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

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

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

Estimated cost savings associated with the transfer of office-administered specialty pharmaceuticals to a specialty pharmacy provider in a Medical Injectable Drug program.

Science.gov (United States)

Baldini, Christopher G; Culley, Eric J

2011-01-01

A large managed care organization (MCO) in western Pennsylvania initiated a Medical Injectable Drug (MID) program in 2002 that transferred a specific subset of specialty drugs from physician reimbursement under the traditional "buy-and-bill" model in the medical benefit to MCO purchase from a specialty pharmacy provider (SPP) that supplied physician offices with the MIDs. The MID program was initiated with 4 drugs in 2002 (palivizumab and 3 hyaluronate products/derivatives) growing to more than 50 drugs by 2007-2008. To (a) describe the MID program as a method to manage the cost and delivery of this subset of specialty drugs, and (b) estimate the MID program cost savings in 2007 and 2008 in an MCO with approximately 4.6 million members. Cost savings generated by the MID program were calculated by comparing the total actual expenditure (plan cost plus member cost) on medications included in the MID program for calendar years 2007 and 2008 with the total estimated expenditure that would have been paid to physicians during the same time period for the same medication if reimbursement had been made using HCPCS (J code) billing under the physician "buy-and-bill" reimbursement rates. For the approximately 50 drugs in the MID program in 2007 and 2008, the drug cost savings in 2007 were estimated to be $15.5 million (18.2%) or $290 per claim ($0.28 per member per month [PMPM]) and about $13 million (12.7%) or $201 per claim ($0.23 PMPM) in 2008. Although 28% of MID claims continued to be billed by physicians using J codes in 2007 and 22% in 2008, all claims for MIDs were limited to the SPP reimbursement rates. This MID program was associated with health plan cost savings of approximately $28.5 million over 2 years, achieved by the transfer of about 50 physician-administered injectable pharmaceuticals from reimbursement to physicians to reimbursement to a single SPP and payment of physician claims for MIDs at the SPP reimbursement rates.

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.

Potential cost savings with terrestrial rabies control

Directory of Open Access Journals (Sweden)

Cherry Bryan

2007-04-01

Full Text Available Abstract Background The cost-benefit of raccoon rabies control strategies such as oral rabies vaccination (ORV are under evaluation. As an initial quantification of the potential cost savings for a control program, the collection of selected rabies cost data was pilot tested for five counties in New York State (NYS in a three-year period. Methods Rabies costs reported to NYS from the study counties were computerized and linked to a human rabies exposure database. Consolidated costs by county and year were averaged and compared. Results Reported rabies-associated costs for all rabies variants totalled $2.1 million, for human rabies postexposure prophylaxes (PEP (90.9%, animal specimen preparation/shipment to laboratory (4.7%, and pet vaccination clinics (4.4%. The proportion that may be attributed to raccoon rabies control was 37% ($784,529. Average costs associated with the raccoon variant varied across counties from $440 to $1,885 per PEP, $14 to $44 per specimen, and $0.33 to $15 per pet vaccinated. Conclusion Rabies costs vary widely by county in New York State, and were associated with human population size and methods used by counties to estimate costs. Rabies cost variability must be considered in developing estimates of possible ORV-related cost savings. Costs of PEPs and specimen preparation/shipments, as well as the costs of pet vaccination provided by this study may be valuable for development of more realistic scenarios in economic modelling of ORV costs versus benefits.

Realized Cost Savings 2016

Data.gov (United States)

Department of Veterans Affairs — This dataset is provided as a requirement of OMB’s Integrated Data Collection (IDC) and links to VA’s Realized Cost Savings and Avoidances data in JSON format. Cost...

Implementation of an optical diagnosis strategy saves costs and does not impair clinical outcomes of a fecal immunochemical test-based colorectal cancer screening program.

Science.gov (United States)

Vleugels, Jasper L A; Greuter, Marjolein J E; Hazewinkel, Yark; Coupé, Veerle M H; Dekker, Evelien

2017-12-01

 In an optical diagnosis strategy, diminutive polyps that are endoscopically characterized with high confidence are removed without histopathological analysis and distal hyperplastic polyps are left in situ. We evaluated the effectiveness and costs of optical diagnosis.  Using the Adenoma and Serrated pathway to Colorectal CAncer (ASCCA) model, we simulated biennial fecal immunochemical test (FIT) screening in individuals aged 55 - 75 years. In this program, we compared an optical diagnosis strategy with current histopathology assessment of all diminutive polyps. Base-case assumptions included 76 % high-confidence predictions and sensitivities of 88 %, 91 %, and 88 % for endoscopically characterizing adenomas, sessile serrated polyps, and hyperplastic polyps, respectively. Outcomes were colorectal cancer burden, number of colonoscopies, life-years, and costs.  Both the histopathology strategy and the optical diagnosis strategy resulted in 21 life-days gained per simulated individual compared with no screening. For optical diagnosis, €6 per individual was saved compared with the current histopathology strategy. These cost savings were related to a 31 % reduction in colonoscopies in which histopathology was needed for diminutive polyps. Projecting these results onto the Netherlands (17 million inhabitants), assuming a fully implemented FIT-based screening program, resulted in an annual undiscounted cost saving of € 1.7 - 2.2 million for optical diagnosis.  Implementation of optical diagnosis in a FIT-based screening program saves costs without decreasing program effectiveness when compared with current histopathology analysis of all diminutive polyps. Further work is required to evaluate how endoscopists participating in a screening program should be trained, audited, and monitored to achieve adequate competence in optical diagnosis.

Targeting utility customers to improve energy savings from conservation and efficiency programs

International Nuclear Information System (INIS)

Taylor, Nicholas W.; Jones, Pierce H.; Kipp, M. Jennison

2014-01-01

Highlights: • Improving DSM program impacts by targeting high energy users. • DSM energy savings potential hinges on pre-participation performance. • Targeting can benefit different utilities and energy efficiency programs. • Overall performance can be improved by up to 250% via targeting strategies. - Abstract: Electric utilities, government agencies, and private interests in the US have committed and continue to invest substantial resources – including billions of dollars of financial capital – in the pursuit of energy efficiency and conservation through demand-side management (DSM) programs. While most of these programs are deemed to be cost effective, and therefore in the public interest, opportunities exist to improve cost effectiveness by targeting programs to those customers with the greatest potential for energy savings. This article details an analysis of three DSM programs offered by three Florida municipal electric utilities to explore such opportunities. First, we estimate programs’ energy savings impacts; second, we measure and compare energy savings across subgroups of program participants as determined by their pre-intervention energy performance, and third, we explore potential changes in program impacts that might be realized by targeting specific customers for participation in the DSM programs. All three programs resulted in statistically significant average (per-participant) energy savings, yet average savings varied widely, with the customers who performed best (i.e., most efficient) before the intervention saving the least energy and those who performed worst (i.e., least efficient) before the intervention saving the most. Assessment of alternative program participation scenarios with varying levels of customer targeting suggests that program impacts could be increased by as much as 80% for a professional energy audit program, just over 100% for a high-efficiency heat pump upgrade program, and nearly 250% for an attic insulation

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

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.

Cost-saving production technologies and partial ownership

OpenAIRE

Juan Carlos Barcena-Ruiz; Norma Olaizola

2007-01-01

This work analyzes the incentives to acquire cost-saving production technologies when cross-participation exists at ownership level. We show that cross-participation reduces the incentives to adopt the cost-saving production technology.

Invisible costs, visible savings.

Science.gov (United States)

Lefever, G

1999-08-01

By identifying hidden inventory costs, nurse managers can save money for the organization. Some measures include tracking and standardizing supplies, accurately evaluating patients' needs, and making informed purchasing decisions.

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.

Nuclear recycling: costs, savings, and safeguards

International Nuclear Information System (INIS)

Spinrad, B.I.

1985-01-01

This chapter discusses the economics, physical and chemical processes, and safety of nuclear fuel recycling. The spent fuel must be chemically reprocessed in order to recover uranium and plutonium. Topics considered include indifference costs, recycling in light water reactors (LWRs), plutonium in fast reactors, the choice between recycling and storage, safeguards, and weapons proliferation. It is shown that the economics of recycling nuclear fuel involves the actual costs and savings of the recycling operation in terms of money spent, made, and saved, and the impact of the recycling on the future cost of uranium

Cost savings and enhanced hospice enrollment with a home-based palliative care program implemented as a hospice-private payer partnership.

Science.gov (United States)

Kerr, Christopher W; Donohue, Kathleen A; Tangeman, John C; Serehali, Amin M; Knodel, Sarah M; Grant, Pei C; Luczkiewicz, Debra L; Mylotte, Kathleen; Marien, Melanie J

2014-12-01

In the United States, 5% of the population is responsible for nearly half of all health care expenditures, with a large concentration of spending driven by individuals with expensive chronic conditions in their last year of life. Outpatient palliative care under the Medicare Hospice Benefit excludes a large proportion of the chronically ill and there is widespread recognition that innovative strategies must be developed to meet the needs of the seriously ill while reducing costs. This study aimed to evaluate the impact of a home-based palliative care program, implemented through a hospice-private payer partnership, on health care costs and utilization. This was a prospective, observational database study where insurance enrollment and claims data were analyzed. The study population consisted of Home Connections (HC) program patients enrolled between January 1, 2010 and December 31, 2012 who subsequently expired (n=149) and who were also Independent Health members. A control group (n=537) was derived using propensity-score matching. The primary outcome variable was overall costs within the last year of life. Costs were also examined at six months, three months, one month, and two weeks. Inpatient, outpatient, ancillary, professional, and pharmacy costs were compared between the two groups. Medical service utilization and hospice enrollment and length of stay were also evaluated. Cost savings were apparent in the last three months of life—$6,804 per member per month (PMPM) cost for palliative care participants versus $10,712 for usual care. During the last two weeks of life, total allowed PMPM was $6,674 versus $13,846 for usual care. Enhanced hospice entry (70% versus 25%) and longer length of stay in hospice (median 34 versus 9 days) were observed. Palliative care programs partnered with community hospice providers may achieve cost savings while helping provide care across the continuum.

Health care costs: saving in the private sector.

Science.gov (United States)

Robeson, F E

1979-01-01

Robeson offers a number of options to employers to help reduce the impact of increasing health care costs. He points out that large organizations which employ hundreds of people have considerable market power which can be exerted to contain costs. It is suggested that the risk management departments assume the responsibility for managing the effort to reduce the costs of medical care and of the health insurance programs of these organizations since that staff is experienced at evaluating premiums and negotiating with third-party payors. The article examines a number of short-run strategies for firms to pursue to contain health care costs: (1) use alternative delivery systems such as health maintenance organizations (HMOs) which have cost-cutting potential but require marketing efforts to persuade employees of their desirability; (2) contracts with third-party payors which require a second opinion (peer review), a practice which saved one labor union over $2 million from 1972 to 1976; (3) implementation of insurance coverage for less expensive outpatient care; and (4) the use of claims review. These strategies are compared in terms of four criteria: supply of demand for health services; management effort; cost; and time necessary for realized savings. Robeson concludes that development of a management plan for containing health care costs requires an extensive analysis of alternatives, organizational objectives, existing policies, and resources, and offers a table summarizing the cost-containment strategies that a firm should consider.

Energy saving and cost saving cooling; Energie und Kosten sparende Kuehlung

Energy Technology Data Exchange (ETDEWEB)

Koenig, Klaus W. [Architektur- und Fachpressebuero Klaus W. Koenig, Ueberlingen (Germany)

2012-07-01

In the case of cost reduction, energy conservation and resource savings, rain water is an ideal medium offering more advantages in comparison to the cooling with drinking water. There are no fees for the drinking water and drainage of rain water. It is not necessary to soften rain water so that further operational costs for the treatment and drainage of waste water can be saved. The avoidance of the related material flows and necessary energy is a practiced environmental protection and climate protection.

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.

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.

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.

Pediatric Specialty Care Model for Management of Chronic Respiratory Failure: Cost and Savings Implications and Misalignment With Payment Models.

Science.gov (United States)

Graham, Robert J; McManus, Michael L; Rodday, Angie Mae; Weidner, Ruth Ann; Parsons, Susan K

2018-05-01

To describe program design, costs, and savings implications of a critical care-based care coordination model for medically complex children with chronic respiratory failure. All program activities and resultant clinical outcomes were tracked over 4 years using an adapted version of the Care Coordination Measurement Tool. Patient characteristics, program activity, and acute care resource utilization were prospectively documented in the adapted version of the Care Coordination Measurement Tool and retrospectively cross-validated with hospital billing data. Impact on total costs of care was then estimated based on program outcomes and nationally representative administrative data. Tertiary children's hospital. Critical Care, Anesthesia, Perioperative Extension and Home Ventilation Program enrollees. None. The program provided care for 346 patients and families over the study period. Median age at enrollment was 6 years with more than half deriving secondary respiratory failure from a primary neuromuscular disease. There were 11,960 encounters over the study period, including 1,202 home visits, 673 clinic visits, and 4,970 telephone or telemedicine encounters. Half (n = 5,853) of all encounters involved a physician and 45% included at least one care coordination activity. Overall, we estimated that program interventions were responsible for averting 556 emergency department visits and 107 hospitalizations. Conservative monetization of these alone accounted for annual savings of $1.2-2 million or $407/pt/mo net of program costs. Innovative models, such as extension of critical care services, for high-risk, high-cost patients can result in immediate cost savings. Evaluation of financial implications of comprehensive care for high-risk patients is necessary to complement clinical and patient-centered outcomes for alternative care models. When year-to-year cost variability is high and cost persistence is low, these savings can be estimated from documentation within care

Cost basis for implementing ALARA programs

International Nuclear Information System (INIS)

Kent, C.E.

1985-01-01

A method of implementing effective ALARA programs is discussed. A basic element of the cost benefit methodology is the valuation of a man-rem. In the program, this is derived from an assessment of radiation exposure risk and societal valuation of harmful effects. The man-rem value is used as an element in the cost benefit analysis. The analysis includes an assessment of the differential man-rem resulting from the action, implementation cost, and operational savings

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.

The High Cost of Saving Energy Dollars.

Science.gov (United States)

Rose, Patricia

1985-01-01

In alternative financing a private company provides the capital and expertise for improving school energy efficiency. Savings are split between the school system and the company. Options for municipal leasing, cost sharing, and shared savings are explained along with financial, procedural, and legal considerations. (MLF)

Estimated Incident Cost Savings in Shipping Due to Inspections

NARCIS (Netherlands)

S. Knapp (Sabine); G.E. Bijwaard (Govert); C. Heij (Christiaan)

2010-01-01

textabstractThe effectiveness of safety inspections has been analysed from various angles, but until now, relatively little attention has been given to translate risk reduction into incident cost savings. This paper quantifies estimated cost savings based on port state control inspections and

Super Energy Savings Performance Contracts: Federal Energy Management Program (FEMP) Program Overview (revision)

International Nuclear Information System (INIS)

Pitchford, P.

2001-01-01

This four-page publication describes the U.S. Department of Energy's (DOE's) streamlined energy savings performance contracting, or ''Super ESPC,'' process, which is managed by DOE's Federal Energy Management Program (FEMP). Under a Super ESPC, a qualifying energy service company (ESCO) from the private sector pays for energy efficiency improvements or advanced renewable energy technologies (e.g., photovoltaic systems, wind turbines, or geothermal heat pumps, among others) for a facility of a government agency. The ESCO is then repaid over time from the agency's resulting energy cost savings. Delivery orders under these contracts specify the level of performance (energy savings) and the repayment schedule; the contract term can be up to 25 years, although many Super ESPCs are for about 10 years or less

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.

Estimated incident cost savings in shipping due to inspections

NARCIS (Netherlands)

Knapp, S.; Bijwaard, G.E.; Heij, C.

2011-01-01

The effectiveness of safety inspections of ships has been analysed from various angles, but until now, relatively little attention has been given to translate risk reduction into incident cost savings. This paper provides a monetary quantification of the cost savings that can be attributed to port

Electricity-cost savings obtained by means of nuclear plant life extension

International Nuclear Information System (INIS)

Forest, L.; Fletcher, T.; DuCharme, A.; Harrison, D.L.

1987-01-01

This study examines savings caused by nuclear-plant life extension (NUPLEX) and describes the effects of changes in assumptions on costs and technology using an approach simpler than the large economic-model simulations used in other reports. Under the simplified approach, we estimate savings at the broad national level by comparing projected costs/kWh for the typical NUPLEX plant with those for new coal-fired plants, which seem the most likely alternative in most regions. While ignoring some complications handled by the large, regionally disaggregated econometric models, the approach used in this study has advantages in sensitivity analyses. It reveals relationships between savings and basic assumptions on costs and technology in a more transparent way than in large-model simulations. We find that, absent major technological breakthroughs for present generating options, NUPLEX saves consumers money on their electric bills under most plausible economic scenarios. Using mid-range assumptions, we find that NUPLEX saves consumers a total of about dollar 180 billion spread over the period 2010-50. Under optimistic assumptions, the savings swell to over dollar 900 billion. Under extremely pessimistic assumptions, the savings actually turn negative. This wide range of estimates largely reflects the uncertainty in cost projections. Within plausible limits, higher- or lower-than-expected load growth does not affect the savings estimates. The NUPLEX construction costs stand out as the most critical unknown. If they turn out to be 50% (dollar 500 billion) above the baseline estimate savings would fall by almost 60% (dollar 105 billion). A 50% rise in nuclear fuel costs would drop baseline savings by almost 22%. A 50% increase in nuclear-plant operations-and-maintenance costs, would cut baseline savings by about 36%. These sensitivities highlight the need for continued monitoring of economic developments

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.

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

Science.gov (United States)

Davis, Jennifer “J. J.”

2008-01-01

Background 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. Objectives 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. Methods 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. Results 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. Conclusions 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

Evaluation of Missed Energy Saving Opportunity Based on Illinois Home Performance Program Field Data: Homeowner Selected Upgrades Versus Cost-Optimized Solutions

Energy Technology Data Exchange (ETDEWEB)

Yee, S. [Partnership for Advanced Residential Retrofit, Chicago, IL (United States); Milby, M. [Partnership for Advanced Residential Retrofit, Chicago, IL (United States); Baker, J. [Partnership for Advanced Residential Retrofit, Chicago, IL (United States)

2014-06-01

Expanding on previous research by PARR, this study compares measure packages installed during 800 Illinois Home Performance with ENERGY STAR® (IHP) residential retrofits to those recommended as cost-optimal by Building Energy Optimization (BEopt) modeling software. In previous research, cost-optimal measure packages were identified for 15 Chicagoland single family housing archetypes. In the present study, 800 IHP homes are first matched to one of these 15 housing groups, and then the average measures being installed in each housing group are modeled using BEopt to estimate energy savings. For most housing groups, the differences between recommended and installed measure packages is substantial. By comparing actual IHP retrofit measures to BEopt-recommended cost-optimal measures, missed savings opportunities are identified in some housing groups; also, valuable information is obtained regarding housing groups where IHP achieves greater savings than BEopt-modeled, cost-optimal recommendations. Additionally, a measure-level sensitivity analysis conducted for one housing group reveals which measures may be contributing the most to gas and electric savings. Overall, the study finds not only that for some housing groups, the average IHP retrofit results in more energy savings than would result from cost-optimal, BEopt recommended measure packages, but also that linking home categorization to standardized retrofit measure packages provides an opportunity to streamline the process for single family home energy retrofits and maximize both energy savings and cost effectiveness.

Winglets Save Billions of Dollars in Fuel Costs

Science.gov (United States)

2010-01-01

The upturned ends now featured on many airplane wings are saving airlines billions of dollars in fuel costs. Called winglets, the drag-reducing technology was advanced through the research of Langley Research Center engineer Richard Whitcomb and through flight tests conducted at Dryden Flight Research Center. Seattle-based Aviation Partners Boeing -- a partnership between Aviation Partners Inc., of Seattle, and The Boeing Company, of Chicago -- manufactures Blended Winglets, a unique design featured on Boeing aircraft around the world. These winglets have saved more than 2 billion gallons of jet fuel to date, representing a cost savings of more than $4 billion and a reduction of almost 21.5 million tons in carbon dioxide emissions.

Evaluation of Missed Energy Saving Opportunity Based on Illinois Home Performance Program Field Data: Homeowner Selected Upgrades Versus Cost-Optimized Solutions

Energy Technology Data Exchange (ETDEWEB)

Yee, S.; Milby, M.; Baker, J.

2014-06-01

Expanding on previous research by PARR, this study compares measure packages installed during 800 Illinois Home Performance with ENERGY STAR(R) (IHP) residential retrofits to those recommended as cost-optimal by Building Energy Optimization (BEopt) modeling software. In previous research, cost-optimal measure packages were identified for fifteen Chicagoland single family housing archetypes, called housing groups. In the present study, 800 IHP homes are first matched to one of these fifteen housing groups, and then the average measures being installed in each housing group are modeled using BEopt to estimate energy savings. For most housing groups, the differences between recommended and installed measure packages is substantial. By comparing actual IHP retrofit measures to BEopt-recommended cost-optimal measures, missed savings opportunities are identified in some housing groups; also, valuable information is obtained regarding housing groups where IHP achieves greater savings than BEopt-modeled, cost-optimal recommendations. Additionally, a measure-level sensitivity analysis conducted for one housing group reveals which measures may be contributing the most to gas and electric savings. Overall, the study finds not only that for some housing groups, the average IHP retrofit results in more energy savings than would result from cost-optimal, BEopt recommended measure packages, but also that linking home categorization to standardized retrofit measure packages provides an opportunity to streamline the process for single family home energy retrofits and maximize both energy savings and cost-effectiveness.

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.

Faith community nursing demonstrates good stewardship of community benefit dollars through cost savings and cost avoidance.

Science.gov (United States)

Brown, Ameldia R; Coppola, Patricia; Giacona, Marian; Petriches, Anne; Stockwell, Mary Ann

2009-01-01

Health systems seeking responsible stewardship of community benefit dollars supporting Faith Community Nursing Networks require demonstration of positive measurable health outcomes. Faith Community Nurses (FCNs) answer the call for measurable outcomes by documenting cost savings and cost avoidances to families, communities, and health systems associated with their interventions. Using a spreadsheet tool based on Medicare reimbursements and diagnostic-related groupings, 3 networks of FCNs have together shown more than 600 000 (for calendar year 2008) healthcare dollars saved by avoidance of unnecessary acute care visits and extended care placements. The cost-benefit ratio of support dollars to cost savings and cost avoidance demonstrates that support of FCNs is good stewardship of community benefit dollars.

Telephone-based disease management: why it does not save money.

Science.gov (United States)

Motheral, Brenda R

2011-01-01

To understand why the current telephone-based model of disease management (DM) does not provide cost savings and how DM can be retooled based on the best available evidence to deliver better value. Literature review. The published peer-reviewed evaluations of DM and transitional care models from 1990 to 2010 were reviewed. Also examined was the cost-effectiveness literature on the treatment of chronic conditions that are commonly included in DM programs, including heart failure, diabetes mellitus, coronary artery disease, and asthma. First, transitional care models, which have historically been confused with commercial DM programs, can provide credible savings over a short period, rendering them low-hanging fruit for plan sponsors who desire real savings. Second, cost-effectiveness research has shown that the individual activities that constitute contemporary DM programs are not cost saving except for heart failure. Targeting of specific patients and activity combinations based on risk, actionability, treatment and program effectiveness, and costs will be necessary to deliver a cost-saving DM program, combined with an outreach model that brings vendors closer to the patient and physician. Barriers to this evidence-driven approach include resources required, marketability, and business model disruption. After a decade of market experimentation with limited success, new thinking is called for in the design of DM programs. A program design that is based on a cost-effectiveness approach, combined with greater program efficacy, will allow for the development of DM programs that are cost saving.

Clinical effectiveness and cost savings in diabetes care, supported by pharmacist counselling.

Science.gov (United States)

Rodriguez de Bittner, Magaly; Chirikov, Viktor V; Breunig, Ian M; Zaghab, Roxanne W; Shaya, Fadia Tohme

To determine the effectiveness and cost savings of a real-world, continuous, pharmacist-delivered service with an employed patient population with diabetes over a 5-year period. The Patients, Pharmacists Partnerships (P 3 Program) was offered as an "opt-in" benefit to employees of 6 public and private self-insured employers in Maryland and Virginia. Care was provided in ZIP code-matched locations and at 2 employers' worksites. Six hundred two enrolled patients with type 1 and 2 diabetes were studied between July 2006 and May 2012 with an average follow-up of 2.5 years per patient. Of these patients, 162 had health plan cost and utilization data. A network of 50 trained pharmacists provided chronic disease management to patients with diabetes using a common process of care. Communications were provided to patients and physicians. Employers provided incentives for patients who opted in, including waived medication copayments and free diabetes self-monitoring supplies. The service was provided at no cost to the patient. A Web-based, electronic medical record that complied with the Health Insurance Portability and Accountability Act helped to standardize care. Quality assurance was conducted to ensure the standard of care. Glycosylated hemoglobin (A1c), blood pressure, and total health care costs (before and after enrollment). Statistically significant improvements were shown by mean decreases in A1c (-0.41%, P care costs to employers declined by $1031 per beneficiary after the cost of the program was deducted. This 66-month real-world study confirms earlier findings. Employers netted savings through improved clinical outcomes and reduced emergency and hospital utilization when comparing costs 12 months before and after enrollment. The P 3 program had positive clinical outcomes and economic outcomes. Pharmacist-provided comprehensive medication therapy management services should be included as a required element of insurance offered by employers and health insurance

24 CFR 221.1 - Savings clause.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Savings clause. 221.1 Section 221.1... MORTGAGE AND LOAN INSURANCE PROGRAMS UNDER NATIONAL HOUSING ACT AND OTHER AUTHORITIES LOW COST AND MODERATE INCOME MORTGAGE INSURANCE-SAVINGS CLAUSE Eligibility Requirements-Low Cost Homes-Savings Clause § 221.1...

Estimated incident cost savings in shipping due to inspections.

Science.gov (United States)

Knapp, Sabine; Bijwaard, Govert; Heij, Christiaan

2011-07-01

The effectiveness of safety inspections of ships has been analysed from various angles, but until now, relatively little attention has been given to translate risk reduction into incident cost savings. This paper provides a monetary quantification of the cost savings that can be attributed to port state control inspections and industry vetting inspections. The dataset consists of more than half a million ship arrivals between 2002 and 2007 and contains inspections of port state authorities in the USA and Australia and of three industry vetting regimes. The effect of inspections in reducing the risk of total loss accidents is estimated by means of duration models, in terms of the gained probability of survival. The monetary benefit of port state control inspections is estimated to range, on average, from about 70 to 190 thousand dollars, with median values ranging from about 20 to 45 thousand dollars. Industry inspections have even higher benefits, especially for tankers. The savings are in general higher for older and larger vessels, and also for vessels with undefined flag and unknown classification society. As inspection costs are relatively low in comparison to potential cost savings, the results underline the importance of determining ships with relatively high risk of total loss. Copyright © 2011 Elsevier Ltd. All rights reserved.

Solitary pulmonary nodules: cost-savings indicated by Australian experience with FDG-PET

International Nuclear Information System (INIS)

Keith, C.J.; Miles, K.A.; Pitman, A.G.; Hicks, R.J.

2002-01-01

Full text: To date, decision tree analyses demonstrating the cost-effectiveness of PET in Australia have been constrained by the need to use overseas values for diagnostic performance and disease prevalence. This study uses Australian PET experience to estimate the cost-savings produced by incorporation of FDG-PET into diagnostic algorithms for characterisation of solitary pulmonary nodules (SPNs). Values for disease prevalence and diagnostic accuracy of PET from a combined series of 89 SPNs from the Wesley Hospital and Peter MacCallum Cancer Institute were applied to two previously published decision tree models. Procedure costs were derived from the Medicare Benefits Schedule and DRG Cost Weights for Australian public hospitals. A cost of $1200 was assigned to PET. Sensitivity analyses evaluated the effect of disease prevalence and PET cost on the cost savings produced by each strategy. The values for disease prevalence (0.54), PET sensitivity (92%) and specificity (95%) from the combined series indicated cost savings per patient of $774 and $554 for the two decision trees. PET would remain cost-saving for values of prevalence up to 0.90 and 0.76, and PET costs of $1974 and $1967, for each model respectively. FDG-PET evaluation of SPNs would produce cost-savings within Australia even with substantial variations in disease prevalence and PET costs. Copyright (2002) Blackwell Science Pty Ltd

Measured energy savings and cost-effectiveness of conservation retrofits in commercial buildings

International Nuclear Information System (INIS)

Greely, K.M.; Harris, J.P.; Hatcher, A.M.

1990-01-01

In this study, the authors examine the measured savings and cost-effectiveness of 447 commercial retrofit projects in the US, Canada, and Europe, representing over 1,700 buildings. For these projects, they examine savings and cost-effectiveness by building type and retrofit strategy, savings from individual measures, peak electric demand savings, comparisons of measured vs. predicted savings, and the persistence of savings in the years following a retrofit. Median annual site energy savings amounted to 20 kBtu/ft 2 , or 18% of whole-building usage; median retrofit cost was $0.56/ft 2 (1988 $), the median payback time was 3.1 years, and the median cost of conserved energy was $3.10/site MBtu. When examined by retrofit strategy, they found that projects with only HVAC and/or lighting retrofits had median payback times of one to three years, while those affecting the building shell, either alone or in combination with other types of measures, had payback times of five or more years. Projects in which only maintenance practices were changed typically saved 12% of their pre-retrofit consumption, often using in-house labor. Their research suggests that, despite significant savings and short payback times for the majority of projects, optimum savings are often not being achieved, due to limited owner willingness to invest in all cost-effective measures, as well as to improper retrofit installation and/or maintenance. A comprehensive understanding of energy management as a process is needed, including both inspection and commissioning of installed retrofits and ongoing tracking of energy consumption as an indicator of operating problems

Cost Savings through Innovation in Decontamination, Decommissioning, and Dismantlement

International Nuclear Information System (INIS)

Yancey, Neal A.

