cost savings for the reporting periods addressed were $210.6 million, total reported cost savings were $215.1 million, and total guaranteed cost savings were $204.5 million. This means that on average: ESPC contractors guaranteed 97% of the estimated cost savings; projects reported achieving 102% of the estimated cost savings; and projects reported achieving 105% of the guaranteed cost savings. For 155 of the projects examined, there was sufficient information to compare estimated and reported energy savings. On the basis of site energy, estimated savings for those projects for the previous year totaled 11.938 million MMBtu, and reported savings were 12.138 million MMBtu, 101.7% of the estimated energy savings. On the basis of source energy, total estimated energy savings for the 155 projects were 19.052 million MMBtu, and reported saving were 19.516 million MMBtu, 102.4% of the estimated energy savings.

  4. 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

  5. Reported Energy and Cost Savings from the DOE ESPC Program: FY 2015

    Energy Technology Data Exchange (ETDEWEB)

    Slattery, Bob S. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2017-01-01

    The objective of this work was to determine the realization rate of energy and cost savings from the Department of Energy’s Energy Savings Performance Contract (ESPC) program based on information reported by the energy services companies (ESCOs) that are carrying out ESPC projects at federal sites. Information was extracted from 151 Measurement and Verification (M&V) reports to determine reported, estimated, and guaranteed cost savings and reported and estimated energy savings for the previous contract year. Because the quality of the reports varied, it was not possible to determine all of these parameters for each project.

  6. Implementation of a shared-savings program for surgical supplies decreases inventory cost.

    Science.gov (United States)

    Eiferman, Daniel; Bhakta, Ankur; Khan, Safdar

    2015-10-01

    Management of operating room inventory has substantial cost-saving opportunities if surgeons agree to standardize supplies used to perform procedures; however, there is no incentive for surgeons to participate in these decisions, because the cost-savings are realized only by the hospital, not the practitioner. In an attempt to engage surgeons with the management of the operating room supply chain, a shared-savings programs was instituted that returned 50% of money saved to the surgery divisions. Opportunities for savings in the use of biologic mesh, cranial plating systems, and neurostimulators was identified. Each item was assigned a physician champion responsible for ensuring that there was clinical equipoise between the products being used. Any cost-savings realized during the fiscal year were shared 50-50 between the hospital and the surgery divisions. The total cost-savings was $893,865 with $446,932 being shared across 15 surgery divisions. Standardization of cranial plating systems ($374,805) generated the greatest amounts of savings followed by neurostimulators ($278,404) and biologic mesh ($240,655). Aligning hospital and surgeon incentives led to dramatic cost-savings and standardization of the operative inventory used. Quality of care is not compromised by this approach, and no conflicts of interest are created. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. 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

  8. 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…

  9. 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.

  10. 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

  11. 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

    ,979 per life year saved. Suicide prevention programs such as the NAD trial are cost-effective and can result in important potential cost-savings due to averted suicide deaths and reduced life years lost. Implementation of suicide prevention programs at the population level in Canada is cost-effective. Community mental health programs aimed at increasing awareness and the treatment of depression and better follow-up of high risk individuals for suicide are associated with a minimal per capita investment. These programs can result in important potential cost-savings due to averted suicide deaths and decreased disability due to depression. Additional research should focus on whether the outcomes of multi-modal suicide programs are specific or synergistic and most effective for which population subgroups. This may help inform how best to invest resources for the highest return.

  12. Cost Savings From the Provision of Specific Methods of Contraception in a Publicly Funded Program

    Science.gov (United States)

    Rostovtseva, Daria P.; Brindis, Claire D.; Biggs, M. Antonia; Hulett, Denis; Darney, Philip D.

    2009-01-01

    Objectives. We examined the cost-effectiveness of contraceptive methods dispensed in 2003 to 955 000 women in Family PACT (Planning, Access, Care and Treatment), California's publicly funded family planning program. Methods. We estimated the number of pregnancies averted by each contraceptive method and compared the cost of providing each method with the savings from averted pregnancies. Results. More than half of the 178 000 averted pregnancies were attributable to oral contraceptives, one fifth to injectable methods, and one tenth each to the patch and barrier methods. The implant and intrauterine contraceptives were the most cost-effective, with cost savings of more than $7.00 for every $1.00 spent in services and supplies. Per $1.00 spent, injectable contraceptives yielded savings of $5.60; oral contraceptives, $4.07; the patch, $2.99; the vaginal ring, $2.55; barrier methods, $1.34; and emergency contraceptives, $1.43. Conclusions. All contraceptive methods were cost-effective—they saved more in public expenditures for unintended pregnancies than they cost to provide. Because no single method is clinically recommended to every woman, it is medically and fiscally advisable for public health programs to offer all contraceptive methods. PMID:18703437

  13. The SmokingPaST Framework: illustrating the impact of quit attempts, quit methods, and new smokers on smoking prevalence, years of life saved, medical costs saved, programming costs, cost effectiveness, and return on investment.

    Science.gov (United States)

    O'Donnell, Michael P; Roizen, Michael F

    2011-01-01

    Describe the specifications of the Smoking Prevalence, Savings, and Treatment (SmokingPaST) Framework and show how it can illustrate the impact of quit attempts, quit method, number of new smokers, smoking rates of immigrants and emigrants, and death rates of smokers and nonsmokers on future smoking prevalence rates, program costs, years of life saved, medical costs saved, cost effectiveness of programs, and return on investment (ROI). FRAMEWORK SPECIFICATIONS: Mathematical relationships among factors in SmokingPaST are described. Input variables include baseline smoking rates among current adults, new adults, immigrants, and emigrants; population counts for these groups; annual quit attempts; and distribution of quit methods. Assumption variables include success rate by quit method, death rates of smokers and nonsmokers, annual medical costs of smoking, costs per person for four tobacco treatment methods, age distribution of quitters, and distribution of medical cost funding by source. Output variables include year-end adult smoking rates, successful quitters, years of life saved by quitting, medical costs saved by quitting and by not hiring smokers, total costs of smoking treatment programs, cost per quitter, cost per life-year saved, distribution of medical cost savings from quitting, and ROI of treatment costs. The Framework was applied at the employer, county, state, and national levels. The SmokingPaST Framework provides a conceptually simple framework that can be applied to any population. It illustrates that significant drops in smoking rates can be achieved and significant savings in medical costs can be captured by employers as well as state and federal governments through tobacco treatment and prevention programs. Savings are especially important for reducing state and federal government deficits and enhancing job competitiveness.

  14. Impact of a University-Based Outpatient Telemedicine Program on Time Savings, Travel Costs, and Environmental Pollutants.

    Science.gov (United States)

    Dullet, Navjit W; Geraghty, Estella M; Kaufman, Taylor; Kissee, Jamie L; King, Jesse; Dharmar, Madan; Smith, Anthony C; Marcin, James P

    2017-04-01

    The objective of this study was to estimate travel-related and environmental savings resulting from the use of telemedicine for outpatient specialty consultations with a university telemedicine program. The study was designed to retrospectively analyze the telemedicine consultation database at the University of California Davis Health System (UCDHS) between July 1996 and December 2013. Travel distances and travel times were calculated between the patient home, the telemedicine clinic, and the UCDHS in-person clinic. Travel cost savings and environmental impact were calculated by determining differences in mileage reimbursement rate and emissions between those incurred in attending telemedicine appointments and those that would have been incurred if a visit to the hub site had been necessary. There were 19,246 consultations identified among 11,281 unique patients. Telemedicine visits resulted in a total travel distance savings of 5,345,602 miles, a total travel time savings of 4,708,891 minutes or 8.96 years, and a total direct travel cost savings of $2,882,056. The mean per-consultation round-trip distance savings were 278 miles, average travel time savings were 245 minutes, and average cost savings were $156. Telemedicine consultations resulted in a total emissions savings of 1969 metric tons of CO 2 , 50 metric tons of CO, 3.7 metric tons of NO x , and 5.5 metric tons of volatile organic compounds. This study demonstrates the positive impact of a health system's outpatient telemedicine program on patient travel time, patient travel costs, and environmental pollutants. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  15. 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

  16. Return on investment: a fuller assessment of the benefits and cost savings of the US publicly funded family planning program.

    Science.gov (United States)

    Frost, Jennifer J; Sonfield, Adam; Zolna, Mia R; Finer, Lawrence B

    2014-12-01

    Policy Points: The US publicly supported family planning effort serves millions of women and men each year, and this analysis provides new estimates of its positive impact on a wide range of health outcomes and its net savings to the government. The public investment in family planning programs and providers not only helps women and couples avoid unintended pregnancy and abortion, but also helps many thousands avoid cervical cancer, HIV and other sexually transmitted infections, infertility, and preterm and low birth weight births. This investment resulted in net government savings of $13.6 billion in 2010, or $7.09 for every public dollar spent. Each year the United States' publicly supported family planning program serves millions of low-income women. Although the health impact and public-sector savings associated with this program's services extend well beyond preventing unintended pregnancy, they never have been fully quantified. Drawing on an array of survey data and published parameters, we estimated the direct national-level and state-level health benefits that accrued from providing contraceptives, tests for the human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs), Pap tests and tests for human papillomavirus (HPV), and HPV vaccinations at publicly supported family planning settings in 2010. We estimated the public cost savings attributable to these services and compared those with the cost of publicly funded family planning services in 2010 to find the net public-sector savings. We adjusted our estimates of the cost savings for unplanned births to exclude some mistimed births that would remain publicly funded if they had occurred later and to include the medical costs for births through age 5 of the child. In 2010, care provided during publicly supported family planning visits averted an estimated 2.2 million unintended pregnancies, including 287,500 closely spaced and 164,190 preterm or low birth weight (LBW) births, 99

  17. FY 1995 cost savings report

    Energy Technology Data Exchange (ETDEWEB)

    Andrews-Smith, K.L., Westinghouse Hanford

    1996-06-21

    Fiscal Year (FY) 1995 challenged us to dramatically reduce costs at Hanford. We began the year with an 8 percent reduction in our Environmental Management budget but at the same time were tasked with accomplishing additional workscope. This resulted in a Productivity Challenge whereby we took on more work at the beginning of the year than we had funding to complete. During the year, the Productivity Challenge actually grew to 23 percent because of recissions, Congressional budget reductions, and DOE Headquarters actions. We successfully met our FY 1995 Productivity Challenge through an aggressive cost reduction program that identified and eliminated unnecessary workscope and found ways to be more efficient. We reduced the size of the workforce, cut overhead expenses, eliminated paperwork, cancelled construction of new facilities, and reengineered our processes. We are proving we can get the job done better and for less money at Hanford. DOE`s drive to do it ``better, faster, cheaper`` has led us to look for more and larger partnerships with the private sector. The biggest will be privatization of Hanford`s Tank Waste Remediation System, which will turn liquid tank waste into glass logs for eventual disposal. We will also save millions of dollars and avoid the cost of replacing aging steam plants by contracting Hanford`s energy needs to a private company. Other privatization successes include the Hanford Mail Service, a spinoff of advanced technical training, low level mixed waste thermal treatment, and transfer of the Hanford Museums of Science and history to a private non-profit organization. Despite the rough roads and uncertainty we faced in FY 1995, less than 3 percent of our work fell behind schedule, while the work that was performed was completed with an 8.6 percent cost under-run. We not only met the FY 1995 productivity challenge, we also met our FY 1995-1998 savings commitments and accelerated some critical cleanup milestones. The challenges continue

  18. Saving Green on Energy Costs

    Science.gov (United States)

    Tacke, Diane L.

    2006-01-01

    In recent years, colleges and universities have begun efforts to reduce their energy costs, an initiative that can not only save an institution money, but also strengthen relationships across campus. Board leadership has been central to this endeavor in setting goals, prioritizing projects, and financing those projects. Using her experiences with…

  19. The costs and savings of a regional public palliative care program: the Catalan experience at 18 years.

    Science.gov (United States)

    Paz-Ruiz, Silvia; Gomez-Batiste, Xavier; Espinosa, Jose; Porta-Sales, Josep; Esperalba, Joaquim

    2009-07-01

    Conceived as a World Health Organization demonstration project for public health initiatives at the end of life, the palliative care program in Catalonia illustrates the impact that similar initiatives may have in terms of cost savings for a regional health system. In a publicly funded and freely accessible health system, decreasing the number of hospital admissions, shortening the lengths of hospital stay, diminishing the frequency of emergency room consultations, shifting the use of acute hospital beds to palliative care beds for treating advanced disease inpatients, and substantially improving the use of opioids in the community are major determinants of the palliative care program's success. These features add to the opportunity the discipline offers to improve the quality of health care at the end of life. In this article, the information gathered over an 18-year trajectory of the program is summarized. Key features of the existing financial models used while developing palliative care in Catalonia are described, and the mechanisms by which palliative care may have contributed to increase savings for the health care system in end-of-life care, from euro3,000,000 in 1995 to euro8,000,000 in 2005, are discussed.

  20. 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.

  1. Program Potential: Estimates of Federal Energy Cost Savings from Energy Efficient Procurement

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, Margaret [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Fujita, K. Sydny [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2012-09-17

    In 2011, energy used by federal buildings cost approximately $7 billion. Reducing federal energy use could help address several important national policy goals, including: (1) increased energy security; (2) lowered emissions of greenhouse gases and other air pollutants; (3) increased return on taxpayer dollars; and (4) increased private sector innovation in energy efficient technologies. This report estimates the impact of efficient product procurement on reducing the amount of wasted energy (and, therefore, wasted money) associated with federal buildings, as well as on reducing the needless greenhouse gas emissions associated with these buildings.

  2. Calculating cost savings in utilization management.

    Science.gov (United States)

    MacMillan, Donna

    2014-01-01

    A major motivation for managing the utilization of laboratory testing is to reduce the cost of medical care. For this reason it is important to understand the basic principles of cost accounting in the clinical laboratory. The process of laboratory testing includes three distinct components termed the pre-analytic, analytic and post-analytic phases. Utilization management efforts may impact the cost structure of these three phases in different ways depending on the specific details of the initiative. Estimates of cost savings resulting from utilization management programs reported in the literature have often been fundamentally flawed due to a failure to understand basic concepts such as the difference between laboratory costs versus charges and the impact of reducing laboratory test volumes on the average versus marginal cost structure in the laboratory. This article will provide an overview of basic cost accounting principles in the clinical laboratory including both job order and process cost accounting. Specific examples will be presented to illustrate these concepts in various different scenarios. © 2013.

  3. 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.

  4. USAID IT Reform Cost Savings/Avoidance

    Data.gov (United States)

    US Agency for International Development — The Office of the Chief Information Officer in the Management Bureau of USAID launched initiatives designed for IT cost savings and avoidance. This dataset includes...

  5. Potential Logistics Cost Savings from Engine Commonality

    National Research Council Canada - National Science Library

    Henderson, Robert L; Higer, Matthew W

    2007-01-01

    The purpose of this MBA Project is to determine potential logistics cost savings the USAF and DoD could have realized through the life of the F-16 fighter aircraft had they required engine commonality...

  6. The PrePex device is unlikely to achieve cost-savings compared to the forceps-guided method in male circumcision programs in sub-Saharan Africa.

    Directory of Open Access Journals (Sweden)

    Walter Obiero

    Full Text Available Male circumcision (MC reduces the risk of heterosexual HIV acquisition in men by approximately 60%. MC programs for HIV prevention are currently being scaled-up in fourteen countries in sub-Saharan Africa. The current standard surgical technique for MC in many sub-Saharan African countries is the forceps-guided male circumcision (FGMC method. The PrePex male circumcision (PMC method could replace FGMC and potentially reduce MC programming costs. We compared the potential costs of introducing the PrePex device into MC programming to the cost of the forceps-guided method.Data were obtained from the Nyanza Reproductive Health Society (NRHS, an MC service delivery organization in Kenya, and from the Kenya Ministry of Health. Analyses are based on 48,265 MC procedures performed in four Districts in western Kenya from 2009 through 2011. Data were entered into the WHO/UNAIDS Decision Makers Program Planning Tool. The tool assesses direct and indirect costs of MC programming. Various sensitivity analyses were performed. Costs were discounted at an annual rate of 6% and are presented in United States Dollars.Not including the costs of the PrePex device or referral costs for men with phimosis/tight foreskin, the costs of one MC surgery were $44.54-$49.02 and $54.52-$55.29 for PMC and FGMC, respectively.The PrePex device is unlikely to result in significant cost-savings in comparison to the forceps-guided method. MC programmers should target other aspects of the male circumcision minimum package for improved cost efficiency.

  7. Theoretical, Methodological, and Empirical Approaches to Cost Savings: A Compendium

    Energy Technology Data Exchange (ETDEWEB)

    M Weimar

    1998-12-10

    This publication summarizes and contains the original documentation for understanding why the U.S. Department of Energy's (DOE's) privatization approach provides cost savings and the different approaches that could be used in calculating cost savings for the Tank Waste Remediation System (TWRS) Phase I contract. The initial section summarizes the approaches in the different papers. The appendices are the individual source papers which have been reviewed by individuals outside of the Pacific Northwest National Laboratory and the TWRS Program. Appendix A provides a theoretical basis for and estimate of the level of savings that can be" obtained from a fixed-priced contract with performance risk maintained by the contractor. Appendix B provides the methodology for determining cost savings when comparing a fixed-priced contractor with a Management and Operations (M&O) contractor (cost-plus contractor). Appendix C summarizes the economic model used to calculate cost savings and provides hypothetical output from preliminary calculations. Appendix D provides the summary of the approach for the DOE-Richland Operations Office (RL) estimate of the M&O contractor to perform the same work as BNFL Inc. Appendix E contains information on cost growth and per metric ton of glass costs for high-level waste at two other DOE sites, West Valley and Savannah River. Appendix F addresses a risk allocation analysis of the BNFL proposal that indicates,that the current approach is still better than the alternative.

  8. Reactors Save Energy, Costs for Hydrogen Production

    Science.gov (United States)

    2014-01-01

    While examining fuel-reforming technology for fuel cells onboard aircraft, Glenn Research Center partnered with Garrettsville, Ohio-based Catacel Corporation through the Glenn Alliance Technology Exchange program and a Space Act Agreement. Catacel developed a stackable structural reactor that is now employed for commercial hydrogen production and results in energy savings of about 20 percent.

  9. Federal Aviation Administration retained savings program proposal

    Energy Technology Data Exchange (ETDEWEB)

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

    1998-03-01

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

  10. Wellness incentives in the workplace: cost savings through cost shifting to unhealthy workers.

    Science.gov (United States)

    Horwitz, Jill R; Kelly, Brenna D; DiNardo, John E

    2013-03-01

    The Affordable Care Act encourages workplace wellness programs, chiefly by promoting programs that reward employees for changing health-related behavior or improving measurable health outcomes. Recognizing the risk that unhealthy employees might be punished rather than helped by such programs, the act also forbids health-based discrimination. We reviewed results of randomized controlled trials and identified challenges for workplace wellness programs to function as the act intends. For example, research results raise doubts that employees with health risk factors, such as obesity and tobacco use, spend more on medical care than others. Such groups may not be especially promising targets for financial incentives meant to save costs through health improvement. Although there may be other valid reasons, beyond lowering costs, to institute workplace wellness programs, we found little evidence that such programs can easily save costs through health improvement without being discriminatory. Our evidence suggests that savings to employers may come from cost shifting, with the most vulnerable employees--those from lower socioeconomic strata with the most health risks--probably bearing greater costs that in effect subsidize their healthier colleagues.

  11. Can health promotion programs save Medicare money?

    Directory of Open Access Journals (Sweden)

    Ron Z Goetzel

    2007-04-01

    Full Text Available Ron Z Goetzel1, David Shechter2, Ronald J Ozminkowski1, David C Stapleton3, Pauline J Lapin4, J Michael McGinnis5, Catherine R Gordon6, Lester Breslow71Institute for Health and Productivity Studies, Cornell University, Washington, DC; 2Health and Productivity Research, Thomson Medstat, Santa Barbara, CA; 3Cornell Institute for Policy Research, Cornell University, Washington, DC; 4Office of Research, Development, and Information, Centers for Medicare and Medicaid Services, Baltimore, MD; 5National Academy of Sciences, Institute of Medicine, The National Academies, Washington, DC; 6Office of the Director, Centers for Disease Control and Prevention, Washington, DC; 7UCLA School of Public Health, Dept. of Health Services, Los Angeles, CA, USAAbstract: The impact of an aging population on escalating US healthcare costs is influenced largely by the prevalence of chronic disease in this population. Consequently, preventing or postponing disease onset among the elderly has become a crucial public health issue. Fortunately, much of the total burden of disease is attributable to conditions that are preventable. In this paper, we address whether well-designed health promotion programs can prevent illness, reduce disability, and improve the quality of life. Furthermore, we assess evidence that these programs have the potential to reduce healthcare utilization and related expenditures for the Medicare program. We hypothesize that seniors who reduce their modifiable health risks can forestall disability, reduce healthcare utilization, and save Medicare money. We end with a discussion of a new Senior Risk Reduction Demonstration, which will be initiated by the Centers for Medicare and Medicaid Services in 2007, to test whether risk reduction programs developed in the private sector can achieve health improvements among seniors and a positive return on investment for the Medicare program.Keywords: health promotion, return on investment, Medicare, financial

  12. 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.

  13. GSA IT Reform Cost Savings/Avoidance

    Data.gov (United States)

    General Services Administration — GSA IT provides data related to Agency IT initiatives that save or avoid expenditures. This data is provided as a requirement of OMB's Integrated Data Collection...

  14. Lifestyle intervention: from cost savings to value for money.

    Science.gov (United States)

    Rappange, David R; Brouwer, Werner B F; Rutten, Frans F H; van Baal, Pieter H M

    2010-09-01

    Prevention of unhealthy lifestyles has sometimes been promoted as simultaneously reducing costs and improving public health but this will unlikely prove to be true. Additional medical costs in life years gained due to treatment of unrelated diseases may offset possible savings in related diseases, but are often ignored both in health promotion policies and in economic evaluations of life-prolonging interventions. Many national guidelines explicitly recommend excluding these costs from economic evaluations or leave inclusion up to the discretion of the analyst. This may result in too favorable estimations of cost-effectiveness, feeding the unjustified optimism among policymakers regarding lifestyle interventions as a cost-saving option. However, prevention may still be a cost-effective way to improve public health, even when it does not result in cost savings, but this should be judged taking all future costs into account and be based on the true value for money provided by lifestyle interventions.

  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. DETERMINING ENERGY SAVINGS IN BUILDINGS USING THE REDUCING COSTS METHOD

    OpenAIRE

    STAN IVAN F.E.; MIRCEA I

    2015-01-01

    The paper is structured in four parts. The first part presents the importance of thermal insulation for buildings energy economy and some insulation properties. In the second part of the paper it is described the reducing cost method to determine the energy savings. The third part of the paper includes an analysis and a comparison for an exterior wall provided with different thicknesses of insulation layer in order to determine the average savings cost. The last par...

  17. Cost Savings Analysis Guidelines for Manufacturing Technology Projects.

    Science.gov (United States)

    1985-06-28

    14 3.2.1 ’CHANGED COSTO SAMPLE PROJECT .................. .. 16 3.2.1.1 COST SAVINGS NARRATIVE ..................... 17 3.2.1.2 RECURRING COSTS...an MT project, an abbreviated format called Worksheet A is used. In such cases, all capital , operating, and implementation costs are . reflected in...not necessary to factor in the capital investment in the crystal Puller and other such implementation costs to the contractor. All such costs are

  18. Potential Logistics Cost Savings from Engine Commonality

    Science.gov (United States)

    2007-12-01

    BASICS AND COST-ESTIMATING METHODOLOGY Several RAND studies detail cost methodology and spending assessments across the full range of support of both...Moore, Lorell, Mason, and Graser’s 2002 RAND Report Military Jet Engine Acquisition: Technology Basics and Cost- Estimating Methodology, pages 9 -14...9 2 2 ,016 .75$ F t W ayn e F W A 3 3 .6 7.9 3 2 0 .526 2 .326 1 .01 5 2 .8 9 2 92 .5 2 3 ,400 .00$ D ulu th D LH 4 0

  19. Cost savings from performance-based maintenance contracting

    OpenAIRE

    Straub, A

    2009-01-01

    New procurement approaches combined with performance-based building approaches should reduce costs, but empirical qualitative and quantitative studies are lacking. Performance-based maintenance contracts give maintenance suppliers incentives to improve their way of working. Innovative, cost-effective solutions that meet the performance criteria can be achieved, especially if the principle of whole-life costing is being adopted. Indirect cost savings are expected as well. It enables maintenanc...

  20. COST SAVING WITH ULTRASONOGRAPHY IN A DEVELOPING ...

    African Journals Online (AJOL)

    1999-05-05

    May 5, 1999 ... under the Progamme of Science, Research and Development. STD 111 (Science and Technology for Development nr. TS3. - CT 94 - 0330) and Glaxo, Wellcome, Hamburg, Germany. REFERENCES. Margulis, A.R. Radiologic imaging: Changing cost, greater benefits (Whitehouse Lecture). Amer. J. Radiol.

  1. Energy efficiency improvement and cost saving opportunities forpetroleum refineries

    Energy Technology Data Exchange (ETDEWEB)

    Worrell, Ernst; Galitsky, Christina

    2005-02-15

    The petroleum refining industry in the United States is the largest in the world, providing inputs to virtually any economic sector,including the transport sector and the chemical industry. The industry operates 146 refineries (as of January 2004) around the country,employing over 65,000 employees. The refining industry produces a mix of products with a total value exceeding $151 billion. Refineries spend typically 50 percent of cash operating costs (i.e., excluding capital costs and depreciation) on energy, making energy a major cost factor and also an important opportunity for cost reduction. Energy use is also a major source of emissions in the refinery industry making energy efficiency improvement an attractive opportunity to reduce emissions and operating costs. Voluntary government programs aim to assist industry to improve competitiveness through increased energy efficiency and reduced environmental impact. ENERGY STAR (R), a voluntary program managed by the U.S. Environmental Protection Agency, stresses the need for strong and strategic corporate energy management programs. ENERGY STAR provides energy management tools and strategies for successful corporate energy management programs. This Energy Guide describes research conducted to support ENERGY STAR and its work with the petroleum refining industry.This research provides information on potential energy efficiency opportunities for petroleum refineries. This Energy Guide introduces energy efficiency opportunities available for petroleum refineries. It begins with descriptions of the trends, structure, and production of the refining industry and the energy used in the refining and conversion processes. Specific energy savings for each energy efficiency measure based on case studies of plants and references to technical literature are provided. If available, typical payback periods are also listed. The Energy Guide draws upon the experiences with energy efficiency measures of petroleum refineries worldwide

  2. Lives Saved Tool (LiST) costing: a module to examine costs and prioritize interventions.

    Science.gov (United States)

    Bollinger, Lori A; Sanders, Rachel; Winfrey, William; Adesina, Adebiyi

    2017-11-07

    Achieving the Sustainable Development Goals will require careful allocation of resources in order to achieve the highest impact. The Lives Saved Tool (LiST) has been used widely to calculate the impact of maternal, neonatal and child health (MNCH) interventions for program planning and multi-country estimation in several Lancet Series commissions. As use of the LiST model increases, many have expressed a desire to cost interventions within the model, in order to support budgeting and prioritization of interventions by countries. A limited LiST costing module was introduced several years ago, but with gaps in cost types. Updates to inputs have now been added to make the module fully functional for a range of uses. This paper builds on previous work that developed an initial version of the LiST costing module to provide costs for MNCH interventions using an ingredients-based costing approach. Here, we update in 2016 the previous econometric estimates from 2013 with newly-available data and also include above-facility level costs such as program management. The updated econometric estimates inform percentages of intervention-level costs for some direct costs and indirect costs. These estimates add to existing values for direct cost requirements for items such as drugs and supplies and required provider time which were already available in LiST Costing. Results generated by the LiST costing module include costs for each intervention, as well as disaggregated costs by intervention including drug and supply costs, labor costs, other recurrent costs, capital costs, and above-service delivery costs. These results can be combined with mortality estimates to support prioritization of interventions by countries. The LiST costing module provides an option for countries to identify resource requirements for scaling up a maternal, neonatal, and child health program, and to examine the financial impact of different resource allocation strategies. It can be a useful tool for

  3. 21 Cost-Saving Measures For The Judiciary

    Directory of Open Access Journals (Sweden)

    Jessica Vapnek

    2013-02-01

    Full Text Available Courts around the world are increasingly facing budget cuts and funding shortfalls. Budget problems are particularly acute in developing countries, where courts need to increase efficiency and access to justice while also managing resource limitations. International development agencies and donors expect measurable progress to justify continued funding of judicial reform projects. Yet, as rule of law efforts in developing countries improve public perception of courts and streamline court administration, more cases may be filed. Greater use of the courts puts greater strain on court resources, triggering the need to implement cost-saving measures while maintaining effective court administration.This paper outlines 21 measures that courts can implement to reduce costs. Specific examples from developing countries are presented wherever possible, with additional examples drawn from the United States and Europe. Although this paper is intended mainly for audiences in developing countries, the issues facing those courts are similar to issues addressed through court reforms in the United States over the past 50 years. For this reason, examples of cost-saving measures from developed countries such as the United States may be directly applicable or could be used as starting points to spur further cost savings innovation in the developing world.Section I of this paper explains the context for the implementation of judicial cost-saving measures, and raises some issues for reflection. Section II sets out specific judicial cost-saving measures, dividing them into three categories: measures that address court operations; measures directed at staffing and salaries; and measures that relate to court and case management. Section III discusses ways that countries and judiciaries can generate ideas for new and innovative cost-saving mechanisms.

  4. Energy-saving wastewater treatment systems: formulation of cost functions.

    Science.gov (United States)

    Nogueira, R; Ferreira, I; Janknecht, P; Rodríguez, J J; Oliveira, P; Brito, A G

    2007-01-01

    Natural interactions between water, soil, atmosphere, plants and microorganisms include physical, chemical and biological processes with decontaminating capacities. Natural or energy-saving wastewater treatment systems utilize these processes and thereby enable a sustainable management in the field of wastewater treatment, offering low investment and operation costs, little or no energy consumption, little and low-skill labor requirements, good landscape integration and excellent feasibility for small settlements, especially when remote from centralized sewer systems. The objective of this work is the development of cost functions for investment and operation of energy-saving wastewater treatment technologies. Cost functions are essential for making cost estimations based on a very reduced number of variables. The latter are easily identified and quantified and have a direct bearing on the costs in question. The formulated investment and operation cost functions follow a power law, and the costs decrease with the increase of the population served. The different energy-saving wastewater treatment systems serving small population settlements, between 50 p.e. and 250 p.e., present associated investment costs varying from 400 Euro/p.e. to 200 Euro/p.e. and annual operation costs in the range of 70 Euro/p.e. to 20 Euro/p.e., respectively.

  5. DETERMINING ENERGY SAVINGS IN BUILDINGS USING THE REDUCING COSTS METHOD

    Directory of Open Access Journals (Sweden)

    STAN IVAN F.E.

    2015-03-01

    Full Text Available The paper is structured in four parts. The first part presents the importance of thermal insulation for buildings energy economy and some insulation properties. In the second part of the paper it is described the reducing cost method to determine the energy savings. The third part of the paper includes an analysis and a comparison for an exterior wall provided with different thicknesses of insulation layer in order to determine the average savings cost. The last part presents conclusions and discussion.

  6. Costs and savings associated with implementation of a police crisis intervention team.

    Science.gov (United States)

    El-Mallakh, Peggy L; Kiran, Kranti; El-Mallakh, Rif S

    2014-06-01

    Police crisis intervention teams (CIT) have demonstrated their effectiveness in reducing injury to law enforcement personnel and citizens and the criminalization of mental illness; however, their financial effect has not been fully investigated. The objective of the study was to determine the total costs or total savings associated with implementing a CIT program in a medium-size city. The costs and savings associated with the implementation of a CIT program were analyzed in a medium-size city, Louisville, Kentucky, 9 years after the program's initiation. Costs associated with officer training, increased emergency psychiatry visits, and hospital admissions resulting from CIT activity were compared with the savings associated with diverted hospitalizations and reduced legal bookings. Based on an average of 2400 CIT calls annually, the overall costs associated with CIT per year were $2,430,128 ($146,079 for officer training, $1,768,536 for hospitalizations of patients brought in by CIT officers, $508,690 for emergency psychiatry evaluations, and $6823 for arrests). The annual savings of the CIT were $3,455,025 ($1,148,400 in deferred hospitalizations, $2,296,800 in reduced inpatient referrals from jail, and $9825 in avoided bookings and jail time). The balance is $1,024,897 in annual cost savings. The net financial effect of a CIT program is of modest benefit; however, much of this analysis was based on estimates and average length of stay. Furthermore, the costs and savings associated with officer or citizen injuries were not included because there was inadequate information about their prevalence and costs. Finally, this analysis does not take into account the nonmonetary gains of a CIT program.

  7. SWEEP - Save Water & Energy Education Program

    Energy Technology Data Exchange (ETDEWEB)

    Sullivan, Gregory P.; Elliott, Douglas B.; Hillman, Tim C.; Hadley, Adam; Ledbetter, Marc R.; Payson, David R.

    2001-05-03

    The objective of this study was to develop, monitor, analyze, and report on an integrated resource-conservation program highlighting efficient residential appliances and fixtures. The sites of study were 50 homes in two water-constrained communities located in Oregon. The program was designed to maximize water savings to these communities and to serve as a model for other communities seeking an integrated approach to energy and water resource efficiency. The program included the installation and in-place evaluation of energy- and water-efficient devices including the following: horizontal axis clothes washers (and the matching clothes dryers), resource-efficient dishwashers, an innovative dual flush low-flow toilet, low-flow showerheads, and faucet aerators. The significance of this activity lies in its integrated approach and unique metering evaluation of individual end-use, aggregated residential total use, and system-wide energy and water benefits.

  8. Delaware's Wellness Program: Motivating Employees Improves Health and Saves Money.

    Science.gov (United States)

    Davis, Jennifer J J

    2008-09-01

    Every year, employers around the country evaluate their company benefits package in the hopes of finding a solution to the ever-rising cost of health insurance premiums. For many business executives, the only logical choice is to pass along those costs to the employee. As an employer, our goal in Delaware has always been to come up with innovative solutions to drive down the cost of health insurance premiums while encouraging our employees to take responsibility for their own health and wellness by living a healthy and active lifestyle, and provide them with the necessary tools. The DelaWELL program (N = 68,000) was launched in 2007, after being tested in initial (N = 100) and expanded (N = 1500) pilot programs from 2004 to 2006 in which 3 similar groups were compared before and after the pilot. Employee health risk assessment, education, and incentives provided employees the necessary tools we had assumed would help them make healthier lifestyle choices. In the first pilot, fewer emergency department visits and lower blood pressure levels resulted in direct savings of more than $62,000. In the expanded pilot, in all 3 groups blood pressure was significantly reduced (P employees participating in DelaWELL had a combined weight loss of 5162 lb. Decision makers in the State of Delaware have come up with an innovative solution to controlling costs while offering employees an attractive benefits package. The savings from its employee benefit program have allowed the state to pass along the savings to employees by maintaining employee-paid health insurance contributions at the same level for the past 3 years. DelaWELL has already confirmed our motto, "Although it may seem an unusual business investment to pay for healthcare before the need arises, in Delaware we concluded that this makes perfect sense." This promising approach to improving health and reducing healthcare costs could potentially be applied to other employer groups.

  9. Energy-saving wastewater treatment systems : formulation of cost functions

    OpenAIRE

    Nogueira, R.; Ferreira, I.; Janknecht, P; Rodríguez, Juan José; de Oliveira, Pedro; A. G. Brito

    2007-01-01

    Natural interactions between water, soil, atmosphere, plants and microorganisms include physical, chemical and biological processes with decontaminating capacities. Natural or energy-saving wastewater treatment systems utilize these processes and thereby enable a sustainable management in the field of wastewater treatment, offering low investment and operation costs, little or no energy consumption, little and low-skill labor requirements, good landscape integration and excellent ...

  10. Potential cost savings from generic medicines – protecting the ...

    African Journals Online (AJOL)

    One way to do this would be to limit the costs of medicines provided for the management of chronic conditions listed in the PMBs. This study assessed the potential savings that would be achievable by substituting generics for brand name (originator) medicines listed in the chronic disease algorithms set out by the CMS.

  11. Potential Energy Cost Savings from Increased Commercial Energy Code Compliance

    Energy Technology Data Exchange (ETDEWEB)

    Rosenberg, Michael I.; Hart, Philip R.; Athalye, Rahul A.; Zhang, Jian; Cohan, David F.

    2016-08-22

    An important question for commercial energy code compliance is: “How much energy cost savings can better compliance achieve?” This question is in sharp contrast to prior efforts that used a checklist of code requirements, each of which was graded pass or fail. Percent compliance for any given building was simply the percent of individual requirements that passed. A field investigation method is being developed that goes beyond the binary approach to determine how much energy cost savings is not realized. Prototype building simulations were used to estimate the energy cost impact of varying levels of non-compliance for newly constructed office buildings in climate zone 4C. Field data collected from actual buildings on specific conditions relative to code requirements was then applied to the simulation results to find the potential lost energy savings for a single building or for a sample of buildings. This new methodology was tested on nine office buildings in climate zone 4C. The amount of additional energy cost savings they could have achieved had they complied fully with the 2012 International Energy Conservation Code is determined. This paper will present the results of the test, lessons learned, describe follow-on research that is needed to verify that the methodology is both accurate and practical, and discuss the benefits that might accrue if the method were widely adopted.

  12. Permanent magnets in accelerators can save energy, space and cost

    DEFF Research Database (Denmark)

    Bødker, F.; Baandrup, L.O.; Hauge, N.

    2013-01-01

    Green Magnet® technology with close to zero electrical power consumption without the need for cooling water saves costs, space and natural resources. A compact dipole based on permanent magnets has been developed at Danfysik in collaboration with Sintex and Aarhus University. Our first Green Magnet...

  13. Paternity leave in Sweden: costs, savings and health gains.

    Science.gov (United States)

    Månsdotter, Anna; Lindholm, Lars; Winkvist, Anna

    2007-06-01

    The initial objective is to examine the relationship between paternity leave in 1978-1979 and male mortality during 1981-2001, and the second objective is to calculate the cost-effectiveness of the 1974 parental insurance reform in Sweden. Based on a population of all Swedish couples who had their first child together in 1978 (45,801 males), the risk of death for men who took paternity leave, compared with men who did not, was estimated by odds ratios. The cost-effectiveness analysis considered costs for information, administration and production losses, minus savings due to decreased sickness leave and inpatient care, compared to health gains in life-years and quality-adjusted life-years (QALYs). It is demonstrated that fathers who took paternity leave have a statistically significant decreased death risk of 16%. Costs minus savings (discounted values) stretch from a net cost of EUR 19 million to a net saving of EUR 11 million, and the base case cost-effectiveness is EUR 8000 per QALY. The study indicates that that the right to paternity leave is a desirable reform based on commonly stated public health, economic, and feminist goals. The critical issue in future research should be to examine impact from health-related selection.

  14. Congenital toxoplasmosis in Austria: Prenatal screening for prevention is cost-saving.

    Science.gov (United States)

    Prusa, Andrea-Romana; Kasper, David C; Sawers, Larry; Walter, Evelyn; Hayde, Michael; Stillwaggon, Eileen

    2017-07-01

    Primary infection of Toxoplasma gondii during pregnancy can be transmitted to the unborn child and may have serious consequences, including retinochoroiditis, hydrocephaly, cerebral calcifications, encephalitis, splenomegaly, hearing loss, blindness, and death. Austria, a country with moderate seroprevalence, instituted mandatory prenatal screening for toxoplasma infection to minimize the effects of congenital transmission. This work compares the societal costs of congenital toxoplasmosis under the Austrian national prenatal screening program with the societal costs that would have occurred in a No-Screening scenario. We retrospectively investigated data from the Austrian Toxoplasmosis Register for birth cohorts from 1992 to 2008, including pediatric long-term follow-up until May 2013. We constructed a decision-analytic model to compare lifetime societal costs of prenatal screening with lifetime societal costs estimated in a No-Screening scenario. We included costs of treatment, lifetime care, accommodation of injuries, loss of life, and lost earnings that would have occurred in a No-Screening scenario and compared them with the actual costs of screening, treatment, lifetime care, accommodation, loss of life, and lost earnings. We replicated that analysis excluding loss of life and lost earnings to estimate the budgetary impact alone. Our model calculated total lifetime costs of €103 per birth under prenatal screening as carried out in Austria, saving €323 per birth compared with No-Screening. Without screening and treatment, lifetime societal costs for all affected children would have been €35 million per year; the implementation costs of the Austrian program are less than €2 million per year. Calculating only the budgetary impact, the national program was still cost-saving by more than €15 million per year and saved €258 million in 17 years. Cost savings under a national program of prenatal screening for toxoplasma infection and treatment are

  15. Can home care services achieve cost savings in long-term care for older people?

    Science.gov (United States)

    Greene, V L; Ondrich, J; Laditka, S

    1998-07-01

    To determine whether efficient allocation of home care services can produce net long-term care cost savings. Hazard function analysis and nonlinear mathematical programming. Optimal allocation of home care services resulted in a 10% net reduction in overall long-term care costs for the frail older population served by the National Long-Term Care (Channeling) Demonstration, in contrast to the 12% net cost increase produced by the demonstration intervention itself. Our findings suggest that the long-sought goal of overall cost-neutrality or even cost-savings through reducing nursing home use sufficiently to more than offset home care costs is technically feasible, but requires tighter targeting of services and a more medically oriented service mix than major home care demonstrations have implemented to date.

  16. The Energy Smart Guide to Campus Cost Savings.

    Science.gov (United States)

    Department of Energy, Washington, DC. Office of Energy Efficiency and Renewable Energy.

    Rebuild America is a program of the U.S. Department of Energy that focuses on energy-savings solutions as community solutions. It works with K-12 schools, colleges and universities, state and local governments, public and multifamily housing, and commercial buildings. This guide focuses on colleges and universities. Each chapter spells out options…

  17. Disease prevention: saving lives or reducing health care costs?

    Directory of Open Access Journals (Sweden)

    Inge Grootjans-van Kampen

    Full Text Available BACKGROUND: Disease prevention has been claimed to reduce health care costs. However, preventing lethal diseases increases life expectancy and, thereby, indirectly increases the demand for health care. Previous studies have argued that on balance preventing diseases that reduce longevity increases health care costs while preventing non-fatal diseases could lead to health care savings. The objective of this research is to investigate if disease prevention could result in both increased longevity and lower lifetime health care costs. METHODS: Mortality rates for Netherlands in 2009 were used to construct cause-deleted life tables. Data originating from the Dutch Costs of Illness study was incorporated in order to estimate lifetime health care costs in the absence of selected disease categories. We took into account that for most diseases health care expenditures are concentrated in the last year of life. RESULTS: Elimination of diseases that reduce life expectancy considerably increase lifetime health care costs. Exemplary are neoplasms that, when eliminated would increase both life expectancy and lifetime health care spending with roughly 5% for men and women. Costs savings are incurred when prevention has only a small effect on longevity such as in the case of mental and behavioural disorders. Diseases of the circulatory system stand out as their elimination would increase life expectancy while reducing health care spending. CONCLUSION: The stronger the negative impact of a disease on longevity, the higher health care costs would be after elimination. Successful treatment of fatal diseases leaves less room for longevity gains due to effective prevention but more room for health care savings.

  18. 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

  19. Accrued Cost Savings of a Free Clinic Using Quality-Adjusted Life Years Saved and Return on Investment.

    Science.gov (United States)

    Sanders, Jim; Lacey, Marcus; Guse, Clare E

    2017-01-01

    Savings garnered through the provision of preventive services is a form of profit for health systems. Free clinics have been using this logic to demonstrate their cost-savings. The Community-Based Chronic Disease Management (CCDM) clinic treats hypertension using nurse-led teams, clinical protocols, and community-based settings. We calculated CCDM's cost-effectiveness from 2007 to 2013 using 2 metrics: Quality-adjusted life years (QALYs) saved and return on investment (ROI). QALYs were calculated using the Clinical Preventive Burden (CPB) score for hypertension care. ROI was calculated by tallying the savings from prevented heart attacks, strokes, and emergency department visits against the total operating costs. Using conservative assumptions for cost estimates, hypertension care resulted in a value of QALYs saved of $711,000 to $2,133,000 and an ROI ratio range of 0.35 to 1.20. Our study shows that when using conservative assumptions to calculate cost-savings, our free clinic did not save money. Cost-savings did occur, but the amount was modest, was less than that of cost-inputs, and was not likely captured by any single health entity. Although free clinics remain a vital health care access point for many Americans, it has yet to be demonstrated that they generate a net savings. © Copyright 2017 by the American Board of Family Medicine.

  20. Assessing the cost saving potential of shared product architectures

    DEFF Research Database (Denmark)

    Mortensen, Niels Henrik; Hansen, Christian Lindschou; Løkkegaard, Martin

    2016-01-01

    company. Experiences from the case company show it is possible to reduce the number of architectures with 60% which leads to significant reduction in direct material and labor costs. This can be achieved without compromising the market offerings of products. Experiences from the case study indicate cost......This article presents a method for calculating cost savings of shared architectures in industrial companies called Architecture Mapping and Evaluation. The main contribution is an operational method to evaluate the cost potential and evaluate the number of product architectures in an industrial...... reductions between 0.5% and 2% of turnover. The main implication is that the method provides a quantitative basis for the discussion on whether or not to implement shared product architectures. This means a more fact-based approach is introduced....

  1. 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).

  2. Keys to the House: Unlocking Residential Savings With Program Models for Home Energy Upgrades

    Energy Technology Data Exchange (ETDEWEB)

    Grevatt, Jim [Energy Futures Group (United States); Hoffman, Ian [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Hoffmeyer, Dale [US Department of Energy, Washington, DC (United States)

    2017-07-05

    After more than 40 years of effort, energy efficiency program administrators and associated contractors still find it challenging to penetrate the home retrofit market, especially at levels commensurate with state and federal goals for energy savings and emissions reductions. Residential retrofit programs further have not coalesced around a reliably successful model. They still vary in design, implementation and performance, and they remain among the more difficult and costly options for acquiring savings in the residential sector. If programs are to contribute fully to meeting resource and policy objectives, administrators need to understand what program elements are key to acquiring residential savings as cost effectively as possible. To that end, the U.S. Department of Energy (DOE) sponsored a comprehensive review and analysis of home energy upgrade programs with proven track records, focusing on those with robustly verified savings and constituting good examples for replication. The study team reviewed evaluations for the period 2010 to 2014 for 134 programs that are funded by customers of investor-owned utilities. All are programs that promote multi-measure retrofits or major system upgrades. We paid particular attention to useful design and implementation features, costs, and savings for nearly 30 programs with rigorous evaluations of performance. This meta-analysis describes program models and implementation strategies for (1) direct install retrofits; (2) heating, ventilating and air-conditioning (HVAC) replacement and early retirement; and (3) comprehensive, whole-home retrofits. We analyze costs and impacts of these program models, in terms of both energy savings and emissions avoided. These program models can be useful guides as states consider expanding their strategies for acquiring energy savings as a resource and for emissions reductions. We also discuss the challenges of using evaluations to create program models that can be confidently applied in

  3. Autonomous hip exoskeleton saves metabolic cost of walking uphill.

    Science.gov (United States)

    Seo, Keehong; Lee, Jusuk; Park, Young Jin

    2017-07-01

    We have developed a hip joint exoskeleton to boost gait function in the elderly and rehabilitation of post-stroke patients. To quantitatively evaluate the impact of the power and mass of the exoskeleton, we measured the metabolic cost of walking on slopes of 0, 5, and 10% grade, once not wearing the exoskeleton and then wearing it. The exoskeleton reduced the metabolic cost by 13.5,15.5 and 9.8% (31.9, 51.6 and 45.6 W) at 0, 5, and 10% grade, respectively. The exoskeleton performance index was computed as 0.97, 1.24, and 1.24 at each grade, implicating that the hip exoskeleton was more effective on slopes than level ground in saving the metabolic cost.

  4. Dialyzer reuse: justified cost saving for south Asian region.

    Science.gov (United States)

    Dhrolia, Murtaza F; Nasir, Kiran; Imtiaz, Salman; Ahmad, Aasim

    2014-08-01

    In spite of controversies, dialyzer reuse has remained an integral part of hemodialysis because of lower cost, good overall safety record, and improved membrane biocompatibility. Reuse declined in developed countries from the beginning of this century because of mass production of hemodialyzers at favourable price with better biocompatible membrane. Abandoning dialyzer reuse became challenging in South Asian region, where more than 40% of the population live below the International Poverty Line of $1.25 per day, less than 10% of end stage renal disease patients receive renal replacement therapy, and upto 70% of those starting dialysis stop treatment due to cost within the first 3 months. Dialyzer reuse is an efficient cost-saving method that allows the use of more efficient and expensive biocompatible synthetic membranes, thereby providing high-quality dialysis to individuals living in countries with limited medical resources without compromising the safety or effectiveness of the treatment.

  5. Save water to save carbon and money: developing abatement costs for expanded greenhouse gas reduction portfolios.

    Science.gov (United States)

    Stokes, Jennifer R; Hendrickson, Thomas P; Horvath, Arpad

    2014-12-02

    The water-energy nexus is of growing interest for researchers and policy makers because the two critical resources are interdependent. Their provision and consumption contribute to climate change through the release of greenhouse gases (GHGs). This research considers the potential for conserving both energy and water resources by measuring the life-cycle economic efficiency of greenhouse gas reductions through the water loss control technologies of pressure management and leak management. These costs are compared to other GHG abatement technologies: lighting, building insulation, electricity generation, and passenger transportation. Each cost is calculated using a bottom-up approach where regional and temporal variations for three different California water utilities are applied to all alternatives. The costs and abatement potential for each technology are displayed on an environmental abatement cost curve. The results reveal that water loss control can reduce GHGs at lower cost than other technologies and well below California's expected carbon trading price floor. One utility with an energy-intensive water supply could abate 135,000 Mg of GHGs between 2014 and 2035 and save--rather than spend--more than $130/Mg using the water loss control strategies evaluated. Water loss control technologies therefore should be considered in GHG abatement portfolios for utilities and policy makers.

  6. Compressed air systems. A guidebook on energy and cost savings

    Energy Technology Data Exchange (ETDEWEB)

    1984-03-30

    This guidebook shows how energy can be saved in compressed air systems. It discusses basic compressed air systems which are typical of those found in industry and describes them and the engineering practices behind them. Energy conservation recommendations follow. These recommendations cover equipment selection, design, maintenance, and operation. Included is information which will help the reader to make economic evaluations of various engineering and equipment alternatives as they affect operations and costs. The appendices include some modern computer based approaches to predicting pressure drop for designing compressed air distribution systems. Also included is a bibliography providing leads for further and more detailed technical information on these and related subjects.

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

    DEFF Research Database (Denmark)

    Klinge Jacobsen, Henrik; Baldini, Mattia

    Energy savings are a key element in reaching ambitious climate targets and may contribute to increased productivity as well. For identification of the most attractive saving options cost curves for savings are constructed illustrating potentials of savings with associated costs. In optimisation...... modelling these cost options are then compared with the cost of producing energy and all savings with negative costs and cost below the cost of producing the energy including the associated externality costs are expected to be implemented. There are however several methodological issues associated...... with constructing and applying the cost curves in modelling: • Cost curves do not have the same cost interpretation across economic subsectors and end-use technologies (investment cost for equipment varies – including/excluding installation – adaptation costs – indirect production costs) • The time issue of when...

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

    Science.gov (United States)

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

    2007-01-01

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

  9. Energy Savings Lifetimes and Persistence

    Energy Technology Data Exchange (ETDEWEB)

    Hoffman, Ian M. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Schiller, Steven R. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Todd, Annika [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Billingsley, Megan A. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Goldman, Charles A. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Schwartz, Lisa C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2016-02-01

    This technical brief explains the concepts of energy savings lifetimes and savings persistence and discusses how program administrators use these factors to calculate savings for efficiency measures, programs and portfolios. Savings lifetime is the length of time that one or more energy efficiency measures or activities save energy, and savings persistence is the change in savings throughout the functional life of a given efficiency measure or activity. Savings lifetimes are essential for assessing the lifecycle benefits and cost effectiveness of efficiency activities and for forecasting loads in resource planning. The brief also provides estimates of savings lifetimes derived from a national collection of costs and savings for electric efficiency programs and portfolios.

