WorldWideScience

Sample records for program costs measures

  1. How can a cost/benefit ratio be optimized for an output measurement program of external photon radiotherapy beams?

    Science.gov (United States)

    Kapanen, Mika; Bly, Ritva; Sipilä, Petri; Järvinen, Hannu; Tenhunen, Mikko

    2011-04-07

    We estimated cost/benefit ratios for different quality control programs of radiation output measurements of medical linear accelerators. The cost/benefit ratios of quality control (QC) programs (a combination of output measurement time interval and measurement action levels) were defined as workload divided by achievable dose accuracy. Dose accuracy was assumed to be inversely proportional to the 99% confidence limit of shifts of total treatment doses and workload as inversely proportional to the output measurement time interval. Our previously reported method was used to estimate the distribution of shifts of total treatment doses due to changes in accelerator radiation output (Gy/MU). The confidence limits of dose shifts were estimated for different QC programs and for different levels of output measurement reproducibility. Output shifts used in the estimations had previously been observed for four linear accelerators over 5 years. We observed that the cost/benefit ratio increases remarkably when the output measurement time interval is less than 1 month. The ratio depends strongly on the action levels and reproducibility of the QC measurements. Improvement of these factors optimizes the cost/benefit ratio by a factor of several times. The most cost-effective output measurement time interval to achieve 99% confidence limits of ±2, ±2.5 or ±3% for dose shifts ranged from 0.25 month to as much as 6 months depending on the factors given above and the intended accuracy level. It is several times more cost effective to increase dose accuracy by lowering the action levels of the QC measurements and by attempting to improve their reproducibility than by simply shortening the time interval of the output measurements. Methods improving utilization and interpretation of the results of the QC measurements play a key role in further optimization of cost/benefit ratios in dosimetric QC.

  2. [Needle exchange programs are a cost-effective preventative measure against HIV in Iceland].

    Science.gov (United States)

    Eythórsson, Elías Sæbjorn; Ásgeirsdóttir, Tinna Laufey; Gottfređsson, Magnús

    2014-07-01

    In 2007 there was a sudden increase in HIV cases among intravenous drug users (IDUs) in Iceland. In 2007 - 2011 there were 34 new HIV cases among IDUs compared to four in the previous four year period. The purpose of this study was to assess whether needle exchange programs (NEPs) were cost-effective in preventing the spread of HIV among IDUs in Iceland. Cost-utility analysis was conducted from a societal perspective. Costs are presented at the 2011 price level and values were discounted using a 3% discount rate. A ten year period, 2011 - 2020 was compared with and without NEPs. The Incremental Cost-Utility Ratio (ICUR) was calculated as societal cost per quality adjusted life year (QALY). Sensitivity analysis was performed on study assumptions. The estimated societal costs associated with HIV infections among IDUs from 2011 - 2020 was 914.369.621 ISK without NEP and 947.653.758 ISK with NEP. Excess societal cost due to NEP was 33.284.137 ISK. Societal utility from NEP was 7,39 QALYs. Additionally, NEP prevented 4-5 HIV infections. The ICUR of providing NEP was 4.506.720 ISK. According to WHO an intervention is considered cost-effective if the ICUR is less than three-fold national GDP per capita. In 2011 the GDP per capita in Iceland was 15.315.000 ISK. Sensitivity analysis on study assumptions yielded a societal cost within the WHO limit. Therefore, the results indicate that NEPs are cost-effective in preventing the spread of HIV among IDUs in Iceland.

  3. Cost-Estimation Program

    Science.gov (United States)

    Cox, Brian

    1995-01-01

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

  4. 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,...

  5. Cost-Effectiveness Model for Youth EFNEP Programs: What Do We Measure and How Do We Do It?

    Science.gov (United States)

    Serrano, Elena; McFerren, Mary; Lambur, Michael; Ellerbock, Michael; Hosig, Kathy; Franz, Nancy; Townsend, Marilyn; Baker, Susan; Muennig, Peter; Davis, George

    2011-01-01

    The Youth Expanded Food and Nutrition Education Program (EFNEP) is one of the United States Department of Agriculture's hallmark nutrition education programs for limited-resource youth. The objective of this study was to gather opinions from experts in EFNEP and related content areas to identify costs, effects (impacts), and related instruments to…

  6. Energy management. Measures on consumption-, and cost reduction, financing programs, regulations; Energiemanagement. Massnahmen zur Verbrauchs- und Kostenreduzierung, Foerderprogramme, Vorschriften

    Energy Technology Data Exchange (ETDEWEB)

    Hessel, Volker

    2008-07-01

    The book informs quickly and soundly on possibilities to reduce energy cost by load management and optimization of facilities, on fundamentals of energy management and valuable frame conditions, on relevant laws and important financing programs. (orig./GL) [German] Das Buch informiert schnell und fundiert ueber die Moeglichkeiten zur Reduzierung der Energiekosten durch Lastmanagement und Anlagenoptimierung, ueber die Grundlagen des Energiemanagements und gueltige Rahmenbedingungen, ueber relevante Gesetze und wichtige Foerderprogramme. (orig.)

  7. COST MEASUREMENT AND COST MANAGEMENT IN TARGET COSTING

    Directory of Open Access Journals (Sweden)

    Moisello Anna Maria

    2012-07-01

    Full Text Available Firms are coping with a competitive scenario characterized by quick changes produced by internationalization, concentration, restructuring, technological innovation processes and financial market crisis. On the one hand market enlargement have increased the number and the segmentation of customers and have raised the number of competitors, on the other hand technological innovation has reduced product life cycle. So firms have to adjust their management models to this scenario, pursuing customer satisfaction and respecting cost constraints. In a context where price is a variable fixed by the market, firms have to switch from the cost measurement logic to the cost management one, adopting target costing methodology. The target costing process is a price driven, customer oriented profit planning and cost management system. It works, in a cross functional way, from the design stage throughout all the product life cycle and it involves the entire value chain. The process implementation needs a costing methodology consistent with the cost management logic. The aim of the paper is to focus on Activity Based Costing (ABC application to target costing process. So: -it analyzes target costing logic and phases, basing on a literary review, in order to highlight the costing needs related to this process; -it shows, through a numerical example, how to structure a flexible ABC model – characterized by the separation between variable, fixed in the short and fixed costs - that effectively supports target costing process in the cost measurement phase (drifting cost determination and in the target cost alignment; -it points out the effectiveness of the Activity Based Costing as a model of cost measurement applicable to the supplier choice and as a support for supply cost management which have an important role in target costing process. The activity based information allows a firm to optimize the supplier choice by following the method of minimizing the

  8. Transaction Costs from a Program Manager’s Perspective

    Science.gov (United States)

    2009-09-28

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

  9. Product costing program for wood component manufacturers

    Science.gov (United States)

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

    2013-01-01

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

  10. School District Program Cost Accounting: An Alternative Approach

    Science.gov (United States)

    Hentschke, Guilbert C.

    1975-01-01

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

  11. Low-cost inertial measurement unit.

    Energy Technology Data Exchange (ETDEWEB)

    Deyle, Travis Jay

    2005-03-01

    Sandia National Laboratories performs many expensive tests using inertial measurement units (IMUs)--systems that use accelerometers, gyroscopes, and other sensors to measure flight dynamics in three dimensions. For the purpose of this report, the metrics used to evaluate an IMU are cost, size, performance, resolution, upgradeability and testing. The cost of a precision IMU is very high and can cost hundreds of thousands of dollars. Thus the goals and results of this project are as follows: (1) Examine the data flow in an IMU and determine a generic IMU design. (2) Discuss a high cost IMU implementation and its theoretically achievable results. (3) Discuss design modifications that would save money for suited applications. (4) Design and implement a low cost IMU and discuss its theoretically achievable results. (5) Test the low cost IMU and compare theoretical results with empirical results. (6) Construct a more streamlined printed circuit board design reducing noise, increasing capabilities, and constructing a self-contained unit. Using these results, we can compare a high cost IMU versus a low cost IMU using the metrics from above. Further, we can examine and suggest situations where a low cost IMU could be used instead of a high cost IMU for saving cost, size, or both.

  12. 7 CFR 246.14 - Program costs.

    Science.gov (United States)

    2010-01-01

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

  13. Planning influenza vaccination programs: a cost benefit model

    Directory of Open Access Journals (Sweden)

    Duncan Ian G

    2012-07-01

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

  14. Cost Functions for Airframe Production Programs.

    Science.gov (United States)

    1982-07-01

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

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

    Science.gov (United States)

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

    2016-02-01

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

  16. Measuring Direct Teaching Costs: Does an Undergraduate Business Degree Cost More to Produce than a Nonbusiness Degree?

    Science.gov (United States)

    Barth, Michael M.; Karagiannidis, Iordanis

    2016-01-01

    Many universities have implemented tuition differentials for certain undergraduate degree programs, citing higher degree costs or higher demand. However, most college accounting systems are unsuited for measuring cost differentials by degree program. This research outlines a method that can convert commonly available financial data to a more…

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

    Science.gov (United States)

    Macy, Barry A.; Mirvis, Philip H.

    1982-01-01

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

  18. A calculation program for electricity generation costs using LOTUS

    Energy Technology Data Exchange (ETDEWEB)

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

    1994-12-01

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

  19. Quantum correlation cost of the weak measurement

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Jun; Wu, Shao-xiong; Yu, Chang-shui, E-mail: quaninformation@sina.com

    2014-12-15

    Quantum correlation cost (QCC) characterizing how much quantum correlation is used in a weak-measurement process is presented based on the trace norm. It is shown that the QCC is related to the trace-norm-based quantum discord (TQD) by only a factor that is determined by the strength of the weak measurement, so it only catches partial quantumness of a quantum system compared with the TQD. We also find that the residual quantumness can be ‘extracted’ not only by the further von Neumann measurement, but also by a sequence of infinitesimal weak measurements. As an example, we demonstrate our outcomes by the Bell-diagonal state.

  20. Measuring the Environmental Cost of Hypocrisy

    OpenAIRE

    Caplan, Arthur

    2013-01-01

    My thesis offers one example of a cost associated with hypocrisy, environmental loss. Hypocrisy is defined as “the practice of professing standards, beliefs, etc., contrary to one’s real character or actual behavior” (Collins Dictionary, 2003). In order to measure hypocrisy two types of data are needed: (1) a measure of a person’s “professed standards” and (2) a measure of “actual behavior.” A study of the various ways in which hypocrisy affects an individual’s entire life is obviously beyond...

  1. Cost estimation for unmanned lunar and planetary programs

    Science.gov (United States)

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

    1973-01-01

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

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

    Science.gov (United States)

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

    2016-09-01

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

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

    Science.gov (United States)

    Lee, A James; Shepard, Donald S

    2009-01-01

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

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

    Science.gov (United States)

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

    2009-01-01

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

  5. Low cost subpixel method for vibration measurement

    Energy Technology Data Exchange (ETDEWEB)

    Ferrer, Belen [Department of Civil Engineering, Univ. Alicante P.O. Box, 99, 03080 Alicante (Spain); Espinosa, Julian; Perez, Jorge; Acevedo, Pablo; Mas, David [Inst. of Physics Applied to the Sciences and Technologies, Univ. Alicante P.O. Box, 99, 03080 Alicante (Spain); Roig, Ana B. [Department of Optics, Univ. Alicante P.O. Box, 99, 03080 Alicante (Spain)

    2014-05-27

    Traditional vibration measurement methods are based on devices that acquire local data by direct contact (accelerometers, GPS) or by laser beams (Doppler vibrometers). Our proposal uses video processing to obtain the vibration frequency directly from the scene, without the need of auxiliary targets or devices. Our video-vibrometer can obtain the vibration frequency at any point in the scene and can be implemented with low-cost devices, such as commercial cameras. Here we present the underlying theory and some experiments that support our technique.

  6. VENVAL : a plywood mill cost accounting program

    Science.gov (United States)

    Henry Spelter

    1991-01-01

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

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

    Science.gov (United States)

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

    2006-01-01

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

  8. Integrated regional-economic modeling of cost-effective programs of water quality measures in the WFD: Development of a demonstration tool

    NARCIS (Netherlands)

    Soesbergen, van A.; Dellink, R.; Brouwer, R.; Linderhof, V.G.M.; Reinhard, A.J.

    2008-01-01

    The Water Economic Modelling for Policy Analysis (WEMPA) project aims to develop and operationalize an integrated water and economy model framework to enable the analysis of the economic effects of measures to reach the Water Framework Directive objectives. This framework is developed on both a

  9. 20 CFR 641.859 - What other special rules govern the classification of costs as administrative costs or program...

    Science.gov (United States)

    2010-04-01

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

  10. 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.

  11. The social impact of cost recovery measures in Zimbabwe.

    Science.gov (United States)

    Nyambuya, M N

    1994-03-01

    Since the International Monetary Fund/World Bank Economic Structural Adjustment Program (ESAP) in Zimbabwe was adopted in 1990, health care and education costs have escalated, and many people fail to get these services owing to poverty. The post-independence era in Zimbabwe witnessed a tremendous growth in education and health with many schools, colleges, hospitals and clinics built, professional staff employed, and a general expansion in demand. Nevertheless, the question of drug shortages and ever-increasing health care costs were not addressed. A deficient transport network, the increases in drug prices, the exodus of professional staff, the devaluation of the Zimbabwe dollar, and the cost recovery measures endangered the right to acceptable health care. The social service cutbacks adopted by the government in education will deepen poverty. After independence, the Zimbabwean education system had a free tuition policy at primary school levels. Now that the government reintroduced school fees, a generation of illiterate and semi-illiterate school dropouts will grow up. The social implications of this include increases in crime, prostitution, the number of street kids, the spread of diseases, and social discontent, which are the symptoms of a shrinking economy. As a result of the cost recovery measures, school enrollment in rural areas has gone up. Some urban parents have been forced to transfer their children to rural schools. Higher education also suffers, as government subsidies to colleges and universities have been drastically curtailed. The budgetary cuts have grave repercussions for teaching and research, as poor working conditions and low morals of lecturers and students become prevalent. Most wage-earning Zimbabweans' living standards have deteriorated as the cost of living continues to escalate, coupled with the cost recovery measures in the name of ESAP.

  12. Cost Estimation Lessons Learned for Future Submarine Acquisition Programs

    Science.gov (United States)

    2010-02-17

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

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

    Science.gov (United States)

    Rowe, Harold R.; Flitter, Hessel H.

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

  14. Measuring the Cost of Supermarket Promotions

    DEFF Research Database (Denmark)

    Gao, Cixiu

    2014-01-01

    The widespread use of retail promotions and the magnitude of dollars spent on them call economists to examine the role of promotional costs in shaping the coordination of pricing and promotion decisions. In this study, I estimate the marginal cost of price promotion in the retail industry....... The estimates imply that the marginal cost of promotion ranges from $0.97 to $4.98 per promotion, and the total promotion cost comprises 3.6 to 17.1 percent of store revenues, or 10.4 to 23.7 percent of profits. The results also indicate that stores with higher promotion elasticities are able to afford more...

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

    Science.gov (United States)

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

    2014-02-01

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

  16. Simple and Low-Cost Wireless Distributed Measurement System

    Directory of Open Access Journals (Sweden)

    Alessandra Flammini

    2007-07-01

    Full Text Available This paper describes the design and realization of a simple and low-cost system for distributed measurements. Traditional handheld digital multimeters have been equipped with a radio-frequency interface in order to implement what the authors call WDMM, the basic block of a wireless multi-probe data logger. New functionalities require very few components and result in a cost increase of less than 10$. In addition, also maintenance has been facilitated since tracking data such as working state or last calibration time are available to the user. Data inquiry can be performed by a purposely designed module that has the same hardware of the WDMM but a different user interface or by a PDA (Personal Digital Assistant or a traditional personal computer thanks to a USB connection. Simple supervisory software has been realized under the LabVIEW graphical programming environment.

  17. Costs of the Smoking Cessation Program in Brazil

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2018-02-07

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

  19. 10 CFR 436.18 - Measuring cost-effectiveness.