2003-01-01

The United States Department of Energy (DOE) continually seeks safer and more cost effective technologies for the decontamination and decommissioning (D and D) of nuclear facilities. The Deactivation and Decommissioning Focus Area (DDFA) of the DOE's Office of Science and Technology (OST) sponsored large-scale demonstration and deployment projects (LSDDPs) to help bring new technologies into the D and D programs. The Idaho National Engineering and Environmental Laboratory (INEEL) LSDDP generated a list of needs defining specific problems where improved technologies could be incorporated into ongoing D and D tasks. The needs fell into 5 major categories--characterization, dismantlement, safety, material dispositioning, and decontamination. Technologies were carefully selected that provide a large benefit for a small investment. The technologies must provide significant improvements in cost, safety, radiation exposure, waste volume reduction, or schedule savings and widely applicable throughout the DOE complex. The LSDDP project provided training for the new technologies and worked with technology suppliers to resolve any questions that arose. Since 1998, 26 technologies have been demonstrated or deployed through the LSDDP for the D and D program at the INEEL. Of the 26 demonstrated and deployed technologies, 14 were in characterization, 3 were in decontamination, 4 were in dismantlement, 3 were in safety, and 2 were in material dispositioning. To promote the use of these technologies at other sites within the DOE complex, the LSDDP team published fact sheets, videos, technology summary reports, articles in INEEL star newspaper, posters, and maintained an internet home page on the project. As a result, additional deployments have taken place at the Hanford, Mound, Fernald, Oak Ridge, Ashtabula, and West Valley. Eight of the 26 technologies evaluated were developed in foreign countries. The technologies demonstrated have been shown to be faster, less expensive, and

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

DEFF Research Database (Denmark)

Klinge Jacobsen, Henrik; Baldini, Mattia

the costs are incurred and savings (difference in discount rates both private and social) • The issue of marginal investment in a case of replacement anyway or a full investment in the energy saving technology • Implementation costs (and probability of investment) differs across sectors • Cost saving...... 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...... options are not additive - meaning that marginal energy savings from one option depends on what other options implemented We address the importance of these issues and illustrate with Danish cases how large the difference in savings cost curves can be if different methodologies are used. For example...

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

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

Directory of Open Access Journals (Sweden)

Lori A. Bollinger

2017-11-01

Full Text Available Abstract Background 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. Methods 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 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. Conclusions 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

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.

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.

Federal Aviation Administration retained savings program proposal

International Nuclear Information System (INIS)

Hostick, D.J.; Larson, L.L.; Hostick, C.J.

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

Canada Education Savings Program: Annual Statistical Review--2009

Science.gov (United States)

Human Resources and Skills Development Canada, 2009

2009-01-01

The Canada Education Savings Program is an initiative of the Government of Canada. As part of the Department of Human Resources and Skills Development, the program administers the Canada Education Savings Grant and the Canada Learning Bond. These two initiatives help Canadian families save for a child's post-secondary education in Registered…

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.

Cost effectiveness of a screen-and-treat program for asymptomatic vaginal infections in pregnancy: towards a significant reduction in the costs of prematurity.

Science.gov (United States)

Kiss, H; Pichler, Eva; Petricevic, L; Husslein, P

2006-08-01

The purpose of this investigation was to determine the cost-saving potential of a simple screen-and-treat program for vaginal infection, which has previously been shown to lead to a reduction of 50% in the rate of preterm births. To determine the potential cost savings, we compared the direct costs of preterm delivery of infants with a birth weight below 1900g with the costs of the screen-and-treat program. We used a cut-off birth weight of 1900g because, in our population, all infants with a birth weight below 1900g were transferred to the neonatal intensive care unit. The direct costs associated with preterm delivery were defined to include the costs of the initial hospitalization of both mother and infant and the costs of outpatient follow-up throughout the first 6 years of life of the former preterm infant. The costs of the screen-and-treat program were defined to include the costs of the screening examination and the resulting costs of antimicrobial treatment and follow-up. All calculations were based on health-economic data obtained in the metropolitan area of Vienna, Austria. The number of preterm infants with a birth weight below 1900g was 12 (0.5%) in the intervention group (N=2058) and 29 (1.3%) in the control group (N=2097). The direct costs per preterm birth were found to amount to EUR (euro) 60262. Overall, the expected total savings in direct costs achieved by the screen-and-treat program and the ensuing 50% reduction in the number preterm births with a birth weight below 1900g amounted to more than euro 11 million. The costs of screening and treatment were found to amount to merely 7% of the direct costs saved as a result of the screen-and-treat program. A simple preterm prevention program, consisting of screening and antimicrobial treatment and follow-up of women with asymptomatic vaginal infection, leads not only to a significant reduction in the rate of preterm births but also to substantial savings in the direct costs associated with prematurity.

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.

Canada Education Savings Program: Annual Statistical Review 2011

Science.gov (United States)

Human Resources and Skills Development Canada, 2011

2011-01-01

The Canada Education Savings Program has been an initiative of the Government of Canada since 1998. As part of the Department of Human Resources and Skills Development, the program administers the Canada Education Savings Grant and the Canada Learning Bond. These two initiatives help Canadian families save for a child's post-secondary education in…

Canada Education Savings Program: Annual Statistical Review 2012

Science.gov (United States)

Human Resources and Skills Development Canada, 2012

2012-01-01

The Canada Education Savings Program (CESP) has been an initiative of the Government of Canada since 1998. As part of the Department of Human Resources and Skills Development Canada, the program administers the Canada Education Savings Grant (CESG) and the Canada Learning Bond (CLB). These two initiatives help Canadian families save for a child's…

Preventing Domestic Violence in Alberta: A Cost Savings Perspective

Directory of Open Access Journals (Sweden)

Lana Wells

2012-06-01

Full Text Available Recent studies show that Alberta has the fifth highest rate of police reported intimate partner violence and the second highest rate of self reported spousal violence in Canada, and despite a 2.3 percent decline over the last decade, the province’s rate of self-reported domestic violence has stubbornly remained among the highest in Canada; rates of violence against women alone are 2.3 percentage points higher than the national average. In fact, every hour of every day, a woman in Alberta will undergo some form of interpersonal violence from an ex-partner or ex-spouse. Besides the devastating toll that domestic violence has on victims and their families, the ongoing cost to Albertans is significant. In the past five years alone it is estimated that over $600 million will have been spent on the provision of a few basic health and non health supports and that the majority of this cost ($521 million is coming out of the pockets of Albertans in the form of tax dollars directed at the provision of services. Fortunately, investment in quality prevention and intervention initiatives can be very cost effective, returning as much as $20 for every dollar invested. Recent research on preventative programming in the context of domestic violence shows promising results in reducing incidents of self-reported domestic violence. The economic analysis of this preventative programming suggests that the benefits of providing the various types of programming outweighed the costs by as much as 6:1. The potential cost savings for the Alberta context are significant; the implementation of these preventative programs has been estimated to be approximately $9.6 million while generating net cost-benefits of over $54 million. Domestic violence is a persistent blight, and continues to have a significant impact on individuals and families in Alberta, but potent tools exist to fight it. This brief paper offers a cogent summary of its costs, and the benefits that could be

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....

Cost savings from reduced catheter-related bloodstream infection after simulation-based education for residents in a medical intensive care unit.

Science.gov (United States)

Cohen, Elaine R; Feinglass, Joe; Barsuk, Jeffrey H; Barnard, Cynthia; O'Donnell, Anna; McGaghie, William C; Wayne, Diane B

2010-04-01

Interventions to reduce preventable complications such as catheter-related bloodstream infections (CRBSI) can also decrease hospital costs. However, little is known about the cost-effectiveness of simulation-based education. The aim of this study was to estimate hospital cost savings related to a reduction in CRBSI after simulation training for residents. This was an intervention evaluation study estimating cost savings related to a simulation-based intervention in central venous catheter (CVC) insertion in the Medical Intensive Care Unit (MICU) at an urban teaching hospital. After residents completed a simulation-based mastery learning program in CVC insertion, CRBSI rates declined sharply. Case-control and regression analysis methods were used to estimate savings by comparing CRBSI rates in the year before and after the intervention. Annual savings from reduced CRBSIs were compared with the annual cost of simulation training. Approximately 9.95 CRBSIs were prevented among MICU patients with CVCs in the year after the intervention. Incremental costs attributed to each CRBSI were approximately $82,000 in 2008 dollars and 14 additional hospital days (including 12 MICU days). The annual cost of the simulation-based education was approximately $112,000. Net annual savings were thus greater than $700,000, a 7 to 1 rate of return on the simulation training intervention. A simulation-based educational intervention in CVC insertion was highly cost-effective. These results suggest that investment in simulation training can produce significant medical care cost savings.

A model to estimate cost-savings in diabetic foot ulcer prevention efforts.

Science.gov (United States)

Barshes, Neal R; Saedi, Samira; Wrobel, James; Kougias, Panos; Kundakcioglu, O Erhun; Armstrong, David G

2017-04-01

Sustained efforts at preventing diabetic foot ulcers (DFUs) and subsequent leg amputations are sporadic in most health care systems despite the high costs associated with such complications. We sought to estimate effectiveness targets at which cost-savings (i.e. improved health outcomes at decreased total costs) might occur. A Markov model with probabilistic sensitivity analyses was used to simulate the five-year survival, incidence of foot complications, and total health care costs in a hypothetical population of 100,000 people with diabetes. Clinical event and cost estimates were obtained from previously-published trials and studies. A population without previous DFU but with 17% neuropathy and 11% peripheral artery disease (PAD) prevalence was assumed. Primary prevention (PP) was defined as reducing initial DFU incidence. PP was more than 90% likely to provide cost-savings when annual prevention costs are less than $50/person and/or annual DFU incidence is reduced by at least 25%. Efforts directed at patients with diabetes who were at moderate or high risk for DFUs were very likely to provide cost-savings if DFU incidence was decreased by at least 10% and/or the cost was less than $150 per person per year. Low-cost DFU primary prevention efforts producing even small decreases in DFU incidence may provide the best opportunity for cost-savings, especially if focused on patients with neuropathy and/or PAD. Mobile phone-based reminders, self-identification of risk factors (ex. Ipswich touch test), and written brochures may be among such low-cost interventions that should be investigated for cost-savings potential. Published by Elsevier Inc.

UMTRA Project-Level Cost Reduction/Productivity Improvement Program manual

International Nuclear Information System (INIS)

1995-06-01

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

10 CFR 436.20 - Net savings.

Science.gov (United States)

2010-01-01

... ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Methodology and Procedures for Life Cycle Cost Analyses § 436.20 Net savings. For a retrofit project, net savings may be found by subtracting life cycle costs based on the proposed project from life cycle costs based on not having it. For a...

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...

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.

Can health promotion programs save Medicare money?

Science.gov (United States)

Goetzel, Ron Z; Shechter, David; Ozminkowski, Ronald J; Stapleton, David C; Lapin, Pauline J; McGinnis, J Michael; Gordon, Catherine R; Breslow, Lester

2007-01-01

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. PMID:18044084

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.

Cost-Savings Analysis of the Better Beginnings, Better Futures Community-Based Project for Young Children and Their Families: A 10-Year Follow-up.

Science.gov (United States)

Peters, Ray DeV; Petrunka, Kelly; Khan, Shahriar; Howell-Moneta, Angela; Nelson, Geoffrey; Pancer, S Mark; Loomis, Colleen

2016-02-01

This study examined the long-term cost-savings of the Better Beginnings, Better Futures (BBBF) initiative, a community-based early intervention project for young children living in socioeconomically disadvantaged neighborhoods during their transition to primary school. A quasi-experimental, longitudinal two-group design was used to compare costs and outcomes for children and families in three BBBF project neighborhoods (n = 401) and two comparison neighborhoods (n = 225). A cost-savings analysis was conducted using all project costs for providing up to 4 years of BBBF programs when children were in junior kindergarten (JK) (4 years old) to grade 2 (8 years old). Data on 19 government service cost measures were collected from the longitudinal research sample from the time the youth were in JK through to grade 12 (18 years old), 10 years after ending project participation. The average family incremental net savings to government of providing the BBBF project was $6331 in 2014 Canadian dollars. When the BBBF monetary return to government as a ratio of savings to costs was calculated, for every dollar invested by the government, a return of $2.50 per family was saved. Findings from this study have important implications for government investments in early interventions focused on a successful transition to primary school as well as parenting programs and community development initiatives in support of children's development.

A Study on Development of a Cost Optimal and Energy Saving Building Model: Focused on Industrial Building

Directory of Open Access Journals (Sweden)

Hye Yeon Kim

2016-03-01

Full Text Available This study suggests an optimization method for the life cycle cost (LCC in an economic feasibility analysis when applying energy saving techniques in the early design stage of a building. Literature and previous studies were reviewed to select appropriate optimization and LCC analysis techniques. The energy simulation (Energy Plus and computational program (MATLAB were linked to provide an automated optimization process. From the results, it is suggested that this process could outline the cost optimization model with which it is possible to minimize the LCC. To aid in understanding the model, a case study on an industrial building was performed to outline the operations of the cost optimization model including energy savings. An energy optimization model was also presented to illustrate the need for the cost optimization model.

Energy-saving behavior and marginal abatement cost for household CO2 emissions

International Nuclear Information System (INIS)

Hamamoto, Mitsutsugu

2013-01-01

This paper attempts to measure consumers' perceived net benefits (or net costs) of energy-saving measures in using energy-consuming durable goods. Using the estimated net costs and the volume of CO 2 reduced by the measures, a marginal abatement cost (MAC) curve for the average household's CO 2 emissions is produced. An analysis using the curve suggests that in order to provide households with an incentive to take actions that can lead to CO 2 emission reductions in using energy-consuming durables, a high level of carbon price is needed. In addition, a regression analysis reveals that the net benefits of the measures are larger for households that put a higher priority on energy saving, for those living in detached houses, for those with a smaller number of persons living together, and for those with less income. The result of the analysis using the MAC curve may suggest that promoting energy-saving behavior will require not only a policy to provide economic incentives but also interventions to influence psychological factors of household behavior. - Highlights: • Consumers' perceived net costs of energy-saving measures in using energy-consuming durables are measured. • Using the estimated net costs, a marginal abatement cost (MAC) curve for the average household's CO 2 emissions is produced. • A high carbon price is needed in order to provide households with an incentive to take actions for energy-savings. • Households' attributes affecting their energy-saving behavior are revealed by a regression analysis

Strategic design of cost savings guarantee in energy performance contracting under uncertainty

International Nuclear Information System (INIS)

Deng, Qianli; Jiang, Xianglin; Cui, Qingbin; Zhang, Limao

2015-01-01

Highlights: • A methodology is proposed to assist Energy Service Companies to maintain competitiveness in winning bids. • Uncertainties within the energy cost savings are modeled stochastically using the Monte-Carlo simulation. • A strategic energy savings guarantee design curve is derived, where all points return as appropriate guarantees. • A campus case is presented to demonstrate the applicability for finding appropriate guaranteed savings value. - Abstract: Among the key barriers to profit in Energy Performance Contracting (EPC) are uncertainties about attaining the realized energy cost savings and potential disputes over the guaranteed cost savings. In this paper, a methodology has been proposed to assist the Energy Service Company (ESCO): (1) to evaluate the risk threshold if the guarantee has already been made, and (2) to determine the guarantee design, if the guarantee has not been made yet, that not only promises the ESCO’s profitability from EPC but also maintains its competitiveness to win the bid. Uncertainties within the energy cost savings are modeled stochastically using Monte-Carlo simulation, taking both the energy price fluctuation and the facility performance variability into account. Based on that, a strategic energy savings guarantee design curve is derived, that all the points on it would return as appropriate guarantees. Finally, a campus case is presented to demonstrate the applicability for finding the appropriate guaranteed savings value. This method is also worth popularizing in similar performance-based projects

What are the cost savings associated with providing access to specialist care through the Champlain BASE eConsult service? A costing evaluation

Science.gov (United States)

Liddy, Clare; Drosinis, Paul; Deri Armstrong, Catherine; McKellips, Fanny; Afkham, Amir; Keely, Erin

2016-01-01

Objective This study estimates the costs and potential savings associated with all eConsult cases completed between 1 April 2014 and 31 March 2015. Design Costing evaluation from the societal perspective estimating the costs and potential savings associated with all eConsults completed during the study period. Setting Champlain health region in Eastern Ontario, Canada. Population Primary care providers and specialists registered to use the eConsult service. Main outcome measures Costs included (1) delivery costs; (2) specialist remuneration; (3) costs associated with traditional (face-to-face) referrals initiated as a result of eConsult. Potential savings included (1) costs of traditional referrals avoided; (2) indirect patient savings through avoided travel and lost wages/productivity. Net potential societal cost savings were estimated by subtracting total costs from total potential savings. Results A total of 3487 eConsults were completed during the study period. In 40% of eConsults, a face-to-face specialist visit was originally contemplated but avoided as result of eConsult. In 3% of eConsults, a face-to-face specialist visit was not originally contemplated but was prompted as a result of the eConsult. From the societal perspective, total costs were estimated at $207 787 and total potential savings were $246 516. eConsult led to a net societal saving of $38 729 or $11 per eConsult. Conclusions Our findings demonstrate potential cost savings from the societal perspective, as patients avoided the travel costs and lost wages/productivity associated with face-to-face specialist visits. Greater savings are expected once we account for other costs such as avoided tests and visits and potential improved health outcomes associated with shorter wait times. Our findings are valuable for healthcare delivery decision-makers as they seek solutions to improve care in a patient-centred and efficient manner. PMID:27338880

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.

Revised cost savings estimate with uncertainty for enhanced sludge washing of underground storage tank waste

International Nuclear Information System (INIS)

DeMuth, S.

1998-01-01

Enhanced Sludge Washing (ESW) has been selected to reduce the amount of sludge-based underground storage tank (UST) high-level waste at the Hanford site. During the past several years, studies have been conducted to determine the cost savings derived from the implementation of ESW. The tank waste inventory and ESW performance continues to be revised as characterization and development efforts advance. This study provides a new cost savings estimate based upon the most recent inventory and ESW performance revisions, and includes an estimate of the associated cost uncertainty. Whereas the author's previous cost savings estimates for ESW were compared against no sludge washing, this study assumes the baseline to be simple water washing which more accurately reflects the retrieval activity along. The revised ESW cost savings estimate for all UST waste at Hanford is $6.1 B ± $1.3 B within 95% confidence. This is based upon capital and operating cost savings, but does not include development costs. The development costs are assumed negligible since they should be at least an order of magnitude less than the savings. The overall cost savings uncertainty was derived from process performance uncertainties and baseline remediation cost uncertainties, as determined by the author's engineering judgment

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

2018-05-01

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 payment rate change. Cost savings were found for all primary diagnoses analyzed except dementia.

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.

What are the cost savings associated with providing access to specialist care through the Champlain BASE eConsult service? A costing evaluation.

Science.gov (United States)

Liddy, Clare; Drosinis, Paul; Deri Armstrong, Catherine; McKellips, Fanny; Afkham, Amir; Keely, Erin

2016-06-23

This study estimates the costs and potential savings associated with all eConsult cases completed between 1 April 2014 and 31 March 2015. Costing evaluation from the societal perspective estimating the costs and potential savings associated with all eConsults completed during the study period. Champlain health region in Eastern Ontario, Canada. Primary care providers and specialists registered to use the eConsult service. Costs included (1) delivery costs; (2) specialist remuneration; (3) costs associated with traditional (face-to-face) referrals initiated as a result of eConsult. Potential savings included (1) costs of traditional referrals avoided; (2) indirect patient savings through avoided travel and lost wages/productivity. Net potential societal cost savings were estimated by subtracting total costs from total potential savings. A total of 3487 eConsults were completed during the study period. In 40% of eConsults, a face-to-face specialist visit was originally contemplated but avoided as result of eConsult. In 3% of eConsults, a face-to-face specialist visit was not originally contemplated but was prompted as a result of the eConsult. From the societal perspective, total costs were estimated at $207 787 and total potential savings were $246 516. eConsult led to a net societal saving of $38 729 or $11 per eConsult. Our findings demonstrate potential cost savings from the societal perspective, as patients avoided the travel costs and lost wages/productivity associated with face-to-face specialist visits. Greater savings are expected once we account for other costs such as avoided tests and visits and potential improved health outcomes associated with shorter wait times. Our findings are valuable for healthcare delivery decision-makers as they seek solutions to improve care in a patient-centred and efficient manner. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

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

Future cost savings from engineering innovations

International Nuclear Information System (INIS)

Roemer, R.E.; Foster, D.C.; Jacobs, S.B.

1987-01-01

Nuclear power plant design and operating experience in the 1970s and 1980s continues to provide feedback to the technology base. The lessons learned in these two decades, coupled with engineering innovation, will lead to improvements and cost-reductions in the plants of the 1990s. Two types of innovations related to piping are described: snubber reduction and pipe rupture elimination. A brief account of the industry experience is given for each, followed by an account of the technical methodology involved. A discussion of expected benefits, including cost savings of millions of dollars (U.S.), is provided. (author)

Offshore wind energy storage concept for cost-of-rated-power savings

International Nuclear Information System (INIS)

Qin, Chao; Saunders, Gordon; Loth, Eric

2017-01-01

Highlights: •Investigated CAES + HPT system concept for offshore wind energy; •Validated cost model for offshore wind farm including CAPEX and OPEX items; •Quantified cost-of-rated-power savings associated with CAES + HPT concept; •Estimated savings of 21.6% with CAES + HPT for a sample $2.92 billion project. -- Abstract: The size and number of off-shore wind turbines over the next decade is expected to rapidly increase due to the high wind energy potential and the ability of such farms to provide utility-scale energy. In this future, inexpensive and efficient on-site wind energy storage can be critical to address short-time (hourly) mismatches between wind supply and energy demand. This study investigates a compressed air energy storage (CAES) and hydraulic power transmission (HPT) system concept. To assess cost impact, the NREL Cost and Scaling Model was modified to improve accuracy and robustness for offshore wind farms with large turbines. Special attention was paid to the support structure, installation, electrical interface and connections, land leasing, and operations and maintenance cost items as well as specific increased/reduced costs reductions associated with CAES + HPT systems. This cost model was validated and applied to a sample $2.92 billion project Virginia Offshore case It was found that adaption of CAES + HPT can lead to a substantial savings of 21.6% of this 20-year lifetime cost by dramatically reducing capital and operating cost of the generator and power transmission components. However, there are several additional variables that can impact the off-shore energy policy and planning for this new CAES + HPT concept. Furthermore, these cost-savings are only first-order estimates based on linear mass-cost relationships, and thus detailed engineering and economic analysis are recommended.

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.

Savings impact of a corporate energy manager

International Nuclear Information System (INIS)

Sikorski, B.D.; O'Donnell, B.A.

1999-01-01

This paper discusses the cost savings impact of employing an energy manager with a 16,000-employee corporation. The corporation, Canada's second largest airline, is currently operating nearly 3,000,000 ft 2 of mixed-use facilities spread across the country, with an annual energy budget for ground facilities of over Cdn $4,000,000. This paper outlines the methodology used by the energy manager to deploy an energy management program over a two-year period between April 1995 and May 1997. The paper examines the successes and the lessons learned during the period and summarizes the costs and benefits of the program. The energy manager position was responsible for developing an energy history database with more than 100 active accounts and for monitoring and verifying energy savings. The energy manager implemented many relatively low-cost energy conservation measures, as well as some capital projects, during the first two years of the program. In total, these measures provided energy cost savings of $210,000 per year, or 5% of the total budget. In each case, technologies installed as part of the energy retrofit projects provided not only cost savings but also better control, reduced maintenance, and improved working conditions for employees

Potential Cost Savings for Use of 3D Printing Combined With 3D Imaging and CPLM for Fleet Maintenance and Revitalization

Science.gov (United States)

2014-04-30

bäÉîÉåíÜ=^ååì~ä=^Åèìáëáíáçå= oÉëÉ~êÅÜ=póãéçëáìã= qÜìêëÇ~ó=pÉëëáçåë= sçäìãÉ=ff= = Potential Cost Savings for Use of 3D Printing Combined With 3D...TYPE 3. DATES COVERED 00-00-2014 to 00-00-2014 4. TITLE AND SUBTITLE Potential Cost Savings for Use of 3D Printing Combined With 3D Imaging and...Chair: RADM David Lewis, USN Program Executive Officer, SHIPS Potential Cost Savings for Use of 3D Printing Combined With 3D Imaging and CPLM for

Implementation cost analysis of a community-based exercise program for seniors in South Florida.

Science.gov (United States)

Page, Timothy F; Batra, Anamica; Ghouse, Muddasir M; Palmer, Richard C

2014-07-01

The objective of the study was to measure the costs of implementing the EnhanceFitness program to elderly residents of South Florida. The Health Foundation of South Florida's Healthy Aging Regional Collaborative implemented EnhanceFitness as part of their initiative to make evidence-based healthy aging programs available to South Florida seniors. Cost data were collected from agencies participating in the delivery of EnhanceFitness classes in South Florida. Cost questionnaires were e-mailed to program coordinators from agencies participating in the delivery of EnhanceFitness classes. Program coordinators worked with accounting staff to complete the questionnaires. Questionnaires were returned via e-mail. Costs were presented from the perspective of participating agencies. Total costs were divided by the number of classes being offered by each agency to determine cost per class per month. Average monthly costs per class were $1,713 during the first year of implementation and $873 during the second year of implementation. The cost measurements, combined with information from the literature on cost savings attributable to EnhanceFitness participation, suggest that EnhanceFitness has the potential to generate a net societal cost savings among program participants. The results are useful for community agencies considering implementing EnhanceFitness for their populations. © 2014 Society for Public Health Education.

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 cost-savings threshold range at our institution of $863 below which PSI pricing would provide net cost-savings. Two-way sensitivity 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

Potential Cost Savings Ideas for FAA and Users

Science.gov (United States)

1997-06-04

The intent of this paper is to catalogue potential cost-savings ideas which : impact both the FAA and the aviation community. These ideas have come from : various sources including MITRE, Coopers & Lybrand (C&L), FAA studies, General : Accounting Off...

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.

Metaldyne: Plant-Wide Assessment at Royal Oak Finds Opportunities to Improve Manufacturing Efficiency, Reduce Energy Use, and Achieve Significant Cost Savings

Energy Technology Data Exchange (ETDEWEB)

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.

Faith community nursing: real care, real cost savings.

Science.gov (United States)

Yeaworth, Rosalee C; Sailors, Ronnette

2014-01-01

At a time when healthcare costs are increasing more than other aspects of the economy, churches are stepping up to help fill needs through congregational health ministries. Faith Community Nursing (FCN) is a rapidly growing health service in the churches of many denominations. This article documents healthcare services and financial savings provided by FCNs and health ministries, showing the critical role faith community nursing can play in containing healthcare costs.

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.

Financial Impact of Cancer Drug Wastage and Potential Cost Savings From Mitigation Strategies.

Science.gov (United States)

Leung, Caitlyn Y W; Cheung, Matthew C; Charbonneau, Lauren F; Prica, Anca; Ng, Pamela; Chan, Kelvin K W

2017-07-01

Cancer drug wastage occurs when a parenteral drug within a fixed vial is not administered fully to a patient. This study investigated the extent of drug wastage, the financial impact on the hospital budget, and the cost savings associated with current mitigation strategies. We conducted a cross-sectional study in three University of Toronto-affiliated hospitals of various sizes. We recorded the actual amount of drug wasted over a 2-week period while using current mitigation strategies. Single-dose vial cancer drugs with the highest wastage potentials were identified (14 drugs). To calculate the hypothetical drug wastage with no mitigation strategies, we determined how many vials of drugs would be needed to fill a single prescription. The total drug costs over the 2 weeks ranged from $50,257 to $716,983 in the three institutions. With existing mitigation strategies, the actual drug wastage over the 2 weeks ranged from $928 to $5,472, which was approximately 1% to 2% of the total drug costs. In the hypothetical model with no mitigation strategies implemented, the projected drug cost wastage would have been $11,232 to $149,131, which accounted for 16% to 18% of the total drug costs. As a result, the potential annual savings while using current mitigation strategies range from 15% to 17%. The financial impact of drug wastage is substantial. Mitigation strategies lead to substantial cost savings, with the opportunity to reinvest those savings. More research is needed to determine the appropriate methods to minimize risk to patients while using the cost-saving mitigation strategies.

Cost savings from extended life nuclear plants

International Nuclear Information System (INIS)

Forest, L.R. Jr.; Deutsch, T.R.; Schenler, W.W.

1988-09-01

This study assesses the costs and benefits of nuclear power plant life extension (NUPLEX) for the overall US under widely varying economic assumptions and compares these with alternative new coal- fired plants (NEWCOAL). It is found that NUPLEX saves future electricity consumers more than 3 cents/-kwh compared with NEWCOAL. The NUPLEX costs and benefits for existing individual US nuclear power plants under base-line, or most likely, assumptions are assessed to determine the effects of the basic plant design and plant age. While benefits vary widely, virtually all units would have a positive benefit from NUPLEX. The study also presents a cost-benefit analysis of the nuclear industry's planned advanced light water reactor (ALWR). It is concluded that ALWR offers electrical power at a substantially lower cost than NEWCOAL. 9 refs., 6 figs

Cost-benefit analysis simulation of a hospital-based violence intervention program.