  10. Congenital toxoplasmosis in Austria: Prenatal screening for prevention is cost-saving

    Science.gov (United States)

    Prusa, Andrea-Romana; Kasper, David C.; Sawers, Larry; Walter, Evelyn; Hayde, Michael

    2017-01-01

    Background Primary infection of Toxoplasma gondii during pregnancy can be transmitted to the unborn child and may have serious consequences, including retinochoroiditis, hydrocephaly, cerebral calcifications, encephalitis, splenomegaly, hearing loss, blindness, and death. Austria, a country with moderate seroprevalence, instituted mandatory prenatal screening for toxoplasma infection to minimize the effects of congenital transmission. This work compares the societal costs of congenital toxoplasmosis under the Austrian national prenatal screening program with the societal costs that would have occurred in a No-Screening scenario. Methodology/Principal findings We retrospectively investigated data from the Austrian Toxoplasmosis Register for birth cohorts from 1992 to 2008, including pediatric long-term follow-up until May 2013. We constructed a decision-analytic model to compare lifetime societal costs of prenatal screening with lifetime societal costs estimated in a No-Screening scenario. We included costs of treatment, lifetime care, accommodation of injuries, loss of life, and lost earnings that would have occurred in a No-Screening scenario and compared them with the actual costs of screening, treatment, lifetime care, accommodation, loss of life, and lost earnings. We replicated that analysis excluding loss of life and lost earnings to estimate the budgetary impact alone. Our model calculated total lifetime costs of €103 per birth under prenatal screening as carried out in Austria, saving €323 per birth compared with No-Screening. Without screening and treatment, lifetime societal costs for all affected children would have been €35 million per year; the implementation costs of the Austrian program are less than €2 million per year. Calculating only the budgetary impact, the national program was still cost-saving by more than €15 million per year and saved €258 million in 17 years. Conclusions/Significance Cost savings under a national program of

  11. Congenital toxoplasmosis in Austria: Prenatal screening for prevention is cost-saving.

    Directory of Open Access Journals (Sweden)

    Andrea-Romana Prusa

    2017-07-01

    Full Text Available Primary infection of Toxoplasma gondii during pregnancy can be transmitted to the unborn child and may have serious consequences, including retinochoroiditis, hydrocephaly, cerebral calcifications, encephalitis, splenomegaly, hearing loss, blindness, and death. Austria, a country with moderate seroprevalence, instituted mandatory prenatal screening for toxoplasma infection to minimize the effects of congenital transmission. This work compares the societal costs of congenital toxoplasmosis under the Austrian national prenatal screening program with the societal costs that would have occurred in a No-Screening scenario.We retrospectively investigated data from the Austrian Toxoplasmosis Register for birth cohorts from 1992 to 2008, including pediatric long-term follow-up until May 2013. We constructed a decision-analytic model to compare lifetime societal costs of prenatal screening with lifetime societal costs estimated in a No-Screening scenario. We included costs of treatment, lifetime care, accommodation of injuries, loss of life, and lost earnings that would have occurred in a No-Screening scenario and compared them with the actual costs of screening, treatment, lifetime care, accommodation, loss of life, and lost earnings. We replicated that analysis excluding loss of life and lost earnings to estimate the budgetary impact alone. Our model calculated total lifetime costs of €103 per birth under prenatal screening as carried out in Austria, saving €323 per birth compared with No-Screening. Without screening and treatment, lifetime societal costs for all affected children would have been €35 million per year; the implementation costs of the Austrian program are less than €2 million per year. Calculating only the budgetary impact, the national program was still cost-saving by more than €15 million per year and saved €258 million in 17 years.Cost savings under a national program of prenatal screening for toxoplasma infection and

  12. Boiler house modernization through shared savings program

    Energy Technology Data Exchange (ETDEWEB)

    Breault, R.W. [Tecogen, Waltham, MA (United States)

    1995-12-31

    Throughout Poland as well as the rest of Eastern Europe, communities and industries rely on small heat only boilers to provide district and process heat. Together these two sectors produce about 85,000 MW from boilers in the 2 to 35 MW size range. The bulk of these units were installed prior to 1992 and must be completely overhauled to meet the emission regulations which will be coming into effect on January 1, 1998. Since the only practical fuel is coal in most cases, these boilers must be either retrofit with emission control technology or be replaced entirely. The question that arises is how to accomplish this given the current tight control of capital in Poland and other East European countries. A solution that we have for this problem is shared savings. These boilers are typically operating with a quiet low efficiency as compared to western standards and with excessive manual labor. Installing modernization equipment to improve the efficiency and to automate the process provides savings. ECOGY provides the funds for the modernization to improve the efficiency, add automation and install emission control equipment. The savings that are generated during the operation of the modernized boiler system are split between the client company and ECOGY for a number of years and then the system is turned over in entirety to the client. Depending on the operating capacity, the shared savings agreement will usually span 6 to 10 years.

  13. Incorporating shared savings programs into primary care: from theory to practice.

    Science.gov (United States)

    Hayen, Arthur P; van den Berg, Michael J; Meijboom, Bert R; Struijs, Jeroen N; Westert, Gert P

    2015-12-30

    In several countries, health care policies gear toward strengthening the position of primary care physicians. Primary care physicians are increasingly expected to take accountability for overall spending and quality. Yet traditional models of paying physicians do not provide adequate incentives for taking on this new role. Under a so-called shared savings program physicians are instead incentivized to take accountability for spending and quality, as the program lets them share in cost savings when quality targets are met. We provide a structured approach to designing a shared savings program for primary care, and apply this approach to the design of a shared savings program for a Dutch chain of primary care providers, which is currently being piloted. Based on the literature, we defined five building blocks of shared savings models that encompass the definition of the scope of the program, the calculation of health care expenditures, the construction of a savings benchmark, the assessment of savings and the rules and conditions under which savings are shared. We apply insights from a variety of literatures to assess the relative merits of alternative design choices within these building blocks. The shared savings program uses an econometric model of provider expenditures as an input to calculating a casemix-corrected benchmark. The minimization of risk and uncertainty for both payer and provider is pertinent to the design of a shared savings program. In that respect, the primary care setting provides a number of unique opportunities for achieving cost and quality targets. Accountability can more readily be assumed due to the relatively long-lasting relationships between primary care physicians and patients. A stable population furthermore improves the confidence with which savings can be attributed to changes in population management. Challenges arise from the institutional context. The Dutch health care system has a fragmented structure and providers are typically

  14. Energy cost saving strategies in distributed power networks

    Directory of Open Access Journals (Sweden)

    Tcheukam Alain

    2016-01-01

    Full Text Available In this paper we study energy cost saving strategies in power networks in presence of prosumers. Three tips are considered: (i distributed power network architecture, (ii peak energy shaving with the integration of prosumers’ contribution, (iii Electric vehicles self-charging by means of prosumers’ production. The proposed distributed power network architecture reduces significantly the transmission costs and can reduce significantly the global energy cost up to 42 percent. Different types of prosumer who use self-charging photovoltaic systems, are able to intelligently buy energy from, or sell it, to the power grid. Therein, prosumers interact in a distributed environment during the purchase or sale of electric power using a double auction with negotiation mechanism. Using a two-step combined learning and optimization scheme, each prosumer can learn its optimal bidding strategy and forecast its energy production, consumption and storage. Our simulation results, conducted for the region of Sicily in Italy, show that the integration of prosumers can reduce peak hour costs up to 19 percent and 6 percent for eligible prosumers with electric vehicles.

  15. The design and application of shared savings programs: lessons from early adopters.

    Science.gov (United States)

    Weissman, Joel S; Bailit, Michael; D'Andrea, Guy; Rosenthal, Meredith B

    2012-09-01

    Different forms of physician payment result in different levels of financial risk for health care payers and providers, and can affect clinical decision making and the cost of care. Shared savings programs reward providers for holding spending below specific targets, thus introducing a level of financial accountability not present in strictly volume-based payment models, such as fee-for-service. Here we examine the design and application of shared savings formulas across a range of actual programs. We also present a more detailed description of one particular shared savings program-the Massachusetts Patient-Centered Medical Home Initiative-focusing on key trade-offs between payers and providers that eventually led to agreement on specific aspects of the program. We conclude with principles for the design of future shared savings arrangements and consideration of issues that will confront decision makers as these efforts mature and expand.

  16. Medication nonadherence in diabetes: longitudinal effects on costs and potential cost savings from improvement.

    Science.gov (United States)

    Egede, Leonard E; Gebregziabher, Mulugeta; Dismuke, Clara E; Lynch, Cheryl P; Axon, R Neal; Zhao, Yumin; Mauldin, Patrick D

    2012-12-01

    To examine the longitudinal effects of medication nonadherence (MNA) on key costs and estimate potential savings from increased adherence using a novel methodology that accounts for shared correlation among cost categories. Veterans with type 2 diabetes (740,195) were followed from January 2002 until death, loss to follow-up, or December 2006. A novel multivariate, generalized, linear, mixed modeling approach was used to assess the differential effect of MNA, defined as medication possession ratio (MPR) ≥0.8 on healthcare costs. A sensitivity analysis was performed to assess potential cost savings at different MNA levels using the Consumer Price Index to adjust estimates to 2012 dollar value. Mean MPR for the full sample over 5 years was 0.78, with a mean of 0.93 for the adherent group and 0.58 for the MNA group. In fully adjusted models, all annual cost categories increased ∼3% per year (P = 0.001) during the 5-year study time period. MNA was associated with a 37% lower pharmacy cost, 7% lower outpatient cost, and 41% higher inpatient cost. Based on sensitivity analyses, improving adherence in the MNA group would result in annual estimated cost savings ranging from ∼$661 million (MPR <0.6 vs. ≥0.6) to ∼$1.16 billion (MPR <1 vs. 1). Maximal incremental annual savings would occur by raising MPR from <0.8 to ≥0.8 ($204,530,778) among MNA subjects. Aggressive strategies and policies are needed to achieve optimal medication adherence in diabetes. Such approaches may further the so-called "triple aim" of achieving better health, better quality care, and lower cost.

  17. 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,...

  18. Cost savings deliverables and criteria for the OST technology decision process

    Energy Technology Data Exchange (ETDEWEB)

    McCown, A.

    1997-04-01

    This document has been prepared to assist focus area (FA) technical and management teams in understanding the cost savings deliverables associated with a technology system during its research and development (R and D) phases. It discusses the usefulness of cost analysis in the decision-making process, and asserts that the level of confidence and data quality of a cost analysis is proportional to the maturity of the technology system`s development life cycle. Suggestions of specific investment criteria or cost savings metrics that a FA might levy on individual research projects are made but the final form of these elements should be stipulated by the FA management based on their rationale for a successful technology development project. Also, cost savings deliverables for a single FA will be more detailed than those for management of the Office of Science and Technology (OST). For example, OST management may want an analysis of the overall return on investment for each FA, while the FA program manager may want this analysis and the return on investment metrics for each technology research activity the FA supports.

  19. Shared Savings Program ACO Provider-level RIF

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Centers for Medicare (CM) has created a set of standard analytical files that contain Shared Savings Program Accountable Care Organizations. Provider-level RIF...

  20. Shared Savings Program ACO Beneficiary-level RIF

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Centers for Medicare (CM) has created a set of standard analytical files that contain Shared Savings Program Accountable Care Organizations. Beneficiary-level...

  1. Evaluation of energy and cost savings in mobile Cloud RAN

    DEFF Research Database (Denmark)

    Checko, Aleksandra; Christiansen, Henrik Lehrmann; Berger, Michael Stübert

    2013-01-01

    The load in mobile networks is subject to variations during the day, due to user mobility and varying network average usage. Therefore, the traditional or Distributed Radio Access Network (D-RAN) architecture, where the BaseBand processing Units (BBUs) are assigned statically to a number of cells...... using OPNET Modeler. A real case scenario is built upon the mobile traffic forecast for year 2017, a number of recommendations on traffic models and a proposed C-RAN implementation. The results achieved show that the maximum statistical multiplexing gain for user plane traffic in C-RAN architecture is 4......, is sub optimal, comparing to a novel, cloud based architecture called Cloud Radio Access Network (C-RAN). In C-RAN a group of cells shares processing resources, and hence benefit from statistical multiplexing gain is expected. In this paper, the energy and cost savings in C-RAN are evaluated numerically...

  2. Cost and Benefit Tradeoffs in Using a Shade Tree for Residential Building Energy Saving

    Directory of Open Access Journals (Sweden)

    Sappinandana Akamphon

    2014-01-01

    Full Text Available Global warming and urban heat islands result in increased cooling energy consumption in buildings. Previous literature shows that planting trees to shade a building can reduce its cooling load. This work proposes a model to determine the cost effectiveness and profitability of planting a shade tree by considering both its potential to reduce cooling energy and its purchase and maintenance cost. A comparison between six selected tree species is used for illustration. Using growth rates, crown sizes, and shading coefficients, cooling energy savings from the tree shades are computed using an industrial-standard building energy simulation program, offset by costs of purchase, planting, and maintenance of these trees. The result shows that most worthwhile tree to plant should have high shading coefficient and moderate crown size to maximize shading while keeping the maintenance costs manageable.

  3. A cost-savings analysis of a candidate universal antiretroviral regimen.

    Science.gov (United States)

    Ripin, David; Prabhu, Vineet R

    2017-07-01

    Despite significant strides in tackling HIV/AIDS in low-income and middle-income countries (LMICs), many treatment shortcomings remain, with limited drug selection to patients emerging as a critical challenge. The potential cost-savings benefits of adopting newer drugs as near-universal first-line antiretroviral (ARV) regimens that also provide improved clinical outcomes are discussed. In the near term, a fixed-dose combination of dolutegravir (DTG or D) with tenofovir disoproxil fumarate (TDF), and either lamivudine or emtricitabine (XTC), that is, tenofovir disoproxil fumarate/XTC/DTG (TXD) (X = XTC), could represent a near-universal first-line antiretroviral regimen offering significant clinical benefit, commodity savings, and overall health system savings. In the longer term, tenofovir alafenamide fumarate (TAF) could further reduce the cost of the first-line treatment backbone, with possible clinical benefits. Relative to the current generic standard of care in first-line, currently priced at ∼USD 90 per patient per year (pppy), high-volume production of TXD could lead to price reductions of ∼USD 20 pppy, whereas high-volume production of tenofovir alafenamide fumarate/XTC/DTG (TAFXD) could offer a reduction of ∼USD 40 pppy. With TXD in the near term, and TAFXD in the longer term, patients can benefit from better tolerated and more durable treatment, and programs will benefit by simplifying patient care and reducing cost to cover more patients.

  4. Value drivers: an approach for estimating health and disease management program savings.

    Science.gov (United States)

    Phillips, V L; Becker, Edmund R; Howard, David H

    2013-12-01

    Health and disease management (HDM) programs have faced challenges in documenting savings related to their implementation. The objective of this eliminate study was to describe OptumHealth's (Optum) methods for estimating anticipated savings from HDM programs using Value Drivers. Optum's general methodology was reviewed, along with details of 5 high-use Value Drivers. The results showed that the Value Driver approach offers an innovative method for estimating savings associated with HDM programs. The authors demonstrated how real-time savings can be estimated for 5 Value Drivers commonly used in HDM programs: (1) use of beta-blockers in treatment of heart disease, (2) discharge planning for high-risk patients, (3) decision support related to chronic low back pain, (4) obesity management, and (5) securing transportation for primary care. The validity of savings estimates is dependent on the type of evidence used to gauge the intervention effect, generating changes in utilization and, ultimately, costs. The savings estimates derived from the Value Driver method are generally reasonable to conservative and provide a valuable framework for estimating financial impacts from evidence-based interventions.

  5. Cost-Savings and Economic Benefits due to the Assistive Robotic Manipulator (ARM)

    NARCIS (Netherlands)

    Römer, G.R.B.E.; Stuyt, Harry J.A.; Peters, Albér

    2005-01-01

    Besides the social and personal benefits of a rehabilitation robot, the direct cost-savings and other (indirect) economic benefits, or effectiveness, are of major importance to party who pays for (or reimburses) the rehabilitation robot. This paper gives an overview of these cost-savings and, on a

  6. Direct and indirect costs and potential cost savings of laparoscopic adjustable gastric banding among obese patients with diabetes.

    Science.gov (United States)

    Finkelstein, Eric A; Allaire, Benjamin T; DiBonaventura, Marco DaCosta; Burgess, Somali M

    2011-09-01

    To estimate the time to breakeven and 5-year net costs for laparoscopic adjustable gastric banding among obese patients with diabetes taking direct and indirect costs into account. Indirect cost savings were generated by quantifying the cross-sectional relationship between medical expenditures and absenteeism and between medical expenditures and presenteeism (reduced on-the-job productivity) and simulating indirect cost savings based on these multipliers and reductions in direct medical costs available in the literature. Time to breakeven was estimated to be nine quarters with and without the inclusion of indirect costs. After 5 years, net savings increase from $26570 (±$9000) to $34160 (±$10 380) when indirect costs are included. This study presented a novel approach for incorporating indirect costs into cost-benefit analyses. Application to gastric banding revealed that inclusion of indirect costs improves the financial outlook for the procedure. (C)2011The American College of Occupational and Environmental Medicine

  7. The total lifetime health cost savings of smoking cessation to society

    DEFF Research Database (Denmark)

    Rasmussen, Gitte Susanne; Prescott, Eva; Sørensen, Thorkild I A

    2005-01-01

    Smoking cessation has major immediate and long-term health benefits. However, ex-smokers' total lifetime health costs and continuing smokers' costs remain uncompared, and hence the economic savings of smoking cessation to society have not been determined.......Smoking cessation has major immediate and long-term health benefits. However, ex-smokers' total lifetime health costs and continuing smokers' costs remain uncompared, and hence the economic savings of smoking cessation to society have not been determined....

  8. Selected bibliography: cost and energy savings of conservation and renewable energy technologies

    Energy Technology Data Exchange (ETDEWEB)

    None

    1980-05-01

    This bibliography is a compilation of reports on the cost and energy savings of conservation and renewable energy applications throughout the United States. It is part of an overall effort to inform utilities of technological developments in conservation and renewable energy technologies and so aid utilities in their planning process to determine the most effective and economic combination of capital investments to meet customer needs. Department of Energy assessments of the applications, current costs and cost goals for the various technologies included in this bibliography are presented. These assessments are based on analyses performed by or for the respective DOE Program Offices. The results are sensitive to a number of variables and assumptions; however, the estimates presented are considered representative. These assessments are presented, followed by some conclusions regarding the potential role of the conservation and renewable energy alternative. The approach used to classify the bibliographic citations and abstracts is outlined.

  9. Performing impact evaluations in industrial retrofit: The Energy Savings Plan Program

    Energy Technology Data Exchange (ETDEWEB)

    Riewer, S. [USDOE Bonneville Power Administration, Portland, OR (United States); Spanner, G.E. [Pacific Northwest Lab., Richland, WA (United States)

    1991-08-01

    The Energy Savings Plan (ESP) is Bonneville Power Administration`s retrofit program for the industrial sector. The program pays incentives for energy conservation measures involving electrical energy efficiency improvements in manufacturing, processing, and refining industries. This paper will describe the ESP program, recount the techniques selected to evaluate the retrofits, and report the findings from five ESP project impact evaluations completed to date. The impact evaluations provide a framework for assessing the energy saving achieved by the provides implemented under the ESP. In addition to energy savings, the evaluations assess process changes, net utility impacts, levelized costs, and ``free ridership.`` The five ESP projects evaluated include: a waste heat recovery system for a food processing blancher, an energy management control system used to upgrade refrigeration, a variable speed drive for a fan motor in a lumber mill, a sludge screw press for waste water treatment, and replacement of rod anodes with blades anodes in mercury cells in an electrochemical plant.

  10. 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.

  11. A Model of Cost Reduction and Standardization: Improved Cost Savings While Maintaining the Quality of Care.

    Science.gov (United States)

    Guzman, Michael J; Gitelis, Matthew E; Linn, John G; Ujiki, Michael B; Waskerwitz, Matthew; Umanskiy, Konstantin; Muldoon, Joseph P

    2015-11-01

    Surgeon instrument choices are influenced by training, previous experience, and established preferences. This causes variability in the cost of common operations, such as laparoscopic appendectomy. Many surgeons are unaware of the impact that this has on healthcare spending. We sought to educate surgeons on their instrument use and develop standardized strategies for operating room cost reduction. We collected the individual surgeon instrument cost for performing a laparoscopic appendectomy. Sixteen surgeons were educated about these costs and provided with cost-effective instruments and techniques. This study was conducted in a university-affiliated hospital system. Patients included those undergoing a laparoscopic appendectomy within the hospital system. Patient demographics, operating room costs, and short-term outcomes for the fiscal year before and after the education program were then compared. During fiscal year 2013, a total of 336 laparoscopic appendectomies were performed compared with 357 in 2014. Twelve surgeons had a ≥5% reduction in average cost per case. Overall, the average cost per case was reduced by 17% (p costs are based on our institution contracts and vary compared with other institutions. In this study we demonstrate that operative instrument costs for laparoscopic appendectomy can be significantly reduced by informing the surgeons of their operating room costs compared with their peers and providing a low-cost standardized instrument tray. Importantly, this can be realized without any incentive or punitive measures and does not negatively impact outcomes. Additional work is needed to expand these results to more operations, hospital systems, and training programs.

  12. Potential for the Use of Energy Savings Performance Contracts to Reduce Energy Consumption and Provide Energy and Cost Savings in Non-Building Applications

    Energy Technology Data Exchange (ETDEWEB)

    Williams, Charles; Green, Andrew S.; Dahle, Douglas; Barnett, John; Butler, Pat; Kerner, David

    2013-08-01

    The findings of this study indicate that potential exists in non-building applications to save energy and costs. This potential could save billions of federal dollars, reduce reliance on fossil fuels, increase energy independence and security, and reduce greenhouse gas emissions. The Federal Government has nearly twenty years of experience with achieving similar energy cost reductions, and letting the energy costs savings pay for themselves, by applying energy savings performance contracts (ESPC) inits buildings. Currently, the application of ESPCs is limited by statute to federal buildings. This study indicates that ESPCs can be a compatible and effective contracting tool for achieving savings in non-building applications.

  13. Relationship Between Timing of Multiple Retention Bonuses and the Quality of Officers Retained on the Cost Savings for the Navy

    Science.gov (United States)

    2016-12-01

    BETWEEN TIMING OF MULTIPLE RETENTION BONUSES AND THE QUALITY OF OFFICERS RETAINED ON THE COST SAVINGS FOR THE NAVY by Marley E. Cassels...RETENTION BONUSES AND THE QUALITY OF OFFICERS RETAINED ON THE COST SAVINGS FOR THE NAVY 5. FUNDING NUMBERS 6. AUTHOR(S) Marley E. Cassels 7...objectives and providing cost savings. We found that a quality auction system could provide cost savings as much as $1,850,000 or could increase costs by

  14. Energy savings estimates and cost benefit calculations for high performance relocatable classrooms

    Energy Technology Data Exchange (ETDEWEB)

    Rainer, Leo I.; Hoeschele, Marc A.; Apte, Michael G.; Shendell, Derek G.; Fisk, Wlliam J.

    2003-12-01

    This report addresses the results of detailed monitoring completed under Program Element 6 of Lawrence Berkeley National Laboratory's High Performance Commercial Building Systems (HPCBS) PIER program. The purpose of the Energy Simulations and Projected State-Wide Energy Savings project is to develop reasonable energy performance and cost models for high performance relocatable classrooms (RCs) across California climates. A key objective of the energy monitoring was to validate DOE2 simulations for comparison to initial DOE2 performance projections. The validated DOE2 model was then used to develop statewide savings projections by modeling base case and high performance RC operation in the 16 California climate zones. The primary objective of this phase of work was to utilize detailed field monitoring data to modify DOE2 inputs and generate performance projections based on a validated simulation model. Additional objectives include the following: (1) Obtain comparative performance data on base case and high performance HVAC systems to determine how they are operated, how they perform, and how the occupants respond to the advanced systems. This was accomplished by installing both HVAC systems side-by-side (i.e., one per module of a standard two module, 24 ft by 40 ft RC) on the study RCs and switching HVAC operating modes on a weekly basis. (2) Develop projected statewide energy and demand impacts based on the validated DOE2 model. (3) Develop cost effectiveness projections for the high performance HVAC system in the 16 California climate zones.

  15. Savings in acute care costs if all older adults treated for fall-related injuries completed matter of balance.

    Science.gov (United States)

    Howland, Jonathan; Shankar, Kalpana Narayan; Peterson, Elizabeth W; Taylor, Alyssa A

    Falls among older adults are a common and serious public health problem. Evidence-based fall prevention programs delivered in community settings and targeting older adults living independently are increasingly deployed throughout the nation. These programs tend to be offered by public and private organizations that serve older adults, and recruitment usually occurs through direct marketing to the target population, rather than through referrals from healthcare providers. Matter of Balance, a program developed to reduce fear of falling and associated activity restriction in community-dwelling older adults, is currently being delivered in 38 of the 50 United States. In this study, we estimate the one-year medical care cost savings if older adults treated at Massachusetts hospitals for fall-related injuries were referred by healthcare providers to participate in Matter of Balance. Data from several sources were used for this study. We estimated annual cost savings in older adult falls recidivism for a hypothetical 100 patients presenting at an emergency department for a fall-related injury, assuming that all were referred to, and 50 % completed, Matter of Balance. This cost-saving estimate was subsequently expanded based on the actual number (43,931) of older adult patients presenting at, and discharged from Massachusetts emergency departments for all fall-related injuries in 2012. Cost savings were calculated for two additional participation rates: 25 % and 75 %. The return on investment (ROI), was calculated based on the percentage of return per each dollar invested. The calculated ROI for Matter of Balance was 144 %. Statewide savings ranged from $2.79 million assuming a 25 % participation rate to $8.37 million, assuming a 75 % participation rate. Referral to evidence-based falls prevention programs of older adult patients presenting at EDs with a fall-related injury could reduce subsequent falls and associated treatment costs.

  16. Energy Savings From System Efficiency Improvements in Iowa's HVAC SAVE Program

    Energy Technology Data Exchange (ETDEWEB)

    Yee, S. [Partnership for Advanced Residential Retrofit, Chicago, IL (United States); Baker, J. [Partnership for Advanced Residential Retrofit, Chicago, IL (United States); Brand, L. [Partnership for Advanced Residential Retrofit, Chicago, IL (United States); Wells, J. [Partnership for Advanced Residential Retrofit, Chicago, IL (United States)

    2013-08-01

    The objective of this project is to explore the energy savings potential of maximizing furnace and distribution system performance by adjusting operating, installation, and distribution conditions. The goal of the Iowa HVAC System Adjusted and Verified Efficiency (SAVE) program is to train contractors to measure installed system efficiency as a diagnostic tool to ensure that the homeowner achieves the energy reduction target for the home rather than simply performing a tune-up on the furnace or having a replacement furnace added to a leaky system. The PARR research team first examined baseline energy usage from a sample of 48 existing homes, before any repairs or adjustments were made, to calculate an average energy savings potential and to determine which system deficiencies were prevalent. The results of the baseline study of these homes found that, on average, about 10% of the space heating energy available from the furnace was not reaching the conditioned space. In the second part of the project, the team examined a sample of 10 homes that had completed the initial evaluation for more in-depth study. For these homes, the diagnostic data shows that it is possible to deliver up to 23% more energy from the furnace to the conditioned space by doing system tune ups with or without upgrading the furnace. Replacing the furnace provides additional energy reduction. The results support the author's belief that residential heating and cooling equipment should be tested and improved as a system rather than a collection of individual components.

  17. Purging energy costs. [Energy savings in ammonia refrigeration system

    Energy Technology Data Exchange (ETDEWEB)

    Whitwell, Ian (Energy Technology Support Unit, Harwell (United Kingdom))

    1992-09-01

    Energy savings of over Pound 8,000 per year have been achieved by Exel Logistics, which has installed a five-point automatic purger to the evaporative condenser and receiver of the ammonia refrigeration system at its Glasgow service depot. The main features of the system are described in this article. (Author).

  18. Potential Cost Savings from Generic Medicines - Protecting the ...

    African Journals Online (AJOL)

    Background: South Africa has followed a pro-generic policy since the introduction of the National Drug Policy in 1996. ... This study assessed the potential savings that would be achievable by substituting generics for brand name (originator) medicines listed in the chronic disease algorithms set out by the Council for ...

  19. Incorrect storage of medicines and potential for cost savings

    DEFF Research Database (Denmark)

    Colberg, Lene; Schmidt-Petersen, Lone; Hansen, Merete Kock

    2017-01-01

    Objective Incorrect storage and handling of refrigerated medicines may result in destruction of medicines and financial loss for hospitals. At the Medicine Information Centre we receive and answer queries on drug-related issues. In this study we aimed to investigate and quantify savings made foll...

  20. Saving Energy in Industrial Companies: Case Studies of Energy Efficiency Programs in Large U.S. Industrial Corporations and the Role of Ratepayer-Funded Support

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    2017-03-08

    This paper is designed for companies looking to cut costs through energy savings, ratepayer-funded program administrators interested in increasing large industrial company participation in energy efficiency program offerings, and state utility commissions.

  1. Tele-Dysphagia management: an opportunity for prevention, cost-savings and advanced training.

    Science.gov (United States)

    Coyle, James

    2012-01-01

    Many patients survive severe stroke because of aggressive management in intensive care units. However, acquiring pneumonia during the post-onset phase significantly reduces both the quality and likelihood of survival. Aspiration pneumonia (AP), a relatively recent addition to the list of the pneumonias, is associated with dysphagia, a swallowing disorder that may cause aspiration of swallowed food or liquids mixed with bacterial pathogens common to saliva, or by aspiration of gastric contents due to emesis or gastroesophageal reflux. While it is within the purview of speech-language pathologists to provide evaluation, treatment, and management of dysphagia, the number of patients with dysphagia is growing faster than the number of qualified dysphagia clinicians. Because dysphagia consultations via telepractice are feasible and relatively accessible from a technological standpoint, they offer a promising strategy to bring the expertise of distant dysphagia experts to patients in underserved areas. Tele-dysphagia management has the potential to increase patients' survival, enhance the expertise of primary, local clinicians, and reduce healthcare costs. Even a modest reduction in either hospital admissions for aspiration pneumonia, or in the length of stay for AP, could save the US health care system hundreds of millions of dollars each year. Wide spread tele-dysphagia management offers significant opportunities for prevention, cost-savings and advanced training, and is therefore worthy of consideration by stakeholders in the health care system and university training programs.

  2. Tele-Dysphagia Management: An Opportunity for Prevention, Cost-Savings and Advanced Training

    Directory of Open Access Journals (Sweden)

    James Coyle

    2012-06-01

    Full Text Available Many patients survive severe stroke because of aggressive management in intensive care units.  However, acquiring pneumonia during the post-onset phase significantly reduces both the quality and likelihood of survival. Aspiration pneumonia (AP, a relatively recent addition to the list of the pneumonias, is associated with dysphagia, a swallowing disorder that may cause aspiration of swallowed food or liquids mixed with bacterial pathogens common to saliva, or by aspiration of gastric contents due to emesis or gastroesophageal reflux. While it is within the purview of speech-language pathologists to provide evaluation, treatment, and management of dysphagia, the number of patients with dysphagia is growing faster than the number of qualified dysphagia clinicians.  Because dysphagia consultations via telepractice are feasible and relatively accessible from a technological standpoint, they offer a promising strategy to bring the expertise of distant dysphagia experts to patients in underserved areas.  Tele-dysphagia management has the potential to increase patients’ survival, enhance the expertise of primary, local clinicians, and reduce healthcare costs. Even a modest reduction in either hospital admissions for aspiration pneumonia, or in the length of stay for AP, could save the US health care system hundreds of millions of dollars each year.  Wide spread tele-dysphagia management offers significant opportunities for prevention, cost-savings and advanced training, and is therefore worthy of consideration by stakeholders in the health care system and university training programs.

  3. Energy conserved and costs saved by small and medium-size manufacturers, 1988--1989

    Energy Technology Data Exchange (ETDEWEB)

    Kirsch, F.W.

    1991-05-01

    Energy Analysis and Diagnostic Centers (EADCs) provided energy-conserving and cost saving assistance in 339 small and medium-size manufacturing plants nationwide during 1988-89. This report presents the results of what was recommended to those manufacturers, the record of what was implemented by them, and an analysis of the financial rewards gained by them. It also includes an accounting of the financial returns to the federal government, derived from taxes upon the cost savings, or incremental income, of the manufacturers who implement the EADCs` recommendations. EADCs collect implementation data within a year of the energy audit, and for these results that time period extended through 1990. The EADCs are located at accredited engineering departments of universities and staffed by faculty and students. At present there are 18 EADCs serving manufacturers in 37 states; of these, two were established as a result of the 1989 competition, and five more were chosen competitively in 1990. Most of the results in this report were generated by 11 EADCs (named in the Appendix); two others withdrew voluntarily after completing only 10 energy audits during 1988-89. Primary responsibility for selecting, training, evaluating, and managing the EADCs belongs to the Industrial Technology and Energy Management (ITEM) division of University City Science Center (UCSC). The Department of Energy`s Office of Industrial Technologies sponsors the EADC program through an agreement with UCSC.

  4. 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.

  5. Heat savings and heat generation technologies: Modelling of residential investment behaviour with local health costs

    DEFF Research Database (Denmark)

    Zvingilaite, Erika; Klinge Jacobsen, Henrik

    2015-01-01

    The trade-off between investing in energy savings and investing in individual heating technologies with high investment and low variable costs in single family houses is modelled for a number of building and consumer categories in Denmark. For each group the private economic cost of providing...... heating comfort is minimised. The private solution may deviate from the socio-economical optimal solution and we suggest changes to policy to incentivise the individuals to make choices more in line with the socio-economic optimal mix of energy savings and technologies. The households can combine...... to a combination of low costs of primary fuel and low environmental performance of woodstoves today, included health costs lead to decreased use of secondary heating. Overall the interdependence of heat generation technology- and heat saving-choice is significant. The total optimal level of heat savings...

  6. Net Zero Pilot Program Lights the Path to Big Savings in Guam

    Energy Technology Data Exchange (ETDEWEB)

    PNNL

    2016-11-03

    Case study describes how the Army Reserve 9th Mission Support Command (MSC) reduced lighting energy consumption by 62% for a total savings of 125,000 kWh and more than $50,000 per year by replacing over 400 fluorescent troffers with 36 W LED troffers. This project was part of the Army Reserve Net Zero Pilot Program, initiated in 2013, to reduce energy and water consumption, waste generation, and utility costs.

  7. I-SAVE conservation program. Implementing title II of NECPA residential conservation service. Final draft

    Energy Technology Data Exchange (ETDEWEB)

    None

    1980-05-30

    The I-SAVE (Iowa Saves America's Vital Energy) conservation plan provides comprehensive energy-conservation information and services to residential consumers served by large investor-owned electric and gas utilities and participating home-heating suppliers. The overall objective of the I-SAVE plan is to conserve energy by facilitating cost-effective retrofit of existing housing and promoting more-efficient energy use. The ultimate benefit available to the customer under the I-SAVE plan - reduction in energy use - is dependent upon the action he or she takes as a result of the program audit. Benefits to the utility and the ratepayers as a whole, however, will accrue only upon widespread customer acceptance and utilization of program services. This degree of program acceptance and the resulting benefits to ratepayers can be attained only through an aggressive educational and promotional effort by the covered utilities. All electric and gas utilities which have sales, other than resale, exceeding 750 million kWh of electricity or 10 billion cubic feet of gas and participating home-heating suppliers, shall provide a program announcement and shall offer conservation services to their customers who occupy a residential building containing at least one, but not more than four units, in a manner as provided by the rules. The text of the rules is presented. (MCW)

  8. Determinants of success in Shared Savings Programs: An analysis of ACO and market characteristics.

    Science.gov (United States)

    Ouayogodé, Mariétou H; Colla, Carrie H; Lewis, Valerie A

    2017-03-01

    Medicare's Accountable Care Organization (ACO) programs introduced shared savings to traditional Medicare, which allow providers who reduce health care costs for their patients to retain a percentage of the savings they generate. To examine ACO and market factors associated with superior financial performance in Medicare ACO programs. We obtained financial performance data from the Centers for Medicare and Medicaid Services (CMS); we derived market-level characteristics from Medicare claims; and we collected ACO characteristics from the National Survey of ACOs for 215 ACOs. We examined the association between ACO financial performance and ACO provider composition, leadership structure, beneficiary characteristics, risk bearing experience, quality and process improvement capabilities, physician performance management, market competition, CMS-assigned financial benchmark, and ACO contract start date. We examined two outcomes from Medicare ACOs' first performance year: savings per Medicare beneficiary and earning shared savings payments (a dichotomous variable). When modeling the ACO ability to save and earn shared savings payments, we estimated positive regression coefficients for a greater proportion of primary care providers in the ACO, more practicing physicians on the governing board, physician leadership, active engagement in reducing hospital re-admissions, a greater proportion of disabled Medicare beneficiaries assigned to the ACO, financial incentives offered to physicians, a larger financial benchmark, and greater ACO market penetration. No characteristic of organizational structure was significantly associated with both outcomes of savings per beneficiary and likelihood of achieving shared savings. ACO prior experience with risk-bearing contracts was positively correlated with savings and significantly increased the likelihood of receiving shared savings payments. In the first year, performance is quite heterogeneous, yet organizational structure does not

  9. Directions of organisational and low-cost energy saving of engineering enterprises

    Directory of Open Access Journals (Sweden)

    Dzhedzhula Viacheslav V.

    2014-01-01

    Full Text Available The article analyses directions of energy saving of industrial enterprises. Taking into account the tendency to continuous growth of cost of energy resources, introduction of measures that would allow reduction of energy consumption of enterprises is an urgent task. One of the most important obstacles in the process of introduction of energy efficient solutions are fund limits and low awareness of owners and managers of industrial enterprises. The article offers a new classification of energy saving measures: apart from traditional expense and organisation measures it introduces the low-cost measures notion. It offers to consider low-cost those measures that are realised by the enterprise by means of own funds, moreover, their repayment term is not more than one year. It offers analytical expression for identification of annual funds saving from introduction of low-cost measures. It considers the process of identification of saving of funds from introduction of some of the main low-cost measures in detail: replacement of lighting units, balancing of ventilation networks and elimination of water leakages from pipelines and water supply equipment. Based on the analysis of bibliography information the article provides a list of main measures on energy saving, which could be referred to the low-cost ones. The proposed approaches would allow paying more attention to practical aspects of realisation of the concept of energy saving in the industry.

  10. Cost savings from a telemedicine model of care in northern Queensland, Australia.

    Science.gov (United States)

    Thaker, Darshit A; Monypenny, Richard; Olver, Ian; Sabesan, Sabe

    2013-09-16

    To conduct a cost analysis of a telemedicine model for cancer care (teleoncology) in northern Queensland, Australia, compared with the usual model of care from the perspective of the Townsville and other participating hospital and health services. Retrospective cost-savings analysis; and a one-way sensitivity analysis performed to test the robustness of findings in net savings. Records of all patients managed by means of teleoncology at the Townsville Cancer Centre (TCC) and its six rural satellite centres in northern Queensland, Australia between 1 March 2007 and 30 November 2011. Costs for set-up and staffing to manage the service, and savings from avoidance of travel expenses for specialist oncologists, patients and their escorts, and for aeromedical retrievals. There were 605 teleoncology consultations with 147 patients over 56 months, at a total cost of $442 276. The cost for project establishment was $36 000, equipment/maintenance was $143 271, and staff was $261 520. The estimated travel expense avoided was $762 394; this figure included the costs of travel for patients and escorts of $658 760, aeromedical retrievals of $52 400 and travel for specialists of $47 634, as well as an estimate of accommodation costs for a proportion of patients of $3600. This resulted in a net saving of $320 118. Costs would have to increase by 72% to negate the savings. The teleoncology model of care at the TCC resulted in net savings, mainly due to avoidance of travel costs. Such savings could be redirected to enhancing rural resources and service capabilities. This teleoncology model is applicable to geographically distant areas requiring lengthy travel.

  11. Variable speed drives principles and applications for energy cost savings

    CERN Document Server

    Spitzer, David William

    2014-01-01

    Simply put, a variable speed drive is a controller that allows a motor and its associated equipment to run at different speeds depending upon automated input from an industrial process. That in turn provides the ability to provide smoother operations, and most importantly, energy savings by slowing down machinery when a process does not have to run at full speed. Long a leading book on this technology, this new edition by industry authority David William Spitzer provides insights to improving the applications of variable speed drives. Whether you have basic knowledge or advanced knowledge, you will find this book to be an extremely useful introduction to how variable speed drivers work, how they are best applied, and what to do and what to avoid when employing them as part of an overall automated industrial enterprise, all with an eye on energy savings. Inside, you will find: A basic overview of electrical, hydraulic, and instrumentation principles of variable speed drives. Coverage of the role that variabl...

  12. 75 FR 5248 - Requirements and Procedures for Consumer Assistance To Recycle and Save Program

    Science.gov (United States)

    2010-02-02

    ... for Consumer Assistance To Recycle and Save Program AGENCY: National Highway Traffic Safety... the regulations implementing the Consumer Assistance to Recycle and Save (CARS) program, published on... implementing the Consumer Assistance to Recycle and Save (CARS) program, published on July 29, 2009 in the...

  13. Saving on design doesn't save money, life-cycle costing studies show.

    Science.gov (United States)

    Sprague, J G

    1982-09-01

    Design and energy management decisions significantly affect both initial construction and ongoing operation costs. Because of their importance, they are examined in this article, which also provides some general background concerning construction project development and typical fees expected by architect/engineers and construction managers.

  14. Potential Medicaid Cost Savings from Maternity Care Based..

    Data.gov (United States)

    U.S. Department of Health & Human Services — Medicaid pays for about half the births in the United States, at very high cost. Compared to usual obstetrical care, care by midwives at a birth center could reduce...

  15. Disease Prevention : Saving Lives or Reducing Health Care Costs?

    NARCIS (Netherlands)

    Grootjans-van Kampen, I.; Engelfriet, P.M.; Van Baal, P.H.M.

    2014-01-01

    Background Disease prevention has been claimed to reduce health care costs. However, preventing lethal diseases increases life expectancy and, thereby, indirectly increases the demand for health care. Previous studies have argued that on balance preventing diseases that reduce longevity increases

  16. Cost savings from performance-based maintenance contracting

    NARCIS (Netherlands)

    Straub, A.

    2009-01-01

    New procurement approaches combined with performance-based building approaches should reduce costs, but empirical qualitative and quantitative studies are lacking. Performance-based maintenance contracts give maintenance suppliers incentives to improve their way of working. Innovative,

  17. THAAD radar: examination of a cost saving initiative

    OpenAIRE

    Lewis, John W.

    1999-01-01

    Approved for public release; distribution is unlimited This thesis analyzes two acquisition reform initiatives that made Theater High Altitude Area Defense (THAAD) Radar Product Office's Best of Breed Transmit/Receive Module study a success and examines the risk involved in the pursuit of this study. The initiatives are Cost As an Independent Variable (CAIV) and commercial items in the form of dual-use technology. Analysis of the radar subsystem of THAAD reveals a major cost driver to be t...

  18. Energy Savings from GSA's National Deep Retrofit Program

    Energy Technology Data Exchange (ETDEWEB)

    Shonder, John A [ORNL

    2014-09-01

    Under its National Deep Energy Retrofit (NDER) program, the U.S. General Services Administration (GSA) awarded 10 ESPC projects with the objectives of using innovative technologies and renewable energy technologies, and moving buildings toward net zero energy consumption. This report analyzes data on energy savings from the 10 NDER projects, and compares them with the savings of a sample of other recently awarded Federal ESPC projects. It is shown that by emphasizing the need for deeper energy savings, and by the establishment of a central Project Management Office (PMO) to provide authoritative contracting, technical and pricing assistance, the NDER projects achieved an average level of savings more than twice that of the other Federal ESPC projects. The level of savings achieved in each project seems to be dependent more on the availability of ECMs at the site than on energy price, energy cost per square foot, pre-retrofit EUI or the length of the contract term. This suggests that GSA can achieve similar results in a wide variety of building

  19. Solar thermal technology development: Estimated market size and energy cost savings. Volume 1: Executive summary

    Science.gov (United States)

    Gates, W. R.

    1983-02-01

    Estimated future energy cost savings associated with the development of cost-competitive solar thermal technologies (STT) are discussed. Analysis is restricted to STT in electric applications for 16 high-insolation/high-energy-price states. The fuel price scenarios and three 1990 STT system costs are considered, reflecting uncertainty over future fuel prices and STT cost projections. STT R&D is found to be unacceptably risky for private industry in the absence of federal support. Energy cost savings were projected to range from $0 to $10 billion (1990 values in 1981 dollars), dependng on the system cost and fuel price scenario. Normal R&D investment risks are accentuated because the Organization of Petroleum Exporting Countries (OPEC) cartel can artificially manipulate oil prices and undercut growth of alternative energy sources. Federal participation in STT R&D to help capture the potential benefits of developing cost-competitive STT was found to be in the national interest.

  20. Green Energy in New Construction: Maximize Energy Savings and Minimize Cost

    Science.gov (United States)

    Ventresca, Joseph

    2010-01-01

    People often use the term "green energy" to refer to alternative energy technologies. But green energy doesn't guarantee maximum energy savings at a minimum cost--a common misconception. For school business officials, green energy means getting the lowest energy bills for the lowest construction cost, which translates into maximizing green energy…

  1. On the assessment of marginal life saving costs for risk acceptance criteria

    DEFF Research Database (Denmark)

    Fischer, Katharina; Virguez, Edgar; Sánchez-Silva, Mauricio

    2013-01-01

    : The definition of the marginal life saving costs, the discount rate used for comparing costs and benefits that accrue at different points in time and the time horizon over which future consequences of the decision are taken into account. In the present paper these issues are discussed based on a clear...

  2. Speech Therapy Telepractice for Vocal Cord Dysfunction (VCD: MaineCare (Medicaid Cost Savings

    Directory of Open Access Journals (Sweden)

    Michael P. Towey

    2012-06-01

    Full Text Available This Brief Communication represents an analysis of the cost savings to MaineCare (also referred to as Medicaid directly attributable to service provided via speech therapy telepractice. Seven female (primarily adolescent MaineCare patients consecutively referred to Waldo County General Hospital (WCGH with suspected diagnosis of Vocal Cord Dysfunction (VCD were treated by speech therapy telepractice. Outcome data demonstrated a first month cost savings of $2376.72. The analysis additionally projected thousands of dollars of potential savings each month in reduced medical costs for this patient group as a result of successful treatment via speech therapy telepractice.  The study suggests that without access to speech therapy telepractice for patients with VCD, the ongoing medical costs to MaineCare will be ongoing and significant.

  3. Speech Therapy Telepractice for Vocal Cord Dysfunction (VCD): MaineCare (Medicaid) Cost Savings.

    Science.gov (United States)

    Towey, Michael P

    2012-01-01

    This Brief Communication represents an analysis of the cost savings to MaineCare (also referred to as Medicaid) directly attributable to service provided via speech therapy telepractice. Seven female (primarily adolescent) MaineCare patients consecutively referred to Waldo County General Hospital (WCGH) with suspected diagnosis of Vocal Cord Dysfunction (VCD) were treated by speech therapy telepractice. Outcome data demonstrated a first month cost savings of $2376.72. The analysis additionally projected thousands of dollars of potential savings each month in reduced medical costs for this patient group as a result of successful treatment via speech therapy telepractice. The study suggests that without access to speech therapy telepractice for patients with VCD, the medical costs to MaineCare will be ongoing and significant.

  4. Potential cost savings from generic medicines – protecting the ...

    African Journals Online (AJOL)

    Results: Three of the algorithms (diabetes insipidus, haemophilia and hypothyroidism) list medicines for which no generic equivalent was available at the time of the study. The median cost differential between brand and generic equivalents for the remaining 22 chronic conditions ranged from 19.5%. (for type 1 diabetes ...

  5. Disease prevention: Saving lives or reducing health care costs?

    NARCIS (Netherlands)

    I.G.-V. Kampen (Inge Grootjans-Van); P.M. Engelfriet (Peter); P.H.M. Van Baal (Pieter)

    2014-01-01

    textabstractBackground: Disease prevention has been claimed to reduce health care costs. However, preventing lethal diseases increases life expectancy and, thereby, indirectly increases the demand for health care. Previous studies have argued that on balance preventing diseases that reduce longevity

  6. Rightsizing HVAC Systems to Reduce Capital Costs and Save Energy

    Science.gov (United States)

    Sebesta, James

    2010-01-01

    Nearly every institution is faced with the situation of having to reduce the cost of a construction project from time to time through a process generally referred to as "value engineering." Just the mention of those words, however, gives rise to all types of connotations, thoughts, and memories (usually negative) for those in the…

  7. Pressure sores in spinal cord injury: Active intervention saves costs ...

    African Journals Online (AJOL)

    Summary. Pressure sores are a predictable consequence of poorly managed spinal cord-injured patients. Not only do pressure sores contribute to the morbidity, but also add significantly to the medical/nursing management, cost and admission stay, limiting optimal bed utilisation. This intervention study assesses the impact ...

  8. Energy Costs of Energy Savings in Buildings: A Review

    Directory of Open Access Journals (Sweden)

    Daniel Rousse

    2012-08-01

    Full Text Available It is often claimed that the cheapest energy is the one you do not need to produce. Nevertheless, this claim could somehow be unsubstantiated. In this article, the authors try to shed some light on this issue by using the concept of energy return on investment (EROI as a yardstick. This choice brings semantic issues because in this paper the EROI is used in a different context than that of energy production. Indeed, while watts and negawatts share the same physical unit, they are not the same object, which brings some ambiguities in the interpretation of EROI. These are cleared by a refined definition of EROI and an adapted nomenclature. This review studies the research in the energy efficiency of building operation, which is one of the most investigated topics in energy efficiency. This study focuses on the impact of insulation and high efficiency windows as means to exemplify the concepts that are introduced. These results were normalized for climate, life time of the building, and construction material. In many cases, energy efficiency measures imply a very high EROI. Nevertheless, in some circumstances, this is not the case and it might be more profitable to produce the required energy than to try to save it.

  9. The impact of changing dental needs on cost savings from fluoridation.

    Science.gov (United States)

    Campain, A C; Mariño, R J; Wright, F A C; Harrison, D; Bailey, D L; Morgan, M V

    2010-03-01

    Although community water fluoridation has been one of the cornerstone strategies for the prevention and control of dental caries, questions are still raised regarding its cost-effectiveness. This study assessed the impact of changing dental needs on the cost savings from community water fluoridation in Australia. Net costs were estimated as Costs((programme)) minus Costs((averted caries).) Averted costs were estimated as the product of caries increment in non-fluoridated community, effectiveness of fluoridation and the cost of a carious surface. Modelling considered four age-cohorts: 6-20, 21-45, 46-65 and 66+ years and three time points 1970s, 1980s, and 1990s. Cost of a carious surface was estimated by conventional and complex methods. Real discount rates (4, 7 (base) and 10%) were utilized. With base-case assumptions, the average annual cost savings/person, using Australian dollars at the 2005 level, ranged from $56.41 (1970s) to $17.75 (1990s) (conventional method) and from $249.45 (1970s) to $69.86 (1990s) (complex method). Under worst-case assumptions fluoridation remained cost-effective with cost savings ranging from $24.15 (1970s) to $3.87 (1990s) (conventional method) and $107.85 (1970s) and $24.53 (1990s) (complex method). For 66+ years cohort (1990s) fluoridation did not show a cost saving, but costs/person were marginal. Community water fluoridation remains a cost-effective preventive measure in Australia.

  10. Pollution Prevention Cost Savings Using Supply Chain Reengineering

    National Research Council Canada - National Science Library

    Webb, Gregory

    1999-01-01

    .... The reengineering of the Air Force hazardous material supply chain brought about by the Hazardous Material Pharmacy Program was tested to evaluate if hazardous waste had been precluded in this effort...