    Science.gov (United States)

    2010-01-01

    ... section, each Federal agency shall measure cost-effectiveness by combining cost data established under... Costing (FBLCC) software provided by DOE or software consistent with this subpart. (c) Replacement of a... Federal building or by substitution in the design for a new Federal building shall be deemed cost...

  20. Cost effectiveness of two army physical fitness programs.

    Science.gov (United States)

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

    2013-12-01

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

  1. 48 CFR 9904.412 - Cost accounting standard for composition and measurement of pension cost.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Cost accounting standard for composition and measurement of pension cost. 9904.412 Section 9904.412 Federal Acquisition... accounting standard for composition and measurement of pension cost. ...

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

    National Research Council Canada - National Science Library

    Hoff, Russell V

    2007-01-01

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

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

    Science.gov (United States)

    Spadoni, D. J.

    1983-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1994-05-01

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

  5. A computer program for analysis of fuelwood harvesting costs

    Science.gov (United States)

    George B. Harpole; Giuseppe Rensi

    1985-01-01

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

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

    Science.gov (United States)

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

    2015-05-01

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

  7. 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.

  8. Cost of transformation: a measure on matchings

    NARCIS (Netherlands)

    Can, Burak; Pourpouneh, Mohsen; Storcken, Ton

    2017-01-01

    This paper constructs a normative framework to quantify the difference between two matchings in roommate markets. We investigate the “cost of transformation” from one mechanism to another, based on the differences in the outputs of these mechanisms. Several conditions are introduced to ensure this

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

    Science.gov (United States)

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

    2013-10-01

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

  10. Low Cost Motor Demonstration Program. Volume 1

    Science.gov (United States)

    1977-02-01

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

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

    Science.gov (United States)

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

    2013-03-01

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

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

    Science.gov (United States)

    Hilles, William C.

    1973-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Sathaye, Jayant; Andrasko, Ken; Chan, Peter

    2011-04-11

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

  14. Low-cost flywheel demonstration program. Final report

    Energy Technology Data Exchange (ETDEWEB)

    None

    1980-04-01

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

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

    Science.gov (United States)

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

    2010-01-01

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

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

    Science.gov (United States)

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

    2016-06-01

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

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

    Science.gov (United States)

    Biruk, Sławomir; Jaśkowski, Piotr; Czarnigowska, Agata

    2017-10-01

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

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

    Directory of Open Access Journals (Sweden)

    Yu Shuo

    2015-01-01

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

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

    Science.gov (United States)

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

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

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

    Science.gov (United States)

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

    2015-01-01

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

  1. Measurement errors with low-cost citizen science radiometers

    OpenAIRE

    Bardají, R.; Piera Fernández, Jaume

    2016-01-01

    The KdUINO is a Do-It-Yourself buoy with low-cost radiometers that measure a parameter related to water transparency, the diffuse attenuation coefficient integrated into all the photosynthetically active radiation. In this contribution, we analyze the measurement errors of a novel low-cost multispectral radiometer that is used with the KdUINO. Peer Reviewed

  2. ''When Cost Measures Contradict''

    Energy Technology Data Exchange (ETDEWEB)

    Montgomery, W. D.; Smith, A. E.; Biggar, S. L.; Bernstein, P. M.

    2003-05-09

    When regulators put forward new economic or regulatory policies, there is a need to compare the costs and benefits of these new policies to existing policies and other alternatives to determine which policy is most cost-effective. For command and control policies, it is quite difficult to compute costs, but for more market-based policies, economists have had a great deal of success employing general equilibrium models to assess a policy's costs. Not all cost measures, however, arrive at the same ranking. Furthermore, cost measures can produce contradictory results for a specific policy. These problems make it difficult for a policy-maker to determine the best policy. For a cost measures to be of value, one would like to be confident of two things. First one wants to be sure whether the policy is a winner or loser. Second, one wants to be confident that a measure produces the correct policy ranking. That is, one wants to have confidence in a policy measure's ability to correctly rank policies from most beneficial to most harmful. This paper analyzes empirically these two properties of different costs measures as they pertain to assessing the costs of the carbon abatement policies, especially the Kyoto Protocol, under alternative assumptions about implementation.

  3. NASA's Optical Measurement Program 2014

    Science.gov (United States)

    Cowardin, H.; Lederer, S.; Stansbery, G.; Seitzer, P.; Buckalew, B.; Abercromby, K.; Barker, E.

    2014-01-01

    The Optical Measurements Group (OMG) within the NASA Orbital Debris Program Office (ODPO) addresses U.S. National Space Policy goals by monitoring and characterizing debris. Since 2001, the OMG has used the Michigan Orbital Debris Survey Telescope (MODEST) at Cerro Tololo Inter-American Observatory (CTIO) in Chile for general orbital debris survey. The 0.6-m Schmidt MODEST provides calibrated astronomical data of GEO targets, both catalogued and uncatalogued debris, with excellent image quality. The data are utilized by the ODPO modeling group and are included in the Orbital Debris Engineering Model (ORDEM) v. 3.0. MODEST and the CTIO/SMARTS (Small and Moderate Aperture Research Telescope System) 0.9 m both acquire filter photometric data, as well as synchronously observing targets in selected optical filters. This information provides data used in material composition studies as well as longer orbital arc data on the same target, without time delay or bias from a rotating, tumbling, or spinning target. NASA, in collaboration with the University of Michigan, began using the twin 6.5-m Magellan telescopes at Las Campanas Observatory in Chile for deep imaging (Baade) and spectroscopic data (Clay) in 2011. Through the data acquired on Baade, debris have been detected that are 3 magnitudes fainter than detections with MODEST, while the data from Clay provide better resolved information used in material characterization analyses via selected bandpasses. To better characterize and model optical data, the Optical Measurements Center (OMC) at NASA/JSC has been in operation since 2005, resulting in a database of comparison laboratory data. The OMC is designed to emulate illumination conditions in space using equipment and techniques that parallel telescopic observations and source-target-sensor orientations. Lastly, the OMG is building the Meter Class Autonomous Telescope (MCAT) at Ascension Island. The 1.3-m telescope is designed to observe GEO and LEO targets, using a

  4. LC21-Hopes and Cautions for the Library of Congress; The NSF National Science, Mathematics, Engineering, and Technology Education Digital Library (NSDL) Program: A Progress Report; A Grammar of Dublin Core; Measuring the Impact of an Electronic Journal Collection on Library Costs: A Framework and Preliminary Observations; Emulation As a Digital Preservation Strategy.

    Science.gov (United States)

    O'Donnell, James J.; Zia, Lee L.; Baker, Thomas; Montgomery, Carol Hansen; Granger, Stewart

    2000-01-01

    Includes five articles: (1) discusses Library of Congress efforts to include digital materials; (2) describes the National Science Foundation (NSF) digital library program to improve science, math, engineering, and technology education; (3) explains Dublin Core grammar; (4) measures the impact of electronic journals on library costs; and (5)…

  5. Planning influenza vaccination programs: a cost benefit model

    OpenAIRE

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

    2012-01-01

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

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

    Science.gov (United States)

    Luyten, Jeroen; Beutels, Philippe

    2016-02-01

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

  7. Novel surface measurement system reading cost savings

    Energy Technology Data Exchange (ETDEWEB)

    Sword, M.

    1996-05-01

    A new state-of-the-art data acquisition system for the oil and natural gas industries is being marketed by OPSCO`92 Industries Ltd. The unit is portable, it measures surface data which is calibrated to bottom-hole conditions and designed to measure temperature and pressure information without the necessity of sending testing equipment downhole. The Surface Data System (SDS) uses silicon-crystal technology, is mounted in a suitcase size carrying case, and runs off a 12-volt battery enclosure which can be backed up by a small solar panel. The first generation system can handle 16 different channels of information input on a laptop computer. Pressure, pressure differential, temperature, frequency and pulse signals for flow meter measurements are handled by standard sensors. Areas of application include build-up and fall-off tests, pipeline evaluation, pre-frac tests, underbalanced drilling and gas well evaluation. 1 fig., 1 photo.

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

    Science.gov (United States)

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

    2002-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-03-19

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

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

    Directory of Open Access Journals (Sweden)

    Olufolake (Odufuwa Akanni

    2017-05-01

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

  11. Cost and Time Overruns in Major Defense Acquisition Programs

    OpenAIRE

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

    2010-01-01

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

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

    Science.gov (United States)

    2015-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Snow Jill

    2008-10-01

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

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

    Science.gov (United States)

    Baker, M

    1992-01-01

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

  15. Measurement problem in PROGRAM UNIVERSE

    Energy Technology Data Exchange (ETDEWEB)

    Noyes, H.P.; Gefwert, C.

    1984-12-01

    We present a discrete theory that meets the measurement problem in a new way. We generate a growing universe of bit strings, labeled by 2/sup 127/ + 136 strings organized by some representation of the closed, four level, combinatorial hierarchy, of bit-length N/sub 139/ greater than or equal to 139. The rest of the strings for each label, which grow in both length and number, are called addresses. The generating algorithm, called PROGRAM UNIVERSE, starts from a random choice between the two symbols ''0'' and ''1'' and grows (a) by discriminating between two randomly chosen strings and adjoining a novel result to the universe, or when the string so generated is not novel, by (b) adjoining a randomly chosen bit at the growing end of each string. We obtain, by appropriate definitions and interpretations, stable ''particles'' which satisfy the usual relativistic kinematics and quantized angular momentum without being localizable in a continuum space-time. The labeling scheme is congruent with the ''standard model'' of quarks and leptons with three generations, but for the problem at hand, the implementation of this aspect of the theory is unimportant. What matters most is that (a) these complicated ''particles'' have the periodicities familiar from relativistic ''deBroglie waves'' and resolve in a discrete way the ''wave-particle dualism'' and (b) can be ''touched'' by our discrete equivalent of ''soft photons'' in such a way as to follow, macroscopically, the usual Rutherford scattering trajectories with the associated bound states. Thus our theory could provide a discrete description of ''measurement'' in a way that allows no conceptual barrier between the ''micro'' and the ''macro'' worlds, if we are willing to base our physics on

  16. The cost of travel time variability: three measures with properties

    DEFF Research Database (Denmark)

    Engelson, Leonid; Fosgerau, Mogens

    2016-01-01

    This paper explores the relationships between three types of measures of the cost of travel time variability: measures based on scheduling preferences and implicit departure time choice, Bernoulli type measures based on a univariate function of travel time, and mean-dispersion measures. We...

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

    Science.gov (United States)

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

    2010-07-01

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

  18. Measurement of excellence and cost in a supply chain

    OpenAIRE

    Pettersson, Annelie

    2015-01-01

    This Doctoral Thesis addresses the topic of measurement of excellence and cost in a supply chain. In this thesis, a framework for monitoring and analysis of cost in the supply chain is developed. A model for analyzing excellence in a supply chain is also developed. The work aims to facilitate improvements and to improve decisionmaking regarding Supply Chain Management (SCM) and excellence and cost improvements in supply chains. The thesis contains an introduction, a literature review and five...

  19. Transaction costs and social networks in productivity measurement

    DEFF Research Database (Denmark)

    Henningsen, Geraldine; Henningsen, Arne; Henning, Christian H. C. A.

    2015-01-01

    and support. Hence, we use measures of a firm’s access to social networks as a proxy for the transaction costs the firm faces. We develop a microeconomic production model that takes into account transaction costs and networks. Using a data set of 384 Polish farms, we empirically estimate this model......We argue that in the presence of transaction costs, observed productivity measures may in many cases understate the true productivity, as production data seldom distinguish between resources entering the production process and resources of a similar type that are sacrificed for transaction costs....... Hence, both the absolute productivity measures and, more importantly, the productivity ranking will be distorted. A major driver of transaction costs is poor access to information and contract enforcement assistance. Social networks often catalyse information exchange as well as generate trust...

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

    Science.gov (United States)

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

    2017-10-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-07-31

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

  2. Measurement of cost efficiency in the European banking industry

    Directory of Open Access Journals (Sweden)

    Branka Tuškan

    2016-04-01

    Full Text Available In this paper we analysed and compared efficiency results in the banking industry using two different approaches: financial indicators and the Data Envelopment Analysis (DEA methodology. In the indicator-based approach, we used chosen accounting ratios (Return on Assets - ROA, Return on Equity – ROE and Cost to Income Ratio - CIR and the descriptive statistics methodology to conduct analysis. In the case of DEA, a nonparametric linear programming methodology approach, expenses as input data and income as output data are used for measuring efficiency using the CCR DEA model, BCC DEA model and window analysis DEA technique. The objective of this research is ascertain whether a correlation exists between the results of the different ways of measuring efficiency. In that sense, the main purpose of this research is to draw a more precise conclusion about the efficiency of the banking industry, as tested for the period 2008–2012 on a sample of 28 European banking systems. The main difference in the obtained results is a lag of values of average accounting ratios in comparison to the results of the DEA methodology. Such a finding suggests that the DEA methodology can be useful in detecting early signs of inadequate business strategies, which can lead to the slowdown of business activity or poorer efficiency results. This can be especially important in times of an unstable financial or macroeconomic environment, as it can assist in detecting early signs of a crisis. In general, the results of both approaches suggest that banking systems in post-transition countries have a higher cost efficiency. Such systems continue to be dominantly financed through long-term deposits and are also exposed to a specific risk. They do business in a specific competitive, financial and macroeconomic environment that significantly influences the prices of financial services (i.e. higher margins, and as a consequence, leads to potentially higher banking sector earnings.

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

    Science.gov (United States)

    Shim, Eunha

    2017-05-01

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

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

    Science.gov (United States)

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

  5. Mitigation measures and programs in Hungary

    Energy Technology Data Exchange (ETDEWEB)

    Molnar, S. [Systemexpert Consulting Ltd., Budapest (Hungary)

    1996-12-31

    In Hungary there are four main governmental programs, which may result in a decrease of emissions of anthropogenic greenhouse gases (GHGs): (1) National program of energy efficiency improvement and energy conservation, (2) Afforestation program, (3) Volatile organic compounds (VOC) emission reduction program, and (4) Program to reduce the use of ozone depleting substances. These ambitious programs were launched in the beginning of the 90`s, but they have been slowed down because of budgetary problems. The comprehensive action plan for mitigation of GHG emissions should be based on these ongoing programs. These programs should be expanded by further measures and programs in order to fulfill the requirements of the FCCC. In the next sections the results and prospects of the above mentioned programs will be summarized. Also the results of the mitigation study supported by the U.S. Country Studies Program are included.

  6. Comparing the Medicaid Retrospective Drug Utilization Review Program Cost-Savings Methods Used by State Agencies.

    Science.gov (United States)

    Prada, Sergio I

    2017-12-01

    The Medicaid Drug Utilization Review (DUR) program is a 2-phase process conducted by Medicaid state agencies. The first phase is a prospective DUR and involves electronically monitoring prescription drug claims to identify prescription-related problems, such as therapeutic duplication, contraindications, incorrect dosage, or duration of treatment. The second phase is a retrospective DUR and involves ongoing and periodic examinations of claims data to identify patterns of fraud, abuse, underutilization, drug-drug interaction, or medically unnecessary care, implementing corrective actions when needed. The Centers for Medicare & Medicaid Services requires each state to measure prescription drug cost-savings generated from its DUR programs on an annual basis, but it provides no guidance or unified methodology for doing so. To describe and synthesize the methodologies used by states to measure cost-savings using their Medicaid retrospective DUR program in federal fiscal years 2014 and 2015. For each state, the cost-savings methodologies included in the Medicaid DUR 2014 and 2015 reports were downloaded from Medicaid's website. The reports were then reviewed and synthesized. Methods described by the states were classified according to research designs often described in evaluation textbooks. In 2014, the most often used prescription drugs cost-savings estimation methodology for the Medicaid retrospective DUR program was a simple pre-post intervention method, without a comparison group (ie, 12 states). In 2015, the most common methodology used was a pre-post intervention method, with a comparison group (ie, 14 states). Comparisons of savings attributed to the program among states are still unreliable, because of a lack of a common methodology available for measuring cost-savings. There is great variation among states in the methods used to measure prescription drug utilization cost-savings. This analysis suggests that there is still room for improvement in terms of

  7. Whole Building Cost and Performance Measurement: Data Collection Protocol Revision 2

    Energy Technology Data Exchange (ETDEWEB)

    Fowler, Kimberly M.; Spees, Kathleen L.; Kora, Angela R.; Rauch, Emily M.; Hathaway, John E.; Solana, Amy E.