Science.gov (United States)

Purtle, Jonathan; Rich, Linda J; Bloom, Sandra L; Rich, John A; Corbin, Theodore J

2015-02-01

Violent injury is a major cause of disability, premature mortality, and health disparities worldwide. Hospital-based violence intervention programs (HVIPs) show promise in preventing violent injury. Little is known, however, about how the impact of HVIPs may translate into monetary figures. To conduct a cost-benefit analysis simulation to estimate the savings an HVIP might produce in healthcare, criminal justice, and lost productivity costs over 5 years in a hypothetical population of 180 violently injured patients, 90 of whom received HVIP intervention and 90 of whom did not. Primary data from 2012, analyzed in 2013, on annual HVIP costs/number of clients served and secondary data sources were used to estimate the cost, number, and type of violent reinjury incidents (fatal/nonfatal, resulting in hospitalization/not resulting in hospitalization) and violent perpetration incidents (aggravated assault/homicide) that this population might experience over 5 years. Four different models were constructed and three different estimates of HVIP effect size (20%, 25%, and 30%) were used to calculate a range of estimates for HVIP net savings and cost-benefit ratios from different payer perspectives. All benefits were discounted at 5% to adjust for their net present value. Estimates of HVIP cost savings at the base effect estimate of 25% ranged from $82,765 (narrowest model) to $4,055,873 (broadest model). HVIPs are likely to produce cost savings. This study provides a systematic framework for the economic evaluation of HVIPs and estimates of HVIP cost savings and cost-benefit ratios that may be useful in informing public policy decisions. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

A Simple Application Program Interface for Saving Java Program Data on a Wiki

OpenAIRE

Yamanoue, Takashi; Oda, Kentaro; Shimozono, Koichi

2012-01-01

A simple application program interface (API) for Java programs running on a wiki is implemented experimentally. A Java program with the API can be running on a wiki, and the Java program can save its data on the wiki. The Java program consists of PukiWiki, which is a popular wiki in Japan, and a plug-in, which starts up Java programs and classes of Java. A Java applet with default access privilege cannot save its data at a local host. We have constructed an API of applets for easy and unified...

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.

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

International Nuclear Information System (INIS)

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

1993-09-01

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

Assessing cost-effectiveness in obesity: active transport program for primary school children--TravelSMART Schools Curriculum program.

Science.gov (United States)

Moodie, Marj; Haby, Michelle M; Swinburn, Boyd; Carter, Robert

2011-05-01

To assess from a societal perspective the cost-effectiveness of a school program to increase active transport in 10- to 11-year-old Australian children as an obesity prevention measure. The TravelSMART Schools Curriculum program was modeled nationally for 2001 in terms of its impact on Body Mass Index (BMI) and Disability-Adjusted Life Years (DALYs) measured against current practice. Cost offsets and DALY benefits were modeled until the eligible cohort reached age 100 or died. The intervention was qualitatively assessed against second stage filter criteria ('equity,' 'strength of evidence,' 'acceptability to stakeholders,' 'feasibility of implementation,' 'sustainability,' and 'side-effects') given their potential impact on funding decisions. The modeled intervention reached 267,700 children and cost $AUD13.3M (95% uncertainty interval [UI] $6.9M; $22.8M) per year. It resulted in an incremental saving of 890 (95%UI -540; 2,900) BMI units, which translated to 95 (95% UI -40; 230) DALYs and a net cost per DALY saved of $AUD117,000 (95% UI dominated; $1.06M). The intervention was not cost-effective as an obesity prevention measure under base-run modeling assumptions. The attribution of some costs to nonobesity objectives would be justified given the program's multiple benefits. Cost-effectiveness would be further improved by considering the wider school community impacts.

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...

Development of a prediction model for the cost saving potentials in implementing the building energy efficiency rating certification

International Nuclear Information System (INIS)

Jeong, Jaewook; Hong, Taehoon; Ji, Changyoon; Kim, Jimin; Lee, Minhyun; Jeong, Kwangbok; Koo, Choongwan

2017-01-01

Highlights: • This study evaluates the building energy efficiency rating (BEER) certification. • Prediction model was developed for cost saving potentials by the BEER certification. • Prediction model was developed using LCC analysis, ROV, and Monte Carlo simulation. • Cost saving potential was predicted to be 2.78–3.77% of the construction cost. • Cost saving potential can be used for estimating the investment value of BEER. - Abstract: Building energy efficiency rating (BEER) certification is an energy performance certificates (EPCs) in South Korea. It is critical to examine the cost saving potentials of the BEER-certification in advance. This study aimed to develop a prediction model for the cost saving potentials in implementing the BEER-certification, in which the cost saving potentials included the energy cost savings of the BEER-certification and the relevant CO_2 emissions reduction as well as the additional construction cost for the BEER-certification. The prediction model was developed by using data mining, life cycle cost analysis, real option valuation, and Monte Carlo simulation. The database were established with 437 multi-family housing complexes (MFHCs), including 116 BEER-certified MFHCs and 321 non-certified MFHCs. The case study was conducted to validate the developed prediction model using 321 non-certified MFHCs, which considered 20-year life cycle. As a result, compared to the additional construction cost, the average cost saving potentials of the 1st-BEER-certified MFHCs in Groups 1, 2, and 3 were predicted to be 3.77%, 2.78%, and 2.87%, respectively. The cost saving potentials can be used as a guideline for the additional construction cost of the BEER-certification in the early design phase.

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.

The Quit Benefits Model: a Markov model for assessing the health benefits and health care cost savings of quitting smoking

Directory of Open Access Journals (Sweden)

Hurley Susan F

2007-01-01

Full Text Available Abstract Background In response to the lack of comprehensive information about the health and economic benefits of quitting smoking for Australians, we developed the Quit Benefits Model (QBM. Methods The QBM is a Markov model, programmed in TreeAge, that assesses the consequences of quitting in terms of cases avoided of the four most common smoking-associated diseases, deaths avoided, and quality-adjusted life-years (QALYs and health care costs saved (in Australian dollars, A$. Quitting outcomes can be assessed for males and females in 14 five year age-groups from 15–19 to 80–84 years. Exponential models, based on data from large case-control and cohort studies, were developed to estimate the decline over time after quitting in the risk of acute myocardial infarction (AMI, stroke, lung cancer, chronic obstructive pulmonary disease (COPD, and death. Australian data for the year 2001 were sourced for disease incidence and mortality and health care costs. Utility of life estimates were sourced from an international registry and a meta analysis. In this paper, outcomes are reported for simulated subjects followed up for ten years after quitting smoking. Life-years, QALYs and costs were estimated with 0%, 3% and 5% per annum discount rates. Summary results are presented for a group of 1,000 simulated quitters chosen at random from the Australian population of smokers aged between 15 and 74. Results For every 1,000 males chosen at random from the reference population who quit smoking, there is a an average saving in the first ten years following quitting of A$408,000 in health care costs associated with AMI, COPD, lung cancer and stroke, and a corresponding saving of A$328,000 for every 1,000 female quitters. The average saving per 1,000 random quitters is A$373,000. Overall 40 of these quitters will be spared a diagnosis of AMI, COPD, lung cancer and stroke in the first ten years following quitting, with an estimated saving of 47 life-years and

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

International Nuclear Information System (INIS)

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 their primary heating source with secondary heating e.g. a woodstove. This choice results in increased indoor air pollution with fine particles causing health effects. We integrate health cost due to use of woodstoves into household optimisation of heating expenditures. The results show that due 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 for private consumers decrease by 66% when all have the option to shift to the technology with lowest variable costs. - Highlights: • Heat saving investment and heat technology choice are interdependent. • Health damage costs should be included in private heating choice optimisation. • Flexibility in heating technology choice reduce the optimal level of saving investments. • Models of private and socioeconomic optimal heating produce different technology mix. • Rebound effects are moderate but varies greatly among consumer categories

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.

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

Directory of Open Access Journals (Sweden)

David A Watkins

Full Text Available 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

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

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.

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.

Design of a low-cost hybrid powertrain with large fuel savings

NARCIS (Netherlands)

Berkel, van K.; Romers, L.H.J.; Vroemen, B.G.; Hofman, T.; Steinbuch, M.

2010-01-01

This paper presents a new design of a low-cost hybrid powertrain with large fuel savings. The hybrid powertrain contains only low-cost mechanical components, such as a flywheel module and a continuously variable transmission (CVT). Noelectrical motor/generator or battery is used. Based on

A cost-benefit analysis of the Mexican Social Security Administration's family planning program.

Science.gov (United States)

Nortman, D L; Halvas, J; Rabago, A

1986-01-01

A cost-benefit analysis of the family planning program of the Mexican Social Security System (IMSS) was undertaken to test the hypothesis that IMSS's family planning services yield a net savings to IMSS by reducing the load on its maternal and infant care service. The cost data are believed to be of exceptionally high quality because they were empirically ascertained by a retrospective and prospective survey of unit time and personnel costs per specified detailed type of service in 37 IMSS hospitals and 16 clinics in 13 of Mexico's 32 states. Based on the average cost per case, the analysis disclosed that for every peso (constant 1983 currency) that IMSS spent on family planning services to its urban population during 1972-1984 inclusive, the agency saved nine pesos. The article concludes by raising the speculative question as to the proportion of the births averted by the IMSS family planning program that would have been averted in the absence of IMSS's family planning services.

Incorrect storage of medicines and potential for cost savings

DEFF Research Database (Denmark)

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

2017-01-01

continue to be used, possibly with a shortened expiry date. Thus, by examining all cases of incorrect storage, the value of drugs that pharmacists advised could be used despite a broken cold chain, could be estimated. Results The Medicine Information Centre dealt with 171 cases concerning incorrect storage...... in 2013. Data show that advice from Medicine Information Centre pharmacists resulted medicine cost savings of DKK 13 million (approx. €1.7 million) in hospitals in the Capital Region for that year. Conclusions Substantial savings can be made by seeking the advice of a team of information pharmacists...

Cost-savings for biosimilars in the United States: a theoretical framework and budget impact case study application using filgrastim.

Science.gov (United States)

Grewal, Simrun; Ramsey, Scott; Balu, Sanjeev; Carlson, Josh J

2018-05-18

Biosimilars can directly reduce the cost of treating patients for whom a reference biologic is indicated by offering a highly similar, lower priced alternative. We examine factors related to biosimilar regulatory approval, uptake, pricing, and financing and the potential impact on drug expenditures in the U.S. We developed a framework to illustrate how key factors including regulatory policies, provider and patient perception, pricing, and payer policies impact biosimilar cost-savings. Further, we developed a budget impact cost model to estimate savings from filgrastim biosimilars under various scenarios. The model uses publicly available data on disease incidence, treatment patterns, market share, and drug prices to estimate the cost-savings over a 5-year time horizon. We estimate five-year cost savings of $256 million, of which 18% ($47 million) are from reduced patient out-of-pocket costs, 34% ($86 million) are savings to commercial payers, and 48% ($123 million) are savings for Medicare. Additional scenarios demonstrate the impact of uncertain factors, including price, uptake, and financing policies. A variety or interrelated factors influence the development, uptake, and cost-savings for Biosimilars use in the U.S. The filgrastim case is a useful example that illustrates these factors and the potential magnitude of costs savings.

VA Telemedicine: An Analysis of Cost and Time Savings.

Science.gov (United States)

Russo, Jack E; McCool, Ryan R; Davies, Louise

2016-03-01

The Veterans Affairs (VA) healthcare system provides beneficiary travel reimbursement ("travel pay") to qualifying patients for traveling to appointments. Travel pay is a large expense for the VA and hence the U.S. Government, projected to cost nearly $1 billion in 2015. Telemedicine in the VA system has the potential to save money by reducing patient travel and thus the amount of travel pay disbursed. In this study, we quantify this savings and also report trends in VA telemedicine volumes over time. All telemedicine visits based at the VA Hospital in White River Junction, VT between 2005 and 2013 were reviewed (5,695 visits). Travel distance and time saved as a result of telemedicine were calculated. Clinical volume in the mental health department, which has had the longest participation in telemedicine, was analyzed. Telemedicine resulted in an average travel savings of 145 miles and 142 min per visit. This led to an average travel payment savings of $18,555 per year. Telemedicine volume grew significantly over the study period such that by the final year the travel pay savings had increased to $63,804, or about 3.5% of the total travel pay disbursement for that year. The number of mental health telemedicine visits rose over the study period but remained small relative to the number of face-to-face visits. A higher proportion of telemedicine visits involved new patients. Telemedicine at the VA saves travel distance and time, although the reduction in travel payments remains modest at current telemedicine volumes.

Cost Savings for Manufacturing Lithium Batteries in a Flexible Plant

Energy Technology Data Exchange (ETDEWEB)

Nelson, Paul A.; Ahmed, Shabbir; Gallagher, Kevin G.; Dees, Dennis W.

2015-06-01

The flexible plant postulated in this study would produces types of batteries for electric-drive vehicles of the types hybrid (HEV), 10-mile range and 40-mile range plug-in hybrids (PHEV) and a 150-mile range battery-electric (EV). The annual production rate of the plant is 235,000 per year (30,000 EV batteries and 100,000 HEV batteries). The unit cost savings as calculated with the Argonne BatPaC model for this flex plant vs. dedicated plants range from 8% for the EV battery packs to 23% for the HEV packs including the battery management systems (BMS). The investment cost savings are even larger, ranging from 21% for EVs to 43% for HEVs. The costs of the 1.0-kWh HEV batteries are projected to approach $710 per unit and that of the EV batteries $228 per kWh with the most favorable cell chemistries and including the BMS. The best single indicator of the cost of producing lithium-manganate spinel/graphite batteries in a flex plant is the total cell area of the battery. For the four batteries studied, the price range is $20-24 per m2 of cell area including the cost of the BMS, averaging $21 per m2 for the entire flex plant.

Energy conservation. Federal shared energy savings contracting

International Nuclear Information System (INIS)

Fultz, Keith O.; Milans, Flora H.; Kirk, Roy J.; Welker, Robert A.; Sparling, William J.; Butler, Sharon E.; Irwin, Susan W.

1989-04-01

A number of impediments have discouraged federal agencies from using shared energy savings contracts. As of November 30, 1988, only two federal agencies - the U.S. Postal Service (USPS) and the Department of the Army -had awarded such contracts even though they can yield significant energy and cost savings. The three major impediments we identified were uncertainty about the applicability of a particular procurement policy and practice, lack of management incentives, and difficulty in measuring energy and cost savings. To address the first impediment, the Department of Energy (DOE) developed a manual on shared energy savings contracting. The second impediment was addressed when the 100th Congress authorized incentives for federal agencies to enter into shared savings contracts. DOE addressed the third impediment by developing a methodology for calculating energy consumption and cost savings. However, because of differing methodological preferences, this issue will need to be addressed on a contract-by-contract basis. Some state governments and private sector firms are using performance contracts to reduce energy costs in their buildings and facilities. We were able to identify six states that were using performance contracts. Five have established programs, and all six states have projects under contract. The seven energy service companies we contacted indicated interest in federal shared energy savings contracting

Maintenance cost savings - snubber elimination with limit stops

International Nuclear Information System (INIS)

Cloud, R.L.; Taylor, W.H.

1993-01-01

'Active' snubbers can be replaced with 'passive' Limit Stops using two separate strategies. One is a straightforward piping re-analysis to optimize the number of dynamic supports and replace remaining snubbers with Limit Stops. A second approach is to take implicit advantage of the margins afforded by the ASME Code Case N-411 reduced damping ratios and simply replace snubbers one-for-one with no re-analysis. Both methods result in major maintenance cost savings and both have been discussed with the NRC. Approaches to maintenance cost reduction using these strategies are discussed in this paper

Cost effective water treatment program in Heavy Water Plant (Manuguru)

International Nuclear Information System (INIS)

Mohapatra, C.; Prasada Rao, G.

2002-01-01

Water treatment technology is in a state of continuous evolution. The increasing urgency to conserve water and reduce pollution has in recent years produced an enormous demand for new chemical treatment programs and technologies. Heavy water plant (Manuguru) uses water as raw material (about 3000 m 3 /hr) and its treatment and management has benefited the plant in a significant way. It is a fact that if the water treatment is not proper, it can result in deposit formation and corrosion of metals, which can finally leads to production losses. Therefore, before selecting treatment program, complying w.r.t. quality requirements, safety and pollution aspects cost effectiveness shall be examined. The areas where significant benefits are derived, are raw water treatment using polyelectrolyte instead of inorganic coagulant (alum), change over of regenerant of cation exchangers from hydrochloric acid to sulfuric acid and in-house development of cooling water treatment formulation. The advantages and cost effectiveness of these treatments are discussed in detail. Further these treatments has helped the plant in achieving zero discharge and indirectly increased cost reduction of final product (heavy water); the dosage of 3 ppm of polyelectrolyte can replace 90 ppm alum at turbidity level of 300 NTU of raw water which has resulted in cost saving of Rs. 15-20 lakhs in a year beside other advantages; the change over of regenerant from HCl to H 2 SO 4 will result in cost saving of at least Rs.1.4 crore a year besides other advantages; the change over to proprietary formulation to in-house formulation in cooling water treatment has resulted in a saving about Rs.11 lakhs a year. To achieve the above objectives in a sustainable way the performance results are being monitored. (author)

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.

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

Potential Cost Savings From Reduction of Regional Variation in Medicare Spending

Directory of Open Access Journals (Sweden)

Yunjie Song

2016-04-01

Full Text Available Potential cost savings estimated from reduction of regional variation in Medicare spending are considerable but questioned. This article evaluates the validity of the principal methods that have been used in the estimations of the potential savings. Three estimation approaches were identified. The first approach uses adjusted expenditures to calculate avoidable costs, but adjusted expenditures can be independent of avoidable costs, and measurement errors are not controlled. The second approach uses an outcome variable to replace its causal factors, and is not acceptable because the association between the outcomes and the causes is untestable. The final approach uses surveys to directly measure physician beliefs and patient preferences, but the sole study using this approach is weakened by sample selection biases and incomplete controls. A development of reliable measures and a switch of observation from clinic settings to geographic contexts could make the estimations more convincing.

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

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.

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.

Maintenance cost savings - snubber elimination with limit stops

International Nuclear Information System (INIS)

Monette, P.; Baltus, R.; Cloud, R.L.

1995-01-01

''Active'' snubbers can be replaced with ''passive'' Limit Stops using two separate strategies. One is a straightforward piping re-analysis to optimize the number of dynamics supports and replace remaining snubbers with Limit Stops. A second approach is to take implicit advantage of the margins afforded by the ASME Code Case N-411 damping ratios and simply replace snubbers one-for-one with no re-analysis. Both methods result in major maintenance cost savings and both have been received favorably by the USNRC (United States Nuclear Regulatory Commission). Approaches to maintenance cost reduction using these strategies are discussed in this paper. (Author). 11 refs., 4 figs

Exergy costing for energy saving in combined heating and cooling applications

International Nuclear Information System (INIS)

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

2014-01-01

Highlights: • We investigate the basis for cost apportioning of simultaneous heating and cooling. • Two thermoeconomic methods based on energy and exergy costing is demonstrated. • The unit cost of heating and cooling for a heat pump system is found and compared. • Energy costing may obstruct efficient use of energy. • Exergy costing provides the most rational cost apportioning for energy saving. - Abstract: 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. In the first method, referred to as energy costing, a conventional thermoeconomic analysis is used. Here the ammonia heat pump is subject to a thermodynamic analysis with mass and energy balance equations. In the second method referred to as exergy costing, an exergy based economic analysis is used, where 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 analysis shows that the two methods yield significantly different results. Rather surprisingly, it is demonstrated that the exergy costing method results in about three times higher unit cost for heating than for cooling as opposed to equal unit costs when using the energy method. Further the exergy-based cost for heating changes considerably with the heating temperature while that of cooling is much less affected

Hanford general employee training - A million dollar cost beneficial program

International Nuclear Information System (INIS)

Gardner, P.R.

1991-02-01

In January 1990, Westinghouse Hanford Company implemented an interactive videodisc training program entitled Hanford General Employee Training. Covering all Institute of Nuclear Power Operations general employee training objectives, training mandated by US Department of Energy orders, and training prescribed by internal Westinghouse Hanford Company policies, Hanford General Employee Training presents and manages engaging training programs individually tailored to each of the 9,000 employees. Development costs for a sophisticated program such as Hanford General Employee Training were high compared to similar costs for developing ''equivalent'' traditional training. Hardware ($500,000) and labor costs ($400,000) totaled $900,000. Annual maintenance costs, equipment plus labor, are totalling about $200,000. On the benefit side, by consolidating some 17 previous Westinghouse Hanford Company courses and more effectively managing the instructional process, Hanford General Employee Training reduced the average student training time from over 11 hours to just under 4 hours. For 9,000 employees, the computed net annual savings exceeds $1.3 million. 2 refs

A Cost-Benefit Analysis of a State-Funded Healthy Homes Program for Residents With Asthma: Findings From the New York State Healthy Neighborhoods Program.

Science.gov (United States)

Gomez, Marta; Reddy, Amanda L; Dixon, Sherry L; Wilson, Jonathan; Jacobs, David E

Despite considerable evidence that the economic and other benefits of asthma home visits far exceed their cost, few health care payers reimburse or provide coverage for these services. To evaluate the cost and savings of the asthma intervention of a state-funded healthy homes program. Pre- versus postintervention comparisons of asthma outcomes for visits conducted during 2008-2012. The New York State Healthy Neighborhoods Program operates in select communities with a higher burden of housing-related illness and associated risk factors. One thousand households with 550 children and 731 adults with active asthma; 791 households with 448 children and 551 adults with asthma events in the previous year. The program provides home environmental assessments and low-cost interventions to address asthma trigger-promoting conditions and asthma self-management. Conditions are reassessed 3 to 6 months after the initial visit. Program costs and estimated benefits from changes in asthma medication use, visits to the doctor for asthma, emergency department visits, and hospitalizations over a 12-month follow-up period. For the asthma event group, the per person savings for all medical encounters and medications filled was $1083 per in-home asthma visit, and the average cost of the visit was $302, for a benefit to program cost ratio of 3.58 and net benefit of $781 per asthma visit. For the active asthma group, per person savings was $613 per asthma visit, with a benefit to program cost ratio of 2.03 and net benefit of $311. Low-intensity, home-based, environmental interventions for people with asthma decrease the cost of health care utilization. Greater reductions are realized when services are targeted toward people with more poorly controlled asthma. While low-intensity approaches may produce more modest benefits, they may also be more feasible to implement on a large scale. Health care payers, and public payers in particular, should consider expanding coverage, at least for

Societal value of generic medicines beyond cost-saving through reduced prices.

Science.gov (United States)

Dylst, Pieter; Vulto, Arnold; Simoens, Steven

2015-01-01

This paper aims to provide an overview of the added societal value of generic medicines beyond their cost-saving potential through reduced prices. In addition, an observational case study will document the impact of generic entry on access to pharmacotherapy in The Netherlands and an illustrative exercise was carried out to highlight the budget impact of generic entry. A narrative literature review was carried out to explore the impact of generic medicines on access to pharmacotherapy, innovation and medication adherence. Data from the Medicines and Medical Devices Information Project database in The Netherlands were used for the case study in which the impact of generic medicine entrance on the budget and the number of users was calculated as an illustrative exercise. Generic medicines have an additional societal value beyond their cost-saving potential through reduced prices. Generic medicines increase access to pharmacotherapy, provide a stimulus for innovation by both originator companies and generic companies and, under the right circumstances, have a positive impact on medication adherence. Generic medicines offer more to society than just their cost-saving potential through reduced prices. As such, governments must not focus only on the prices of generic medicines as this will threaten their long-term sustainability. Governments must therefore act appropriately and implement a coherent set of policies to increase the use of generic medicines.

Cost-effectiveness of dog rabies vaccination programs in East Africa

Science.gov (United States)

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

2018-01-01

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

Do Medicaid home and community based service waivers save money?

Science.gov (United States)

Harrington, Charlene; Ng, Terence; Kitchener, Martin

2011-10-01

This article estimates the potential savings to the Medicaid program of using 1915c Home and Community Based Services (HCBS) waivers rather than institutional care. For Medicaid HCBS waiver expenditures of $25 billion in 2006, we estimate the national savings to be over $57 billion, or $57,338 per waiver participant in 2006 compared with the cost of Medicaid institutional care (for which all waiver participants are eligible). When taking into account a potential 50% "woodwork effect" (for people who might have refused institutional services), the saving would be $21 billion. This analysis demonstrates that HCBS waiver programs present significant direct financial savings to Medicaid long-term care (LTC) programs.

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

New York Power Authority`s energy-efficient refigerator program for the New York City Housing Authority - savings evaluation

Energy Technology Data Exchange (ETDEWEB)

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

1997-09-01

The New York Power Authority (NYPA) and the New York City Housing Authority (NYCHA) are replacing refrigerators in New York City public housing with new, highly energy-efficient models over a five-year period. This report describes the analysis of the energy cost savings achieved through the replacement of 20,000 refrigerators in 1996, the first year of the NYPA/NYCHA program. The NYPA/NYCHA project serves as the lynchpin of a larger program designed to offer energy-efficient appliances to housing authorities across the country. The national program is a partnership between the U.S. Department of Energy (DOE) and the Consortium for Energy Efficiency (CEE). Starting with the 1997 refrigerator contract, this program invites other housing authorities to join NYPA in its volume purchase of energy-efficient refrigerators, at the same price and terms available to NYPA. Through these volume purchases, DOE`s ENERGY STAR{reg_sign} Partnerships program hopes to encourage appliance manufacturers to bring more efficient appliances to the market and to provide volume purchasers with the per-unit price savings of a bulk purchaser. DOE asked the Pacific Northwest National Laboratory (PNNL) to establish a protocol for evaluating the savings achieved with the NYPA refrigerators. That protocol is summarized in this report.

Calculation of direct antiretroviral treatment costs and potential cost savings by using generics in the German HIV ClinSurv cohort.

Directory of Open Access Journals (Sweden)

Matthias Stoll

Full Text Available UNLABELLED: BACKGROUND/AIM OF THE STUDY: The study aimed to determine the cost impacts of antiretroviral drugs by analysing a long-term follow-up of direct costs for combined antiretroviral therapy, cART, -regimens in the nationwide long-term observational multi-centre German HIV ClinSurv Cohort. The second aim was to develop potential cost saving strategies by modelling different treatment scenarios. METHODS: Antiretroviral regimens (ART from 10,190 HIV-infected patients from 11 participating ClinSurv study centres have been investigated since 1996. Biannual data cART-initiation, cART-changes, surrogate markers, clinical events and the Centre of Disease Control- (CDC-stage of HIV disease are reported. Treatment duration was calculated on a daily basis via the documented dates for the beginning and end of each antiretroviral drug treatment. Prices were calculated for each individual regimen based on actual office sales prices of the branded pharmaceuticals distributed by the license holder including German taxes. RESULTS: During the 13-year follow-up period, 21,387,427 treatment days were covered. Cumulative direct costs for antiretroviral drugs of €812,877,356 were determined according to an average of €42.08 per day (€7.52 to € 217.70. Since cART is widely used in Germany, the costs for an entire regimen increased by 13.5%. Regimens are more expensive in the advanced stages of HIV disease. The potential for cost savings was calculated using non-nucleotide-reverse-transcriptase-inhibitor, NNRTI, more frequently instead of ritonavir-boosted protease inhibitor, PI/r, in first line therapy. This calculation revealed cumulative savings of 10.9% to 19.8% of daily treatment costs (50% and 90% substitution of PI/r, respectively. Substituting certain branded drugs by generic drugs showed potential cost savings of between 1.6% and 31.8%. CONCLUSIONS: Analysis of the data of this nationwide study reflects disease-specific health services research

Calculation of direct antiretroviral treatment costs and potential cost savings by using generics in the German HIV ClinSurv cohort.

Science.gov (United States)

Stoll, Matthias; Kollan, Christian; Bergmann, Frank; Bogner, Johannes; Faetkenheuer, Gerd; Fritzsche, Carlos; Hoeper, Kirsten; Horst, Heinz-August; van Lunzen, Jan; Plettenberg, Andreas; Reuter, Stefan; Rockstroh, Jürgen; Stellbrink, Hans-Jürgen; Hamouda, Osamah; Bartmeyer, Barbara

2011-01-01

BACKGROUND/AIM OF THE STUDY: The study aimed to determine the cost impacts of antiretroviral drugs by analysing a long-term follow-up of direct costs for combined antiretroviral therapy, cART, -regimens in the nationwide long-term observational multi-centre German HIV ClinSurv Cohort. The second aim was to develop potential cost saving strategies by modelling different treatment scenarios. Antiretroviral regimens (ART) from 10,190 HIV-infected patients from 11 participating ClinSurv study centres have been investigated since 1996. Biannual data cART-initiation, cART-changes, surrogate markers, clinical events and the Centre of Disease Control- (CDC)-stage of HIV disease are reported. Treatment duration was calculated on a daily basis via the documented dates for the beginning and end of each antiretroviral drug treatment. Prices were calculated for each individual regimen based on actual office sales prices of the branded pharmaceuticals distributed by the license holder including German taxes. During the 13-year follow-up period, 21,387,427 treatment days were covered. Cumulative direct costs for antiretroviral drugs of €812,877,356 were determined according to an average of €42.08 per day (€7.52 to € 217.70). Since cART is widely used in Germany, the costs for an entire regimen increased by 13.5%. Regimens are more expensive in the advanced stages of HIV disease. The potential for cost savings was calculated using non-nucleotide-reverse-transcriptase-inhibitor, NNRTI, more frequently instead of ritonavir-boosted protease inhibitor, PI/r, in first line therapy. This calculation revealed cumulative savings of 10.9% to 19.8% of daily treatment costs (50% and 90% substitution of PI/r, respectively). Substituting certain branded drugs by generic drugs showed potential cost savings of between 1.6% and 31.8%. Analysis of the data of this nationwide study reflects disease-specific health services research and will give insights into the cost impacts of

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.