  11. Vehicle Lightweighting: 40% and 45% Weight Savings Analysis: Technical Cost Modeling for Vehicle Lightweighting

    Energy Technology Data Exchange (ETDEWEB)

    Mascarin, Anthony [Idaho National Lab. (INL), Idaho Falls, ID (United States); Hannibal, Ted [Idaho National Lab. (INL), Idaho Falls, ID (United States); Raghunathan, Anand [Idaho National Lab. (INL), Idaho Falls, ID (United States); Ivanic, Ziga [Idaho National Lab. (INL), Idaho Falls, ID (United States); Francfort, James [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-04-01

    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. The strategic targets were a 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. The baseline vehicle was an average of several available vehicles in this class. Mass and cost breakdowns from several sources were used, including original equipment manufacturers’ (OEMs’) input through U.S. Department of Energy’s Vehicle Technologies Office programs and public presentations, A2Mac1 LLC’s teardown information, Lotus Engineering Limited and FEV, Inc. breakdowns in their respective lightweighting studies, and IBIS Associates, Inc.’s decades of experience in automotive lightweighting and materials substitution analyses. Information on lightweighting strategies in this analysis came from these same sources and the ongoing 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, and many United States Council for Automotive Research’s/United States Automotive Materials Partnership LLC lightweight materials programs.

  12. Sun pipeline`s tensioned cover system saves storage costs

    Energy Technology Data Exchange (ETDEWEB)

    Blaisdell, J.R. [Sun Pipe Line Co., Detroit, MI (United States); Lydick, L. [National Seal Co., Aurora, IL (United States)

    1996-02-01

    Sun Pipe Line chose the Columbia tensioned floating cover (TFC) system from Columbia Geosystems for several reasons. First, capital costs for the TFC system are considerably lower than those for structural metal or concrete systems. Installation requires less time than fixed structures, and construction costs are about one-tenth as much. A second reason for the choice is its patented tower/tension cover design which easily accommodates fluctuating fluid levels in brine ponds, even in a rapid drawdown. When brine is pumped into the storage chambers, changes in brine ponds can be as great as ten feet. The tensioned design maintains folds of extra material on the outer perimeter of the cover above fluid level. As fluid levels fall, the curtain unfolds and adequate reservoir coverage is maintained.

  13. Strategy on energy saving reconstruction of distribution networks based on life cycle cost

    Science.gov (United States)

    Chen, Xiaofei; Qiu, Zejing; Xu, Zhaoyang; Xiao, Chupeng

    2017-08-01

    Because the actual distribution network reconstruction project funds are often limited, the cost-benefit model and the decision-making method are crucial for distribution network energy saving reconstruction project. From the perspective of life cycle cost (LCC), firstly the research life cycle is determined for the energy saving reconstruction of distribution networks with multi-devices. Then, a new life cycle cost-benefit model for energy-saving reconstruction of distribution network is developed, in which the modification schemes include distribution transformers replacement, lines replacement and reactive power compensation. In the operation loss cost and maintenance cost area, the operation cost model considering the influence of load season characteristics and the maintenance cost segmental model of transformers are proposed. Finally, aiming at the highest energy saving profit per LCC, a decision-making method is developed while considering financial and technical constraints as well. The model and method are applied to a real distribution network reconstruction, and the results prove that the model and method are effective.

  14. Shared Savings Contracting for Reducing Energy Costs of Defense Facilities.

    Science.gov (United States)

    1983-01-01

    Program Evaluation for Resource Management," October 17, 1972. BUILDING ENERGY EFFICIENCY D. C. Solar Task Force, "Thirty Five Steps - Making...Conservation and Solar Work in the District of Columbia," Washington, D. C., 1982. National Institute of Building Sciences, " Building Energy Efficiency Project

  15. Major cost savings associated with biologic dose reduction in patients with inflammatory arthritis.

    LENUS (Irish Health Repository)

    Murphy, C L

    2015-01-01

    The purpose of this study was to explore whether patients with Inflammatory Arthritis (IA) (Rheumatoid Arthritis (RA), Psoriatic Arthritis (PsA) or Ankylosing Spondylitis (AS)) would remain in remission following a reduction in biologic dosing frequency and to calculate the cost savings associated with dose reduction. This prospective non-blinded non-randomised study commenced in 2010. Patients with Inflammatory Arthritis being treated with a biologic agent were screened for disease activity. A cohort of those in remission according to standardized disease activity indices (DAS28 < 2.6, BASDAI < 4) was offered a reduction in dosing frequency of two commonly used biologic therapies (etanercept 50 mg once per fortnight instead of weekly, adalimumab 40 mg once per month instead of fortnightly). Patients were assessed for disease activity at 3, 6, 12, 18 and 24 months following reduction in dosing frequency. Cost saving was calculated. 79 patients with inflammatory arthritis in remission were recruited. 57% had rheumatoid arthritis (n = 45), 13% psoriatic arthritis (n = 10) and 30% ankylosing spondylitis (n = 24). 57% (n = 45) were taking etanercept and 43% (n = 34) adalimumab. The percentage of patients in remission at 24 months was 56% (n = 44). This resulted in an actual saving to the state of approximately 600,000 euro over two years. This study demonstrates the reduction in biologic dosing frequency is feasible in Inflammatory Arthritis. There was a considerable cost saving at two years. The potential for major cost savings in biologic usage should be pursued further.

  16. Energy Efficiency Improvement and Cost Saving Oportunities for the Concrete Industry

    Energy Technology Data Exchange (ETDEWEB)

    Kermeli, Katerina; Worrell, Ernst; Masanet, Eric

    2011-12-01

    The U.S. concrete industry is the main consumer of U.S.-produced cement. The manufacturing of ready mixed concrete accounts for more than 75% of the U.S. concrete production following the manufacturing of precast concrete and masonry units. The most significant expenditure is the cost of materials accounting for more than 50% of total concrete production costs - cement only accounts for nearly 24%. In 2009, energy costs of the U.S. concrete industry were over $610 million. Hence, energy efficiency improvements along with efficient use of materials without negatively affecting product quality and yield, especially in times of increased fuel and material costs, can significantly reduce production costs and increase competitiveness. The Energy Guide starts with an overview of the U.S. concrete industry’s structure and energy use, a description of the various manufacturing processes, and identification of the major energy consuming areas in the different industry segments. This is followed by a description of general and process related energy- and cost-efficiency measures applicable to the concrete industry. Specific energy and cost savings and a typical payback period are included based on literature and case studies, when available. The Energy Guide intends to provide information on cost reduction opportunities to energy and plant managers in the U.S. concrete industry. Every cost saving opportunity should be assessed carefully prior to implementation in individual plants, as the economics and the potential energy and material savings may differ.

  17. Will Changes to Medicare Payment Rates Alter Hospice's Cost-Saving Ability?

    Science.gov (United States)

    Taylor, Donald H; Bhavsar, Nrupen A; Bull, Janet H; Kassner, Cordt T; Olson, Andrew; Boucher, Nathan A

    2018-02-07

    On January 1, 2016, Medicare implemented a new "two-tiered" model for hospice services, with per diem rates increased for days 1 through 60, decreased for days 61 and greater, and service intensity add-on payments made retrospectively for the last seven days of life. To estimate whether the Medicare hospice benefit's potential for cost savings will change as a result of the January 2016 change in payment structure. Analysis of decedents' claims records using propensity score matching, logistic regression, and sensitivity analysis. All age-eligible Medicare decedents who received care and died in North Carolina in calendar years 2009 and 2010. Costs to Medicare for hospice and other healthcare services. Medicare costs were reduced from hospice election until death using both 2009-2010 and new 2016 payment structures and rates. Mean cost savings were $1,527 with actual payment rates, and would have been $2,105 with the new payment rates (p period, hospice increased costs to Medicare. Medicare savings could continue with the 2016 payment rate change. Cost savings were found for all primary diagnoses analyzed except dementia.

  18. Performing impact evaluations in industrial retrofit: The Energy Savings Plan Program

    Energy Technology Data Exchange (ETDEWEB)

    Riewer, S. (USDOE Bonneville Power Administration, Portland, OR (United States)); Spanner, G.E. (Pacific Northwest Lab., Richland, WA (United States))

    1991-08-01

    The Energy Savings Plan (ESP) is Bonneville Power Administration's retrofit program for the industrial sector. The program pays incentives for energy conservation measures involving electrical energy efficiency improvements in manufacturing, processing, and refining industries. This paper will describe the ESP program, recount the techniques selected to evaluate the retrofits, and report the findings from five ESP project impact evaluations completed to date. The impact evaluations provide a framework for assessing the energy saving achieved by the provides implemented under the ESP. In addition to energy savings, the evaluations assess process changes, net utility impacts, levelized costs, and free ridership.'' The five ESP projects evaluated include: a waste heat recovery system for a food processing blancher, an energy management control system used to upgrade refrigeration, a variable speed drive for a fan motor in a lumber mill, a sludge screw press for waste water treatment, and replacement of rod anodes with blades anodes in mercury cells in an electrochemical plant.

  19. Does task shifting yield cost savings and improve efficiency for health systems? A systematic review of evidence from low-income and middle-income countries.

    Science.gov (United States)

    Seidman, Gabriel; Atun, Rifat

    2017-04-13

    Task shifting has become an increasingly popular way to increase access to health services, especially in low-resource settings. Research has demonstrated that task shifting, including the use of community health workers (CHWs) to deliver care, can improve population health. This systematic review investigates whether task shifting in low-income and middle-income countries (LMICs) results in efficiency improvements by achieving cost savings. Using the PRISMA guidelines for systematic reviews, we searched PubMed, Embase, CINAHL, and the Health Economic Evaluation Database on March 22, 2016. We included any original peer-review articles that demonstrated cost impact of a task shifting program in an LMIC. We identified 794 articles, of which 34 were included in our study. We found that substantial evidence exists for achieving cost savings and efficiency improvements from task shifting activities related to tuberculosis and HIV/AIDS, and additional evidence exists for the potential to achieve cost savings from activities related to malaria, NCDs, NTDs, childhood illness, and other disease areas, especially at the primary health care and community levels. Task shifting presents a viable option for health system cost savings in LMICs. Going forward, program planners should carefully consider whether task shifting can improve population health and health systems efficiency in their countries, and researchers should investigate whether task shifting can also achieve cost savings for activities related to emerging global health priorities and health systems strengthening activities such as supply chain management or monitoring and evaluation.

  20. What price commitment: what benefit? The cost of a saved life in a developing level I trauma center.

    Science.gov (United States)

    Rotondo, Michael F; Bard, Michael R; Sagraves, Scott G; Toschlog, Eric A; Schenarts, Paul J; Goettler, Claudia E; Newell, Mark A; Robertson, Matthew J

    2009-11-01

    In 1999, a Level I Trauma Center committed significant resources for development, recruitment of trauma surgeons, and call pay for subspecialists. Although this approach has sparked a national ethical debate, little has been published investigating efficacy. This study examines the price of commitment and outcomes at a Level I Trauma Center. Direct personnel costs including salary, call pay, and personnel expenses were analyzed against outcomes for two periods defined as PRE (1994-1999) and POST (2000-2005). Patient care costs and 1999 to 2000 transition data were excluded. Demographics, outcomes, and direct personnel costs were compared. Significant mortality reductions stratified by age and injury severity score (ISS) were used to calculate lives saved in relation to direct personnel costs. Student's t test and chi were used (significance *p gender (62.4% vs. 63.7% male), mechanism of injury (11.5% vs. 11.8% penetrating), and percent intensive care unit admissions (30.1 vs. 29.9). Significant differences were noted for ISS (10.5 +/- 9.7 vs. 11.6 +/- 10.1*), percent admissions with ISS >or=16 (18.5 vs. 27.3*), and revised trauma score (10.8 +/- 2.8 vs. 10.7 +/- 2.8*). Both the average length of stay (6.8 +/- 8.8 vs. 6.5 +/- 9.8*) and percent mortality for ISS >or=16 (23 vs. 17*) were reduced. When mortality was stratified by both age and ISS, significant reductions were noted and a total of 173 lives were saved as a result. However, direct personnel costs increased from $7.6 million to $22.7 million. When cost is allocated to lives saved; the cost of a saved life was more than $87,000. Resources for program development, including salary and call pay, significantly reduced mortality. Price of commitment: $3 million per year. The cost of a saved life: $87,000. The benefit: 173 surviving patients who would otherwise be dead.

  1. Measuring energy-saving retrofits: Experiences from the Texas LoanSTAR program

    Energy Technology Data Exchange (ETDEWEB)

    Haberl, J.S.; Reddy, T.A.; Claridge, D.E.; Turner, W.D.; O`Neal, D.L.; Heffington, W.M. [Texas A and M Univ., College Station, TX (United States). Energy Systems Lab.

    1996-02-01

    In 1988 the Governor`s Energy Management Center of Texas received approval from the US Department of Energy to establish a $98.6 million state-wide retrofit demonstration revolving loan program to fund energy-conserving retrofits in state, public school, and local government buildings. As part of this program, a first-of-its-kind, statewide Monitoring and Analysis Program (MAP) was established to verify energy and dollar savings of the retrofits, reduce energy costs by identifying operational and maintenance improvements, improve retrofit selection in future rounds of the LoanSTAR program, and initiate a data base of energy use in institutional and commercial buildings located in Texas. This report discusses the LoanSTAR MAP with an emphasis on the process of acquiring and analyzing data to measure savings from energy conservation retrofits when budgets are a constraint. This report includes a discussion of the program structure, basic measurement techniques, data archiving and handling, data reporting and analysis, and includes selected examples from LoanSTAR agencies. A summary of the program results for the first two years of monitoring is also included.

  2. A Method for Estimating Potential Energy and Cost Savings for Cooling Existing Data Centers

    Energy Technology Data Exchange (ETDEWEB)

    Van Geet, Otto

    2017-04-24

    NREL has developed a methodology to prioritize which data center cooling systems could be upgraded for better efficiency based on estimated cost savings and economics. The best efficiency results are in cool or dry climates where 'free' economizer or evaporative cooling can provide most of the data center cooling. Locations with a high cost of energy and facilities with high power usage effectiveness (PUE) are also good candidates for data center cooling system upgrades. In one case study of a major cable provider's data centers, most of the sites studied had opportunities for cost-effective cooling system upgrades with payback period of 5 years or less. If the cable provider invested in all opportunities for upgrades with payback periods of less than 15 years, it could save 27% on annual energy costs.

  3. Exergy costing for energy saving in combined heating and cooling applications

    DEFF Research Database (Denmark)

    Nguyen, Chan; Veje, Christian T.; Willatzen, Morten

    2014-01-01

    exergy balance equations are used in conjunction with mass and energy balance equations. In both costing methods the thermodynamic analysis is followed by an economic analysis which includes investment and operating costs. For both methods the unit costs of heating and cooling are found and compared......The aim of this study is to provide a price model that motivates energy saving for a combined district heating and cooling system. A novel analysis using two thermoeconomic methods for apportioning the costs to heating and cooling provided simultaneously by an ammonia heat pump is demonstrated...

  4. Annual Energy Usage Reduction and Cost Savings of a School: End-Use Energy Analysis

    Science.gov (United States)

    Alghoul, M. A.; Bakhtyar, B.; Asim, Nilofar; Sopian, K.

    2014-01-01

    Buildings are among the largest consumers of energy. Part of the energy is wasted due to the habits of users and equipment conditions. A solution to this problem is efficient energy usage. To this end, an energy audit can be conducted to assess the energy efficiency. This study aims to analyze the energy usage of a primary school and identify the potential energy reductions and cost savings. A preliminary audit was conducted, and several energy conservation measures were proposed. The energy conservation measures, with reference to the MS1525:2007 standard, were modelled to identify the potential energy reduction and cost savings. It was found that the school's usage of electricity exceeded its need, incurring an excess expenditure of RM 2947.42. From the lighting system alone, it was found that there is a potential energy reduction of 5489.06 kWh, which gives a cost saving of RM 2282.52 via the improvement of lighting system design and its operating hours. Overall, it was found that there is a potential energy reduction and cost saving of 20.7% when the energy conservation measures are earnestly implemented. The previous energy intensity of the school was found to be 50.6 kWh/m2/year, but can theoretically be reduced to 40.19 kWh/mm2/year. PMID:25485294

  5. Costs, effects, and savings of screening for cystic fibrosis gene carriers

    NARCIS (Netherlands)

    Wildhagen, MF; Hilderink, HBM; Verzijl, JG; Verheij, JBGM; Kooij, L; Tijmstra, T; ten Kate, LP; Habbema, JDF

    Study objective-Evaluating the costs, effects, and savings of several strategies for cystic fibrosis (CF) gene carrier screening. Design-A general model for evaluating prenatal, preconceptional, school, and neonatal carrier screening was constructed. For prenatal and preconceptional screening, two

  6. Shortened first-line TB treatment in Brazil: potential cost savings for patients and health services

    NARCIS (Netherlands)

    Trajman, Anete; Bastos, Mayara Lisboa; Belo, Marcia; Calaça, Janaína; Gaspar, Júlia; Dos Santos, Alexandre Martins; Dos Santos, Camila Martins; Brito, Raquel Trindade; Wells, William A.; Cobelens, Frank G.; Vassall, Anna; Gomez, Gabriela B.

    2016-01-01

    Shortened treatment regimens for tuberculosis are under development to improve treatment outcomes and reduce costs. We estimated potential savings from a societal perspective in Brazil following the introduction of a hypothetical four-month regimen for tuberculosis treatment. Data were gathered in

  7. Annual Energy Usage Reduction and Cost Savings of a School: End-Use Energy Analysis

    Directory of Open Access Journals (Sweden)

    Aiman Roslizar

    2014-01-01

    Full Text Available Buildings are among the largest consumers of energy. Part of the energy is wasted due to the habits of users and equipment conditions. A solution to this problem is efficient energy usage. To this end, an energy audit can be conducted to assess the energy efficiency. This study aims to analyze the energy usage of a primary school and identify the potential energy reductions and cost savings. A preliminary audit was conducted, and several energy conservation measures were proposed. The energy conservation measures, with reference to the MS1525:2007 standard, were modelled to identify the potential energy reduction and cost savings. It was found that the school’s usage of electricity exceeded its need, incurring an excess expenditure of RM 2947.42. From the lighting system alone, it was found that there is a potential energy reduction of 5489.06 kWh, which gives a cost saving of RM 2282.52 via the improvement of lighting system design and its operating hours. Overall, it was found that there is a potential energy reduction and cost saving of 20.7% when the energy conservation measures are earnestly implemented. The previous energy intensity of the school was found to be 50.6 kWh/m2/year, but can theoretically be reduced to 40.19 kWh/mm2/year.

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

    Science.gov (United States)

    Abdullah, Mohammad M. H.; Marinangeli, Christopher P. F.; Jones, Peter J. H.; Carlberg, Jared G.

    2017-01-01

    Consumption of dietary pulses, including beans, peas and lentils, is recommended by health authorities across jurisdictions for their nutritional value and effectiveness in helping to prevent and manage major diet-related illnesses of significant socioeconomic burden. The aim of this study was to estimate the potential annual healthcare and societal cost savings relevant to rates of reduction in complications from type 2 diabetes (T2D) and incidence of cardiovascular disease (CVD) following a low glycemic index (GI) or high fiber diet that includes pulses, or 100 g/day pulse intake in Canada, respectively. A four-step cost-of-illness analysis was conducted to: (1) estimate the proportions of individuals who are likely to consume pulses; (2) evaluate the reductions in established risk factors for T2D and CVD; (3) assess the percent reduction in incidences or complications of the diseases of interest; and (4) calculate the potential annual savings in relevant healthcare and related costs. A low GI or high fiber diet that includes pulses and 100 g/day pulse intake were shown to potentially yield Can$6.2 (95% CI $2.6–$9.9) to Can$62.4 (95% CI $26–$98.8) and Can$31.6 (95% CI $11.1–$52) to Can$315.5 (95% CI $110.6–$520.4) million in savings on annual healthcare and related costs of T2D and CVD, respectively. Specific provincial/territorial analyses suggested annual T2D and CVD related cost savings that ranged from up to Can$0.2 million in some provinces to up to Can$135 million in others. In conclusion, with regular consumption of pulse crops, there is a potential opportunity to facilitate T2D and CVD related socioeconomic cost savings that could be applied to Canadian healthcare or re-assigned to other priority domains. Whether these potential cost savings will be offset by other healthcare costs associated with longevity and diseases of the elderly is to be investigated over the long term. PMID:28737688

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

    Science.gov (United States)

    Abdullah, Mohammad M H; Marinangeli, Christopher P F; Jones, Peter J H; Carlberg, Jared G

    2017-07-22

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

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

    Directory of Open Access Journals (Sweden)

    Mohammad M. H. Abdullah

    2017-07-01

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

  11. Cost savings from a teledentistry model for school dental screening: an Australian health system perspective.

    Science.gov (United States)

    Estai, Mohamed; Bunt, Stuart; Kanagasingam, Yogesan; Tennant, Marc

    2017-06-05

    Objective The aim of the present study was to compare the costs of teledentistry and traditional dental screening approaches in Australian school children.Methods A cost-minimisation analysis was performed from the perspective of the oral health system, comparing the cost of dental screening in school children using a traditional visual examination approach with the cost of mid-level dental practitioners (MLDPs), such as dental therapists, screening the same cohort of children remotely using teledentistry. A model was developed to simulate the costs (over a 12-month period) of the two models of dental screening for all school children (2.7million children) aged 5-14 years across all Australian states and territories. The fixed costs and the variable costs, including staff salary, travel and accommodation costs, and cost of supply were calculated. All costs are given in Australian dollars.Results The total estimated cost of the teledentistry model was $50million. The fixed cost of teledentistry was $1million and that of staff salaries (tele-assistants, charters and their supervisors, as well as information technology support was estimated to be $49million. The estimated staff salary saved with the teledentistry model was $56million, and the estimated travel allowance and supply expenses avoided were $16million and $14million respectively; an annual reduction of $85million in total.Conclusions The present study shows that the teledentistry model of dental screening can minimise costs. The estimated savings were due primarily to the low salaries of dental therapists and the avoidance of travel and accommodation costs. Such savings could be redistributed to improve infrastructure and oral health services in rural or other underserved areas.What is known about the topic? Caries is a preventable disease, which, if it remains untreated, can cause significant morbidity requiring costly treatment. Regular dental screening and oral health education have the great potential

  12. Vegetable output and cost savings of community gardens in San Jose, California.

    Science.gov (United States)

    Algert, Susan J; Baameur, Aziz; Renvall, Marian J

    2014-07-01

    Urban dwellers across the United States increasingly access a variety of fresh vegetables through participation in neighborhood-level community gardens. Here we document vegetable output and cost savings of community gardens in the city of San Jose, CA, to better understand the capacity of community gardens to affect food affordability in an urban setting. A convenience sample of 83 community gardeners in San Jose completed a background survey during spring and summer 2012. On average, gardeners were aged 57 years and had a monthly income of $4,900; 25% had completed college. A representative subset of 10 gardeners was recruited to weigh vegetable output of their plots using portable electronic scales at three separate garden sites. Accuracy of each portable scale was verified by comparing the weight of a sample vegetable to weights obtained using a lab scale precise to 0.2 oz. Garden yields and cost savings were tabulated overall for each plot. Results indicate that community garden practices are more similar to biointensive high-production farming, producing 0.75 lb vegetables/sq ft, rather than conventional agricultural practices, producing 0.60 lb/sq ft. Gardens produced on average 2.55 lb/plant and saved $435 per plot for the season. Results indicate that cost savings are greatest if vertical high value crops such as tomatoes and peppers are grown in community gardens, although yields depend on growing conditions, gardener's skill, availability of water, and other factors. Future research is needed to document cost savings and yields for specific crops grown in community gardens. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  13. Cost savings of telemedicine utilization for child psychiatry in a rural Kansas community.

    Science.gov (United States)

    Spaulding, Ryan; Belz, Norbert; DeLurgio, Stephen; Williams, Arthur R

    2010-10-01

    The costs of pediatric telemedicine services remain underreported and understudied; however, there is evidence that telepediatric services can be cost competitive with traditional ones. For 15 years, the University of Kansas Center for Telemedicine and Telehealth has been providing telemental health outreach from the University of Kansas Medical Center (KUMC). One service site is located in Crawford County, Kansas, which provides telepsychiatry services to children and adolescents. The purpose of this study was to examine the costs of operating the Crawford County site relative to accessing services at KUMC, the likely alternative service location. The cost of travel time to parents who accompanied a dependent to either location also was estimated. Patients and parents were examined over a 6-month period in 2006. One hundred thirty-two patients received 257 telemedicine psychiatric consultations during this period. Cost estimates for using the pediatric telemedicine service were assessed for all patients; however, travel and related costs were collected from a sample of 26 patient-parent dyads. The estimated costs of services were obtained using standard cost-accounting procedures. An average cost per consultation in Crawford County was $168.61. The cost savings in travel time and other expenses to parents and patients were substantial between use of the county site and KUMC. Subtracting average savings in travel costs to patients and parents produced an average cost of a telepsychiatry consult in Crawford County of only $30.99. This study was conducted over 6 months with a small number of observations; it should be replicated over a longer study period, with more patients, and with more data that might capture marginal costs of services.

  14. Primary care focus and utilization in the Medicare shared savings program accountable care organizations.

    Science.gov (United States)

    Herrel, Lindsey A; Ayanian, John Z; Hawken, Scott R; Miller, David C

    2017-02-15

    Although Accountable Care Organizations (ACOs) are defined by the provision of primary care services, the relationship between the intensity of primary care and population-level utilization and costs of health care services has not been examined during early implementation of Medicare Shared Savings Program (MSSP) ACOs. Our objective was to evaluate the association between primary care focus and healthcare utilization and spending in the first performance period of the Medicare Shared Savings Program (MSSP) Accountable Care Organizations (ACOs). In this retrospective cohort study, we divided the 220 MSSP ACOs into quartiles of primary care focus based on the percentage of all ambulatory evaluation and management services delivered by a PCP (internist, family physician, or geriatrician). Using multivariable regression, we evaluated rates of utilization and spending during the initial performance period, adjusting for the percentage of non-white patients, region, number of months enrolled in the MSSP, number of beneficiary person years, percentage of dual eligible beneficiaries and percentage of beneficiaries over the age of 74. The proportion of ambulatory evaluation and management services delivered by a PCP ranged from focus) to >46% (highest quartile, ACOs with greatest PCP focus). ACOs in the highest quartile of PCP focus had higher adjusted rates of utilization of acute care hospital admissions (328 per 1000 person years vs 292 per 1000 person years, p = 0.01) and emergency department visits (756 vs 680 per 1000 person years, p = 0.02) compared with ACOs in the lowest quartile of PCP focus. ACOs in the highest quartile of PCP focus achieved no greater savings per beneficiary relative to their spending benchmarks ($142 above benchmark vs $87 below benchmark, p = 0.13). Primary care focus was not associated with increased savings or lower utilization of healthcare during the initial implementation of MSSP ACOs.

  15. Impact of pharmacist interventions on rational prophylactic antibiotic use and cost saving in elective cesarean section.

    Science.gov (United States)

    Wang, Jingwen; Dong, Mohan; Lu, Yang; Zhao, Xian; Li, Xin; Wen, Aidong

    2015-08-01

    To assess the impact of pharmacist interventions on rational use of prophylactic antibiotics and cost saving in elective cesarean section and the economic outcomes of implementing pharmacist interventions. A pre-to-post intervention design was applied to the practices of prophylactic antibiotic use in the department of gynecology and obstetrics in a Chinese tertiary hospital. Patients admitted during a 3-month period from June to August 2012 and during that from October to December 2012 undergoing elective cesarean section were assigned to the pre-intervention and the post-intervention group, respectively. Pharmacist interventions were performed in the post-intervention group, including obstetrician education, realtime monitoring of clinical records and making recommendations to obstetricians on prophylactic antibiotic prescription based on the criteria set at the beginning of the study. Data from the two groups were then compared to evaluate the outcomes of pharmacist interventions. Cost-outcome analysis was performed to determine the economic effect of implementing pharmacist interventions in preoperative antibiotic prophylaxis. Pharmacist interventions led to significant reductions in antibiotic usage cost/patient-day (p antibiotic cost (p antibiotics (p antibiotic use to the cost of pharmacist time was 27.23 : 1 and the net cost benefit was $65,255.84. This study provides evidence that pharmacist interventions promoted rational use of prophylactic antibiotics and substantial cost saving in elective cesarean section.

  16. Metaldyne. Plant-Wide Assessment at Royal Oak Finds Opportunities to Improve Manufacturing Effciency, Reduce Energy Use, and Achieve Sigificant Cost Savings

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    2005-05-01

    This case study prepared for the U.S. Department of Energy's Industrial Technologies Program describes a plant-wide energy assessment conducted at the Metaldyne, Inc., forging plant in Royal Oak, Michigan. The assessment focused on reducing the plant's operating costs, inventory, and energy use. If the company were to implement all the recommendations that came out of the assessment, its total annual energy savings for electricity would be about 11.5 million kWh and annual cost savings would be $12.6 million.

  17. Energy Savings and Breakeven Cost for Residential Heat Pump Water Heaters in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Maguire, J.; Burch, J.; Merrigan, T.; Ong, S.

    2013-07-01

    Heat pump water heaters (HPWHs) have recently reemerged in the U.S. residential water heating market and have the potential to provide homeowners with significant energy savings. However, there are questions as to the actual performance and energy savings potential of these units, in particular in regards to the heat pump's performance in unconditioned space and the impact of the heat pump on space heating and cooling loads when it is located in conditioned space. To help answer these questions, simulations were performed of a HPWH in both conditioned and unconditioned space at over 900 locations across the continental United States and Hawaii. Simulations included a Building America benchmark home so that any interaction between the HPWH and the home's HVAC equipment could be captured. Comparisons were performed to typical gas and electric water heaters to determine the energy savings potential and cost effectiveness of a HPWH relative to these technologies. HPWHs were found to have a significant source energy savings potential when replacing typical electric water heaters, but only saved source energy relative to gas water heater in the most favorable installation locations in the southern US. When replacing an electric water heater, the HPWH is likely to break even in California, the southern US, and parts of the northeast in most situations. However, the HPWH will only break even when replacing a gas water heater in a few southern states.

  18. Energy Savings and Breakeven Costs for Residential Heat Pump Water Heaters in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Maguire, Jeff [National Renewable Energy Lab. (NREL), Golden, CO (United States); Burch, Jay [National Renewable Energy Lab. (NREL), Golden, CO (United States); Merrigan, Tim [National Renewable Energy Lab. (NREL), Golden, CO (United States); Ong, Sean [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2013-07-01

    Heat pump water heaters (HPWHs) have recently re-emerged in the U.S. residential water heating market and have the potential to provide homeowners with significant energy savings. However, there are questions as to the actual performance and energy savings potential of these units, in particular in regards to the heat pump's performance in unconditioned space and the impact of the heat pump on space heating and cooling loads when it is located in conditioned space. To help answer these questions, NREL performed simulations of a HPWH in both conditioned and unconditioned space at over 900 locations across the continental United States and Hawaii. Simulations included a Building America benchmark home so that any interaction between the HPWH and the home's HVAC equipment could be captured. Comparisons were performed to typical gas and electric water heaters to determine the energy savings potential and cost effectiveness of a HPWH relative to these technologies. HPWHs were found to have a significant source energy savings potential when replacing typical electric water heaters, but only saved source energy relative to gas water heater in the most favorable installation locations in the southern United States. When replacing an electric water heater, the HPWH is likely to break even in California, the southern United States, and parts of the northeast in most situations. However, the HPWH will only break even when replacing a gas water heater in a few southern states.

  19. Modern methods of cost saving of the production activity in construction

    Science.gov (United States)

    Silka, Dmitriy

    2017-10-01

    Every time economy faces recession, cost saving questions acquire increased urgency. This article shows how companies of the construction industry have switched to the new kind of economic relations over recent years. It is specified that the dominant type of economic relations does not allow to quickly reorient on the necessary tools in accordance with new requirements of economic activity. Successful experience in the new environment becomes demanded. Cost saving methods, which were proven in other industries, are offered for achievement of efficiency and competitiveness of the companies. Analysis is performed on the example of the retail sphere, which, according to the authoritative analytical reviews, is extremely innovative on both local and world economic levels. At that, methods, based on the modern unprecedentedly high opportunities of communications and informational exchange took special place among offered methods.

  20. Guide to resource conservation and cost savings opportunities in the dairy processing sector

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-12-31

    This guide identifies and promotes opportunities for conserving energy and water, as well as reducing waste, in the dairy processing sector. The guide begins with an introduction and a profile of Ontario`s dairy processing sector, outlining the context for resource conservation and cost savings opportunities. It then outlines the rationale and the generic processes selected for careful examination of resource conservation and cost savings opportunities. Subsequent chapters describe the energy, water, and material resources commonly used in relation to the generic processes; the air, water, and solid waste residuals commonly derived from those processes; and new technologies with potential application in dairy processing. The generic processes covered in the guide are for fluid milk, cheese, ice cream and frozen products, cultured products such as yogurt, butter, and dried or evaporated products. The report ends with additional useful information for dairy processors.

  1. Assessing Potential Energy Cost Savings from Increased Energy Code Compliance in Commercial Buildings

    Energy Technology Data Exchange (ETDEWEB)

    Rosenberg, Michael I.; Hart, Philip R.; Athalye, Rahul A.; Zhang, Jian; Wang, Weimin

    2016-02-15

    The US Department of Energy’s most recent commercial energy code compliance evaluation efforts focused on determining a percent compliance rating for states to help them meet requirements under the American Recovery and Reinvestment Act (ARRA) of 2009. That approach included a checklist of code requirements, each of which was graded pass or fail. Percent compliance for any given building was simply the percent of individual requirements that passed. With its binary approach to compliance determination, the previous methodology failed to answer some important questions. In particular, how much energy cost could be saved by better compliance with the commercial energy code and what are the relative priorities of code requirements from an energy cost savings perspective? This paper explores an analytical approach and pilot study using a single building type and climate zone to answer those questions.

  2. Does remediation save lives? - on the cost of cleaning up arsenic-contaminated sites in Sweden.

    Science.gov (United States)

    Forslund, Johanna; Samakovlis, Eva; Johansson, Maria Vredin; Barregard, Lars

    2010-07-15

    Sweden has only just begun remediation of its many contaminated sites, a process that will cost an estimated SEK 60,000 million (USD 9100 million). Although the risk assessment method, carried out by the Swedish EPA, is driven by health effects, it does not consider actual exposure. Instead, the sites are assessed based on divergence from guideline values. This paper uses an environmental medicine approach that takes exposure into account to analyse how cancer risks on and near arsenic-contaminated sites are implicitly valued in the remediation process. The results show that the level of ambition is high. At 23 contaminated sites, the cost per life saved varies from SEK 287 million to SEK 1,835,000 million, despite conservative calculations that in fact probably underestimate the costs. It is concluded that if environmental health risks are to be reduced, there are probably other areas where economic resources can be used more cost-effectively.

  3. Achieving the 30% Goal: Energy and Cost Savings Analysis of ASHRAE Standard 90.1-2010

    Energy Technology Data Exchange (ETDEWEB)

    Thornton, Brian A.; Rosenberg, Michael I.; Richman, Eric E.; Wang, Weimin; Xie, YuLong; Zhang, Jian; Cho, Heejin; Mendon, Vrushali V.; Athalye, Rahul A.; Liu, Bing

    2011-05-24

    This Technical Support Document presents the energy and cost savings analysis that PNNL conducted to measure the potential energy savings of 90.1-2010 relative to 90.1-2004. PNNL conducted this analysis with inputs from many other contributors and source of information. In particular, guidance and direction was provided by the Simulation Working Group under the auspices of the SSPC90.1. This report documents the approach and methodologies that PNNL developed to evaluate the energy saving achieved from use of ASHRAE/IES Standard 90.1-2010. Specifically, this report provides PNNL’s Progress Indicator process and methodology, EnergyPlus simulation framework, prototype model descriptions. This report covers the combined upgrades from 90.1-2004 to 90.1-2010, resulting in a total of 153 addenda. PNNL has reviewed and considered all 153 addenda for quantitative analysis in the Progress Indicator process. 53 of those are included in the quantitative analysis. This report provides information on the categorization of all of the addenda, a summary of the content, and deeper explanation of the impact and modeling of 53 identified addenda with quantitative savings.

  4. Graphic Warning Labels and the Cost Savings from Reduced Smoking among Pregnant Women.

    Science.gov (United States)

    Tauras, John A; Peck, Richard M; Cheng, Kai-Wen; Chaloupka, Frank J

    2017-02-08

    Introduction: The U.S. Food and Drug Administration (FDA) has estimated the economic impact of Graphic Warning Labels (GWLs). By omitting the impact on tobacco consumption by pregnant women, the FDA analysis underestimates the economic benefits that would occur from the proposed regulations. There is a strong link between the occurrence of low birth weight babies and smoking while pregnant. Low birth weight babies in turn generate much higher hospital costs than normal birth weight babies. This study aims to fill the gap by quantifying the national hospital cost savings from the reductions in prenatal smoking that will arise if GWLs are implemented in the U.S. Data and Methods: This study uses several data sources. It uses Natality Data from the National Vital Statistics System of the National Center for Health Statistics (NCHS) in 2013 to estimate the impact of prenatal smoking on the likelihood of having a low-birth-weight baby, controlling for socio-economic and demographic characteristics as well as medical and non-medical risk factors. Using these estimates, along with the estimates of Huang et al. (2014) regarding the effect of GWLs on smoking, we calculate the change in the number of LBW (low birth weight) babies resulting from decreased prenatal smoking due to GWLs. Using this estimated change and the estimates from Russell et al. (2007) and AHRQ (2013) on the excess hospital costs of LBW babies, we calculate cost saving that arises from reduced prenatal smoking in response of GWLs. Results and Conclusions: Our results indicated that GWLs for this population could lead to hospital cost savings of 1.2 billion to 2.0 billion dollars over a 30 year horizon.

  5. Potential unintended pregnancies averted and cost savings associated with a revised Medicaid sterilization policy.

    Science.gov (United States)

    Borrero, Sonya; Zite, Nikki; Potter, Joseph E; Trussell, James; Smith, Kenneth

    2013-12-01

    Medicaid sterilization policy, which includes a mandatory 30-day waiting period between consent and the sterilization procedure, poses significant logistical barriers for many women who desire publicly funded sterilization. Our goal was to estimate the number of unintended pregnancies and the associated costs resulting from unfulfilled sterilization requests due to Medicaid policy barriers. We constructed a cost-effectiveness model from the health care payer perspective to determine the incremental cost over a 1-year time horizon of the current Medicaid sterilization policy compared to a hypothetical, revised policy in which women who desire a postpartum sterilization would face significantly reduced barriers. Probability estimates for potential outcomes in the model were based on published sources; costs of Medicaid-funded sterilizations and Medicaid-covered births were based on data from the Medicaid Statistical Information System and The Guttmacher Institute, respectively. With the implementation of a revised Medicaid sterilization policy, we estimated that the number of fulfilled sterilization requests would increase by 45%, from 53.3% of all women having their sterilization requests fulfilled to 77.5%. Annually, this increase could potentially lead to over 29,000 unintended pregnancies averted and $215 million saved. A revised Medicaid sterilization policy could potentially honor women's reproductive decisions, reduce the number of unintended pregnancies and save a significant amount of public funds. Compared to the current federal Medicaid sterilization policy, a hypothetical, revised policy that reduces logistical barriers for women who desire publicly funded, postpartum sterilization could potentially avert over 29,000 unintended pregnancies annually and therefore lead to cost savings of $215 million each year. © 2013.

  6. Developing Information on Energy Savings and Associated Costs and Benefits of Energy Efficient Emerging Technologies Applicable in California

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Tengfang; Slaa, Jan Willem; Sathaye, Jayant

    2010-12-15

    Implementation and adoption of efficient end-use technologies have proven to be one of the key measures for reducing greenhouse gas (GHG) emissions throughout the industries. In many cases, implementing energy efficiency measures is among one of the most cost effective investments that the industry could make in improving efficiency and productivity while reducing carbon dioxide (CO2) emissions. Over the years, there have been incentives to use resources and energy in a cleaner and more efficient way to create industries that are sustainable and more productive. With the working of energy programs and policies on GHG inventory and regulation, understanding and managing the costs associated with mitigation measures for GHG reductions is very important for the industry and policy makers around the world and in California. Successful implementation of applicable emerging technologies not only may help advance productivities, improve environmental impacts, or enhance industrial competitiveness, but also can play a significant role in climate-mitigation efforts by saving energy and reducing the associated GHG emissions. Developing new information on costs and savings benefits of energy efficient emerging technologies applicable in California market is important for policy makers as well as the industries. Therefore, provision of timely evaluation and estimation of the costs and energy savings potential of emerging technologies applicable to California is the focus of this report. The overall goal of the project is to identify and select a set of emerging and under-utilized energy-efficient technologies and practices as they are important to reduce energy consumption in industry while maintaining economic growth. Specifically, this report contains the results from performing Task 3 Technology Characterization for California Industries for the project titled Research Opportunities in Emerging and Under-Utilized Energy-Efficient Industrial Technologies, sponsored by

  7. 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.

  8. Maximizing Energy Savings Reliability in BC Hydro Industrial Demand-side Management Programs: An Assessment of Performance Incentive Models

    Science.gov (United States)

    Gosman, Nathaniel

    of alternative performance incentive program models to manage DSM risk in BC. Three performance incentive program models were assessed and compared to BC Hydro's current large industrial DSM incentive program, Power Smart Partners -- Transmission Project Incentives, itself a performance incentive-based program. Together, the selected program models represent a continuum of program design and implementation in terms of the schedule and level of incentives provided, the duration and rigour of measurement and verification (M&V), energy efficiency measures targeted and involvement of the private sector. A multi criteria assessment framework was developed to rank the capacity of each program model to manage BC large industrial DSM risk factors. DSM risk management rankings were then compared to program costeffectiveness, targeted energy savings potential in BC and survey results from BC industrial firms on the program models. The findings indicate that the reliability of DSM energy savings in the BC large industrial sector can be maximized through performance incentive program models that: (1) offer incentives jointly for capital and low-cost operations and maintenance (O&M) measures, (2) allow flexible lead times for project development, (3) utilize rigorous M&V methods capable of measuring variable load, process-based energy savings, (4) use moderate contract lengths that align with effective measure life, and (5) integrate energy management software tools capable of providing energy performance feedback to customers to maximize the persistence of energy savings. While this study focuses exclusively on the BC large industrial sector, the findings of this research have applicability to all energy utilities serving large, energy intensive industrial sectors.

  9. 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.

  10. Determining the Cost-Savings Threshold and Alignment Accuracy of Patient-Specific Instrumentation in Total Ankle Replacements.

    Science.gov (United States)

    Hamid, Kamran S; Matson, Andrew P; Nwachukwu, Benedict U; Scott, Daniel J; Mather, Richard C; DeOrio, James K

    2017-01-01

    Traditional intraoperative referencing for total ankle replacements (TARs) involves multiple steps and fluoroscopic guidance to determine mechanical alignment. Recent adoption of patient-specific instrumentation (PSI) allows for referencing to be determined preoperatively, resulting in less steps and potentially decreased operative time. We hypothesized that usage of PSI would result in decreased operating room time that would offset the additional cost of PSI compared with standard referencing (SR). In addition, we aimed to compare postoperative radiographic alignment between PSI and SR. Between August 2014 and September 2015, 87 patients undergoing TAR were enrolled in a prospectively collected TAR database. Patients were divided into cohorts based on PSI vs SR, and operative times were reviewed. Radiographic alignment parameters were retrospectively measured at 6 weeks postoperatively. Time-driven activity-based costing (TDABC) was used to derive direct costs. Cost vs operative time-savings were examined via 2-way sensitivity analysis to determine cost-saving thresholds for PSI applicable to a range of institution types. Cost-saving thresholds defined the price of PSI below which PSI would be cost-saving. A total of 35 PSI and 52 SR cases were evaluated with no significant differences identified in patient characteristics. Operative time from incision to completion of casting in cases without adjunct procedures was 127 minutes with PSI and 161 minutes with SR ( P analysis generated a globally applicable cost-savings threshold model based on institution-specific costs and surgeon-specific time-savings. This study demonstrated equivalent postoperative TAR alignment with PSI and SR referencing systems but with a significant decrease in operative time with PSI. Based on TDABC and associated sensitivity analysis, a cost-savings threshold of $863 was identified for PSI pricing at our institution below which PSI was less costly than SR. Similar internal cost accounting

  11. Planning influenza vaccination programs: a cost benefit model

    Directory of Open Access Journals (Sweden)

    Duncan Ian G

    2012-07-01

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

  12. Geothermal Heat Pumps as a Cost Saving and Capital Renewal Too!

    Energy Technology Data Exchange (ETDEWEB)

    Hughes, P.J.

    1998-11-06

    An independent evaluation of the Fort Polk, Louisiana energy savings performance contract (ESPC) has verified the financial value of geothermal heat pump (GHP)-centered ESPCS to the federal government. The Department of Energy (DOE) Federal Energy Management Program (FEMP) has responded by issuing an RFP for the "National GHP-Technology-Specific Super ESPC Procurement." Federal agency sites anywhere in the nation will be able to implement GHP-centered ESPC projects as delivery orders against the awarded contracts.

  13. Mission science value-cost savings from the Advanced Imaging Communication System (AICS)

    Science.gov (United States)

    Rice, R. F.

    1984-01-01

    An Advanced Imaging Communication System (AICS) was proposed in the mid-1970s as an alternative to the Voyager data/communication system architecture. The AICS achieved virtually error free communication with little loss in the downlink data rate by concatenating a powerful Reed-Solomon block code with the Voyager convolutionally coded, Viterbi decoded downlink channel. The clean channel allowed AICS sophisticated adaptive data compression techniques. Both Voyager and the Galileo mission have implemented AICS components, and the concatenated channel itself is heading for international standardization. An analysis that assigns a dollar value/cost savings to AICS mission performance gains is presented. A conservative value or savings of $3 million for Voyager, $4.5 million for Galileo, and as much as $7 to 9.5 million per mission for future projects such as the proposed Mariner Mar 2 series is shown.

  14. Saving Grace - A Climate Change Documentary Education Program

    Science.gov (United States)

    Byrne, J. M.; McDaniel, S.; Graham, J.; Little, L.; Hoggan, J. C.

    2012-12-01

    Saving Grace conveys climate change knowledge from the best international scientists and social scientists using a series of new media formats. An Education and Communication Plan (ECP) has been developed to disseminate climate change knowledge on impacts, mitigation and adaptation for individuals, and for all sectors of society. The research team is seeking contacts with science and social science colleagues around the world to provide the knowledge base for the ECP. Poverty enslaves…and climate change has, and will, spread and deepen poverty to hundreds of millions of people, primarily in the developing world. And make no mistake; we are enslaving hundreds of millions of people in a depressing and debilitating poverty that in numbers will far surpass the horrors of the slave trade of past centuries. Saving Grace is the story of that poverty - and minimizing that poverty. Saving Grace stars the best of the world's climate researchers. Saving Grace presents the science; who, where and why of greenhouse gases that drive climate change; current and projected impacts of a changing climate around the world; and most important, solutions to the climate change challenges we face.

  15. Cost savings associated with 10 years of road safety policies in Catalonia, Spain

    Science.gov (United States)

    Suelves, Josep M; Barbería, Eneko

    2013-01-01

    Abstract Objective To determine whether the road safety policies introduced between 2000 and 2010 in Catalonia, Spain, which aimed primarily to reduce deaths from road traffic collisions by 50% by 2010, were associated with economic benefits to society. Methods A cost analysis was performed from a societal perspective with a 10-year time horizon. It considered the costs of: hospital admissions; ambulance transport; autopsies; specialized health care; police, firefighter and roadside assistance; adapting to disability; and productivity lost due to institutionalization, death or sick leave of the injured or their caregivers; as well as material and administrative costs. Data were obtained from a Catalan hospital registry, the Catalan Traffic Service information system, insurance companies and other sources. All costs were calculated in euros (€) at 2011 values. Findings A substantial reduction in deaths from road traffic collisions was observed between 2000 and 2010. Between 2001 and 2010, with the implementation of new road safety policies, there were 26 063 fewer road traffic collisions with victims than expected, 2909 fewer deaths (57%) and 25 444 fewer hospitalizations. The estimated total cost savings were around €18 000 million. Of these, around 97% resulted from reductions in lost productivity. Of the remaining cost savings, 63% were associated with specialized health care, 15% with adapting to disability and 8.1% with hospital care. Conclusion The road safety policies implemented in Catalonia in recent years were associated with a reduction in the number of deaths and injuries from traffic collisions and with substantial economic benefits to society. PMID:23397348

  16. 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.

  17. Holistic impact assessment and cost savings of rainwater harvesting at the watershed scale

    Directory of Open Access Journals (Sweden)

    Santosh R. Ghimire

    2017-03-01

    Full Text Available We evaluated the impacts of domestic and agricultural rainwater harvesting (RWH systems in three watersheds within the Albemarle-Pamlico river basin (southeastern U.S. using life cycle assessment (LCA and life cycle cost assessment. Life cycle impact assessment (LCIA categories included energy demand, fossil fuel, metals, ozone depletion, global warming, acidification, smog, blue and green water use, ecotoxicity, eutrophication, and human health effects. Building upon previous LCAs of near-optimal domestic and agricultural RWH systems in the region, we scaled functional unit LCIA scores for adoption rates of 25%, 50%, 75%, and 100% and compared these to conventional municipal water and well water systems. In addition to investigating watershed-scale impacts of RWH adoption, which few studies have addressed, potential life cycle cost savings due to reduced cumulative energy demand were scaled in each watershed for a more comprehensive analysis. The importance of managing the holistic water balance, including blue water (surface/ground water, green water (rainwater use, and annual precipitation and their relationship to RWH are also addressed. RWH contributes to water resource sustainability by offsetting surface and ground water consumption and by reducing environmental and human health impacts compared to conventional sources. A watershed-wide RWH adoption rate of 25% has a number of ecological and human health benefits including blue water use reduction ranging from 2–39 Mm3, cumulative energy savings of 12–210 TJ, and reduced global warming potential of 600–10,100 Mg CO2 eq. Potential maximum lifetime energy cost savings were estimated at $5M and $24M corresponding to domestic RWH in Greens Mill and agricultural RWH in Back Creek watersheds.

  18. Estimate of Cost-Effective Potential for Minimum Efficiency Performance Standards in 13 Major World Economies Energy Savings, Environmental and Financial Impacts

    Energy Technology Data Exchange (ETDEWEB)

    Letschert, Virginie E. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Bojda, Nicholas [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Ke, Jing [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); McNeil, Michael A. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2012-07-01

    This study analyzes the financial impacts on consumers of minimum efficiency performance standards (MEPS) for appliances that could be implemented in 13 major economies around the world. We use the Bottom-Up Energy Analysis System (BUENAS), developed at Lawrence Berkeley National Laboratory (LBNL), to analyze various appliance efficiency target levels to estimate the net present value (NPV) of policies designed to provide maximum energy savings while not penalizing consumers financially. These policies constitute what we call the “cost-effective potential” (CEP) scenario. The CEP scenario is designed to answer the question: How high can we raise the efficiency bar in mandatory programs while still saving consumers money?