    2009-03-27

    This protocol was written for the Department of Energy’s Federal Energy Management Program (FEMP) to be used by the public as a tool for assessing building cost and performance measurement. The primary audiences are sustainable design professionals, asset owners, building managers, and research professionals within the Federal sector. The protocol was developed based on the need for measured performance and cost data on sustainable design projects. Historically there has not been a significant driver in the public or private sector to quantify whole building performance in comparable terms. The deployment of sustainable design into the building sector has initiated many questions on the performance and operational cost of these buildings.

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Science.gov (United States)

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

    2010-01-01

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

  10. 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.

  11. Cost-Utility Analysis of a Cardiac Telerehabilitation Program

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  12. SUPPLIES COSTS: AN EXPLORATORY STUDY WITH APPLICATION OF MEASUREMENT MODEL OF LOGISTICS COSTS

    Directory of Open Access Journals (Sweden)

    Ana Paula Ferreira Alves

    2013-12-01

    Full Text Available One of the main reasons for the difficulty in adopting an integrated method of calculation of logistics costs is still a lack of adequate information about costs. The management of the supply chain and identify its costs can provide information for their managers, with regard to decision making, generating competitive advantage. Some models of calculating logistics costs are proposed by Uelze (1974, Dias (1996, Goldratt (2002, Christopher (2007, Castiglioni (2009 and Borba & Gibbon (2009, with little disclosure of the results. In this context, this study aims to evaluate the costs of supplies, applying a measurement model of logistics costs. Methodologically, the study characterized as exploratory. The model applied pointed, in original condition, that about R$ 2.5 million were being applied in the process of management of supplies, with replacement costs and storage imbalance. Upgrading the company's data, it is possible obtain a 52% reduction in costs to replace and store supplies. Thus, the cost model applied to logistical supplies showed feasibility of implementation, as well as providing information to assist in management and decision-making in logistics supply.

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

    Science.gov (United States)

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

    2017-01-10

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

  14. Transaction costs and social networks in productivity measurement

    DEFF Research Database (Denmark)

    Henningsen, Geraldine; Henningsen, Arne; Henning, Christian H. C. A.

    2015-01-01

    . Hence, both the absolute productivity measures and, more importantly, the productivity ranking will be distorted. A major driver of transaction costs is poor access to information and contract enforcement assistance. Social networks often catalyse information exchange as well as generate trust...... and support. Hence, we use measures of a firm’s access to social networks as a proxy for the transaction costs the firm faces. We develop a microeconomic production model that takes into account transaction costs and networks. Using a data set of 384 Polish farms, we empirically estimate this model...... and compare different parametric, semiparametric, and nonparametric model specifications. Our results generally support our hypothesis. Especially, large trading networks and dense household networks have a positive influence on a farm’s productivity. Furthermore, our results indicate that transaction costs...

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

    Science.gov (United States)

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

    2017-02-15

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

  16. 34 CFR 263.4 - What training costs may a Professional Development program include?

    Science.gov (United States)

    2010-07-01

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

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

    Science.gov (United States)

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

    2013-10-01

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

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

    Science.gov (United States)

    1978-05-01

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

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

    Science.gov (United States)

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

    2005-12-01

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

  20. A measurement system for large, complex software programs

    Science.gov (United States)

    Rone, Kyle Y.; Olson, Kitty M.; Davis, Nathan E.

    1994-01-01

    This paper describes measurement systems required to forecast, measure, and control activities for large, complex software development and support programs. Initial software cost and quality analysis provides the foundation for meaningful management decisions as a project evolves. In modeling the cost and quality of software systems, the relationship between the functionality, quality, cost, and schedule of the product must be considered. This explicit relationship is dictated by the criticality of the software being developed. This balance between cost and quality is a viable software engineering trade-off throughout the life cycle. Therefore, the ability to accurately estimate the cost and quality of software systems is essential to providing reliable software on time and within budget. Software cost models relate the product error rate to the percent of the project labor that is required for independent verification and validation. The criticality of the software determines which cost model is used to estimate the labor required to develop the software. Software quality models yield an expected error discovery rate based on the software size, criticality, software development environment, and the level of competence of the project and developers with respect to the processes being employed.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-02-01

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

  2. Cost-effectiveness of SHINE: A Telephone Translation of the Diabetes Prevention Program

    Directory of Open Access Journals (Sweden)

    Christopher S. Hollenbeak

    2016-01-01

    Full Text Available Background The Support, Health Information, Nutrition, and Exercise (SHINE trial recently showed that a telephone adaptation of the Diabetes Prevention Program (DPP lifestyle intervention was effective in reducing weight among patients with metabolic syndrome. The aim of this study is to determine whether a conference call (CC adaptation was cost effective relative to an individual call (IC adaptation of the DPP lifestyle intervention in the primary care setting. Methods We performed a stochastic cost-effectiveness analysis alongside a clinical trial comparing two telephone adaptations of the DPP lifestyle intervention. The primary outcomes were incremental cost-effectiveness ratios estimated for weight loss, body mass index (BMI, waist circumference, and quality-adjusted life years (QALYs. Costs were estimated from the perspective of society and included direct medical costs, indirect costs, and intervention costs. Results After one year, participants receiving the CC intervention accumulated fewer costs ($2,831 vs. $2,933 than the IC group, lost more weight (6.2 kg vs. 5.1 kg, had greater reduction in BMI (2.1 vs. 1.9, and had greater reduction in waist circumference (6.5 cm vs. 5.9 cm. However, participants in the CC group had fewer QALYs than those in the IC group (0.635 vs. 0.646. The incremental cost-effectiveness ratio for CC vs. IC was $9,250/QALY, with a 48% probability of being cost-effective at a willingness-to-pay of $100,000/QALY. Conclusions CC delivery of the DPP was cost effective relative to IC delivery in the first year in terms of cost per clinical measure (weight lost, BMI, and waist circumference but not in terms of cost per QALY, most likely because of the short time horizon.

  3. Cost-Utility Analysis of a Cardiac Telerehabilitation Program: The Teledialog Project.

    Science.gov (United States)

    Kidholm, Kristian; Rasmussen, Maja Kjær; Andreasen, Jan Jesper; Hansen, John; Nielsen, Gitte; Spindler, Helle; Dinesen, Birthe

    2016-07-01

    Cardiac rehabilitation can reduce mortality of patients with cardiovascular disease, but a frequently low participation rate in rehabilitation programs has been found globally. The objective of the Teledialog study was to assess the cost-utility (CU) of a cardiac telerehabilitation (CTR) program. The aim of the intervention was to increase the patients' participation in the CTR program. At discharge, an individualized 3-month rehabilitation plan was formulated for each patient. At home, the patients measured their own blood pressure, pulse, weight, and steps taken for 3 months. The analysis was carried out together with a randomized controlled trial with 151 patients during 2012-2014. Costs of the intervention were estimated with a health sector perspective following international guidelines for CU. Quality of life was assessed using the 36-Item Short Form Health Survey. The rehabilitation activities were approximately the same in the two groups, but the number of contacts with the physiotherapist was higher among the intervention group. The mean total cost per patient was €1,700 higher in the intervention group. The quality-adjusted life-years (QALYs) gain was higher in the intervention group, but the difference was not statistically significant. The incremental CU ratio was more than €400,000 per QALY gained. Even though the rehabilitation activities increased, the program does not appear to be cost-effective. The intervention itself was not costly (less than €500), and increasing the number of patients may show reduced costs of the devices and make the CTR more cost-effective. Telerehabilitation can increase participation, but the intervention, in its current form, does not appear to be cost-effective.

  4. Costs of the Smoking Cessation Program in Brazil.

    Science.gov (United States)

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

    2016-11-10

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

  5. Chain Risk Model for quantifying cost effectiveness of phytosanitary measures

    NARCIS (Netherlands)

    Benninga, J.; Hennen, W.H.G.J.; Schans, van de J.

    2010-01-01

    A Chain Risk Model (CRM) was developed for a cost effective assessment of phytosanitary measures. The CRM model can be applied to phytosanitary assessments of all agricultural product chains. In CRM, stages are connected by product volume flows with which pest infections can be spread from one stage

  6. Nutritional, Economic, and Environmental Costs of Milk Waste in a Classroom School Breakfast Program.

    Science.gov (United States)

    Blondin, Stacy A; Cash, Sean B; Goldberg, Jeanne P; Griffin, Timothy S; Economos, Christina D

    2017-04-01

    To measure fluid milk waste in a US School Breakfast in the Classroom Program and estimate its nutritional, economic, and environmental effects. Fluid milk waste was directly measured on 60 elementary school classroom days in a medium-sized, urban district. The US Department of Agriculture nutrition database, district cost data, and carbon dioxide equivalent (CO2e) emissions and water footprint estimates for fluid milk were used to calculate the associated nutritional, economic, and environmental costs. Of the total milk offered to School Breakfast Program participants, 45% was wasted. A considerably smaller portion of served milk was wasted (26%). The amount of milk wasted translated into 27% of vitamin D and 41% of calcium required of School Breakfast Program meals. The economic and environmental costs amounted to an estimated $274 782 (16% of the district's total annual School Breakfast Program food expenditures), 644 893 kilograms of CO2e, and 192 260 155 liters of water over the school year in the district. These substantial effects of milk waste undermine the School Breakfast Program's capacity to ensure short- and long-term food security and federal food waste reduction targets. Interventions that reduce waste are urgently needed.

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Science.gov (United States)

    Jayaratne, K. S. U.

    2015-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-12-31

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

  10. Post-acute traumatic brain injury rehabilitation: effects on outcome measures and life care costs.

    Science.gov (United States)

    Griesbach, Grace S; Kreber, Lisa A; Harrington, David; Ashley, Mark J

    2015-05-15

    Rehabilitation is the predominant post-acute treatment for patients with traumatic brain injury (TBI). We retrospectively evaluated the effectiveness of post-acute TBI rehabilitation by comparing outcome measures and life care cost with that of patients with cerebrovascular accident (CVA) who underwent a multidisciplinary rehabilitation program within the same facility. To better assess the effects of rehabilitation, we only included patients with no benefit limitations from the insurance carrier. Functional effectiveness was determined by comparing outcome scales, which included the Disability Rating Scale, Mayo Portland Inventory, Occupational Status Scale, Living Status Scale, and the Centre for Neuro Skills Scale. Cost-effectiveness was determined by having certified life care planners create separate cost projections from the admission and discharge patient files. This allowed us to compare cost projections with and without rehabilitation for each patient. Significant decreases in the cost projections, i.e., rehabilitation savings (RS), were found after rehabilitation for TBI. These RS were equivalent to those of patients with CVA. Likewise, equivalent improvements were found on all of the outcome scales for both brain injury groups. We also evaluated if the latency from TBI to admission in the rehabilitation program had an influence on outcome. Cost and functional effectiveness was more marked when rehabilitation was initiated within the first year after TBI. The effects of age of TBI were also evaluated. Although RS were most marked in younger patients, improvements in outcome measures were observed in all age groups after post-acute rehabilitation.

  11. Measuring Student Transformation in Entrepreneurship Education Programs

    Directory of Open Access Journals (Sweden)

    Steven A. Gedeon

    2017-01-01

    Full Text Available This article describes how to measure student transformation primarily within a university entrepreneurship degree program. Student transformation is defined as changes in knowledge (“Head”, skills (“Hand”, and attitudinal (“Heart” learning outcomes. Following the institutional impact model, student transformation is the primary goal of education and all other program goals and aspects of quality desired by stakeholders are either input factors (professors, courses, facilities, support, etc. or output performance (number of startups, average starting salary, % employment, etc.. This goal-setting framework allows competing stakeholder quality expectations to be incorporated into a continuous process improvement (CPI model when establishing program goals. How to measure these goals to implement TQM methods is shown. Measuring student transformation as the central focus of a program promotes harmony among competing stakeholders and also provides a metric on which other program decisions (e.g., class size, assignments, and pedagogical technique may be based. Different stakeholders hold surprisingly different views on defining program quality. The proposed framework provides a useful way to bring these competing views into a CPI cycle to implement TQM requirements of accreditation. The specific entrepreneurial learning outcome goals described in the tables in this article may also be used directly by educators in nonaccredited programs and single courses/workshops or for other audiences.

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

    Energy Technology Data Exchange (ETDEWEB)

    1992-08-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    1992-08-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-01-01

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

  15. Building evidence for peer-led interventions: assessing the cost of the Adolescent Asthma Action program in Australia.

    Science.gov (United States)

    Otim, Michael E; Jayasinha, Ranmalie; Forbes, Hayley; Shah, Smita

    2015-01-01

    Asthma is the most common chronic illness among adolescents in Australia. Aboriginal and Torres Strait Islander adolescents, in particular, face substantial inequalities in asthma-related outcomes. Triple A (Adolescent Asthma Action) is a peer-led education intervention, which aims to improve asthma self-management and reduce the uptake of smoking among adolescents. The aim of this study was to determine the cost of implementing the Triple A program in Australia. Standard economic costing methods were used. It involved identifying the resources that were utilised (such as personnel and program materials), measuring them and then valuing them. We later performed sensitivity analysis so as to identify the cost drivers and a stress test to test how the intervention can perform when some inputs are lacking. Results indicate that the estimated cost of implementing the Triple A program in five schools was $41060, assuming that the opportunity cost of all the participants and venues was accounted for. This translated to $8212 per school or $50 per target student. From sensitivity analysis and a stress test, it was identified that the cost of the intervention (in practice) was $14 per student. This appears to be a modest cost, given the burden of asthma. In conclusion, the Triple A program is an affordable intervention to implement in high schools. The potential asthma cost savings due to the program are significant. If the Triple A program is implemented nation-wide, the benefits would be substantial.

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

    Science.gov (United States)

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

    2011-12-01

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

  17. 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.

  18. Cost benefit analysis of the California HVS program

    CSIR Research Space (South Africa)

    Du Plessis, L

    2008-10-01

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

  19. Low cost electrochemical sensor module for measurement of gas concentration

    Science.gov (United States)

    Jasinski, Grzegorz; Strzelczyk, Anna; Koscinski, Piotr

    2016-01-01

    This paper describes a low cost electrochemical sensor module for gas concentration measurement. A module is universal and can be used for many types of electrochemical gas sensors. Device is based on AVR ATmega8 microcontroller. As signal processing circuit a specialized integrated circuit LMP91000 is used. The proposed equipment will be used as a component of electronic nose system employed for classifying and distinguishing different levels of air contamination.

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

    Science.gov (United States)

    Kuri, Carlos J.; Corripio, Armando B.

    1984-01-01

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

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

    Science.gov (United States)

    2013-01-01

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

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

    Science.gov (United States)

    Kivela, Jari; Ketting, Evert; Baltussen, Rob

    2013-08-01

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

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

    Directory of Open Access Journals (Sweden)

    Hoelscher Deanna M

    2007-10-01

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

  4. 76 FR 54999 - Notice of 2011 National Organic Certification Cost-Share Program

    Science.gov (United States)

    2011-09-06

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

  5. 75 FR 54590 - Notice of 2010 National Organic Certification Cost-Share Program

    Science.gov (United States)

    2010-09-08

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

  6. 75 FR 54591 - Notice of Agricultural Management Assistance Organic Certification Cost-Share Program

    Science.gov (United States)

    2010-09-08

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

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

    Science.gov (United States)

    2010-10-01

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

  8. Optimal Design of Measurement Programs for the Parameter Identification of Dynamic Systems

    DEFF Research Database (Denmark)

    Kirkegaard, Poul Henning; Sørensen, John Dalsgaard; Brincker, Rune

    The design of a measured program devoted to parameter identification of structural dynamic systems is considered, the design problem is formulated as an optimization problem due to minimize the total expected cost of the measurement program. All the calculations are based on a priori knowledge...