The German energy audit program for firms. A cost-effective way to improve energy efficiency?

Energy Technology Data Exchange (ETDEWEB)

Fleiter, T.; Eichhammer, W. [Fraunhofer Institute for Systems and Innovation Research ISI, Breslauer Str. 48, 76139, Karlsruhe (Germany); Gruber, E. [Institute for Resource Efficiency and Energy Strategies IREES GmbH, Schoenfeldstr. 8, 76131, Karlsruhe (Germany); Worrell, E. [Copernicus Institute of Sustainable Development, Utrecht University, Heidelberglaan 2, 3584, Utrecht (Netherlands)

2012-11-15

In 2008, a program was established in Germany to provide grants for energy audits in small- and medium-sized enterprises. It aims to overcome barriers to energy efficiency, like the lack of information or a lack of capacity, and is intended to increase the adoption of energy efficiency measures. We evaluate the program's impact in terms of energy savings, CO2 mitigation, and cost-effectiveness. We find that firms adopt 1.7-2.9 energy efficiency measures, which they would not have adopted without the program. Taking a firm's perspective, the program shows a net present value ranging from -0.4 to 6 euro/MWh saved, which very likely implies a net benefit. For the government, each ton of CO2 mitigated costs between 1.8 and 4.1 euro. Each euro of public expenditure on audit grants led to 17-33 euro of private investment. The cost-effectiveness of the program for firms and the low share of public expenditure underline its value for the German energy efficiency policy mix and suggest that it should be expanded in Germany. Further, the good experiences with the program in Germany should encourage countries which have not yet established an audit program to do so.

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

Economic Evaluation of Community-Based HIV Prevention Programs in Ontario: Evidence of Effectiveness in Reducing HIV Infections and Health Care Costs.

Science.gov (United States)

Choi, Stephanie K Y; Holtgrave, David R; Bacon, Jean; Kennedy, Rick; Lush, Joanne; McGee, Frank; Tomlinson, George A; Rourke, Sean B

2016-06-01

Investments in community-based HIV prevention programs in Ontario over the past two and a half decades are assumed to have had an impact on the HIV epidemic, but they have never been systematically evaluated. To help close this knowledge gap, we conducted a macro-level evaluation of investment in Ontario HIV prevention programs from the payer perspective. Our results showed that, from 1987 to 2011, province-wide community-based programs helped to avert a total of 16,672 HIV infections, saving Ontario's health care system approximately $6.5 billion Canadian dollars (range 4.8-7.5B). We also showed that these community-based HIV programs were cost-saving: from 2005 to 2011, every dollar invested in these programs saved about $5. This study is an important first step in understanding the impact of investing in community-based HIV prevention programs in Ontario and recognizing the impact that these programs have had in reducing HIV infections and health care costs.

Advancements in valve technology and industry lessons lead to improved plant reliability and cost savings

International Nuclear Information System (INIS)

Sharma, V.; Kalsi, M.S.

2005-01-01

Plant reliability and safety hinges on the proper functioning of several valves. Recent advancements in valve technology have resulted in new analytical and test methods for evaluating and improving valve and actuator reliability. This is especially significant in critical service applications in which the economic impact of a valve failure on production, outage schedules and consequential damages far surpasses the initial equipment purchase price. This paper presents an overview of recent advances in valve technology driven by reliability concerns and cost savings objectives without comprising safety in the Nuclear Power Industry. This overview is based on over 27 years of experience in supporting US and International nuclear power utilities, and contributing to EPRI, and NSSS Owners' Groups in developing generic models/methodologies to address industry wide issues; performing design basis reviews; and implementing plant-wide valve reliability improvement programs. Various analytical prediction software and hardware solutions and training seminars are now available to implement valve programs covering power plants' lifecycle from the construction phase through life extension and power up rate. These tools and methodologies can enhance valve-engineering activities including the selection, sizing, proper application, condition monitoring, failure analysis, and condition based maintenance optimization with a focus on potential bad actors. This paper offers two such examples, the Kalsi Valve and Actuator Program (KVAP) and Check Valve Analysis and Prioritization (CVAP) [1-3, 8, 9, 11-13]. The advanced, validated torque prediction models incorporated into KVAP software for AOVs and MOVs have improved reliability of margin predictions and enabled cost savings through elimination of unwarranted equipment modifications. CVAP models provides a basis to prioritize the population of valves recommended for preventive maintenance, inspection and/or modification, allowing

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...

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.

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.

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.

Ensuring Efficient Incentive and Disincentive Values for Highway Construction Projects: A Systematic Approach Balancing Road User, Agency and Contractor Acceleration Costs and Savings

Directory of Open Access Journals (Sweden)

Eul-Bum Lee

2018-03-01

Full Text Available United States State Highway Agencies (SHAs use Incentive/Disincentives (I/D to minimize negative impacts of construction on the traveling public through construction acceleration. Current I/D practices have the following short-comings: not standardized, over- or under-compensate contractors, lack of auditability result in disincentives that leave SHAs vulnerable to contractor claims and litigation and are based on agency costs/savings rather than contractor acceleration. Presented within this paper is an eleven-step I/D valuation process. The processes incorporate a US-nationwide RUC and agency cost calculation program, CA4PRS and a time-cost tradeoff I/D process. The incentive calculation used is the summation of the contractor acceleration and a reasonable contractor bonus (based on shared agency savings with an optional reduction of contractor’s own saving from schedule compression (acceleration. The process has a capability to be used both within the US and internationally with minor modifications, relies on historical costs, is simple and is auditable and repeatable. As such, it is a practical tool for optimizing I/D amounts and bridges the gap in existing literature both by its industry applicability, integrating the solution into existing SHA practices and its foundation of contractor acceleration costs.

Cost-effectiveness of active transport for primary school children - Walking School Bus program

Directory of Open Access Journals (Sweden)

Swinburn Boyd

2009-09-01

Full Text Available Abstract Background To assess from a societal perspective the incremental cost-effectiveness of the Walking School Bus (WSB program for Australian primary school children as an obesity prevention measure. The intervention was modelled as part of the ACE-Obesity study, which evaluated, using consistent methods, thirteen interventions targeting unhealthy weight gain in Australian children and adolescents. Methods A logic pathway was used to model the effects on body mass index [BMI] and disability-adjusted life years [DALYs] of the Victorian WSB program if applied throughout Australia. Cost offsets and DALY benefits were modelled until the eligible cohort reached 100 years of age or death. The reference year was 2001. Second stage filter criteria ('equity', 'strength of evidence', 'acceptability', feasibility', sustainability' and 'side-effects' were assessed to incorporate additional factors that impact on resource allocation decisions. Results The modelled intervention reached 7,840 children aged 5 to 7 years and cost $AUD22.8M ($16.6M; $30.9M. This resulted in an incremental saving of 30 DALYs (7:104 and a net cost per DALY saved of $AUD0.76M ($0.23M; $3.32M. The evidence base was judged as 'weak' as there are no data available documenting the increase in the number of children walking due to the intervention. The high costs of the current approach may limit sustainability. Conclusion Under current modelling assumptions, the WSB program is not an effective or cost-effective measure to reduce childhood obesity. The attribution of some costs to non-obesity objectives (reduced traffic congestion and air pollution etc. is justified to emphasise the other possible benefits. The program's cost-effectiveness would be improved by more comprehensive implementation within current infrastructure arrangements. The importance of active transport to school suggests that improvements in WSB or its variants need to be developed and fully evaluated.

Cost-effectiveness of active transport for primary school children - Walking School Bus program.

Science.gov (United States)

Moodie, Marjory; Haby, Michelle; Galvin, Leah; Swinburn, Boyd; Carter, Robert

2009-09-14

To assess from a societal perspective the incremental cost-effectiveness of the Walking School Bus (WSB) program for Australian primary school children as an obesity prevention measure. The intervention was modelled as part of the ACE-Obesity study, which evaluated, using consistent methods, thirteen interventions targeting unhealthy weight gain in Australian children and adolescents. A logic pathway was used to model the effects on body mass index [BMI] and disability-adjusted life years [DALYs] of the Victorian WSB program if applied throughout Australia. Cost offsets and DALY benefits were modelled until the eligible cohort reached 100 years of age or death. The reference year was 2001. Second stage filter criteria ('equity', 'strength of evidence', 'acceptability', feasibility', sustainability' and 'side-effects') were assessed to incorporate additional factors that impact on resource allocation decisions. The modelled intervention reached 7,840 children aged 5 to 7 years and cost $AUD22.8M ($16.6M; $30.9M). This resulted in an incremental saving of 30 DALYs (7:104) and a net cost per DALY saved of $AUD0.76M ($0.23M; $3.32M). The evidence base was judged as 'weak' as there are no data available documenting the increase in the number of children walking due to the intervention. The high costs of the current approach may limit sustainability. Under current modelling assumptions, the WSB program is not an effective or cost-effective measure to reduce childhood obesity. The attribution of some costs to non-obesity objectives (reduced traffic congestion and air pollution etc.) is justified to emphasise the other possible benefits. The program's cost-effectiveness would be improved by more comprehensive implementation within current infrastructure arrangements. The importance of active transport to school suggests that improvements in WSB or its variants need to be developed and fully evaluated.

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.

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

, 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...

Evaluating direct energy savings and market transformation effects: A decade of technical design assistance in the northwestern USA

International Nuclear Information System (INIS)

Van Den Wymelenberg, Kevin; Brown, G.Z.; Burpee, Heather; Djunaedy, Ery; Gladics, Gunnar; Kline, Jeff; Loveland, Joel; Meek, Christopher; Thimmanna, Harshana

2013-01-01

This paper documents the direct energy savings and energy efficiency market transformation impacts of a multi-state design assistance program in the northwestern US. The paper addresses four specific aims. (1) It provides a conservative and justified estimate of the direct energy savings associated with design assistance activities of a market transformation program from 2001 to 2010. (2) It provides a rigorous methodology to evaluate direct energy savings associated with design assistance market transformation programs. (3) It provides a low-cost replicable method to predict energy savings in new buildings by evaluating the integrated design process. (4) It provides quantitative indicators useful for estimating indirect energy savings from market transformation. Applying the recommended analysis method and assuming a 12-year measure life, the direct energy savings of the population (626 buildings; 51,262,000 ft 2 ) is estimated as 45.3 aMW (average megawatts) (electric), and 265,738.089 therms (non-electric). If the entire program budget were divided into the electric savings only, the Lab Network cost per kWh saved ranged from $0.0016 to $0.003 using the recommended method and $0.0092/kWh using the most conservative method. These figures do not isolate contextual influences or represent total resource cost. Statistically significant correlations (r 2 =0.1−0.3) between integrated design scores and energy savings are reported. - Highlights: ► Estimated direct energy savings of a market transformation program are presented. ► A methodology to evaluate energy savings from multiple baselines is documented. ► Level of integrated design can be used to estimate energy savings in new buildings. ► Quantitative evaluation indicators of efficiency market transformation are provided. ► Electric energy saved from design assistance costs between $0.0016 and $0.0092/kWh.

Savings potential of ENERGY STAR (registered trademark) voluntary labeling programs

International Nuclear Information System (INIS)

Webber, Carrie A.; Brown, Richard E.

1998-01-01

In 1993 the U.S. Environmental Protection Agency (EPA) introduced ENERGY STAR (registered trademark), a voluntary labeling program designed to identify and promote energy-efficient products. Since then EPA, now in partnership with the U.S. Department of Energy (DOE), has introduced programs for more than twenty products, spanning office equipment, residential heating and cooling equipment, new homes, commercial and residential lighting, home electronics, and major appliances. We present potential energy, dollar and carbon savings forecasts for these programs for the period 1998 to 2010. Our target market penetration case 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 results under the assumption of 100% market penetration; that is, we assume that all purchasers buy ENERGY STAR-compliant products instead of standard efficiency products throughout the analysis period. Finally, we assess the sensitivity of our target penetration case forecasts to greater or lesser marketing success by EPA and DOE, lower-than-expected future energy prices, and higher or lower rates of carbon emission by electricity generators. The potential savings of ENERGY STAR are substantial. If all purchasers chose Energy Star-compliant products instead of standard efficiency products over the next 15 years, they would save more than$100 billion on their energy bills during those 15 years. (Bill savings are in 1995 dollars, discounted at a 4% real discount rate.)

Energy and cost savings potential of oscillating heat pipes for waste heat recovery ventilation

Directory of Open Access Journals (Sweden)

Govinda Mahajan

2017-11-01

Full Text Available The feasibility of using finned oscillating heat pipes (OHPs for heat exchange between counter-flowing air streams in HVAC air systems (i.e., outdoor and exhaust air flows, along with the associated cost savings in typical North American climates, is investigated. For a prescribed temperature difference and volumetric flow rate of air, rudimentary design parameters for a viable OHP Heat Recovery Ventilator (OHP-HRV were determined using the ε-NTU (effectiveness-Number of Transfer Unit method. The two-phase heat transfer within the OHP-HRV is modeled via effective evaporation/condensation heat transfer coefficients, while the latent heat transfer required to initiate OHP operation via boiling and evaporation is also considered. Results suggest that an OHP-HRV can possess a reasonable pressure drop (5 kW. The proposed OHP-HRV can possess an effectiveness near 0.5 and can pre-cool/heat HVAC air by >5°C. Potential energy and cost savings associated with using an OHP-HRV were estimated for commercial building envelopes in various regions of the United States. It is found that the proposed OHP-HRV can save more than $2500 annually in cities that have continental climatic conditions, such as Chicago and Denver, and for the selected locations the average yearly cost savings per building is found to be on-the-order of $700. Overall, the OHP-HRV shows potential in effectively reducing energy consumption and the operational cost of air handling units in buildings.

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 hea...... for private consumers decrease by 66% when all have the option to shift to the technology with lowest variable costs. © 2014 Elsevier Ltd. All Rights reserved......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...

Analysis of the total system life cycle cost for the Civilian Radioactive Waste Management Program

International Nuclear Information System (INIS)

1989-05-01

The total-system life-cycle cost (TSLCC) analysis for the Department of Energy's (DOE) Civilian Radioactive Waste Management Program is an ongoing activity that helps determine whether the revenue-producing mechanism established by the Nuclear Waste Policy Act of 1982 -- a fee levied on electricity generated in commercial nuclear power plants -- is sufficient to cover the cost of the program. This report provides cost estimates for the sixth annual evaluation of the adequacy of the fee and is consistent with the program strategy and plans contained in the DOE's Draft 1988 Mission Plan Amendment. The total-system cost for the system with a repository at Yucca Mountain, Nevada, a facility for monitored retrievable storage (MRS), and a transportation system is estimated at $24 billion (expressed in constant 1988 dollars). In the event that a second repository is required and is authorized by the Congress, the total-system cost is estimated at $31 to $33 billion, depending on the quantity of spent fuel to be disposed of. The $7 billion cost savings for the single-repository system in comparison with the two-repository system is due to the elimination of $3 billion for second-repository development and $7 billion for the second-repository facility. These savings are offset by $2 billion in additional costs at the first repository and $1 billion in combined higher costs for the MRS facility and transportation. 55 refs., 2 figs., 24 tabs

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.

The costs and potential savings of a novel telepaediatric service in Queensland

Directory of Open Access Journals (Sweden)

Scuffham Paul

2007-03-01

Full Text Available Abstract Background There are few cost-minimisation studies in telemedicine. We have compared the actual costs of providing a telepaediatric service to the potential costs if patients had travelled to see the specialist in person. Methods In November 2000, we established a novel telepaediatric service for selected regional hospitals in Queensland. Instead of transferring patients to Brisbane, the majority of referrals to specialists in Brisbane were dealt with via videoconference. Since the service began, 1499 consultations have been conducted for a broad range of paediatric sub-specialities including burns, cardiology, child development, dermatology, diabetes, endocrinology, gastroenterology, nephrology, neurology, oncology, orthopaedics, paediatric surgery and psychiatry. Results During a five year period, the total cost of providing 1499 consultations through the telepaediatric service was A$955,996. The estimated potential cost of providing an outpatient service to the same number of patients at the Royal Children's Hospital in Brisbane was A$1,553,264; thus, telepaediatric services resulted in a net saving of approximately A$600,000 to the health service provider. Conclusion Telepaediatrics was a cheaper method for the delivery of outpatient services when the workload exceeded 774 consultations. A sensitivity analysis showed that the threshold point was most sensitive to changes related to patient travel costs, coordinator salaries and videoconference equipment costs. The study showed substantial savings for the health department, mainly due to reduced costs associated with patient travel.

Cost-effectiveness and budget impact analyses of a long-term hypertension detection and control program for stroke prevention.

Science.gov (United States)

Yamagishi, Kazumasa; Sato, Shinichi; Kitamura, Akihiko; Kiyama, Masahiko; Okada, Takeo; Tanigawa, Takeshi; Ohira, Tetsuya; Imano, Hironori; Kondo, Masahide; Okubo, Ichiro; Ishikawa, Yoshinori; Shimamoto, Takashi; Iso, Hiroyasu

2012-09-01

The nation-wide, community-based intensive hypertension detection and control program, as well as universal health insurance coverage, may well be contributing factors for helping Japan rank near the top among countries with the longest life expectancy. We sought to examine the cost-effectiveness of such a community-based intervention program, as no evidence has been available for this issue. The hypertension detection and control program was initiated in 1963 in full intervention and minimal intervention communities in Akita, Japan. We performed comparative cost-effectiveness and budget-impact analyses for the period 1964-1987 of the costs of public health services and treatment of patients with hypertension and stroke on the one hand, and incidence of stroke on the other in the full intervention and minimal intervention communities. The program provided in the full intervention community was found to be cost saving 13 years after the beginning of program in addition to the fact of effectiveness that; the prevalence and incidence of stroke were consistently lower in the full intervention community than in the minimal intervention community throughout the same period. The incremental cost was minus 28,358 yen per capita over 24 years. The community-based intensive hypertension detection and control program was found to be both effective and cost saving. The national government's policy to support this program may have contributed in part to the substantial decline in stroke incidence and mortality, which was largely responsible for the increase in Japanese life expectancy.

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.

Potential travel cost saving in urban public-transport networks using smartphone guidance

Science.gov (United States)

2018-01-01

Public transport (PT) is a key element in most major cities around the world. With the development of smartphones, available journey planning information is becoming an integral part of the PT system. Each traveler has specific preferences when undertaking a trip, and these preferences can also be reflected on the smartphone. This paper considers transit assignment in urban public-transport networks in which the passengers receive smartphone-based information containing elements that might influence the travel decisions in relation to line loads, as well as passenger benefits, and the paper discusses the transition from the current widespread choosing approach to a personalized decision-making approach based on smartphone information. The approach associated with smartphone guidance that considers passengers’ preference on travel time, waiting time and transfer is proposed in the process of obtaining his/her preferred route from the potential travel routes generated by the Deep First Search (DFS) method. Two other approaches, based on the scenarios reflecting reality, include passengers with access to no real time information, and passengers that only have access to the arrival time at the platform are used as comparisons. For illustration, the same network proposed by Spiess and Florian is utilized on the experiments in an agent-based model. Two experiments are conducted respectively according to whether each passenger’s choosing method is consistent. As expected, the results in the first experiment showed that the travel for consistent passengers with smartphone guidance was clearly shorter and that it can reduce travel time exceeding 15% and weighted cost exceeding 20%, and the average saved time approximated 3.88 minutes per passenger. The second experiment presented that travel cost, as well as cost savings, gradually decreased by employing smartphone guidance, and the maximum cost savings accounted for 14.2% of the total weighted cost. PMID:29746528

Potential travel cost saving in urban public-transport networks using smartphone guidance.

Science.gov (United States)

Song, Cuiying; Guan, Wei; Ma, Jihui

2018-01-01

Public transport (PT) is a key element in most major cities around the world. With the development of smartphones, available journey planning information is becoming an integral part of the PT system. Each traveler has specific preferences when undertaking a trip, and these preferences can also be reflected on the smartphone. This paper considers transit assignment in urban public-transport networks in which the passengers receive smartphone-based information containing elements that might influence the travel decisions in relation to line loads, as well as passenger benefits, and the paper discusses the transition from the current widespread choosing approach to a personalized decision-making approach based on smartphone information. The approach associated with smartphone guidance that considers passengers' preference on travel time, waiting time and transfer is proposed in the process of obtaining his/her preferred route from the potential travel routes generated by the Deep First Search (DFS) method. Two other approaches, based on the scenarios reflecting reality, include passengers with access to no real time information, and passengers that only have access to the arrival time at the platform are used as comparisons. For illustration, the same network proposed by Spiess and Florian is utilized on the experiments in an agent-based model. Two experiments are conducted respectively according to whether each passenger's choosing method is consistent. As expected, the results in the first experiment showed that the travel for consistent passengers with smartphone guidance was clearly shorter and that it can reduce travel time exceeding 15% and weighted cost exceeding 20%, and the average saved time approximated 3.88 minutes per passenger. The second experiment presented that travel cost, as well as cost savings, gradually decreased by employing smartphone guidance, and the maximum cost savings accounted for 14.2% of the total weighted cost.

Education and empowerment of the nursing assistant: validating their important role in skin care and pressure ulcer prevention, and demonstrating productivity enhancement and cost savings.

Science.gov (United States)

Howe, Lynn

2008-06-01

This article details an educational program designed to utilize nonlicensed personnel (certified nursing assistants [CNAs] and nursing assistants [NAs]) in the prevention of pressure ulcers and improved skin care in a 250-bed acute care facility in a suburban setting. The article is divided into 2 parts: A and B. Part A addresses the educational program, which was part of a major initiative for improving patient outcomes that included a review and standardization of skin care products and protocols. Part B addresses productivity enhancement and cost savings experienced because of changing bathing and incontinence care products and procedures. The educational program included instruction on time-saving methods for increasing productivity in bathing and incontinence care, and effectively promoted the importance of proper skin care and pressure ulcer prevention techniques. Methods incorporated into the educational training targeted different reading and comprehension levels, ranging from the use of PowerPoint slides, hands-on return demonstration, and group discussion related to pressure ulcer staging and wound treatment. These educational methods provided the participants with significant reinforcement of each day's learning objectives. Productivity enhancement and cost savings are addressed in part B, as well as the results of a time-motion study. Because of the program, CNAs/NAs were empowered in their integral caregiver roles. This program was part of a larger, major process improvement initiative, but the rate of acquired pressure ulcers declined from 2.17% in 2002 to 1.71% in 2003. This educational program was considered a contributor to the improved patient outcomes.

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.

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

Science.gov (United States)

Gates, W. R.

1983-01-01

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.

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.

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?

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.

Marginal costs of water savings from cooling system retrofits: a case study for Texas power plants

Science.gov (United States)

Loew, Aviva; Jaramillo, Paulina; Zhai, Haibo

2016-10-01

The water demands of power plant cooling systems may strain water supply and make power generation vulnerable to water scarcity. Cooling systems range in their rates of water use, capital investment, and annual costs. Using Texas as a case study, we examined the cost of retrofitting existing coal and natural gas combined-cycle (NGCC) power plants with alternative cooling systems, either wet recirculating towers or air-cooled condensers for dry cooling. We applied a power plant assessment tool to model existing power plants in terms of their key plant attributes and site-specific meteorological conditions and then estimated operation characteristics of retrofitted plants and retrofit costs. We determined the anticipated annual reductions in water withdrawals and the cost-per-gallon of water saved by retrofits in both deterministic and probabilistic forms. The results demonstrate that replacing once-through cooling at coal-fired power plants with wet recirculating towers has the lowest cost per reduced water withdrawals, on average. The average marginal cost of water withdrawal savings for dry-cooling retrofits at coal-fired plants is approximately 0.68 cents per gallon, while the marginal recirculating retrofit cost is 0.008 cents per gallon. For NGCC plants, the average marginal costs of water withdrawal savings for dry-cooling and recirculating towers are 1.78 and 0.037 cents per gallon, respectively.

Effect of a therapeutic maximum allowable cost (MAC) program on the cost and utilization of proton pump inhibitors in an employer-sponsored drug plan in Canada.

Science.gov (United States)

Mabasa, Vincent H; Ma, Johnny

2006-06-01

Therapeutic maximum allowable cost (MAC) is a managed care intervention that uses reference pricing in a therapeutic class or category of drugs or an indication (e.g., heartburn). Therapeutic MAC has not been studied in Canada or the United States. The proton pump inhibitor (PPI) rabeprazole was used as the reference drug in this therapeutic MAC program based on prices for PPIs in the province of Ontario. No PPI is available over the counter in Canada. To evaluate the utilization and anticipated drug cost savings for PPIs in an employer-sponsored drug plan in Canada that implemented a therapeutic MAC program for PPIs. An employer group with an average of 6,300 covered members, which adopted the MAC program for PPIs in June 2003, was compared with a comparison group comprising the book of business throughout Canada (approximately 5 million lives) without a PPI MAC program (non-MAC group). Pharmacy claims for PPIs were identified using the first 6 characters of the generic product identifier (GPI 492700) for a 36-month period from June 1, 2002, through May 31, 2005. The primary comparison was the year prior to the intervention (from June 1, 2002, through May 31, 2003) and the first full year following the intervention (June 1, 2004, through May 31, 2005). Drug utilization was evaluated by comparing the market share of each of the PPIs for the 2 time periods and by the days of PPI therapy per patient per year (PPPY) and days of therapy per prescription (Rx). Drug cost was defined as the cost of the drug (ingredient cost), including allowable provincial pharmacy markup but excluding pharmacy dispense fee. Cost savings were calculated from the allowed drug cost per claim, allowed cost per day, and allowed cost PPPY. (All amounts are in Canadian dollars.) The MAC intervention group experienced an 11.7% reduction in the average cost per day of PPI drug therapy, from 2.14 US dollars in the preperiod to 1.89 US dollars in the postperiod, compared with a 3.7% reduction in

Potential Cost Savings with 3D Printing Combined With 3D Imaging and CPLM for Fleet Maintenance and Revitalization

Science.gov (United States)

2014-05-01

1 Potential Cost Savings with 3D Printing Combined With 3D Imaging and CPLM for Fleet Maintenance and Revitalization David N. Ford...2014 4. TITLE AND SUBTITLE Potential Cost Savings with 3D Printing Combined With 3D Imaging and CPLM for Fleet Maintenance and Revitalization 5a...Manufacturing ( 3D printing ) 2 Research Context Problem: Learning curve savings forecasted in SHIPMAIN maintenance initiative have not materialized

Promoting cooperative federalism through state shared savings.

Science.gov (United States)

Weil, Alan

2013-08-01

The Affordable Care Act is transforming American federalism and creating strain between the states and the federal government. By expanding the scale of intergovernmental health programs, creating new state requirements, and setting the stage for increased federal fiscal oversight, the act has disturbed an uneasy truce in American federalism. This article outlines a policy proposal designed to harness cooperative federalism, based on the shared state and federal desire to control health care cost growth. The proposal, which borrows features of the Medicare Shared Savings Program, would provide states with an incentive in the form of an increased share of the savings they generate in programs that have federal financial participation, as long as they meet defined performance standards.

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.

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.

An effectiveness and cost-benefit analysis of a hospital-based discharge transition program for elderly Medicare recipients.

Science.gov (United States)

Saleh, Shadi S; Freire, Chris; Morris-Dickinson, Gwendolyn; Shannon, Trip

2012-06-01

To investigate the business case of postdischarge care transition (PDCT) among Medicare beneficiaries by conducting a cost-benefit analysis. Randomized controlled trial. A general hospital in upstate New York State. Elderly Medicare beneficiaries being treated from October 2008 through December 2009 were randomly selected to receive services as part of a comprehensive PDCT program (intervention--173 patients) or regular discharge process (control--160 patients) and followed for 12 months. The intervention comprised five activities: development of a patient-centered health record, a structured discharge preparation checklist of critical activities, delivery of patient self-activation and management sessions, follow-up appointments, and coordination of data flow. Cost-benefit ratio of the PDCT program; self-management skills and abilities. The 1-year readmission analysis revealed that control participants were more likely to be readmitted than intervention participants (58.2% vs 48.2%; P = .08); with most of that difference observed in the 91 to 365 days after discharge. Findings from the cost-benefit analysis revealed a cost-benefit ratio of 1.09, which indicates that, for every $1 spent on the program, a saving of $1.09 was realized. In addition, participating in a care transition program significantly enhanced self-management skills and abilities. Postdischarge care transition programs have a dual benefit of enhancing elderly adults' self-management skills and abilities and producing cost savings. This study builds a case for the inclusion of PDCT programs as a reimbursable service in benefit packages. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

Estimating the cost-savings associated with bundling maternal and child health interventions: a proposed methodology.