  19. Estimation of Energy Savings Resulting From the BestPractices Program, Fiscal Year 2002

    Energy Technology Data Exchange (ETDEWEB)

    Truett, LF

    2003-09-24

    Within the U.S. Department of Energy (DOE), the Office of Energy Efficiency and Renewable Energy (EERE) has a vision of a future with clean, abundant, reliable, and affordable energy. Within EERE, the Industrial Technologies Program (ITP), formerly the Office of Industrial Technologies, works in partnership with industry to increase energy efficiency, improve environmental performance, and boost productivity. The BestPractices (BP) Program, within ITP, works directly with industries to encourage energy efficiency. The purpose of the BP Program is to improve energy utilization and management practices in the industrial sector. The program targets distinct technology areas, including pumps, process heating, steam, compressed air, motors, and insulation. This targeting is accomplished with a variety of delivery channels, such as computer software, printed publications, Internet-based resources, technical training, technical assessments, and other technical assistance. A team of program evaluators from Oak Ridge National Laboratory (ORNL) was tasked to evaluate the fiscal year 2002 (FY02) energy savings of the program. The ORNL assessment enumerates levels of program activity for technology areas across delivery channels. In addition, several mechanisms that target multiple technology areas--e.g., Plant-wide Assessments (PWAs), the ''Energy Matters'' newsletter, and special events--are also evaluated for their impacts. When possible, the assessment relies on published reports and the Industrial Assessment Center (IAC) database for estimates of energy savings that result from particular actions. Data were also provided by ORNL, Lawrence Berkeley National Laboratory (LBNL) and Project Performance Corporation (PPC), the ITP Clearinghouse at Washington State University, the National Renewable Energy Laboratory (NREL), Energetics Inc., and the Industrial Technologies Program Office. The estimated energy savings in FY02 resulting from activities of the BP

  20. 77 FR 20123 - Fee Change for Paying Agents Redeeming Definitive Savings Bonds and Savings Notes

    Science.gov (United States)

    2012-04-03

    ... Fiscal Service Fee Change for Paying Agents Redeeming Definitive Savings Bonds and Savings Notes AGENCY..., the Department of the Treasury will no longer pay fees to paying agents for redeeming definitive savings bonds and savings notes. The purpose of this change is to reduce Treasury's program costs. DATES...

  1. Cost savings and clinical acceptability of an intravascular line tip culture triage policy.

    Science.gov (United States)

    Colston, J; Batchelor, B; Bowler, I C J W

    2013-05-01

    Culture of intravascular line tips is useful for the diagnosis of intravascular line-related phlebitis and bacteraemia. However, the test lacks specificity, with a low predictive value for intravascular line bacteraemia. A recent randomised study showed that predictive value could be increased and costs reduced by refrigerating intravascular lines and retrieving them for culture only if there was a bacteraemia in the seven days before or after the intravascular line was received. We studied whether a similar triage policy could be introduced into our 1400-bed National Health Service (NHS) teaching hospital in the UK. We assessed cost reduction in the laboratory and clinical acceptability. Data regarding the number of intravascular lines received, stored and cultured and blood cultures received was retrieved from the microbiology computer, for five-month periods before and after the introduction of the new triage policy. Of the 134 intravascular line tips received in the five months after the policy had been introduced, 101 (75%) were stored without retrieval and 33 were cultured. Of these, 7/134 (5%) were culture positive and three matched a concurrent blood culture. Audit showed that compliance with the policy was >98%. The estimated annual cost reduction following the introduction of the policy was £3,166.96. The policy was acceptable to clinicians. The policy was both cost saving and clinically acceptable. If the policy were adopted throughout the NHS in the UK, the annual cost saving to the service might be in the order of £300,000. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  2. 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.

  3. Web-based Tool Identifies and Quantifies Potential Cost Savings Measures at the Hanford Site

    Energy Technology Data Exchange (ETDEWEB)

    Renevitz, Marisa J.; Peschong, Jon C.; Charboneau, Briant L.; Simpson, Brett C.

    2014-01-09

    The Technical Improvement system is an approachable web-based tool that is available to Hanford DOE staff, site contractors, and general support service contractors as part of the baseline optimization effort underway at the Hanford Site. Finding and implementing technical improvements are a large part of DOE’s cost savings efforts. The Technical Improvement dashboard is a key tool for brainstorming and monitoring the progress of submitted baseline optimization and potential cost/schedule efficiencies. The dashboard is accessible to users over the Hanford Local Area Network (HLAN) and provides a highly visual and straightforward status to management on the ideas provided, alleviating the need for resource intensive weekly and monthly reviews.

  4. Successful protocol for eliminating excessive urine microscopies: Quality improvement and cost savings with physician support.

    Science.gov (United States)

    Chen, Michael; Eintracht, Shaun; MacNamara, Elizabeth

    2017-01-01

    Clinical laboratories are under growing pressure to provide faster turn-around-time and maintain high quality while decreasing costs. In a setting of rising test volumes, implementation of evidence-based protocols with physician cooperation and feedback may provide frameworks and support for laboratory utilization optimization. The purpose of this study was to eliminate wasteful urine microscopy by targeting physician ordering behavior, and to ensure quality of care with physician satisfaction surveys. We evaluated how physicians use the laboratory for routine urine testing. Urinalysis requisition was redesigned with emphasis on clinical indications for testing. In collaboration with requesting physicians, restriction in reflex microscopy testing was applied with exceptions. Cost saving analysis was conducted based on test volume. After policy change, 2 physician satisfaction surveys were conducted 5year apart to address potential complaints. Over 47,000 urine microscopies have been eliminated annually, while the number of urine dipsticks and cultures remained stable. This translated into a 95% reduction in manual microscopy performed, and an estimated annual saving of $200,000. In both satisfaction surveys, 9 out of 10 physicians considered the change to have "no" or "a beneficial effect" on their clinical practice. Our laboratory did not receive any formal complaints in regards to the protocol change. By implementing changes to the way physicians order urinalysis, the number of tests can be substantially reduced. Satisfaction survey proved to be an effective tool for obtaining physician feedback, and support. The results of surveys indicated that new policy achieved significant savings without compromising on patient care. This experience has provided us with strategies on taking initiatives to further optimize utilization of laboratory tests. Copyright © 2016 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  5. Safety and cost savings of reducing adult dengue hospitalization in a tertiary care hospital in Singapore.

    Science.gov (United States)

    Lee, Linda K; Earnest, Arul; Carrasco, Luis R; Thein, Tun L; Gan, Victor C; Lee, Vernon J; Lye, David C; Leo, Yee-Sin

    2013-01-01

    Previously, most dengue cases in Singapore were hospitalized despite low incidence of dengue hemorrhagic fever (DHF) or death. To minimize hospitalization, the Communicable Disease Centre at Tan Tock Seng Hospital (TTSH) in Singapore implemented new admission criteria which included clinical, laboratory, and DHF predictive parameters in 2007. All laboratory-confirmed dengue patients seen at TTSH during 2006-2008 were retrospectively reviewed for clinical data. Disease outcome and clinical parameters were compared over the 3 years. There was a 33.0% mean decrease in inpatients after the new criteria were implemented compared with the period before (p accumulation (15.5% vs 2.9% of outpatients), while most DHF outpatients had hypoproteinemia (92.7% vs 81.3% of inpatients). The eight intensive care unit admissions and five deaths during this time period all occurred among inpatients. The new criteria resulted in a median cost saving of US$1.4 million to patients in 2008. The new dengue admission criteria were effective in sustainably reducing length of hospitalization, yielding considerable cost savings. A minority of DHF patients with mild symptoms recovered uneventfully through outpatient management.

  6. School nurses' role in asthma management, school absenteeism, and cost savings: a demonstration project.

    Science.gov (United States)

    Rodriguez, Eunice; Rivera, Diana Austria; Perlroth, Daniella; Becker, Edmund; Wang, Nancy Ewen; Landau, Melinda

    2013-12-01

    With increasing budget cuts to education and social services, rigorous evaluation needs to document school nurses' impact on student health, academic outcomes, and district funding. Utilizing a quasi-experimental design, we evaluated outcomes in 4 schools with added full-time nurses and 5 matched schools with part-time nurses in the San Jose Unified School District. Student data and logistic regression models were used to examine predictors of illness-related absenteeism for 2006-2007 and 2008-2009. We calculated average daily attendance (ADA) funding and parent wages associated with an improvement in illness-related absenteeism. Utilizing parent surveys, we also estimated the cost of services for asthma-related visits to the emergency room (ER; N = 2489). Children with asthma were more likely to be absent due to illness; however, mean absenteeism due to illness decreased when full-time nurses were added to demonstration schools but increased in comparison schools during 2008-2009, resulting in a potential savings of $48,518.62 in ADA funding (N = 6081). Parents in demonstration schools reported fewer ER visits, and the estimated savings in ER services and parent wages were significant. Full-time school nurses play an important role in improving asthma management among students in underserved schools, which can impact school absenteeism and attendance-related economic costs. © 2013, American School Health Association.

  7. Telehealth for paediatric burn patients in rural areas: a retrospective audit of activity and cost savings.

    Science.gov (United States)

    McWilliams, Tania; Hendricks, Joyce; Twigg, Di; Wood, Fiona; Giles, Margaret

    2016-11-01

    Since 2005, the Western Australian paediatric burn unit has provided a state-wide clinical consultancy and support service for the assessment and management of acute and rehabilitative burn patients via its telehealth service. Since then, the use of this telehealth service has steadily increased as it has become imbedded in the model of care for paediatric burn patients. Primarily, the service involves acute and long term patient reviews conducted by the metropolitan-located burn unit in contact with health practitioners, advising patients and their families who reside outside the metropolitan area thereby avoiding unnecessary transfers and inpatient bed days. A further benefit of the paediatric burn service using telehealth is more efficient use of tertiary level burn unit beds, with only those patients meeting clinical criteria for admission being transferred. To conduct a retrospective audit of avoided transfers and bed days in 2005/06-2012/13 as a result of the use of the paediatric Burns Telehealth Service and estimate their cost savings in 2012/13. A retrospective chart audit identified activity, avoided unnecessary acute and scar review patient transfers, inpatient bed days and their associated avoided costs to the tertiary burn unit and patient travel funding. Over the period 2005/06-2012/13 the audit identified 4,905 avoided inpatient bed days, 364 avoided acute patient transfers and 1,763 avoided follow up review transfers for a total of 1,312 paediatric burn patients as a result of this telehealth service. This paper presents the derivation of these outcomes and an estimation of their cost savings in 2012/13 of AUD 1.89million. This study demonstrates avoided patient transfers, inpatient bed days and associated costs as the result of an integrated burns telehealth service. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  8. Project SAVE (State Adult Volunteers in Education). Organizing a Community Based Literacy Program.

    Science.gov (United States)

    Sizemore, Mamie, Ed.

    This handbook provides administrators and staffs of adult education programs with general information on volunteerism in adult education; information on specific programs and strategies, specifically Project SAVE (State Adult Volunteers in Education); and guidelines for program implementation. An overview of the impact of adult illiteracy precedes…

  9. Meeting the Challenge: The Prospect of Achieving 30 Percent Savings Through the Weatherization Assistance Program

    Energy Technology Data Exchange (ETDEWEB)

    Schweitzer, M.

    2002-05-31

    The U.S. Department of Energy's (DOE's) Weatherization Assistance Program has been installing energy-efficiency measures in low-income houses for over 25 years, achieving savings exceeding 30 percent of natural gas used for space heating. Recently, as part of its Weatherization Plus initiative, the Weatherization Assistance Program adopted the goal of achieving 30 percent energy savings for all household energy usage. The expansion of the Weatherization Assistance Program to include electric baseload components such as lighting and refrigerators provides additional opportunities for saving energy and meeting this ambitious goal. This report documents an Oak Ridge National Laboratory study that examined the potential savings that could be achieved by installing various weatherization measures in different types of dwellings throughout the country. Three different definitions of savings are used: (1) reductions in pre-weatherization expenditures; (2) savings in the amount of energy consumed at the house site, regardless of fuel type (''site Btus''); and (3) savings in the total amount of energy consumed at the source (''source Btus''), which reflects the fact that each Btu* of electricity consumed at the household level requires approximately three Btus to produce at the generation source. In addition, the effects of weatherization efforts on carbon dioxide (CO{sub 2}) emissions are examined.

  10. Medical cost savings for participants and nonparticipants in health risk assessments, lifestyle management, disease management, depression management, and nurseline in a large financial services corporation.

    Science.gov (United States)

    Serxner, Seth; Alberti, Angela; Weinberger, Sarah

    2012-01-01

    To compare changes in medical costs between participants and nonparticipants in five different health and productivity management (HPM) programs. Quasi-experimental pre/post intervention study. A large financial services corporation. A cohort population of employees enrolled in medical plans (n  =  49,723) [corrected]. A comprehensive HPM program, which addressed health risks, acute and chronic conditions, and psychosocial disorders from 2005 to 2007. Incentives were used to encourage health risk assessment participation in years 2 and 3. Program participation and medical claims data were collected for members at the end of each program year to assess the change in total costs from the baseline period. Analysis . Multivariate analyses for participation categories were conducted comparing baseline versus program year cost differences, controlling for demographics. All participation categories yielded a lower cost increase compared to nonparticipation and a positive return on investment (ROI) for years 2 and 3, resulting in a 2.45∶1 ROI for the combined program years. Medical cost savings exceeded program costs in a wide variety of health and productivity management programs by the second year.

  11. 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...

  12. Going Global: Can Dual-Language Programs Save Bilingual Education?

    Science.gov (United States)

    Varghese, Manka M.; Park, Caryn

    2010-01-01

    In this commentary, we extend the cautionary tales regarding dual-language programs raised by several scholars by considering the interface of such programs with global education. We consider the possible pitfalls of uncritically framing dual-language programs within the global education movement in the United States, especially in light of how…

  13. [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.

  14. Three Interventions That Reduce Childhood Obesity Are Projected To Save More Than They Cost To Implement.

    Science.gov (United States)

    Gortmaker, Steven L; Wang, Y Claire; Long, Michael W; Giles, Catherine M; Ward, Zachary J; Barrett, Jessica L; Kenney, Erica L; Sonneville, Kendrin R; Afzal, Amna Sadaf; Resch, Stephen C; Cradock, Angie L

    2015-11-01

    Policy makers seeking to reduce childhood obesity must prioritize investment in treatment and primary prevention. We estimated the cost-effectiveness of seven interventions high on the obesity policy agenda: a sugar-sweetened beverage excise tax; elimination of the tax subsidy for advertising unhealthy food to children; restaurant menu calorie labeling; nutrition standards for school meals; nutrition standards for all other food and beverages sold in schools; improved early care and education; and increased access to adolescent bariatric surgery. We used systematic reviews and a microsimulation model of national implementation of the interventions over the period 2015-25 to estimate their impact on obesity prevalence and their cost-effectiveness for reducing the body mass index of individuals. In our model, three of the seven interventions--excise tax, elimination of the tax deduction, and nutrition standards for food and beverages sold in schools outside of meals--saved more in health care costs than they cost to implement. Each of the three interventions prevented 129,000-576,000 cases of childhood obesity in 2025. Adolescent bariatric surgery had a negligible impact on obesity prevalence. Our results highlight the importance of primary prevention for policy makers aiming to reduce childhood obesity. Project HOPE—The People-to-People Health Foundation, Inc.

  15. Cost-saving potentials using demand side management in households and electric mobility

    Energy Technology Data Exchange (ETDEWEB)

    Schinz, S.; Najib, H.; Steiner, L. [Darmstadt Univ. of Technology (Germany). Inst. for Renewable Energies

    2010-07-01

    The increasing share of renewable energies in the electricity production has an influence on the grid and on the electricity markets, where higher price fluctuations are expected. One way of integrating renewable energies is using demand side management (DSM). In this case online energy markets enable private households to participate with their loads in these markets. Especially their household appliances participate on the basis of hourly electricity prices. Thus these markets can provide DSM-services for the grid by means of aggregating household loads. To estimate the cost-savings of DSM for the purpose of reducing electricity costs in private households different gadget-models are developed and minimal costs are calculated by formulating linear optimization models. In private households especially refrigerators, freezers, washing machines, tumble- dryers and dishwashers can be considered as shiftable loads for DSM purposes. This application of DSM is examined in this paper precisely. Future developments regarding DSM are analyzed with scenarios for 2010 and 2030. The gadget-models have average specifications of gadgets in Europe and Germany. Their operation is optimized for minimal electricity cost over one year on the basis of electricity prices from the European Energy Exchange EEX in Leipzig, Germany. Finally DSM in Micro Grids is analyzed and different control options are considered to solve the voltage stability problem. (orig.)

  16. Costs and longer-term savings of parenting programmes for the prevention of persistent conduct disorder: a modelling study

    Directory of Open Access Journals (Sweden)

    Beecham Jennifer

    2011-10-01

    Full Text Available Abstract Background Conduct disorders are the most common psychiatric disorders in children and may persist into adulthood in about 50% of cases. The costs to society are high and impact many public sector agencies. Parenting programmes have been shown to positively affect child behaviour, but little is known about their potential long-term cost-effectiveness. We therefore estimate the costs of and longer-term savings from evidence-based parenting programmes for the prevention of persistent conduct disorder. Methods A decision-analytic Markov model compares two scenarios: 1 a 5-year old with clinical conduct disorder receives an evidence-based parenting programme; 2 the same 5-year old does not receive the programme. Cost-savings analysis is performed by comparing the probability that conduct disorder persists over time in each scenario, adopting both a public sector and a societal perspective. If the intervention is successful in reducing persistent conduct disorder, cost savings may arise from reduced use of health services, education support, social care, voluntary agencies and from crimes averted. Results Results strongly suggest that parenting programmes reduce the chance that conduct disorder persists into adulthood and are cost-saving to the public sector within 5-8 years under base case conditions. Total savings to society over 25 years are estimated at £16,435 per family, which compares with an intervention cost in the range of £952-£2,078 (2008/09 prices. Conclusions Effective implementation of evidence-based parenting programmes is likely to yield cost savings to the public sector and society. More research is needed to address evidence gaps regarding the current level of provision, longer-term effectiveness and questions of implementation, engagement and equity.

  17. Energy and Energy Cost Savings Analysis of the 2015 IECC for Commercial Buildings

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Jian [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Xie, YuLong [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Athalye, Rahul A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhuge, Jing Wei [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Rosenberg, Michael I. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Hart, Philip R. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Liu, Bing [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2015-06-01

    As required by statute (42 USC 6833), DOE recently issued a determination that ANSI/ASHRAE/IES Standard 90.1-2013 would achieve greater energy efficiency in buildings subject to the code compared to the 2010 edition of the standard. Pacific Northwest National Laboratory (PNNL) conducted an energy savings analysis for Standard 90.1-2013 in support of its determination . While Standard 90.1 is the model energy standard for commercial and multi-family residential buildings over three floors (42 USC 6833), many states have historically adopted the International Energy Conservation Code (IECC) for both residential and commercial buildings. This report provides an assessment as to whether buildings constructed to the commercial energy efficiency provisions of the 2015 IECC would save energy and energy costs as compared to the 2012 IECC. PNNL also compared the energy performance of the 2015 IECC with the corresponding Standard 90.1-2013. The goal of this analysis is to help states and local jurisdictions make informed decisions regarding model code adoption.

  18. Energy and Energy Cost Savings Analysis of the 2015 IECC for Commercial Buildings

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Jian [Pacific Northwest National Laboratory (PNNL), Richland, WA (United States); Xie, YuLong [Pacific Northwest National Laboratory (PNNL), Richland, WA (United States); Athalye, Rahul A. [Pacific Northwest National Laboratory (PNNL), Richland, WA (United States); Zhuge, Jing Wei [Pacific Northwest National Laboratory (PNNL), Richland, WA (United States); Rosenberg, Michael I. [Pacific Northwest National Laboratory (PNNL), Richland, WA (United States); Hart, Philip R. [Pacific Northwest National Laboratory (PNNL), Richland, WA (United States); Liu, Bing [Pacific Northwest National Laboratory (PNNL), Richland, WA (United States)

    2015-09-01

    As required by statute (42 USC 6833), DOE recently issued a determination that ANSI/ASHRAE/IES Standard 90.1-2013 would achieve greater energy efficiency in buildings subject to the code compared to the 2010 edition of the standard. Pacific Northwest National Laboratory (PNNL) conducted an energy savings analysis for Standard 90.1-2013 in support of its determination . While Standard 90.1 is the model energy standard for commercial and multi-family residential buildings over three floors (42 USC 6833), many states have historically adopted the International Energy Conservation Code (IECC) for both residential and commercial buildings. This report provides an assessment as to whether buildings constructed to the commercial energy efficiency provisions of the 2015 IECC would save energy and energy costs as compared to the 2012 IECC. PNNL also compared the energy performance of the 2015 IECC with the corresponding Standard 90.1-2013. The goal of this analysis is to help states and local jurisdictions make informed decisions regarding model code adoption.

  19. Greenbelt Homes Pilot Program: Summary of Building Envelope Retrofits, Planned HVAC Equipment Upgrades, and Energy Savings

    Energy Technology Data Exchange (ETDEWEB)

    Wiehagen, J. [Partnership for Home Innovation, Upper Marlboro, MD (United States); Del Bianco, M. [Partnership for Home Innovation, Upper Marlboro, MD (United States); Mallay, D. [Partnership for Home Innovation, Upper Marlboro, MD (United States)

    2015-05-01

    In the fall of 2010, a multiyear pilot energy efficiency retrofit project was undertaken by Greenbelt Homes, Inc, (GHI) a 1,566 home cooperative of circa 1930 and 1940 homes in Greenbelt, Maryland. GHI established this pilot project to serve as a basis for decision making for the rollout of a decade-long community-wide upgrade program that will incorporate energy efficiency improvements to the building envelope and mechanical equipment. It presents a unique opportunity to evaluate and prioritize the wide-range of benefits of high-performance retrofits based on member experience with and acceptance of the retrofit measures implemented during the pilot project. Addressing the complex interactions between benefits, trade-offs, construction methods, project management implications, realistic upfront costs, financing, and other considerations, serves as a case study for energy retrofit projects to include high-performance technologies based on the long-term value to the homeowner. The pilot project focused on identifying the added costs and energy savings benefits of improvements.

  20. Energy-Smart Building Choices: How School Facilities Managers and Business Officials Are Reducing Operating Costs and Saving Money

    Energy Technology Data Exchange (ETDEWEB)

    Energy Smart Schools Team

    2001-08-06

    Most K-12 schools could save 25% of their energy costs by being smart about energy. Nationwide, the savings potential is $6 billion. While improving energy use in buildings and busses, schools are likely to create better places for teaching and learning, with better lighting, temperature control, acoustics, and air quality. This brochure, targeted to school facilities managers and business officials, describes how schools can become more energy efficient.

  1. Cost-Effectiveness of a Savings-Led Economic Empowerment Intervention for AIDS-Affected Adolescents in Uganda: Implications for Scale-up in Low-Resource Communities.

    Science.gov (United States)

    Ssewamala, Fred M; Wang, Julia Shu-Huah; Neilands, Torsten B; Bermudez, Laura Gauer; Garfinkel, Irwin; Waldfogel, Jane; Brooks-Gunn, Jeanne; Kirkbride, Gwyneth

    2018-01-01

    Nearly 12 million children and adolescents in sub-Saharan Africa have lost one or both parents to AIDS. Within sub-Saharan Africa, Uganda has been greatly impacted, with an estimated 1.2 million orphaned children, nearly half of which have experienced parental loss due to the epidemic. Cost-effective and scalable interventions are needed to improve developmental outcomes for these children, most of whom are growing up in poverty. This article examines the direct impacts and cost-effectiveness of a savings-led family economic empowerment intervention, Bridges to the Future, that employed varying matched savings incentives to encourage investment in Ugandan children orphaned by AIDS. Using data from 48 primary schools in southwestern Uganda, we calculate per-person costs in each of the two treatment arms-Bridges (1:1 match savings) versus Bridges PLUS (1:2 match savings); estimate program effectiveness across outcomes of interest; and provide the ratios of per-person costs to their corresponding effectiveness. At the 24-month postintervention initiation, children in the two treatment arms showed better results in health, mental health, and education when compared to the usual care condition; however, no statistically significant differences were found between treatment arms with the exception of school attendance rates which were higher for those in Bridges PLUS. Owing to the minimal cost difference between the Bridges and Bridges PLUS arms, we did not find substantial cost-effectiveness differences across the two treatment arms. After 24 months, an economic intervention that incorporated matched savings yielded positive results on critical development outcomes for adolescents orphaned by AIDS in Uganda. The 1:1 and 1:2 match rates did not demonstrate variable levels of cost-effectiveness at 24-month follow-up, suggesting that governments intending to incorporate savings-led interventions within their social protection frameworks may not need to select a higher

  2. Surgeon’s dilemma: should I save patient’s life at any cost?

    Directory of Open Access Journals (Sweden)

    Kamila Kocańda

    2017-12-01

    Full Text Available Every doctor practicing treatment in the field of medicine may be confronted with a serious question: should I save my patient’s life at any cost? If a doctor resigns from emergency procedures, he/she will risk the patient’s death. However, if he/she decides to proceed regardless of a Jehovah’s Witness patient’s statement of will, in which he or she refuses transfusion, he/she takes a risk of illegal medical intervention. There is neither an easy answer, nor a serious solution, thus the only way is to choose the lesser of two evils. Notwithstanding legal issues, there are still ethical problems, which result in an internal dilemma for a doctor.

  3. Can business impact analysis play a meaningful role in planning a cost-saving programme?

    Science.gov (United States)

    Wright, Trevor

    2011-02-01

    Business continuity as it exists today would appear to have reached something of a plateau. Considering the history of the discipline, and how it has developed from 'simple' disaster recovery to its present position, it is clear that the trend has been to move from a reactive discipline to a proactive process. Following on from this broadly-accepted point, it is perhaps time to consider how the discipline may develop and what wider and deeper contribution the business continuity profession may make to add further value for our clients. In the present climate, it seems appropriate to consider how (and if) business continuity practice can make a meaningful contribution to a cost saving exercise. The public and private sectors are considered and the differences are compared.

  4. Review of the Fuel Saving, Life Cycle GHG Emission, and Ownership Cost Impacts of Lightweighting Vehicles with Different Powertrains.

    Science.gov (United States)

    Luk, Jason M; Kim, Hyung Chul; De Kleine, Robert; Wallington, Timothy J; MacLean, Heather L

    2017-08-01

    The literature analyzing the fuel saving, life cycle greenhouse gas (GHG) emission, and ownership cost impacts of lightweighting vehicles with different powertrains is reviewed. Vehicles with lower powertrain efficiencies have higher fuel consumption. Thus, fuel savings from lightweighting internal combustion engine vehicles can be higher than those of hybrid electric and battery electric vehicles. However, the impact of fuel savings on life cycle costs and GHG emissions depends on fuel prices, fuel carbon intensities and fuel storage requirements. Battery electric vehicle fuel savings enable reduction of battery size without sacrificing driving range. This reduces the battery production cost and mass, the latter results in further fuel savings. The carbon intensity of electricity varies widely and is a major source of uncertainty when evaluating the benefits of fuel savings. Hybrid electric vehicles use gasoline more efficiently than internal combustion engine vehicles and do not require large plug-in batteries. Therefore, the benefits of lightweighting depend on the vehicle powertrain. We discuss the value proposition of the use of lightweight materials and alternative powertrains. Future assessments of the benefits of vehicle lightweighting should capture the unique characteristics of emerging vehicle powertrains.

  5. You say you want a revolution: casing drilling targets 30 per cent well-cost saving

    Energy Technology Data Exchange (ETDEWEB)

    Polczer, S.; Marsters, S.

    1999-10-01

    Casing drilling is a new method of drilling that eliminates drill strings by using standard casing to simultaneously drill and case wells. Tesco Corporation of Calgary acquired patent rights to casing drilling technology in 1995. The company now offers a conversion kit for existing drill rigs as well a new compact casing drilling rig for shallow markets. The single derrick will be rated at 1,500 meters, but initially it will be used to drill 700-800 meter gas wells in southeast Alberta. Some cost savings will be realized at these shallow depths, but the real cost saving advantages will be realized on deep holes. In the meantime, improvements are planned to the cutting structures of the under-rimming bit to increase safety and withstand higher torque loads. It will be also necessary to adapt techniques such as directional drilling and logging to the casing drilling conveyance mechanism which has been only partially successful thus far, especially in the retrieving mode. Another challenge already met, involved ensuring that casing could be run in high-compression loads without damage to connections. Despite these problems, the system attracted considerable attention with several international companies placing orders for immediate delivery. Another system, this one developed by Sperry-Sun Drilling Services and known as a 'casing while drilling' (CWD) system, is strictly a downhole assembly and is targeted for offshore use and deeper vertical holes. This system is currently being tested in two commercial operations in offshore Indonesia for Unocal Corporation. Despite numerous problems to fill casing with fluid during connections, penetration rates of 300-400 feet per hour were achieved.

  6. [Radiology in managed care environment: opportunities for cost savings in an HMO].

    Science.gov (United States)

    Schmidt, C; Mohr, A; Möller, J; Levin-Scherz, J; Heller, M

    2003-09-01

    A large regional health plan in the Northeastern United States noted that its radiology costs were increasing more than it anticipated in its pricing, and noted further that other similar health plans in markets with high managed care penetration had significantly lower expenses for radiology services. This study describes the potential areas of improvement and managed care techniques that were implemented to reduce costs and reform processes. We performed an in-depth analysis of financial data, claims logic, contracting with provider units and conducted interviews with employees, to identify potential areas of improvement and cost reduction. A detailed market analysis of the environment, competitors and vendors was accompanied by extensive literature, Internet and Medline search for comparable projects. All data were docu-mented in Microsoft Excel(R) and analyzed by non-parametric tests using SPSS(R) 8.0 (Statistical Package for the Social Sciences) for Windows(R). The main factors driving the cost increases in radiology were divided into those internal or external to the HMO. Among the internal factors, the claims logic was allowing overpayment due to limitations of the IT system. Risk arrangements between insurer and provider units (PU) as well as the extent of provider unit management and administration showed a significant correlation with financial performance in terms of variance from budget. Among the external factors, shared risk arrangements between HMO and provider unit were associated with more efficient radiology utilization and overall improvement in financial performance. PU with full-time management had significantly less variance from their budget than those without. Finally, physicians with imaging equipment in their offices ordered up to 4 to 5 times more imaging procedures than physicians who did not perform imaging studies themselves. We identified initiatives with estimated potential savings of approximately $ 5.5 million. Some of these

  7. Lives saved from malaria prevention in Africa--evidence to sustain cost-effective gains

    Directory of Open Access Journals (Sweden)

    Korenromp Eline L

    2012-03-01

    Full Text Available Abstract Lives saved have become a standard metric to express health benefits across interventions and diseases. Recent estimates of malaria-attributable under-five deaths prevented using the Lives Saved tool (LiST, extrapolating effectiveness estimates from community-randomized trials of scale-up of insecticide-treated nets (ITNs in the 1990s, confirm the substantial impact and good cost-effectiveness that ITNs have achieved in high-endemic sub-Saharan Africa. An even higher cost-effectiveness would likely have been found if the modelling had included the additional indirect mortality impact of ITNs on preventing deaths from other common child illnesses, to which malaria contributes as a risk factor. As conventional ITNs are being replaced by long-lasting insecticidal nets and scale-up is expanded to target universal coverage for full, all-age populations at risk, enhanced transmission reduction may--above certain thresholds--enhance the mortality impact beyond that observed in the trials of the 1990s. On the other hand, lives saved by ITNs might fall if improved malaria case management with artemisinin-based combination therapy averts the deaths that ITNs would otherwise prevent. Validation and updating of LiST's simple assumption of a universal, fixed coverage-to-mortality-reduction ratio will require enhanced national programme and impact monitoring and evaluation. Key indicators for time trend analysis include malaria-related mortality from population-based surveys and vital registration, vector control and treatment coverage from surveys, and parasitologically-confirmed malaria cases and deaths recorded in health facilities. Indispensable is triangulation with dynamic transmission models, fitted to long-term trend data on vector, parasite and human populations over successive phases of malaria control and elimination. Sound, locally optimized budget allocation including on monitoring and evaluation priorities will benefit much if policy

  8. Lives saved from malaria prevention in Africa--evidence to sustain cost-effective gains.

    Science.gov (United States)

    Korenromp, Eline L

    2012-03-28

    Lives saved have become a standard metric to express health benefits across interventions and diseases. Recent estimates of malaria-attributable under-five deaths prevented using the Lives Saved tool (LiST), extrapolating effectiveness estimates from community-randomized trials of scale-up of insecticide-treated nets (ITNs) in the 1990s, confirm the substantial impact and good cost-effectiveness that ITNs have achieved in high-endemic sub-Saharan Africa. An even higher cost-effectiveness would likely have been found if the modelling had included the additional indirect mortality impact of ITNs on preventing deaths from other common child illnesses, to which malaria contributes as a risk factor. As conventional ITNs are being replaced by long-lasting insecticidal nets and scale-up is expanded to target universal coverage for full, all-age populations at risk, enhanced transmission reduction may--above certain thresholds--enhance the mortality impact beyond that observed in the trials of the 1990s. On the other hand, lives saved by ITNs might fall if improved malaria case management with artemisinin-based combination therapy averts the deaths that ITNs would otherwise prevent.Validation and updating of LiST's simple assumption of a universal, fixed coverage-to-mortality-reduction ratio will require enhanced national programme and impact monitoring and evaluation. Key indicators for time trend analysis include malaria-related mortality from population-based surveys and vital registration, vector control and treatment coverage from surveys, and parasitologically-confirmed malaria cases and deaths recorded in health facilities. Indispensable is triangulation with dynamic transmission models, fitted to long-term trend data on vector, parasite and human populations over successive phases of malaria control and elimination.Sound, locally optimized budget allocation including on monitoring and evaluation priorities will benefit much if policy makers and programme planners

  9. 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.

  10. Supply chain collaboration and cost saving as a result of returns handling programmes in retail corporations in Poland

    Directory of Open Access Journals (Sweden)

    Anna Maria Jeszka

    2015-09-01

    Full Text Available Background: The objective is to define on the basis of the literature as well as to test empirically the main factors that affect the cost saving of many retail chains, resulting from deliberate and conscious policies as well as organized activities in the area of product returns management. Methods: Based on a survey developed for the study, standardized interviews were conducted with representatives of trade corporations in the apparel industry in Poland. The data collected were analysed statistically. Results:  The results of the statistical analysis showed that the analysed factors had a significant impact on cost saving. A company's ability to cooperate in the supply chain, limited  for the purposes of the study to the distributor - retailer relationship, is relevant to the cost savings resulting from the policies of retail corporations in the area of reverse logistics. The integration of IT systems with suppliers and customers also influences the level of cost saving, as does collaboration within a team. Conclusions: To date, studies in this field have not been conducted in Poland. A particularly important element seems to be the relationship between cooperation in the supply chain and the possible savings which this can generate. This study contributes to the growing trend of research into reverse logistics and emphasizes the role of retailers and cooperation in the supply chain.  

  11. Program-oriented approach to resource saving issues in construction materials industry

    Directory of Open Access Journals (Sweden)

    Novikova Galina

    2017-01-01

    Full Text Available The construction as a sector of the economy is one of the largest consumers of energy resources, and the building materials industry is today one of the most energy-intensive construction industry. At the enterprises of the building materials industry the different approaches and methods are used to solve resource and energy problems. Energy saving is considered not as an complex approach in the enterprise activity, but as activity for the implementation of specific energy-saving projects, which have limitations in time and in resources. The authors suggest to use a softwareoriented approach to solving the problems of resource and energy saving. For practical application of program-oriented approach we offer to use a structuring method of the decision-making, not previously used to solve problems of resource and energy saving.

  12. Reusing dialyzer in low income countries: A good cost saving tactic with complex ethics.

    Science.gov (United States)

    Dhrolia, Murtaza Fakhruddin; Imtiaz, Salman; Qureshi, Ruqaya; Ahmed, Aasim

    2017-08-01

    Despite almost universal practice of dialyzer reuse from the earliest days of haemodialysis, reusing dialyzer always remains a controversial issue and several ethical concerns have been raised. Some of the important are safety of reuse over single use, informed consent of the patient, conflict of interest on the part of physician or manufacturer, fiscal responsibility and environmental stewardship. Indeed, at the beginning of this century, there was a drastic shift of practice in favour of single use in developed countries due to availability of biocompatible haemodialyzers, at favourable price. Despite this mega shift, dialyzer reuse is still widely practised in low-income countries. Considering cost inflation and limited medical resources in such countries, dialyzer reuse may be justified as a cost-saving strategy for this part of world. However, it poses the same ethical questions to us which were a matter of debate for the western world in the 1980s and 1990s. This review of literature was planned to revisit and highlight these concerns.

  13. 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.

  14. Economic Utility: Combinatorial Pharmacogenomics and Medication Cost Savings for Mental Health Care in a Primary Care Setting.

    Science.gov (United States)

    Brown, Lisa C; Lorenz, Raymond A; Li, James; Dechairo, Bryan M

    2017-03-01

    This study was an analysis based on a previously completed prospective study investigating medication costs of patients with mental illness guided by using the GeneSight proprietary combinatorial pharmacogenomic (PGx) test. The primary objective of this study was to determine potential cost savings of combinatorial PGx testing over the course of 1 year in patients with mental illness treated by primary care providers (PCPs) and psychiatrists who had switched or added a new psychiatric medication after patients failed to respond to monotherapy. The current evaluation details cost savings of treatment decisions congruent and incongruent with the combinatorial PGx test recommendations specific to PCPs and psychiatrists. This study was a subanalysis of a 1-year, prospective trial comparing medication costs of 2168 patients undergoing GeneSight testing. Pharmacy claims were provided by a pharmacy benefits manager, comparing medication costs 6 months before combinatorial PGx testing and followed up for 1 year after the testing. This analysis compared congruence and cost savings per patient based on the type of health care provider administering care. Using data from a large pharmacy benefits manager, we found that PCPs treat the majority of mental health patients receiving psychotropic medication prescriptions, including treatment-resistant patients. PCPs congruent with combinatorial PGx testing provided the most medication cost savings for payers and patients at $3988 per member per year (P Health care providers treating patients with mental illness can significantly reduce medication costs by following the combinatorial PGx report recommendations. PCPs, who treat the majority of patients with mental illness, reported a significant reduction in medication costs for both central nervous system and non-central nervous system drugs. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  15. The cost-saving effect and prevention of medication errors by clinical pharmacist intervention in a nephrology unit.

    Science.gov (United States)

    Chen, Chia-Chi; Hsiao, Fei-Yuan; Shen, Li-Jiuan; Wu, Chien-Chih

    2017-08-01

    Medication errors may lead to adverse drug events (ADEs), which endangers patient safety and increases healthcare-related costs. The on-ward deployment of clinical pharmacists has been shown to reduce preventable ADEs, and save costs. The purpose of this study was to evaluate the ADEs prevention and cost-saving effects by clinical pharmacist deployment in a nephrology ward.This was a retrospective study, which compared the number of pharmacist interventions 1 year before and after a clinical pharmacist was deployed in a nephrology ward. The clinical pharmacist attended ward rounds, reviewed and revised all medication orders, and gave active recommendations of medication use. For intervention analysis, the numbers and types of the pharmacist's interventions in medication orders and the active recommendations were compared. For cost analysis, both estimated cost saving and avoidance were calculated and compared.The total numbers of pharmacist interventions in medication orders were 824 in 2012 (preintervention), and 1977 in 2013 (postintervention). The numbers of active recommendation were 40 in 2012, and 253 in 2013. The estimated cost savings in 2012 and 2013 were NT$52,072 and NT$144,138, respectively. The estimated cost avoidances of preventable ADEs in 2012 and 2013 were NT$3,383,700 and NT$7,342,200, respectively. The benefit/cost ratio increased from 4.29 to 9.36, and average admission days decreased by 2 days after the on-ward deployment of a clinical pharmacist.The number of pharmacist's interventions increased dramatically after her on-ward deployment. This service could reduce medication errors, preventable ADEs, and costs of both medications and potential ADEs.

  16. Cost analysis of a prospective multi-site cohort study of palliative care consultation teams for adults with advanced cancer: Where do cost-savings come from?

    Science.gov (United States)

    May, Peter; Garrido, Melissa M; Cassel, J Brian; Kelley, Amy S; Meier, Diane E; Normand, Charles; Smith, Thomas J; Morrison, R Sean

    2017-04-01

    Studies report cost-savings from hospital-based palliative care consultation teams compared to usual care only, but drivers of observed differences are unclear. To analyse cost-differences associated with palliative care consultation teams using two research questions: (Q1) What is the association between early palliative care consultation team intervention, and intensity of services and length of stay, compared to usual care only? (Q2) What is the association between early palliative care consultation team intervention and day-to-day hospital costs, compared to a later intervention? Prospective multi-site cohort study (2007-2011). Patients who received a consultation were placed in the intervention group, those who did not in the comparison group. Intervention group was stratified by timing, and groups were matched using propensity scores. Adults admitted to three US hospitals with advanced cancer. Principle analytic sample contains 863 patients ( nUC = 637; nPC EARLY = 177; nPC LATE = 49) discharged alive. Cost-savings from early palliative care accrue due to both reduced length of stay and reduced intensity of treatment, with an estimated 63% of savings associated with shorter length of stay. A reduction in day-to-day costs is observable in the days immediately following initial consult but does not persist indefinitely. A comparison of early and late palliative care consultation team cost-effects shows negligible difference once the intervention is administered. Reduced length of stay is the biggest driver of cost-saving from early consultation for patients with advanced cancer. Patient- and family-centred discussions on goals of care and transition planning initiated by palliative care consultation teams may be at least as important in driving cost-savings as the reduction of unnecessary tests and pharmaceuticals identified by previous studies.

  17. CHARACTERIZING COSTS, SAVINGS AND BENEFITS OF A SELECTION OF ENERGY EFFICIENT EMERGING TECHNOLOGIES IN THE UNITED STATES

    Energy Technology Data Exchange (ETDEWEB)

    Xu, T.; Slaa, J.W.; Sathaye, J.

    2010-12-15

    Implementation and adoption of efficient end-use technologies have proven to be one of the key measures for reducing greenhouse gas (GHG) emissions throughout the industries. In many cases, implementing energy efficiency measures is among one of the most cost effective investments that the industry could make in improving efficiency and productivity while reducing CO2 emissions. Over the years, there have been incentives to use resources and energy in a cleaner and more efficient way to create industries that are sustainable and more productive. With the working of energy programs and policies on GHG inventory and regulation, understanding and managing the costs associated with mitigation measures for GHG reductions is very important for the industry and policy makers around the world. Successful implementation of emerging technologies not only can help advance productivities and competitiveness but also can play a significant role in mitigation efforts by saving energy. Providing evaluation and estimation of the costs and energy savings potential of emerging technologies is the focus of our work in this project. The overall goal of the project is to identify and select emerging and under-utilized energy-efficient technologies and practices as they are important to reduce energy consumption in industry while maintaining economic growth. This report contains the results from performing Task 2"Technology evaluation" for the project titled"Research Opportunities in Emerging and Under-Utilized Energy-Efficient Industrial Technologies," which was sponsored by California Energy Commission and managed by CIEE. The project purpose is to analyze market status, market potential, and economic viability of selected technologies applicable to the U.S. In this report, LBNL first performed re-assessments of all of the 33 emerging energy-efficient industrial technologies, including re-evaluation of the 26 technologies that were previously identified by Martin et al. (2000) and

  18. Process control, energy recovery and cost savings in acetic acid wastewater treatment

    Energy Technology Data Exchange (ETDEWEB)

    Vaiopoulou, E., E-mail: vaiop@env.duth.gr [Department of Environmental Engineering, Democritus University of Thrace, Vas. Sofias 12, 67 100 Xanthi (Greece); Melidis, P., E-mail: pmelidis@env.duth.gr [Department of Environmental Engineering, Democritus University of Thrace, Vas. Sofias 12, 67 100 Xanthi (Greece); Aivasidis, A., E-mail: aavazid@env.duth.gr [Department of Environmental Engineering, Democritus University of Thrace, Vas. Sofias 12, 67 100 Xanthi (Greece)

    2011-02-28

    An anaerobic fixed bed loop (AFBL) reactor was applied for treatment of acetic acid (HAc) wastewater. Two pH process control concepts were investigated; auxostatic and chemostatic control. In the auxostatic pH control, feed pump is interrupted when pH falls below a certain pH value in the bioreactor, which results in reactor operation at maximum load. Chemostatic control assures alkaline conditions by setting a certain pH value in the influent, preventing initial reactor acidification. The AFBL reactor treated HAc wastewater at low hydraulic residence time (HRT) (10-12 h), performed at high space time loads (40-45 kg COD/m{sup 3} d) and high space time yield (30-35 kg COD/m{sup 3} d) to achieve high COD (Chemical Oxygen Demand) removal (80%). Material and cost savings were accomplished by utilizing the microbial potential for wastewater neutralization during anaerobic treatment along with application of favourable pH-auxostatic control. NaOH requirement for neutralization was reduced by 75% and HRT was increased up to 20 h. Energy was recovered by applying costless CO{sub 2} contained in the biogas for neutralization of alkaline wastewater. Biogas was enriched in methane by 4 times. This actually brings in more energy profits, since biogas extra heating for CO{sub 2} content during biogas combustion is minimized and usage of other acidifying agents is omitted.

  19. Savings estimates for the ENERGY STAR (registered trademark) voluntary labeling program: 2001 status report

    Energy Technology Data Exchange (ETDEWEB)

    Webber, Carrie A.; Brown, Richard E.; Mahajan, Akshay; Koomey, Jonathan G.

    2002-02-15

    ENERGY STAR(Registered Trademark) is a voluntary labeling program designed to identify and promote energy-efficient products, buildings and practices. Operated jointly by the Environmental Protection Agency (EPA) and the U.S. Department of Energy (DOE), ENERGY STAR labels exist for more than thirty products, spanning office equipment, residential heating and cooling equipment, commercial and residential lighting, home electronics, and major appliances. This report presents savings estimates for a subset of ENERGY STAR program activities, focused primarily on labeled products. We present estimates of the energy, dollar and carbon savings achieved by the program in the year 2000, what we expect in 2001, and provide savings forecasts for two market penetration scenarios for the period 2001 to 2020. The target market penetration forecast represents our best estimate of future ENERGY STAR savings. It is based on realistic market penetration goals for each of the products. We also provide a forecast under the assumption of 100 percent market penetration; that is, we assume that all purchasers buy ENERGY STAR-compliant products instead of standard efficiency products throughout the analysis period.

  20. 2003 status report savings estimates for the energy star(R)voluntary labeling program

    Energy Technology Data Exchange (ETDEWEB)

    Webber, Carrie A.; Brown, Richard E.; McWhinney, Marla

    2004-11-09

    ENERGY STAR(R) is a voluntary labeling program designed to identify and promote energy-efficient products, buildings and practices. Operated jointly by the Environmental Protection Agency (EPA) and the U.S. Department of Energy (DOE), ENERGY STAR labels exist for more than thirty products, spanning office equipment, residential heating and cooling equipment, commercial and residential lighting, home electronics, and major appliances. This report presents savings estimates for a subset of ENERGY STAR program activities, focused primarily on labeled products. We present estimates of the energy, dollar and carbon savings achieved by the program in the year 2002, what we expect in 2003, and provide savings forecasts for two market penetration scenarios for the period 2003 to 2020. The target market penetration forecast represents our best estimate of future ENERGY STAR savings. It is based on realistic market penetration goals for each of the products. We also provide a forecast under the assumption of 100 percent market penetration; that is, we assume that all purchasers buy ENERGY STAR-compliant products instead of standard efficiency products throughout the analysis period.

  1. 2002 status report: Savings estimates for the ENERGY STAR(R) voluntary labeling program

    Energy Technology Data Exchange (ETDEWEB)

    Webber, Carrie A.; Brown, Richard E.; McWhinney, Marla; Koomey, Jonathan

    2003-03-03

    ENERGY STAR [registered trademark] is a voluntary labeling program designed to identify and promote energy-efficient products, buildings and practices. Operated jointly by the Environmental Protection Agency (EPA) and the U.S. Department of Energy (DOE), ENERGY STAR labels exist for more than thirty products, spanning office equipment, residential heating and cooling equipment, commercial and residential lighting, home electronics, and major appliances. This report presents savings estimates for a subset of ENERGY STAR program activities, focused primarily on labeled products. We present estimates of the energy, dollar and carbon savings achieved by the program in the year 2001, what we expect in 2002, and provide savings forecasts for two market penetration scenarios for the period 2002 to 2020. The target market penetration forecast represents our best estimate of future ENERGY STAR savings. It is based on realistic market penetration goals for each of the products. We also provide a forecast under the assumption of 100 percent market penetration; that is, we assume that all purchasers buy ENERGY STAR-compliant products instead of standard efficiency products throughout the analysis period.

  2. WaterSense Program: Methodology for National Water Savings Analysis Model Indoor Residential Water Use

    Energy Technology Data Exchange (ETDEWEB)

    Whitehead, Camilla Dunham; McNeil, Michael; Dunham_Whitehead, Camilla; Letschert, Virginie; della_Cava, Mirka

    2008-02-28

    The U.S. Environmental Protection Agency (EPA) influences the market for plumbing fixtures and fittings by encouraging consumers to purchase products that carry the WaterSense label, which certifies those products as performing at low flow rates compared to unlabeled fixtures and fittings. As consumers decide to purchase water-efficient products, water consumption will decline nationwide. Decreased water consumption should prolong the operating life of water and wastewater treatment facilities.This report describes the method used to calculate national water savings attributable to EPA?s WaterSense program. A Microsoft Excel spreadsheet model, the National Water Savings (NWS) analysis model, accompanies this methodology report. Version 1.0 of the NWS model evaluates indoor residential water consumption. Two additional documents, a Users? Guide to the spreadsheet model and an Impacts Report, accompany the NWS model and this methodology document. Altogether, these four documents represent Phase One of this project. The Users? Guide leads policy makers through the spreadsheet options available for projecting the water savings that result from various policy scenarios. The Impacts Report shows national water savings that will result from differing degrees of market saturation of high-efficiency water-using products.This detailed methodology report describes the NWS analysis model, which examines the effects of WaterSense by tracking the shipments of products that WaterSense has designated as water-efficient. The model estimates market penetration of products that carry the WaterSense label. Market penetration is calculated for both existing and new construction. The NWS model estimates savings based on an accounting analysis of water-using products and of building stock. Estimates of future national water savings will help policy makers further direct the focus of WaterSense and calculate stakeholder impacts from the program.Calculating the total gallons of water the

  3. Rumble over jailhouse healthcare. As states broaden outsourcing to private vendors, critics question quality of care and cost savings.

    Science.gov (United States)

    Kutscher, Beth; Meyer, Harris

    2013-09-02

    The trend for states to outsource prison healthcare has met opposition from inmate advocates and legal aid groups. They fear quality of care will suffer, while others debate whether outsourcing care saves any money. Corizon, the largest U.S. private prison healthcare provider, says it definitely delivers savings. "We are the model because we've been doing capitated rates since we've been in business. Our cost per individual is significantly less than in the 'free world,' "says Corizon CEO Rich Hallworth.

  4. 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

  5. Lives saved from malaria prevention in Africa - Evidence to sustain cost-effective gains

    NARCIS (Netherlands)

    E.L. Korenromp (Eline)

    2012-01-01

    textabstractLives saved have become a standard metric to express health benefits across interventions and diseases. Recent estimates of malaria-attributable under-five deaths prevented using the Lives Saved tool (LiST), extrapolating effectiveness estimates from community-randomized trials of

  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. 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.

  8. Do cost savings from reductions in nosocomial infections justify additional costs of single-bed rooms in intensive care units? A simulation case study.

    Science.gov (United States)

    Sadatsafavi, Hessam; Niknejad, Bahar; Zadeh, Rana; Sadatsafavi, Mohsen

    2016-02-01

    Evidence shows that single-patient rooms can play an important role in preventing cross-transmission and reducing nosocomial infections in intensive care units (ICUs). This case study investigated whether cost savings from reductions in nosocomial infections justify the additional construction and operation costs of single-bed rooms in ICUs. We conducted deterministic and probabilistic return-on-investment analyses of converting the space occupied by open-bay rooms to single-bed rooms in an exemplary ICU. We used the findings of a study of an actual ICU in which the association between the locations of patients in single-bed vs open-bay rooms with infection risk was evaluated. Despite uncertainty in the estimates of costs, infection risks, and length of stay, the cost savings from the reduction of nosocomial infections in single-bed rooms in this case substantially outweighed additional construction and operation expenses. The mean value of internal rate of return over a 5-year analysis period was 56.18% (95% credible interval, 55.34%-57.02%). This case study shows that although single-patient rooms are more costly to build and operate, they can result in substantial savings compared with open-bay rooms by avoiding costs associated with nosocomial infections. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Cost savings of reduced constipation rates attributed to increased dietary fiber intakes: a decision-analytic model

    Science.gov (United States)

    2014-01-01

    Background Nearly five percent of Americans suffer from functional constipation, many of whom may benefit from increasing dietary fiber consumption. The annual constipation-related healthcare cost savings associated with increasing intakes may be considerable but have not been examined previously. The objective of the present study was to estimate the economic impact of increased dietary fiber consumption on direct medical costs associated with constipation. Methods Literature searches were conducted to identify nationally representative input parameters for the U.S. population, which included prevalence of functional constipation; current dietary fiber intakes; proportion of the population meeting recommended intakes; and the percentage that would be expected to respond, in terms of alleviation of constipation, to a change in dietary fiber consumption. A dose–response analysis of published data was conducted to estimate the percent reduction in constipation prevalence per 1 g/day increase in dietary fiber intake. Annual direct medical costs for constipation were derived from the literature and updated to U.S. $ 2012. Sensitivity analyses explored the impact on adult vs. pediatric populations and the robustness of the model to each input parameter. Results The base case direct medical cost-savings was $12.7 billion annually among adults. The base case assumed that 3% of men and 6% of women currently met recommended dietary fiber intakes; each 1 g/day increase in dietary fiber intake would lead to a reduction of 1.9% in constipation prevalence; and all adults would increase their dietary fiber intake to recommended levels (mean increase of 9 g/day). Sensitivity analyses, which explored numerous alternatives, found that even if only 50% of the adult population increased dietary fiber intake by 3 g/day, annual medical costs savings exceeded $2 billion. All plausible scenarios resulted in cost savings of at least $1 billion. Conclusions Increasing dietary fiber

  10. 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.