  9. Dually Enrolled Beneficiaries Have Higher Episode Costs On The Medicare Spending Per Beneficiary Measure.

    Science.gov (United States)

    Samson, Lok Wong; Chen, Lena M; Epstein, Arnold M; Maddox, Karen E Joynt

    2018-01-01

    Cost measures are a growing part of Medicare's value-based payment programs. Medicare Spending per Beneficiary (MSPB) is the cost measure included in Medicare's Hospital Value-Based Purchasing (VBP) Program. Beneficiaries who are dually enrolled in Medicare and Medicaid are known to have higher spending on care, but it is unknown whether spending on the MSPB measure varies based on dual enrollment and whether this has implications for the performance of safety-net hospitals. We found that after adjustment for comorbidities, dually enrolled beneficiaries had 4.3 percent higher spending, which was primarily driven by higher costs in the postacute setting associated with use of institutional postacute care. Hospitals in the highest quintile of the disproportionate share hospital index had poorer performance on the MSPB measure, and were more likely to be penalized under VBP. After adjustment for dual status, differences in MSPB performance between safety-net and non-safety-net hospitals were no longer significant. This suggests that differences in performance between the two types of hospitals were driven at least in part by differences in their patient populations. However, overall VBP payment impacts were largely unchanged after the MSPB measure was adjusted for dual-enrollment status.

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-03-01

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

  12. In situ measurements of phytoplankton fluorescence using low cost electronics.

    Science.gov (United States)

    Leeuw, Thomas; Boss, Emmanuel S; Wright, Dana L

    2013-06-19

    Chlorophyll a fluorometry has long been used as a method to study phytoplankton in the ocean. In situ fluorometry is used frequently in oceanography to provide depth-resolved estimates of phytoplankton biomass. However, the high price of commercially manufactured in situ fluorometers has made them unavailable to some individuals and institutions. Presented here is an investigation into building an in situ fluorometer using low cost electronics. The goal was to construct an easily reproducible in situ fluorometer from simple and widely available electronic components. The simplicity and modest cost of the sensor makes it valuable to students and professionals alike. Open source sharing of architecture and software will allow students to reconstruct and customize the sensor on a small budget. Research applications that require numerous in situ fluorometers or expendable fluorometers can also benefit from this study. The sensor costs US$150.00 and can be constructed with little to no previous experience. The sensor uses a blue LED to excite chlorophyll a and measures fluorescence using a silicon photodiode. The sensor is controlled by an Arduino microcontroller that also serves as a data logger.

  13. In situ Measurements of Phytoplankton Fluorescence Using Low Cost Electronics

    Directory of Open Access Journals (Sweden)

    Dana L. Wright

    2013-06-01

    Full Text Available Chlorophyll a fluorometry has long been used as a method to study phytoplankton in the ocean. In situ fluorometry is used frequently in oceanography to provide depth-resolved estimates of phytoplankton biomass. However, the high price of commercially manufactured in situ fluorometers has made them unavailable to some individuals and institutions. Presented here is an investigation into building an in situ fluorometer using low cost electronics. The goal was to construct an easily reproducible in situ fluorometer from simple and widely available electronic components. The simplicity and modest cost of the sensor makes it valuable to students and professionals alike. Open source sharing of architecture and software will allow students to reconstruct and customize the sensor on a small budget. Research applications that require numerous in situ fluorometers or expendable fluorometers can also benefit from this study. The sensor costs US$150.00 and can be constructed with little to no previous experience. The sensor uses a blue LED to excite chlorophyll a and measures fluorescence using a silicon photodiode. The sensor is controlled by an Arduino microcontroller that also serves as a data logger.

  14. Cost benefit analysis of policy measures in the transport sector

    Energy Technology Data Exchange (ETDEWEB)

    Buus Kristensen, N. [COWI (Denmark)

    1996-12-01

    The Government has introduced a national target for the reduction of CO{sub 2} emissions from the transport sector, which aims to stabilize emissions at the 1988 level, by the year 2005. This target was first formalized in the Government`s 1990 transport action plan, and later repeated in `Traffic 2005`, published in December 1993. The latter document also makes reference to six strategies, which the Government proposed in order to attain the national target. The majority of the transport policy measures will impact on CO{sub 2} emissions from the sector, even if they are targeted at different objectives, e.g. road safety, air pollution, time savings, etc. A long-list of potential measures, which might be adopted with the primary purpose is to reduce CO{sub 2} emissions, has been identified from the six overall strategies. The measures identified have been subjected to detailed analyses, to ascertain all the potential impacts. The main emphasis has been on clarifying the potential efficacy of each of the measures in reducing CO{sub 2} emissions, and the social costs in a wide sense. The analysis assumes that each policy measure is implemented separately. A methodology is developed that presents the respective consequences in commensurate terms. Similar calculations are undertaken for two different combinations of policy measures. (EG)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1996-03-31

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

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

    Science.gov (United States)

    Heitmann, George

    2008-01-01

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

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

    Science.gov (United States)

    Selameab, Tehout; Yeh, Stuart S.

    2008-01-01

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

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

    Science.gov (United States)

    1979-09-01

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

  19. 78 FR 5164 - Notice of Agricultural Management Assistance Organic Certification Cost-Share Program

    Science.gov (United States)

    2013-01-24

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

  20. 76 FR 55000 - Notice of Agricultural Management Assistance Organic Certification Cost-Share Program

    Science.gov (United States)

    2011-09-06

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

  1. Awareness of pharmaceutical cost-assistance programs among inner-city seniors.

    Science.gov (United States)

    Federman, Alex D; Safran, Dana Gelb; Keyhani, Salomeh; Cole, Helen; Halm, Ethan A; Siu, Albert L

    2009-04-01

    Lack of awareness may be a significant barrier to participation by low- and middle-income seniors in pharmaceutical cost-assistance programs. The goal of this study was to determine whether older adults' awareness of 2 major state and federal pharmaceutical cost-assistance programs was associated with the seniors' ability to access and process information about assistance programs. Data were gathered from a cross-sectional study of independently living, English- or Spanish-speaking adults aged > or =60 years. Participants were interviewed in 30 community-based settings (19 apartment complexes and 11 senior centers) in New York, New York. The analysis focused on adults aged > or =65 years who lacked Medicaid coverage. Multivariable logistic regression was used to model program awareness as a function of information access (family/social support, attendance at senior or community centers and places of worship, viewing of live health insurance presentations, instrumental activities of daily living, site of medical care, computer use, and having a proxy decision maker for health insurance matters) and information-processing ability (education level, English proficiency, health literacy, and cognitive function). The main outcome measure was awareness of New York's state pharmaceutical assistance program (Elderly Pharmaceutical Insurance Coverage [EPIC

  2. A low-cost miniaturised detector for environmental radioactivity measurements

    Science.gov (United States)

    Aplin, Karen; Briggs, Aaron; Hastings, Peter; Harrison, R. Giles; Marlton, Graeme; Baird, Adam

    2017-04-01

    We have developed a low-cost (£ few hundred), low-power (40mA), low-mass (30g) detector for environmental radioactivity measurements, using scintillator and solid state technology. The detector can measure energy and therefore has the capability to distinguish between different types of energetic particle. Results from recent tests, when our detector was integrated with a meteorological radiosonde system, and flew on a balloon up to 25km, identified the transition region between energetic particles near the surface, dominated by terrestrial gamma emissions, and higher-energy particles in the free troposphere from cosmic rays. The detector can be used with Bluetooth technology for remote monitoring, which is particularly useful for hazardous areas. It is also small and cheap enough to be used in sensor networks for a wide range of applications, from atmospheric science to disaster monitoring.

  3. Integrating livestock health measures into marginal abatement cost curves.

    Science.gov (United States)

    Macleod, M; Moran, D

    2017-04-01

    Improving livestock health offers both private and social benefits. Among the potential social benefits is a reduction in the greenhouse gas (GHG) emissions arising from livestock production. Reductions in emissions intensity (the amount of GHG produced per kilogram of meat, milk or eggs) may occur, as improving health can lead to improvements in the parameters that emissions intensity is sensitive to, such as (for ruminants): maternal fertility and abortion rates, calf and lamb mortality rates and growth rates, milk yields and feed conversion rates. However, improved health is not yet widely recognised as a GHG mitigation measure due, in part, to difficulties in reliably quantifying the financial and GHG effects of disease control options. This paper discusses how the GHG effects of disease control can be quantified and included in a marginal abatement cost curve (MACC). To illustrate some of the challenges, it draws on the experience of including health measures in the most recent (2015) agricultural MACCs in the United Kingdom.

  4. 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.

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

    Directory of Open Access Journals (Sweden)

    Víctor Granados-García

    2014-09-01

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

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

    National Research Council Canada - National Science Library

    Goff, Debra A; Nicolau, David P

    2013-01-01

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

  7. Design of Networked Low-Cost Wireless Noise Measurement Sensor

    Directory of Open Access Journals (Sweden)

    Ilkka KIVELÄ

    2011-02-01

    Full Text Available Environmental noise is considered as one of the big issues in environmental pollutions. Typical noise sources like traffic can have great influence on wellbeing and healthy. In this paper, we report the sensor function design and implementation of a wireless sensor network application for measuring environmental acoustic noise. The sensing system is built on Atmega128 and CC2420 platform. The protocol stack is based on CiNet stack with a global synchronization scheme and supports multi-hop communications. Strict filtering function specified by ITU-R 468 (namely A-weighting is followed. Both the indoor and outdoor test results were compared with a standard sound level meter and showed a less than ± 2.1 dB mean differences in both short-term and long-term measurement. Power consumption has been measured that a single AA-type battery can sustain the application. Comparing to the traditional noise measurement method, the designed wireless sensor network solution is much lower in cost.

  8. Measuring the costs of outreach motivational interviewing for smoking cessation and relapse prevention among low-income pregnant women

    Directory of Open Access Journals (Sweden)

    Kearney Margaret H

    2009-09-01

    Full Text Available Abstract Background Economic theory provides the philosophical foundation for valuing costs in judging medical and public health interventions. When evaluating smoking cessation interventions, accurate data on costs are essential for understanding resource consumption. Smoking cessation interventions, for which prior data on resource costs are typically not available, present special challenges. We develop a micro-costing methodology for estimating the real resource costs of outreach motivational interviewing (MI for smoking cessation and relapse prevention among low-income pregnant women and report results from a randomized controlled trial (RCT employing the methodology. Methodological standards in cost analysis are necessary for comparison and uniformity in analysis across interventions. Estimating the costs of outreach programs is critical for understanding the economics of reaching underserved and hard-to-reach populations. Methods Randomized controlled trial (1997-2000 collecting primary cost data for intervention. A sample of 302 low-income pregnant women was recruited from multiple obstetrical sites in the Boston metropolitan area. MI delivered by outreach health nurses vs. usual care (UC, with economic costs as the main outcome measures. Results The total cost of the MI intervention for 156 participants was $48,672 or $312 per participant. The total cost of $311.8 per participant for the MI intervention compared with a cost of $4.82 per participant for usual care, a difference of $307 ([CI], $289.2 to $322.8. The total fixed costs of the MI were $3,930 and the total variable costs of the MI were $44,710. The total expected program costs for delivering MI to 500 participants would be 147,430, assuming no economies of scale in program delivery. The main cost components of outreach MI were intervention delivery, travel time, scheduling, and training. Conclusion Grounded in economic theory, this methodology systematically identifies and

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

    Science.gov (United States)

    2000-12-01

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

  10. Relating costs to the user value of farmland biodiversity measurements.

    Science.gov (United States)

    Targetti, S; Herzog, F; Geijzendorffer, I R; Pointereau, P; Viaggi, D

    2016-01-01

    The impact of agricultural management on global biodiversity highlights the need for farm-scale monitoring programmes capable of determining the performance of agriculture practices. Yet the identification of appropriate indicators is a challenging process and one that involves considering a number of different aspects and requirements. Besides the attention given to scientific effectiveness, relevant but less studied issues related to biodiversity measurements include the economic feasibility of monitoring programmes and the relevance of indicators for different end-users. In this paper, we combine an analytic assessment of costs and a stakeholder-based evaluation of the usefulness of a set of biodiversity-related parameters (habitat mapping, vegetation, bees, earthworms, spiders, and a farmer questionnaire) tested for scientific consistency in 12 European case studies and on more than 14,000 ha of farmland. The results point to the possibility of meeting the expectations of different end-users (administrators, farmers and consumers) with a common indicator set. Combining costs and usefulness also suggests the possibility of designing more efficient monitoring approaches involving private agencies and networks of volunteers and farmers for the field data collection at different stages of a monitoring programme. Although complex, such an approach would make it possible to enhance the effectiveness of available funds for farmland biodiversity monitoring. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Cost-Effectiveness of Four Parenting Programs and Bibliotherapy for Parents of Children with Conduct Problems.

    Science.gov (United States)

    Sampaio, Filipa; Enebrink, Pia; Mihalopoulos, Cathrine; Feldman, Inna

    2016-12-01

    Parenting programs and self-help parenting interventions employing written materials are effective in reducing child conduct problems (CP) in the short-term compared to control groups, however evidence on the cost-effectiveness of such interventions is insufficient. Few studies have looked at the differences in effects between interventions in the same study design. This study aimed to determine the cost-effectiveness of four parenting programs: Comet, Incredible Years (IY), Cope and Connect, and bibliotherapy, compared to a waitlist control (WC), with a time horizon of 4 months, targeting CP in children aged 3-12 years. This economic evaluation was conducted alongside an RCT of the four parenting interventions and bibliotherapy compared to a WC. The study sample consisted of 961 parents of 3-12 year-old children with CP. CP was measured by the Eyberg Child Behavior Inventory. Effectiveness was expressed as the proportion of "recovered" cases of CP. The time horizon of the study was four months with a limited health sector perspective, including parents' time costs. We performed an initial comparative cost analysis for interventions whose outcomes differed significantly from the WC, and later a cost-effectiveness analysis of interventions whose outcomes differed significantly from both the WC and each other. Secondary analyses were performed: (i) joint outcome "recovered and improved", (ii) intervention completers, (iii) exclusion of parents' time costs, (iv) exclusion of training costs. All interventions apart from Connect significantly reduced CP compared to the WC. Of the other interventions Comet resulted in a significantly higher proportion of recovered cases compared to bibliotherapy. A comparative cost analysis of the effective interventions rendered an average cost per recovered case for bibliotherapy of USD 483, Cope USD 1972, Comet USD 3741, and IY USD 6668. Furthermore, Comet had an ICER of USD 8375 compared to bibliotherapy. Secondary analyses of

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

    Science.gov (United States)

    Gandjour, Afschin

    2010-06-01

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

  13. Measuring the cost of care in benign prostatic hyperplasia using time-driven activity-based costing (TDABC).

    Science.gov (United States)

    Kaplan, A L; Agarwal, N; Setlur, N P; Tan, H J; Niedzwiecki, D; McLaughlin, N; Burke, M A; Steinberg, K; Chamie, K; Saigal, C S

    2015-03-01

    Determining '"value'" in health care, defined as outcomes per unit cost, depends on accurately measuring cost. We used time-driven activity-based costing (TDABC) to determine the cost of care in men with benign prostatic hyperplasia (BPH) - a common urologic condition. We implemented TDABC across the entire care pathway for BPH including primary and specialist care in both inpatient and outpatient settings. A team of expert stakeholders created detailed process maps, determined space and product costs, and calculated personnel capacity cost rates. A model pathway was derived from practice guidelines and calculated costs were applied. Although listed as 'optional' in practice guidelines, invasive diagnostic testing can increase costs by 150% compared with the standalone urology clinic visit. Of five different surgical options, a 400% cost discrepancy exists between the most and least expensive treatments. TDABC can be used to measure cost across an entire care pathway in a large academic medical center. Sizable cost variation exists between diagnostic and surgical modalities for men with BPH. As financial risk is shifted toward providers, understanding the cost of care will be vital. Future work is needed to determine outcome discrepancy between the diagnostic and surgical modalities in BPH. Copyright © 2014 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2015-09-01

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

  15. Environmental Measurements Laboratory program review, December 1983

    Energy Technology Data Exchange (ETDEWEB)

    Volchok, H.L.; de Planque, G. (EDS.)