Science.gov (United States)

Adesina, Adebiyi; Bollinger, Lori A

2013-01-01

There is a pressing need to include cost data in the Lives Saved Tool (LiST). This paper proposes a method that combines data from both the WHO CHOosing Interventions that are Cost-Effective (CHOICE) database and the OneHealth Tool (OHT) to develop unit costs for delivering child and maternal health services, both alone and bundled. First, a translog cost function is estimated to calculate factor shares of personnel, consumables, other direct (variable or recurrent costs excluding personnel and consumables) and indirect (capital or investment) costs. Primary source facility level data from Kenya, Namibia, South Africa, Uganda, Zambia and Zimbabwe are utilized, with separate analyses for hospitals and health centres. Second, the resulting other-direct and indirect factor shares are applied to country unit costs from the WHO CHOICE unit cost database to calculate those portions of unit cost. Third, the remainder of the costs is calculated using default data from the OHT. Fourth, we calculate the effect of bundling services by assuming that a LiST intervention visit takes an average of 20 minutes when delivered alone but only incremental time in addition to the basic visit when delivered in a bundle. Personnel costs account for the greatest share of costs for both hospitals and health centres at 50% and 38%, respectively. The percentages differ between hospitals and health centres for consumables (21% versus 17%), other direct (7.5% versus 6.75%), and indirect (22% versus 23%) costs. Combining the other-direct and indirect factor shares with the WHO CHOICE database and the other costs from OHT provides a comprehensive cost estimate of LiST interventions. Finally, the cost of six recommended antenatal care (ANC) interventions is $69.76 when delivered alone, but $61.18 when delivered as a bundle, a savings of $8.58 (12.2%). This paper proposes a method for estimating a comprehensive cost of providing child and maternal health interventions by combining labor

Patterns of Cost for Patients Dying in the Intensive Care Unit and Implications for Cost Savings of Palliative Care Interventions.

Science.gov (United States)

Khandelwal, Nita; Benkeser, David; Coe, Norma B; Engelberg, Ruth A; Teno, Joan M; Curtis, J Randall

2016-11-01

Terminal intensive care unit (ICU) stays represent an important target to increase value of care. To characterize patterns of daily costs of ICU care at the end of life and, based on these patterns, examine the role for palliative care interventions in enhancing value. Secondary analysis of an intervention study to improve quality of care for critically ill patients. 572 patients who died in the ICU between 2003 and 2005 at a Level-1 trauma center. Data were linked with hospital financial records. Costs were categorized into direct fixed, direct variable, and indirect costs. Patterns of daily costs were explored using generalized estimating equations stratified by length of stay, cause of death, ICU type, and insurance status. Estimates from the literature of effects of palliative care interventions on ICU utilization were used to simulate potential cost savings under different time horizons and reimbursement models. Mean cost for a terminal ICU stay was 39.3K ± 45.1K. Direct fixed costs represented 45% of total hospital costs, direct variable costs 20%, and indirect costs 34%. Day of admission was most expensive (mean 9.6K ± 7.6K); average cost for subsequent days was 4.8K ± 3.4K and stable over time and patient characteristics. Terminal ICU stays display consistent cost patterns across patient characteristics. Savings can be realized with interventions that align care with patient preferences, helping to prevent unwanted ICU utilization at end of life. Cost modeling suggests that implications vary depending on time horizon and reimbursement models.

Maximum power point tracking: a cost saving necessity in solar energy systems

Energy Technology Data Exchange (ETDEWEB)

Enslin, J H.R. [Stellenbosch Univ. (South Africa). Dept. of Electrical and Electronic Engineering

1992-12-01

A well engineered renewable remote energy system, utilizing the principal of Maximum Power Point Tracking (MPPT) can improve cost effectiveness, has a higher reliability and can improve the quality of life in remote areas. A high-efficient power electronic converter, for converting the output voltage of a solar panel, or wind generator, to the required DC battery bus voltage has been realized. The converter is controlled to track the maximum power point of the input source under varying input and output parameters. Maximum power point tracking for relative small systems is achieved by maximization of the output current in a battery charging regulator, using an optimized hill-climbing, inexpensive microprocessor based algorithm. Through practical field measurements it is shown that a minimum input source saving of between 15 and 25% on 3-5 kWh/day systems can easily be achieved. A total cost saving of at least 10-15% on the capital cost of these systems are achievable for relative small rating Remote Area Power Supply (RAPS) systems. The advantages at large temperature variations and high power rated systems are much higher. Other advantages include optimal sizing and system monitor and control. (author).

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.

Determining the Optimal Solution for Quadratically Constrained Quadratic Programming (QCQP) on Energy-Saving Generation Dispatch Problem

Science.gov (United States)

Lesmana, E.; Chaerani, D.; Khansa, H. N.

2018-03-01

Energy-Saving Generation Dispatch (ESGD) is a scheme made by Chinese Government in attempt to minimize CO2 emission produced by power plant. This scheme is made related to global warming which is primarily caused by too much CO2 in earth’s atmosphere, and while the need of electricity is something absolute, the power plants producing it are mostly thermal-power plant which produced many CO2. Many approach to fulfill this scheme has been made, one of them came through Minimum Cost Flow in which resulted in a Quadratically Constrained Quadratic Programming (QCQP) form. In this paper, ESGD problem with Minimum Cost Flow in QCQP form will be solved using Lagrange’s Multiplier Method

Cost effectiveness of recycling: A systems model

Energy Technology Data Exchange (ETDEWEB)

Tonjes, David J., E-mail: david.tonjes@stonybrook.edu [Department of Technology and Society, College of Engineering and Applied Sciences, Stony Brook University, Stony Brook, NY 11794-3560 (United States); Waste Reduction and Management Institute, School of Marine and Atmospheric Sciences, Stony Brook University, Stony Brook, NY 11794-5000 (United States); Center for Bioenergy Research and Development, Advanced Energy Research and Technology Center, Stony Brook University, 1000 Innovation Rd., Stony Brook, NY 11794-6044 (United States); Mallikarjun, Sreekanth, E-mail: sreekanth.mallikarjun@stonybrook.edu [Department of Technology and Society, College of Engineering and Applied Sciences, Stony Brook University, Stony Brook, NY 11794-3560 (United States)

2013-11-15

Highlights: • Curbside collection of recyclables reduces overall system costs over a range of conditions. • When avoided costs for recyclables are large, even high collection costs are supported. • When avoided costs for recyclables are not great, there are reduced opportunities for savings. • For common waste compositions, maximizing curbside recyclables collection always saves money. - Abstract: Financial analytical models of waste management systems have often found that recycling costs exceed direct benefits, and in order to economically justify recycling activities, externalities such as household expenses or environmental impacts must be invoked. Certain more empirically based studies have also found that recycling is more expensive than disposal. Other work, both through models and surveys, have found differently. Here we present an empirical systems model, largely drawn from a suburban Long Island municipality. The model accounts for changes in distribution of effort as recycling tonnages displace disposal tonnages, and the seven different cases examined all show that curbside collection programs that manage up to between 31% and 37% of the waste stream should result in overall system savings. These savings accrue partially because of assumed cost differences in tip fees for recyclables and disposed wastes, and also because recycling can result in a more efficient, cost-effective collection program. These results imply that increases in recycling are justifiable due to cost-savings alone, not on more difficult to measure factors that may not impact program budgets.

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.  

Deemed Savings Estimates for Legacy Air Conditioning and WaterHeating Direct Load Control Programs in PJM Region

Energy Technology Data Exchange (ETDEWEB)

Goldman, Charles

2007-03-01

During 2005 and 2006, the PJM Interconnection (PJM) Load Analysis Subcommittee (LAS) examined ways to reduce the costs and improve the effectiveness of its existing measurement and verification (M&V) protocols for Direct Load Control (DLC) programs. The current M&V protocol requires that a PURPA-compliant Load Research study be conducted every five years for each Load-Serving Entity (LSE). The current M&V protocol is expensive to implement and administer particularly for mature load control programs, some of which are marginally cost-effective. There was growing evidence that some LSEs were mothballing or dropping their DLC programs in lieu of incurring the expense associated with the M&V. This project had several objectives: (1) examine the potential for developing deemed savings estimates acceptable to PJM for legacy air conditioning and water heating DLC programs, and (2) explore the development of a collaborative, regional, consensus-based approach for conducting monitoring and verification of load reductions for emerging load management technologies for customers that do not have interval metering capability.

Vaginal microbicides save money: a model of cost-effectiveness in South Africa and the USA.

Science.gov (United States)

Verguet, S; Walsh, J A

2010-06-01

To determine the hypothetical cost-effectiveness of vaginal microbicides preventing male to female HIV transmission. A mathematical epidemiological and cost-effectiveness model using data from South Africa and the USA was used. The prospective 1-year-long intervention targeted a general population of women in a city of 1,000,000 inhabitants in two very different epidemiological settings, South Africa with a male HIV prevalence of 18.80% and the USA with a male HIV prevalence of 0.72%. The base case scenario assumes a microbicide effective at 55%, used in 30% of sexual episodes at a retail price for the public sector in South Africa of US$0.51 per use and in the USA of US$2.23 per use. In South Africa, over 1 year, the intervention would prevent 1908 infections, save US$6712 per infection averted as compared with antiretroviral treatment. In the USA, it would be more costly: over 1 year, the intervention would prevent 21 infections, amounting to a net cost per infection averted of US$405,077. However, in the setting of Washington DC, with a higher HIV prevalence, the same intervention would prevent 93 infections and save US$91,176 per infection averted. Sensitivity analyses were conducted and even a microbicide with a low effectiveness of 30% would still save healthcare costs in South Africa. A microbicide intervention is likely to be very cost-effective in a country undergoing a high-level generalised epidemic such as South Africa, but is unlikely to be cost-effective in a developed country presenting epidemiological features similar to the USA unless the male HIV prevalence exceeds 2.4%.

Office-based narrow band imaging-guided flexible laryngoscopy tissue sampling: A cost-effectiveness analysis evaluating its impact on Taiwanese health insurance program

Directory of Open Access Journals (Sweden)

Tuan-Jen Fang

2015-07-01

Conclusion: Office-based NBI flexible laryngoscopy tissue sampling is a cost-saving procedure for patients and the Taiwanese National Health Insurance program. It also saves the procedure time. However, the net financial loss for the institution and physician would limit its popularization unless reimbursement patterns are changed.

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.

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.

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.

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

International Nuclear Information System (INIS)

Kemp, A.G.; MacDonald, Bruce

1995-01-01

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

Saving Blood and Reducing Costs: Updating Blood Transfusion Practice in Lower Limb Arthroplasty

LENUS (Irish Health Repository)

Fenelon, C

2018-04-01

Our aim was to quantify blood transfusion rates in lower limb arthroplasty following the introduction of a multimodal enhanced recovery programme (ERP). We then sought to update the maximum surgical blood ordering schedule (MSBOS) and calculate cost savings achieved.

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 hospital claims was $3,549 over 4-years; savings values for each program year were significant and increased with time (P = 0.003 to P hospital utilization and costs for individuals with heart disease or diabetes and demonstrate the increasing program effect with continued participation over time.

Energy and cost savings results for advanced technology systems from the Cogeneration Technology Alternatives Study /CTAS/

Science.gov (United States)

Sagerman, G. D.; Barna, G. J.; Burns, R. K.

1979-01-01

The Cogeneration Technology Alternatives Study (CTAS), a program undertaken to identify the most attractive advanced energy conversion systems for industrial cogeneration applications in the 1985-2000 time period, is described, and preliminary results are presented. Two cogeneration options are included in the analysis: a topping application, in which fuel is input to the energy conversion system which generates electricity and waste heat from the conversion system is used to provide heat to the process, and a bottoming application, in which fuel is burned to provide high temperature process heat and waste heat from the process is used as thermal input to the energy conversion system which generates energy. Steam turbines, open and closed cycle gas turbines, combined cycles, diesel engines, Stirling engines, phosphoric acid and molten carbonate fuel cells and thermionics are examined. Expected plant level energy savings, annual energy cost savings, and other results of the economic analysis are given, and the sensitivity of these results to the assumptions concerning fuel prices, price of purchased electricity and the potential effects of regional energy use characteristics is discussed.

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

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.

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.

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.

Listening to the vocal citizens: how do politically active individuals choose between life saving programs?

Energy Technology Data Exchange (ETDEWEB)

Ramsberg, J. [Stockholm School of Economics, Stockholm (Sweden)

1998-07-01

Large disparities in the cost per life saved for different life saving interventions have been reported in many studies. According to some researchers, these differences reflect the public's preoccupation with selected qualitative aspects of risk. However, it is not obvious that these disparities reflect public preferences. In studies of the variation in cost per life saved the public accept, most respondents are willing to trade qualitative characteristics for lives saved, but there is a small but significant group of respondents who will not make the tradeoff, i.e. assign infinite value to one or more of the qualitative factors. It has been suggested that this group could be particularly vocal, which might account for the large variation in cost per life saved. In the first attempt to address this issue, a survey of people living under a power line in Stockholm was undertaken. This population was chosen because the local government had decided to remove the power line after being pressured by the citizens and on interest group. Tests of how more politically active individuals differ from less active were undertaken. Most importantly, it was found that more politically active respondents were less likely to trade qualitative characteristics for lives saved, but only for the risk in which they were active and only up to a point. There still was a group of respondents who were unwilling to make the tradeoff. (author)

Savings and Loans Program, The Revenue of Small Micro Enterprises and Poverty Reduction among Women Groups

Directory of Open Access Journals (Sweden)

Ana Zahrotun Nihayah

2017-04-01

Full Text Available This research aims to understand the micro small medium business income both before and after receiving the program, to find out the number of poverty reduction, and to see the application of Islamic economic values on the women’s saving and loans program.The population of this research are members of the women’s saving and loans program, which is 215 people in total and scattered in 16 business group. Using random sampling techniques, there are 70 people that was taken into consideration. The method analysis used in in this research is using Wilcoxon rank test analysis, the poverty reduction analysis, and the Islamic economics values. Based on data analysis is(1 founded that the women’s saving and loans program affecting the micro small medium enterprises income. (2 Due to the women’s saving and loans program there are decreasing number of poverty rate about 20 percent. (3 It is realized that there are some applications of Islamic economics values upon the women’s saving and loans program, they are time extensions, fine replacement, social activities, and the improvement of society welfare.

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.

A cost benefit analysis of an enhanced seat belt enforcement program in South Africa.

Science.gov (United States)

Harris, G T; Olukoga, I A

2005-04-01

To examine whether a program to increase the wearing of seat belts in a South African urban area would be worthwhile in societal terms. A cost benefit analysis of a one year enhanced seat belt enforcement program in eThekwini (Durban) Municipality. Data were drawn from two main sources--a 1998 study of the cost of road crashes in South Africa and, given the absence of other data, a meta-analysis of the effectiveness of various types of interventions to reduce road crash casualties in the United States--and were analyzed using cost benefit analysis. A program designed to enforce greater wearing of seat belts, estimated to cost 2 million rand in one year, could be reasonably expected to increase seat belt usage rates by 16 percentage points and reduce fatalities and injuries by 9.5%. This would result in saved social costs of 13.6 million rand in the following year or a net present value of 11.6 million rand. There would also be favorable consequences for municipal finances. Investment in a program to increase seat belt wearing rates is highly profitable in societal terms.

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.

The costs of the different pathways of electricity production and saving

International Nuclear Information System (INIS)

Dessus, B.

2012-01-01

The author discusses the content and methodology of a report published by the French Court of Audit on the assessment of the costs of the nuclear sector. He briefly recalls the principle adopted by the Court, i.e. the method of the economic current cost which calculates a global MWh cost on the whole operation duration of the selected production tool. The author discusses the application of this method to different electricity production and consumption sectors: ground-based wind energy, the Flamanville EPR, use of low-energy bulbs, air-air heat pumps, a refrigerator. He compares and discusses the results obtained for different electricity production sectors (EPR, ground-based wind energy, and gas combined cycle technology) and their sensitivity to adopted hypotheses. He comments the evolution of the investment cost of nuclear reactors in France, the economic current costs of offshore wind energy and small photovoltaic production. He finally discusses the economic current costs of the different ways of energy saving and their sensitivity to the adopted hypotheses

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

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.

Identifying and quantifying energy savings on fired plant using low cost modelling techniques

International Nuclear Information System (INIS)

Tucker, Robert; Ward, John

2012-01-01

Research highlights: → Furnace models based on the zone method for radiation calculation are described. → Validated steady-state and transient models have been developed. → We show how these simple models can identify the best options for saving energy. → High emissivity coatings predicted to give performance enhancement on a fired heater. → Optimal heat recovery strategies on a steel reheating furnace are predicted. -- Abstract: Combustion in fired heaters, boilers and furnaces often accounts for the major energy consumption on industrial processes. Small improvements in efficiency can result in large reductions in energy consumption, CO 2 emissions, and operating costs. This paper will describe some useful low cost modelling techniques based on the zone method to help identify energy saving opportunities on high temperature fuel-fired process plant. The zone method has for many decades, been successfully applied to small batch furnaces through to large steel-reheating furnaces, glass tanks, boilers and fired heaters on petrochemical plant. Zone models can simulate both steady-state furnace operation and more complex transient operation typical of a production environment. These models can be used to predict thermal efficiency and performance, and more importantly, to assist in identifying and predicting energy saving opportunities from such measures as: ·Improving air/fuel ratio and temperature controls. ·Improved insulation. ·Use of oxygen or oxygen enrichment. ·Air preheating via flue gas heat recovery. ·Modification to furnace geometry and hearth loading. There is also increasing interest in the application of refractory coatings for increasing surface radiation in fired plant. All of the techniques can yield savings ranging from a few percent upwards and can deliver rapid financial payback, but their evaluation often requires robust and reliable models in order to increase confidence in making financial investment decisions. This paper gives

The cost of starting and maintaining a large home hemodialysis program.

Science.gov (United States)

Komenda, Paul; Copland, Michael; Makwana, Jay; Djurdjev, Ogdjenka; Sood, Manish M; Levin, Adeera

2010-06-01

Home extended hours hemodialysis improves some measurable biological and quality-of-life parameters over conventional renal replacement therapies in patients with end-stage renal disease. Published small studies evaluating costs have shown savings in terms of ongoing operating costs with this modality. However, all estimates need to include the total costs, including infrastructure, patient training, and maintenance; patient attrition by death, transplantation, technique failure; and the necessity of in-center dialysis. We describe a comprehensive funding model for a large centrally administered but locally delivered home hemodialysis program in British Columbia, Canada that covered 122 patients, of which 113 were still in the program at study end. The majority of patients performed home nocturnal hemodialysis in this 2-year retrospective study. All training periods, both in-center and in-home dialysis, medications, hospitalizations, and deaths were captured using our provincial renal database and vital statistics. Comparative data from the provincial database and pricing models were used for costing purposes. The total comprehensive costs per patient-incorporating startup, home, and in-center dialysis; medications; home remodeling; and consumables-was $59,179 for years 2004-2005 and $48,648 for 2005-2006. The home dialysis patients required multiple in-center dialysis runs, significantly contributing to the overall costs. Our study describes a valid, comprehensive funding model delineating reliable cost estimates of starting and maintaining a large home-based hemodialysis program. Consideration of hidden costs is important for administrators and planners to take into account when designing budgets for home hemodialysis.

Potential savings of harmonising hospital and community formularies for chronic disease medications initiated in hospital.

Directory of Open Access Journals (Sweden)

Lauren Lapointe-Shaw

Full Text Available Hospitals in Canada manage their formularies independently, yet many inpatients are discharged on medications which will be purchased through publicly-funded programs. We sought to determine how much public money could be saved on chronic medications if hospitals promoted the initiation of agents with the lowest outpatient formulary prices.We used administrative databases for the province of Ontario to identify patients initiated on a proton pump inhibitor (PPI, angiotensin-converting enzyme (ACE inhibitor or angiotensin receptor blocker (ARB following hospital admission from April 1(st 2008-March 31(st 2009. We assessed the cost to the Ontario Drug Benefit Program (ODB over the year following initiation and determined the cost savings if prescriptions were substituted with the least expensive agent in each class.The cost for filling all PPI, ACE inhibitor and ARB prescriptions was $ 2.48 million, $968 thousand and $325 thousand respectively. Substituting the least expensive agent could have saved $1.16 million (47% for PPIs, $162 thousand (17% for ACE inhibitors and $14 thousand (4% for ARBs over the year following discharge.In a setting where outpatient prescriptions are publicly funded, harmonising outpatient formularies with inpatient therapeutic substitution resulted in modest cost savings and may be one way to control rising pharmaceutical costs.

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.

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.

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

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.

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.

Solar thermal technology development: Estimated market size and energy cost savings. Volume 2: Assumptions, methodology and results

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. Three fuel price scenarios and three 1990 STT system costs are considered, reflecting uncertainty over future fuel prices and STT cost projections. Solar thermal technology research and development (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), depending 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. Analysis is also provided regarding two federal incentives currently in use: The Federal Business Energy Tax Credit and direct R&D funding.

Solar thermal technology development: Estimated market size and energy cost savings. Volume 2: Assumptions, methodology and results

Science.gov (United States)

Gates, W. R.

1983-01-01

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. Three fuel price scenarios and three 1990 STT system costs are considered, reflecting uncertainty over future fuel prices and STT cost projections. Solar thermal technology research and development (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), depending 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. Analysis is also provided regarding two federal incentives currently in use: The Federal Business Energy Tax Credit and direct R&D funding.

Two weeks of additional standing balance circuit classes during inpatient rehabilitation are cost saving and effective: an economic evaluation.

Science.gov (United States)

Treacy, Daniel; Howard, Kirsten; Hayes, Alison; Hassett, Leanne; Schurr, Karl; Sherrington, Catherine

2018-01-01

Among people admitted for inpatient rehabilitation, is usual care plus standing balance circuit classes more cost-effective than usual care alone? Cost-effectiveness study embedded within a randomised controlled trial with concealed allocation, assessor blinding and intention-to-treat analysis. 162 rehabilitation inpatients from a metropolitan hospital in Sydney, Australia. The experimental group received a 1-hour standing balance circuit class, delivered three times a week for 2 weeks, in addition to usual therapy. The circuit classes were supervised by one physiotherapist and one physiotherapy assistant for up to eight patients. The control group received usual therapy alone. Costs were estimated from routinely collected hospital use data in the 3 months after randomisation. The functional outcome measure was mobility measured at 3 months using the Short Physical Performance Battery administered by a blinded assessor. An incremental analysis was conducted and the joint probability distribution of costs and outcomes was examined using bootstrapping. The median cost savings for the intervention group was AUD4,741 (95% CI 137 to 9,372) per participant; 94% of bootstraps showed that the intervention was both effective and cost saving. Two weeks of additional standing balance circuit classes delivered in addition to usual therapy resulted in decreased healthcare costs at 3 months in hospital inpatients admitted for rehabilitation. There is a high probability that this intervention is both cost saving and effective. ACTRN12611000412932. [Treacy D, Howard K, Hayes A, Hassett L, Schurr K, Sherrington C (2018) Two weeks of additional standing balance circuit classes during inpatient rehabilitation are cost saving and effective: an economic evaluation. Journal of Physiotherapy 64: 41-47]. Copyright © 2017 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

Evaluation of increased adherence and cost savings of an employer value-based benefits program targeting generic antihyperlipidemic and antidiabetic medications.

Science.gov (United States)

Clark, Bobby; DuChane, Janeen; Hou, John; Rubinstein, Elan; McMurray, Jennifer; Duncan, Ian

2014-02-01

A major employer implemented a change to its employee health benefits program to allow beneficiaries with diabetes or high cholesterol to obtain preselected generic antidiabetic or generic antihyperlipidemic medications with a zero dollar copayment. To receive this benefit, plan beneficiaries were required to participate in a contracted vendor's case management and/or wellness program.  To assess changes in medication adherence and the costs for generic antidiabetic and generic antihyperlipidemic medications resulting from participation in a zero copay (ZCP) program.   This was a retrospective pre-post comparison group study, evaluating adherence and cost. Participants using an antihyperlipidemic and/or antidiabetic medication during the study identification period and post-implementation period for the program were considered eligible for the study. Eligible beneficiaries who enrolled in the ZCP program during the post-implementation period were considered participants, while those who did not enroll during this period were considered nonparticipants. ZCP program participants and nonparticipants were matched via a 1-to-1 propensity scoring method using age, gender, comorbidity count, medication type (antihyperlipidemic, antidiabetic, or both), and baseline adherence as matching criteria. The proportion of days covered (PDC) metric expressed as a mean percentage was used to assess adherence to medication therapy, while payer cost was examined using prescription drug utilization expressed as per member per year (PMPY) and cost change per 30 days of medication expressed in dollars.   Among participants who were users of antidiabetic medications, the mean adherence rate was sustained from pre- to post-implementation (81.8% vs. 81.9%); however, it decreased in the matched nonparticipant group (81.9% vs. 73.1%). This difference in mean adherence over time between the participants and nonparticipants was statistically significant (0.1% vs. -8.8%, P  less than  0

Cost-Value Analysis and the SAVE: A Work in Progress, But an Option for Localised Decision Making?

Science.gov (United States)

Karnon, Jonathan; Partington, Andrew

2015-12-01

Cost-value analysis aims to address the limitations of the quality-adjusted life-year (QALY) by incorporating the strength of public concerns for fairness in the allocation of scarce health care resources. To date, the measurement of value has focused on equity weights to reflect societal preferences for the allocation of QALY gains. Another approach is to use a non-QALY-based measure of value, such as an outcome 'equivalent to saving the life of a young person' (a SAVE). This paper assesses the feasibility and validity of using the SAVE as a measure of value for the economic evaluation of health care technologies. A web-based person trade-off (PTO) survey was designed and implemented to estimate equivalent SAVEs for outcome events associated with the progression and treatment of early-stage breast cancer. The estimated equivalent SAVEs were applied to the outputs of an existing decision analytic model for early breast cancer. The web-based PTO survey was undertaken by 1094 respondents. Validation tests showed that 68 % of eligible responses revealed consistent ordering of responses and 32 % displayed ordinal transitivity, while 37 % of respondents showing consistency and ordinal transitivity approached cardinal transitivity. Using consistent and ordinally transitive responses, the mean incremental cost per SAVE gained was £ 3.72 million. Further research is required to improve the validity of the SAVE, which may include a simpler web-based survey format or a face-to-face format to facilitate more informed responses. A validated method for estimating equivalent SAVEs is unlikely to replace the QALY as the globally preferred measure of outcome, but the SAVE may provide a useful alternative for localized decision makers with relatively small, constrained budgets-for example, in programme budgeting and marginal analysis.

Estimating Costs and Benefits Associated with Evidence-Based Violence Prevention: Four Case Studies Based on the Fourth R Program

Directory of Open Access Journals (Sweden)

Claire V. Crooks

2017-05-01

a life of crime, up to $5 million can be saved in costs to society. Research involving 1,700 Grade 9 students in 20 schools showed that those who did not take the Fourth R programming had a rate of relationship violence 2.5 times greater than those who did, and that the program had the greatest impact on boys, who are the most frequent perpetrators. There was also a significant reduction in violence towards peers, especially for youth who were at risk to be violent because they had experienced previous child abuse. Students likewise became more aware of violence and its impacts on others, and they gained a greater command of coping strategies. The program’s start-up costs vary depending on the school’s geographical location. This paper shows that the program’s costs per student are small compared to the savings to society in terms of violence avoidance. In a large Ontario school board, costs were down to $5 per student. In the Northwest Territories, smaller class sizes and bigger geographic distances make implementing the program more expensive, but still only $15-33 per student. The authors calculated savings based on costs avoided related to dating and peer violence at $2,101 per student. Violence prevention is an ethical imperative and it must start with teenagers. In an era of fiscal restraint and demand for more financial accountability, the Fourth R has proven to be a pro-active success in terms of saving both public money and young lives from the deleterious effects of violence.

EMC Phenomena in HEP Detectors: Prevention and Cost Savings

International Nuclear Information System (INIS)

Arteche, F.; Rivetta, C.

2006-01-01

This paper addresses electromagnetic compatibility (EMC) studies applied to high-energy physics (HEP) detectors. They are focused on the quantification of the front-end electronic (FEE) sensitivity to conductive noise coupled through the input/output cables. Immunity tests performed on FEE prototypes of both the CMS hadron calorimeter and the CMS silicon tracker are presented. These tests characterize the sensitivity of the FEE to common and differential mode noise coupled through the power cables and the slow control network. Immunity tests allow evaluating the weakest areas of the system to take corrective actions before the integration of the overall detector, saving time and important costs

Transaction costs and sequential bargaining in transferable discharge permit markets.

Science.gov (United States)

Netusil, N R; Braden, J B

2001-03-01

Market-type mechanisms have been introduced and are being explored for various environmental programs. Several existing programs, however, have not attained the cost savings that were initially projected. Modeling that acknowledges the role of transactions costs and the discrete, bilateral, and sequential manner in which trades are executed should provide a more realistic basis for calculating potential cost savings. This paper presents empirical evidence on potential cost savings by examining a market for the abatement of sediment from farmland. Empirical results based on a market simulation model find no statistically significant change in mean abatement costs under several transaction cost levels when contracts are randomly executed. An alternative method of contract execution, gain-ranked, yields similar results. At the highest transaction cost level studied, trading reduces the total cost of compliance relative to a uniform standard that reflects current regulations.