  11. Dry Kraft Pulping at Ambient Pressure for Cost Effective Energy Saving and Pollution Deduction

    Energy Technology Data Exchange (ETDEWEB)

    Yulin Deng; Art Ragauskas

    2012-08-28

    Sponsored by the DOE Industrial Energy Efficiency Grand Challenge program, our research team at the Georgia Institute of Technology conducted laboratory studies and confirmed the concept of making wood pulp using a dry pulping technology. This technology is a new process different from any prior pulping technology used in Kraft and CTMP pulping. Three different kinds of dry pulping methods were investigated. (a) Dry Pulping at Atmospheric Pressure: The first one is to dry and bake the pretreated woodchips in a conventional oven at atmospheric pressure without the use of a catalyst. (b) Dry Pulping at Reduced Pressure: The second method is to dry the pretreated woodchips first in a vacuum oven in the presence of anthraquinone (AQ) as a pulping catalyst, followed by baking at elevated temperature. (c) Liquid Free Chemical Pulping, LFCP. The third method is to first remove the free water of pretreated woodchips, followed by dry pulping using a conventional Kraft pulping digester with AQ and triton as additives. Method one: Experimental results indicated that Dry Pulping at Atmospheric Pressure could produce pulp with higher brightness and lower bulk than conventional Kraft pulp. However, tensile strength of the acquired pulp is much lower than traditional Kraft pulp, and their Kappa number and energy consumption are higher than conventional Kraft pulp. By fully analyzing the results, we concluded that wood fibers might be damaged during the drying process at elevated temperature. The main reason for wood fiber damage is that a long drying time was used during evaporation of water from the woodchips. This resulted in an un-uniform reaction condition on the woodchips: the outside layer of the woodchips was over reacted while inside the woodchips did not reacted at all. To solve this problem, dry pulping at reduced pressure was investigated. Method two: To achieve uniform reaction throughout the entire reaction system, the water inside the pretreated woodchips was

  12. 2004 status report: Savings estimates for the Energy Star(R)voluntarylabeling program

    Energy Technology Data Exchange (ETDEWEB)

    Webber, Carrie A.; Brown, Richard E.; McWhinney, Marla

    2004-03-09

    ENERGY STAR(R) is a voluntary labeling program designed toidentify and promote energy-efficient products, buildings and practices.Operated jointly by the Environmental Protection Agency (EPA) and theU.S. Department of Energy (DOE), ENERGY STAR labels exist for more thanthirty products, spanning office equipment, residential heating andcooling equipment, commercial and residential lighting, home electronics,and major appliances. This report presents savings estimates for a subsetof ENERGY STAR labeled products. We present estimates of the energy,dollar and carbon savings achieved by the program in the year 2003, whatwe expect in 2004, and provide savings forecasts for two marketpenetration scenarios for the periods 2004 to 2010 and 2004 to 2020. Thetarget market penetration forecast represents our best estimate of futureENERGY STAR savings. It is based on realistic market penetration goalsfor each of the products. We also provide a forecast under the assumptionof 100 percent market penetration; that is, we assume that all purchasersbuy ENERGY STAR-compliant products instead of standard efficiencyproducts throughout the analysis period.

  13. 2005 Status Report Savings Estimates for the ENERGY STAR(R)Voluntary Labeling Program

    Energy Technology Data Exchange (ETDEWEB)

    Webber, Carrie A.; Brown, Richard E.; Sanchez, Marla

    2006-03-07

    ENERGY STAR(R) is a voluntary labeling program designed toidentify and promote energy-efficient products, buildings and practices.Operated jointly by the Environmental Protection Agency (EPA) and theU.S. Department of Energy (DOE), Energy Star labels exist for more thanforty products, spanning office equipment, residential heating andcooling equipment, commercial and residential lighting, home electronics,and major appliances. This report presents savings estimates for a subsetof ENERGY STAR labeled products. We present estimates of the energy,dollar and carbon savings achieved by the program in the year 2004, whatwe expect in 2005, and provide savings forecasts for two marketpenetration scenarios for the periods 2005 to 2010 and 2005 to 2020. Thetarget market penetration forecast represents our best estimate of futureENERGY STAR savings. It is based on realistic market penetration goalsfor each of the products. We also provide a forecast under the assumptionof 100 percent market penetration; that is, we assume that all purchasersbuy ENERGY STAR-compliant products instead of standard efficiencyproducts throughout the analysis period.

  14. 2006 Status Report Savings Estimates for the ENERGY STAR(R)Voluntary Labeling Program

    Energy Technology Data Exchange (ETDEWEB)

    Webber, Carrie A.; Brown, Richard E.; Sanchez, Marla; Homan,Gregory K.

    2006-03-07

    ENERGY STAR(R) is a voluntary labeling program designed toidentify and promote energy-efficient products, buildings and practices.Operated jointly by the Environmental Protection Agency (EPA) and theU.S. Department of Energy (DOE), ENERGY STAR labels exist for more thanthirty products, spanning office equipment, residential heating andcooling equipment, commercial and residential lighting, home electronics,and major appliances. This report presents savings estimates for a subsetof ENERGY STAR labeled products. We present estimates of the energy,dollar and carbon savings achieved by the program in the year 2005, whatwe expect in 2006, and provide savings forecasts for two marketpenetration scenarios for the periods 2006 to 2015 and 2006 to 2025. Thetarget market penetration forecast represents our best estimate of futureENERGY STAR savings. It is based on realistic market penetration goalsfor each of the products. We also provide a forecast under the assumptionof 100 percent market penetration; that is, we assume that all purchasersbuy ENERGY STAR-compliant products instead of standard efficiencyproducts throughout the analysis period.

  15. 2007 Status Report: Savings Estimates for the ENERGY STAR(R)VoluntaryLabeling Program

    Energy Technology Data Exchange (ETDEWEB)

    Sanchez, Marla; Webber, Carrie A.; Brown, Richard E.; Homan,Gregory K.

    2007-03-23

    ENERGY STAR(R) is a voluntary labeling program designed toidentify and promote energy-efficient products, buildings and practices.Operated jointly by the Environmental Protection Agency (EPA) and theU.S. Department of Energy (DOE), ENERGY STAR labels exist for more thanthirty products, spanning office equipment, residential heating andcooling equipment, commercial and residential lighting, home electronics,and major appliances. This report presents savings estimates for a subsetof ENERGY STAR labeled products. We present estimates of the energy,dollar and carbon savings achieved by the program in the year 2006, whatwe expect in 2007, and provide savings forecasts for two marketpenetration scenarios for the periods 2007 to 2015 and 2007 to 2025. Thetarget market penetration forecast represents our best estimate of futureENERGY STAR savings. It is based on realistic market penetration goalsfor each of the products. We also provide a forecast under the assumptionof 100 percent market penetration; that is, we assume that all purchasersbuy ENERGY STAR-compliant products instead of standard efficiencyproducts throughout the analysis period.

  16. 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)

  17. An economic evaluation of anticipated costs and savings of a behavior change intervention to enhance medication adherence

    Directory of Open Access Journals (Sweden)

    Wiegand PN

    2008-06-01

    Full Text Available Medication adherence across disease states is generally poor. Research has focused on various methods to improve medication adherence, but there is little conclusive evidence regarding specific methods efficacy. The Transtheoretical Model for Behavior Change has been used to modify existing addictive behaviors but not in medication adherence specifically. As a behavioral component is inherently related to medication adherence, it is thought that this model may be applicable. Objective: The purpose of this research is to evaluate the costs and savings of implementing a novel behavioral intervention against the cost of poor medication adherence to determine whether further development is realistic.Methods: The basic tools required to administer this intervention were determined through primary literature review and priced by vendors supplying such materials. Diabetes Mellitus Type 2 (DM2 was used as a vehicle to establish the cost of care for long-term complications of a chronic disease. The primary literature provided information regarding the cost of care for DM2 morbidity and outpatient annual drug therapy expenditure. The total cost of the behavioral intervention components and the cost of care for DM2 morbidity were applied to a theoretical cohort of 1000 patients. By dividing this cost across 1000 patients, a per-patient cost was yielded and multiplied over a 16-year timeframe. Results: It was found that the cost to implement the behavioral intervention and resultant medication costs is USD13,574 per-patient over 16 years. The cost to treat complications of diabetes mellitus is USD 36,528 per patient over the 16 years. The total amount of healthcare dollars potentially saved by utilizing this intervention is USD 22,954 per-patient. Conclusions: It appears that the cost to implement this behavioral intervention is reasonable and permits further evaluation in other chronic conditions with notoriously poor adherence levels.

  18. What Strategies Do Physicians and Patients Discuss to Reduce Out-of-Pocket Costs? Analysis of Cost-Saving Strategies in 1,755 Outpatient Clinic Visits.

    Science.gov (United States)

    Hunter, Wynn G; Zhang, Cecilia Z; Hesson, Ashley; Davis, J Kelly; Kirby, Christine; Williamson, Lillie D; Barnett, Jamison A; Ubel, Peter A

    2016-10-01

    More than 1 in 4 Americans report difficulty paying medical bills. Cost-reducing strategies discussed during outpatient physician visits remain poorly characterized. We sought to determine how often patients and physicians discuss health care costs during outpatient visits and what strategies, if any, they discussed to lower patient out-of-pocket costs. Retrospective analysis of dialogue from 1,755 outpatient visits in community-based practices nationwide from 2010 to 2014. The study population included 677 patients with breast cancer, 422 with depression, and 656 with rheumatoid arthritis visiting 56 oncologists, 36 psychiatrists, and 26 rheumatologists, respectively. Thirty percent of visits contained cost conversations (95% confidence interval [CI], 28 to 32). Forty-four percent of cost conversations involved discussion of cost-saving strategies (95% CI, 40 to 48; median duration, 68 s). We identified 4 strategies to lower costs without changing the care plan. They were, in order of overall frequency: 1) changing logistics of care, 2) facilitating co-pay assistance, 3) providing free samples, and 4) changing/adding insurance plans. We also identified 4 strategies to reduce costs by changing the care plan: 1) switching to lower-cost alternative therapy/diagnostic, 2) switching from brand name to generic, 3) changing dosage/frequency, and 4) stopping/withholding interventions. Strategies were relatively consistent across health conditions, except for switching to a lower-cost alternative (more common in breast oncology) and providing free samples (more common in depression). Focus on 3 conditions with potentially high out-of-pocket costs. Despite price opacity, physicians and patients discuss a variety of out-of-pocket cost reduction strategies during clinic visits. Almost half of cost discussions mention 1 or more cost-saving strategies, with more frequent mention of those not requiring care-plan changes. © The Author(s) 2016.

  19. Cost and radiation savings of partial substitution of ultrasound for CT in appendicitis evaluation: a national projection.

    Science.gov (United States)

    Parker, Laurence; Nazarian, Levon N; Gingold, Eric L; Palit, Charles D; Hoey, Courtney L; Frangos, Andrea J

    2014-01-01

    The costs of an ultrasound-CT protocol and a CT-only protocol for an appendicitis evaluation are compared. For the ultrasound-CT protocol, patients with right lower quadrant abdominal pain undergo an ultrasound examination. If it is positive for appendicitis, they are sent directly to surgery, avoiding CT. A comparative effectiveness research study was conducted. The costs of imaging tests, excess surgeries, and excess surgical deaths for the ultrasound-CT protocol and the costs of imaging tests and excess cancer deaths in the CT-only protocol were estimated. Data sources were Centers for Medicare & Medicaid Services (CMS) datasets, national hospital discharge surveys, radiology information system cases, and U.S. Census Bureau life tables. A meta-analysis and sensitivity analyses were also conducted. The meta-analysis showed a positive predictive value of 92.5% for CT and 91.0% for ultrasound. Analysis of CMS files showed that utilization of CT was almost exactly 2.0 examinations (one abdominal and one pelvic) per patient and for ultrasound was almost nil. The cost of this imaging protocol was $547 per patient, whereas the cost of a limited ultrasound study would be $88 per patient. For the total U.S. population, the cost savings in imaging minus the cost of extra surgeries and extra surgical deaths is $24.9 million per year. Following model VII proposed by the Committee on the Biological Effects of Ionizing Radiation (BEIR), which is known as "BEIR VII," the avoidance of a 12.4-mSv exposure for 262,500 persons would prevent 180 excess cancer deaths. The value of the years of life lost would be $339.5 million. The sensitivity analyses indicate that the cost savings are robust. An ultrasound-CT protocol for appendicitis evaluation offers potentially large savings over the standard CT-only protocol. There are moderate savings from using a less expensive imaging technique despite extra surgeries and large savings from radiation exposure avoided.

  20. Effects of an Individual Development Account Program on Retirement Saving: Follow-up Evidence From a Randomized Experiment.

    Science.gov (United States)

    Grinstein-Weiss, Michal; Sherraden, Michael; Gale, William G; Rohe, William M; Schreiner, Mark; Key, Clinton; Oliphant, Jane E

    2015-01-01

    We examine the 10-year follow-up effects on retirement saving of an individual development account (IDA) program using data from a randomized experiment that ran from 1998 to 2003 in Tulsa, Oklahoma. The IDA program included financial education, encouragement to save, and matching funds for several qualified uses of the saving, including contributions to retirement accounts. The results indicate that as of 2009, 6 years after the program ended, the IDA program had no impact on the propensity to hold a retirement account, the account balance, or the sufficiency of retirement balances to meet retirement expenses.

  1. Scope-of-practice laws for nurse practitioners limit cost savings that can be achieved in retail clinics.

    Science.gov (United States)

    Spetz, Joanne; Parente, Stephen T; Town, Robert J; Bazarko, Dawn

    2013-11-01

    Retail clinics have the potential to reduce health spending by offering convenient, low-cost access to basic health care services. Retail clinics are often staffed by nurse practitioners (NPs), whose services are regulated by state scope-of-practice regulations. By limiting NPs' work scope, restrictive regulations could affect possible cost savings. Using multistate insurance claims data from 2004-07, a period in which many retail clinics opened, we analyzed whether the cost per episode associated with the use of retail clinics was lower in states where NPs are allowed to practice independently and to prescribe independently. We also examined whether retail clinic use and scope of practice were associated with emergency department visits and hospitalizations. We found that visits to retail clinics were associated with lower costs per episode, compared to episodes of care that did not begin with a retail clinic visit, and the costs were even lower when NPs practiced independently. Eliminating restrictions on NPs' scope of practice could have a large impact on the cost savings that can be achieved by retail clinics.

  2. United States menhaden oil could save billions in U.S. health care costs and improve IQ in children

    OpenAIRE

    Bibus, Douglas M

    2016-01-01

    The United States menhaden oil annual production is sufficient to supply all of the recommended long chain Omega?3s for Americans over 55 with coronary heart disease (CHD) and pregnant and lactating women. According to a recent study, the utilization of preventable intake levels could potentially save up to $1.7 billion annually in hospital costs alone. In addition, the remaining oil could be used to support a culture of enough Atlantic salmon to provide every pregnant and lactating woman in ...

  3. Can energy utilities play a role in local political energy savings programs?

    DEFF Research Database (Denmark)

    Dirckinck-Holmfeld, Kasper

    2012-01-01

    businesses to achieve GHG reductions, seven Danish municipalities (Copenhagen, Albertslund, Allerød, Ballerup, Herning, Kolding and Næstved) have joined forces in an EU LIFE project “Carbon 20”. A key element in the Carbon 20 project is to offer an energy screening free of charge for the participating...... companies. The Carbon 20 project has entered agreements with different energy consultants to provide these screenings for little or no cost - utilising a national scheme obligating the Danish energy utilities to reduce energy use among customers. However, the energy consultants are rather reluctant to offer...... the screening to small companies since the savings are rather limited in absolute terms. This article will focus on the appropriateness of using energy utilities (or consultants working on their behalf) in a local political context of engaging the local business sector in achieving energy savings and GHG...

  4. Potential cost savings from internal/external CO{sub 2} emissions trading in the Korean electric power industry

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Myunghun, E-mail: leemh@inha.ac.kr [Department of International Trade, Inha University, 253 Yonghyun-dong, Nam-gu, Incheon 402-751 (Korea, Republic of)

    2011-10-15

    Korea plans to introduce an emissions trading scheme for the controlling greenhouse gas emissions in 2015. Using Shephard's (1970) output distance function, we first estimate the shadow price of CO{sub 2} for power generators in the Korean fossil-fueled electric generation industry. Then, by assuming that each power generator is required to reduce CO{sub 2} emissions by one ton, we compute the potential cost savings from internal trading among generators within the same plant and from external trading across plants at prevailing market prices. The results indicate that, on average, the generators paid $14.63 to abate one ton of CO{sub 2} emissions in 2007. Plants realized additional gains through external trading. In particular, cost savings from trades between different fuel-fired plants were substantial. - Highlights: > We estimated the shadow price of CO{sub 2} for the Korean steam power plants. > On average, the generators paid $14.63 to abate one ton of CO{sub 2} emissions in 2007. > We computed the potential cost savings from internal trading and external trading. > Plants realized additional gains through external trading.

  5. A comparative analysis of the epidemiological impact and disease cost-savings of HPV vaccines in France

    Science.gov (United States)

    Bresse, Xavier; Adam, Marjorie; Largeron, Nathalie; Roze, Stephane; Marty, Remi

    2013-01-01

    The aim was to compare the epidemiological and economic impact of 16/18 bivalent and 6/11/16/18 quadrivalent HPV vaccination in France, considering differences in licensed outcomes, protection against non-vaccine HPV types and prevention of HPV-6/11-related diseases. The differential impact of the two vaccines was evaluated using a published model adapted to the French setting. The target population was females aged 14–23 y and the time horizon was 100 y. A total of eight different scenarios compared vaccination impact in terms of reduction in HPV-16/18-associated carcinomas (cervical, vulvar, vaginal, anal, penile and head and neck), HPV-6/11-related genital warts and recurrent respiratory papillomatosis, and incremental reduction in cervical cancer due to potential cross-protection. Quadrivalent vaccine was associated with total discounted cost savings ranging from EUR 544–1,020 million vs. EUR 177–538 million with the bivalent vaccination (100-y time horizon). Genital wart prevention thanks to quadrivalent HPV vaccination accounted for EUR 306–380 million savings (37–56% of costs saved). In contrast, the maximal assumed cross-protection against cervical cancer resulted in EUR 13–33 million savings (4%). Prevention of vulvar, vaginal and anal cancers accounted for additional EUR 71–89 million savings (13%). In France, the quadrivalent HPV vaccination would result in significant incremental epidemiological and economic benefits vs. the bivalent vaccination, driven primarily by prevention of genital. The present analysis is the first in the French setting to consider the impact of HPV vaccination on all HPV diseases and non-vaccine types. PMID:23563511

  6. A comparative analysis of the epidemiological impact and disease cost-savings of HPV vaccines in France.

    Science.gov (United States)

    Bresse, Xavier; Adam, Marjorie; Largeron, Nathalie; Roze, Stephane; Marty, Rémi

    2013-04-01

    The aim was to compare the epidemiological and economic impact of 16/18 bivalent and 6/11/16/18 quadrivalent HPV vaccination in France, considering differences in licensed outcomes, protection against non-vaccine HPV types and prevention of HPV-6/11-related diseases. The differential impact of the two vaccines was evaluated using a published model adapted to the French setting. The target population was females aged 14-23 y and the time horizon was 100 y. A total of eight different scenarios compared vaccination impact in terms of reduction in HPV-16/18-associated carcinomas (cervical, vulvar, vaginal, anal, penile and head and neck), HPV-6/11-related genital warts and recurrent respiratory papillomatosis, and incremental reduction in cervical cancer due to potential cross-protection. Quadrivalent vaccine was associated with total discounted cost savings ranging from EUR 544-1,020 million vs. EUR 177-538 million with the bivalent vaccination (100-y time horizon). Genital wart prevention thanks to quadrivalent HPV vaccination accounted for EUR 306-380 million savings (37-56% of costs saved). In contrast, the maximal assumed cross-protection against cervical cancer resulted in EUR 13-33 million savings (4%). Prevention of vulvar, vaginal and anal cancers accounted for additional EUR 71-89 million savings (13%). In France, the quadrivalent HPV vaccination would result in significant incremental epidemiological and economic benefits vs. the bivalent vaccination, driven primarily by prevention of genital. The present analysis is the first in the French setting to consider the impact of HPV vaccination on all HPV diseases and non-vaccine types.

  7. Water-saving interventions assessment framework: an application for the Urmia Lake Restoration Program

    Science.gov (United States)

    Shadkam, Somayeh; Oel, Pieter; Kabat, Pavel; Ludwig, Fulco

    2017-04-01

    Increasing water demand often results in unsustainable water use leaving insufficient amounts of water for sustaining natural environments. Therefore, to save natural resources water-saving interventions have been introduced to the environmental policy agenda in many (semi)-arid regions. Many policies, however, have failed reaching their objectives to increase water availability for the environment. This calls for a comprehensive tool to assess water-saving policies. Therefore, this study introduces a constructive framework to assess the policies by estimating five components: 1) Total water demand under socio-economic scenarios, 2) Water supply under climate change scenarios, 3) Water withdrawal for different sectors, 4) Water depletion and 5) Environmental flow. The framework, was applied to assess Urmia Lake Restoration Program (ULRP), which aims to restore the drying Urmia Lake in north-western Iran by increasing the lake inflow by 3.1×106m3yr-1. Results suggest that although the ULRP helps to increase inflow by up to 57% it is unlikely to fully reach its target. The analysis shows that there are three main reasons for the potential poor performance. The first reason is decreasing return flows due to increasing irrigation efficiency. This means that the expected increase in lake inflow volume is smaller than the volume saved by increasing irrigation efficiency. The second reason is increased depletion which is due to neglecting the fact that agricultural water demand is currently higher than available water for agriculture. As a result, increasing water use efficiency may result in increased water depletion. The third reason is ignoring the potential impact of climate change, which might decrease future water availability by 3% to 15%. Our analysis suggests that to reach the intervention target, measures need to focus on reducing Water demand and Water depletion rather than on reducing Water withdrawals. The assessment framework can be used to comprehensively

  8. 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...

  9. State-level evaluations of the Weatherization Assistance Program in 1990-1996: a metaevaluation that estimates national savings

    Energy Technology Data Exchange (ETDEWEB)

    Berry, L.

    1997-01-01

    The DOE Weatherization Assistance Program is one of the largest energy conservation programs in the nation. To obtain an updated estimate of national Program savings, an approach of metaevaluation was selected, which involved locating, assembling, and summarizing the results of all state-level evaluations of the Program that have become available since 1990. All of the savings estimates that are presented in this report are for dwellings that heat primarily with natural gas.This review of the state-level evaluations conducted since 1990 concluded that Program performance has improved significantly in the last seven years. The finding that savings are increasing are supported by a literature review, within-state comparisons of savings over time, and regression modeling results.

  10. 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

  11. 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.

  12. The cost-effectiveness of a successful community-based obesity prevention program: the be active eat well program.

    Science.gov (United States)

    Moodie, Marjory L; Herbert, Jessica K; de Silva-Sanigorski, Andrea M; Mavoa, Helen M; Keating, Catherine L; Carter, Robert C; Waters, Elizabeth; Gibbs, Lisa; Swinburn, Boyd A

    2013-10-01

    To examine the cost-effectiveness of Be Active Eat Well (BAEW), a large, multifaceted, community-based capacity-building demonstration program that promoted healthy eating and physical activity for Australian children aged 4-12 years between 2003 and 2006. A quasi-experimental, longitudinal design was used with anthropometric data collected at baseline (1001 children-intervention; 1183-comparator) and follow-up. A societal perspective was employed, with intervention resource use measured retrospectively based on process evaluation reports, school newsletters, reports, and key stakeholder interviews, and valued in 2006 Australian dollars (AUD). Outcomes were measured as Body Mass Index (BMI) units saved and Disability Adjusted Life Years (DALYs) averted over the predicted cohort lifetime, and reported as incremental cost-effectiveness ratios (with 95% uncertainty intervals). The intervention cost AUD0.34M ($0.31M; $0.38M) annually, and resulted in savings of 547 (-104; 1209) BMI units and 10.2 (-0.19; 21.6) DALYs. This translated to modest cost offsets of AUD27 311 (-$1803; $58 242) and a net cost per DALY saved of AUD29 798 (dominated; $0.26M). BAEW was affordable and cost-effective, and generated substantial spin-offs in terms of activity beyond funding levels. Elements fundamental to its success and any potential cost efficiencies associated with scaling-up now require identification. Copyright © 2013 The Obesity Society.

  13. Standardization: Hardware and Software Standardization Can Reduce Costs and Save Time

    Science.gov (United States)

    Brooks-Young, Susan

    2005-01-01

    Sadly, technical support doesn't come cheap. One money-saving strategy that's gained popularity among school technicians is equipment and software standardization. When it works, standardization can be very effective. However, standardization has its drawbacks. This article discusses the advantages and disadvantages of standardization.

  14. Prime focus architectures for large space telescopes: reduce surfaces to save cost

    Science.gov (United States)

    Breckinridge, J. B.; Lillie, C. F.

    2016-07-01

    Conceptual architectures are now being developed to identify future directions for post JWST large space telescope systems to operate in the UV Optical and near IR regions of the spectrum. Here we show that the cost of optical surfaces within large aperture telescope/instrument systems can exceed $100M/reflection when expressed in terms of the aperture increase needed to over come internal absorption loss. We recommend a program in innovative optical design to minimize the number of surfaces by considering multiple functions for mirrors. An example is given using the Rowland circle imaging spectrometer systems for UV space science. With few exceptions, current space telescope architectures are based on systems optimized for ground-based astronomy. Both HST and JWST are classical "Cassegrain" telescopes derived from the ground-based tradition to co-locate the massive primary mirror and the instruments at the same end of the metrology structure. This requirement derives from the dual need to minimize observatory dome size and cost in the presence of the Earth's 1-g gravitational field. Space telescopes, however function in the zero gravity of space and the 1- g constraint is relieved to the advantage of astronomers. Here we suggest that a prime focus large aperture telescope system in space may have potentially have higher transmittance, better pointing, improved thermal and structural control, less internal polarization and broader wavelength coverage than Cassegrain telescopes. An example is given showing how UV astronomy telescopes use single optical elements for multiple functions and therefore have a minimum number of reflections.

  15. Rotavirus diarrhea disease burden in Peru: the need for a rotavirus vaccine and its potential cost savings

    Directory of Open Access Journals (Sweden)

    Ehrenkranz Peter

    2001-01-01

    Full Text Available Objective. To assess the disease burden of rotavirus diarrhea in Peru as well the need for and the potential cost savings with a rotavirus vaccine in that country. Methods. To assess the burden of rotavirus diarrhea in Peru, we reviewed published and unpublished reports where rotavirus was sought as the etiologic agent of diarrhea in children. Rotavirus detection rates obtained from these studies were combined with diarrhea incidence rates from a number of national surveys in order to estimate both the burden of rotavirus diarrhea in the country and its associated medical costs. Results. Rotavirus is a significant cause of morbidity and mortality in Peruvian children. In their first 5 years of life, an estimated 1 in 1.6 children will experience an episode of rotavirus diarrhea, 1 in 9.4 will seek medical care, 1 in 19.7 will require hospitalization, and 1 in 375 will die of the disease. Per year, this represents approximately 384 000 cases, 64 000 clinic visits, 30 000 hospitalizations, and 1 600 deaths. The annual cost of medical care alone for these children is approximately US$ 2.6 million--and that does not take into account the indirect or societal costs of the illness and the deaths. Conclusions. Rotavirus immunization provides the prospect of decreasing the morbidity and mortality from diarrhea in Peru, but a vaccine regimen would have to be relatively inexpensive, a few dollars or less per child. Future cost-effectiveness analyses should explore the total costs (medical as well as indirect or societal associated with rotavirus diarrhea. Newly licensed vaccines should be tested according to both their ability to avert deaths and their efficacy with fewer than three doses. All three of these factors could increase the cost savings associated with a rotavirus vaccine.

  16. Rotavirus diarrhea disease burden in Peru: the need for a rotavirus vaccine and its potential cost savings

    Directory of Open Access Journals (Sweden)

    Peter Ehrenkranz

    2001-10-01

    Full Text Available Objective. To assess the disease burden of rotavirus diarrhea in Peru as well the need for and the potential cost savings with a rotavirus vaccine in that country. Methods. To assess the burden of rotavirus diarrhea in Peru, we reviewed published and unpublished reports where rotavirus was sought as the etiologic agent of diarrhea in children. Rotavirus detection rates obtained from these studies were combined with diarrhea incidence rates from a number of national surveys in order to estimate both the burden of rotavirus diarrhea in the country and its associated medical costs. Results. Rotavirus is a significant cause of morbidity and mortality in Peruvian children. In their first 5 years of life, an estimated 1 in 1.6 children will experience an episode of rotavirus diarrhea, 1 in 9.4 will seek medical care, 1 in 19.7 will require hospitalization, and 1 in 375 will die of the disease. Per year, this represents approximately 384 000 cases, 64 000 clinic visits, 30 000 hospitalizations, and 1 600 deaths. The annual cost of medical care alone for these children is approximately US$ 2.6 million--and that does not take into account the indirect or societal costs of the illness and the deaths. Conclusions. Rotavirus immunization provides the prospect of decreasing the morbidity and mortality from diarrhea in Peru, but a vaccine regimen would have to be relatively inexpensive, a few dollars or less per child. Future cost-effectiveness analyses should explore the total costs (medical as well as indirect or societal associated with rotavirus diarrhea. Newly licensed vaccines should be tested according to both their ability to avert deaths and their efficacy with fewer than three doses. All three of these factors could increase the cost savings associated with a rotavirus vaccine.

  17. 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.

  18. 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.

  19. Low-cost, highly transparent flexible low-e coating film to enable electrochromic windows with increased energy savings

    Energy Technology Data Exchange (ETDEWEB)

    Berland, Brian [ITN Energy Systems, Inc., Littleton, CO (United States); Hollingsworth, Russell [ITN Energy Systems, Inc., Littleton, CO (United States)

    2015-03-31

    Five Quads of energy are lost through windows annually in the U.S. Low-e coatings are increasingly employed to reduce the wasted energy. Most commonly, the low-e coating is an oxide material applied directly to the glass at high temperature. With over 100,000,000 existing homes, a retrofit product is crucial to achieve widespread energy savings. Low-e films, i.e. coatings on polymeric substrates, are now also available to meet this need. However, the traditional oxide materials and process is incompatible with low temperature plastics. Alternate high performing low-e films typically incorporate materials that limit visible transmission to 35% or less. Further, the cost is high. The objective of this award was to develop a retrofit, integrated low-e/electrochromic window film to dramatically reduce energy lost through windows. While field testing of state-of-the-art electrochromic (EC) windows show the energy savings are maximized if a low-e coating is used in conjunction with the EC, available low-e films have a low visible transmission (~70% or less) that limits the achievable clear state and therefore, appearance and energy savings potential. Comprehensive energy savings models were completed at Lawrence Berkeley National Lab (LBNL). A parametric approach was used to project energy usage for windows with a large range of low-e properties across all U.S. climate zones, without limiting the study to materials that had already been produced commercially or made in a lab. The model enables projection of energy savings for low-e films as well as integrated low-e/EC products. This project developed a novel low-e film, optimized for compatibility with EC windows, using low temperature, high deposition rate processes for the growth of low-e coatings on plastic films by microwave plasma enhanced chemical vapor deposition. Silica films with good density and optical properties were demonstrated at deposition rates as high as 130Å/sec. A simple bi-layer low-e stack of

  20. ResStock - Targeting Energy and Cost Savings for U.S. Homes

    Energy Technology Data Exchange (ETDEWEB)

    Wilson, Eric J [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2017-09-29

    The ResStock analysis tool is helping states, municipalities, utilities, and manufacturers identify which home upgrades save the most energy and money. Across the country there's a vast diversity in the age, size, construction practices, installed equipment, appliances, and resident behavior of the housing stock, not to mention the range of climates. These variations have hindered the accuracy of predicting savings for existing homes. Researchers at the National Renewable Energy Laboratory (NREL) developed ResStock. It's a versatile tool that takes a new approach to large-scale residential energy analysis by combining: large public and private data sources, statistical sampling, detailed subhourly building simulations, high-performance computing. This combination achieves unprecedented granularity and most importantly - accuracy - in modeling the diversity of the single-family housing stock.

  1. 5 case studies : boiler system increases availability of hot water in CAP REIT apartment buildings while saving energy : electric-to-gas retrofit drives down energy costs and improves building performance : Novitherm heat reflector panels saves 28 per cent in heating costs for apartment building : Novitherm heat reflector panel installation with system adjustment saves 33.2 per cent in energy costs : natural gas conversion saves over $315,000 a year for condominium

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2010-07-01

    These 5 case studies presented the details of new systems and retrofits conducted by Enbridge Gas Distribution and its partners to improve the energy efficiency of various public and residential buildings. System retrofits included the installation of boiler system installed to address tenant demands on the domestic hot water systems of properties purchased purchased by the CAP REIT organization. The comprehensive program used to address the problems included replacement of the systems with high efficiency heating boilers designed to integrate space, hot water, ramp, and pool heat. A centralized controller included setback control, trend-following processors, and the isolation of heating equipment. The second case study described an electric-to-gas conversion of a make-up air unit and boiler system at an all-electric apartment building. The system was designed to address excessive air handling and water heating costs. The gas conversion included new heating and hot water boilers, as well as a number of efficiency upgrades. The third and fourth case study described the installation of Novitherm heat reflector panels at apartment buildings in Toronto. The fifth case study described a natural gas conversion project conducted at a luxury condominium. Energy savings for all 5 projects were presented. 9 figs.

  2. 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

  3. Network unites payers, physicians, hospitals. System participants work together to improve access to care and to design cost-saving incentives.

    Science.gov (United States)

    Cassidy, J

    1993-05-01

    Through Sacred Heart Health System (SHHS), Eugene, OR, physicians, payers, and hospitals are designing a network that will integrate care and improve access by reducing healthcare costs. Together, system members design cost-saving incentives and the products the system offers the community. They promote managed care as the most efficient means to coordinate care and reduce costs. All participants share in the risks of a capitated payment system. Since the system pulled together the payers, physician groups, and hospitals, many of these entities' management functions were consolidated at the system level to avoid duplication and reduce administrative costs. Bringing in physicians was the most difficult yet important aspect of forming a successful network. Working with two physician groups in the community, the system's sponsor-the Sisters of St. Joseph of Peace, Health and Hospital Services-developed the Physician Practice Board. The board, representing 300 physicians, meets weekly and makes recommendations on issues that affect physicians. SHHS also added innovative new functions such as an integrated medical cost management and continuous quality improvement program. Another key to success is a clinically oriented information system, which will allow the system to track patients once they leave the hospital. It also will provide a better understanding of what things have an impact on outcomes and will reduce paperwork. A portion of the system's revenue is designated for initiatives to improve access. And the system recently appointed a tack force on access to explore what they can do in cooperation with others in the community.

  4. Can a transitional work grant program in a workers' compensation system reduce cost and facilitate return to work?

    Science.gov (United States)

    Dunning, K K; Davis, K G; Kotowski, S E; Elliott, T; Jewell, G; Lockey, J

    2008-09-01

    Although previous research has shown returning the injured worker to work as soon as possible is important to the long-term prospects of the worker remaining in the work force, there is limited economic support for implementing such programs. Thus, the purpose of this case control study was to determine the cost savings of the implementation of a Transitional Work Grant (TWG) program, which consisted of several components including job analyses, education, communication and transitional work (TW). Companies that enrolled in the TWG program were matched to nonparticipating companies (NTW) based on employer size, type of industry, number of overall claims, and number of claims with > 7 days lost time (LT claims) submitted the year prior to enrollment. The study analyzed economic data: number of claims, number of LT claims, indemnity costs, medical costs, and days lost (days away from the workplace). An additional outcome was the ratio of LT claims (> 7 days lost work) to medical only (MO) claims (LT/MO ratio). Overall, participation in the TWG program was associated with decreased indemnity cost and decreased LT/MO ratio. However, effectiveness of the program varied by employer size and industry. In terms of the state of Ohio, these costs translate into substantial savings: more than $2.3 million per year. Although the cost savings and reduction in lost time claims is encouraging, the true benefit of TW has yet to be completely quantified. Future work must account for other potential co-factors and programs that could also contribute to the savings as well as document further the indirect benefits associated with a TWG program, such as improved employee morale and increased productivity and product quality that could be four times greater than the direct savings. In summary, programs such as this one adopted by several companies in Ohio can reduce the cost burden of injuries.

  5. Evaluation of the cost saving potential of introducing Benepali® and Flixabi® on the European and Italian markets

    Directory of Open Access Journals (Sweden)

    Cristina Negrini

    2017-10-01

    CONCLUSIONS: The introduction of Benepali® and Flixabi® has a substantial cost saving potential for the Italian and European health systems, and the budget impact is sensitive to the uptake rates of the biosimilars market.

  6. Shared Savings Financing for College and University Energy Efficiency Investments.

    Science.gov (United States)

    Business Officer, 1984

    1984-01-01

    Shared savings arrangements for campus energy efficient investments are discussed. Shared savings is a term for an agreement in which a private company offers to implement an energy efficiency program, including capital improvements, in exchange for a portion of the energy cost savings. Attention is directed to: types of shared savings…

  7. Insights from Smart Meters: Identifying Specific Actions, Behaviors, and Characteristics That Drive Savings in Behavior-Based Programs

    Energy Technology Data Exchange (ETDEWEB)

    Todd, A. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Perry, M. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Smith, B. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Sullivan, M. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Cappers, P. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Goldman, C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2014-12-01

    In this report, we use smart meter data to analyze specific actions, behaviors, and characteristics that drive energy savings in a BB program. Specifically, we examine a Home Energy Report (HER) program. These programs typically obtain 1% to 3% annual savings, and recent studies have shown hourly savings of between 0.5% and 3%.1 But what is driving these savings? What types of households tend to be “high-savers,” and what behaviors are they adopting? There are several possibilities: one-time behaviors (e.g., changing thermostat settings), reoccurring habitual behaviors (e.g., turning off lights), and equipment purchase behaviors (e.g., energy efficient appliances); these may vary across households, regions, and over time.

  8. Insights from Smart Meters. Identifying Specific Actions, Behaviors and Characteristics that drive savings in Behavior-Based Programs

    Energy Technology Data Exchange (ETDEWEB)

    Todd, Annika [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Perry, Michael [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Smith, Brian [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Pacific Gas & Electric, San Francisco, CA (United States); Sullivan, Michael [Nexant, San Francisco, CA (United States); Cappers, Peter [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Goldman, Charles A. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2014-12-01

    In this report, we use smart meter data to analyze specific actions, behaviors, and characteristics that drive energy savings in a behavior-based (BB) program. Specifically, we examine a Home Energy Report (HER) program. These programs typically obtain 1% to 3% annual savings, and recent studies have shown hourly savings of between 0.5% and 3%. But what is driving these savings? What types of households tend to be “high-savers”, and what behaviors are they adopting? There are several possibilities: one-time behaviors (e.g., changing thermostat settings); reoccurring habitual behaviors (e.g., turning off lights); and equipment purchase behaviors (e.g., energy efficient appliances), and these may vary across households, regions, and over time.

  9. Estimating health care cost savings from an educational intervention to prevent bleeding-related complications: the outcomes impact analysis model.

    Science.gov (United States)

    Ravyn, Dana; Ravyn, Vipa; Lowney, Rob; Ferraris, Victor

    2014-01-01

    Investments in continuing medical education (CME) exceed $2 billion annually, but few studies report the economic impact of CME activities. Analysis of patient-level economic outcomes data is often not feasible. Accordingly, we developed a model to illustrate estimation of the potential economic impact associated with CME activity outcomes. Outcomes impact analysis demonstrated how costs averted from a CME symposium that promoted prevention of bleeding-related complications (BRC) and reoperation for bleeding (RFB) in cardiac and thoracic operations could be estimated. Model parameter estimates were from published studies of costs associated with BRC and RFB. Operative volume estimates came from the Society of Thoracic Surgeons workforce data. The base case predicted 3 in 10 participants preventing one BRC or RFB in 2% or 1.5% of annual operations, respectively. Probabilistic sensitivity analysis (PSA) evaluated the effect of parameter uncertainty. 92% of participants (n = 133) self-reported commitment to change, a validated measure of behavior change. For BRC, estimates for costs averted were $1,502,769 (95% confidence interval [CI], $869,860-$2,359,068) for cardiac operations and $2,715,246 (95% CI, $1,590,308-$4,217,092) for thoracic operations. For RFB, the savings estimates were $2,233,988 (95% CI, $1,223,901-$3,648,719). Our economic model demonstrates that application of CME-related learning to prevent bleeding complications may yield substantial cost savings. Model prediction of averted costs associated with CME allows estimation of the economic impact on outcomes in the absence of patient-level outcomes data related to CME activities. © 2014 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education.

  10. Sustained Energy Savings Achieved through Successful Industrial Customer Interaction with Ratepayer Programs: Case Studies

    Energy Technology Data Exchange (ETDEWEB)

    Goldberg, Amelie [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Hedman, Bruce [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Taylor, Robert P. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Russell, Christopher [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2015-10-01

    Many states have implemented ratepayer-funded programs to acquire energy efficiency as a predictable and reliable resource for meeting existing and future energy demand. These programs have become a fixture in many U.S. electricity and natural gas markets as they help postpone or eliminate the need for expensive generation and transmission investments. Industrial energy efficiency (IEE) is an energy efficiency resource that is not only a low cost option for many of these efficiency programs, but offers productivity and competitive benefits to manufacturers as it reduces their energy costs. However, some industrial customers are less enthusiastic about participating in these programs. IEE ratepayer programs suffer low participation by industries across many states today despite a continual increase in energy efficiency program spending across all types of customers, and significant energy efficiency funds can often go unused for industrial customers. This paper provides four detailed case studies of companies that benefited from participation in their utility’s energy efficiency program offerings and highlights the business value brought to them by participation in these programs. The paper is designed both for rate-payer efficiency program administrators interested in improving the attractiveness and effectiveness of industrial efficiency programs for their industrial customers and for industrial customers interested in maximizing the value of participating in efficiency programs.

  11. 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.

  12. Cost-Savings Achieved in Two Semesters through the Adoption of Open Educational Resources

    Science.gov (United States)

    Hilton, John Levi, III; Robinson, Jared; Wiley, David; Ackerman, J. Dale

    2014-01-01

    Textbooks represent a significant portion of the overall cost of higher education in the United States. The burden of these costs is typically shouldered by students, those who support them, and the taxpayers who fund the grants and student loans which pay for textbooks. Open educational resources (OER) provide students a way to receive…

  13. "Dial-an-ROI?" changing basic variables impacts cost trends in single-population pre-post ("DMAA type") savings analysis.

    Science.gov (United States)

    Juster, Iver A; Rosenberg, Stephen N; Senapati, Deeptimayee; Shah, Mayur R

    2009-02-01

    Disease management (DM) programs claim to achieve cost savings by reducing clinical adverse events. While measuring changes in adverse events is straightforward, plausibly demonstrating savings has been contentious, especially absent an external comparison population. In this situation, a single-population methodology is often used, in which the cost trend for those with no program conditions ("non-chronics"--NC) forms the expected trend for those who have at least 1 program condition ("chronics"--C). The methodology's fundamental assumption is that--absent DM--C and NC trends would be identical (or bear a constant relationship over time). We assessed this assumption by altering the values of key variables used to identify C and NC, and to calculate trend. We compared C and NC baseline trends for a 23-condition telephonic DM multiemployer program representing nearly 300,000 members. Trends were calculated for 16 combinations of values for 4 key variables: identification look-back frame (12 vs. 24 months); identification threshold (high vs. lower specificity); claims runout (3 vs. 6 months); and minimum required insurance eligibility (any 6 months vs. 12 months continuous eligibility in the measurement year). Identification was performed by annual qualification. Changes in values for the 4 key variables markedly impacted baseline C and NC trends. C trends varied between 10.1% and 13.1%; NC trends between 5.2% and 12.8%. C-NC trend differences ranged between -1.9% and +7.0%. The combination of 24 months identification look-back, high identification threshold, 6 months runout, and any-6-months eligibility gave the most convergent C and NC trends (10.4% and 10.7%). Seemingly minor changes in key variables impact C and NC trends in single-population pre-post DM savings methodologies. When a suitable comparison population is not available, at least 1 year of baseline C and NC trends should be reported-as recommended by the DMAA--and values of key variables used should be

  14. The health gains and cost savings of dietary salt reduction interventions, with equity and age distributional aspects

    Directory of Open Access Journals (Sweden)

    Nhung Nghiem

    2016-05-01

    Full Text Available Abstract Background A “diet high in sodium” is the second most important dietary risk factor for health loss identified in the Global Burden of Disease Study 2013. We therefore aimed to model health gains and costs (savings of salt reduction interventions related to salt substitution and maximum levels in bread, including by ethnicity and age. We also ranked these four interventions compared to eight other modelled interventions. Methods A Markov macro-simulation model was used to estimate QALYs gained and net health system costs for four dietary sodium reduction interventions, discounted at 3 % per annum. The setting was New Zealand (NZ (2.3 million adults, aged 35+ years which has detailed individual-level administrative cost data. Results The health gain was greatest for an intervention where most (59 % of the sodium in processed foods was replaced by potassium and magnesium salts. This intervention gained 294,000 QALYs over the remaining lifetime of the cohort (95 % UI: 238,000 to 359,000; 0.13 QALY per 35+ year old. Such salt substitution also produced the highest net cost-savings of NZ$ 1.5 billion (US$ 1.0 billion (95 % UI: NZ$ 1.1 to 2.0 billion. All interventions generated relatively larger per capita QALYs for men vs women and for the indigenous Māori population vs non-Māori (e.g., 0.16 vs 0.12 QALYs per adult for the 59 % salt substitution intervention. Of relevance to workforce productivity, in the first 10 years post-intervention, 22 % of the QALY gain was among those aged <65 years (and 37 % for those aged <70. Conclusions The benefits are consistent with the international literature, with large health gains and cost savings possible from some, but not all, sodium reduction interventions. Health gain appears likely to occur among working-age adults and all interventions contributed to reducing health inequalities.

  15. Palliative Care Teams’ Cost-Saving Effect Is Larger For Cancer Patients With Higher Numbers Of Comorbidities

    Science.gov (United States)

    May, Peter; Garrido, Melissa M.; Cassel, J. Brian; Kelley, Amy S.; Meier, Diane E.; Normand, Charles; Stefanis, Lee; Smith, Thomas J.; Morrison, R. Sean

    2016-01-01

    Patients with multiple serious conditions account for a high proportion of health care spending. Such spending is projected to continue to grow substantially because of increased insurance eligibility, the ever-rising cost of care, the continued use of nonbeneficial high-intensity treatments at the end of life, and demographic changes. We evaluated the impact of palliative care consultation on hospital costs for adults with advanced cancer, excluding those with dementia. We found that compared to usual care, the receipt of a palliative care consultation within two days of admission was associated with 22 percent lower costs for patients with a comorbidity score of 2–3 and with 32 percent lower costs for those with a score of 4 or higher. Earlier consultation was also found to be systematically associated with a larger cost-saving effect for all subsamples defined by multimorbidity. Given ongoing workforce shortages, targeting early specialist palliative care to hospitalized patients with advanced cancer and higher numbers of serious concurrent conditions could improve care while complementing strategies to curb the growth of health spending. PMID:26733700

  16. Energy Efficiency Improvement and Cost Saving Opportunities for Cement Making. An ENERGY STAR Guide for Energy and Plant Managers

    Energy Technology Data Exchange (ETDEWEB)

    Galitsky, Christina; Worrell, Ernst; Galitsky, Christina

    2008-01-01

    The cost of energy as part of the total production costs in the cement industry is significant, warranting attention for energy efficiency to improve the bottom line. Historically, energy intensity has declined, although more recently energy intensity seems to have stabilized with the gains. Coal and coke are currently the primary fuels for the sector, supplanting the dominance of natural gas in the 1970s. Most recently, there is a slight increase in the use of waste fuels, including tires. Between 1970 and 1999, primary physical energy intensity for cement production dropped 1 percent/year from 7.3 MBtu/short ton to 5.3 MBtu/short ton. Carbon dioxide intensity due to fuel consumption and raw material calcination dropped 16 percent, from 609 lb. C/ton of cement (0.31 tC/tonne) to 510 lb. C/ton cement (0.26 tC/tonne). Despite the historic progress, there is ample room for energy efficiency improvement. The relatively high share of wet-process plants (25 percent of clinker production in 1999 in the U.S.) suggests the existence of a considerable potential, when compared to other industrialized countries. We examined over 40 energy efficient technologies and measures and estimated energy savings, carbon dioxide savings, investment costs, and operation and maintenance costs for each of the measures. The report describes the measures and experiences of cement plants around the wold with these practices and technologies. Substantial potential for energy efficiency improvement exists in the cement industry and in individual plants. A portion of this potential will be achieved as part of (natural) modernization and expansion of existing facilities, as well as construction of new plants in particular regions. Still, a relatively large potential for improved energy management practices exists.

  17. Impact of five years of rotavirus vaccination in Finland - And the associated cost savings in secondary healthcare.

    Science.gov (United States)

    Leino, Tuija; Baum, Ulrike; Scott, Peter; Ollgren, Jukka; Salo, Heini

    2017-10-09

    This study aimed to estimate the impact of the national rotavirus (RV) vaccination programme, starting 2009, on the total hospital-treated acute gastroenteritis (AGE) and severe RV disease burden in Finland during the first five years of the programme. This study also evaluated the costs saved in secondary healthcare by the RV vaccination programme. The RV related outcome definitions were based on ICD10 diagnostic codes recorded in the Care Register for Health Care. Incidences of hospitalised and hospital outpatient cases of AGE (A00-A09, R11) and RVGE (A08.0) were compared prior (1999-2005) and after (2010-2014) the start of the programme among children less than five years of age. The reduction in disease burden in 2014, when all children under five years of age have been eligible for RV vaccination, was 92.9% (95%CI: 91.0%-94.5%) in hospitalised RVGE and 68.5% (66.6%-70.3%) in the total hospitalised AGE among children less than five years of age. For the corresponding hospital outpatient cases, there was a reduction of 91.4% (82.4%-96.6%) in the RVGE incidence, but an increase of 6.3% (2.7%-9.9%) in the AGE incidence. The RV vaccination programme prevented 2206 secondary healthcare AGE cases costing €4.5 million annually. As the RV immunisation costs were €2.3 million, the total net savings just in secondary healthcare costs were €2.2 million, i.e. €33 per vaccinated child. The RV vaccination programme clearly controlled the severe, hospital-treated forms of RVGE. The total disease burden is a more valuable end point than mere specifically diagnosed cases as laboratory confirmation practises usually change after vaccine introduction. The RV vaccination programme annually pays for itself at least two times over. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  18. Health and Environmental Benefits from the Implementation of an Energy Saving Program in Hungary

    Energy Technology Data Exchange (ETDEWEB)

    Aunan, Kristin; Patzay, Gyoergy

    1997-12-31

    This report studies the cost and benefit of implementing a specific energy conservation programme in Hungary. It considers the possible reduction in damage to public health, materials and crops that may be obtained by reducing the emission of important air pollutants and examines how the programme contributes to reduced emission of greenhouse gases. The measures are described in the National Energy Efficiency Improvement and Energy Conservation Programmes (NEEIECP), a programme elaborated by the Hungarian Ministry of Industry and Trade and accepted by the Government in 1994. The energy saving expected from the programme is about 64 PJ/year. Possible benefits were estimated by the use of monitoring data and population and recipient data from urban and rural areas in Hungary together with dose response functions and valuation estimates mainly from western studies. The main benefits of reducing the concentration of pollutants are found in the health sector, the most pronounced effect being less chronic respiratory deceases. Reduced premature mortality is also important. It is calculated that the annual benefit on public health alone probably exceeds the implementation costs of the programme. In addition, the maintenance and replacement costs for building materials have decreased. The damage to crops due to ozone is large, but a significant improvement in Hungary depends upon concerted action in several countries. 68 refs., 9 figs., 14 tabs.