    1984-03-01

    This volume contains all of the written material that was submitted to the panel of Reviewers in advance of a Program Review conducted by the US Department of Energy, Office of Health and Environmental Research at the Environmental Measurements Laboratory (EML) December 7-9, 1983. In addition to a general introduction there are nineteen papers grouped into the five broad program categories covering all of the scientific and engineering projects of the Laboratory: Natural Radioactivity and Radiation, Anthropogenic Radioactivity and Radiation, Non-nuclear, Quality Assurance, and Development and Support. These short articles, for the most part, focus on the rationale for EML's involvement in each project, emphasizing their relevance to the EML and Department of Energy missions. Project results and their interpretation were presented at the Review and can be found in the material referenced in this volume.

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

    Science.gov (United States)

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

    2008-12-01

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

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

    Science.gov (United States)

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

    2018-02-01

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

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

    Science.gov (United States)

    Zapata, Edgar

    2017-01-01

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

  19. Rotavirus vaccine: a cost effective control measure for India.

    Science.gov (United States)

    Kumar, Arun; Goel, Manish K; Jain, Ram Bilas; Khanna, Pardeep; Vibha, Vibha

    2012-04-01

    Globally, rotavirus diarrhea results in 453,000 deaths in children younger than 5 y—37% of deaths attributable to diarrhea and 5% of all deaths in children younger than 5 y. India alone accounts for 22% (~100,000 deaths) of all deaths attributable to rotavirus infection. Two oral rotavirus vaccines are available: Rotarix, a monovalent P1A[8] G1 vaccine (GlaxoSmithKline), and RotaTeq, a pentavalent bovine-human reassortant vaccine (Merck). Rotarix is administered in a 2-dose schedule with the first and second doses of DTP (DTP1, DTP2). RotaTeq requires a 3-dose schedule with DTP1, DTP2 and DTP3 with an interval of 4–10 weeks between doses. The first dose of either vaccine should be administered to infants aged 6–15 weeks irrespective of the history of previous rotavirus infection, and the maximum age for administering the last dose of either vaccine should be 32 weeks. Although India would require funding from international health organizations/GAVI until new indigenous rotavirus vaccine candidates are developed at a cheaper price, introduction of vaccination into the national immunization program would be a cost-effective step toward control of the rotavirus diarrhea-related morbidity and mortality in India.

  20. Measuring the costs of children: an alternative approach.

    Science.gov (United States)

    Ray, R

    1983-10-01

    Problems related to the concept of the "cost of a child", more commonly known as the general equivalence scale, are reviewed. The importance of this concept is noted with regard to both theoretical and empirical studies relating to taxation, poverty, income distribution, dietary needs, income maintenance programs, supplementary and child benefits, and other social security payments. "This paper proposes a new methodology for calculating the scale using a framework which is consistent with utility theory and which overcomes the identification problem without having to enforce the arbitrary prior assumptions of recent studies. The proposed method allows easy calculation of not only the basic 'scale' parameter but also how it varies with price and reference utility. [The author illustrates] the usefulness of the procedure by estimating on U.K. budget data at two different levels of aggregation and employing two sets of quite different functional forms. The results are plausible, compare favourably with one another and, hence, confirm the robustness and usefulness of the proposed procedure." excerpt

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

    Science.gov (United States)

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

    2017-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Clint Pecenka

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

  3. Cost and quality planning for large NASA programs

    Science.gov (United States)

    Rone, Kyle Y.

    1990-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    NARCIS (Netherlands)

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

    2013-01-01

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

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

    Science.gov (United States)

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

    2010-01-01

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

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

    NARCIS (Netherlands)

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

    2009-01-01

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

  8. 75 FR 78798 - Airport Improvement Program: Proposed Changes to Benefit Cost Analysis (BCA) Threshold

    Science.gov (United States)

    2010-12-16

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

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

    Science.gov (United States)

    Soong, Robert K.; And Others

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

  10. 78 FR 53425 - Indirect Cost Rates for the Damage Assessment, Remediation, and Restoration Program for Fiscal...

    Science.gov (United States)

    2013-08-29

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

  11. 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.

  12. Cost Management Competencies for Department of Defense Program Managers

    Science.gov (United States)

    1994-09-01

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

  13. Cost effectiveness of the MDOT preventive maintenance program.

    Science.gov (United States)

    2013-04-01

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

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

    Science.gov (United States)

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

    2011-01-01

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

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

    Science.gov (United States)

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

    2011-09-01

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

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

    Science.gov (United States)

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

    2014-08-01

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

  17. [Cost-effectiveness of an organized breast cancer screening program in Southern Brazil].

    Science.gov (United States)

    Ribeiro, Rodrigo Antonini; Caleffi, Maira; Polanczyk, Carisi Anne

    2013-11-01

    The aim of this study was to evaluate the cost-effectiveness of an organized breast cancer mammographic screening program implemented in Porto Alegre (Núcleo Mama Porto Alegre - NMPOA), Rio Grande do Sul State, Brazil. A Markov model was constructed to estimate the incremental cost-effectiveness ratio of NMPOA compared to current BC diagnosis and care in the Brazilian public health system, in a hypothetical cohort of women aged 40-69 years at risk of developing breast cancer. Model parameters were collected from NMPOA and the national literature. In the NMPOA strategy, effectiveness was modeled taking into account the actual observed screening adherence. Effectiveness was measured in quality-adjusted life years (QALYs). Incremental cost-effectiveness ratio in the base case was R$ 13,426 per QALY. This result was not sensitive to variation in the main model parameters in sensitivity analyses. Considering the threshold usually suggested as highly attractive in Brazil, breast cancer screening as performed in NMPOA is cost-effective in cities with high incidence of breast cancer.

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

    National Research Council Canada - National Science Library

    1980-01-01

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

  19. 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.

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

    Science.gov (United States)

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

    2010-11-01

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

  1. Measuring adherence to a women's walking program.

    Science.gov (United States)

    Wilbur, J; Chandler, P; Miller, A M

    2001-02-01

    The purpose of this study is to demonstrate the use of a self-report exercise log and a heart-rate monitor in the measurement of adherence to the dimensions of an exercise prescription and to propose an alternative way to define adherence to a 24-week home-based women's walking program, which reflects the dynamic process of behavior change. Adherence was measured with exercise logs, Polar Vantage XL Heart-Rate Monitors, and pre- to postintervention change in VO2 max. Of the dimensions of the exercise prescription, frequency of walks documented by both the heart-rate monitor and the exercise log had a higher correlation than duration and intensity of walking, with change in VO2 max suggesting that frequency was potentially the most predictive adherence measure. Examination of the total number of walks and the number and sequence of weeks without walks over the 24-week intervention revealed dynamic patterns of adherence suggesting variation in the degree of behavioral change.

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-04-01

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

  4. Solution of resource allocation problem for identification of cost-effective measures to reduce nuclear proliferation risks

    Energy Technology Data Exchange (ETDEWEB)

    Andrianov, A.; Kuptsov, I. [Obninsk Institute for Nuclear Power Engineering, Studgorodok 1, Obninsk, Kaluga region 249030 (Russian Federation)

    2013-07-01

    This report presents a methodology of selection of cost-effective measures to reduce nuclear proliferation risks. The methodology relies on a graded security model used in practice in different applications. The method is based on the controlled finite Markov chain approach set in combination with discrete dynamic programming and MCDM (Multi Criteria Decision Making) techniques that enables the expert to select the cost-effective measures to reduce nuclear proliferation risks depending on availability of resources. The analysis performed with different number of possible measures confirms the conclusions that the implementation of extra-large costs may not produce the required effect, and the increase in resources above a certain level does not appear sensitive. Diversification in improving the effectiveness of other measures seems more rational and efficient for the whole system than the unlimited improvement of the effectiveness of only one measure.

  5. The cost of policy simplification in conservation incentive programs

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  6. How Should the Treatment Costs of Distal Radius Fractures Be Measured?

    Science.gov (United States)

    Swart, Eric; Tulipan, Jacob; Rosenwasser, Melvin P

    Distal radius fractures (DRFs) are common, but the best way to measure the total cost of treating these injuries is not known. We conducted a study to measure the total treatment cost of DRFs to identify which items should be measured, and for how long, to capture all major cost-drivers. Eighty-two patients with DRFs were included in this prospective, observational study. All costs, both direct and indirect, were measured. Direct costs were measured for each patient from internal billing records. Indirect costs were obtained with a customized questionnaire. The major contributors to overall cost were physician fees, operating room costs, occupational therapy, and missed work, which together accounted for 92% of total cost. Recurring indirect costs largely resolved within 3 months for nonoperative management and within 6 months for operative management. Physician fees, operating room costs, occupational therapy, and missed work are the major cost-drivers for DRFs and should be measured for at least 6 months after injury. Indirect costs, particularly those associated with missed work, represent a significant amount of the total overall cost.

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

    Science.gov (United States)

    Schwartz, Heather L.; Karoly, Lynn A.

    2011-01-01

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

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

    Science.gov (United States)

    Foytik, Jerry

    1981-01-01

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

  9. 76 FR 65769 - Airport Improvement Program: Modifications to Benefit Cost Analysis (BCA) Threshold

    Science.gov (United States)

    2011-10-24

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

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

    Science.gov (United States)

    2015-12-01

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

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

    Science.gov (United States)

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

    1993-12-01

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

  12. [Direct costs of the dengue fever control and prevention program in 2005 in the City of São Paulo].

    Science.gov (United States)

    Taliberti, Helena; Zucchi, Paola

    2010-03-01

    To estimate the direct costs associated with the control of Aedes aegypti and prevention of dengue fever in the City of São Paulo Dengue Control Program, Brazil, in 2005. The following items were considered: human resources, uniforms, field materials, individual protection equipment, spraying equipment, strategic supplies (insecticides and larvicides), and vehicles. The costs associated with laboratory tests for entomological surveillance and dengue fever diagnosis were also calculated, as well as costs relating to information and printed materials for educational campaigns. The total direct costs of the City of São Paulo Dengue Fever Program in 2005 were R$ 21,774,282.82 (US$ 12,486,941.34 considering the dollar/real exchange rate in December 2009). Of this amount, 59.4% were directed to human resources, 38.3% to epidemic control measures, and 2.2% to capital expenditure. The cost per capita was R$ 1.99 in 2005. The control of dengue fever is essential given the growth of epidemics. Knowledge about the costs of strategies and priority items employed in dengue fever control and prevention programs can guide decision-making regarding the application of budget resources in both the City of São Paulo and Brazil as a whole.

  13. Good research practices for measuring drug costs in cost-effectiveness analyses: an international perspective: the ISPOR Drug Cost Task Force report--Part VI.

    Science.gov (United States)

    Shi, Lizheng; Hodges, Meredith; Drummond, Michael; Ahn, Jeonghoon; Li, Shu Chuen; Hu, Shanlian; Augustovski, Federico; Hay, Joel W; Smeeding, Jim

    2010-01-01

    The pharmacoeconomic guidelines available in the literature or promulgated in many countries are either vague or silent about how drug costs should be established or measured so an international comparison of cost-effectiveness analysis (CEA) results can be made. The objective of this report is to provide guidance and recommendations on how drug costs should be measured for CEAs done from an internationally comparative perspective. Members of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Task Force on Good Research Practices-Use of Drug Costs for Cost Effectiveness Analysis (Drug Cost Task Force [DCTF]) subgroup from several countries were experienced developers or users of CEA models, and worked in academia, industry, and as advisors to governments. They solicited comments on drafts from a core group of 174 external reviewers and more broadly, from the members of the ISPOR at the ISPOR 12th Annual International meeting and via the ISPOR Web site. Drug units should be standardized in terms of volume of active ingredient, regardless of packaging and dosing strength variations across countries. Drug costs should be measured in local currency per unit of active ingredient and should be converted to other currencies using sensitivity analyses of purchasing power parities (PPP) and exchange rates, whichever is more appropriate. When using drug prices from different years, the consumer price index for the local currency should be applied before the PPP and/or exchange rate conversion. CEA researchers conducting international pharmacoeconomic analysis should tailor the appropriate measure of drug costs to the international perspective, to maintain clarity and transparency on drug cost measurement in the context of international drug comparison and report the sensitivity of CEA results to reasonable cost conversions.

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

    Directory of Open Access Journals (Sweden)

    Sheena Xin Liu

    2016-01-01

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

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

    Science.gov (United States)

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

    2015-05-07

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

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

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

    DEFF Research Database (Denmark)

    Wennhall, Inger; Norlund, Anders; Matsson, Lars

    2010-01-01

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

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

    CERN Document Server

    Porter-Reynolds, Daisy

    2014-01-01

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

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

    National Research Council Canada - National Science Library

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

    1999-01-01

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

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

    Directory of Open Access Journals (Sweden)

    E. Puigdollers

    2003-04-01

    Full Text Available Objetivo: Actualmente, los programas de mantenimiento con metadona (PMM son la mejor alternativa de tratamiento para los adictos a opiáceos. Se pretende valorar el coste-efectividad de tres PMM que ofrecían diferentes servicios auxiliares utilizando como medida de efectividad el incremento de la calidad de vida. Métodos: Estudio de seguimiento a 12 meses de 586 pacientes que iniciaron tratamiento con metadona en los centros de atención y seguimiento municipales de Barcelona. Para medir la evolución de la calidad de vida se utilizó el Perfil de Salud de Nottingham (PSN. Se calcularon los costes unitarios estándar y el coste total por paciente a partir de los registros de actividad. Los datos sociodemográficos, de salud y toxicológicos se obtuvieron a través de una entrevista semiestructurada. El análisis coste-efectividad se realizó mediante dos modelos multivariados con idénticas variables de ajuste. Resultados: Cuanto mayor es la intensidad de programa, más elevado es el coste. Los modelos ajustados detectaron un aumento significativo de la calidad de vida (mejora de un 8% en el PSN y de los costes (17% entre el programa de intensidad baja y el de intensidad media. Conclusiones: El programa de media intensidad demostró la mejor relación coste-efectividad pero, dadas las limitaciones del estudio, es difícil ser taxativo en la generalización de sus resultados.Objective: Methadone maintenance programs (MMP currently offer the best treatment for opioid-addicted patients. The aim of this study was to examine the cost-effectiveness of three MMPs that offered varying levels of supplementary services. Health-related quality of life was used as a measure of effectiveness. Methods: A 12-month follow-up study of 586 patients beginning methadone treatment in Drug Care Centers in Barcelona was performed. The Nottingham Health Profile was used to measure quality of life. Standard unit costs and total cost per patient were calculated from

  1. What Does a College Degree Cost? Comparing Approaches to Measuring "Cost Per Degree". Delta Cost Project White Paper Series

    Science.gov (United States)

    Johnson, Nate

    2009-01-01

    What does it cost to provide a bachelor's-level education? This question arises with increasing frequency and urgency as pressure mounts on policymakers and education leaders to increase the education attainment level in the United States, to "Double the Numbers" in some cases. At the same time, the two traditional sources of…

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

    DEFF Research Database (Denmark)

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

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

  3. An inventory of measures for internalising external costs in transport

    Energy Technology Data Exchange (ETDEWEB)

    Van Essen, H.; Nelissen, D.; Smit, M.; Van Grinsven, A.; Aarnink, S. [CE Delft, Delft (Netherlands); Breemersch, T. [Transport and Mobility Leuven TML, Leuven (Belgium); Martino, A.; Rosa, C.; Parolin, R. [Trasporti e Territorio TRT, Brussels (Belgium); Harmsen, J. [Sustainable Transport and Logistics TNO, Rotterdam (Netherlands)

    2012-11-15

    This study provides an overview of all existing and close to implementation pricing policies in transport. It supported the European Commission with the evaluation of existing pricing policies in the light of Article 11.4 of the revised Eurovignette Directive. The study covers all existing pricing instruments in all transport modes in all EU Member States. In addition it includes data on revenues and administrative costs and some comparisons across Member States and transport modes. The most recent data have been gathered: data for 2010 and where possible 2011. Also the link with external and infrastructure costs is discussed, and where possible, high level comparisons have been made.