Cost-Sharing Contracts for Energy Saving and Emissions Reduction of a Supply Chain under the Conditions of Government Subsidies and a Carbon Tax

Directory of Open Access Journals (Sweden)

Yi Yuyin

2018-03-01

Full Text Available To study the cooperation of upstream and downstream enterprises of a supply chain in energy saving and emissions reduction, we establish a Stackelberg game model. The retailer moves first to decide a cost-sharing contract, then the manufacturer determines the energy-saving level, carbon-emission level, and wholesale price successively. In the end, the retailer determines the retail price. As a regulation, the government provides subsidies for energy-saving products, while imposing a carbon tax on the carbon emitted. The results show that (1 both the energy-saving cost-sharing (ECS and the carbon emissions reduction cost-sharing (CCS contracts are not the dominant strategy of the two parties by which they can facilitate energy savings and emissions reductions; (2 compared with single cost-sharing contracts, the bivariate cost-sharing (BCS contract for energy saving and emissions reduction is superior, although it still cannot realise prefect coordination of the supply chain; (3 government subsidy and carbon tax policies can promote the cooperation of both the upstream and downstream enterprises of the supply chain—a subsidy policy can always drive energy saving and emissions reductions, while a carbon tax policy does not always exert positive effects, as it depends on the initial level of pollution and the level of carbon tax; and (4 the subsidy policy reduces the coordination efficiency of the supply chain, while the influences of carbon tax policy upon the coordination efficiency relies on the initial carbon-emission level.

Cost Savings Realized by Implementation of Routine Microbiological Identification by Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry.

Science.gov (United States)

Tran, Anthony; Alby, Kevin; Kerr, Alan; Jones, Melissa; Gilligan, Peter H

2015-08-01

Matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry (MS) is an emerging technology for rapid identification of bacterial and fungal isolates. In comparison to conventional methods, this technology is much less labor intensive and can provide accurate and reliable results in minutes from a single isolated colony. We compared the cost of performing the bioMérieux Vitek MALDI-TOF MS with conventional microbiological methods to determine the amount saved by the laboratory by converting to the new technology. Identification costs for 21,930 isolates collected between April 1, 2013, and March 31, 2014, were directly compared for MALDI-TOF MS and conventional methodologies. These isolates were composed of commonly isolated organisms, including commonly encountered aerobic and facultative bacteria and yeast but excluding anaerobes and filamentous fungi. Mycobacterium tuberculosis complex and rapidly growing mycobacteria were also evaluated for a 5-month period during the study. Reagent costs and a total cost analysis that included technologist time in addition to reagent expenses and maintenance service agreement costs were analyzed as part of this study. The use of MALDI-TOF MS equated to a net savings of $69,108.61, or 87.8%, in reagent costs annually compared to traditional methods. When total costs are calculated to include technologist time and maintenance costs, traditional identification would have cost $142,532.69, versus $68,886.51 with the MALDI-TOF MS method, resulting in a laboratory savings of $73,646.18, or 51.7%, annually by adopting the new technology. The initial cost of the instrument at our usage level would be offset in about 3 years. MALDI-TOF MS not only represents an innovative technology for the rapid and accurate identification of bacterial and fungal isolates, it also provides a significant cost savings for the laboratory. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

Evaluating the Effects of Child Savings Accounts Program Participation on Parental Well-Being

Science.gov (United States)

Okech, David

2012-01-01

Objectives: Using baseline and second wave data, the study evaluated the impact of child savings accounts participation on parenting stress, personal mastery, and economic strain with N = 381 lower income parents who decided to join and those who did not join in a child development savings account program. Methods: Structural equation modeling for…

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

International Nuclear Information System (INIS)

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

1996-01-01

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

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.

Cost avoidance techniques through the Fernald controlled area trash segregation program and the RIMIA solid waste reduction program

International Nuclear Information System (INIS)

Menche, C.E.

1997-01-01

The Fernald Environmental Management Project is a Department of Energy owned facility that produced high quality uranium metals for military defense. The Fernald mission has changed from one of production to remediation. Remediation is intended to clean up legacy (primary) waste from past practices. Little opportunity is available to reduce the amount of primary waste. However, there is an opportunity to reduce secondary waste generation, primarily through segregation. Two programs which accomplish this are the Controlled Area Trash Segregation Program and the RIMIA Solid Waste Reduction Program. With these two programs now in place at the FEMP, it has been estimated that a 60% reduction has been achieved in unnecessary clean waste being disposed as Low Level Waste at the Nevada Test Site. The cost savings associated with these programs (currently 79,000 cubic feet, $428,000) could easily run into the millions of dollars based on the upcoming restoration activities to be undertaken. The segregation of non-radiological waste in the radiologically Controlled Area not only establishes a firm commitment to send only low-level radioactive waste to the Nevada Test Site, but also results in substantial cost avoidance

Prescription Program Provides Significant Savings

Science.gov (United States)

Rowan, James M.

2010-01-01

Most school districts today are looking for ways to save money without decreasing services to its staff. Retired pharmacist Tim Sylvester, a lifelong resident of Alpena Public Schools in Alpena, Michigan, presented the district with a pharmaceuticals plan that would save the district money without raising employee co-pays for prescriptions. The…

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.

Savings estimates for the Energy Star(registered trademark) voluntary labeling program

International Nuclear Information System (INIS)

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

2000-01-01

ENERGY STAR7 is a voluntary labeling program designed to identify and promote energy-efficient products. Operated jointly by the Environmental Protection Agency (EPA) and the U.S. Department of Energy (DOE), ENERGY STAR labels exist for more than twenty products, spanning office equipment, residential heating and cooling equipment, new homes, commercial and residential lighting, home electronics, and major appliances. We present estimates of the energy, dollar and carbon savings already achieved by the program and provide savings forecasts for several market penetration scenarios for the period 2001 to 2010. 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. Finally, we assess the sensitivity of our target penetration case forecasts to greater or lesser marketing success by EPA and DOE, lower-than-expected future energy prices, and higher or lower rates of carbon emissions by electricity generators

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.

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

Science.gov (United States)

Ostermann, Julia K.; Reinhold, Thomas; Witt, Claudia M.

2015-01-01

Objectives 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). Methods 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). Results 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]; phomeopathy 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. Conclusion 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. PMID:26230412

Potential savings from an evidence-based consumer-oriented public education campaign on prescription drugs.

Science.gov (United States)

Donohue, Julie M; Fischer, Michael A; Huskamp, Haiden A; Weissman, Joel S

2008-10-01

To estimate potential savings associated with the Consumer Reports Best Buy Drugs program, a national educational program that provides consumers with price and effectiveness information on prescription drugs. National data on 2006 prescription sales and retail prices paid for angiotensin-converting enzyme inhibitors (ACEIs), β-blockers, calcium channel blockers, and 3-hydroxy-3-methylglutaryl coenzyme A (HMG-coA) reductase inhibitors (statins). We converted national data on aggregate unit sales of drugs in the four classes to defined daily doses (DDD) and estimated a range of potential savings from generic and therapeutic substitution. We estimated that $2.76 billion, or 7.83 percent of sales, could be saved if use of the drugs recommended by the educational program was increased. The recommended drugs' prices were 15-65 percent lower per DDD than their therapeutic alternatives. The majority (57.4 percent) of potential savings would be achieved through therapeutic substitution. Substantial savings can be achieved through greater use of comparatively effective and lower cost drugs recommended by a national consumer education program. However, barriers to dissemination of consumer-oriented drug information must be addressed before savings can be realized. © Health Research and Educational Trust.

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

International Nuclear Information System (INIS)

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

2002-01-01

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

Is Exercise Stress Testing a Cost-Saving Strategy For Risk Assessment of Pediatric Wolff-Parkinson-White Syndrome Patients?

Science.gov (United States)

Moltedo, Jose M.; Iyer, Ramesh V.; Forman, Howard; Fahey, John; Rosenthal, Geoffrey; Snyder, Christopher S.

2006-01-01

Background: In Wolff-Parkinson-White syndrome (WPW) patients the loss of pre-excitation in a single heartbeat during exercise stress testing (EST) is a predictor of low risk of sudden death. The purpose of this study was to: 1) assess the frequency of loss of pre-excitation in a single heartbeat during exercise testing, and 2) compare the cost of EST versus trans-catheter electrophysiology study (EPS) in the risk assessment of WPW patients. Methods: A retrospective review of 50 cases of patients with WPW who underwent EST was conducted including demographics, history of supraventricular tachycardia, associated congenital heart disease, maximum heart rate achieved, and loss of pre-excitation in a single heartbeat. Hospital costs of EST and EPS were compared. Results: Of the 50 patients who underwent EST, 4 (8%), lost pre-excitation in a single heartbeat during EST. No differences were found regarding gender, age at diagnosis or EST, history of supraventricular tachycardia, presence of congenital heart disease or maximal heart rate. A cost comparison, utilizing the cost data: EST ($62.75) and EPS ($5,597) found EST to be a cost-saving approach in WPW patients. With 4 patients losing pre-excitation during EST, the cost saving of EST was $22,388 for this population of WPW patients. Conclusions: A frequency of 8% loss of pre-excitation was found in a pediatric sample that underwent EST. Additionally, EST was shown to be a cost-saving strategy in risk assessment of pediatric WPW patients. PMID:21845141

A strategic approach to the unfinished fortification agenda: feasibility, costs, and cost-effectiveness analysis of fortification programs in 48 countries.

Science.gov (United States)

Fiedler, John L; Macdonald, Barbara

2009-12-01

Food fortification is a promising strategy for combating micronutrient deficiencies, which plague one-third of the world's population. Which foods to fortify, with which micronutrients, and in which countries remain essential questions that to date have not been addressed at the global level. To provide a tool for international agencies to identify and organize the next phase of the unfinished global fortification agenda by prioritizing roughly 250 potential interventions in 48 priority countries. By explicitly defining the structure and operations of the fortification interventions in a detailed and transparent manner, and incorporating a substantial amount of country-specific data, the study also provides a potentially useful starting point for policy discussions in each of the 48 countries, which--it is hoped--will help to catalyze the development of public-private partnerships and accelerate the introduction of fortification and reduction of micronutrient deficiencies. Forty-eight high-priority countries were identified, and the feasibility of fortifying vegetable oil and sugar with vitamin A and fortifying wheat flour and maize flour with two alternative multiple micronutrient formulations was assessed. One hundred twenty-two country-, food-, and fortification formulation-specific interventions were assessed to be feasible, and the costs of each intervention were estimated. Assuming a 30% reduction in the micronutrient deficiencies of the persons consuming the food, the number of disability-adjusted life years (DALYs) saved by each of the programs was estimated. The cost per DALY saved was calculated for each of the 122 interventions, and the interventions were rank-ordered by cost-effectiveness. It is estimated that the 60 most cost-effective interventions would carry a 10-year price tag of US$1 billion and have costs per DALY saved ranging from US$1 to US$134. The single "best bet" intervention--i.e., the most cost-effective intervention--in each of the 48

Risk transfer via energy savings insurance; TOPICAL

International Nuclear Information System (INIS)

Mills, Evan

2001-01-01

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 sheets to self

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.

Cost savings using a protocol approach to manage anemia in a hemodialysis unit.

Science.gov (United States)

Charlesworth, Emily C; Richardson, Robert M; Battistella, Marisa

2014-01-01

National guidelines recommend using anemia management protocols to guide treatment. The objective of this study was to determine if an anemia management protocol would improve hemoglobin (Hgb) indices in hemodialysis patients and to measure whether the protocol would reduce the use and cost of darbepoetin alfa (DBO) and intravenous (IV) iron in hemodialysis patients. An anemia management protocol was created and implemented for hemodialysis patients at our institution. A retrospective observational review of the use of DBO and IV iron as well as changes in Hgb, transferrin saturation and ferritin in 174 patients was conducted 6 months before and after implementation of the anemia protocol. The number of Hgb measurements in the target range increased from 44.3 to 46.0% (p = 0.48) after protocol implementation. The mean weekly dose of DBO was reduced from 34.56 ± 31.12 to 31.11 ± 28.64 μg post-protocol implementation (p = 0.011), which translated to a cost savings of USD 41,649 over 6 months. The mean monthly IV iron dose also decreased from 139.56 ± 98.83 to 97.65 ± 79.05 mg (p DBO and iron agents while increasing the number of patients in the target Hgb range, which led to significant cost savings in the treatment of anemia.

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

SWEEP - Save Water and Energy Education Program; FINAL

International Nuclear Information System (INIS)

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

2001-01-01

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

The Cost-Effectiveness of High-Risk Lung Cancer Screening and Drivers of Program Efficiency.

Science.gov (United States)

Cressman, Sonya; Peacock, Stuart J; Tammemägi, Martin C; Evans, William K; Leighl, Natasha B; Goffin, John R; Tremblay, Alain; Liu, Geoffrey; Manos, Daria; MacEachern, Paul; Bhatia, Rick; Puksa, Serge; Nicholas, Garth; McWilliams, Annette; Mayo, John R; Yee, John; English, John C; Pataky, Reka; McPherson, Emily; Atkar-Khattra, Sukhinder; Johnston, Michael R; Schmidt, Heidi; Shepherd, Frances A; Soghrati, Kam; Amjadi, Kayvan; Burrowes, Paul; Couture, Christian; Sekhon, Harmanjatinder S; Yasufuku, Kazuhiro; Goss, Glenwood; Ionescu, Diana N; Hwang, David M; Martel, Simon; Sin, Don D; Tan, Wan C; Urbanski, Stefan; Xu, Zhaolin; Tsao, Ming-Sound; Lam, Stephen

2017-08-01

Lung cancer risk prediction models have the potential to make programs more affordable; however, the economic evidence is limited. Participants in the National Lung Cancer Screening Trial (NLST) were retrospectively identified with the risk prediction tool developed from the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. The high-risk subgroup was assessed for lung cancer incidence and demographic characteristics compared with those in the low-risk subgroup and the Pan-Canadian Early Detection of Lung Cancer Study (PanCan), which is an observational study that was high-risk-selected in Canada. A comparison of high-risk screening versus standard care was made with a decision-analytic model using data from the NLST with Canadian cost data from screening and treatment in the PanCan study. Probabilistic and deterministic sensitivity analyses were undertaken to assess uncertainty and identify drivers of program efficiency. Use of the risk prediction tool developed from the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial with a threshold set at 2% over 6 years would have reduced the number of individuals who needed to be screened in the NLST by 81%. High-risk screening participants in the NLST had more adverse demographic characteristics than their counterparts in the PanCan study. High-risk screening would cost $20,724 (in 2015 Canadian dollars) per quality-adjusted life-year gained and would be considered cost-effective at a willingness-to-pay threshold of $100,000 in Canadian dollars per quality-adjusted life-year gained with a probability of 0.62. Cost-effectiveness was driven primarily by non-lung cancer outcomes. Higher noncurative drug costs or current costs for immunotherapy and targeted therapies in the United States would render lung cancer screening a cost-saving intervention. Non-lung cancer outcomes drive screening efficiency in diverse, tobacco-exposed populations. Use of risk selection can reduce the budget impact, and

[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.

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

International Nuclear Information System (INIS)

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. (author)

Cost-Effectiveness Analysis of the Self-Management Program for Thai Patients with Metabolic Syndrome.

Science.gov (United States)

Sakulsupsiri, Anut; Sakthong, Phantipa; Winit-Watjana, Win

2016-05-01

Lifestyle modification programs are partly evaluated for their usefulness. This study aimed to assess the cost-effectiveness and healthy lifestyle persistence of a self-management program (SMP) for patients with metabolic syndrome (MetS) in Thai health care settings. A cost-effectiveness analysis was performed on the basis of an intervention study of 90 patients with MetS randomly allocated to the SMP and control groups. A Markov model with the Difference-in-Difference method was used to predict the lifetime costs from a societal perspective and quality-adjusted life-years (QALYs), of which 95% confidence intervals (CIs) were estimated by bootstrapping. The cost-effectiveness analysis, along with healthy lifestyle persistence, was performed using the discount rate of 3% per annum. Parameter uncertainties were identified using one-way and probabilistic sensitivity analyses. The lifetime costs tended to decrease in both groups. The SMP could save lifetime costs (-2310 baht; 95% CI -5960 to 1400) and gain QALYs (0.0098; 95% CI -0.0003 to 0.0190), compared with ordinary care. The probability of cost-effectiveness was 99.4% from the Monte-Carlo simulation, and the program was deemed cost-effective at dropout rates below 69% per year as determined by the threshold of 160,000 baht per QALY gained. The cost of macrovascular complications was the most influencing variable for the overall incremental cost-effectiveness ratio. The SMP provided by the health care settings is marginally cost-effective, and the persistence results support the implementation of the program to minimize the complications and economic burden of patients with MetS. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

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.

Cardiovascular Magnetic Resonance Imaging—Incremental Value in a Series of 361 Patients Demonstrating Cost Savings and Clinical Benefits: An Outcome-Based Study

Science.gov (United States)

Hegde, Vinayak A; Biederman, Robert WW; Mikolich, J Ronald

2017-01-01

BACKGROUND This study was designed to assess the clinical impact and cost-benefit of cardiovascular magnetic resonance imaging (CMR). In the face of current health care cost concerns, cardiac imaging modalities have come under focused review. Data related to CMR clinical impact and cost-benefit are lacking. METHODS AND RESULTS Retrospective review of 361 consecutive patients (pts) who underwent CMR exams was conducted. Indications for CMR were tabulated for appropriateness criteria. Components of the CMR exam were identified along with evidence of clinical impact. The cost of each CMR exam was ascertained along with cost savings attributable to the CMR exam for calculation of an incremental cost-effectiveness ratio. A total of 354 of 361 pts (98%) had diagnostic quality studies. Of the 361 pts, 350 (97%) had at least 1 published Appropriateness Criterion for CMR. A significant clinical impact attributable to CMR exam results was observed in 256 of 361 pts (71%). The CMR exam resulted in a new diagnosis in 69 of 361 (27%) pts. Cardiovascular magnetic resonance imaging results avoided invasive procedures in 38 (11%) pts and prevented additional diagnostic testing in 26 (7%) pts. Comparison of health care savings using CMR as opposed to current standards of care showed a net cost savings of $833 037, ie, per patient cost savings of $2308. CONCLUSIONS Cardiovascular magnetic resonance imaging provides diagnostic image quality in >98% of cases. Cardiovascular magnetic resonance imaging findings have documentable clinical impact on patient management in 71% of pts undergoing the exam, in a cost beneficial manner. PMID:28579858

Cardiovascular Magnetic Resonance Imaging-Incremental Value in a Series of 361 Patients Demonstrating Cost Savings and Clinical Benefits: An Outcome-Based Study.

Science.gov (United States)

Hegde, Vinayak A; Biederman, Robert Ww; Mikolich, J Ronald

2017-01-01

This study was designed to assess the clinical impact and cost-benefit of cardiovascular magnetic resonance imaging (CMR). In the face of current health care cost concerns, cardiac imaging modalities have come under focused review. Data related to CMR clinical impact and cost-benefit are lacking. Retrospective review of 361 consecutive patients (pts) who underwent CMR exams was conducted. Indications for CMR were tabulated for appropriateness criteria. Components of the CMR exam were identified along with evidence of clinical impact. The cost of each CMR exam was ascertained along with cost savings attributable to the CMR exam for calculation of an incremental cost-effectiveness ratio. A total of 354 of 361 pts (98%) had diagnostic quality studies. Of the 361 pts, 350 (97%) had at least 1 published Appropriateness Criterion for CMR. A significant clinical impact attributable to CMR exam results was observed in 256 of 361 pts (71%). The CMR exam resulted in a new diagnosis in 69 of 361 (27%) pts. Cardiovascular magnetic resonance imaging results avoided invasive procedures in 38 (11%) pts and prevented additional diagnostic testing in 26 (7%) pts. Comparison of health care savings using CMR as opposed to current standards of care showed a net cost savings of $833 037, ie, per patient cost savings of $2308. Cardiovascular magnetic resonance imaging provides diagnostic image quality in >98% of cases. Cardiovascular magnetic resonance imaging findings have documentable clinical impact on patient management in 71% of pts undergoing the exam, in a cost beneficial manner.

Cardiovascular Magnetic Resonance Imaging—Incremental Value in a Series of 361 Patients Demonstrating Cost Savings and Clinical Benefits: An Outcome-Based Study

Directory of Open Access Journals (Sweden)

Vinayak A Hegde

2017-05-01

Full Text Available Background: This study was designed to assess the clinical impact and cost-benefit of cardiovascular magnetic resonance imaging (CMR. In the face of current health care cost concerns, cardiac imaging modalities have come under focused review. Data related to CMR clinical impact and cost-benefit are lacking. Methods and Results: Retrospective review of 361 consecutive patients (pts who underwent CMR exams was conducted. Indications for CMR were tabulated for appropriateness criteria. Components of the CMR exam were identified along with evidence of clinical impact. The cost of each CMR exam was ascertained along with cost savings attributable to the CMR exam for calculation of an incremental cost-effectiveness ratio. A total of 354 of 361 pts (98% had diagnostic quality studies. Of the 361 pts, 350 (97% had at least 1 published Appropriateness Criterion for CMR. A significant clinical impact attributable to CMR exam results was observed in 256 of 361 pts (71%. The CMR exam resulted in a new diagnosis in 69 of 361 (27% pts. Cardiovascular magnetic resonance imaging results avoided invasive procedures in 38 (11% pts and prevented additional diagnostic testing in 26 (7% pts. Comparison of health care savings using CMR as opposed to current standards of care showed a net cost savings of $833 037, ie, per patient cost savings of $2308. Conclusions: Cardiovascular magnetic resonance imaging provides diagnostic image quality in >98% of cases. Cardiovascular magnetic resonance imaging findings have documentable clinical impact on patient management in 71% of pts undergoing the exam, in a cost beneficial manner.

The distribution over time of costs and social net benefits for pertussis immunization programs.

Science.gov (United States)

Girard, Dorota Zdanowska

2010-03-01

The cost of a six-dose pertussis immunization programs for children and adolescents is investigated in relation to estimators of the price of acellular vaccine, the value of a child's life, levels of vaccination rate and discount rates. We compare the cost of the program maintained over time at 90% with three alternative strategies, each involving a decrease in vaccination coverage. Data from England and Wales, 1966-2005, is used to formalize a delay in occurrence of pertussis cases as a result of a fall in coverage. We first apply the criterion of minimization of the total social cost of pertussis to identify the best cost saving immunization strategy. The results are also discussed in form of the discounted present value of the total social net benefits. We find that the discounted present value of the total social net benefit is maximized when a stable vaccination program at 90% is compared to a gradual decrease in vaccination coverage leading to the lowest vaccination rate. The benefits to society of providing sustained immunization strategy, vaccinating the highest proportion of children and adolescents, are systematically proved on the basis of the second optimisation criterion, independently of the level of estimators applied during economic evaluation for the cost variables.

Health economic modeling of the potential cost saving effects of Neurally Adjusted Ventilator Assist.

Science.gov (United States)

Hjelmgren, Jonas; Bruce Wirta, Sara; Huetson, Pernilla; Myrén, Karl-Johan; Göthberg, Sylvia

2016-02-01

Asynchrony between patient and ventilator breaths is associated with increased duration of mechanical ventilation (MV). Neurally Adjusted Ventilatory Assist (NAVA) controls MV through an esophageal reading of diaphragm electrical activity via a nasogastric tube mounted with electrode rings. NAVA has been shown to decrease asynchrony in comparison to pressure support ventilation (PSV). The objective of this study was to conduct a health economic evaluation of NAVA compared with PSV. We developed a model based on an indirect link between improved synchrony with NAVA versus PSV and fewer days spent on MV in synchronous patients. Unit costs for MV were obtained from the Swedish intensive care unit register, and used in the model along with NAVA-specific costs. The importance of each parameter (proportion of asynchronous patients, costs, and average MV duration) for the overall results was evaluated through sensitivity analyses. Base case results showed that 21% of patients ventilated with NAVA were asynchronous versus 52% of patients receiving PSV. This equals an absolute difference of 31% and an average of 1.7 days less on MV and a total cost saving of US$7886 (including NAVA catheter costs). A breakeven analysis suggested that NAVA was cost effective compared with PSV given an absolute difference in the proportion of asynchronous patients greater than 2.5% (49.5% versus 52% asynchronous patients with NAVA and PSV, respectively). The base case results were stable to changes in parameters, such as difference in asynchrony, duration of ventilation and daily intensive care unit costs. This study showed economically favorable results for NAVA versus PSV. Our results show that only a minor decrease in the proportion of asynchronous patients with NAVA is needed for investments to pay off and generate savings. Future studies need to confirm this result by directly relating improved synchrony to the number of days on MV. © The Author(s), 2015.

Client-server computer architecture saves costs and eliminates bottlenecks

International Nuclear Information System (INIS)

Darukhanavala, P.P.; Davidson, M.C.; Tyler, T.N.; Blaskovich, F.T.; Smith, C.

1992-01-01

This paper reports that workstation, client-server architecture saved costs and eliminated bottlenecks that BP Exploration (Alaska) Inc. experienced with mainframe computer systems. In 1991, BP embarked on an ambitious project to change technical computing for its Prudhoe Bay, Endicott, and Kuparuk operations on Alaska's North Slope. This project promised substantial rewards, but also involved considerable risk. The project plan called for reservoir simulations (which historically had run on a Cray Research Inc. X-MP supercomputer in the company's Houston data center) to be run on small computer workstations. Additionally, large Prudhoe Bay, Endicott, and Kuparuk production and reservoir engineering data bases and related applications also would be moved to workstations, replacing a Digital Equipment Corp. VAX cluster in Anchorage

A Cost Estimation Analysis of U.S. Navy Ship Fuel-Savings Techniques and Technologies

Science.gov (United States)

2009-09-01

Horngren , C. T., Datar, S . M., & Foster, G. (2006). Cost Accounting : A Managerial Emphasis. 12th ed. Saddle River, NJ: Pearson...COVERED Master’s Thesis 4. TITLE AND SUBTITLE A Cost Estimation Analysis of U.S. Navy Ship Fuel-Savings Techniques and Technologies 6. AUTHOR( S ...FY12 FY13 FY14 FY15 FY16 FY17 FY18 N P V   C u m   S a v i n g s   ( $ / y r / S D   s h i p s ) Time

Cost-effectiveness of a national enterovirus 71 vaccination program in China.

Science.gov (United States)

Wang, Wenjun; Song, Jianwen; Wang, Jingjing; Li, Yaping; Deng, Huiling; Li, Mei; Gao, Ning; Zhai, Song; Dang, Shuangsuo; Zhang, Xin; Jia, Xiaoli

2017-09-01

Enterovirus 71 (EV71) has caused great morbidity, mortality, and use of health service in children younger than five years in China. Vaccines against EV71 have been proved effective and safe by recent phase 3 trials and are now available in China. The purpose of this study was to evaluate the health impact and cost-effectiveness of a national EV71 vaccination program in China. Using Microsoft Excel, a decision model was built to calculate the net clinical and economic outcomes of EV71 vaccination compared with no EV71 vaccination in a birth cohort of 1,000,000 Chinese children followed for five years. Model parameters came from published epidemiology, clinical and cost data. In the base-case, vaccination would annually avert 37,872 cases of hand, foot and mouth disease (HFMD), 2,629 herpangina cases, 72,900 outpatient visits, 6,363 admissions to hospital, 29 deaths, and 945 disability adjusted life years. The break-even price of the vaccine was $5.2/dose. When the price was less than $8.3 or $14.6/dose, the vaccination program would be highly cost-effective or cost-effective, respectively (incremental cost-effectiveness ratio less than or between one to three times China GDP per capita, respectively). In one-way sensitivity analyses, the HFMD incidence was the only influential parameter at the price of $5/dose. Within the price range of current routine vaccines paid by the government, a national EV71 vaccination program would be cost-saving or highly cost-effective to prevent EV71 related morbidity, mortality, and use of health service among children younger than five years in China. Policy makers should consider including EV71 vaccination as part of China's routine childhood immunization schedule.

How School Choice Programs Can Save Money. WebMemo #727

Science.gov (United States)

Johnson, Kirk A.

2005-01-01

Educational choice can improve educational achievement and states' bottom lines. Not only do choice programs help students from lower-income families attend schools that they otherwise might not be able to attend, but they can also save money in the process. A record number of state legislatures have considered school choice legislation this year,…

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

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.

24 CFR 700.115 - Program costs.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Program costs. 700.115 Section 700... PUBLIC AND INDIAN HOUSING PROGRAMS) CONGREGATE HOUSING SERVICES PROGRAM § 700.115 Program costs. (a) Allowable costs. (1) Allowable costs for direct provision of supportive services includes the provision of...

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.

Cost-savings accruable to removing value added tax from antiretrovirals in the South African private health sector

Directory of Open Access Journals (Sweden)

Varsha Bangalee

2017-10-01

Full Text Available Background: Despite the important and essential role that medicines play in any society, all medicines, including those identified as essential, are uniformly subjected to 14% value added tax (VAT, regardless of their therapeutic value in the private healthcare sector of South Africa. The aim of this article is to demonstrate the potential cost-saving attained from the removal of VAT from the private sector pricing of essential medicines, using antiretroviral treatment as an example. Methods: An empirical analysis was undertaken to illustrate the potential cost-saving achieved by removing VAT from the Single Exit Price and the dispensing fee of essential medicines. This outcome was demonstrated by applying the methodology to an adult fixed dose combination 1st line antiretroviral regimen as well as to a group of 3rd line antiretroviral medicines. Results: The potential saving for the lowest priced generic and originator 1st line antiviral regimen accrued to ZAR 693.84 and ZAR 1085.04 over a year respectively. Regarding the 3rd line antiretroviral drugs, results yielded an annual saving of ZAR 1678.68 (darunavir, ZAR5741.04 (maraviroc and ZAR 159.48 (rilpivirine. Conclusions: Lobbying for the removal of VAT from the supply chain of medicines should be intensified. Policy development to monitor and recover lost government revenue through the removal of taxes should be explored.