  19. Development of a budget-impact model to quantify potential cost savings from prescription opioids designed to deter abuse or ease of extraction.

    Science.gov (United States)

    White, Alan G; Birnbaum, Howard G; Rothman, Dov B; Katz, Nathaniel

    2009-01-01

    Prescription opioid (RxO) abuse, dependence and misuse is a significant and growing problem in the US, and is associated with a substantial economic burden. Such abuse may be reduced by theoretical formulations that minimize the possibility of abuse, dependence and misuse of RxOs by injection, snorting, crushing or chewing. As well as public health and safety benefits, use of an abuse-deterrent/resistant RxO (ADO) that may deter abuse, dependence and misuse could also generate cost savings. To estimate potential annual cost savings to US third-party payers realized from introducing a theoretical ADO. A budget-impact model (BIM) was developed to assess potential cost savings from the introduction of an ADO to third-party payers. The BIM included information on ADO attributes, costs associated with RxO abuse-related episodes, prevalence of RxO abuse and potential market share capture of the new ADO. Numbers of abuse-related episodes were calculated using a database on admissions to substance abuse treatment centres and other national surveys. Direct (medical and pharmaceutical) costs associated with RxO abuse, dependence and misuse were calculated using de-identified employer claims data (n > 6 000 000) for costs of abuse-related episodes. All cost estimates are in $US, year 2006 values. The BIM was developed for a theoretical prescription drug with therapeutic properties similar to those of controlled-release oxycodone, in a formulation that is specifically designed to resist or deter common methods of abuse, including injection, crushing, snorting and chewing. Potential cost savings to third-party payers from introducing an ADO for the US (assuming a privately insured cost structure) could range from approximately $US0.6 billion to $US1.6 billion per year depending on different possible scenarios. While savings estimates from introduction of an ADO depend on a range of assumptions, cost savings would be substantial.

  20. Designing Rainwater Harvesting Systems Cost-Effectively in a Urban Water-Energy Saving Scheme by Using a GIS-Simulation Based Design System

    Directory of Open Access Journals (Sweden)

    Yie-Ru Chiu

    2015-11-01

    Full Text Available Current centralized urban water supply depends largely on energy consumption, creating critical water-energy challenge especially for many rapid growing Asian cities. In this context, harvesting rooftop rainwater for non-potable use has enormous potential to ease the worsening water-energy issue. For this, we propose a geographic information system (GIS-simulation-based design system (GSBDS to explore how rainwater harvesting systems (RWHSs can be systematically and cost-effectively designed as an innovative water-energy conservation scheme on a city scale. This GSBDS integrated a rainfall data base, water balance model, spatial technologies, energy-saving investigation, and economic feasibility analysis based on a case study of eight communities in the Taipei metropolitan area, Taiwan. Addressing both the temporal and spatial variations in rainfall, the GSBDS enhanced the broad application of RWHS evaluations. The results indicate that the scheme is feasible based on the optimal design when both water and energy-savings are evaluated. RWHSs were observed to be cost-effective and facilitated 21.6% domestic water-use savings, and 138.6 (kWh/year-family energy-savings. Furthermore, the cost of per unit-energy-saving is lower than that from solar PV systems in 85% of the RWHS settings. Hence, RWHSs not only enable water-savings, but are also an alternative renewable energy-saving approach that can address the water-energy dilemma caused by rapid urbanization.

  1. 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.

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

    Directory of Open Access Journals (Sweden)

    Corinna Vossius

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

  3. Insights from Smart Meters: The Potential for Peak-Hour Savings from Behavior-Based Programs

    Energy Technology Data Exchange (ETDEWEB)

    Todd, Annika; Perry, Michael; Smith, Brian; Sullivan, Michael; Cappers, Peter; Goldman, Charles

    2014-03-25

    The rollout of smart meters in the last several years has opened up new forms of previously unavailable energy data. Many utilities are now able in real-time to capture granular, household level interval usage data at very high-frequency levels for a large proportion of their residential and small commercial customer population. This can be linked to other time and locationspecific information, providing vast, constantly growing streams of rich data (sometimes referred to by the recently popular buzz word, “big data”). Within the energy industry there is increasing interest in tapping into the opportunities that these data can provide. What can we do with all of these data? The richness and granularity of these data enable many types of creative and cutting-edge analytics. Technically sophisticated and rigorous statistical techniques can be used to pull interesting insights out of this highfrequency, human-focused data. We at LBNL are calling this “behavior analytics”. This kind of analytics has the potential to provide tremendous value to a wide range of energy programs. For example, highly disaggregated and heterogeneous information about actual energy use would allow energy efficiency (EE) and/or demand response (DR) program implementers to target specific programs to specific households; would enable evaluation, measurement and verification (EM&V) of energy efficiency programs to be performed on a much shorter time horizon than was previously possible; and would provide better insights in to the energy and peak hour savings associated with specifics types of EE and DR programs (e.g., behavior-based (BB) programs). In this series, “Insights from Smart Meters”, we will present concrete, illustrative examples of the type of value that insights from behavior analytics of these data can provide (as well as pointing out its limitations). We will supply several types of key findings, including: • Novel results, which answer questions the industry

  4. Interactive internet-based clinical education: an efficient and cost-savings approach to point-of-care test training.

    Science.gov (United States)

    Knapp, Herschel; Chan, Kee; Anaya, Henry D; Goetz, Matthew B

    2011-06-01

    We successfully created and implemented an effective HIV rapid testing training and certification curriculum using traditional in-person training at multiple sites within the U.S. Department of Veterans Affairs (VA) Healthcare System. Considering the multitude of geographically remote facilities in the nationwide VA system, coupled with the expansion of HIV diagnostics, we developed an alternate training method that is affordable, efficient, and effective. Using materials initially developed for in-person HIV rapid test in-services, we used a distance learning model to offer this training via live audiovisual online technology to educate clinicians at a remote outpatient primary care VA facility. Participants' evaluation metrics showed that this form of remote education is equivalent to in-person training; additionally, HIV testing rates increased considerably in the months following this intervention. Although there is a one-time setup cost associated with this remote training protocol, there is potential cost savings associated with the point-of-care nurse manager's time productivity by using the Internet in-service learning module for teaching HIV rapid testing. If additional in-service training modules are developed into Internet-based format, there is the potential for additional cost savings. Our cost analysis demonstrates that the remote in-service method provides a more affordable and efficient alternative compared with in-person training. The online in-service provided training that was equivalent to in-person sessions based on first-hand supervisor observation, participant satisfaction surveys, and follow-up results. This method saves time and money, requires fewer personnel, and affords access to expert trainers regardless of geographic location. Further, it is generalizable to training beyond HIV rapid testing. Based on these consistent implementation successes, we plan to expand use of online training to include remote VA satellite facilities spanning

  5. Energy Efficiency Improvement and Cost Saving Opportunities for the Vehicle Assembly Industry: An ENERGY STAR Guide for Energy and Plant Managers

    Energy Technology Data Exchange (ETDEWEB)

    Galitsky, Christina; Galitsky, Christina; Worrell, Ernst

    2008-01-01

    The motor vehicle industry in the U.S. spends about $3.6 billion on energy annually. In this report, we focus on auto assembly plants. In the U.S., over 70 assembly plants currently produce 13 million cars and trucks each year. In assembly plants, energy expenditures is a relatively small cost factor in the total production process. Still, as manufacturers face an increasingly competitive environment, energy efficiency improvements can provide a means to reduce costs without negatively affecting the yield or the quality of the product. In addition, reducing energy costs reduces the unpredictability associated with variable energy prices in today?s marketplace, which could negatively affect predictable earnings, an important element for publicly-traded companies such as those in the motor vehicle industry. In this report, we first present a summary of the motor vehicle assembly process and energy use. This is followed by a discussion of energy efficiency opportunities available for assembly plants. Where available, we provide specific primary energy savings for each energy efficiency measure based on case studies, as well as references to technical literature. If available, we have listed costs and typical payback periods. We include experiences of assembly plants worldwide with energy efficiency measures reviewed in the report. Our findings suggest that although most motor vehicle companies in the U.S. have energy management teams or programs, there are still opportunities available at individual plants to reduce energy consumption cost effectively. Further research on the economics of the measures for individual assembly plants, as part of an energy management program, is needed to assess the potential impact of selected technologies at these plants.

  6. Electricity savings among participants three years after weatherization in Bonneville's 1986 residential weatherization program

    Energy Technology Data Exchange (ETDEWEB)

    White, D.L.; Brown, M.A.

    1990-09-01

    To ensure proper assessment of its weatherization activities, the Bonneville Power Administration (Bonneville) has examined several cohorts of participants in various phases of its Long-Term Residential Weatherization Program (Long-Term RWP). Beginning in 1980, energy savings one, two, and three years after program participation have been evaluated. This study, which continues the series of Bonneville's ongoing evaluation of weatherization activities, examines electricity savings three years after weatherization in the 1986 Long-Term RWP. Electricity bills were weather-adjusted using the Princeton Scorekeeping Method (PRISM). Normalized Annual Consumption (NAC) was calculated for each participant and control household for which data were available. Gross energy savings were calculated by subtracting a household's NAC for each postretrofit year (1986--87, 1986--88, and 1988--89) from its preretrofit NAC (1985--86). Household level data were aggregated and examined at the utility level allowing the calculation of average net savings, which is the difference between gross savings by nonparticipants and participants. Utility-level data were then weighted, based on the extent of each utility's participation in the Long-Term RWP in 1986, to allow the identification of overall program savings. 29 refs., 5 figs., 14 tabs.

  7. Energy Efficiency Improvement and Cost Saving Opportunities for Breweries: An ENERGY STAR(R) Guide for Energy and Plant Managers

    Energy Technology Data Exchange (ETDEWEB)

    Galitsky, Christina; Martin, Nathan; Worrell, Ernst; Lehman, Bryan

    2003-09-01

    Annually, breweries in the United States spend over $200 million on energy. Energy consumption is equal to 38 percent of the production costs of beer, making energy efficiency improvement an important way to reduce costs, especially in times of high energy price volatility. After a summary of the beer making process and energy use, we examine energy efficiency opportunities available for breweries. We provide specific primary energy savings for each energy efficiency measure based on case studies that have implemented the measures, as well as references to technical literature. If available, we have also listed typical payback periods. Our findings suggest that given available technology, there are still opportunities to reduce energy consumption cost-effectively in the brewing industry. Brewers value highly the quality, taste and drinkability of their beer. Brewing companies have and are expected to continue to spend capital on cost-effective energy conservation measures that meet these quality, taste and drinkability requirements. For individual plants, further research on the economics of the measures, as well as their applicability to different brewing practices, is needed to assess implementation of selected technologies.

  8. Energy Efficiency Improvement and Cost Saving Opportunities for the Pharmaceutical Industry. An ENERGY STAR Guide for Energy and Plant Managers

    Energy Technology Data Exchange (ETDEWEB)

    Galitsky, Christina; Galitsky, Christina; Chang, Sheng-chieh; Worrell, Ernst; Masanet, Eric

    2008-03-01

    The U.S. pharmaceutical industry consumes almost $1 billion in energy annually. Energy efficiency improvement is an important way to reduce these costs and to increase predictable earnings, especially in times of high energy price volatility. There are a variety of opportunities available at individual plants in the U.S. pharmaceutical industry to reduce energy consumption in a cost-effective manner. This Energy Guide discusses energy efficiency practices and energy efficient technologies that can be implemented at the component, process, system, and organizational levels. A discussion of the trends, structure, and energy consumption characteristics of the U.S. pharmaceutical industry is provided along with a description of the major process steps in the pharmaceutical manufacturing process. Expected savings in energy and energy-related costs are given for many energy efficiency measures, based on case study data from real-world applications in pharmaceutical and related facilities worldwide. Typical measure payback periods and references to further information in the technical literature are also provided, when available. The information in this Energy Guide is intended to help energy and plant managers reduce energy consumption in a cost-effective manner while meeting regulatory requirements and maintaining the quality of products manufactured. At individual plants, further research on the economics of the measures?as well as their applicability to different production practices?is needed to assess potential implementation of selected technologies.

  9. Evaluating C-RAN Fronthaul Functional Splits in Terms of Network Level Energy and Cost Savings

    DEFF Research Database (Denmark)

    Checko, Aleksandra; Popovska Avramova, Andrijana; Berger, Michael Stübert

    2016-01-01

    split in the baseband processing chain has been proposed to overcome these challenges. This paper evaluates, by mathematical and simulation methods, different splits with respect to network level energy and cost efficiency having in the mind the expected quality of service.The proposed mathematical......The placement of the complete baseband processing in a centralized pool results in high data rate requirement and inflexibility of the fronthaul network, which challenges the energy and cost effectiveness of the cloud radio access network (C-RAN). Recently, redesign of the C-RAN through functional...... model quantifies the multiplexing gains and the trade-offs between centralization and decentralization concerning the cost of the pool, fronthaul network capacity and resource utilization. The event-based simulation captures the influence of the traffic load dynamics and traffic type variation...

  10. Does the use of atypical antipsychotics as adjunctive therapy in depression result in cost savings? Comparing healthcare costs and utilization between second-line treatment options.

    Science.gov (United States)

    Hassan, Amany K; Farmer, Kevin C; Brahm, Nancy C; Keast, Shellie; Nesser, Nancy; Neas, Barbara R

    2016-12-01

    Several atypical antipsychotics (AAPs) are used as second-line agents for treatment resistant depression. AAPs can be expensive compared to other treatment options and can cause several side effects. To estimate healthcare costs and utilization of AAPs compared to other second-line agents. Observational study using Medicaid claims data (2006-2011). Subjects were depression-diagnosed adult members with at least two prescriptions of antidepressant medications followed by a second-line agent. Gamma generalized linear models (GLM) produced estimates of the difference in mean expenditures among treatment groups after adjusting for individual baseline characteristics using propensity scores. Negative binomial models produced estimates of the difference in number of hospitalizations and emergency department (ED) visits. A total of 3910 members received second-line treatment. Treatment groups were AAPs (n = 2211), augmentation agents other than AAPs (n = 1008), and antidepressant switching (n = 691). AAPs resulted in higher mean adjusted pharmacy costs and higher mean adjusted total mental health-related costs. Mean adjusted total healthcare costs and number of inpatient and ED visits were not different among treatments. The results show no evidence that AAPs used as second-line treatment for depression results in overall cost savings or lower inpatient and ED visits compared to other treatment strategies.

  11. Cost-benefit of energy saving in bioclimatic designs; Costo-beneficio del ahorro de energia en los disenos bioclimatios

    Energy Technology Data Exchange (ETDEWEB)

    Lopez P, J. Manuel A. [Doble dos soluciones de Negocios (Mexico); Morillon G, David; Rdriguez V, Luis [Universidad Autonoma de Mexico (Mexico)

    2001-06-01

    Tools and criteria for Cost-Benefit Analysis (ACB) of energy saving in bioclimatic designs (DB) are presented, for which a reference project is established. Based on the traditional design of air conditioning of a building and with the support of this one, the estimation of costs and benefits of the same building is made; but with passive systems. The tools used consider related resources such as time and money. Criteria are used such as: Present value (VP), Equivalent Annual Cost (EAC) and the Cost of the conserved Energy (CEC). The costs related to the construction, maintenance and operation of the design are taken into consideration. The differences between the design of reference and the Bioclimatic Design, established from the application of these criteria, allow evaluating the economic margin as far as operation and maintenance. Finally, the cost of the conserved energy of the bioclimatic measures is evaluated as an initiative for energy saving and calculates the present value from them in all of the period of useful life of the bioclimatic design. [Spanish] Se presentan herramientas y criterios para el analisis Costo-Beneficio (ACB) del ahorro de energia en los disenos bioclimaticos (DB), para lo cual se establece un proyecto de referencia. Basado en el diseno tradicional de la climatizacion de un edificio y con apoyo en este, se realiza la estimacion de costos y beneficios del mismo edificio; pero con sistema pasivos. Las herramientas usadas consideran recursos relacionados como son tiempo y dinero. Se usan criterios tales como: Valor Presente (VP), Costo Anual Equivalente (CAE) y el Costo de la Energia conservada (CEC). Se toman en consideracion los costos relacionados con la construccion, mantenimiento y operacion del diseno. Las diferencias entre el diseno de referencia y el Diseno Bioclimatico, establecidas a partir de la aplicacion de estos criterios, permiten evaluar el margen economico en cuanto a la operacion y el mantenimiento. Finalmente, se

  12. [Estimation of cost-saving for reducing radioactive waste from nuclear medicine facilities by implementing decay in storage (DIS) in Japan].

    Science.gov (United States)

    Kida, Tetsuo; Hiraki, Hitoshi; Yamaguchi, Ichirou; Fujibuchi, Toshioh; Watanabe, Hiroshi

    2012-01-01

    DIS has not yet been implemented in Japan as of 2011. Therefore, even if risk was negligible, medical institutions have to entrust radioactive temporal waste disposal to Japan Radio Isotopes Association (JRIA) in the current situation. To decide whether DIS should be implemented in Japan or not, cost-saving effect of DIS was estimated by comparing the cost that nuclear medical facilities pay. By implementing DIS, the total annual cost for all nuclear medical facilities in Japan is estimated to be decreased to 30 million yen or less from 710 million yen. DIS would save 680 million yen (96%) per year.

  13. Adding a dietitian to a Danish Liaison-team after discharge of geriatric patients at nutritional risk may save health care costs

    DEFF Research Database (Denmark)

    Pohju, Anne; Belqaid, Kerstin; Brandt, Christopher Flintenborg

    2016-01-01

    Background: A previous study investigated the value of adding a dietitian to a geriatric discharge Liaison-Team. The scope of this study was to explore the possible economic savings of this. Methods: Patients, 70+ and at nutritional risk, were randomized to receive discharge Liaison-Team either w......,416 compared to €1,150 (ONS only) in the CG. For hospitalizations, estimated cost was €92,020 in the IG and €220,025 in the CG. Cost savings added up to €3,048 per patient in the IG. Conclusion: Adding a dietitian to a Danish geriatric discharge Liaison-Team decreased health care costs...

  14. How to save costs by reducing unnecessary testing: Lean thinking in clinical practice

    NARCIS (Netherlands)

    Vegting, I.L.; van Beneden, M.; Kramer, M.H.H.; Thijs, A.; Kostense, P.J.; Nanayakkara, P.W.B.

    2012-01-01

    Background: The burden of health care expenditure on national budgets has increased dramatically over the past decade. A pilot study in our hospital demonstrated that many unnecessary diagnostic tests were performed routinely. The aim of this study was to reduce the costs of unnecessary diagnostic

  15. Modeling fuel treatment impacts on fire suppression cost savings: A review

    Science.gov (United States)

    Matthew P. Thompson; Nathaniel M. Anderson

    2015-01-01

    High up-front costs and uncertain return on investment make it difficult for land managers to economically justify large-scale fuel treatments, which remove trees and other vegetation to improve conditions for fire control, reduce the likelihood of ignition, or reduce potential damage from wildland fire if it occurs. In the short-term, revenue from harvested forest...

  16. Energy Efficiency Improvement and Cost Saving Opportunities for the Concrete Industry

    NARCIS (Netherlands)

    Kermeli, Katerina; Worrell, E.; Masanet, Eric

    2011-01-01

    The U.S. concrete industry is the main consumer of U.S.-produced cement. The manufacturing of ready mixed concrete accounts for about 75% of the U.S. concrete production following the manufacturing of precast concrete and masonry units. The most significant expenditure is the cost of materials

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

    Directory of Open Access Journals (Sweden)

    Snow Jill

    2008-10-01

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

  18. Energy Efficiency Improvement and Cost Saving Opportunities for the Glass Industry. An ENERGY STAR Guide for Energy and Plant Managers

    Energy Technology Data Exchange (ETDEWEB)

    Galitsky, Christina; Worrell, Ernst; Galitsky, Christina; Masanet, Eric; Graus, Wina

    2008-03-01

    The U.S. glass industry is comprised of four primary industry segments--flat glass, container glass, specialty glass, and fiberglass--which together consume $1.6 billion in energy annually. On average, energy costs in the U.S. glass industry account for around 14 percent of total glass production costs. Energy efficiency improvement is an important way to reduce these costs and to increase predictable earnings, especially in times of high energy price volatility. There is a variety of opportunities available at individual plants in the U.S. glass industry to reduce energy consumption in a cost-effective manner. This Energy Guide discusses energy efficiency practices and energy-efficient technologies that can be implemented at the component, process, system, and organizational levels. A discussion of the trends, structure, and energy consumption characteristics of the U.S. glass industry is provided along with a description of the major process steps in glass manufacturing. Expected savings in energy and energy-related costs are given for many energy efficiency measures, based on case study data from real-world applications in glass production facilities and related industries worldwide. Typical measure payback periods and references to further information in the technical literature are also provided, when available. The information in this Energy Guide is intended to help energy and plant managers in the U.S. glass industry reduce energy consumption in a cost-effective manner while maintaining the quality of products manufactured. Further research on the economics of the measures--as well on as their applicability to different production practices--is needed to assess potential implementation of selected technologies at individual plants.

  19. Cost, utilization, and quality of care: an evaluation of illinois' medicaid primary care case management program.

    Science.gov (United States)

    Phillips, Robert L; Han, Meiying; Petterson, Stephen M; Makaroff, Laura A; Liaw, Winston R

    2014-01-01

    In 2006, Illinois established Illinois Health Connect (IHC), a primary care case management program for Medicaid that offered enhanced fee-for-service, capitation payments, performance incentives, and practice support. Illinois also implemented a complementary disease management program, Your Healthcare Plus (YHP). This external evaluation explored outcomes associated with these programs. We analyzed Medicaid claims and enrollment data from 2004 to 2010, covering both pre- and post-implementation. The base year was 2006, and 2006-2010 eligibility criteria were applied to 2004-2005 data to allow comparison. We studied costs and utilization trends, overall and by service and setting. We studied quality by incorporating Healthcare Effectiveness Data and Information Set (HEDIS) measures and IHC performance payment criteria. Illinois Medicaid expanded considerably between 2006 (2,095,699 full-year equivalents) and 2010 (2,692,123). Annual savings were 6.5% for IHC and 8.6% for YHP by the fourth year, with cumulative Medicaid savings of $1.46 billion. Per-beneficiary annual costs fell in Illinois over this period compared to those in states with similar Medicaid programs. Quality improved for nearly all metrics under IHC, and most prevention measures more than doubled in frequency. Medicaid inpatient costs fell by 30.3%, and outpatient costs rose by 24.9% to 45.7% across programs. Avoidable hospitalizations fell by 16.8% for YHP, and bed-days fell by 15.6% for IHC. Emergency department visits declined by 5% by 2010. The Illinois Medicaid IHC and YHP programs were associated with substantial savings, reductions in inpatient and emergency care, and improvements in quality measures. This experience is not typical of other states implementing some, but not all, of these same policies. Although specific features of the Illinois reforms may have accounted for its better outcomes, the limited evaluation design calls for caution in making causal inferences. © 2014 Annals of

  20. Costs for integrating wind into the future ERCOT system with related costs for savings in CO2 emissions.

    Science.gov (United States)

    Lu, Xi; McElroy, Michael B; Sluzas, Nora A

    2011-04-01

    Wind power can make an important contribution to the goal of reducing emissions of CO2. The major problem relates to the intrinsic variability of the source and the difficulty of reconciling the supply of electricity with demand particularly at high levels of wind penetration. This challenge is explored for the case of the ERCOT system in Texas. Demand for electricity in Texas is projected to increase by approximately 60% by 2030. Considering hourly load data reported for 2006, assuming that the pattern of demand in 2030 should be similar to 2006, and adopting as a business as usual (BAU) reference an assumption that the anticipated additional electricity should be supplied by a combination of coal and gas with prices, discounted to 2007 dollars of $2 and $6 per MMBTU respectively, we conclude that the bus-bar price for electricity would increase by about 1.1 ¢/kWh at a wind penetration level of 30%, by about 3.4 ¢/kWh at a penetration level of 80%. Corresponding costs for reductions in CO2 range from $20/ton to $60/ton. A number of possibilities are discussed that could contribute to a reduction in these costs including the impact of an expanded future fleet of electrically driven vehicles.

  1. Saving costs through the decontamination of the packaging of unused medical supplies using hydrogen peroxide vapor.

    Science.gov (United States)

    Otter, Jonathan A; Nowakowski, Elaine; Salkeld, James A G; Duclos, Mike; Passaretti, Catherine L; Yezli, Saber; Ross, Tracy; Carroll, Karen C; Perl, Trish M

    2013-05-01

    OBJECTIVE. Individually packaged sterile supply items may become contaminated and act as vectors for nosocomial transmission of multidrug-resistant organisms (MDROs). Thus, many hospitals have a policy to dispose of these unused, packaged supply items at patient discharge from the hospital, which has considerable cost implications. We evaluated the frequency of contamination of these items, the efficacy of hydrogen peroxide vapor (HPV) in disinfecting them, and costs associated with discarded supplies. DESIGN. Before-after study. METHODS. A pilot study was performed in the rooms of 20 patients known to be colonized or infected with vancomycin-resistant enterococci (VRE), and a follow-up study was performed in an additional 20 rooms of patients under precautions for various MDROs in 6 high-risk units. Five pairs of supply items were selected. One item of each pair was sampled without exposure to HPV, and the other was sampled after HPV exposure. The cost of discarded supplies was calculated by examining stock lists of supplies stored on the study units. RESULTS. Seven (7%) of 100 items were contaminated with VRE in the pilot study, and 9 (9%) of 100 items were contaminated with MDROs in the follow-up study. None of the items were contaminated after exposure to HPV (P supplies discarded at patient hospital discharge was $387,055. This figure does not include the cost of waste disposal and is therefore likely to be an underestimation of the financial burden. CONCLUSIONS. HPV effectively disinfected the packaging of supply items, which could generate considerable financial and environmental benefits.

  2. United States menhaden oil could save billions in U.S. health care costs and improve IQ in children.

    Science.gov (United States)

    Bibus, Douglas M

    2016-02-01

    The United States menhaden oil annual production is sufficient to supply all of the recommended long chain Omega-3s for Americans over 55 with coronary heart disease (CHD) and pregnant and lactating women. According to a recent study, the utilization of preventable intake levels could potentially save up to $1.7 billion annually in hospital costs alone. In addition, the remaining oil could be used to support a culture of enough Atlantic salmon to provide every pregnant and lactating woman in the U.S. with 8-12 ounces of fish per week, as recommended by the Food and Drug Administration (FDA), throughout the duration of pregnancy and lactation. Based on the FDA's quantitative assessment, this may result in a net increase of IQ by 5.5 points in children and improve their early age verbal development.

  3. Socio-economic impact of antiretroviral treatment in HIV patients. An economic review of cost savings after introduction of HAART.

    Science.gov (United States)

    Gonzalo, Teresa; García Goñi, Manuel; Muñoz-Fernández, María Angeles

    2009-01-01

    Star celebrities such as Rock Hudson, Freddie Mercury, Magic Johnson, and Isaac Asimov have unfortunately something in common: they were all victims of the HIV global pandemic. Since then HIV infection has become considered a pandemic disease, and it is regarded as a priority in healthcare worldwide. It is ranked as the first cause of death among young people in industrialized countries, and it is recognized as a public healthcare problem due to its human, social, mass media, and economic impact. Incorporation of new and highly active antiretroviral treatment, available since 1996 for HIV/AIDS treatment, has provoked a radical change in the disease pattern, as well as in the impact on patient survival and quality of life. The pharmaceutical industry's contribution, based on the research for more active new drugs, has been pivotal. Mortality rates have decreased significantly in 20 years by 50% and now AIDS is considered a chronic and controlled disease. In this review we have studied the impact of HAART treatment on infected patients, allowing them to maintain their status as active workers and the decreased absenteeism from work derived from this, contributing ultimately to overall social wealth and, thus, to economic growth. Furthermore, an analysis of the impact on healthcare costs, quality of life per year, life per year gained, cost economic savings and cost opportunity among other parameters has shown that society and governments are gaining major benefits from the inclusion of antiretroviral therapies in HIV/AIDS patients.

  4. Ambulatory transradial percutaneous coronary intervention: a safe, effective, and cost-saving strategy.

    Science.gov (United States)

    Le Corvoisier, Philippe; Gellen, Barnabas; Lesault, Pierre-François; Cohen, Remy; Champagne, Stéphane; Duval, Anne-Marie; Montalescot, Gilles; Elhadad, Simon; Montagne, Olivier; Durand-Zaleski, Isabelle; Dubois-Randé, Jean-Luc; Teiger, Emmanuel

    2013-01-01

    The aim of this prospective, multicenter study was to assess the safety, feasibility, acceptance, and cost of ambulatory transradial percutaneous coronary intervention (PCI) under the conditions of everyday practice. Major advances in PCI techniques have considerably reduced the incidence of post-procedure complications. However, overnight admission still constitutes the standard of care in most interventional cardiology centers. Eligibility for ambulatory management was assessed in 370 patients with stable angina referred to three high-volume angioplasty centers. On the basis of pre-specified clinical and PCI-linked criteria, 220 patients were selected for ambulatory PCI. The study population included a substantial proportion of patients with complex procedures: 115 (52.3%) patients with multivessel coronary artery disease, 50 (22.7%) patients with multilesion procedures, and 60 (21.5%) bifurcation lesions. After 4-6 hr observation period, 213 of the 220 patients (96.8%) were cleared for discharge. The remaining seven (3.2%) patients were kept overnight for unstable angina (n = 1), atypical chest discomfort (n = 2), puncture site hematoma (n = 1), or non-cardiovascular reasons (n = 3). Within 24 hr after discharge, no patients experienced readmission, stent occlusion, recurrent ischemia, or local complications. Furthermore, 99% of patients were satisfied with ambulatory management and 85% reported no anxiety. The average non-procedural cost was lower for ambulatory PCI than conventional PCI (1,230 ± 98 Euros vs. 2,304 ± 1814 Euros, P < 10(-6)). Ambulatory PCI in patients with stable coronary artery disease is safe, effective, and well accepted by the patients. It may both significantly reduce costs and optimize hospital resource utilization. Copyright © 2012 Wiley Periodicals, Inc.

  5. Designing Green Networks and Network Operations Saving Run-the-Engine Costs

    CERN Document Server

    Minoli, Daniel

    2011-01-01

    In recent years the confluence of socio-political trends toward environmental responsibility and the pressing need to reduce Run-the-Engine (RTE) costs has given birth to a nascent discipline of Green IT. A clear and concise introduction to green networks and green network operations, this book examines analytical measures and discusses virtualization, network computing, and web services as approaches for green data centers and networks. It identifies some strategies for green appliance and end devices and examines the methodical steps that can be taken over time to achieve a seamless migratio

  6. Cost-of-illness analysis reveals potential healthcare savings with reductions in type 2 diabetes and cardiovascular disease following recommended intakes of dietary fiber in Canada

    OpenAIRE

    Abdullah, Mohammad M. H.; Gyles, Collin L.; Marinangeli, Christopher P F; Carlberg, Jared G.; Jones, Peter J.H.

    2015-01-01

    Background: Type 2 diabetes (T2D) and cardiovascular disease (CVD) are leading causes of mortality and two of the most costly diet-related ailments worldwide. Consumption of fiber-rich diets has been repeatedly associated with favorable impacts on these co-epidemics, however, the healthcare cost-related economic value of altered dietary fiber intakes remains poorly understood. In this study, we estimated the annual cost savings accruing to the Canadian healthcare system in association with re...

  7. How much might a society spend on life-saving interventions at different ages while remaining cost-effective? A case study in a country with detailed data.

    Science.gov (United States)

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

    2015-01-01

    We aimed to estimate the maximum intervention cost (EMIC) a society could invest in a life-saving intervention at different ages while remaining cost-effective according to a user-specified cost-effectiveness threshold. New Zealand (NZ) was used as a case study, and a health system perspective was taken. Data from NZ life tables and morbidity data from a burden of disease study were used to estimate health-adjusted life-years (HALYs) gained by a life-saving intervention. Health system costs were estimated from a national database of all publicly funded health events (hospitalizations, outpatient events, pharmaceuticals, etc.). For illustrative purposes we followed the WHO-CHOICE approach and used a cost-effectiveness threshold of the gross domestic product (GDP) per capita (NZ$45,000 or US$30,000 per HALY). We then calculated EMICs for an "ideal" life-saving intervention that fully returned survivors to the same average morbidity, mortality, and cost trajectories as the rest of their cohort. The EMIC of the "ideal" life-saving intervention varied markedly by age: NZ$1.3 million (US$880,000) for an intervention to save the life of a child, NZ$0.8 million (US$540,000) for a 50-year-old, and NZ$0.235 million (US$158,000) for an 80-year-old. These results were predictably very sensitive to the choice of discount rate and to the selected cost-effectiveness threshold. Using WHO data, we produced an online calculator to allow the performance of similar calculations for all other countries. We present an approach to estimating maximal cost-effective investment in life-saving health interventions, under various assumptions. Our online calculator allows this approach to be applied in other countries. Policymakers could use these estimates as a rapid screening tool to determine if more detailed cost-effectiveness analyses of potential life-saving interventions might be worthwhile or which proposed life-saving interventions are very unlikely to benefit from such additional

  8. Medicare Program; Medicare Shared Savings Program: Extreme and Uncontrollable Circumstances Policies for Performance Year 2017. Interim final rule with comment period.

    Science.gov (United States)

    2017-12-26

    This interim final rule with comment period establishes policies for assessing the financial and quality performance of Medicare Shared Savings Program (Shared Savings Program) Accountable Care Organizations (ACOs) affected by extreme and uncontrollable circumstances during performance year 2017, including the applicable quality reporting period for the performance year. Under the Shared Savings Program, providers of services and suppliers that participate in ACOs continue to receive traditional Medicare fee-for-service (FFS) payments under Parts A and B, but the ACO may be eligible to receive a shared savings payment if it meets specified quality and savings requirements. ACOs in performance-based risk agreements may also share in losses. This interim final rule with comment period establishes extreme and uncontrollable circumstances policies for the Shared Savings Program that will apply to ACOs subject to extreme and uncontrollable events, such as Hurricanes Harvey, Irma, and Maria, and the California wildfires, effective for performance year 2017, including the applicable quality data reporting period for the performance year.

  9. Energy and Energy Cost Savings Analysis of the IECC for Commercial Buildings

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Jian; Athalye, Rahul A.; Hart, Philip R.; Rosenberg, Michael I.; Xie, YuLong; Goel, Supriya; Mendon, Vrushali V.; Liu, Bing

    2013-08-30

    The purpose of this analysis is to assess the relative energy and energy cost performance of commercial buildings designed to meet the requirements found in the commercial energy efficiency provisions of the International Energy Conservation Code (IECC). Section 304(b) of the Energy Conservation and Production Act (ECPA), as amended, requires the Secretary of Energy to make a determination each time a revised version of ASHRAE Standard 90.1 is published with respect to whether the revised standard would improve energy efficiency in commercial buildings. As many states have historically adopted the IECC for both residential and commercial buildings, PNNL has evaluated the impacts of the commercial provisions of the 2006, 2009, and 2012 editions of the IECC. PNNL also compared energy performance with corresponding editions of ANSI/ASHRAE/IES Standard 90.1 to help states and local jurisdictions make informed decisions regarding model code adoption.

  10. 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.

  11. Can digital pathology result in cost savings? A financial projection for digital pathology implementation at a large integrated health care organization.

    Science.gov (United States)

    Ho, Jonhan; Ahlers, Stefan M; Stratman, Curtis; Aridor, Orly; Pantanowitz, Liron; Fine, Jeffrey L; Kuzmishin, John A; Montalto, Michael C; Parwani, Anil V

    2014-01-01

    Digital pathology offers potential improvements in workflow and interpretive accuracy. Although currently digital pathology is commonly used for research and education, its clinical use has been limited to niche applications such as frozen sections and remote second opinion consultations. This is mainly due to regulatory hurdles, but also to a dearth of data supporting a positive economic cost-benefit. Large scale adoption of digital pathology and the integration of digital slides into the routine anatomic/surgical pathology "slide less" clinical workflow will occur only if digital pathology will offer a quantifiable benefit, which could come in the form of more efficient and/or higher quality care. As a large academic-based health care organization expecting to adopt digital pathology for primary diagnosis upon its regulatory approval, our institution estimated potential operational cost savings offered by the implementation of an enterprise-wide digital pathology system (DPS). Projected cost savings were calculated for the first 5 years following implementation of a DPS based on operational data collected from the pathology department. Projected savings were based on two factors: (1) Productivity and lab consolidation savings; and (2) avoided treatment costs due to improvements in the accuracy of cancer diagnoses among nonsubspecialty pathologists. Detailed analyses of incremental treatment costs due to interpretive errors, resulting in either a false positive or false negative diagnosis, was performed for melanoma and breast cancer and extrapolated to 10 other common cancers. When phased in over 5-years, total cost savings based on anticipated improvements in pathology productivity and histology lab consolidation were estimated at $12.4 million for an institution with 219,000 annual accessions. The main contributing factors to these savings were gains in pathologist clinical full-time equivalent capacity impacted by improved pathologist productivity and workload

  12. Can Digital Pathology Result In Cost Savings? A Financial Projection For Digital Pathology Implementation At A Large Integrated Health Care Organization

    Science.gov (United States)

    Ho, Jonhan; Ahlers, Stefan M.; Stratman, Curtis; Aridor, Orly; Pantanowitz, Liron; Fine, Jeffrey L.; Kuzmishin, John A.; Montalto, Michael C.; Parwani, Anil V.

    2014-01-01

    Background: Digital pathology offers potential improvements in workflow and interpretive accuracy. Although currently digital pathology is commonly used for research and education, its clinical use has been limited to niche applications such as frozen sections and remote second opinion consultations. This is mainly due to regulatory hurdles, but also to a dearth of data supporting a positive economic cost-benefit. Large scale adoption of digital pathology and the integration of digital slides into the routine anatomic/surgical pathology “slide less” clinical workflow will occur only if digital pathology will offer a quantifiable benefit, which could come in the form of more efficient and/or higher quality care. Aim: As a large academic-based health care organization expecting to adopt digital pathology for primary diagnosis upon its regulatory approval, our institution estimated potential operational cost savings offered by the implementation of an enterprise-wide digital pathology system (DPS). Methods: Projected cost savings were calculated for the first 5 years following implementation of a DPS based on operational data collected from the pathology department. Projected savings were based on two factors: (1) Productivity and lab consolidation savings; and (2) avoided treatment costs due to improvements in the accuracy of cancer diagnoses among nonsubspecialty pathologists. Detailed analyses of incremental treatment costs due to interpretive errors, resulting in either a false positive or false negative diagnosis, was performed for melanoma and breast cancer and extrapolated to 10 other common cancers. Results: When phased in over 5-years, total cost savings based on anticipated improvements in pathology productivity and histology lab consolidation were estimated at $12.4 million for an institution with 219,000 annual accessions. The main contributing factors to these savings were gains in pathologist clinical full-time equivalent capacity impacted by

  13. Regulatory and cost barriers are likely to limit biosimilar development and expected savings in the near future.

    Science.gov (United States)

    Grabowski, Henry G; Guha, Rahul; Salgado, Maria

    2014-06-01

    In March 2010 Congress established an abbreviated Food and Drug Administration approval pathway for biosimilars-drugs that are very similar but not identical to a reference biological product and cost less. Because bringing biosimilars to the market currently requires large investments of money, fewer biosimilars are expected to enter the biologics market than has been the case with generic drugs entering the small-molecule drug market. Additionally, given the high regulatory hurdles to obtaining interchangeability-which would allow pharmacists to substitute a biosimilar for its reference product, subject to evolving state substitution laws-most biosimilars will likely compete as therapeutic alternatives instead of as therapeutic equivalents. In other words, biosimilars will need to compete with their reference product on the basis of quality; price; and manufacturer's reputation with physicians, insurers, and patient groups. Biosimilars also will face dynamic competition from new biologics in the same therapeutic class-including "biobetters," which offer incremental improvements on reference products, such as extended duration of action. The prospects for significant cost savings from the use of biosimilars appear to be limited for the next several years, but their use should increase over time because of both demand- and supply-side factors. Project HOPE—The People-to-People Health Foundation, Inc.

  14. Peripherally Inserted Central Catheters (PICCs) and Potential Cost Savings and Shortened Bed Stays In an Acute Hospital Setting.

    LENUS (Irish Health Repository)

    O’Brien, C

    2018-01-01

    Peripheral inserted central catheters (PICCs) have increasingly become the mainstay of patients requiring prolonged treatment with antibiotics, transfusions, oncologic IV therapy and total parental nutrition. They may also be used in delivering a number of other medications to patients. In recent years, bed occupancy rates have become hugely pressurized in many hospitals and any potential solutions to free up beds is welcome. Recent introductions of doctor or nurse led intravenous (IV) outpatient based treatment teams has been having a direct effect on early discharge of patients and in some cases avoiding admission completely. The ability to deliver outpatient intravenous treatment is facilitated by the placement of PICCs allowing safe and targeted treatment of patients over a prolonged period of time. We carried out a retrospective study of 2,404 patients referred for PICCs from 2009 to 2015 in a university teaching hospital. There was an exponential increase in the number of PICCs requested from 2011 to 2015 with a 64% increase from 2012 to 2013. The clear increase in demand for PICCs in our institution is directly linked to the advent of outpatient intravenous antibiotic services. In this paper, we assess the impact that the use of PICCs combined with intravenous outpatient treatment may have on cost and hospital bed demand. We advocate that a more widespread implementation of this service throughout Ireland may result in significant cost savings as well as decreasing the number of patients on hospital trollies.

  15. Participatory Assessment of a Matched Savings Program for Human Trafficking Survivors and their Family Members in the Philippines

    Directory of Open Access Journals (Sweden)

    Laura Cordisco Tsai

    2017-05-01

    Full Text Available Survivors of human trafficking often experience considerable financial difficulties upon exiting human trafficking, including pressure to provide financially for their families, challenges securing employment, lack of savings, and familial debt. Few evaluations have been conducted of reintegration support interventions addressing financial vulnerability among trafficking survivors. In this article, we present findings from a participatory assessment of the BARUG program, a matched savings and financial capability program for survivors of human trafficking and their family members in the Philippines. Photovoice was used to understand the experiences of two cohorts of BARUG participants. Survivors collaborated with research team members in conducting thematic analysis of transcripts from the photovoice sessions. Themes included: the positive emotional impact of financial wellness, overcoming the challenges of saving, applying financial management skills in daily decision making, developing a habit of savings, building a future-oriented mindset, receiving guidance and enlightenment, the learning process, and the change process. Findings reinforce the importance of interventions to support trafficked persons and their family members in getting out of debt and accumulating emergency savings, while also providing emotional support to survivors in coping with family financial pressures. The study also highlights the value of using participatory research methods to understand the experiences of trafficked persons. URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs1702116

  16. Long-term monitoring of Sacramento Shade program trees: tree survival, growth and energy-saving performance

    Science.gov (United States)

    Yekang Ko; Jun-Hak Lee; E. Gregory McPherson; Lara A. Roman

    2015-01-01

    Long-term survival and growth of urban forests are critical to achieve the targeted benefits of urban tree planting programs, such as building energy savings from tree shade. However, little is known about how trees perform in the long-term, especially in residential areas. Given this gap in the literature, we monitored 22-years of post-planting survival, growth, and...

  17. The New York Power Authority`s energy-efficient refrigerator program for the New York City Housing Authority -- 1997 savings evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Pratt, R.G.; Miller, J.D.

    1998-09-01

    This document describes the estimation of the annual energy savings achieved from the replacement of 20,000 refrigerators in New York City Housing Authority (NYCHA) public housing with new, highly energy-efficient models in 1997. The US Department of Housing and Urban Development (HUD) pays NYCHA`s electricity bills, and agreed to reimburse NYCHA for the cost of the refrigerator installations. Energy savings over the lifetime of the refrigerators accrue to HUD. Savings were demonstrated by a metering project and are the subject of the analysis reported here. The New York Power Authority (NYPA) identified the refrigerator with the lowest life-cycle cost, including energy consumption over its expected lifetime, through a request for proposals (RFP) issued to manufacturers for a bulk purchase of 20,000 units in 1997. The procurement was won by Maytag with a 15-ft{sup 3} top-freezer automatic-defrost refrigerator rated at 437 kilowatt-hours/year (kWh/yr). NYCHA then contracted with NYPA to purchase, finance, and install the new refrigerators, and demanufacture and recycle materials from the replaced units. The US Department of Energy (DOE) helped develop and plan the project through the ENERGY STAR{reg_sign} Partnerships program conducted by its Pacific Northwest National Laboratory (PNNL). PNNL designed the metering protocol and occupant survey used in 1997, supplied and calibrated the metering equipment, and managed and analyzed the data collected by NYPA. The objective of the 1997 metering study was to achieve a general understanding of savings as a function of refrigerator label ratings, occupant effects, indoor and compartment temperatures, and characteristics (such as size, defrost features, and vintage). The data collected in 1997 was used to construct models of refrigerator energy consumption as a function of key refrigerator and occupant characteristics.

  18. 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.

  19. 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.…

  20. A stitch in time saves nine. The costs of postponing action in climate policy

    Energy Technology Data Exchange (ETDEWEB)

    Steinshamn, Stein Ivar; Kvamsdal, Sturla F.; Sandal, Leif K.

    2011-07-01

    The main purpose of this report is to investigate the effects of postponing implementation of a carbon tax assuming that externalities associated with climate change and global warming is real. Failing to internalize these externalities will only lead to a suboptimal situation. The model applied to investigate these externalities starts with the basic relationships, namely supply and demand for fossil fuel, and an added damage term that accounts for the externality. The objective is then to maximize the sum of consumers' and producers' surplus adjusted for the externality. This must be done subject to the dynamic constraint derived from emissions of carbon associated with extraction and consumption of fossil fuel and the natural assimilation of carbon in the atmosphere. The model is solved as a closed loop feedback policy. First the optimal emission path is calculated, and then the corresponding tax path is found. As the externality dealt with here is a pure stock externality it turns out that the optimal tax is equal to the shadow cost of the pollutant. The dynamic equation for assimilation, or natural decay, of carbon is specified using a fairly sophisticated method, namely the ensemble Kalman filter. Given the relative simplicity of the model with only one type of production and one type of pollutant, this method is supposed to give a best possible estimate of the parameters in the assimilation function.The main message in this report is that it may possibly be very expensive to postpone implementation of a carbon tax as the tax rate may have to increase by up to 30 per cent and more for each year implementation is postponed in order to recover optimality in the most pessimistic cases. In the more optimistic cases an increase of down to 0.5 per cent per year may be sufficient.(eb)

  1. Reprocessing single-use cardiac catheters for interventional cardiology. A cost-minimization model for estimating potential saving at departmental scale and national level

    Directory of Open Access Journals (Sweden)

    Francesco Tessarolo

    2009-06-01

    Full Text Available

    Background: The utilization of single-use percutaneous catheters (SUDs is a common practice in interventional cardiology, but the increasing of cardiac interventions and the consequent economic load demand for assessing SUDs’ reuse. The study aimed at estimating the potential saving for Italian cardiology departments in the hypothesis that reprocessing and reuse of SUD is performed by guaranteeing safety and efficiency of the reconditioned device as high as the new marketed one.

    Methods: A cost-minimization model was applied from the perspective of the health national service. Input parameters for the model were settled by reviewing published data on technical, hygiene and functional properties of reprocessed electrophysiology (EP and percutaneous transluminal coronary angioplasty (PTCA catheters. Potential saving at department level was calculated as percentage of the actual expenditure for purchasing single-use devices. Two-ways sensitivity analysis was conducted on main cost drivers. Finally, saving at national level was estimated.

    Results: The revision of technical and safety data showed the feasibility of reprocessing and reuse of EP and PTCA catheters under determined constrains. Potential savings of 39%, and 12% were calculated at department level for EP and PTCA catheters, respectively. Sensitivity analysis showed saving was dependent primarily on departmental workload. Major variations in saving occurred in the range between one and 200 catheters per year. The cut-off between benefit and charges was also related to regeneration rate and maximum number of uses. The estimate of potential saving at national level ranged in the interval from €19.85M to €24.24M.

    Conclusions:When safety and efficiency is assured by certified reuse processing, substantial saving could be achieved both at departmental and national level contributing to optimize budget

  2. 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

  3. 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...

  4. Assessment of Building Energy-Saving Policies and Programs in China During the 11th Five Year Plan

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Nan; Mcneil, Michael; Levine, Mark

    2011-03-01

    China's 11th Five-Year Plan (FYP) sets an ambitious target to reduce the energy intensity per unit of gross domestic product (GDP) by 20% from 2005 to 2010 (NDRC, 2006). In the building sector, the primary energy-saving target allocated during the 11 FYP period is 100 Mtce. Savings are expected to be achieved through the strengthening of enforcement of building energy efficiency codes, existing building retrofits and heat supply system reform, followed by energy management of government office buildings and large scale public buildings, adoption of renewable energy sources. To date, China has reported that it achieved the half of the 20% intensity reduction target by the end of 2008, however, little has been made clear on the status and the impact of the building programs. There has also been lack of description on methodology for calculating the savings and baseline definition, and no total savings that have been officially reported to date. This paper intends to provide both quantitative and qualitative assessment of the key policies and programs in building sector that China has instituted in its quest to fulfill the national goal. Overall, this paper concludes that the largest improvement for building energy efficiency were achieved in new buildings; the program to improve the energy management in government and large scale public buildings are in line with the target; however the progress in the area of existing building retrofits, particularly heating supply system reform lags behind the stated goal by a large amount.

  5. Assessment of Building Energy-Saving Policies and Programs in China During the 11th Five Year Plan

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Nan; McNeil, Michael; Levine, Mark

    2010-06-07

    China's 11th Five-Year Plan (FYP) sets an ambitious target to reduce the energy intensity per unit of gross domestic product (GDP) by 20% from 2005 to 2010 (NDRC, 2006). In the building sector, the primary energy-saving target allocated during the 11 FYP period is 100 Mtce. Savings are expected to be achieved through the strengthening of enforcement of building energy efficiency codes, existing building retrofits and heat supply system reform, followed by energy management of government office buildings and large scale public buildings, adoption of renewable energy sources. To date, China has reported that it achieved the half of the 20% intensity reduction target by the end of 2008, however, little has been made clear on the status and the impact of the building programs. There has also been lack of description on methodology for calculating the savings and baseline definition, and no total savings that have been officially reported to date. This paper intend to provide both quantitative and qualitative assessment of the key policies and programs in building sector that China has instituted in its quest to fulfill the national goal. Overall, this paper concludes that the largest improvement for building energy efficiency were achieved in new buildings; the program to improve the energy management in government and large scale public buildings are in line with the target; however the progress in the area of existing building retrofit particularly heat supply system reform lags the stated goal by a large amount.