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

    OpenAIRE

    Fung, Vicki; Reed, Mary; Hsu, John

    2010-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    1973-01-01

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

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

    Science.gov (United States)

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

    2011-09-01

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

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

    Science.gov (United States)

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

    2014-10-26

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

  9. Orbital Debris and NASA's Measurement Program

    Science.gov (United States)

    Africano, J. L.; Stansbery, E. G.

    2002-05-01

    Since the launch of Sputnik in 1957, the number of manmade objects in orbit around the Earth has dramatically increased. The United States Space Surveillance Network (SSN) tracks and maintains orbits on over nine thousand objects down to a limiting diameter of about ten centimeters. Unfortunately, active spacecraft are only a small percentage ( ~ 7%) of this population. The rest of the population is orbital debris or ``space junk" consisting of expended rocket bodies, dead payloads, bits and pieces from satellite launches, and fragments from satellite breakups. The number of these smaller orbital debris objects increases rapidly with decreasing size. It is estimated that there are at least 130,000 orbital debris objects between one and ten centimeters in diameter. Most objects smaller than 10 centimeters go untracked! As the orbital debris population grows, the risk to other orbiting objects, most importantly manned space vehicles, of a collision with a piece of debris also grows. The kinetic energy of a solid 1 cm aluminum sphere traveling at an orbital velocity of 10 km/sec is equivalent to a 400 lb. safe traveling at 60 mph. Fortunately, the volume of space in which the orbiting population resides is large, collisions are infrequent, but they do occur. The Space Shuttle often returns to earth with its windshield pocked with small pits or craters caused by collisions with very small, sub-millimeter-size pieces of debris (paint flakes, particles from solid rocket exhaust, etc.), and micrometeoroids. To get a more complete picture of the orbital-debris environment, NASA has been using both radar and optical techniques to monitor the orbital debris environment. This paper gives an overview of the orbital debris environment and NASA's measurement program.

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

    Science.gov (United States)

    2015-02-17

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

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

    OpenAIRE

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

    2015-01-01

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

  12. 48 CFR 1819.7214 - Measurement of program success.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Measurement of program success. 1819.7214 Section 1819.7214 Federal Acquisition Regulations System NATIONAL AERONAUTICS AND SPACE... of program success. (a) NASA will measure the overall success of the Program by the extent to which...

  13. Measuring Satisfaction in the Program Manager, Procuring Contracting Officer Relationship

    Science.gov (United States)

    1997-12-01

    Contracting Officer) and one of her customers (a U. S. Navy Program Manager ). From an examination of this relationship , the most appropriate criteria... Customer Satisfaction, Performance Measurement, Metrics, Contracting, Program Management 17. SECURITY CLASSIFICATION OF REPORT Unclassified...methodology for developing an instrument to measure the satisfaction of their customers , Navy Program Managers . The purpose of this thesis was to develop

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

    Science.gov (United States)

    2015-12-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-07-01

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

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

    Science.gov (United States)

    2017-03-01

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

  17. Measuring the True Cost of Active Management by Mutual Funds

    OpenAIRE

    Miller, Ross M.

    2005-01-01

    Recent years have seen a dramatic shift from mutual funds into hedge funds even though hedge funds charge management fees that have been decried as outrageous. While expectations of superior returns may be responsible for this shift, this article shows that mutual funds are more expensive than commonly believed. Mutual funds appear to provide investment services for relatively low fees because they bundle passive and active funds management together in a way that understates the true cost of ...

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

    Science.gov (United States)

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

    2007-01-01

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

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

    Science.gov (United States)

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

    2017-03-01

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

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

    Science.gov (United States)

    Stewart Holmes; George B. Harpole; Edward Bilek

    1983-01-01

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

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

    Science.gov (United States)

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

    2011-01-01

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

  2. 76 FR 61089 - Indirect Cost Rates for the Damage Assessment, Remediation, and Restoration Program for Fiscal...

    Science.gov (United States)

    2011-10-03

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

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

    Science.gov (United States)

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

    2012-01-01

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

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

    Science.gov (United States)

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

    2011-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1980-04-01

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

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  7. Improve forest inventory with access data-measure transport distance and cost to market.

    Science.gov (United States)

    Dennis P. Bradley

    1972-01-01

    Describes a method for relating forest inventory volumes to transport distances and costs. The process, originally developed in Sweden, includes a computer program that can be used to summarize volumes by transport costs per cord to specified delivery point. The method has many potential applications in all aspects of resource analysis.

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

    Science.gov (United States)

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

    2010-10-01

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

  9. 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.

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

    Science.gov (United States)

    Grey, Margaret; Liberti, Lauren; Whittemore, Robin

    2015-07-01

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

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

    Science.gov (United States)

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

    2012-02-01

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

  12. 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

  13. Novel Measure of Opioid Dose and Costs of Care for Diabetes Mellitus: Opioid Dose and Health Care Costs.

    Science.gov (United States)

    Gautam, Santosh; Franzini, Luisa; Mikhail, Osama I; Chan, Wenyaw; Turner, Barbara J

    2016-03-01

    Diabetes mellitus (DM) has well known costly complications but we hypothesized that costs of care for chronic pain treated with opioid analgesic (OA) medications would also be substantial. In a statewide, privately insured cohort of 29,033 adults aged 18 to 64 years with DM and noncancer pain who filled OA prescription(s) from 2008 to 2012, our outcomes were costs for specific health care services and total costs per 6-month intervals after the first filled OA prescription. Average daily OA dose (4 categories) and total dose (quartiles) in morphine-equivalent milligrams were calculated per 6-month interval after the first OA prescription and combined into a novel OA dose measure. Associations of OA measures with costs of care (n = 126,854 6-month intervals) were examined using generalized estimating equations adjusted for clinical conditions, psychotherapeutic drugs, and DM treatment. Incremental costs for each type of health care service and total cost of care increased progressively with average daily and total OA dose versus no OAs. The combined OA measure identified the highest incremental total costs per 6-month interval that were increased by $8,389 for 50- to 99-mg average daily dose plus >900 mg total dose and, by $9,181 and $9,958 respectively, for ≥100 mg average daily dose plus 301- to 900-mg or >900 mg total dose. In this statewide DM cohort, total health care costs per 6-month interval increased progressively with higher average daily OA dose and with total OA dose but the greatest increases of >$8,000 were distinguished by combinations of higher average daily and total OA doses. The higher costs of care for opioid-treated patients appeared for all types of services and likely reflects multiple factors including morbidity from the underlying cause of pain, care and complications related to opioid use, and poorer control of diabetes as found in other studies. Copyright © 2016 American Pain Society. Published by Elsevier Inc. All rights reserved.

  14. Design and implementation of a low-cost multichannel seismic noise recorder for array measurements

    Science.gov (United States)

    Soler-Llorens, Juan Luis; Juan Giner-Caturla, Jose; Molina-Palacios, Sergio; Galiana-Merino, Juan Jose; Rosa-Herranz, Julio; Agea-Medina, Noelia

    2017-04-01

    Soil characterization is the starting point for seismic hazard studies. Currently, the methods based on ambient noise measurements are very used because they are non-invasive methods and relatively easy to implement in urban areas. Among these methods, the analysis of array measurements provides the dispersion curve and subsequently the shear-wave velocity profile associated to the site under study. In this case, we need several sensors recording simultaneously and a data acquisition system with one channel by sensor, what can become the complete equipment unaffordable for small research groups. In this work, we have designed and implemented a low-cost multichannel ambient noise recorder for array measurements. The complete system is based on Arduino, an open source electronic development platform, which allows recording 12 differential input channels simultaneously. Besides, it is complemented with a conditioning circuit that includes an anti-aliasing filter and a selectable gain between 0 and 40dB. The data acquisition is set up through a user-friendly graphical user interface. It is important to note that the electronic scheme as well as the programming code are open hardware and software, respectively, so it allows other researchers to suite the system to their particular requirements. The developed equipment has been tested at several sites around the province of Alicante (southeast of Spain), where the soil characteristics are well-known from previous studies. Array measurements have been taken and after that, the recorded data have been analysed using the frequency-wavenumber (f-k) and the extended spatial autocorrelation (ESAC) methods. The comparison of the obtained dispersion curves with the ones obtained in previous studies shows the suitability of the implemented low-cost system for array measurements.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1994-05-01

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

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

    Science.gov (United States)

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

    1991-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-04-01

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

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

    Science.gov (United States)

    1985-01-01

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

  19. Measuring Satisfaction in the Program Manager, Procuring Contracting Officer Relationship

    National Research Council Canada - National Science Library

    Gray, John

    1997-01-01

    .... To comply with this Executive Order, Navy contracting offices require an effective methodology for developing an instrument to measure the satisfaction of their customers, Navy Program Managers...

  20. Layer of protection analysis: Selecting cost effective safety measures

    NARCIS (Netherlands)

    Boers, M.N.; Gort, J.; Versloot, N.H.A.

    2006-01-01

    Traditionally, in process industry risks are reduced by applying technical solutions and taking organisational measures. The performance of both types of 'solutions' depends on many factors and can not easily be compared. Especially the effectiveness of organisational measures such as the use of

  1. Low-Cost Sensors Deliver Nanometer-Accurate Measurements

    Science.gov (United States)

    2015-01-01

    As part of a unique partnership program, Kennedy Space Center collaborated with a nearby business school to allow MBA students to examine and analyze the market potential for a selection of NASA-patented technologies. Following the semester, a group of students decided to form Winter Park, Florida-based Juntura Group Inc. to license and sell a technology they had worked with: a sensor capable of detecting position changes as small as 10 nanometers-approximately the thickness of a cell wall.

  2. National Guard State Partnership Program: Measuring Effectiveness

    Science.gov (United States)

    2013-06-14

    future development of partnerships. To use an idiomatic expression , gone are the days when we could pick our players and practice before the game. In the...Director, Graduate Degree Programs Robert F. Baumann, Ph.D. The opinions and conclusions expressed herein are those of the student

  3. Giving and Receiving: Measuring the Carbon Cost of Mycorrhizas in the Green Orchid, Goodyera Repens

    National Research Council Canada - National Science Library

    Duncan D. Cameron; Irene Johnson; David J. Read; Jonathan R. Leake

    2008-01-01

    Direct measurement of the carbon (C) 'cost' of mycorrhizas is problematic. Although estimates have been made for arbuscular and ectomycorrhizal symbioses, these are based on incomplete budgets or indirect measurements...

  4. Measurement control program for NDA instruments

    Energy Technology Data Exchange (ETDEWEB)

    Hsue, S.T.; Marks, T.

    1983-01-01

    Measurement control checks for nondestructive assay instruments have been a constant and continuing concern at Los Alamos National Laboratory. This paper summarizes the evolution of the measurement control checks in the various high-resolution gamma systems we have developed. In-plant experiences with these systems and checks will be discussed. Based on these experiences, a set of measurement control checks is recommended for high-resolution gamma-ray systems.

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

    Science.gov (United States)

    Lohse, Barbara; Wamboldt, Patricia

    2013-08-15

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

  6. Test-Cost-Sensitive Attribute Reduction of Data with Normal Distribution Measurement Errors

    OpenAIRE

    Hong Zhao; Fan Min; William Zhu

    2013-01-01

    The measurement error with normal distribution is universal in applications. Generally, smaller measurement error requires better instrument and higher test cost. In decision making based on attribute values of objects, we shall select an attribute subset with appropriate measurement error to minimize the total test cost. Recently, error-range-based covering rough set with uniform distribution error was proposed to investigate this issue. However, the measurement errors satisfy normal distrib...

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

    Science.gov (United States)

    Wang, Y Claire; Pamplin, John; Long, Michael W; Ward, Zachary J; Gortmaker, Steven L; Andreyeva, Tatiana

    2015-11-01

    Efforts to expand Medicaid while controlling spending must be informed by a deeper understanding of the extent to which the high medical costs associated with severe obesity (having a body mass index of [Formula: see text] or higher) determine spending at the state level. Our analysis of population-representative data indicates that in 2013, severe obesity cost the nation approximately $69 billion, which accounted for 60 percent of total obesity-related costs. Approximately 11 percent of the cost of severe obesity was paid for by Medicaid, 30 percent by Medicare and other federal health programs, 27 percent by private health plans, and 30 percent out of pocket. Overall, severe obesity cost state Medicaid programs almost $8 billion a year, ranging from $5 million in Wyoming to $1.3 billion in California. These costs are likely to increase following Medicaid expansion and enhanced coverage of weight loss therapies in the form of nutrition consultation, drug therapy, and bariatric surgery. Ensuring and expanding Medicaid-eligible populations' access to cost-effective treatment for severe obesity should be part of each state's strategy to mitigate rising obesity-related health care costs. Project HOPE—The People-to-People Health Foundation, Inc.

  8. Good research practices for measuring drug costs in cost-effectiveness analyses: a managed care perspective: the ISPOR Drug Cost Task Force report--Part III.

    Science.gov (United States)

    Mansley, Edward C; Carroll, Norman V; Chen, Kristina S; Shah, Nilay D; Piech, Catherine Tak; Hay, Joel W; Smeeding, James

    2010-01-01

    The objective of this report is to provide guidance and recommendations on how drug costs should be measured for cost-effectiveness analyses conducted from the perspective of a managed care organization (MCO). The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Task Force on Good Research Practices-Use of Drug Costs for Cost Effectiveness Analysis (DCTF) was appointed by the ISPOR Board of Directors. Members were experienced developers or users of CEA models. The DCTF met to develop core assumptions and an outline before preparing a draft report. They solicited comments on drafts from external reviewers and from the ISPOR membership at ISPOR meetings and via the ISPOR Web site. The cost of a drug to an MCO equals the amount it pays to the dispenser for the drug's ingredient cost and dispensing fee minus the patient copay and any rebates paid by the drug's manufacturer. The amount that an MCO reimburses for each of these components can differ substantially across a number of factors that include type of drug (single vs. multisource), dispensing site (retail vs. mail order), and site of administration (self-administered vs. physician's office). Accurately estimating the value of cost components is difficult because they are determined by proprietary and confidential contracts. Estimates of drug cost from the MCO perspective should include amounts paid for medication ingredients and dispensing fees, and net out copays, rebates, and other drug price reductions. Because of the evolving nature of drug pricing, ISPOR should publish a Web site where current DCTF costing recommendations are updated as new information becomes available.

  9. Cost-effectiveness of national health insurance programs in high-income countries: A systematic review.

    Directory of Open Access Journals (Sweden)

    Son Nghiem

    Full Text Available National health insurance is now common in most developed countries. This study reviews the evidence and synthesizes the cost-effectiveness information for national health insurance or disability insurance programs across high-income countries.A literature search using health, economics and systematic review electronic databases (PubMed, Embase, Medline, Econlit, RepEc, Cochrane library and Campbell library, was conducted from April to October 2015.Two reviewers independently selected relevant studies by applying screening criteria to the title and keywords fields, followed by a detailed examination of abstracts.Studies were selected for data extraction using a quality assessment form consisting of five questions. Only studies with positive answers to all five screening questions were selected for data extraction. Data were entered into a data extraction form by one reviewer and verified by another.Data on costs and quality of life in control and treatment groups were used to draw distributions for synthesis. We chose the log-normal distribution for both cost and quality-of-life data to reflect non-negative value and high skew. The results were synthesized using a Monte Carlo simulation, with 10,000 repetitions, to estimate the overall cost-effectiveness of national health insurance programs.Four studies from the United States that examined the cost-effectiveness of national health insurance were included in the review. One study examined the effects of medical expenditure, and the remaining studies examined the cost-effectiveness of health insurance reforms. The incremental cost-effectiveness ratio (ICER ranged from US$23,000 to US$64,000 per QALY. The combined results showed that national health insurance is associated with an average incremental cost-effectiveness ratio of US$51,300 per quality-adjusted life year (QALY. Based on the standard threshold for cost-effectiveness, national insurance programs are cost-effective interventions

  10. [Health risks and economic costs associated with obesity requiring a comprehensive weight reduction program].