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

International Nuclear Information System (INIS)

Energy Smart Schools Team

2001-01-01

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

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.

Cost-effectiveness of a ROPS social marketing campaign.

Science.gov (United States)

Sorensen, J A; Jenkins, P; Bayes, B; Clark, S; May, J J

2010-01-01

Tractor rollovers are the most frequent cause of death in the farm community. Rollover protection structures (ROPS) can prevent the injuries and fatalities associated with these events; however, almost half of U.S. farms lack these essential devices. One promising strategy for increasing ROPS use is social marketing. The purpose of this study was to assess the costs associated with the New York ROPS Social Marketing Campaign in relation to the cost of fatalities and injuries averted as a result of the campaign to determine whether cost savings could be demonstrated in the initial years of program implementation. A total of 524 farmers who had retrofitted a tractor through the program were mailed a survey to assess the number of rollovers or close calls that occurred since ROPS installation. Responses were obtained from 382 farmers, two of whom indicated that they had a potential fatality/injury scenario since retrofitting their tractor through the program. The cost savings associated with the intervention was estimated using a decision-tree analysis adapted from Myers and Pana-Cryan with appropriate consumer price index adjustments. The data were compared to the cost of the New York ROPS Social Marketing Campaign to arrive at an associated cost-savings estimate relative to the intervention. This study indicates that a net savings will likely be demonstrated within the third year of the New York ROPS Social Marketing initiative. These data may provide evidence for researchers hoping to generate support from state and private agencies for similar initiatives.

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

Option pricing: a flexible tool to disseminate shared savings contracts.

Science.gov (United States)

Friedberg, Mark W; Buendia, Anthony M; Lauderdale, Katherine E; Hussey, Peter S

2013-08-01

Due to volatility in healthcare costs, shared savings contracts can create systematic financial losses for payers, especially when contracting with smaller providers. To improve the business case for shared savings, we calculated the prices of financial options that payers can "sell" to providers to offset these losses. Using 2009 to 2010 member-level total cost of care data from a large commercial health plan, we calculated option prices by applying a bootstrap simulation procedure. We repeated these simulations for providers of sizes ranging from 500 to 60,000 patients and for shared savings contracts with and without key design features (minimum savings thresholds,bonus caps, cost outlier truncation, and downside risk) and under assumptions of zero, 1%, and 2% real cost reductions due to the shared savings contracts. Assuming no real cost reduction and a 50% shared savings rate, per patient option prices ranged from $225 (3.1% of overall costs) for 500-patient providers to $23 (0.3%) for 60,000-patient providers. Introducing minimum savings thresholds, bonus caps, cost outlier truncation, and downside risk reduced these option prices. Option prices were highly sensitive to the magnitude of real cost reductions. If shared savings contracts cause 2% reductions in total costs, option prices fall to zero for all but the smallest providers. Calculating the prices of financial options that protect payers and providers from downside risk can inject flexibility into shared savings contracts, extend such contracts to smaller providers, and clarify the tradeoffs between different contract designs, potentially speeding the dissemination of shared savings.

Our School Wellness Program Cut Staff Absenteeism and Might Save Lives.

Science.gov (United States)

Oxrieder, Ann

1987-01-01

Describes Bellevue (Washington) School District's employee wellness program's successful efforts to (1) save lives by promoting healthy lifestyles, (2) boost morale by taking health services to the workplace, (3) improve on-the-job performance by providing inexpensive, convenient opportunities for exercise and weight loss, and (4) reduce staff…

Refrigeration: Introducing energy saving opportunities for business

Energy Technology Data Exchange (ETDEWEB)

NONE

2006-04-15

In some industries, most notably food and drink and chemicals, refrigeration accounts for a significant proportion of overall site energy costs. For instance, in the industrial handling of meat, poultry and fish, it often accounts for 50% of total energy costs. In ice-cream production the proportion is 70%. In a number of commercial sectors, refrigeration also represents a significant proportion of overall energy costs. For example: Cold storage 90%; Food supermarkets 50%; Small shops with refrigerated cabinets 70% or over; Pubs and clubs 30%. Against these high costs, even a small reduction in refrigeration energy use can offer significant cost savings, resulting in increased profits. Energy saving need not be expensive. Energy savings of up to 20% can be realised in many refrigeration plant through actions that require little or no investment. In addition, improving the efficiency and reducing the load on a refrigeration plant can improve reliability and reduce the likelihood of a breakdown. Most organisations can save energy and money on refrigeration by: More efficient equipment; Good maintenance; Housekeeping and control. This publication provides an understanding of the operation of refrigeration systems, identifies where savings can be realised and will enable readers to present an informed case on energy savings to key decision makers within their organisation. (GB)

Economic Impact of a Peritoneal Dialysis Continuous Quality Improvement Program in Colombia.

Science.gov (United States)

Makhija, Dilip U; Walton, Surrey M; Mora, Juan P; Sanabria, Rafael M

2017-01-01

♦ BACKGROUND: There is little information regarding the financial burden of peritonitis and the economic impact of continuous quality improvement (CQI) programs in peritoneal dialysis (PD) patients. The objectives of this study were to measure the costs of peritonitis, and determine the net savings of a PD CQI program in Colombia. ♦ METHODS: The Renal Therapy Services (RTS) network in Colombia, along with Coomeva EPS, provided healthcare resource utilization data for PD patients with and without peritonitis between January 2012 and December 2013. Propensity score matching and regression analysis were performed to estimate the incremental cost of peritonitis. Patient months at risk, episodes of peritonitis pre- and post-CQI, and costs of CQI were obtained. Annual net savings of the CQI program were estimated based on the number of peritonitis events prevented. ♦ RESULTS: The incremental cost of a peritonitis episode was $250. In an 8-year period, peritonitis decreased from 1,837 episodes per 38,596 patient-months in 2006 to 841 episodes per 50,910 patient-months in 2014. Overall, the CQI program prevented an estimated 10,409 episodes of peritonitis. The cost of implementing the CQI program was $147,000 in the first year and $119,000 annually thereafter. Using a five percent discount rate, the net present value of the program was $1,346,431, with an average annual net savings of $207,027. The return on investment (i.e. total savings-program cost/program cost) of CQI was 169%. ♦ CONCLUSION: Continuous quality improvement initiatives designed to reduce rates of peritonitis have a strong potential to generate cost savings. Copyright © 2017 International Society for Peritoneal Dialysis.

Saving for Success: Financial Education and Savings Goal Achievement in Individual Development Accounts

Science.gov (United States)

Grinstead, Mary L.; Mauldin, Teresa; Sabia, Joseph J.; Koonce, Joan; Palmer, Lance

2011-01-01

Using microdata from the American Dream Demonstration, the current study examines factors associated with savings and savings goal achievement (indicated by a matched withdrawal) among participants of individual development account (IDA) programs. Multinomial logit results show that hours of participation in financial education programs, higher…

Consumer-Operated Service Programs: monetary and donated costs and cost-effectiveness.

Science.gov (United States)

Yates, Brian T; Mannix, Danyelle; Freed, Michael C; Campbell, Jean; Johnsen, Matthew; Jones, Kristine; Blyler, Crystal R

2011-01-01

Examine cost differences between Consumer Operated Service Programs (COSPs) as possibly determined by a) size of program, b) use of volunteers and other donated resources, c) cost-of-living differences between program locales, d) COSP model applied, and e) delivery system used to implement the COSP model. As part of a larger evaluation of COSP, data on operating costs, enrollments, and mobilization of donated resources were collected for eight programs representing three COSP models (drop-in centers, mutual support, and education/advocacy training). Because the 8 programs were operated in geographically diverse areas of the US, costs were examined with and without adjustment for differences in local cost of living. Because some COSPs use volunteers and other donated resources, costs were measured with and without these resources being monetized. Scale of operation also was considered as a mediating variable for differences in program costs. Cost per visit, cost per consumer per quarter, and total program cost were calculated separately for funds spent and for resources donated for each COSP. Differences between COSPs in cost per consumer and cost per visit seem better explained by economies of scale and delivery system used than by cost-of-living differences between program locations or COSP model. Given others' findings that different COSP models produce little variation in service effectiveness, minimize service costs by maximizing scale of operation while using a delivery system that allows staff and facilities resources to be increased or decreased quickly to match number of consumers seeking services.

Crushing leads to waste disposal savings for FUSRAP

Energy Technology Data Exchange (ETDEWEB)

Darby, J. [Department of Energy, Oak Ridge, TN (United States)

1997-02-01

In this article the author discusses the application of a rock crusher as a means of implementing cost savings in the remediation of FUSRAP sites. Transportation and offsite disposal costs are at present the biggest cost items in the remediation of FUSRAP sites. If these debris disposal problems can be handled in different manners, then remediation savings are available. Crushing can result in the ability to handle some wastes as soil disposal problems, which have different disposal regulations, thereby permitting cost savings.

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.

A cost/benefit analysis of commercial fusion-fission hybrid reactor development

International Nuclear Information System (INIS)

Kostoff, R.N.

1983-01-01

A simple algorithm was developed that allows rapid computation of the ratio R, of present worth of benefits to present worth of hybrid RandD program costs as a function of potential hybrid unit electricity cost savings, discount rate, electricity demand growth rate, total hybrid RandD program cost, and time to complete a demonstration reactor. In the sensitivity study, these variables were assigned nominal values (unit electricity cost savings of 4 mills/k W-hr, discount rate of 4%/year, growth rate of 2.25%/year, total RandD program cost of $20 billion, and time to complete a demonstration reactor of 30 years), and the variable of interest was varied about its nominal value. Results show that R increases with decreasing discount rate and increasing unit electricity savings and ranges from 4 to 94 as discount rateranges from 5 to 3%/year and unit electricity savings range from 2 to 6 mills/k W-hr. R increases with increasing growth rate and ranges from 3 to 187 as growth rate ranges from 1 to 3.5%/year and unit electricity cost savings range from 2 to 6 mills/k W-hr. R attains a maximum value when plotted against time to complete a demonstration reactor. The location of this maximum value occurs at shorter completion times as discount rate increases, and this optimal completion time ranges from 20 years for a discount rate of 4%/year to 45 years for a discount rate of 3%/year

Space system production cost benefits from contemporary philosophies in management and manufacturing

Science.gov (United States)

Rosmait, Russell L.

1991-01-01

The cost of manufacturing space system hardware has always been expensive. The Engineering Cost Group of the Program Planning office at Marshall is attempting to account for cost savings that result from new technologies in manufacturing and management. The objective is to identify and define contemporary philosophies in manufacturing and management. The seven broad categories that make up the areas where technological advances can assist in reducing space system costs are illustrated. Included within these broad categories is a list of the processes or techniques that specifically provide the cost savings within todays design, test, production and operations environments. The processes and techniques listed achieve savings in the following manner: increased productivity; reduced down time; reduced scrap; reduced rework; reduced man hours; and reduced material costs. In addition, it should be noted that cost savings from production and processing improvements effect 20 to 40 pct. of production costs whereas savings from management improvements effects 60 to 80 of production cost. This is important because most efforts in reducing costs are spent trying to reduce cost in the production.

Study on measuring analysis for estimating effect of energy saving policy

Energy Technology Data Exchange (ETDEWEB)

Kim, Joong Ku; Park, Jeong Soon [Korea Energy Economics Institute, Euiwang (Korea)

1999-12-01

Since the study on measuring analysis for estimating effect of energy saving policy is too broad to implement all industries, so it limited its study only on manufacturing industry. This study is concentrated on its effort to measure energy saving using energy saving model by putting energy saving policy as an input and regarding its result as energy saving. It used B/C theory for positive analysis methodology and the result of analysis is investment effect on manufacturing industry. The total cost invested on manufacturing sector from 1982 to 1996 was 5,871 billion won based on constant cost in 1990, and the energy saving cost directly acquired from it reached 1,534.5 billion won based on constant cost in 1990, so B/C rate reached 2.56. Particularly, if you separated the amount supported by the government policy, energy saving support cost reached 3,904.2 billion won (based on constant cost in 1990) and the total benefit was 10,146.4 billion won (based on constant cost in 1990) by adding saving cost 9,997.9 billion won and environmental improvement effect 223.2 billion won. (author). 51 refs., 17 figs., 35 tabs.

Cost savings through innovative technologies

International Nuclear Information System (INIS)

Lankford, J.M.; Jackson, J.P.

1995-01-01

Newly developed technologies can and already are saving money. Other technologies under development will provide solutions to problems which are currently impossible or too expensive to address, and still others will offer alternative strategies where baseline approaches are not acceptable to the public. All of these options will be considered as the nation decides what it wishes to accomplish, and fund, to clean up the nuclear weapons complex

Cost effectiveness of teratology counseling - the Motherisk experience.

Science.gov (United States)

Koren, Gideon; Bozzo, Pina

2014-01-01

While the benefits of evidence-based counseling to large numbers of women and physicians are intuitively evident, there is an urgent need to document that teratology counseling, in addition to improving the quality of life of women and families, also leads to cost saving. The objective of the present study was to calculate the cost effectiveness of the Motherisk Program, a large teratology information and counseling service at The Hospital for Sick Children and the University of Toronto. We analyzed data from the Motherisk Program on its 2012 activities in two domains: 1) Calculation of cost-saving in preventing unjustified pregnancy terminations; and 2) prevention of major birth defects. Cost of pregnancy termination and lifelong cost of specific birth defects were identified from primary literature and prorated for cost of living for the year 2013. Prevention of 255 pregnancy terminations per year led to cost savings of $516,630. The total estimated number of major malformations prevented by Motherisk counseling in 2012 was 8.41 cases at a total estimated cost of $9,032,492. With an estimated minimum annual prevention of 8 major malformations, and numerous unnecessary terminations of otherwise- wanted pregnancies, a cost saving of $10 million can be calculated. In 2013 the operating budget of Motherisk counseling totaled $640,000. Even based on the narrow range of activities for which we calculated cost, this service is highly cost- effective. Because most teratology counseling services are operating in a very similar method to Motherisk, it is fair to assume that these results, although dependent on the size of the service, are generalizable to other countries.

Caring Wisely: A Program to Support Frontline Clinicians and Staff in Improving Healthcare Delivery and Reducing Costs.

Science.gov (United States)

Gonzales, Ralph; Moriates, Christopher; Lau, Catherine; Valencia, Victoria; Imershein, Sarah; Rajkomar, Alvin; Prasad, Priya; Boscardin, Christy; Grady, Deborah; Johnston, S

2017-08-01

We describe a program called "Caring Wisely"®, developed by the University of California, San Francisco's (UCSF), Center for Healthcare Value, to increase the value of services provided at UCSF Health. The overarching goal of the Caring Wisely® program is to catalyze and advance delivery system redesign and innovations that reduce costs, enhance healthcare quality, and improve health outcomes. The program is designed to engage frontline clinicians and staff-aided by experienced implementation scientists-to develop and implement interventions specifically designed to address overuse, underuse, or misuse of services. Financial savings of the program are intended to cover the program costs. The theoretical underpinnings for the design of the Caring Wisely® program emphasize the importance of stakeholder engagement, behavior change theory, market (target audience) segmentation, and process measurement and feedback. The Caring Wisely® program provides an institutional model for using crowdsourcing to identify "hot spot" areas of low-value care, inefficiency and waste, and for implementing robust interventions to address these areas. © 2017 Society of Hospital Medicine.

A method for estimating maternal and newborn lives saved from health-related investments funded by the UK government Department for International Development using the Lives Saved Tool

Directory of Open Access Journals (Sweden)

Ingrid K. Friberg

2017-11-01

Full Text Available Abstract Background In 2010, the UK Government Department for International Development (DFID committed through its 'Framework for results for reproductive, maternal and newborn health (RMNH' to save 50,000 maternal lives and 250,000 newborn lives by 2015. They also committed to monitoring the performance of this portfolio of investments to demonstrate transparency and accountability. Methods currently available to directly measure lives saved are cost-, time-, and labour-intensive. The gold standard for calculating the total number of lives saved would require measuring mortality with large scale population based surveys or annual vital events surveillance. Neither is currently available in all low- and middle-income countries. Estimating the independent effect of DFID support relative to all other effects on health would also be challenging. Methods The Lives Saved Tool (LiST is an evidence based software for modelling the effect of changes in health intervention coverage on reproductive, maternal, newborn and child mortality. A multi-country LiST-based analysis protocol was developed to retrospectively assess the total annual number of maternal and newborn lives saved from DFID aid programming in low- and middle-income countries. Results Annual LiST analyses using the latest program data from DFID country offices were conducted between 2013 and 2016, estimating the annual number of maternal and neonatal lives saved across 2010–2015. For each country, independent project results were aggregated into health intervention coverage estimates, with and in the absence of DFID funding. More than 80% of reported projects were suitable for inclusion in the analysis, with 151 projects analysed in the 2016 analysis. Between 2010 and 2014, it is estimated that DFID contributed to saving the lives of 15,000 women in pregnancy and childbirth with health programming and 88,000 with family planning programming. It is estimated that DFID health programming

A method for estimating maternal and newborn lives saved from health-related investments funded by the UK government Department for International Development using the Lives Saved Tool.

Science.gov (United States)

Friberg, Ingrid K; Baschieri, Angela; Abbotts, Jo

2017-11-07

In 2010, the UK Government Department for International Development (DFID) committed through its 'Framework for results for reproductive, maternal and newborn health (RMNH)' to save 50,000 maternal lives and 250,000 newborn lives by 2015. They also committed to monitoring the performance of this portfolio of investments to demonstrate transparency and accountability. Methods currently available to directly measure lives saved are cost-, time-, and labour-intensive. The gold standard for calculating the total number of lives saved would require measuring mortality with large scale population based surveys or annual vital events surveillance. Neither is currently available in all low- and middle-income countries. Estimating the independent effect of DFID support relative to all other effects on health would also be challenging. The Lives Saved Tool (LiST) is an evidence based software for modelling the effect of changes in health intervention coverage on reproductive, maternal, newborn and child mortality. A multi-country LiST-based analysis protocol was developed to retrospectively assess the total annual number of maternal and newborn lives saved from DFID aid programming in low- and middle-income countries. Annual LiST analyses using the latest program data from DFID country offices were conducted between 2013 and 2016, estimating the annual number of maternal and neonatal lives saved across 2010-2015. For each country, independent project results were aggregated into health intervention coverage estimates, with and in the absence of DFID funding. More than 80% of reported projects were suitable for inclusion in the analysis, with 151 projects analysed in the 2016 analysis. Between 2010 and 2014, it is estimated that DFID contributed to saving the lives of 15,000 women in pregnancy and childbirth with health programming and 88,000 with family planning programming. It is estimated that DFID health programming contributed to saving 187,000 newborn lives. It is

In-office diagnostic arthroscopy for knee and shoulder intra-articular injuries its potential impact on cost savings in the United States

Science.gov (United States)

2014-01-01

Background The purpose of this analysis was to determine whether in office diagnostic needle arthroscopy (Visionscope Imaging System [VSI]) can provide for improved diagnostic assessment and; more cost effective care. Methods Data on arthroscopy procedures in the US for deep seated pathology in the knee and shoulder were used (Calendar Year 2012). These procedures represent approximately 25-30% of all arthroscopic procedures performed annually. Sensitivities, specificities, positive predictive, and negative predictive values for MRI analysis of this deep seated pathology from systematic reviews and meta-analyses were used in assessing for false positive and false negative MRI findings. The costs of performing diagnostic and surgical arthroscopy procedures (using 2013 Medicare reimbursement amounts); costs associated with false negative findings; and the costs for treating associated complications arising from diagnostic and therapeutic arthroscopy procedures were then assessed. Results In patients presenting with medial meniscal pathology (ICD9CM diagnosis 836.0 over 540,000 procedures in CY 2012); use of the VSI system in place of MRI assessment (standard of care) resulted in a net cost savings to the system of $151 million. In patients presenting with rotator cuff pathology (ICD9CM 840.4 over 165,000 procedures in CY2012); use of VSI in place of MRI similarly saved $59 million. These savings were realized along with more appropriate care as; fewer patients were exposed to higher risk surgical arthroscopic procedures. Conclusions The use of an in-office arthroscopy system can: possibly save the US healthcare system money; shorten the diagnostic odyssey for patients; potentially better prepare clinicians for arthroscopic surgery (when needed) and; eliminate unnecessary outpatient arthroscopy procedures, which commonly result in surgical intervention. PMID:24885678

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

International Nuclear Information System (INIS)

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

2014-01-01

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

Demonstration of energy-saving construction works; Shoshigenka wo mezashita kenchiku koji no jissho kenkyu

Energy Technology Data Exchange (ETDEWEB)

Kobayashi, T.; Yamagishi, M.; Kakimi, S. [Chubu Electric Power Co. Inc., Nagoya (Japan)

1997-11-01

Studies are conducted to promote energy-saving in construction works as part of environment protection programs. The first phase is for survey and analysis works for energy-saving in the current building design and construction works, and for processes, procedures and materials in model works (construction of sub-stations). The second phase is for studying energy-saving designs, materials and procedures, which are applied to model works, to assess their energy-saving effects , costs and applicability. The horizontally developed samples are prepared for the future development, based on the `continuous improvement of environment-management systems by establishing the PDCA cycles,` which is one of the basic requirements of the ISO14001 (environment management system). These efforts have reduced CO2 emissions associated with the manufacture of construction materials by 20%, mixed wastes by 45%, and plywood frame requirement by 70%. It is also confirmed that they can be realized at only around 3% higher cost. 9 refs., 10 figs., 3 tabs.

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.

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.

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.

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.

Dedicated orthogeriatric service saves the HSE a million euro

LENUS (Irish Health Repository)

Shanahan, E

2016-03-01

Hip fracture is common in older adults and is associated with high morbidity, mortality and significant health care costs. A pilot orthogeriatrics service was established in an acute hospital. We aimed to establish the cost effectiveness of this service. Length of hospital stay, discharge destination and rehabilitation requirements were analysed for a one year period and compared to patients who received usual care prior to the service. We calculated the costs incurred and savings produced by the orthogeriatric service. Median length of stay was reduced by 3 days (p=<0.001) saving €266,976. There was a 19% reduction in rehabilitation requirements saving €192,600. Median rehabilitation length of stay was reduced by 6.5 days saving €171,093. Reductions in long term care requirements led to savings of €10,934 per week. Costs to establish such a service amount to €171,564. The introduction of this service led to improved patient outcomes in a cost effective manner.

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.

Chapter 11: Sample Design Cross-Cutting Protocol. The Uniform Methods Project: Methods for Determining Energy Efficiency Savings for Specific Measures

Energy Technology Data Exchange (ETDEWEB)

Kurnik, Charles W [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Khawaja, M. Sami [The Cadmus Group, Portland, OR (United States); Rushton, Josh [The Cadmus Group, Portland, OR (United States); Keeling, Josh [The Cadmus Group, Portland, OR (United States)

2017-09-01

Evaluating an energy efficiency program requires assessing the total energy and demand saved through all of the energy efficiency measures provided by the program. For large programs, the direct assessment of savings for each participant would be cost-prohibitive. Even if a program is small enough that a full census could be managed, such an undertaking would almost always be an inefficient use of evaluation resources. The bulk of this chapter describes methods for minimizing and quantifying sampling error. Measurement error and regression error are discussed in various contexts in other chapters.

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.

Market analysis, energy savings potential, and future development requirements for Radiance. Final report

Energy Technology Data Exchange (ETDEWEB)

1993-10-01

The Department of Energy (DOE) Office of Conservation and Renewable Energy (CE), Building Equipment Division has funded the development of a sophisticated computer rendering program called Radiance at Lawrence Berkeley Laboratories (LBL). The project review study included: (1) Surveys of the lighting profession to determine how designers would use an improved, user-friendly Radiance, (2) Elucidation of features, including how Radiance could be used to save energy, which could be incorporated into Radiance to facilitate its more widespread use, (3) Outline of a development plan and determination of what costs the DOE might incur if it were to proceed with the development of an improved version, and (4) Weighing the anticipated development costs against anticipated energy-saving benefits.

Saving Energy. Managing School Facilities, Guide 3.

Science.gov (United States)

Department for Education and Employment, London (England). Architects and Building Branch.

This guide offers information on how schools can implement an energy saving action plan to reduce their energy costs. Various low-cost energy-saving measures are recommended covering heating levels and heating systems, electricity demand reduction and lighting, ventilation, hot water usage, and swimming pool energy management. Additional…

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

Dedicated Perioperative Hip Fracture Comanagement Programs are Cost-effective in High-volume Centers: An Economic Analysis.

Science.gov (United States)

Swart, Eric; Vasudeva, Eshan; Makhni, Eric C; Macaulay, William; Bozic, Kevin J

2016-01-01

Osteoporotic hip fractures are common injuries typically occurring in patients who are older and medically frail. Studies have suggested that creation of a multidisciplinary team including orthopaedic surgeons, internal medicine physicians, social workers, and specialized physical therapists, to comanage these patients can decrease complication rates, improve time to surgery, and reduce hospital length of stay; however, they have yet to achieve widespread implementation, partly owing to concerns regarding resource requirements necessary for a comanagement program. We performed an economic analysis to determine whether implementation of a comanagement model of care for geriatric patients with osteoporotic hip fractures would be a cost-effective intervention at hospitals with moderate volume. We also calculated what annual volume of cases would be needed for a comanagement program to "break even", and finally we evaluated whether universal or risk-stratified comanagement was more cost effective. Decision analysis techniques were used to model the effect of implementing a systems-based strategy to improve inpatient perioperative care. Costs were obtained from best-available literature and included salary to support personnel and resources to expedite time to the operating room. The major economic benefit was decreased initial hospital length of stay, which was determined via literature review and meta-analysis, and a health benefit was improvement in perioperative mortality owing to expedited preoperative evaluation based on previously conducted meta-analyses. A break-even analysis was conducted to determine the annual case volume necessary for comanagement to be either (1) cost effective (improve health-related quality of life enough to be worth additional expenses) or (2) result in cost savings (actually result in decreased total expenses). This calculation assumed the scenario in which a hospital could hire only one hospitalist (and therapist and social worker) on

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

The relationship between health risks and health and productivity costs among employees at Pepsi Bottling Group.

Science.gov (United States)

Henke, Rachel M; Carls, Ginger S; Short, Meghan E; Pei, Xiaofei; Wang, Shaohung; Moley, Susan; Sullivan, Mark; Goetzel, Ron Z

2010-05-01

To evaluate relationships between modifiable health risks and costs and measure potential cost savings from risk reduction programs. Health risk information from active Pepsi Bottling Group employees who completed health risk assessments between 2004 and 2006 (N = 11,217) were linked to medical care, workers' compensation, and short-term disability cost data. Ten health risks were examined. Multivariate analyses were performed to estimate costs associated with having high risk, holding demographics, and other risks constant. Potential savings from risk reduction were estimated. High risk for weight, blood pressure, glucose, and cholesterol had the greatest impact on total costs. A one-percentage point annual reduction in the health risks assessed would yield annual per capita savings of $83.02 to $103.39. Targeted programs that address modifiable health risks are expected to produce substantial cost reductions in multiple benefit categories.

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 day readmissions, postoperative infections, operating time, or reoperations. This retrospective study is subject to the accuracy of the medical chart system. In addition, specific instrument 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.

Determining if disease management saves money: an introduction to meta-analysis.

Science.gov (United States)

Linden, Ariel; Adams, John L

2007-06-01

Disease management (DM) programmes have long been promoted as a major medical cost-saving mechanism, even though the scant research that exists on the topic has provided conflicting results. In a 2004 literature review, the Congressional Budget Office stated that 'there is insufficient evidence to conclude that disease management programs can generally reduce the overall cost of health care services'. To address this question more accurately, a meta-analysis was warranted. Meta-analysis is the quantitative technique used to pool the results of many studies on the same topic and summarize them statistically. This method is also quite suitable for individual DM firms to assess whether their programmes are effective at the aggregate level. This paper describes the elements of a rigorous meta-analytic process and discusses potential biases. A hypothetical DM organization is then evaluated with a specific emphasis on medical cost-savings, simulating a case in which different populations are served, evaluation methodologies are employed, and diseases are managed.

Cost-benefit analysis of targeted hearing directed early testing for congenital cytomegalovirus infection.

Science.gov (United States)

Bergevin, Anna; Zick, Cathleen D; McVicar, Stephanie Browning; Park, Albert H

2015-12-01

In this study, we estimate an ex ante cost-benefit analysis of a Utah law directed at improving early cytomegalovirus (CMV) detection. We use a differential cost of treatment analysis for publicly insured CMV-infected infants detected by a statewide hearing-directed CMV screening program. Utah government administrative data and multi-hospital accounting data are used to estimate and compare costs and benefits for the Utah infant population. If antiviral treatment succeeds in mitigating hearing loss for one infant per year, the public savings will offset the public costs incurred by screening and treatment. If antiviral treatment is not successful, the program represents a net cost, but may still have non-monetary benefits such as accelerated achievement of diagnostic milestones. The CMV education and treatment program costs are modest and show potential for significant cost savings. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

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

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,...

Costs and cost-effectiveness of full implementation of a biennial faecal occult blood test screening program for bowel cancer in Australia.