  6. Contract case managers prove cost effective in federal workers' compensation programs.

    Science.gov (United States)

    Mallon, Timothy Michael; Cloeren, Marianne; Firestone, Lisa Michelle; Burch, Helen Christine

    2008-03-01

    This pilot study examined whether contract case managers are cost effective in reducing workers' compensation (WC) costs and preventing injuries. We placed contract medical case managers at four installations where they employed private industry best practices. A needs assessment was performed and site-specific targeted interventions were developed. Case managers improved WC program effectiveness by ensuring command support, and strengthening the case management process. They minimized lost work time and provided the WC team resources to review the oldest cases. Case managers cost $1.25 million and they generated $4.4 million in savings for a 3.52 return on investment. Case managers removed 73 workers from long-term rolls by making use of vocational rehabilitation, finding modified duty jobs, offering workers medical retirement, and terminating benefits when workers refused to work after being offered a job. This study of medical case managers demonstrates they can reduce WC costs.

  7. Healthcare Expenditure and Productivity Cost Savings from Reductions in Cardiovascular Disease and Type 2 Diabetes Associated with Increased Intake of Cereal Fibre among Australian Adults: A Cost of Illness Analysis.

    Science.gov (United States)

    Fayet-Moore, Flavia; George, Alice; Cassettari, Tim; Yulin, Lev; Tuck, Kate; Pezzullo, Lynne

    2018-01-02

    An ageing population and growing prevalence of chronic diseases including cardiovascular disease (CVD) and type 2 diabetes (T2D) are putting increased pressure on healthcare expenditure in Australia. A cost of illness analysis was conducted to assess the potential savings in healthcare expenditure and productivity costs associated with lower prevalence of CVD and T2D resulting from increased intake of cereal fibre. Modelling was undertaken for three levels of increased dietary fibre intake using cereal fibre: a 10% increase in total dietary fibre; an increase to the Adequate Intake; and an increase to the Suggested Dietary Target. Total healthcare expenditure and productivity cost savings associated with reduced CVD and T2D were calculated by gender, socioeconomic status, baseline dietary fibre intake, and population uptake. Total combined annual healthcare expenditure and productivity cost savings of AUD$17.8 million-$1.6 billion for CVD and AUD$18.2 million-$1.7 billion for T2D were calculated. Total savings were generally larger among adults of lower socioeconomic status and those with lower dietary fibre intakes. Given the substantial healthcare expenditure and productivity cost savings that could be realised through increases in cereal fibre, there is cause for the development of interventions and policies that encourage an increase in cereal fibre intake in Australia.

  8. 25 CFR 900.134 - At the end of a self-determination construction contract, what happens to savings on a cost...

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false At the end of a self-determination construction contract... SERVICES CONTRACTS UNDER THE INDIAN SELF-DETERMINATION AND EDUCATION ASSISTANCE ACT Construction § 900.134 At the end of a self-determination construction contract, what happens to savings on a cost...

  9. Exemplary.... Nine examples to save energy and cost by intelligent engineering; Zur Nachahmung empfohlen.... Neun Faelle, in denen mit intelligenter Technik Energie und Kosten gespart werden

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-07-01

    Contents: Daylighting and energy management, light offices by daylight guidance, fresh air after demand by frequency converters, saving heating cost by intelligent control, optimized lighting systems in schools, fresh air from an external provider and compressed air monitoring in a mine. (GL)

  10. Energy Smart Guide to Campus Cost Savings: Today's Trends in Project Finance, Clean Fuel Fleets, Combined Heat& Power, Emissions Markets

    Energy Technology Data Exchange (ETDEWEB)

    2003-07-01

    The Energy Smart Guide to Campus Cost Savings covers today's trends in project finance, combined heat& power, clean fuel fleets and emissions trading. The guide is directed at campus facilities and business managers and contains general guidance, contact information and case studies from colleges and universities across the country.

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

    Science.gov (United States)

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

    2006-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-04-12

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

  13. Potential cost savings in waste incineration in grate furnaces; Kosteneinsparpotentiale bei der Verbrennung von Abfaellen in Rostfeuerungsanlagen

    Energy Technology Data Exchange (ETDEWEB)

    Wolf, C.; Beckmann, R. [Fraunhofer Inst. fuer Umwelt-, Sicherheits- und Energietechnik UMSICHT, Oberhausen (Germany). Abt. Abfall- und Kreislaufwirtschaft

    1998-09-01

    Shortage of public puts increased cost pressure on thermal treatment of waste. The specific operating cost of current projects is around 200 DM/t. The contribution outlines parameters that can help to reduce the operating and investment cost. This includes economic as well as technical parameters that directly influence plant operation. The analyses were carried out using the UMSICHT-owned calculation program GLOBUS which permits the conservative determination of the cost-determining plant cost as a function of sensitive influencing parameters. (orig./SR) [Deutsch] Nicht zuletzt aufgrund leerer oeffentlicher Kassen hat in den letzten Jahren ein Umdenken stattgefunden, das durch die Forderung nach umweltvertraeglichen Entsorgungsverfahren bei gleichzeitig moderaten Abfallgebuehren gepraegt ist. Somit hat fuer die thermische Abfallbehandlung der Kostendruck stark zugenommen. Fuer aktuelle Projekte werden spezifische Betriebskosten von etwa 200 DM/t erreicht. Der vorliegende Beitrag zeigt kostenwirksame Einflussgroessen auf, durch die eine Reduzierung der Betriebs- und Investitionskosten ermoeglicht wird. Dazu gehoeren sowohl abfallwirtschaftlicher Parameter als auch technische Groessen, die einen direkten Einfluss auf den Betrieb der Anlage besitzen. Die Analysen wurden mit dem UMSICHT-eigenen Kalkulationsprogramm GLOBUS durchgefuehrt, das die belastbare Ermittlung der fuer die Kostenseite bestimmenden Apparatekosten in Abhaengigkeit sensitiver Einflussgroessen erlaubt. (orig./SR)

  14. Cost-of-illness analysis reveals potential healthcare savings with reductions in type 2 diabetes and cardiovascular disease following recommended intakes of dietary fibre in Canada

    Directory of Open Access Journals (Sweden)

    Mohammad eAbdullah

    2015-08-01

    Full Text Available Background: Consumption of fibre-rich diets is associated with favourable impacts on type 2 diabetes (T2D and cardiovascular disease (CVD, two of the most costly ailments worldwide, however the economic value of altered fibre intakes remains poorly understood. Methods: A cost-of-illness analysis was conducted to identify the percentage of adults expected to consume fibre-rich diets in Canada, estimate fibre intakes in relation to T2D and CVD reductions, and assess the potential annual savings in healthcare costs with reductions in rates of these two epidemics. Results: Non-trivial healthcare and related savings of CAD$35.9-$718.8 million in T2D costs and CAD$64.8-$1,295.7 million in CVD costs were calculated under a scenario where cereal fibre was used to increase current intakes of dietary fibre to the recommended levels of 38 g per day for men and 25 g per day for women. Each 1 g per day increase in fibre consumption resulted in annual CAD$2.6-$51.1 and $4.6-$92.1 million savings for T2D and CVD, respectively. Conclusions: Strategies to increase consumers’ knowledge of the recommended dietary fibre intakes, as part of healthy diet, and to facilitate stakeholder synergy are warranted to enable better management of costs associated with T2D and CVD in Canada.

  15. Economic analysis of a new drug: potential savings in hospital operating costs from the use of a once-daily regimen of a parenteral cephalosporin.

    Science.gov (United States)

    Eisenberg, J M; Koffer, H; Finkler, S A

    1984-01-01

    The introduction of a new drug requires clear demonstration of its clinical efficacy and documentation of its adverse effects, but economic consequences of the new drug generally receive less attention. A new cephalosporin antibiotic, cefonicid, can be administered parenterally once daily, rather than three or four times daily, which is required for conventional cephalosporins. Methods of industrial engineering and cost accounting were used to determine the potential savings in hospital operating costs that would be available by reducing the frequency of intravenous administration of cephalosporin antibiotics. The variable cost of administering parenteral cephalosporin antibiotics averaged $2.24 per dose, $0.95 of which was attributable to labor costs and $1.28 to the costs of materials. Given present patterns of cephalosporin use, at four study hospitals the average potential savings per day for patients receiving intravenous cephalosporins ranged from $3.72 to $7.23, with a weighted mean of $5.42. Estimated national savings in hospital operating costs that would occur with use of an intravenous cephalosporin administered once daily range from $85.1 million to $115.4 million yearly.

  16. Discharge Disposition After Joint Replacement and the Potential for Cost Savings: Effect of Hospital Policies and Surgeons.

    Science.gov (United States)

    London, Daniel A; Vilensky, Seth; O'Rourke, Colin; Schill, Michelle; Woicehovich, Lynn; Froimson, Mark I

    2016-04-01

    Up to 55% of total joint arthroplasty costs come from post-acute care, with large variability dependent on a patient's discharge location. At our institution, we identified a group of surgeons using a preoperative discharge planning protocol emphasizing the merits of home discharge. We hypothesized that using the protocol would increase patients' odds for discharge home. Administrative data from 14,315 total hip and knee arthroplasties performed over a 3-year period were retrospectively analyzed to determine predictors of patient discharge location. Bayesian hierarchical logistic regression modeling was used to account for the complex multilevel structure within the data as we considered patient-, surgeon-, and hospital-level predictors. A simplified case-control data structure with logistic regression analysis was also used to better understand the impact of the preoperative discharge planning protocol. A variety of patient- and surgeon-level variables are predictive of patients being discharged home after total joint arthroplasty including a patient's length of stay, age, illness severity, and insurance, as well as surgeon's affiliation. In the case-control data, patients exposed to the rapid recovery protocol had 45% increased odds of being discharged home compared to patients not exposed to the protocol. Although patient factors are known to play a role in predicting postdischarge destination, this analysis describes additional surgeon- and hospital-level factors that predict discharge location. Exogenous factors based on how surgeons and hospital staff practice and interact with patients may impact the postdischarge decision-making process and provide a cost savings opportunity. Copyright © 2016 Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    L M G Steuten

    2008-12-01

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

  18. 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...

  19. The Future of Utility Customer-Funded Energy Efficiency Programs in the United States: Projected Spending and Savings to 2025

    Energy Technology Data Exchange (ETDEWEB)

    Barbose, Galen [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Goldman, Charles [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Hoffman, Ian [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Billingsley, Megan [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2012-09-11

    We develop projections of future spending on, and savings from, energy efficiency programs funded by electric and gas utility customers in the United States, under three scenarios through 2025. Our analysis, which updates a previous LBNL study, relies on detailed bottom-up modeling of current state energy efficiency policies, regulatory decisions, and demand-side management and utility resource plans. The three scenarios are intended to represent a range of potential outcomes under the current policy environment (i.e., without considering possible major new policy developments). By 2025, spending on electric and gas efficiency programs (excluding load management programs) is projected to double from 2010 levels to $9.5 billion in the medium case, compared to $15.6 billion in the high case and $6.5 billion in the low case. Compliance with statewide legislative or regulatory savings or spending targets is the primary driver for the increase in electric program spending through 2025, though a significant share of the increase is also driven by utility DSM planning activity and integrated resource planning. Our analysis suggests that electric efficiency program spending may approach a more even geographic distribution over time in terms of absolute dollars spent, with the Northeastern and Western states declining from over 70% of total U.S. spending in 2010 to slightly more than 50% in 2025, with the South and Midwest splitting the remainder roughly evenly. Under our medium case scenario, annual incremental savings from customer-funded electric energy efficiency programs increase from 18.4 TWh in 2010 in the U.S. (which is about 0.5% of electric utility retail sales) to 28.8 TWh in 2025 (0.8% of retail sales). These savings would offset the majority of load growth in the Energy Information Administration’s most recent reference case forecast, given specific assumptions about the extent to which future energy efficiency program savings are captured in that forecast

  20. 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

  1. Savings estimates for the United States Environmental Protection Agency?s ENERGY STAR voluntary product labeling program

    Energy Technology Data Exchange (ETDEWEB)

    Sanchez, Marla Christine; Sanchez, Marla Christine; Brown, Richard; Homan, Gregory; Webber, Carrie

    2008-06-03

    ENERGY STAR is a voluntary energy efficiency-labeling program operated jointly by the United States Department of Energy and the United States Environmental Protection Agency (US EPA). Since the program inception in 1992, ENERGY STAR has become a leading international brand for energy efficient products. ENERGY STAR's central role in the development of regional, national, and international energy programs necessitates an open process whereby its program achievements to date as well as projected future savings are shared with committed stakeholders. Through 2006, US EPA?S ENERGY STAR labeled products saved 4.8 EJ of primary energy and avoided 82 Tg C equivalent. We project that US EPA?S ENERGY STAR labeled products will save 12.8 EJ and avoid 203 Tg C equivalent over the period 2007-2015. A sensitivity analysis examining two key inputs (carbon factor and ENERGY STAR unit sales) bounds the best estimate of carbon avoided between 54 Tg C and 107 Tg C (1993 to 2006) and between 132 Tg C and 278 Tg C (2007 to 2015).

  2. Reducing the cesarean delivery rates for breech presentations: administration of spinal anesthesia facilitates manipulation to cephalic presentation, but is it cost saving?

    Science.gov (United States)

    2014-01-01

    Background External cephalic version (ECV) is infrequently performed and 98% of breech presenting fetuses are delivered surgically. Neuraxial analgesia can increase the success rate of ECV significantly, potentially reducing cesarean delivery rates for breech presentation. The current study aims to determine whether the additional cost to the hospital of spinal anesthesia for ECV is offset by cost savings generated by reduced cesarean delivery. Methods In our tertiary hospital, three variables manpower, disposables, and fixed costs were calculated for ECV, ECV plus anesthetic doses of spinal block, vaginal delivery and cesarean delivery. Total procedure costs were compared for possible delivery pathways. Manpower data were obtained from management payroll, fixed costs by calculating cost/lifetime usage rate and disposables were micro-costed in 2008, expressed in 2013 NIS. Results Cesarean delivery is the most expensive option, 11670.54 NIS and vaginal delivery following successful ECV under spinal block costs 5497.2 NIS. ECV alone costs 960.21 NIS, ECV plus spinal anesthesia costs 1386.97 NIS. The highest individual cost items for vaginal, cesarean delivery and ECV were for manpower. Expensive fixed costs for cesarean delivery included operating room trays and postnatal hospitalization (minimum 3 days). ECV with spinal block is cheaper due to lower expected cesarean delivery rate and its lower associated costs. Conclusions The additional cost of the spinal anesthesia is offset by increased success rates for the ECV procedure resulting in reduction in the cesarean delivery rate. PMID:24564984

  3. 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.

  4. 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…

  5. The effect of major adverse renal cardiovascular event (MARCE) incidence, procedure volume, and unit cost on the hospital savings resulting from contrast media use in inpatient angioplasty.

    Science.gov (United States)

    Keuffel, Eric; McCullough, Peter A; Todoran, Thomas M; Brilakis, Emmanouil S; Palli, Swetha R; Ryan, Michael P; Gunnarsson, Candace

    2017-12-15

    To determine the net economic impact of switching from low-osmolar contrast media (LOCM) to iso-osmolar contrast media (IOCM; iodixanol) in patients undergoing inpatient coronary or peripheral angioplasty in the United States (US). A budget impact model (BIM) was developed from a hospital perspective. Nationally representative procedural and contrast media prevalence rates, along with MARCE (major adverse renal cardiovascular event) incidence and episode-related cost data were derived from Premier Hospital Data (October 2014 to September 2015). A previously estimated relative risk reduction in MARCE associated with IOCM usage (9.3%) was applied. The higher cost of IOCM was included when calculating the net impact estimates at the aggregate, hospital type, and per hospital levels. One-way (±25%) and probabilistic sensitivity analyses identified the model's most important inputs. Based on weighted analysis, 513,882 US inpatient angioplasties and 35,610 MARCE cases were estimated annually. Switching to an "IOCM only" strategy from a "LOCM only" strategy increases contrast media cost, but prevents 2,900 MARCE events. The annual budget impact was an estimated saving of $30.71 million, aggregated across all US hospitals, $6,316 per hospital, or $60 per procedure. Net savings were maintained across all univariate sensitivity analyses. While MARCE/event-free cost differential was the most important factor driving total net savings for hospitals in the Northeast and West, procedural volume was important in the Midwest and rural locations. Switching to an "IOCM only" strategy from a "LOCM only" approach yields substantial net global savings to hospitals, both at the national level and within hospital sub-groups. Hospital administrators should maintain awareness of the factors that are likely to be more influential for their hospital and recognize that purchasing on the basis of lower contrast media cost may result in higher overall costs for patients undergoing inpatient

  6. 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.

  7. National Weatherization Assistance Program Impact Evaluation: Energy Impacts for Large Multifamily Buildings

    Energy Technology Data Exchange (ETDEWEB)

    Blasnik, Michael [Blasnik & Associates, Roslindale, MA (United States); Dalhoff, Greg [Dalhoff & Associates, Verona, WI (United States); Carroll, David [APPRISE, Inc., Princeton, NJ (United States); Ucar, Ferit [APPRISE, Inc., Princeton, NJ (United States)

    2015-10-01

    This report estimates energy savings, energy cost savings, and cost effectiveness attributable to weatherizing large multifamily buildings under the auspices of the Department of Energy's Weatherization Assistance Program during Program Year 2008.

  8. National Weatherization Assistance Program Impact Evaluation: Energy Impacts for Small Multifamily Buildings

    Energy Technology Data Exchange (ETDEWEB)

    Blasnik, Michael [Blasnik & Associates, Roslindale, MA (United States); Dalhoff, Greg [Dalhoff & Associates, Verona, WI (United States); Carroll, David [APPRISE, Inc., Princeton, NJ (United States); ucar, Ferit [APPRISE, Inc., Princeton, NJ (United States)

    2014-09-01

    This report estimates energy savings, energy cost savings, and cost effectiveness attributable to weatherizing small multifamily buildings under the auspices of the Department of Energy's Weatherization Assistance Program during Program Year 2008.

  9. Feature Selection as a Time and Cost-Saving Approach for Land Suitability Classification (Case Study of Shavur Plain, Iran

    Directory of Open Access Journals (Sweden)

    Saeid Hamzeh

    2016-10-01

    Full Text Available Land suitability classification is important in planning and managing sustainable land use. Most approaches to land suitability analysis combine a large number of land and soil parameters, and are time-consuming and costly. In this study, a potentially useful technique (combined feature selection and fuzzy-AHP method to increase the efficiency of land suitability analysis was presented. To this end, three different feature selection algorithms—random search, best search and genetic methods—were used to determine the most effective parameters for land suitability classification for the cultivation of barely in the Shavur Plain, southwest Iran. Next, land suitability classes were calculated for all methods by using the fuzzy-AHP approach. Salinity (electrical conductivity (EC, alkalinity (exchangeable sodium percentage (ESP, wetness and soil texture were selected using the random search method. Gypsum, EC, ESP, and soil texture were selected using both the best search and genetic methods. The result shows a strong agreement between the standard fuzzy-AHP methods and methods presented in this study. The values of Kappa coefficients were 0.82, 0.79 and 0.79 for the random search, best search and genetic methods, respectively, compared with the standard fuzzy-AHP method. Our results indicate that EC, ESP, soil texture and wetness are the most effective features for evaluating land suitability classification for the cultivation of barely in the study area, and uses of these parameters, together with their appropriate weights as obtained from fuzzy-AHP, can perform good results for land suitability classification. So, the combined feature selection presented and the fuzzy-AHP approach has the potential to save time and money for land suitability classification.

  10. Cost-of-illness analysis reveals potential healthcare savings with reductions in type 2 diabetes and cardiovascular disease following recommended intakes of dietary fiber in Canada

    Science.gov (United States)

    Abdullah, Mohammad M. H.; Gyles, Collin L.; Marinangeli, Christopher P. F.; Carlberg, Jared G.; Jones, Peter J. H.

    2015-01-01

    Background: Type 2 diabetes (T2D) and cardiovascular disease (CVD) are leading causes of mortality and two of the most costly diet-related ailments worldwide. Consumption of fiber-rich diets has been repeatedly associated with favorable impacts on these co-epidemics, however, the healthcare cost-related economic value of altered dietary fiber intakes remains poorly understood. In this study, we estimated the annual cost savings accruing to the Canadian healthcare system in association with reductions in T2D and CVD rates, separately, following increased intakes of dietary fiber by adults. Methods: A three-step cost-of-illness analysis was conducted to identify the percentage of individuals expected to consume fiber-rich diets in Canada, estimate increased fiber intakes in relation to T2D and CVD reduction rates, and independently assess the potential annual savings in healthcare costs associated with the reductions in rates of these two epidemics. The economic model employed a sensitivity analysis of four scenarios (universal, optimistic, pessimistic, and very pessimistic) to cover a range of assumptions within each step. Results: Non-trivial healthcare and related savings of CAD$35.9-$718.8 million in T2D costs and CAD$64.8 million–$1.3 billion in CVD costs were calculated under a scenario where cereal fiber was used to increase current intakes of dietary fiber to the recommended levels of 38 g per day for men and 25 g per day for women. Each 1 g per day increase in fiber consumption resulted in annual CAD$2.6 to $51.1 million savings for T2D and $4.6 to $92.1 million savings for CVD. Conclusion: Findings of this analysis shed light on the economic value of optimal dietary fiber intakes. Strategies to increase consumers’ general knowledge of the recommended intakes of dietary fiber, as part of healthy diet, and to facilitate stakeholder synergy are warranted to enable better management of healthcare and related costs associated with T2D and CVD in Canada. PMID

  11. Cost-of-illness analysis reveals potential healthcare savings with reductions in type 2 diabetes and cardiovascular disease following recommended intakes of dietary fiber in Canada.

    Science.gov (United States)

    Abdullah, Mohammad M H; Gyles, Collin L; Marinangeli, Christopher P F; Carlberg, Jared G; Jones, Peter J H

    2015-01-01

    Type 2 diabetes (T2D) and cardiovascular disease (CVD) are leading causes of mortality and two of the most costly diet-related ailments worldwide. Consumption of fiber-rich diets has been repeatedly associated with favorable impacts on these co-epidemics, however, the healthcare cost-related economic value of altered dietary fiber intakes remains poorly understood. In this study, we estimated the annual cost savings accruing to the Canadian healthcare system in association with reductions in T2D and CVD rates, separately, following increased intakes of dietary fiber by adults. A three-step cost-of-illness analysis was conducted to identify the percentage of individuals expected to consume fiber-rich diets in Canada, estimate increased fiber intakes in relation to T2D and CVD reduction rates, and independently assess the potential annual savings in healthcare costs associated with the reductions in rates of these two epidemics. The economic model employed a sensitivity analysis of four scenarios (universal, optimistic, pessimistic, and very pessimistic) to cover a range of assumptions within each step. Non-trivial healthcare and related savings of CAD$35.9-$718.8 million in T2D costs and CAD$64.8 million-$1.3 billion in CVD costs were calculated under a scenario where cereal fiber was used to increase current intakes of dietary fiber to the recommended levels of 38 g per day for men and 25 g per day for women. Each 1 g per day increase in fiber consumption resulted in annual CAD$2.6 to $51.1 million savings for T2D and $4.6 to $92.1 million savings for CVD. Findings of this analysis shed light on the economic value of optimal dietary fiber intakes. Strategies to increase consumers' general knowledge of the recommended intakes of dietary fiber, as part of healthy diet, and to facilitate stakeholder synergy are warranted to enable better management of healthcare and related costs associated with T2D and CVD in Canada.

  12. 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

  13. Integrated control of emission reductions, energy-saving, and cost-benefit using a multi-objective optimization technique in the pulp and paper industry.

    Science.gov (United States)

    Wen, Zongguo; Xu, Chang; Zhang, Xueying

    2015-03-17

    Reduction of water pollutant emissions and energy consumption is regarded as a key environmental objective for the pulp and paper industry. The paper develops a bottom-up model called the Industrial Water Pollutant Control and Technology Policy (IWPCTP) based on an industrial technology simulation system and multiconstraint technological optimization. Five policy scenarios covering the business as usual (BAU) scenario, the structural adjustment (SA) scenario, the cleaner technology promotion (CT) scenario, the end-treatment of pollutants (EOP) scenario, and the coupling measures (CM) scenario have been set to describe future policy measures related to the development of the pulp and paper industry from 2010-2020. The outcome of this study indicates that the energy saving amount under the CT scenario is the largest, while that under the SA scenario is the smallest. Under the CT scenario, savings by 2020 include 70 kt/year of chemical oxygen demand (COD) emission reductions and savings of 7443 kt of standard coal, 539.7 ton/year of ammonia nitrogen (NH4-N) emission reductions, and savings of 7444 kt of standard coal. Taking emission reductions, energy savings, and cost-benefit into consideration, cleaner technologies like highly efficient pulp washing, dry and wet feedstock preparation, and horizontal continuous cooking, medium and high consistency pulping and wood dry feedstock preparation are recommended.

  14. 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

  15. 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

  16. Medicare Program; Medicare Shared Savings Program; Accountable Care Organizations--Revised Benchmark Rebasing Methodology, Facilitating Transition to Performance-Based Risk, and Administrative Finality of Financial Calculations. Final rule.

    Science.gov (United States)

    2016-06-10

    Under the Medicare Shared Savings Program (Shared Savings Program), providers of services and suppliers that participate in an Accountable Care Organization (ACO) continue to receive traditional Medicare fee-for-service (FFS) payments under Parts A and B, but the ACO may be eligible to receive a shared savings payment if it meets specified quality and savings requirements. This final rule addresses changes to the Shared Savings Program, including: Modifications to the program's benchmarking methodology, when resetting (rebasing) the ACO's benchmark for a second or subsequent agreement period, to encourage ACOs' continued investment in care coordination and quality improvement; an alternative participation option to encourage ACOs to enter performance-based risk arrangements earlier in their participation under the program; and policies for reopening of payment determinations to make corrections after financial calculations have been performed and ACO shared savings and shared losses for a performance year have been determined.

  17. 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.

  18. 7 CFR 272.11 - Systematic Alien Verification for Entitlements (SAVE) Program.

    Science.gov (United States)

    2010-01-01

    ... access to the Alien Status Verification Index (ASVI), a description of the access method and procedures... benefits to which participating households were not entitled. (d) Method of verification. The State agency... 7 Agriculture 4 2010-01-01 2010-01-01 false Systematic Alien Verification for Entitlements (SAVE...

  19. Estimating Lives Saved by Achieving Dietary Micronutrient Adequacy, with a Focus on Vitamin A Intervention Programs in Cameroon.

    Science.gov (United States)

    Engle-Stone, Reina; Perkins, Amanda; Clermont, Adrienne; Walker, Neff; Haskell, Marjorie J; Vosti, Stephen A; Brown, Kenneth H

    2017-11-01

    Background: We previously compared the potential effects of different intervention strategies for achieving dietary vitamin A (VA) adequacy. The Lives Saved Tool (LiST) permits estimates of lives saved through VA interventions but currently only considers periodic VA supplements (VASs).Objective: We aimed to adapt the LiST method for estimating the mortality impact of VASs to estimate the impact of other VA interventions (e.g., food fortification) on child mortality and to estimate the number of lives saved by VA interventions in 3 macroregions in Cameroon.Methods: We used national dietary intake data to predict the effects of VA intervention programs on the adequacy of VA intake. LiST parameters of population affected fraction and intervention coverage were replaced with estimates of prevalence of inadequate intake and effective coverage (proportion achieving adequate VA intake). We used a model of liver VA stores to derive an estimate of the mortality reduction from achieving dietary VA adequacy; this estimate and a conservative assumption of equivalent mortality reduction for VAS and VA intake were applied to projections for Cameroon.Results: There were 2217-3048 total estimated VA-preventable deaths in year 1, with 58% occurring in the North macroregion. The relation between effective coverage and lives saved differed by year and macroregion due to differences in total deaths, diarrhea burden, and prevalence of low VA intake. Estimates of lives saved by VASs (the intervention common to both methods) were similar with the use of the adapted method (in 2012: North, 743-1021; South, 280-385; Yaoundé and Douala, 146-202) and the "usual" LiST method (North: 697; South: 381; Yaoundé and Douala: 147).Conclusions: Linking effective coverage estimates with an adapted LiST method permits estimation of the effects of combinations of VA programs (beyond VASs only) on child mortality to aid program planning and management. Rigorous program monitoring and evaluation are

  20. 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.

  1. 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

  2. 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...

  3. 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.

  4. Chest pain unit using thrombolysis in myocardial infarction score risk stratification: an impact on the length of stay and cost savings.

    Science.gov (United States)

    Shah, Priyank P; Gupta, Nishant; Sharma, Anurag; Bhargava, Rishi K; Bajaj, Sharad; Mittal, Vipin; Johnson, Cynthia; Shamoon, Fayez; Bikkina, Mahesh

    2012-12-01

    Despite the fact that studies have demonstrated cost-effectiveness of chest pain observation units (CPOUs) in emergency departments, they have not been widely implemented. Thrombolysis in Myocardial Infarction (TIMI) score is an easy and reliable tool, but none of the prior studies have used it for risk stratification in CPOUs. We propose to study the impact of CPOU using TIMI risk stratification model on the length of stay (LOS) and cost savings. We studied 777 patients with chest pain admitted to our hospital from July 2010 to June 2011. The patients with a TIMI score of 0 to 2 were observed for 12 hours, those with a score of 3 to 4 were observed for 20 hours, and the ones with a score >4 were deemed appropriate for admission. We calculated the cost differences between the actual admissions and the CPOU. A total of 39.1% of patients had a TIMI score of 0, 31.1% had a TIMI score of 1, 18.1% had a TIMI score of 2, 9.2% and 2.5% had TIMI scores of 3 and 4, respectively. The expected LOS based on this model was 418.5 days versus the actual LOS of 1324 days. The cost of CPOU was estimated to be $1,979,977. However, the actual cost was $3,216,809. Hence, the annual cost savings were estimated to be $1,236,832. CPOU using TIMI score is an easy and reliable risk stratification tool for patients with chest pain in the emergency department and can significantly reduce the LOS, hence saving millions of dollars in this economic crisis.

  5. Estimation of potential cost savings associated with reduced rates of cardiovascular hospitalization among atrial fibrillation/flutter patients treated with dronedarone in the ATHENA trial.

    Science.gov (United States)

    Reynolds, Matthew R; Lin, Jay; Jhaveri, Mehul; Mozaffari, Essy; Plich, Adam

    2014-01-01

    The aim of this study was to estimate, from a US payer perspective, potential cost savings resulting from the reduction in cardiovascular (CV) hospitalizations obtained with dronedarone in the ATHENA (A Placebo-Controlled, Double-Blind, Parallel Arm Trial to Assess the Efficacy of Dronedarone 400 mg bid for the Prevention of Cardiovascular Hospitalization or Death from any Cause in PatiENts with Atrial Fibrillation/Atrial Flutter) trial. ATHENA randomized atrial fibrillation/flutter patients to dronedarone (n=2301) or placebo (n=2327) plus standard care. Dronedarone significantly reduced first CV hospitalization/all-cause mortality over 12-30 months of follow-up. CV hospitalization costs (2008 values) from a US cohort of ATHENA-like atrial fibrillation/flutter patients with Medicare supplemental insurance (n=10,200) and diagnosis-related group costs of adverse event-related hospitalizations were applied to hospitalizations occurring in ATHENA. The impact of cost variation was assessed using Monte Carlo simulation. In ATHENA, dronedarone reduced the overall CV hospitalization rate (vs. placebo) by 29% over the first 12 months (33.36 vs. 47.19 events per 100 patients) and by 25% over the full study (51.15 vs. 68.55 events per 100 patients). Adverse event-related hospitalization rates (dronedarone vs. placebo) were low (0.48 vs. 0.21 and 0.56 vs. 0.26 events per 100 patients over 12 months and the full study, respectively). Overall hospitalization cost savings were estimated at $1329 and $1763 per patient over 12 months and the full study, respectively. Cost savings were relatively stable [mean (95% confidence interval): $1330 ($994-$1676) for the first 12 months and $1763 ($1369-$2184) for the full study] over 10,000 cycles of random variation.

  6. Spending to save

    DEFF Research Database (Denmark)

    Larsen, Anders

    2013-01-01

    framework and guidelines for the following EEO period, i.e. 2013-2020. This paper focuses on the net savings impact and describes the evaluation method used to determine this. Three complementary analyses are described: 1) An analysis of the additionality of the reported saving, 2) an analysis...... the energy distribution companies meet their overall saving obligation, the net savings impact are about a third of the savings reported by the obligated parties. Further it was found that while energy savings in the public and business sector have a high net impact, some subsidies given under the EEO...... are inappropriately high. The net impact in the residential sector, on the other hand, was found to be very low. The evaluation recommended that the new EEO design addresses the additionality issues in order to ensure that savings realised in the residential sector are more cost-effective from a socioeconomic...

  7. Developing a student-led health and wellbeing clinic in an underserved community: collaborative learning, health outcomes and cost savings.

    Science.gov (United States)

    Stuhlmiller, Cynthia M; Tolchard, Barry

    2015-01-01

    The University of New England (UNE), Australia decided to develop innovative placement opportunities for its increasing numbers of nursing students. Extensive community and stakeholder consultation determined that a community centre in rural New South Wales was the welcomed site of the student-led clinic because it fit the goals of the project-to increase access to health care services in an underserved area while providing service learning for students. Supported by a grant from Health Workforce Australia and in partnership with several community organisations, UNE established a student-led clinic in a disadvantaged community using an engaged scholarship approach which joins academic service learning with community based action research. The clinic was managed and run by the students, who were supervised by university staff and worked in collaboration with residents and local health and community services. Local families, many of whom were Indigenous Australians, received increased access to culturally appropriate health services. In the first year, the clinic increased from a one day per week to a three day per week service and offered over 1000 occasions of care and involved 1500 additional community members in health promotion activities. This has led to improved health outcomes for the community and cost savings to the health service estimated to be $430,000. The students learned from members of the community and community members learned from the students, in a collaborative process. Community members benefited from access to drop in help that was self-determined. The model of developing student-led community health and wellbeing clinics in underserved communities not only fulfils the local, State Government, Federal Government and international health reform agenda but it also represents good value for money. It offers free health services in a disadvantaged community, thereby improving overall health and wellbeing. The student-led clinic is an invaluable

  8. 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...

  9. Potential cost saving of Epoetin alfa in elective hip or knee surgery due to reduction in blood transfusions and their side effects: a discrete-event simulation model.

    Directory of Open Access Journals (Sweden)

    Jörg Tomeczkowski

    Full Text Available OBJECTIVES: Transfusion of allogeneic blood is still common in orthopedic surgery. This analysis evaluates from the perspective of a German hospital the potential cost savings of Epoetin alfa (EPO compared to predonated autologous blood transfusions or to a nobloodconservationstrategy (allogeneic blood transfusion strategyduring elective hip and knee replacement surgery. METHODS: Individual patients (N = 50,000 were simulated based on data from controlled trials, the German DRG institute (InEK and various publications and entered into a stochastic model (Monte-Carlo of three treatment arms: EPO, preoperative autologous donation and nobloodconservationstrategy. All three strategies lead to a different risk for an allogeneic blood transfusion. The model focused on the costs and events of the three different procedures. The costs were obtained from clinical trial databases, the German DRG system, patient records and medical publications: transfusion (allogeneic red blood cells: €320/unit and autologous red blood cells: €250/unit, pneumonia treatment (€5,000, and length of stay (€300/day. Probabilistic sensitivity analyses were performed to determine which factors had an influence on the model's clinical and cost outcomes. RESULTS: At acquisition costs of €200/40,000 IU EPO is cost saving compared to autologous blood donation, and cost-effective compared to a nobloodconservationstrategy. The results were most sensitive to the cost of EPO, blood units and hospital days. CONCLUSIONS: EPO might become an attractive blood conservation strategy for anemic patients at reasonable costs due to the reduction in allogeneic blood transfusions, in the modeled incidence of transfusion-associated pneumonia andthe prolongedlength of stay.

  10. 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

  11. RESULTS FROM THE U.S. DOE 2006 SAVE ENERGY NOW ASSESSMENT INITIATIVE: DOE's Partnership with U.S. Industry to Reduce Energy Consumption, Energy Costs, and Carbon Dioxide Emissions

    Energy Technology Data Exchange (ETDEWEB)

    Wright, Anthony L [ORNL; Martin, Michaela A [ORNL; Gemmer, Bob [U.S. Department of Energy, Office of Energy Efficiency and Renewable Energy; Scheihing, Paul [U.S. Department of Energy, Industrial Technologies Program; Quinn, James [U.S. Department of Energy

    2007-09-01

    In the wake of Hurricane Katrina and other severe storms in 2005, natural gas supplies were restricted, prices rose, and industry sought ways to reduce its natural gas use and costs. In October 2005, U.S. Department of Energy (DOE) Energy Secretary Bodman launched his Easy Ways to Save Energy campaign with a promise to provide energy assessments to 200 of the largest U.S. manufacturing plants. A major thrust of the campaign was to ensure that the nation's natural gas supplies would be adequate for all Americans, especially during home heating seasons. In a presentation to the National Press Club on October 3, 2005, Secretary Bodman said: 'America's businesses, factories, and manufacturing facilities use massive amounts of energy. To help them during this period of tightening supply and rising costs, our Department is sending teams of qualified efficiency experts to 200 of the nation's most energy-intensive factories. Our Energy Saving Teams will work with on-site managers on ways to conserve energy and use it more efficiently.' DOE's Industrial Technologies Program (ITP) responded to the Secretary's campaign with its Save Energy Now initiative, featuring a new and highly cost-effective form of energy assessments. The approach for these assessments drew heavily on the existing resources of ITP's Technology Delivery component. Over the years, ITP-Technology Delivery had worked with industry partners to assemble a suite of respected software decision tools, proven assessment protocols, training curricula, certified experts, and strong partnerships for deployment. Because of the program's earlier activities and the resources that had been developed, ITP was prepared to respond swiftly and effectively to the sudden need to promote improved industrial energy efficiency. Because of anticipated supply issues in the natural gas sector, the Save Energy Now initiative strategically focused on natural gas savings and targeted the

  12. Economic Impact of Oritavancin for the Treatment of Acute Bacterial Skin and Skin Structure Infections in the Emergency Department or Observation Setting: Cost Savings Associated with Avoidable Hospitalizations.

    Science.gov (United States)

    Lodise, Thomas P; Fan, Weihong; Sulham, Katherine A

    2016-01-01

    Data indicate that acute bacterial skin and skin structure infection (ABSSSI) patients without major comorbidities can be managed effectively in the outpatient setting. Because most patients with ABSSSIs present to the emergency department, it is essential that clinicians identify candidates for outpatient treatment given the substantially higher costs associated with inpatient care. We examined the potential cost avoidance associated with shifting care from inpatient treatment with vancomycin to outpatient treatment with oritavancin for ABSSSI patients without major complications or comorbidities. A decision analytic, cost-minimization model was developed to compare costs of inpatient vancomycin versus outpatient oritavancin treatment of ABSSSI patients with few or no comorbidities (Charlson Comorbidity Index score ≤1) and no life-threatening conditions presenting to emergency department. Hospital discharge data from the Premier Research Database was used to determine the costs associated with inpatient vancomycin treatment. Mean costs for inpatient treatment with vancomycin ranged from $5973 to $9885, depending on Charlson Comorbidity Index score and presence of systemic symptoms. Switching an individual patient from inpatient vancomycin treatment to outpatient oritavancin treatment was estimated to save $1752.46 to $6475.87 per patient, depending on Charlson Comorbidity Index score, presence of systemic symptoms, and use of observation status. Assuming some patients may be admitted to the hospital after treatment with oritavancin, it is estimated that up to 38.12% of patients could be admitted while maintaining budget neutrality. This cost-minimization model indicates that use of oritavancin in the emergency department or observation setting is associated with substantial cost savings compared with inpatient treatment with vancomycin. Copyright © 2016 Elsevier HS Journals, Inc. All rights reserved.

  13. 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.

  14. 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.

  15. The cost-effectiveness of a school-based overweight program

    Directory of Open Access Journals (Sweden)

    Hoelscher Deanna M

    2007-10-01

    Full Text Available Abstract Background This study assesses the net benefit and the cost-effectiveness of the Coordinated Approach to Child Health (CATCH intervention program, using parameter estimates from the El Paso trial. There were two standard economic measures used. First, from a societal perspective on costs, cost-effectiveness ratios (CER were estimated, revealing the intervention costs per quality-adjusted life years (QALYs saved. QALY weights were estimated using National Health Interview Survey (NHIS data. Second, the net benefit (NB of CATCH was estimated, which compared the present value of averted future costs with the cost of the CATCH intervention. Using National Health and Nutrition Examination Survey I (NHANES and NHANES follow-up data, we predicted the number of adult obesity cases avoided for ages 40–64 with a lifetime obesity progression model. Results The results show that CATCH is cost-effective and net beneficial. The CER was US$900 (US$903 using Hispanic parameters and the NB was US$68,125 (US$43,239 using Hispanic parameters, all in 2004 dollars. This is much lower than the benchmark for CER of US$30,000 and higher than the NB of US$0. Both were robust to sensitivity analyses. Conclusion Childhood school-based programs such as CATCH are beneficial investments. Both NB and CER declined when Hispanic parameters were included, primarily due to the lower wages earned by Hispanics. However, both NB and CER for Hispanics were well within standard cost-effectiveness and net benefit thresholds.

  16. 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

  17. Cost-Benefit of the energy saving in the bioclimatic designs; Costo-Beneficio del ahorro de energia en los disenos bioclimaticos

    Energy Technology Data Exchange (ETDEWEB)

    Lopez P, J. Manuel A. [Doble Dos Soluciones de Negocios, S.A. de C.V., Mexico, D.F. (Mexico); Morillon G, David; Rodriguez V, Luis [Instituto de Ingenieria de la UNAM, Mexico, D.F. (Mexico)

    1999-07-01

    Tools and criteria for the Cost-Benefit analysis from the energy saving in bioclimatic designs (BD) are presented, for which, a reference project is established and the costs and benefits of energy saving in BD with base in that project are evaluated. A case study is presented taking as reference the traditional design of the air conditioning of a building and with this base the estimation of cost-benefit of the same building is made, but with passive systems. The tools used are those that allow to consider related resources such as time and money; in that sense, are used criteria such as: Present value (PV), Equivalent Annual Cost (EAC) and the Cost of the Conserved Energy (CCE). The costs related to the construction, maintenance and operation of the design are taken into account. The differences between the reference design and the BD, established from the application of these criteria, allow to evaluate the economic margin of the BD as far as operation and maintenance is concerned. Finally the CCE of the bioclimatic measures is evaluated as an initiative of energy saving and the present value is calculated of the energy saving in the entire useful life of a bioclimatic design. [Spanish] Se presentan herramientas y criterios para el analisis Costo-Beneficio del ahorro de energia en disenos bioclimaticos (DB), para lo cual, se establece un proyecto de referencia y se evaluan los costos y beneficios del ahorro de energia en DB con base en ese proyecto. Se presenta el estudio de un caso tomando como referencia el dise tradicional de la climatizacion de un edificio y con base en este, se realiza la estimacion de costos y beneficios del mismo edificio, pero con sistemas pasivos. Las herramientas usadas, son aquellas que permiten considerar recursos relacionados como son tiempo y dinero; en ese sentido, se usan criterios como: Valor Presente (VP), Costo Anual Equivalente (CAE) y el Costo de la Energia Conservada (CEC). Se toman en consideracion los costos relacionados

  18. Adding a dietitian to a Danish Liaison-team after discharge of geriatric patients at nutritional risk may save health care costs

    DEFF Research Database (Denmark)

    Pohju, Anne; Belqaid, Kerstin; Brandt, Christopher Flintenborg

    2016-01-01

    Background: A previous study investigated the value of adding a dietitian to a geriatric discharge Liaison-Team. The scope of this study was to explore the possible economic savings of this. Methods: Patients, 70+ and at nutritional risk, were randomized to receive discharge Liaison-Team either......,416 compared to €1,150 (ONS only) in the CG. For hospitalizations, estimated cost was €92,020 in the IG and €220,025 in the CG. Cost savings added up to €3,048 per patient in the IG. Conclusion: Adding a dietitian to a Danish geriatric discharge Liaison-Team decreased health care costs......: Of the 71 included patients, 34 were in the IG, 30 patients received all three dietitian visits. Cumulated number of hospitalization days was 172 in the IG and 415 in the CG. Use of ONS was 48 % in the IG and 17% in the CG (P=0.001). Estimated cost for the dietitian and ONS combined in the IG was €9...

  19. 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.

  20. Cost-effectiveness outcomes of the national gastric cancer screening program in South Korea.

    Science.gov (United States)

    Cho, Eun; Kang, Moon Hae; Choi, Kui Son; Suh, Mina; Jun, Jae Kwan; Park, Eun-Cheol

    2013-01-01

    Although screening is necessary where gastric cancer is particularly common in Asia, the performance outcomes of mass screening programs have remained unclear. This study was conducted to evaluate cost-effectiveness outcomes of the national cancer screening program (NCSP) for gastric cancer in South Korea. People aged 40 years or over during 2002-2003 (baseline) were the target population. Screening recipients and patients diagnosed with gastric cancers were identified using the NCSP and Korea Central Cancer Registry databases. Clinical outcomes were measured in terms of mortality and life-years saved (LYS) of gastric cancer patients during 7 years based on merged data from the Korean National Health Insurance Corporation and National Statistical Office. We considered direct, indirect, and productivity-loss costs associated with screening attendance. Incremental cost-effectiveness ratio (ICER) estimates were produced according to screening method, sex, and age group compared to non-screening. The age-adjusted ICER for survival was 260,201,000-371,011,000 Korean Won (KW; 1USD=1,088 KW) for the upper-gastrointestinal (UGI) tract over non-screening. Endoscopy ICERs were lower (119,099,000-178,700,000 KW/survival) than UGI. To increase 1 life-year, additional costs of approximately 14,466,000-15,014,000 KW and 8,817,000-9,755,000 KW were required for UGI and endoscopy, respectively. Endoscopy was the most cost-effective strategy for males and females. With regard to sensitivity analyses varying based on the upper age limit, endoscopy NCSP was dominant for both males and females. For males, an upper limit of age 75 or 80 years could be considered. ICER estimates for LYS indicate that the gastric cancer screening program in Korea is cost-effective. Endoscopy should be recommended as a first-line method in Korea because it is beneficial among the Korean population.

  1. The Tax-Credit Scholarship Audit: Do Publicly Funded Private School Choice Programs Save Money?

    Science.gov (United States)

    Lueken, Martin F.

    2016-01-01

    This report follows up on previous work that examined the fiscal effects of private school voucher programs. It estimates the total fiscal effects of tax-credit scholarship programs--another type of private school choice program--on state governments, state and local taxpayers, and school districts combined. Based on a range of assumptions, these…

  2. 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.

  3. Liaison neurologists facilitate accurate neurological diagnosis and management, resulting in substantial savings in the cost of inpatient care.

    LENUS (Irish Health Repository)

    Costelloe, L

    2012-02-01

    BACKGROUND: Despite understaffing of neurology services in Ireland, the demand for liaison neurologist input into the care of hospital inpatients is increasing. This aspect of the workload of the neurologist is often under recognised. AIMS\\/METHODS: We prospectively recorded data on referral and service delivery patterns to a liaison neurology service, the neurological conditions encountered, and the impact of neurology input on patient care. RESULTS: Over a 13-month period, 669 consults were audited. Of these, 79% of patients were seen within 48 h and 86% of patients were assessed by a consultant neurologist before discharge. Management was changed in 69% cases, and discharge from hospital expedited in 50%. If adequate resources for neurological assessment had been available, 28% could have been seen as outpatients, with projected savings of 857 bed days. CONCLUSIONS: Investment in neurology services would facilitate early accurate diagnosis, efficient patient and bed management, with substantial savings.

  4. Energy Efficiency Improvement and Cost Saving Opportunities for Cement Making An ENERGY STAR® Guide for Energy and Plant Managers

    NARCIS (Netherlands)

    Worrell, E.|info:eu-repo/dai/nl/106856715; Kermeli, Katerina|info:eu-repo/dai/nl/411260553; Galitsky, Christina

    The cost of energy as part of the total production costs in the cement industry is significant, typically at 20 to 40% of operational costs, warranting attention for energy efficiency to improve the bottom line. Historically, energy intensity has declined, although more recently energy intensity

  5. Effects of a computerized provider order entry and a clinical decision support system to improve cefazolin use in surgical prophylaxis: a cost saving analysis

    Directory of Open Access Journals (Sweden)

    Okumura LM

    2016-09-01

    Full Text Available Background: Computerized Provider Order Entry (CPOE and Clinical Decision Support System (CDSS help practitioners to choose evidence-based decisions, regarding patients’ needs. Despite its use in developed countries, in Brazil, the impact of a CPOE/CDSS to improve cefazolin use in surgical prophylaxis was not assessed yet. Objective: We aimed to evaluate the impact of a CDSS to improve the use of prophylactic cefazolin and to assess the cost savings associated to inappropriate prescribing. Methods: This is a cross-sectional study that compared two different scenarios: one prior CPOE/CDSS versus after software implementation. We conducted twelve years of data analysis (3 years prior and 9 years after CDSS implementation, where main outcomes from this study included: cefazolin Defined Daily Doses/100 bed-days (DDD, crude costs and product of costs-DDD (cost-DDD/100 bed-days. We applied a Spearman rho non-parametric test to assess the reduction of cefazolin consumption through the years. Results: In twelve years, 84,383 vials of cefazolin were dispensed and represented 38.89 DDD/100 bed-days or USD 44,722.99. Surgical wards were the largest drug prescribers and comprised >95% of our studied sample. While in 2002, there were 6.31 DDD/100 bed-days, 9 years later there was a reduction to 2.15 (p<0.05. In a scenario without CDSS, the hospital would have consumed 75.72 DDD/100 bed-days, which is equivalent to USD 116 998.07. It is estimated that CDSS provided USD 50,433.39 of cost savings. Conclusion: The implementation of a CPOE/CDSS helped to improve prophylactic cefazolin use by reducing its consumption and estimated direct costs.

  6. Acute care for stunned myocardium after lightning strike is life-saving: need for public awareness programs

    Directory of Open Access Journals (Sweden)

    Ahmed Armin

    2013-05-01

    Full Text Available Lightning injury is a global public health problem. It still exists as a major environmental threat in developing nations where majority of population lives in rural areas. The different mechanisms of lightning injury can result in a spectrum of injuries ranging from minor, through moderate to severe. The most common cause of death due to lightning strike is cardiopulmonary arrest. Prognosis and outcome in moderate to severe lightning injury depends on timing of cardiopulmonary resuscitation and specialized care to prevent anoxic injury to vital organs. India lags behind in public education, awareness programs and health resources and has the biggest number of reported deaths due to lightning injuries. In this report, the authors highlight the importance of early cardiopulmonary support to a victim of direct lightning strike, which saved his life, and lay emphasis on the need to develop public awareness programs.

  7. 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...

  8. Energy, Pollutant Emissions and Other Negative Externality Savings from Curbing Individual Motorized Transportation (IMT: A Low Cost, Low Technology Scenario Analysis in Brazilian Urban Areas

    Directory of Open Access Journals (Sweden)

    Ursula Maruyama

    2012-03-01

    Full Text Available This article examines the inefficient use of resources in the Brazilian transportation system. The energy use growth and external cost generation in this essential economic sector are considerable, and the trend is towards an increasing problem in the coming years. The continued expansion of Brazilian cities and the increase in demand for mobility is a result of a substantial growth in the number of road transport users, as increased earnings enable lower income groups to acquire and use individual motorized means of transport. The aim of this paper is to estimate the potential gains from reducing individual motorized transport by the year 2020. This investigation concludes that in a conservationist scenario, by prioritizing low cost, low technology public policies—which include operation of Bus Rapid Transit systems, walking and cycling facilities and congestion charges, among others—it should be possible to save over USD 30 billion and USD 26 billion in external transportation and infrastructure costs, respectively, up to 2020. In addition, these public policies can save more than 35 million Tons of Oil Equivalents in energy consumption and avoid almost 4,000 thousand tons of local pollution emissions and 37,500 thousand tons of GHG emissions in the same period.

  9. Modelling the cost of community interventions to reduce child mortality in South Africa using the Lives Saved Tool (LiST).