    Science.gov (United States)

    Hainer, V; Kunesová, M; Parízková, J; Stunkard, A

    1997-06-12

    An increasing prevalence of obesity all over the world reflects a lack of effective measures in both prevention and treatment of obesity. Obesity as a disease has been underestimated by the lay-public as well as health care providers. However, obesity represents a substantial health problem associated with a decreased quality of life. Obesity is linked to numerous chronic diseases (cardiovascular diseases, diabetes, hyperlipidemia, gout, osteoarthritis, gall-stones, and bowel, breast and genitourinary cancers) that lead to premature disability and mortality. Health risks increase with a body mass index (BMI) over 25 in individuals 19-35 years of age and with a BMI over 27 in those 35 years of age and older. Health risks also increase with an excess accumulation of visceral fat manifested as an increase in waist circumference (> 100 cm) or in waist to hip ratio (> 0.85 for females and > 1.00 for males). According to studies carried out in different countries current economic costs of obesity represent 5-8% of all direct health costs. In contrast, effective treatment of obesity results in a substantial decrease in expenditures associated with pharmacotherapy of hypertension, diabetes, hyperlipidemia and osteoarthritis. Both scientists and clinicians involved in obesity research and treatment recommend to introduce the long-term weight management programs focussing more on the overall health of the participants than the weight loss per se. Therefore, it will be necessary to establish new realistic goals in the obesity management that reflect reasonable weights and recently experienced beneficial health effects of modest (5-10%) weight loss. Comprehensive obesity treatment consisting of low fat diet, exercise, behavioral modification, drug therapy and surgical procedures requires differentiated weight management programs modified according to the degree and type of obesity as well as to current health complications present. The Czech Society for the Study of Obesity

  11. An ultra-low cost NMR device with arbitrary pulse programming

    Science.gov (United States)

    Chen, Hsueh-Ying; Kim, Yaewon; Nath, Pulak; Hilty, Christian

    2015-06-01

    Ultra-low cost, general purpose electronics boards featuring microprocessors or field programmable gate arrays (FPGA) are reaching capabilities sufficient for direct implementation of NMR spectrometers. We demonstrate a spectrometer based on such a board, implemented with a minimal need for the addition of custom electronics and external components. This feature allows such a spectrometer to be readily implemented using typical knowledge present in an NMR laboratory. With FPGA technology, digital tasks are performed with precise timing, without the limitation of predetermined hardware function. In this case, the FPGA is used for programming of arbitrarily timed pulse sequence events, and to digitally generate required frequencies. Data acquired from a 0.53 T permanent magnet serves as a demonstration of the flexibility of pulse programming for diverse experiments. Pulse sequences applied include a spin-lattice relaxation measurement using a pulse train with small-flip angle pulses, and a Carr-Purcell-Meiboom-Gill experiment with phase cycle. Mixing of NMR signals with a digitally generated, 4-step phase-cycled reference frequency is further implemented to achieve sequential quadrature detection. The flexibility in hardware implementation permits tailoring this type of spectrometer for applications such as relaxometry, polarimetry, diffusometry or NMR based magnetometry.

  12. Predicting Cost Growth Using Programs Reviews and Milestones for DoD Aircraft

    Science.gov (United States)

    2016-03-24

    growth, percent of programs with cost growth, mean, median, standard deviation, interquartile range, minimum, and maximum. We used Microsoft Excel to...rc en t t ot al  c os t g ro w th Percent Program Completion Mean: % Complete vs % Total Cost  Growth Development Procurement Total 0% 20% 40% 60% 80...100% 120% 0% 20% 40% 60% 80% 100% Pe rc en t t ot al  c os t g ro w th Percent Program Completion Median: % Complete vs % Total Cost  Growth

  13. 25 CFR 170.607 - Can a tribe use its allocation of IRR Program funds for contract support costs?

    Science.gov (United States)

    2010-04-01

    ... costs? Yes. Contract support costs are an eligible item out of a tribe's IRR Program allocation and need... 25 Indians 1 2010-04-01 2010-04-01 false Can a tribe use its allocation of IRR Program funds for contract support costs? 170.607 Section 170.607 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE...

  14. Shared visions: Partnership of Rockwell International and NASA Cost Effectiveness Enhancements (CEE) for the space shuttle system integration program

    Science.gov (United States)

    Bejmuk, Bohdan I.; Williams, Larry

    1992-01-01

    As a result of limited resources and tight fiscal constraints over the past several years, the defense and aerospace industries have experienced a downturn in business activity. The impact of fewer contracts being awarded has placed a greater emphasis for effectiveness and efficiency on industry contractors. It is clear that a reallocation of resources is required for America to continue to lead the world in space and technology. The key to technological and economic survival is the transforming of existing programs, such as the Space Shuttle Program, into more cost efficient programs so as to divert the savings to other NASA programs. The partnership between Rockwell International and NASA and their joint improvement efforts that resulted in significant streamlining and cost reduction measures to Rockwell International Space System Division's work on the Space Shuttle System Integration Contract is described. This work was a result of an established Cost Effectiveness Enhancement (CEE) Team formed initially in Fiscal Year 1991, and more recently expanded to a larger scale CEE Initiative in 1992. By working closely with the customer in agreeing to contract content, obtaining management endorsement and commitment, and involving the employees in total quality management (TQM) and continuous improvement 'teams,' the initial annual cost reduction target was exceeded significantly. The CEE Initiative helped reduce the cost of the Shuttle Systems Integration contract while establishing a stronger program based upon customer needs, teamwork, quality enhancements, and cost effectiveness. This was accomplished by systematically analyzing, challenging, and changing the established processes, practices, and systems. This examination, in nature, was work intensive due to the depth and breadth of the activity. The CEE Initiative has provided opportunities to make a difference in the way Rockwell and NASA work together - to update the methods and processes of the organizations

  15. Shared visions: Partnership of Rockwell International and NASA Cost Effectiveness Enhancements (CEE) for the space shuttle system integration program

    Science.gov (United States)

    Bejmuk, Bohdan I.; Williams, Larry

    As a result of limited resources and tight fiscal constraints over the past several years, the defense and aerospace industries have experienced a downturn in business activity. The impact of fewer contracts being awarded has placed a greater emphasis for effectiveness and efficiency on industry contractors. It is clear that a reallocation of resources is required for America to continue to lead the world in space and technology. The key to technological and economic survival is the transforming of existing programs, such as the Space Shuttle Program, into more cost efficient programs so as to divert the savings to other NASA programs. The partnership between Rockwell International and NASA and their joint improvement efforts that resulted in significant streamlining and cost reduction measures to Rockwell International Space System Division's work on the Space Shuttle System Integration Contract is described. This work was a result of an established Cost Effectiveness Enhancement (CEE) Team formed initially in Fiscal Year 1991, and more recently expanded to a larger scale CEE Initiative in 1992. By working closely with the customer in agreeing to contract content, obtaining management endorsement and commitment, and involving the employees in total quality management (TQM) and continuous improvement 'teams,' the initial annual cost reduction target was exceeded significantly. The CEE Initiative helped reduce the cost of the Shuttle Systems Integration contract while establishing a stronger program based upon customer needs, teamwork, quality enhancements, and cost effectiveness. This was accomplished by systematically analyzing, challenging, and changing the established processes, practices, and systems. This examination, in nature, was work intensive due to the depth and breadth of the activity. The CEE Initiative has provided opportunities to make a difference in the way Rockwell and NASA work together - to update the methods and processes of the organizations

  16. Towards identifying programming expertise with the use of physiological measures

    DEFF Research Database (Denmark)

    Kontogiorgos, Dimosthenis; Manikas, Konstantinos

    2015-01-01

    In this position paper we propose means of measuring programming expertise on novice and expert programmers. Our approach is to measure the cognitive load of programmers while they assess Java/Python code in accordance with their experience in programming. Our hypothesis is that expert programmers...... encounter smaller pupillary dilation within programming problem solving tasks. We aim to evaluate our hypothesis using the EMIP Distributed Data Collection in order to confirm or reject our approach....

  17. A Comparison of Four Software Programs for Implementing Decision Analytic Cost-Effectiveness Models.

    Science.gov (United States)

    Hollman, Chase; Paulden, Mike; Pechlivanoglou, Petros; McCabe, Christopher

    2017-08-01

    The volume and technical complexity of both academic and commercial research using decision analytic modelling has increased rapidly over the last two decades. The range of software programs used for their implementation has also increased, but it remains true that a small number of programs account for the vast majority of cost-effectiveness modelling work. We report a comparison of four software programs: TreeAge Pro, Microsoft Excel, R and MATLAB. Our focus is on software commonly used for building Markov models and decision trees to conduct cohort simulations, given their predominance in the published literature around cost-effectiveness modelling. Our comparison uses three qualitative criteria as proposed by Eddy et al.: "transparency and validation", "learning curve" and "capability". In addition, we introduce the quantitative criterion of processing speed. We also consider the cost of each program to academic users and commercial users. We rank the programs based on each of these criteria. We find that, whilst Microsoft Excel and TreeAge Pro are good programs for educational purposes and for producing the types of analyses typically required by health technology assessment agencies, the efficiency and transparency advantages of programming languages such as MATLAB and R become increasingly valuable when more complex analyses are required.

  18. Software Programs Derive Measurements from Photographs

    Science.gov (United States)

    2012-01-01

    Even under the most unfortunate circumstances, NASA continues on a path of innovation. After the Space Shuttle Columbia reentered the atmosphere on February 1, 2003, it experienced a catastrophic failure, and the entire crew and vehicle were lost. For the two weeks prior to the accident, Columbia STS-107 was on a mission to perform physical, life, and space sciences research in the unique environment of microgravity. Following the accident, the remaining shuttles - Endeavor, Atlantis, and Discovery - were grounded, and an intense investigation ensued. The Columbia Accident Investigation Board spent nearly 7 months examining the cause of the accident and determining what would ensure a safe return to flight. To this end, investigators performed an extensive review down five analytic paths: aerodynamic, thermodynamic, sensor data timeline, debris reconstruction, and imaging. As part of the evaluation of all the available imagery from Columbia's ascent, orbit, and entry, investigators needed a new method for analyzing still video images to determine the size of the material that fell from Columbia, as well as the distance that the material traveled. John Lane, a scientist at Kennedy Space Center, devised a software program to calculate the unknown dimension of the material in the images, and soon after the investigation was complete, continued to enhance the technology. Eventually, the program that assisted in the Columbia investigation became available for licensing.

  19. A calculation program for harvesting and transportation costs of energy wood; Energiapuun korjuun ja kuljetuksen kustannuslaskentaohjelmisto

    Energy Technology Data Exchange (ETDEWEB)

    Kuitto, P.J.

    1996-12-31

    VTT Energy is compiling a large and versatile calculation program for harvesting and transportation costs of energy wood. The work has been designed and will be carried out in cooperation with Metsaeteho and Finntech Ltd. The program has been realised in Windows surroundings using SQLWindows graphical database application development system, using the SQLBase relational database management system. The objective of the research is to intensify and create new possibilities for comparison of the utilization costs and the profitability of integrated energy wood production chains with each other inside the chains

  20. Using biconical dipoles for cost effective EMI measurements

    Science.gov (United States)

    Bronaugh, E. L.

    1985-06-01

    In order to measure radiated electromagnetic interference (EMI) in the frequency range from 20 to 200 MHz, the U.S. civil and military electromagnetic interference test laboratories use either tuned dipole antennas, broadband antennas, or both. In general, there is an economic advantage in using a broadband antenna and automated frequency scanning in EMI testing. The accuracy of this method and its correlation with methods using other antenna types require that the antenna factor be known throughout the useful bandwidth of the antenna. Relationships regarding the antenna factor and its characteristics are discussed. It is important to calibrate EMI antennas for their intended uses. The biconical dipole antenna, because its dimensions are small relative to the test setup dimensions, can be properly calibrated at three meters and used at all three distances involved. Biconical and tuned dipoles are compared, and details regarding the conduction of the measurements are discussed.

  1. An analysis of potential costs of adverse events based on Drug Programs in Poland. Pulmonology focus

    Directory of Open Access Journals (Sweden)

    Szkultecka-Debek Monika

    2014-06-01

    Full Text Available The project was performed within the Polish Society for Pharmacoeconomics (PTFE. The objective was to estimate the potential costs of treatment of side effects, which theoretically may occur as a result of treatment of selected diseases. We analyzed the Drug Programs financed by National Health Fund in Poland in 2012 and for the first analysis we selected those Programs where the same medicinal products were used. We based the adverse events selection on the Summary of Product Characteristics of the chosen products. We extracted all the potential adverse events defined as frequent and very frequent, grouping them according to therapeutic areas. This paper is related to the results in the pulmonology area. The events described as very common had an incidence of ≥ 1/10, and the common ones ≥ 1/100, <1/10. In order to identify the resources used, we performed a survey with the engagement of clinical experts. On the basis of the collected data we allocated direct costs incurred by the public payer. We used the costs valid in December 2013. The paper presents the estimated costs of treatment of side effects related to the pulmonology disease area. Taking into account the costs incurred by the NHF and the patient separately e calculated the total spending and the percentage of each component cost in detail. The treatment of adverse drug reactions generates a significant cost incurred by both the public payer and the patient.

  2. Effect of Medicaid disease management programs on emergency admissions and inpatient costs.

    Science.gov (United States)

    Conti, Matthew S

    2013-08-01

    To determine the impact of state Medicaid diabetes disease management programs on emergency admissions and inpatient costs. National InPatient Sample sponsored by the Agency for Healthcare Research and Quality Project for the years from 2000 to 2008 using 18 states. A difference-in-difference methodology compares costs and number of emergency admissions for Washington, Texas, and Georgia, which implemented disease management programs between 2000 and 2008, to states that did not undergo the transition to managed care (N = 103). Costs and emergency admissions were extracted for diabetic Medicaid enrollees diagnosed in the reform and non-reform states and collapsed into state and year cells. In the three treatment states, the implementation of disease management programs did not have statistically significant impacts on the outcome variables when compared to the control states. States that implemented disease management programs did not achieve improvements in costs or the number of emergency of admissions; thus, these programs do not appear to be an effective way to reduce the burden of this chronic disease. © Health Research and Educational Trust.

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

    Science.gov (United States)

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

    2017-02-15

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

  4. ''Measuring the Costs of Climate Change Policies''

    Energy Technology Data Exchange (ETDEWEB)

    Montgomery, W. D.; Smith, A. E.; Biggar, S. L.; Bernstein, P.M.