Science.gov (United States)

Pignone, Michael P; Flitcroft, Kathy L; Howard, Kirsten; Trevena, Lyndal J; Salkeld, Glenn P; St John, D James B

2011-02-21

To examine the costs and cost-effectiveness of full implementation of biennial bowel cancer screening for Australian residents aged 50-74 years. Identification of existing economic models from 1993 to 2010 through searches of PubMed and economic analysis databases, and by seeking expert advice; and additional modelling to determine the costs and cost-effectiveness of full implementation of biennial faecal occult blood test screening for the five million adults in Australia aged 50-74 years. Estimated number of deaths from bowel cancer prevented, costs, and cost-effectiveness (cost per life-year gained [LYG]) of biennial bowel cancer screening. We identified six relevant economic analyses, all of which found colorectal cancer (CRC) screening to be very cost-effective, with costs per LYG under $55,000 per year in 2010 Australian dollars. Based on our additional modelling, we conservatively estimate that full implementation of biennial screening for people aged 50-74 years would have gross costs of $150 million, reduce CRC mortality by 15%-25%, prevent 300-500 deaths from bowel cancer, and save 3600-6000 life-years annually, for an undiscounted cost per LYG of $25,000-$41,667, compared with no screening, and not taking cost savings as a result of treatment into consideration. The additional expenditure required, after accounting for reductions in CRC incidence, savings in CRC treatment costs, and existing ad-hoc colonoscopy use, is likely to be less than $50 million annually. Full implementation of biennial faecal occult blood test screening in Australia can reduce bowel cancer mortality, and is an efficient use of health resources that would require modest additional government investment.

No Cost – Low Cost Compressed Air System Optimization in Industry

Science.gov (United States)

Dharma, A.; Budiarsa, N.; Watiniasih, N.; Antara, N. G.

2018-04-01

Energy conservation is a systematic, integrated of effort, in order to preserve energy sources and improve energy utilization efficiency. Utilization of energy in efficient manner without reducing the energy usage it must. Energy conservation efforts are applied at all stages of utilization, from utilization of energy resources to final, using efficient technology, and cultivating an energy-efficient lifestyle. The most common way is to promote energy efficiency in the industry on end use and overcome barriers to achieve such efficiency by using system energy optimization programs. The facts show that energy saving efforts in the process usually only focus on replacing tools and not an overall system improvement effort. In this research, a framework of sustainable energy reduction work in companies that have or have not implemented energy management system (EnMS) will be conducted a systematic technical approach in evaluating accurately a compressed-air system and potential optimization through observation, measurement and verification environmental conditions and processes, then processing the physical quantities of systems such as air flow, pressure and electrical power energy at any given time measured using comparative analysis methods in this industry, to provide the potential savings of energy saving is greater than the component approach, with no cost to the lowest cost (no cost - low cost). The process of evaluating energy utilization and energy saving opportunities will provide recommendations for increasing efficiency in the industry and reducing CO2 emissions and improving environmental quality.

Medical Care Expenditures for Individuals with Prediabetes: The Potential Cost Savings in Reducing the Risk of Developing Diabetes.

Science.gov (United States)

Khan, Tamkeen; Tsipas, Stavros; Wozniak, Gregory

2017-10-01

The United States has 86 million adults with prediabetes. Individuals with prediabetes can prevent or delay the development of type 2 diabetes through lifestyle modifications such as participation in the National Diabetes Prevention Program (DPP), thereby mitigating the medical and economic burdens associated with diabetes. A cohort analysis of a commercially insured population was conducted using individual-level claims data from Truven Health MarketScan ® Lab Database to identify adults with prediabetes, track whether they develop diabetes, and compare medical expenditures for those who are newly diagnosed with diabetes to those who are not. This study then illustrates how reducing the risk of developing diabetes by participation in an evidence-based lifestyle change program could yield both positive net savings on medical care expenditures and return on investment (ROI). Annual expenditures are found to be nearly one third higher for those who develop diabetes in subsequent years relative to those who do not transition from prediabetes to diabetes, with an average difference of $2671 per year. At that cost differential, the 3-year ROI for a National DPP is estimated to be as high as 42%. The results show the importance and economic benefits of participation in lifestyle intervention programs to prevent or delay the onset of type 2 diabetes.

Program evaluation: Weatherization Residential Assistance Partnership (WRAP) Program

Energy Technology Data Exchange (ETDEWEB)

1991-12-01

The Connecticut low income weatherization program was developed in response to a 1987 rate docket order from the Connecticut Department of Public Utility Control (DPUC) to Connecticut Light Power Co., an operating subsidiary of Northeast Utilities (NU). (Throughout this report, NU is referred to as the operator of the program.) This program, known as the Weatherization Residential Assistance Partnership, or WRAP, was configured utilizing input from a collaborative group of interested parties to the docket. It was agreed that this program would be put forth by the electric utility, but would not ignore oil and gas savings (thus, it was to be fuel- blind''). The allocated cost of conservation services for each fuel source, however, should be cost effective. It was to be offered to those utility customers at or below 200 percent of the federal poverty levels, and provide a wide array of energy saving measures directed toward heating, water heating and lighting. It was felt by the collaborative group that this program would raise the level of expenditures per participant for weatherization services provided by the state, and by linking to and revising the auditing process for weatherization, would lower the audit unit cost. The program plans ranged from the offering of low-cost heating, water heating and infiltration measures, increased insulation levels, carpentry and plumbing services, to furnace or burner replacement. The program was configured to allow for very comprehensive weatherization and heating system servicing.

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.

Cost-benefit assessment of energy efficiency investments: Accounting for future resources, savings and risks in the Australian residential sector

International Nuclear Information System (INIS)

Morrissey, J.; Meyrick, B.; Sivaraman, D.; Horne, R.E.; Berry, M.

2013-01-01

This article focuses on the impact of the discount rate on cost-benefit assessment of investment options for residential building efficiency. An integrated thermal modeling, life cycle costing approach is applied to an extensive sample of dominant house designs for Australian conditions. The relative significance of predicted thermal performance and the applied discount rate on the Present Value of energy savings from alternative investment scenarios is investigated. Costs and benefits are also evaluated at the economy-wide scale, including carbon pricing considerations, and for a test-case household faced with alternative investment options at the point of construction. The influence of the applied discount rate on produced cost-benefit calculations is investigated, as is the interaction between critical cost-benefit input parameters. Findings support that the discounting framework is the primary driver of difference in estimates about costs and benefits of higher standards of efficiency in the residential sector. Results demonstrate that agreement on a low discount rate based on sustainability principals would prioritise those projects with significant environmental benefits. - Highlights: ► High thermal efficiency is a key strategy to limit energy use in buildings. ► Integrated thermal modeling—life-cycle costing methods are applied to dominant house designs. ► The discounting framework is the primary driver of difference in observed costs. ► The selection of optimal performance investment options depends on the discount rate. ► Application of a discount rate of 3.5% or lower favours energy saving projects

An Information Framework for Facilitating Cost Saving of Environmental Impacts in the Coal Mining Industry in South Africa

Directory of Open Access Journals (Sweden)

Mashudu D. Mbedzi

2018-05-01

Full Text Available Coal-mining contributes much to the economic welfare of a country. Yet it brings along a number of challenges, notably environmental impacts which include water pollution in a water scarce country such as South Africa. This research is conducted in two phases. The first phase intends to establish environmental and other challenges brought about by the coal-mining industry through a comprehensive analysis of available literature. Combatting these challenges is costly; consequently, our work investigates how established management accounting tools and techniques such as Environmental Management Accounting (EMA, Material Flow Cost Accounting (MFCA and Life Cycle Costing (LCC may facilitate cost savings for the companies involved. These techniques promote increased transparency of material usage by tracing and quantifying the flows and inventories of materials within the coal-mining industry in physical and monetary terms, hence hidden costs are elicited. The researchers postulate that an Information Framework integrating these aspects may be the way forward. To this end existing frameworks in the literature are identified. A number of research questions embodying the above aspects are defined and the objective is to define a conceptual framework to facilitate cost savings for coal-mining companies. The main contribution of this work is an information framework presented towards the end of this article. The second phase of the research will involve fieldwork in the form of a survey among stakeholders in industry to validate the conceptual framework.

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.

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

Evaluation of Medicare Health Support chronic disease pilot program.

Science.gov (United States)

Cromwell, Jerry; McCall, Nancy; Burton, Joe

2008-01-01

The Medicare Program is conducting a randomized trial of care management services among fee-for-service (FFS) beneficiaries called the Medicare Health Support (MHS) pilot program. Eight disease management (DM) companies have contracted with CMS to improve clinical quality, increase beneficiary and provider satisfaction, and achieve targeted savings for chronically ill Medicare FFS beneficiaries. In this article, we present 6-month intervention results on beneficiary selection and participation rates, mortality rates, trends in hospitalizations, and success in achieving Medicare cost savings. Results to date indicate limited success in achieving Medicare cost savings or reducing acute care utilization.

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.

Improving the thermal integrity of new single-family detached residential buildings: Documentation for a regional database of capital costs and space conditioning load savings

International Nuclear Information System (INIS)

Koomey, J.G.; McMahon, J.E.; Wodley, C.

1991-07-01

This report summarizes the costs and space-conditioning load savings from improving new single-family building shells. It relies on survey data from the National Association of Home-builders (NAHB) to assess current insulation practices for these new buildings, and NAHB cost data (aggregated to the Federal region level) to estimate the costs of improving new single-family buildings beyond current practice. Space-conditioning load savings are estimated using a database of loads for prototype buildings developed at Lawrence Berkeley Laboratory, adjusted to reflect population-weighted average weather in each of the ten federal regions and for the nation as a whole

The future of utility customer-funded energy efficiency programs in the USA. Projected spending and savings to 2025

Energy Technology Data Exchange (ETDEWEB)

Barbose, G.L.; Goldman, C.A.; Hoffman, I.M.; Billingsley, M. [Ernest Orlando Lawrence Berkeley National Laboratory, One Cyclotron Road, MS 90R4000, Berkeley, CA 94720-8136 (United States)

2013-08-15

We develop projections of future spending on, and savings from, energy efficiency programs funded by electric and gas utility customers in the USA, 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). Key findings from the analysis are as follows: (1) By 2025, spending on electric and gas efficiency programs (excluding load management programs) is projected to double from 2010 levels to USD 9.5 billion in the medium case, compared to USD 15.6 billion in the high case and USD 6.5 billion in the low case; (2) 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; (3) 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 USA spending in 2010 to slightly more than 50 % in 2025, and the South and Midwest splitting the remainder roughly evenly; (4) Under our medium case scenario, annual incremental savings from customer-funded electric energy efficiency programs increase from 18.4 TWh in 2010 in the USA (which is about 0.5 % of electric utility retail sales) to 28.8 TWh in 2025 (0.8 % of retail sales); (5) 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

An Audit of Repeat Testing at an Academic Medical Center: Consistency of Order Patterns With Recommendations and Potential Cost Savings.

Science.gov (United States)

Hueth, Kyle D; Jackson, Brian R; Schmidt, Robert L

2018-05-31

To evaluate the prevalence of potentially unnecessary repeat testing (PURT) and the associated economic burden for an inpatient population at a large academic medical facility. We evaluated all inpatient test orders during 2016 for PURT by comparing the intertest times to published recommendations. Potential cost savings were estimated using the Centers for Medicare & Medicaid Services maximum allowable reimbursement rate. We evaluated result positivity as a determinant of PURT through logistic regression. Of the evaluated 4,242 repeated target tests, 1,849 (44%) were identified as PURT, representing an estimated cost-savings opportunity of $37,376. Collectively, the association of result positivity and PURT was statistically significant (relative risk, 1.2; 95% confidence interval, 1.1-1.3; P < .001). PURT contributes to unnecessary health care costs. We found that a small percentage of providers account for the majority of PURT, and PURT is positively associated with result positivity.

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.

Save Energy Now Assessments Results 2008 Detailed Report

Energy Technology Data Exchange (ETDEWEB)

Wright, Anthony L [ORNL; Martin, Michaela A [ORNL; Nimbalkar, Sachin U [ORNL; Quinn, James [U.S. Department of Energy; Glatt, Ms. Sandy [DOE Industrial Technologies Program; Orthwein, Mr. Bill [U.S. Department of Energy

2010-09-01

In October 2005, U.S. Department of 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. 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 savings assessment. The approach for these assessments drew heavily on the existing resources of ITP's technology delivery component. Over the years, ITP Technology Delivery has worked with industry partners to assemble a suite of respected software tools, proven assessment protocols, training curricula, certified energy experts, and strong partnerships for deployment. The Save Energy Now assessments conducted in calendar year 2006 focused on natural gas savings and targeted many of the nation's largest manufacturing plants - those that consume at least 1 TBtu of energy annually. The 2006 Save Energy Now assessments focused primarily on assessments of steam and process heating systems, which account for an estimated 74% of all natural gas use by U.S. manufacturing plants. Because of the success of the Save Energy Now assessments conducted in 2006 and 2007, the program was expanded and enhanced in two major ways in 2008: (1) a new goal was set to perform at least 260 assessments; and (2) the assessment focus was expanded to include pumping, compressed air, and fan systems in addition to steam and process heating. DOE ITP also has developed software tools to assess energy efficiency improvement opportunities in pumping, compressed air, and fan systems. The Save Energy Now assessments integrate a strong training component designed to teach industrial plant personnel how to use DOE's opportunity assessment software tools. This approach has the advantages of promoting strong buy-in of plant personnel for the assessment and its outcomes and preparing them better to

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

Poor Families Striving to Save in Matched Children's Savings Accounts: Findings from a Randomized Experimental Design in Uganda.

Science.gov (United States)

Karimli, Leyla; Ssewamala, Fred M; Neilands, Torsten B

2014-12-01

This study examines participants' savings in children's savings accounts (CSAs) set up for AIDS-orphaned children ages 10-15 in Uganda. Using a cluster randomized experimental design, we examine the extent to which families participating in a CSA program report more savings than their counterparts not participating in the program, explore the extent to which families who participate in the CSA program report using formal financial institutions compared with families who do not have a CSA, and consider whether families participating in the CSA program bring new money into the CSA or whether they reshuffle existing household assets. We find that participating in a CSA increased families' likelihood to report having saved money. However, our results show no intervention effect either on the amount of self-reported savings or on the likelihood of using formal financial institutions. Further research is needed to understand whether use of a CSA helps families generate new wealth.

Energy savings potential from energy-conserving irrigation systems

Energy Technology Data Exchange (ETDEWEB)

Wilfert, G.L.; Patton, W.P.; Harrer, B.J.; Clark, M.A.

1982-11-01

This report systematically compares, within a consistent framework, the technical and economic characteristics of energy-conserving irrigation systems with those of conventional irrigation systems and to determine total energy savings. Levelized annual costs of owning and operating both energy-conserving and conventional irrigation systems have been developed and compared for all 17 states to account for the differences in energy costs and irrigation conditions in each state. Market penetration of energy-conserving systems is assessed for those systems having lower levelized annual costs than conventional systems performing the same function. Annual energy savings were computed by matching the energy savings per system with an assumed maximum market penetration of 100 percent in those markets where the levelized annual costs of energy-conserving systems are lower than the levelized annual costs of conventional systems.

Incorporating indirect costs into a cost-benefit analysis of laparoscopic adjustable gastric banding.

Science.gov (United States)

Finkelstein, Eric A; Allaire, Benjamin T; Dibonaventura, Marco Dacosta; Burgess, Somali M

2012-01-01

The objective of this study was to estimate the time to breakeven and 5-year net costs of laparoscopic adjustable gastric banding (LAGB) taking both direct and indirect costs and cost savings into account. Estimates of direct cost savings from LAGB were available from the literature. Although longitudinal data on indirect cost savings were not available, these estimates were generated by quantifying the relationship between medical expenditures and absenteeism and between medical expenditures and presenteeism (reduced on-the-job productivity) and combining these elasticity estimates with estimates of the direct cost savings to generate total savings. These savings were then combined with the direct and indirect costs of the procedure to quantify net savings. By including indirect costs, the time to breakeven was reduced by half a year, from 16 to 14 quarters. After 5 years, net savings in medical expenditures from a gastric banding procedure were estimated to be $4970 (±$3090). Including absenteeism increased savings to $6180 (±$3550). Savings were further increased to $10,960 (±$5864) when both absenteeism and presenteeism estimates were included. This study presented a novel approach for including absenteeism and presenteeism estimates in cost-benefit analyses. Application of the approach to gastric banding among surgery-eligible obese employees revealed that the inclusion of indirect costs and cost savings improves the business case for the procedure. This approach can easily be extended to other populations and treatments. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

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.

Does Prevention Pay? Costs and Potential Cost-savings of School Interventions Targeting Children with Mental Health Problems.

Science.gov (United States)

Wellander, Lisa; Wells, Michael B; Feldman, Inna

2016-06-01

In Sweden, the local government is responsible for funding schools in their district. One funding initiative is for schools to provide students with mental health problems with additional support via extra teachers, personal assistants, and special education classes. There are evidence-based preventive interventions delivered in schools, which have been shown to decrease the levels of students' mental health problems. However, little is known about how much the local government currently spends on students' mental health support and if evidence-based interventions could be financially beneficial. The aim of this study was to estimate the costs of providing additional support for students' mental health problems and the potential cost-offsets, defined as reduced school-based additional support, if two evidence-based school interventions targeting children's mental health problems were implemented in routine practice. This study uses data on the additional support students with mental health problems received in schools. Data was collected from one school district for students aged 6 to 16 years. We modeled two Swedish school interventions, Comet for Teachers and Social and Emotional Training (SET), which both had evidence of reducing mental health problems. We used a cost-offset analysis framework, assuming both interventions were fully implemented throughout the whole school district. Based on the published studies, the expected effects and the costs of the interventions were calculated. We defined the cost-offsets as the amount of predicted averted additional support for students with ongoing mental health problems who might no longer require receiving services such as one-on-one time with an extra teacher, a personal assistant, or to be placed in a special education classroom. A cost-offset analysis, from a payer's perspective (the local government responsible for school financing), was conducted comparing the costs of both interventions with the potential cost-savings

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

Science.gov (United States)

Ehrenkranz, P; Lanata, C F; Penny, M E; Salazar-Lindo, E; Glass, R I

2001-10-01

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. 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. 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. 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.

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.

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.

Energy-saving engines reduce operating cost and environmental pollution; Energiesparmotoren senken die Betriebskosten und schonen die Umwelt

Energy Technology Data Exchange (ETDEWEB)

Maletz, H.; Stengel, S. [Siemens AG, Erlangen (Germany). Automatisierungs- und Antriebstechnik

1999-07-01

Reduction of the energy cost will make production more economical and, in consequence, gain a competitive advantage. In view of high energy cost, new international legislation and increasing energy-awareness, the new generation of energy-saving engines is gaining increasing acceptance. [German] Hohe Energiekosten schlagen im Rahmen der Betriebskosten voll zu Buche. Gelingt es, sie spuerbar zu senken, wird die Produktion letzten Endes wirtschaftlicher und wettbewerbsfaehiger. Vor dem Hintergrund hoher Energiepreise, der neuen internationalen Gesetzgebung und zunehmenden Energiebewusstseins, gewinnen Energiesparmotoren der neuen Generation zunehmend an Bedeutung. (orig.)

The cost of assisted outpatient treatment: can it save states money?

Science.gov (United States)

Swanson, Jeffrey W; Van Dorn, Richard A; Swartz, Marvin S; Robbins, Pamela Clark; Steadman, Henry J; McGuire, Thomas G; Monahan, John

2013-12-01

The authors assessed a state's net costs for assisted outpatient treatment, a controversial court-ordered program of community-based mental health services designed to improve outcomes for persons with serious mental illness and a history of repeated hospitalizations attributable to nonadherence with outpatient treatment. A comprehensive cost analysis was conducted using 36 months of observational data for 634 assisted outpatient treatment participants and 255 voluntary recipients of intensive community-based treatment in New York City and in five counties elsewhere in New York State. Administrative, budgetary, and service claims data were used to calculate and summarize costs for program administration, legal and court services, mental health and other medical treatment, and criminal justice involvement. Adjusted effects of assisted outpatient treatment and voluntary intensive services on total service costs were examined using multivariate time-series regression analysis. In the New York City sample, net costs declined 43% in the first year after assisted outpatient treatment began and an additional 13% in the second year. In the five-county sample, costs declined 49% in the first year and an additional 27% in the second year. Psychotropic drug costs increased during the first year after initiation of assisted outpatient treatment, by 40% and 44% in the city and five-county samples, respectively. Regression analyses revealed significant declines in costs associated with both assisted outpatient treatment and voluntary participation in intensive services, although the cost declines associated with assisted outpatient treatment were about twice as large as those seen for voluntary services. Assisted outpatient treatment requires a substantial investment of state resources but can reduce overall service costs for persons with serious mental illness. For those who do not qualify for assisted outpatient treatment, voluntary participation in intensive community

Exploring efficacy of residential energy efficiency programs in Florida

Science.gov (United States)

Taylor, Nicholas Wade

Electric utilities, government agencies, and private interests in the U.S. have committed and continue to invest substantial resources in the pursuit of energy efficiency and conservation through demand-side management (DSM) programs. Program investments, and the demand for impact evaluations that accompany them, are projected to grow in coming years due to increased pressure from state-level energy regulation, costs and challenges of building additional production capacity, fuel costs and potential carbon or renewable energy regulation. This dissertation provides detailed analyses of ex-post energy savings from energy efficiency programs in three key sectors of residential buildings: new, single-family, detached homes; retrofits to existing single-family, detached homes; and retrofits to existing multifamily housing units. Each of the energy efficiency programs analyzed resulted in statistically significant energy savings at the full program group level, yet savings for individual participants and participant subgroups were highly variable. Even though savings estimates were statistically greater than zero, those energy savings did not always meet expectations. Results also show that high variability in energy savings among participant groups or subgroups can negatively impact overall program performance and can undermine marketing efforts for future participation. Design, implementation, and continued support of conservation programs based solely on deemed or projected savings is inherently counter to the pursuit of meaningful energy conservation and reductions in greenhouse gas emissions. To fully understand and optimize program impacts, consistent and robust measurement and verification protocols must be instituted in the design phase and maintained over time. Furthermore, marketing for program participation must target those who have the greatest opportunity for savings. In most utility territories it is not possible to gain access to the type of large scale

[Cost-effectiveness of breast cancer screening policies in Mexico].

Science.gov (United States)

Valencia-Mendoza, Atanacio; Sánchez-González, Gilberto; Bautista-Arredondo, Sergio; Torres-Mejía, Gabriela; Bertozzi, Stefano M

2009-01-01

Generate cost-effectiveness information to allow policy makers optimize breast cancer (BC) policy in Mexico. We constructed a Markov model that incorporates four interrelated processes of the disease: the natural history; detection using mammography; treatment; and other competing-causes mortality, according to which 13 different strategies were modeled. Strategies (starting age, % of coverage, frequency in years)= (48, 25, 2), (40, 50, 2) and (40, 50, 1) constituted the optimal method for expanding the BC program, yielding 75.3, 116.4 and 171.1 thousand pesos per life-year saved, respectively. The strategies included in the optimal method for expanding the program produce a cost per life-year saved of less than two times the GNP per capita and hence are cost-effective according to WHO Commission on Macroeconomics and Health criteria.

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 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.

The cost of harm and savings through safety: using simulated patients for leadership decision support.

Science.gov (United States)

Denham, Charles R; Guilloteau, Franck R

2012-09-01

The ultimate objective of this program is to provide an approach to understanding and communicating health-care harm and cost to compel health-care provider leadership teams to vote "yes" to investments in patient safety initiatives, with the confidence that clinical, financial, and operational performance will be improved by such programs. Through a coordinated combination of literature evaluations, careful mapping of high impact scenarios using simulated patients and consensus review of clinical, operational, and financial factors, we confirmed value in such approaches to decision support information for hospital leadership teams to invest in patient safety projects. The study resulted in the following preliminary findings: ·Communication between hospital quality and finance departments can be much improved by direct collaborative relationships through regular meetings to help both clarify direct costs, indirect costs, and the savings of waste and harm to patients by avoidance of infections. ·Governance leaders and the professional administrative leaders should consider establishing the structures and systems necessary to act on risks and hazards as they evolve to deploy resources to areas of harm and risk. ·Quality and Infection Control Professionals can best wage their war on healthcare waste and harm by keeping abreast of the latest literature regarding the latest measures, standards, and safe practices for healthcare-acquired infections and hospital-acquired conditions. ·Regular reviews of patients with health-careYassociated infections, with direct attention to the attributable cost of treatment and how financial waste and harm to patients may be avoided, may provide hospital leaders with new insights for improvement. ·If hospitals developed their own risk scenarios to determine impact of harm and waste from hospital-acquired conditions in addition to impact scenarios for specific processes through technology and process innovations, they would have

Bases of a fuel saving program for the passenger car traffic in Austria and benefit-cost-analysis of individual fuel economics. Grundlagen eines Energiesparkonzeptes fuer den PKW-Verkehr in Oesterreich und Nutzen-Kosten-Untersuchung einzelner Energiesparmassnahmen

Energy Technology Data Exchange (ETDEWEB)

Bruner-Newton, I.

1979-01-01

The influences on the fuel consumption of the individual automobile are investigated and their importance is appraised. From these data measures are derived to obtain a sensible fuel consumption. After a survey of conventional benefit-cost-analyses, guide lines for a benefit-cost-analyses of fuel economies in passenger car traffic are given. A target system is established which includes the most important criteria, which determine the total fuel consumption of passenger cars in Austria. Hereby it is possible to calculate the fuel saving potential of a certain measure. The economy of a measure is characterized by a benefit-cost-ratio. The developed methods of appraisal are applied to 14 measures and prove to be a suitable instrument for a systematic and comparable analyses of the individual measures. The measures are listed according to their economy when examining three different periods. It is shown which average annual fuel saving potential can be achieved by means of which annual costs.

Cost-estimating relationships for space programs

Science.gov (United States)

Mandell, Humboldt C., Jr.

1992-01-01

Cost-estimating relationships (CERs) are defined and discussed as they relate to the estimation of theoretical costs for space programs. The paper primarily addresses CERs based on analogous relationships between physical and performance parameters to estimate future costs. Analytical estimation principles are reviewed examining the sources of errors in cost models, and the use of CERs is shown to be affected by organizational culture. Two paradigms for cost estimation are set forth: (1) the Rand paradigm for single-culture single-system methods; and (2) the Price paradigms that incorporate a set of cultural variables. For space programs that are potentially subject to even small cultural changes, the Price paradigms are argued to be more effective. The derivation and use of accurate CERs is important for developing effective cost models to analyze the potential of a given space program.

A techno-economic analysis of cost savings for retrofitting industrial aerial coolers with variable frequency drives

International Nuclear Information System (INIS)

Miller, Patrick; Olateju, Babatunde; Kumar, Amit

2012-01-01

Highlights: ► Techno-economic models were developed to assess the retrofitting of aerial coolers. ► The IRR for retrofitting with VFDs exceeds 10% for motor sizes above 20 hp. ► The IRR reaches a maximum of 220% for a cooler with fifty, 250 hp motors. ► The simple payback becomes less than 1 year for motors larger than 120 hp. ► Ambient temperature and location affects the profitability of VFD investment. - Abstract: A techno-economic model was created in order to develop curves that show the typical annual energy savings, rate of return, and payback for retrofitting aerial coolers with variable frequency drives (VFDs) for up to 50 motors, motor sizes from 4 to 186 kW (5–250 hp), and varying climate conditions. The cost savings due to installing a VFD depends on the reduction in energy used, as well as the reduction in power demand, the capital cost of the VFD, installation cost of the VFD, change in operating cost, and cost of electricity. The geographic locations examined in this report were Fort McMurray, Calgary, Vancouver, and Thunder Bay. This study found that the IRR increases rapidly with motor size, becomes greater than 10% at a motor size of approximately 15 kW, and may be as high as 220% (for the case of fifty, 186 kW motors). The IRR is sensitive to the number of fan motors retrofitted with VFDs, however the sensitivity rapidly declines as the number of motors is increased beyond five. The simple payback period becomes less than 1 year and nearly independent of number of motors and motor size for motors larger than 90 kW. Ambient temperature and geographic location affect the profitability of the investment, although the IRR only changes by approximately 4%.

Cost-benefit analysis of retrofit of high-intensity discharge factory lighting with energy-saving alternatives

Energy Technology Data Exchange (ETDEWEB)

Preston, D.J. [Alabama Industrial Assessment Center, The University of Alabama, 1530 W. Tremont St, Allentown, PA 18102 (United States); Woodbury, K.A. [Alabama Industrial Assessment Center, The University of Alabama, 290 Hardaway Hall, Box 870276, Tuscaloosa, AL 35487-0276 (United States)

2013-05-15

Due to increased concern about overall energy costs and the appearance of efficient and inexpensive lighting system alternatives, factories and plants with high-intensity discharge (HID) lighting are forced to consider retrofit with more modern, energy-efficient lighting. The decision is complicated from an economic perspective, and there is a lack of information readily available on the topic. This study provides an analysis of the replacement by retrofit of common probe-start metal halide and high-pressure sodium industrial lighting systems. Retrofit options considered include the more recent pulse-start metal halide lamps and a range of T5 high output and T8 fluorescent lamp configurations. Recent data on lighting system pricing, labor and energy costs, and time required for tasks are reported. The results generated include savings, payback period, and net present value for many retrofit options, as well as the change in energy consumption, carbon footprint, and lumen output for each retrofit. Effects of varying rate of return and daily duration of operation are considered. Based on change in lumen output, payback period, net present value, and comparison of lighting quality, one or two options are recommended from the overall retrofit options considered. A fluorescent retrofit is recommended for each of the HID initial scenarios considered. The payback period is no more than 3 years in any recommended case. The focus of this study is on the potential energy and cost savings, and some proposed solutions may, or may not, be acceptable due to lack of illuminance uniformity.

Industrial Assessment Center Program Impact Evaluation