    Science.gov (United States)

    Nkonki, Lungiswa Ll; Chola, Lumbwe L; Tugendhaft, Aviva A; Hofman, Karen K

    2017-08-28

    To estimate the costs and impact on reducing child mortality of scaling up interventions that can be delivered by community health workers at community level from a provider's perspective. In this study, we used the Lives Saved Tool (LiST), a module in the spectrum software. Within the spectrum software, LiST interacts with other modules, the AIDS Impact Module, Family Planning Module and Demography Projections Module (Dem Proj), to model the impact of more than 60 interventions that affect cause-specific mortality. DemProj Based on National South African Data. A total of nine interventions namely, breastfeeding promotion, complementary feeding, vitamin supplementation, hand washing with soap, hygienic disposal of children's stools, oral rehydration solution, oral antibiotics for the treatment of pneumonia, therapeutic feeding for wasting and treatment for moderate malnutrition. Reducing child mortality. A total of 9 interventions can prevent 8891 deaths by 2030. Hand washing with soap (21%) accounts for the highest number of deaths prevented, followed by therapeutic feeding (19%) and oral rehydration therapy (16%). The top 5 interventions account for 77% of all deaths prevented. At scale, an estimated cost of US$169.5 million (US$3 per capita) per year will be required in community health worker costs. The use of community health workers offers enormous opportunities for saving lives. These programmes require appropriate financial investments. Findings from this study show what can be achieved if concerted effort is channelled towards the identified set of life-saving interventions. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  10. 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.

  11. Demonstration Program for Low-Cost, High-Energy-Saving Dynamic Windows

    Science.gov (United States)

    2014-09-01

    lives at risk in associated logistics support operations. As such, improving windows efficiency with significantly higher efficiency than today’s...during this time period, and used in conjunction with metrological weather file data for annualized environmental load estimates, to annualize the

  12. Great comeback rates AHA award. Franciscan Children's develops less costly, alternative programs to save hospital.

    Science.gov (United States)

    Herreria, J

    1998-01-01

    After struggling financially for several years, Boston-based Franciscan Children's Hospital wins the coveted "Great Comeback of the Year" award. With the award, the hospital produces a PR campaign that resulted a plethora of television, print and radio stories. Officials of the Franciscan Children's Hospital announced its financial soundness and commitment to its Boston market area.

  13. Cost-effectiveness of Access to Critical Cerebral Emergency Support Services (ACCESS): a neuro-emergent telemedicine consultation program.

    Science.gov (United States)

    Whetten, Justin; van der Goes, David N; Tran, Huy; Moffett, Maurice; Semper, Colin; Yonas, Howard

    2018-01-19

    Access to Critical Cerebral Emergency Support Services (ACCESS) was developed as a low-cost solution to providing neuro-emergent consultations to rural hospitals in New Mexico that do not offer comprehensive stroke care. ACCESS is a two-way audio-visual program linking remote emergency department physicians and their patients to stroke specialists. ACCESS also has an education component in which hospitals receive training from stroke specialists on the triage and treatment of patients. This study assessed the clinical and economic outcomes of the ACCESS program in providing services to rural New Mexico from a healthcare payer perspective. A decision tree model was constructed using findings from the ACCESS program and existing literature, the likelihood that a patient will receive a tissue plasminogen activator (tPA), cost of care, and resulting quality adjusted life years (QALYs). Data from the ACCESS program includes emergency room patients in rural New Mexico from May 2015 to August 2016. Outcomes and costs have been estimated for patients who were taken to a hospital providing neurological telecare and patients who were not. The use of ACCESS decreased neuro-emergent stroke patient transfers from rural hospitals to urban settings from 85% to 5% (no tPA) and 90% to 23% (tPA), while stroke specialist reading of patient CT/MRI imaging within 3 h of onset of stroke symptoms increased from 2% to 22%. Results indicate that use of ACCESS has the potential to save $4,241 ($3,952-$4,438) per patient and increase QALYs by 0.20 (0.14-0.22). This increase in QALYs equates to ∼73 more days of life at full health. The cost savings and QALYs are expected to increase when moving from a 90-day model to a lifetime model. The analysis demonstrates potential savings and improved quality-of-life associated with the use of ACCESS for patients presenting to rural hospitals with acute ischemic stroke (AIS).

  14. 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.

  15. Energy Efficiency Improvement and Cost Saving Opportunities for the U.S. Iron and Steel Industry An ENERGY STAR(R) Guide for Energy and Plant Managers

    Energy Technology Data Exchange (ETDEWEB)

    Worrell, Ernst; Blinde, Paul; Neelis, Maarten; Blomen, Eliane; Masanet, Eric

    2010-10-21

    Energy is an important cost factor in the U.S iron and steel industry. Energy efficiency improvement is an important way to reduce these costs and to increase predictable earnings, especially in times of high energy price volatility. There are a variety of opportunities available at individual plants in the U.S. iron and steel industry to reduce energy consumption in a cost-effective manner. This Energy Guide discusses energy efficiency practices and energy-efficient technologies that can be implemented at the component, process, facility, and organizational levels. A discussion of the structure, production trends, energy consumption, and greenhouse gas emissions of the iron and steel industry is provided along with a description of the major process technologies used within the industry. Next, a wide variety of energy efficiency measures are described. Many measure descriptions include expected savings in energy and energy-related costs, based on case study data from real-world applications in the steel and related industries worldwide. Typical measure payback periods and references to further information in the technical literature are also provided, when available. The information in this Energy Guide is intended to help energy and plant managers in the U.S. iron and steel industry reduce energy consumption and greenhouse gas emissions in a cost-effective manner while maintaining the quality of products manufactured. Further research on the economics of all measures?and on their applicability to different production practices?is needed to assess their cost effectiveness at individual plants.

  16. Economic Costs and Benefits of a Community-Based Lymphedema Management Program for Lymphatic Filariasis in Odisha State, India

    Science.gov (United States)

    Stillwaggon, Eileen; Sawers, Larry; Rout, Jonathan; Addiss, David; Fox, LeAnne

    2016-01-01

    Lymphatic filariasis afflicts 68 million people in 73 countries, including 17 million persons living with chronic lymphedema. The Global Programme to Eliminate Lymphatic Filariasis aims to stop new infections and to provide care for persons already affected, but morbidity management programs have been initiated in only 24 endemic countries. We examine the economic costs and benefits of alleviating chronic lymphedema and its effects through a simple limb-care program. For Khurda District, Odisha State, India, we estimated lifetime medical costs and earnings losses due to chronic lymphedema and acute dermatolymphangioadenitis (ADLA) with and without a community-based limb-care program. The program would reduce economic costs of lymphedema and ADLA over 60 years by 55%. Savings of US$1,648 for each affected person in the workforce are equivalent to 1,258 days of labor. Per-person savings are more than 130 times the per-person cost of the program. Chronic lymphedema and ADLA impose a substantial physical and economic burden on the population in filariasis-endemic areas. Low-cost programs for lymphedema management based on limb washing and topical medication for infection are effective in reducing the number of ADLA episodes and stopping progression of disabling and disfiguring lymphedema. With reduced disability, people are able to work longer hours, more days per year, and in more strenuous, higher-paying jobs, resulting in an important economic benefit to themselves, their families, and their communities. Mitigating the severity of lymphedema and ADLA also reduces out-of-pocket medical expense. PMID:27573626

  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. Long-term impact of a chronic disease management program on hospital utilization and cost in an Australian population with heart disease or diabetes.

    Science.gov (United States)

    Hamar, G Brent; Rula, Elizabeth Y; Coberley, Carter; Pope, James E; Larkin, Shaun

    2015-04-22

    To evaluate the longitudinal value of a chronic disease management program, My Health Guardian (MHG), in reducing hospital utilization and costs over 4 years. The MHG program provides individualized support via telephonic nurse outreach and online tools for self-management, behavior change and well-being. In follow up to an initial 18-month analysis of MHG, the current study evaluated program impact over 4 years. A matched-cohort analysis retrospectively compared MHG participants with heart disease or diabetes (treatment, N = 4,948) to non-participants (comparison, N = 28,520) on utilization rates (hospital admission, readmission, total bed days) and hospital claims cost savings. Outcomes were evaluated using regression analyses, controlling for remaining demographic, disease, and pre-program admissions or cost differences between the study groups. Over the 4 year period, program participation resulted in significant reductions in hospital admissions (-11.4%, P costs (and savings) in Australia's risk equalization system for private insurers. Results confirm and extend prior program outcomes and support the longitudinal value of the MHG program in reducing hospital utilization and costs for individuals with heart disease or diabetes and demonstrate the increasing program effect with continued participation over time.

  20. Analysis of Base Services Structure and Development of Cost-Saving Strategies to Counterattack Decreasing Funding Levels

    Science.gov (United States)

    2005-12-01

    social , ethnic , religious, age, etc.), and the individual mix of interests and economic objectives can never be exactly the same between two...41 1. Cost Benefit Analysis .........................................................................41 2. Social Cost Benefit...us salivating for more. This quality cuisine was second only to Kathy’s always phenomenal culinary masterpieces. Thank you, cutie! xviii

  1. 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.

  2. 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

  3. Community partnership to address snack quality and cost in after-school programs.

    Science.gov (United States)

    Beets, Michael W; Tilley, Falon; Turner-McGrievy, Gabrielle; Weaver, Robert G; Jones, Sonya

    2014-08-01

    Policies call on after-school programs (ASPs) to serve more nutritious snacks. A major barrier for improving snack quality is cost. This study describes the impact on snack quality and expenditures from a community partnership between ASPs and local grocery stores. Four large-scale ASPs (serving ˜500 children, aged 6-12 years, each day) and a single local grocery store chain participated in this study. The nutritional quality of snacks served was recorded preintervention (18 weeks spring/fall 2011) and postintervention (7 weeks spring 2012) via direct observation, along with cost/child/snack/day. Preintervention snacks were low-nutrient-density salty snacks (eg, chips, 3.0 servings/week), sugar-sweetened beverages (eg, powdered-lemonade, 1.9 servings/week), and desserts (eg, cookies, 2.1 servings/week), with only 0.4 servings/week of fruits and no vegetables. By postintervention, fruits (3.5 servings/week) and vegetables (1.2 servings/week) were increased, whereas sugar-sweetened beverages and desserts were eliminated. Snack expenditures were $0.26 versus $0.24 from preintervention to postintervention. Partnership savings versus purchasing snacks at full retail cost was 24.5% or $0.25/serving versus $0.34/serving. This innovative partnership can serve as a model in communities where ASPs seek to identify low-cost alternatives to providing nutritious snacks. © 2014, American School Health Association.

  4. Energy Efficiency Improvement and Cost Saving Opportunities for the Baking Industry: An ENERGY STAR® Guide for Plant and Energy Managers

    Energy Technology Data Exchange (ETDEWEB)

    Masanet, Eric [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division; Therkelsen, Peter [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division; Worrell, Ernst [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division

    2012-12-28

    The U.S. baking industry—defined in this Energy Guide as facilities engaged in the manufacture of commercial bakery products such as breads, rolls, frozen cakes, pies, pastries, and cookies and crackers—consumes over $800 million worth of purchased fuels and electricity per year. Energy efficiency improvement is an important way to reduce these costs and to increase predictable earnings, especially in times of high energy price volatility. There are a variety of opportunities available at individual plants to reduce energy consumption in a cost-effective manner. This Energy Guide discusses energy efficiency practices and energy-efficient technologies that can be implemented at the component, process, facility, and organizational levels. Many measure descriptions include expected savings in energy and energy-related costs, based on case study data from real-world applications in food processing facilities and related industries worldwide. Typical measure payback periods and references to further information in the technical literature are also provided, when available. A summary of basic, proven measures for improving plant-level water efficiency is also provided. The information in this Energy Guide is intended to help energy and plant managers in the U.S. baking industry reduce energy and water consumption in a cost-effective manner while maintaining the quality of products manufactured. Further research on the economics of all measures—as well as on their applicability to different production practices—is needed to assess their cost effectiveness at individual plants.

  5. 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.

  6. Risk transfer via energy savings insurance

    Energy Technology Data Exchange (ETDEWEB)

    Mills, Evan

    2001-10-01

    Among the key barriers to investment in energy efficiency improvements are uncertainties about attaining projected energy savings and apprehension about potential disputes over these savings. The fields of energy management and risk management are thus intertwined. While many technical methods have emerged to manage performance risks (e.g. building commissioning), financial risk transfer techniques are less developed in the energy management arena than in other more mature segments of the economy. Energy Savings Insurance (ESI) - formal insurance of predicted energy savings - is one method of transferring financial risks away from the facility owner or energy services contractor. ESI offers a number of significant advantages over other forms of financial risk transfer, e.g. savings guarantees or performance bonds. ESI providers manage risk via pre-construction design review as well as post-construction commissioning and measurement and verification of savings. We found that the two mos t common criticisms of ESI - excessive pricing and onerous exclusions - are not born out in practice. In fact, if properly applied, ESI can potentially reduce the net cost of energy savings projects by reducing the interest rates charged by lenders, and by increasing the level of savings through quality control. Debt service can also be ensured by matching loan payments to projected energy savings while designing the insurance mechanism so that payments are made by the insurer in the event of a savings shortfall. We estimate the U.S. ESI market potential of $875 million/year in premium income. From an energy-policy perspective, ESI offers a number of potential benefits: ESI transfers performance risk from the balance sheet of the entity implementing the energy savings project, thereby freeing up capital otherwise needed to ''self-insure'' the savings. ESI reduces barriers to market entry of smaller energy services firms who do not have sufficiently strong balance

  7. 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 ...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1990-01-01

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

  9. Energy Saving Potential, Costs and Uncertainties in the Industry: A Case Study of the Chemical Industry in Germany

    DEFF Research Database (Denmark)

    Bühler, Fabian; Guminski, Andrej; Gruber, Anna

    2017-01-01

    ), which rank these measures according to specific implementation costs. Existing analyses, however, often do not take uncertainties in costs and potentials into account. The aim of this paper is to create a MCC of energy efficiency measures for the chemical industry in Germany, while quantifying...... to 1990. To achieve this ambitious goal, energy planners and industries alike require an overview of the existing energy efficiency measures, their technical potential as well as the costs for realizing this potential. Energy efficiency opportunities are commonly presented in marginal cost curves (MCCs......In Germany, 19.6 % of the industrial final energy consumption (FEC) can be allocated to the chemical industry. Energy efficiency measures with focus on the chemical industry could thus significantly contribute to reaching the German goal of reducing greenhouse gas emissions by 80 % in 2050 compared...

  10. New environment-friendly and cost-saving fertiliser recommendation system for supporting sustainable agriculture in Hungary and beyond

    Directory of Open Access Journals (Sweden)

    Nándor FODOR

    2011-07-01

    Full Text Available In the current economic situation the former, intensive fertiliser recommendation system is unfit to help Hungarian farmers in their fertilising practice. The aim of the new system has been to apply the lowest possible NPK rates required to achieve safe and high yields as well as allowing minimal agricultural NP losses to surface and subsurface waters. The new system was developed by using the correlations revealed by analyzing the results of long-term fertilisation experiments set up in Hungary between 1960 and 2000. Several field experiments as well as comparative analyses confirmed the correctness of the basic principles as well as of the methods of calculating fertiliser rates of the new system. An estimated amount of 3,200,000 € was saved for the Hungarian farmers in 2007 alone by giving recommendations for more than 160,000 ha arable land applying the new system.

  11. Guide to protect climate. Saving energy and cost, protecting climate; Der Klima-Knigge. Energie sparen, Kosten senken, Klima schuetzen

    Energy Technology Data Exchange (ETDEWEB)

    Griesshammer, Rainer

    2008-07-01

    As a climate protector you mustn't seat in the darkness. The author shows by much humour and esprit how simple it is to save energy. Who is willing to persue his every day tips, must not miss comfort and lowers even carbon dioxide emission. This is good for the environment and fills up the own purse. (orig./GL) [German] Als Klimaschuetzer braucht man nicht im Dunkeln zu sitzen. Mit viel Humor und Esprit zeigt Griesshammer, wie einfach Energie sparen sein kann. Wer seine Alltagstipps befolgt, muss auf keinen Komfort verzichten und mindert trotzdem den CO2-Ausstoss. Das nutzt der Umwelt und fuellt den eigenen Geldbeutel auf. (orig./GL)

  12. Hospital cost effect of a heart failure disease management program: the Specialized Primary and Networked Care in Heart Failure (SPAN-CHF) trial.

    Science.gov (United States)

    Gregory, Douglas; Kimmelstiel, Carey; Perry, Kathleen; Parikh, Amay; Konstam, Varda; Konstam, Marvin A

    2006-05-01

    Determine the effect on hospitalization cost of a heart failure disease management (HFDM) program delivered within a diverse provider network as demonstrated in the SPAN-CHF randomized controlled trial. The SPAN-CHF trial was a prospective randomized assessment of the effectiveness of HFDM delivered for 90 days across a diverse provider network in a heterogeneous population of 200 patients. Baseline clinical and demographic data were obtained on each patient, mortality was monitored, and hospitalizations were tracked for 90 days. Cost estimates for each hospitalization were based on a subsample of patients seen at Tufts-New England Medical Center for whom hospitalization costs were calculated. Heart failure disease management program costs were estimated using a programmatic budget model. Hospital utilization and cost data were combined to estimate medical costs for intervention and control groups. Heart failure disease management had a favorable effect on heart failure hospitalization, which was partially offset by noncardiac hospitalizations. The relative odds of at least one all-cause hospitalization during the intervention period trended less for the intervention group compared with the control group (0.76 [95% CI 0.38-1.51]). The point estimate of the differential hospitalization cost between control and intervention groups was a reduction in cost of $375 per patient. The net effect including the costs of the program was an increase of $488 per patient for the intervention group compared with the control group. The program would have been cost saving if HFDM costs had been 24% lower. The HFDM intervention, administered over 90 days to patients hospitalized for heart failure, succeeded in reducing the rate of heart failure hospitalizations, although this effect was partially offset by an increase in non-heart failure hospitalizations. The resulting modest reduction in all-cause hospitalization costs was exceeded by the cost of the intervention. Thus, although

  13. Linear Programming Approaches for Power Savings in Software-defined Networks

    NARCIS (Netherlands)

    Moghaddam, F.A.; Grosso, P.

    2016-01-01

    Software-defined networks have been proposed as a viable solution to decrease the power consumption of the networking component in data center networks. Still the question remains on which scheduling algorithms are most suited to achieve this goal. We propose 4 different linear programming

  14. Exploring Saving Performance in an IDA Program: Findings for People with Disabilities

    Science.gov (United States)

    Lombe, Margaret; Huang, Jin; Putnam, Michelle; Cooney, Kate

    2010-01-01

    Asset development policies have been promoted as a means to create a more inclusive "ownership society." During the past few years, asset-building scholarship has begun to focus specifically on marginalized groups, including people with disabilities. Using a sample of individual development account (IDA) program participants (N = 376), the authors…

  15. Retirement plans, personal saving, and saving adequacy.

    Science.gov (United States)

    Yakoboski, P

    2000-03-01

    This Issue Brief addresses three questions raised by recent trends in personal saving: How are national savings measured and what is the meaning of the trends in measured personal saving rates, given what is included and what is not included in those measures? What is the effect of retirement saving programs--in particular, 401(k) plans and individual retirement accounts (IRAs)--on personal saving levels? What are the implications of existing saving behavior for the retirement income security of today's workers? The National Income and Product Accounts (NIPA), the most commonly referenced gauge of personal saving, is a widely misunderstood measure. One could argue that a complete measure of saving would include increases in wealth through capital gains, but NIPA does not factor accrued and realized capital gains on stocks and other assets into the saving rate. By one measure, accounting for capital gains results in an aggregate personal saving rate of 33 percent--more than double the rate of four decades ago. A major policy question is the impact of tax-qualified retirement saving plans (i.e., IRAs and 401(k) plans) on personal saving rates. Empirical analysis of this issue is extremely challenging and findings have been contradictory. These programs now represent an enormous store of retirement-earmarked wealth in tax-deferred vehicles: Combined, such tax-deferred retirement accounts currently have assets of about $4 trillion. Ninety percent of IRA contributions are now the result of "rollovers" as employees leave employer plans, like 401(k) plans. While leakage from the system remains a challenge, the majority of the assets in the system can be expected to be available to fund workers' retirements. One could argue that, from a retirement income security perspective, workers in general are better off because IRA and 401(k) programs exist. Surely, many of the dollars in these programs would have been saved even without the programs; but they would not necessarily

  16. Buy now, saved later? The critical impact of time-to-pandemic uncertainty on pandemic cost-effectiveness analyses.

    Science.gov (United States)

    Drake, Tom; Chalabi, Zaid; Coker, Richard

    2015-02-01

    Investment in pandemic preparedness is a long-term gamble, with the return on investment coming at an unknown point in the future. Many countries have chosen to stockpile key resources, and the number of pandemic economic evaluations has risen sharply since 2009. We assess the importance of uncertainty in time-to-pandemic (and associated discounting) in pandemic economic evaluation, a factor frequently neglected in the literature to-date. We use a probability tree model and Monte Carlo parameter sampling to consider the cost effectiveness of antiviral stockpiling in Cambodia under parameter uncertainty. Mean elasticity and mutual information (MI) are used to assess the importance of time-to-pandemic compared with other parameters. We also consider the sensitivity to choice of sampling distribution used to model time-to-pandemic uncertainty. Time-to-pandemic and discount rate are the primary drivers of sensitivity and uncertainty in pandemic cost effectiveness models. Base case cost effectiveness of antiviral stockpiling ranged between is US$112 and US$3599 per DALY averted using historical pandemic intervals for time-to-pandemic. The mean elasticities for time-to-pandemic and discount rate were greater than all other parameters. Similarly, the MI scores for time to pandemic and discount rate were greater than other parameters. Time-to-pandemic and discount rate were key drivers of uncertainty in cost-effectiveness results regardless of time-to-pandemic sampling distribution choice. Time-to-pandemic assumptions can "substantially" affect cost-effectiveness results and, in our model, is a greater contributor to uncertainty in cost-effectiveness results than any other parameter. We strongly recommend that cost-effectiveness models include probabilistic analysis of time-to-pandemic uncertainty. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

  17. Household Savings

    DEFF Research Database (Denmark)

    Browning, Martin; Lusardi, Annamaria

    In this survey, we review the recent theoretical and empirical literature on household saving and consumption. The discussion is structured around a list of motives for saving and how well the standard theory captures these motives. We show that almost all of the motives for saving that have been...... of standard optimization techniques and focuses instead on direct consideration on saving. We provide a section on facts: who save and how much. We then discuss informally the recent decline in the U.S. saving rate and whether the theory is of much use in understanding this and other changes in aggregate...... be rationalized within a simple life cycle model. We also review a great number of studies of the consumption Euler equations. Based on our analysis of the studies cited we conclude that there is still mixed evidence that consumption is excessively sensitive to income. We also examine in depth the recent...

  18. Simplification and Saving

    Science.gov (United States)

    Beshears, John; Choi, James J.; Laibson, David; Madrian, Brigitte C.

    2012-01-01

    The daunting complexity of important financial decisions can lead to procrastination. We evaluate a low-cost intervention that substantially simplifies the retirement savings plan participation decision. Individuals received an opportunity to enroll in a retirement savings plan at a pre-selected contribution rate and asset allocation, allowing them to collapse a multidimensional problem into a binary choice between the status quo and the pre-selected alternative. The intervention increases plan enrollment rates by 10 to 20 percentage points. We find that a similar intervention can be used to increase contribution rates among employees who are already participating in a savings plan. PMID:24443619

  19. Extract BIG savings from physician preference items. Use a data-driven, team-based approach to drive down costs.

    Science.gov (United States)

    Tyson, Patricia

    2010-05-01

    As baby boomers reach retirement age, the demand for cardiac, spine and orthopedic implants is expected to escalate rapidly. Containing spending on these physician preference items (PPI) will be crucial for hospitals, which are facing reduced revenue streams due to bundled payments and other factors. Materials managers will play a lead role in devising cost-reduction strategies. They'll need to establish benchmarking data to share with physicians to build consensus on how to best cut PPI costs without sacrificing the quality of care. Follow these steps to get started.

  20. Feature Selection as a Time and Cost-Saving Approach for Land Suitability Classification (Case Study of Shavur Plain, Iran)

    NARCIS (Netherlands)

    Hamzeh, Saeid; Mokarram, Marzieh; Haratian, Azadeh; Bartholomeus, Harm; Ligtenberg, Arend; Bregt, Arnold

    2016-01-01

    Land suitability classification is important in planning and managing sustainable land use. Most approaches to land suitability analysis combine a large number of land and soil parameters, and are time-consuming and costly. In this study, a potentially useful technique (combined feature selection

  1. Energy Efficiency Improvement and Cost Saving Opportunities for the Petrochemical Industry - An ENERGY STAR(R) Guide for Energy and Plant Managers

    Energy Technology Data Exchange (ETDEWEB)

    Neelis, Maarten; Worrell, Ernst; Masanet, Eric

    2008-09-01

    Energy is the most important cost factor in the U.S petrochemical industry, defined in this guide as the chemical industry sectors producing large volume basic and intermediate organic chemicals as well as large volume plastics. The sector spent about $10 billion on fuels and electricity in 2004. Energy efficiency improvement is an important way to reduce these costs and to increase predictable earnings, especially in times of high energy price volatility. There are a variety of opportunities available at individual plants in the U.S. petrochemical industry to reduce energy consumption in a cost-effective manner. This Energy Guide discusses energy efficiency practices and energy efficient technologies that can be implemented at the component, process, facility, and organizational levels. A discussion of the trends, structure, and energy consumption characteristics of the petrochemical industry is provided along with a description of the major process technologies used within the industry. Next, a wide variety of energy efficiency measures are described. Many measure descriptions include expected savings in energy and energy-related costs, based on case study data from real-world applications in the petrochemical and related industries worldwide. Typical measure payback periods and references to further information in the technical literature are also provided, when available. The information in this Energy Guide is intended to help energy and plant managers in the U.S. petrochemical industry reduce energy consumption in a cost-effective manner while maintaining the quality of products manufactured. Further research on the economics of all measures--and on their applicability to different production practices--is needed to assess their cost effectiveness at individual plants.

  2. 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...

  3. [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.

  4. Energy saving report; Energispareredegoerelse

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2003-05-01

    Making the energy consumption more efficient in Denmark by means of energy saving are connected to the Danish government's overall National Growth Strategy. A reduced consumption of energy as a result of economic attractive energy saving initiatives leads to reduced energy costs and consequently an improvement of Denmark's competitive power. Furthermore, reducing the energy consumption decreases the vulnerability towards rising energy prices, and the security of supplies is increased. Finally energy conservation serves as a means of reducing environmental impact from the energy sector. Energy consumption is not damaging to the environment in itself, however, to the extent that energy consumption causes negative impact on the environment, e.g. through discharge of environmentally damaging substances generated during energy production, a reduction of the energy consumption will benefit the environment. Energy saving in itself does not lead to a decrease in CO{sub 2} emission in Denmark unless it is accompanied by an adjustment of CO{sub 2} quotas on production of electricity. The Danish Government emphasizes that the energy saving efforts are cost-effective both for the society and for the consumers. The energy saving report contains an updated projection of the Danish energy consumption and an evaluation of the impacts of the energy saving efforts. The impacts of more effective end use of energy are described, and an account of the barriers preventing the realization of a number of potential economic attractive energy saving initiatives is made. Finally the energy saving report presents a number of proposals for new energy saving initiatives. (BA)

  5. A cost- and time-saving strategy of spraying TiO2 self-cleaning coatings in tubular substrates by air cold plasma

    Science.gov (United States)

    Zhang, Lujie; Yu, Shuang; Wang, Kaile; Zhang, Jue; Fang, Jing

    2017-11-01

    In this study, using an atmospheric pressure air plasma jet generated by a dielectric barrier structure with hollow electrodes (HEDBS), we developed an ultrafast process for spraying TiO2 self-cleaning films inside tubular substrates. Importantly, SEM images showed that the TiO2 particles were dispersed evenly in the tubular substrates. Furthermore, Raman and XRD pattern indicated the anatase structure of the HEDBS-spayed TiO2 coating after heating at 270 °C. Further results of the self cleaning test suggested that the proposed cost- and time-saving HEDBS approach with air working gas could provide a feasible way for synthesizing thin TiO2 nanofilms.

  6. 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

    mortality in resource-poor settings. It is shown here that nationwide expansion of this program across the range of health provision levels and regions of Tanzania would be feasible. This study provides policymakers and investors with the relevant cost-estimation for national rollout of this potentially neonatal life-saving intervention.

  7. Energy efficiency improvement and cost saving opportunities for the Corn Wet Milling Industry: An ENERGY STAR Guide for Energy and Plant Managers

    Energy Technology Data Exchange (ETDEWEB)

    Galitsky, Christina; Worrell, Ernst; Ruth, Michael

    2003-07-01

    Corn wet milling is the most energy intensive industry within the food and kindred products group (SIC 20), using 15 percent of the energy in the entire food industry. After corn, energy is the second largest operating cost for corn wet millers in the United States. A typical corn wet milling plant in the United States spends approximately $20 to $30 million per year on energy, making energy efficiency improvement an important way to reduce costs and increase predictable earnings, especially in times of high energy-price volatility. This report shows energy efficiency opportunities available for wet corn millers. It begins with descriptions of the trends, structure and production of the corn wet milling industry and the energy used in the milling and refining process. Specific primary energy savings for each energy efficiency measure based on case studies of plants and references to technical literature are provided. If available, typical payback periods are also listed. The report draws upon the experiences of corn, wheat and other starch processing plants worldwide for energy efficiency measures. The findings suggest that given available resources and technology, there are opportunities to reduce energy consumption cost-effectively in the corn wet milling industry while maintaining the quality of the products manufactured. Further research on the economics of the measures, as well as the applicability of these to different wet milling practices, is needed to assess the feasibility of implementation of selected technologies at individual plants.

  8. Energy Efficiency Improvement and Cost Saving Opportunities for the Dairy Processing Industry: An ENERGY STAR? Guide for Energy and Plant Managers

    Energy Technology Data Exchange (ETDEWEB)

    Brush, Adrian [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Masanet, Eric [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Worrell, Ernst [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2011-10-01

    The U.S. dairy processing industry—defined in this Energy Guide as facilities engaged in the conversion of raw milk to consumable dairy products—consumes around $1.5 billion worth of purchased fuels and electricity per year. Energy efficiency improvement is an important way to reduce these costs and to increase predictable earnings, especially in times of high energy price volatility. There are a variety of opportunities available at individual plants in the U.S. dairy processing industry to reduce energy consumption and greenhouse gas emissions in a cost-effective manner. This Energy Guide discusses energy efficiency practices and energy-efficient technologies that can be implemented at the component, process, facility, and organizational levels. A discussion of the trends, structure, and energy consumption characteristics of the U.S. dairy processing industry is provided along with a description of the major process technologies used within the industry. Next, a wide variety of energy efficiency measures applicable to dairy processing plants are described. Many measure descriptions include expected savings in energy and energy-related costs, based on case study data from real-world applications in dairy processing facilities and related industries worldwide. Typical measure payback periods and references to further information in the technical literature are also provided, when available. Given the importance of water in dairy processing, a summary of basic, proven measures for improving water efficiency are also provided. The information in this Energy Guide is intended to help energy and plant managers in the U.S. dairy processing industry reduce energy and water consumption in a cost-effective manner while maintaining the quality of products manufactured. Further research on the economics of all measures—as well as on their applicability to different production practices—is needed to assess their cost effectiveness at individual plants.

  9. Energy Efficiency Improvement and Cost Saving Opportunities for the Fruit and Vegetable Processing Industry. An ENERGY STAR Guide for Energy and Plant Managers

    Energy Technology Data Exchange (ETDEWEB)

    Masanet, Eric; Masanet, Eric; Worrell, Ernst; Graus, Wina; Galitsky, Christina

    2008-01-01

    The U.S. fruit and vegetable processing industry--defined in this Energy Guide as facilities engaged in the canning, freezing, and drying or dehydrating of fruits and vegetables--consumes over $800 million worth of purchased fuels and electricity per year. Energy efficiency improvement isan important way to reduce these costs and to increase predictable earnings, especially in times of high energy price volatility. There are a variety of opportunities available at individual plants in the U.S. fruit and vegetable processing industry to reduce energy consumption in a cost-effective manner. This Energy Guide discusses energy efficiency practices and energy-efficient technologies that can be implemented at the component, process, facility, and organizational levels. A discussion of the trends, structure, and energy consumption characteristics of the U.S. fruit and vegetable processing industry is provided along with a description of the major process technologies used within the industry. Next, a wide variety of energy efficiency measures applicable to fruit and vegetable processing plants are described. Many measure descriptions include expected savings in energy and energy-related costs, based on case study data from real-world applications in fruit and vegetable processing facilities and related industries worldwide. Typical measure payback periods and references to further information in the technical literature are also provided, when available. Given the importance of water in fruit and vegetable processing, a summary of basic, proven measures for improving plant-level water efficiency are also provided. The information in this Energy Guide is intended to help energy and plant managers in the U.S. fruit and vegetable processing industry reduce energy and water consumption in a cost-effective manner while maintaining the quality of products manufactured. Further research on the economics of all measures--as well as on their applicability to different production

  10. The Potential Cost Savings of Greater Use of Home- and Hospice- Based End of Life Care in England

    Science.gov (United States)

    2008-01-01

    medically ill. 12. Title: Strain experienced by caregivers of dementia patients receiving palliative care : findings from the Palliative Excellence...Programs that provide palliative care to individuals with dementia , which is a progressive terminal illness, are likely to encounter different...is available on palliative care for individuals with dementia who live in the community. OBJECTIVE: This study examines predictors of types of

  11. 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...

  12. 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...

  13. Waste molasses alone displaces glucose-based medium for microalgal fermentation towards cost-saving biodiesel production.

    Science.gov (United States)

    Yan, Dong; Lu, Yue; Chen, Yi-Feng; Wu, Qingyu

    2011-06-01

    The by-product of sugar refinery-waste molasses was explored as alternative to glucose-based medium of Chlorella protothecoides in this study. Enzymatic hydrolysis is required for waste molasses suitable for algal growth. Waste molasses hydrolysate was confirmed as a sole source of full nutrients to totally replace glucose-based medium in support of rapid growth and high oil yield from algae. Under optimized conditions, the maximum algal cell density, oil content, and oil yield were respectively 70.9 g/L, 57.6%, and 40.8 g/L. The scalability of the waste molasses-fed algal system was confirmed from 0.5L flasks to 5L fermenters. The quality of biodiesel from waste molasses-fed algae was probably comparable to that from glucose-fed ones. Economic analysis indicated the cost of oil production from waste molasses-fed algae reduced by 50%. Significant cost reduction of algal biodiesel production through fermentation engineering based on the approach is expected. Copyright © 2011 Elsevier Ltd. All rights reserved.

  14. The Use of a Collaborative Common Parts Catalog to Achieve Increased Efficiency and Cost Savings in the Fleet Modernization Plan

    Science.gov (United States)

    2011-12-01

    NAVAL SEA SYSTEMS COMMAND NDE NAVY DATA ENVIRONMENT NGSS NORTHROP GRUMMAN SHIP SYSTEMS NSRP NATIONAL SHIPBUILDING RESEARCH PROGRAM NSWCCD CARDEROCK...GD-EB) and Northrop Grumman Ship Systems ( NGSS ) (NSRP, 2004). The American shipbuilding industry has already implemented collaborative tools and...Electric Boat (GD-EB) and Northrop Grumman Ship Systems ( NGSS ), it was an attempt to explore the value of a collaborative parts catalog that could be

  15. 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.

  16. 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.

  17. Energy Savings from Industrial Water Reductions

    Energy Technology Data Exchange (ETDEWEB)

    Rao, Prakash; McKane, Aimee; de Fontaine, Andre

    2015-08-03

    Although it is widely recognized that reducing freshwater consumption is of critical importance, generating interest in industrial water reduction programs can be hindered for a variety of reasons. These include the low cost of water, greater focus on water use in other sectors such as the agriculture and residential sectors, high levels of unbilled and/or unregulated self-supplied water use in industry, and lack of water metering and tracking capabilities at industrial facilities. However, there are many additional components to the resource savings associated with reducing site water use beyond the water savings alone, such as reductions in energy consumption, greenhouse gas emissions, treatment chemicals, and impact on the local watershed. Understanding and quantifying these additional resource savings can expand the community of businesses, NGOs, government agencies, and researchers with a vested interest in water reduction. This paper will develop a methodology for evaluating the embedded energy consumption associated with water use at an industrial facility. The methodology developed will use available data and references to evaluate the energy consumption associated with water supply and wastewater treatment outside of a facility’s fence line for various water sources. It will also include a framework for evaluating the energy consumption associated with water use within a facility’s fence line. The methodology will develop a more complete picture of the total resource savings associated with water reduction efforts and allow industrial water reduction programs to assess the energy and CO2 savings associated with their efforts.

  18. The National Cancer Screening Program for breast cancer in the Republic of Korea: is it cost-effective?

    Science.gov (United States)

    Kang, Moon Hae; Park, Eun-Cheol; Choi, Kui Son; Suh, Mina; Jun, Jae Kwan; Cho, Eun

    2013-01-01

    This goal of this research was to evaluate the cost-effectiveness of the National Cancer Screening Program (NCSP) for breast cancer in the Republic of Korea from a government expenditure perspective. In 2002-2003 (baseline), a total of 8,724,860 women aged 40 years or over were invited to attend breast cancer screening by the NCSP. Those who attended were identified using the NCSP database, and women were divided into two groups, women who attended screening at baseline (screened group) and those who did not (non-screened group). Breast cancer diagnosis in both groups at baseline, and during 5-year follow-up was identified using the Korean Central Cancer Registry. The effectiveness of the NCSP for breast cancer was estimated by comparing 5-year survival and life years saved (LYS) between the screened and the unscreened groups, measured using mortality data from the Korean National Health Insurance Corporation and the National Health Statistical Office. Direct screening costs, indirect screening costs, and productivity costs were considered in different combinations in the model. When all three of these costs were considered together, the incremental cost to save one life year of a breast cancer patient was 42,305,000 Korean Won (KW) (1 USD=1,088 KW) for the screened group compared to the non-screened group. In sensitivity analyses, reducing the false-positive rate of the screening program by half was the most cost-effective (incremental cost-effectiveness ratio, ICER=30,110,852 KW/LYS) strategy. When the upper age limit for screening was set at 70 years, it became more cost-effective (ICER=39,641,823 KW/LYS) than when no upper age limit was set. The NCSP for breast cancer in Korea seems to be accepted as cost-effective as ICER estimates were around the Gross Domestic Product. However, cost-effectiveness could be further improved by increasing the sensitivity of breast cancer screening and by setting appropriate age limits.

  19. 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

  20. Consumer-directed health plans with health savings accounts: whose skin is in the game and how do costs affect care seeking?

    Science.gov (United States)

    Reed, Mary; Graetz, Ilana; Wang, Huihui; Fung, Vicki; Newhouse, Joseph P; Hsu, John

    2012-07-01

    Employers are increasingly offering high-deductible health insurance plans with associated health savings accounts (HSAs), but there is limited information on account contributions or effects on patient care seeking. We examined HSA contributions and their source, patient-reported effects of costs on care seeking, and reports of financial burden. We conducted telephone interviews with 488 adult members of small group of employer-sponsored HSA-eligible plans within an integrated delivery system. HSA contribution sources and amounts varied with 32% receiving an employer contribution and also making their own employee contribution, 35% only receiving an employer contribution (no employee contribution), 19% only making their own contribution (no employer contribution), and 14% with no HSA contribution from either source. After adjustment for respondent characteristics, those who made their own HSA contributions in addition to their employer's contribution were significantly more likely to report that costs affected their care-seeking behavior, compared with those with only employer contributions (39% vs. 31% for emergency department and 60% vs. 49% for office visits, all Ppaid out-of-pocket for care were significantly more likely to report financial burdens than those with only employer contributions (Pemployer contributions to their HSA, but few have fully funded accounts. Those with only an employer contribution reported fewer changes in their care-seeking behavior and were less likely to report experiencing financial burdens.

  1. Telecardiology application in jordan: its impact on diagnosis and disease management, patients' quality of life, and time- and cost-savings.

    Science.gov (United States)

    Khader, Yousef Saleh; Jarrah, Mohamad Ismail; Al-Shudifat, Abde-Ellah M; Shdaifat, Amjad; Aljanabi, Husham; Al-Fakeh, Shadwan Ismeil; Turk, Elias Emil; Zayed, Khaled Ali; Al Quran, Hanadi A; Ellauzi, Ziad Mohd; Al Tahan, Mohammad

    2014-01-01

    Objectives. To assess the impact of live interactive telecardiology on diagnosis and disease management, patients' quality of life, and time- and cost-savings. Methods. All consecutive patients who attended or were referred to the teleclinics for suspected cardiac problems in two hospitals in remote areas of Jordan during the study period were included in the study. Patients were interviewed for relevant information and their quality of life was assessed during the first visit and 8 weeks after the last visit. Results. A total of 76 patients were included in this study. Final diagnosis and treatment plan were established as part of the telecardiology consultations in 71.1% and 77.3% of patients, respectively. Patients' travel was avoided for 38 (50.0%) who were managed locally. The majority of patients perceived that the visit to the telecardiology clinic results in less travel time (96.1%), less waiting time (98.1%), and lower cost (100.0%). Telecardiology consultations resulted in an improvement in the quality of life after two months of the first visit. Conclusions. Telecardiology care in remote areas of Jordan would improve the access to health care, help to reach proper diagnosis and establish the treatment plan, and improve the quality of life.

  2. Community Partnership to Address Snack Quality and Cost in Afterschool Programs

    Science.gov (United States)

    Tilley, Falon; Turner-McGrievy, Gabrielle; Weaver, Robert Glenn; Jones, Sonya

    2014-01-01

    Background Policies call on afterschool programs (ASPs) to serve more nutritious snacks. A major barrier for improving snack quality is cost. This study describes the impact on snack quality and expenditures from a community-partnership between ASPs and local grocery stores. Methods Four large-scale ASPs (serving ∼500 children aged 6-12 years each day) and a single local grocery store chain participated in the study. The nutritional quality of snacks served was recorded pre-intervention (18 weeks spring/fall 2011) and post-intervention (7 weeks spring 2012) via direct observation, along with cost/child/snack/day. Results Pre-intervention snacks were low-nutrient-density salty snacks (eg, chips, 3.0 servings/week), sugar-sweetened beverages (eg, powdered-lemonade, 1.9 servings/week), and desserts (eg, cookies, 2.1servings/week), with only 0.4 servings/week of fruits and no vegetables. By post-intervention, fruits (3.5 servings/week) and vegetables (1.2 servings/week) increased, while sugar-sweetened beverages and desserts were eliminated. Snack expenditures were $0.26 versus $0.24 from pre-intervention to post-intervention. Partnership savings versus purchasing snacks at full retail cost was 24.5% or $0.25/serving versus $0.34/serving. Conclusions This innovative partnership can serve as a model in communities where ASPs seek to identify low-cost alternatives to providing nutritious snacks. PMID:25040123

  3. Evidence for the long term cost effectiveness of home care reablement programs

    Directory of Open Access Journals (Sweden)

    Lewin GF

    2013-10-01

    Full Text Available Gill F Lewin,1,2 Helman S Alfonso,3 Janine J Alan41Faculty of Health Sciences, Curtin University, Perth, WA, Australia; 2Research Department, Silver Chain Group, Perth, WA, Australia; 3School of Population Health, University of Western Australia, Perth, WA, Australia; 4Faculty of Health Sciences, Curtin University, Perth, WA, AustraliaBackground: The objectives of this study were to determine whether older individuals who participated in a reablement (restorative program rather than immediately receiving conventional home care services had a reduced need for ongoing support and lower home care costs over the next 57 months (nearly 5 years.Materials and methods: Data linkage was used to examine retrospectively the service records of older individuals who had received a reablement service versus a conventional home care service to ascertain their use of home care services over time.Results: Individuals who had received a reablement service were less likely to use a personal care service throughout the follow-up period or any other type of home care over the next 3 years. This reduced use of home care services was associated with median cost savings per person of approximately AU $12,500 over nearly 5 years.Conclusion: The inclusion of reablement as the starting point for individuals referred for home care within Australia's reformed aged care system could increase the system's cost effectiveness and ensure that all older Australians have the opportunity to maximize their independence as they age.Keywords: restorative, older adults, community dwelling, service costs

  4. 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…

  5. Does diabetes disease management save money and improve outcomes? A report of simultaneous short-term savings and quality improvement associated with a health maintenance organization-sponsored disease management program among patients fulfilling health employer data and information set criteria.

    Science.gov (United States)

    Sidorov, Jaan; Shull, Robert; Tomcavage, Janet; Girolami, Sabrina; Lawton, Nadine; Harris, Ronald

    2002-04-01

    Little is known about the impact of disease management programs on medical costs for patients with diabetes. This study compared health care costs for patients who fulfilled health employer data and information set (HEDIS) criteria for diabetes and were in a health maintenance organization (HMO)-sponsored disease management program with costs for those not in disease management. We retrospectively examined paid health care claims and other measures of health care use over 2 years among 6,799 continuously enrolled Geisinger Health Plan patients who fulfilled HEDIS criteria for diabetes. Two groups were compared: those who were enrolled in an opt-in disease management program and those who were not enrolled. We also compared HEDIS data on HbA(1c) testing, percent not in control, lipid testing, diabetic eye screening, and kidney disease screening. All HEDIS measures were based on a hybrid method of claims and chart audits, except for percent not in control, which was based on chart audits only. Of 6,799 patients fulfilling HEDIS criteria for the diagnosis of diabetes, 3,118 (45.9%) patients were enrolled in a disease management program (program), and 3,681 (54.1%) were not enrolled (nonprogram). Both groups had similar male-to-female ratios, and the program patients were 1.4 years younger than the nonprogram patients. Per member per month paid claims averaged 394.62 dollars for program patients compared with 502.48 dollars for nonprogram patients (P 9.5%, as compared with 79 of 548 (14.4%) nonprogram patients. In this HMO, an opt-in disease management program appeared to be associated with a significant reduction in health care costs and other measures of health care use. There was also a simultaneous improvement in HEDIS measures of quality care. These data suggest that disease management may result in savings for sponsored managed care organizations and that improvements in HEDIS measures are not necessarily associated with increased medical costs.

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. Energy conservation, energy efficiency and energy savings regulatory hypotheses - taxation, subsidies and underlying economics

    Energy Technology Data Exchange (ETDEWEB)

    Trumpy, T. [International Legal Counsel, Brussels (Belgium)

    1995-12-01

    More efficient use of energy resources can be promoted by various regulatory means, i.e., taxation, subsidies, and pricing. Various incentives can be provided by income and revenue tax breaks-deductible energy audit fees, energy saving investment credits, breaks for energy saving entrepreneurs, and energy savings accounts run through utility accounts. Value added and excise taxes can also be adjusted to reward energy saving investments and energy saving entrepreneurial activity. Incentives can be provided in the form of cash refunds, including trade-in-and-scrap programs and reimbursements or subsidies on audit costs and liability insurance. Pricing incentives include lower rates for less energy use, prepayment of deposit related to peak load use, electronically dispatched multiple tariffs, savings credits based on prior peak use, and subsidized {open_quotes}leasing{close_quotes} of more efficient appliances and lights. Credits, with an emphasis on pooling small loans, and 5-year energy savings contracts are also discussed.

  11. 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.

  12. 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.

  13. Cost effectiveness of a community-based crisis intervention program for people bereaved by suicide.

    Science.gov (United States)

    Comans, Tracy; Visser, Victoria; Scuffham, Paul

    2013-01-01

    Postvention services aim to ameliorate distress and reduce future incidences of suicide. The StandBy Response Service is one such service operating in Australia for those bereaved through suicide. Few previous studies have reported estimates or evaluations of the economic impact and outcomes associated with the implementation of bereavement/grief interventions. To estimate the cost-effectiveness of a postvention service from a societal perspective. A Markov model was constructed to estimate the health outcomes, quality-adjusted life years, and associated costs such as medical costs and time off work. Data were obtained from a prospective cross-sectional study comparing previous clients of the StandBy service with a control group of people bereaved by suicide who had not had contact with StandBy. Costs and outcomes were measured at 1 year after suicide bereavement and an incremental cost-effectiveness ratio was calculated. The base case found that the StandBy service dominated usual care with a cost saving from providing the StandBy service of AUS $803 and an increase in quality-adjusted life years of 0.02. Probabilistic sensitivity analysis indicates there is an 81% chance the service would be cost-effective given a range of possible scenarios. Postvention services are a cost-effective strategy and may even be cost-saving if all costs to society from suicide are taken into account.

  14. 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

  15. Green liquor impregnation and Kraft pulping of South African Pinus Patula – “A practical approach to provide cost savings in a Kraft mill’s pulping operation”

    CSIR Research Space (South Africa)

    Johakimu, Jonas K

    2011-02-01

    Full Text Available benefits of GLP technology to the Kraft pulping industry are; providing cost savings, increased digester productivity, and mitigation of some of environmental impacts. Depending on the process economics of the pulping process of a Kraft pulp mill, GLP can...

  16. 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

  17. 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...

  18. 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)

  19. 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

  20. 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

  1. Lives saved by Global Fund-supported HIV/AIDS, tuberculosis and malaria programs: estimation approach and results between 2003 and end-2007

    Directory of Open Access Journals (Sweden)

    Lyerla Rob

    2010-04-01

    Full Text Available Abstract Background Since 2003, the Global Fund has supported the scale-up of HIV/AIDS, tuberculosis and malaria control in low- and middle-income countries. This paper presents and discusses a methodology for estimating the lives saved through selected service deliveries reported to the Global Fund. Methods Global Fund-supported programs reported, by end-2007, 1.4 million HIV-infected persons on antiretroviral treatment (ARV, 3.3 million new smear-positive tuberculosis cases detected in DOTS (directly observed TB treatment, short course programs, and 46 million insecticide-treated mosquito nets (ITNs delivered. We estimated the corresponding lives saved using adaptations of existing epidemiological estimation models. Results By end-2007, an estimated 681,000 lives (95% uncertainty range 619,000-774,000 were saved and 1,097,000 (993,000-1,249,000 life-years gained by ARV. DOTS treatment would have saved 1.63 million lives (1.09 - 2.17 million when compared against no treatment, or 408,000 lives (265,000-551,000 when compared against non-DOTS treatment. ITN distributions in countries with stable endemic falciparum malaria were estimated to have achieved protection from malaria for 26 million of child-years at risk cumulatively, resulting in 130,000 (27,000-232,000 under-5 deaths prevented. Conclusions These results illustrate the scale of mortality effects that supported programs may have achieved in recent years, despite margins of uncertainty and covering only selected intervention components. Evidence-based evaluation of disease impact of the programs supported by the Global Fund with international and in-country partners must be strengthened using population-level data on intervention coverage and demographic outcomes, information on quality of services, and trends in disease burdens recorded in national health information systems.

  2. International Comparison of Household Savings Behaviour: The German Savings Puzzle

    OpenAIRE

    Axel Börsch-Supan

    2002-01-01

    This mea discussion paper presents excerpts of the International Savings Comparison Project covering household savings behaviour in seven countries. The whole series of comparative country studies can be found in a special issue of the journal “Research in Economics†, Volume 55, Number 2, June 2001. The introduction gives an outline of the research program of the project. A project as complex as the International Savings Comparison Project has sparked discussions and controversy. Tullio J...

  3. Secure savings

    Energy Technology Data Exchange (ETDEWEB)

    Dawn, Tom

    1996-09-01

    When it was installed, Dartmoor Prison`s environmental management system promised enough savings in labour and energy to pay for itself in well under five years. The system`s benefits are appreciated by staff and are thoroughly practical. (author)

  4. Energy Savings Measure Packages. Existing Homes

    Energy Technology Data Exchange (ETDEWEB)

    Casey, Sean [National Renewable Energy Lab. (NREL), Golden, CO (United States); Booten, Chuck [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2011-11-01

    This document presents the most cost effective Energy Savings Measure Packages (ESMP) for existing mixed-fuel and all electric homes to achieve 15% and 30% savings for each BetterBuildings grantee location across the United States. These packages are optimized for minimum cost to homeowners for source energy savings given the local climate and prevalent building characteristics (i.e. foundation types). Maximum cost savings are typically found between 30% and 50% energy savings over the reference home; this typically amounts to $300 - $700/year.

  5. FEMP: Seven steps to saving: How to implement energy-saving projects