    2003-05-09

    Studies of the costs of climate change policies have utilized a variety of measures or metrics for summarizing costs. The leading economic models have utilized GNP, GDP, the ''area under a marginal cost curve,'' the discounted present value of consumption, and a welfare measure taken directly from the utility function of the model's representative agent (the ''Equivalent Variation''). Even when calculated using a single model, these metrics do not necessarily give similar magnitudes of costs or even rank policies consistently. This paper discusses in non-technical terms the economic concepts lying behind each concept, the theoretical basis for expecting each measure to provide a consistent ranking of policies, and the reasons why different measures provide different rankings. It identifies a method of calculating the ''Equivalent Variation'' as theoretically superior to the other cost metrics in ranking policies. When regulators put forward new economic or regulatory policies, there is a need to compare the costs and benefits of these new policies to existing policies and other alternatives to determine which policy is most cost-effective. For command and control policies, it is quite difficult to compute costs, but for more market-based policies, economists have had a great deal of success employing general equilibrium models to assess a policy's costs. Not all cost measures, however, arrive at the same ranking. Furthermore, cost measures can produce contradictory results for a specific policy. These problems make it difficult for a policy-maker to determine the best policy. For a cost measures to be of value, one would like to be confident of two things. First one wants to be sure whether the policy is a winner or loser. Second, one wants to be confident that a measure produces the correct policy ranking. That is, one wants to have confidence in a policy measure's ability to correctly rank

  5. RECOVERABLE COST: THE BASIS OF A GENERAL THEORY OF FINANCIAL ACCOUNTING MEASUREMENT

    OpenAIRE

    stanley c. w. salvary

    2005-01-01

    This paper addresses a very profound question concerning financial accounting. Is financial accounting measurement. as represented by diverse valuation rules. hodgepodge or is it logically developed? Salvary [1985. p.28. Chap. IV] advances and provides a theoretical development of the concept of 'recoverable cost' as the measurement property observed in (underlying) financial accounting measurement. Sa/vary [1989, pp.50-51] maintains that 'recoverable cost' is the center of 'economic gravity'...

  6. Guide for Conducting Benefit-Cost Evaluation of Realized Impacts of Public R&D Programs

    Energy Technology Data Exchange (ETDEWEB)

    Ruegg, Rosalie [TIA Consulting, Inc., Emerald Isle, NC (United States); Jordan, Gretchen B. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2011-08-01

    This document provides guidance for evaluators who conduct impact assessments to determine the “realized” economic benefits and costs, energy, environmental benefits, and other impacts of the Office of Energy Efficiency and Renewable Energy’s (EERE) R&D programs. The focus of this Guide is on realized outcomes or impacts of R&D programs actually experienced by American citizens, industry, and others. Retrospective evaluations may be contrasted to prospective evaluations that reflect expected or potential outcomes only if assumptions hold. The retrospective approach described in this Guide is based on realized results only and the extent they can be attributed to the efforts of an R&D program. While it has been prepared specifically to guide retrospective benefit-cost analysis of EERE R&D Programs, this report may be used for similar analysis of other public R&D organizations.

  7. The National Cancer Screening Program for breast cancer in the Republic of Korea: is it cost-effective?

    Science.gov (United States)

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

    2013-01-01

    This goal of this research was to evaluate the cost-effectiveness of the National Cancer Screening Program (NCSP) for breast cancer in the Republic of Korea from a government expenditure perspective. In 2002-2003 (baseline), a total of 8,724,860 women aged 40 years or over were invited to attend breast cancer screening by the NCSP. Those who attended were identified using the NCSP database, and women were divided into two groups, women who attended screening at baseline (screened group) and those who did not (non-screened group). Breast cancer diagnosis in both groups at baseline, and during 5-year follow-up was identified using the Korean Central Cancer Registry. The effectiveness of the NCSP for breast cancer was estimated by comparing 5-year survival and life years saved (LYS) between the screened and the unscreened groups, measured using mortality data from the Korean National Health Insurance Corporation and the National Health Statistical Office. Direct screening costs, indirect screening costs, and productivity costs were considered in different combinations in the model. When all three of these costs were considered together, the incremental cost to save one life year of a breast cancer patient was 42,305,000 Korean Won (KW) (1 USD=1,088 KW) for the screened group compared to the non-screened group. In sensitivity analyses, reducing the false-positive rate of the screening program by half was the most cost-effective (incremental cost-effectiveness ratio, ICER=30,110,852 KW/LYS) strategy. When the upper age limit for screening was set at 70 years, it became more cost-effective (ICER=39,641,823 KW/LYS) than when no upper age limit was set. The NCSP for breast cancer in Korea seems to be accepted as cost-effective as ICER estimates were around the Gross Domestic Product. However, cost-effectiveness could be further improved by increasing the sensitivity of breast cancer screening and by setting appropriate age limits.

  8. Measuring human capital cost through benchmarking in health care environment.

    Science.gov (United States)

    Kocakülâh, Mehmet C; Harris, Donna

    2002-01-01

    Each organization should seek to maximize its human capital investments, which ultimately lead to increased profits and asset efficiency. Service companies utilize less capital equipment and more human productivity, customer service, and/or delivery of service as the product. With the measurement of human capital, one can understand what is happening, exercise some degree of control, and make positive changes. Senior management lives or dies by the numbers and if Human Resources (HR) really wants to be a strategic business partner, HR must be judged by the same standards as everyone else in the health care organization.

  9. 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

  10. Cost and Time Overruns for Major Defense Acquisition Programs: An Annotated Brief

    OpenAIRE

    Berteau, David; Ben-Ari, Guy; Hofbauer, Joachim; Sanders, Gregory; Ellman, Jesse; Morrow, David

    2011-01-01

    Proceedings Paper (for Acquisition Research Program) Cost and time overruns in Major Defense Acquisition Programs (MDAPs) have become a high-profile problem attracting the interest of Congress, government, and watchdog groups. According to the GAO, the 98 MDAPs from FY2010 collectively ran $402 billion over budget and were an average of 22 months behind schedule since their first full estimate. President Obama''s memorandum on government contracting of 4 March 2009 also highlighted this i...

  11. Cost effectiveness of a community-based crisis intervention program for people bereaved by suicide.

    Science.gov (United States)

    Comans, Tracy; Visser, Victoria; Scuffham, Paul

    2013-01-01

    Postvention services aim to ameliorate distress and reduce future incidences of suicide. The StandBy Response Service is one such service operating in Australia for those bereaved through suicide. Few previous studies have reported estimates or evaluations of the economic impact and outcomes associated with the implementation of bereavement/grief interventions. To estimate the cost-effectiveness of a postvention service from a societal perspective. A Markov model was constructed to estimate the health outcomes, quality-adjusted life years, and associated costs such as medical costs and time off work. Data were obtained from a prospective cross-sectional study comparing previous clients of the StandBy service with a control group of people bereaved by suicide who had not had contact with StandBy. Costs and outcomes were measured at 1 year after suicide bereavement and an incremental cost-effectiveness ratio was calculated. The base case found that the StandBy service dominated usual care with a cost saving from providing the StandBy service of AUS $803 and an increase in quality-adjusted life years of 0.02. Probabilistic sensitivity analysis indicates there is an 81% chance the service would be cost-effective given a range of possible scenarios. Postvention services are a cost-effective strategy and may even be cost-saving if all costs to society from suicide are taken into account.

  12. Measurement problem in Program Universe. Revision

    Energy Technology Data Exchange (ETDEWEB)

    Noyes, H.P.; Gefwert, C.; Manthey, M.J.

    1985-07-01

    The ''measurement problem'' of contemporary physics is in our view an artifact of its philosophical and mathematical underpinnings. We describe a new philosophical view of theory formation, rooted in Wittgenstein, and Bishop's and Martin-Loef's constructivity, which obviates such discussions. We present an unfinished, but very encouraging, theory which is compatible with this philosophical framework. The theory is based on the concepts of counting and combinatorics in the framework provided by the combinatorial hierarchy, a unique hierarchy of bit strings which interact by an operation called discrimination. Measurement criteria incorporate c, h-bar and m/sub p/ or (not ''and'') G. The resulting theory is discrete throughout, contains no infinities, and, as far as we have developed it, is in agreement with quantum mechanical and cosmological fact. 15 refs.

  13. Cost-effectiveness analysis of neonatal hearing screening program in China: should universal screening be prioritized?

    Science.gov (United States)

    Huang, Li-Hui; Zhang, Luo; Tobe, Ruo-Yan Gai; Qi, Fang-Hua; Sun, Long; Teng, Yue; Ke, Qing-Lin; Mai, Fei; Zhang, Xue-Feng; Zhang, Mei; Yang, Ru-Lan; Tu, Lin; Li, Hong-Hui; Gu, Yan-Qing; Xu, Sai-Nan; Yue, Xiao-Yan; Li, Xiao-Dong; Qi, Bei-Er; Cheng, Xiao-Huan; Tang, Wei; Xu, Ling-Zhong; Han, De-Min

    2012-04-17

    Neonatal hearing screening (NHS) has been routinely offered as a vital component of early childhood care in developed countries, whereas such a screening program is still at the pilot or preliminary stage as regards its nationwide implementation in developing countries. To provide significant evidence for health policy making in China, this study aims to determine the cost-effectiveness of NHS program implementation in case of eight provinces of China. A cost-effectiveness model was conducted and all neonates annually born from 2007 to 2009 in eight provinces of China were simulated in this model. The model parameters were estimated from the established databases in the general hospitals or maternal and child health hospitals of these eight provinces, supplemented from the published literature. The model estimated changes in program implementation costs, disability-adjusted life years (DALYs), average cost-effectiveness ratio (ACER), and incremental cost-effectiveness ratio (ICER) for universal screening compared to targeted screening in eight provinces. A multivariate sensitivity analysis was performed to determine uncertainty in health effect estimates and cost-effectiveness ratios using a probabilistic modeling technique. Targeted strategy trended to be cost-effective in Guangxi, Jiangxi, Henan, Guangdong, Zhejiang, Hebei, Shandong, and Beijing from the level of 9%, 9%, 8%, 4%, 3%, 7%, 5%, and 2%, respectively; while universal strategy trended to be cost-effective in those provinces from the level of 70%, 70%, 48%, 10%, 8%, 28%, 15%, 4%, respectively. This study showed although there was a huge disparity in the implementation of the NHS program in the surveyed provinces, both universal strategy and targeted strategy showed cost-effectiveness in those relatively developed provinces, while neither of the screening strategy showed cost-effectiveness in those relatively developing provinces. This study also showed that both strategies especially universal strategy

  14. Cost-effectiveness analysis of neonatal hearing screening program in china: should universal screening be prioritized?

    Directory of Open Access Journals (Sweden)

    Huang Li-Hui

    2012-04-01

    Full Text Available Abstract Background Neonatal hearing screening (NHS has been routinely offered as a vital component of early childhood care in developed countries, whereas such a screening program is still at the pilot or preliminary stage as regards its nationwide implementation in developing countries. To provide significant evidence for health policy making in China, this study aims to determine the cost-effectiveness of NHS program implementation in case of eight provinces of China. Methods A cost-effectiveness model was conducted and all neonates annually born from 2007 to 2009 in eight provinces of China were simulated in this model. The model parameters were estimated from the established databases in the general hospitals or maternal and child health hospitals of these eight provinces, supplemented from the published literature. The model estimated changes in program implementation costs, disability-adjusted life years (DALYs, average cost-effectiveness ratio (ACER, and incremental cost-effectiveness ratio (ICER for universal screening compared to targeted screening in eight provinces. Results and discussion A multivariate sensitivity analysis was performed to determine uncertainty in health effect estimates and cost-effectiveness ratios using a probabilistic modeling technique. Targeted strategy trended to be cost-effective in Guangxi, Jiangxi, Henan, Guangdong, Zhejiang, Hebei, Shandong, and Beijing from the level of 9%, 9%, 8%, 4%, 3%, 7%, 5%, and 2%, respectively; while universal strategy trended to be cost-effective in those provinces from the level of 70%, 70%, 48%, 10%, 8%, 28%, 15%, 4%, respectively. This study showed although there was a huge disparity in the implementation of the NHS program in the surveyed provinces, both universal strategy and targeted strategy showed cost-effectiveness in those relatively developed provinces, while neither of the screening strategy showed cost-effectiveness in those relatively developing provinces. This

  15. A cost-reducing extracorporeal membrane oxygenation (ECMO) program model: a single institution experience.

    Science.gov (United States)

    Cavarocchi, N C; Wallace, S; Hong, E Y; Tropea, A; Byrne, J; Pitcher, H T; Hirose, H

    2015-03-01

    The worldwide demand for ECMO support has grown. Its provision remains limited due to several factors (high cost, complicated technology, lack of expertise) that increase healthcare cost. Our goal was to assess if an intensive care unit (ICU)-run ECMO model without continuous bedside perfusionists would decrease costs while maintaining patient safety and outcomes. A new ECMO program was implemented in 2010, consisting of dedicated ICU multidisciplinary providers (ICU-registered nurses, mid-level providers and intensivists). In year one, we introduced an education platform, new technology and dedicated space. In year two, continuous bedside monitoring by perfusionists was removed and new management algorithms designating multidisciplinary providers as first responders were established. The patient safety and cost benefit from the removal of the continuous bedside monitoring of the perfusionists of this new ECMO program was retrospectively reviewed and compared. During the study period, 74 patients (28 patients in year 1 and 46 patients in year 2) were placed on ECMO (mean days: 8 ± 5.7). The total annual hospital expenditure for the ECMO program was significantly reduced in the new model ($234,000 in year 2 vs. $600,264 in year 1), showing a 61% decrease in cost. This cost decrease was attributed to a decreased utilization of perfusion services and the introduction of longer lasting and more efficient ECMO technology. We did not find any significant changes in registered nurse ratios or any differences in outcomes related to ICU safety events. We demonstrated that the ICU-run ECMO model managed to lower hospital cost by reducing the cost of continuous bedside perfusion support without a change in outcomes. © The Author(s) 2014.

  16. What linear programming contributes: world food programme experience with the "cost of the diet" tool.

    Science.gov (United States)

    Frega, Romeo; Lanfranco, Jose Guerra; De Greve, Sam; Bernardini, Sara; Geniez, Perrine; Grede, Nils; Bloem, Martin; de Pee, Saskia

    2012-09-01

    Linear programming has been used for analyzing children's complementary feeding diets, for optimizing nutrient adequacy of dietary recommendations for a population, and for estimating the economic value of fortified foods. To describe and apply a linear programming tool ("Cost of the Diet") with data from Mozambique to determine what could be cost-effective fortification strategies. Based on locally assessed average household dietary needs, seasonal market prices of available food products, and food composition data, the tool estimates the lowest-cost diet that meets almost all nutrient needs. The results were compared with expenditure data from Mozambique to establish the affordability of this diet by quintiles of the population. Three different applications were illustrated: identifying likely "limiting nutrients," comparing cost effectiveness of different fortification interventions at the household level, and assessing economic access to nutritious foods. The analysis identified iron, vitamin B2, and pantothenic acid as "limiting nutrients." Under the Mozambique conditions, vegetable oil was estimated as a more cost-efficient vehicle for vitamin A fortification than sugar; maize flour may also be an effective vehicle to provide other constraining micronutrients. Multiple micronutrient fortification of maize flour could reduce the cost of the "lowest-cost nutritious diet" by 18%, but even this diet can be afforded by only 20% of the Mozambican population. Within the context of fortification, linear programming can be a useful tool for identifying likely nutrient inadequacies, for comparing fortification options in terms of cost effectiveness, and for illustrating the potential benefit of fortification for improving household access to a nutritious diet.

  17. Economic impact of dengue illness and the cost-effectiveness of future vaccination programs in Singapore.

    Directory of Open Access Journals (Sweden)

    Luis R Carrasco

    2011-12-01

    Full Text Available BACKGROUND: Dengue illness causes 50-100 million infections worldwide and threatens 2.5 billion people in the tropical and subtropical regions. Little is known about the disease burden and economic impact of dengue in higher resourced countries or the cost-effectiveness of potential dengue vaccines in such settings. METHODS AND FINDINGS: We estimate the direct and indirect costs of dengue from hospitalized and ambulatory cases in Singapore. We consider inter alia the impacts of dengue on the economy using the human-capital and the friction cost methods. Disease burden was estimated using disability-adjusted life years (DALYs and the cost-effectiveness of a potential vaccine program was evaluated. The average economic impact of dengue illness in Singapore from 2000 to 2009 in constant 2010 US$ ranged between $0.85 billion and $1.15 billion, of which control costs constitute 42%-59%. Using empirically derived disability weights, we estimated an annual average disease burden of 9-14 DALYs per 100 000 habitants, making it comparable to diseases such as hepatitis B or syphilis. The proportion of symptomatic dengue cases detected by the national surveillance system was estimated to be low, and to decrease with age. Under population projections by the United Nations, the price per dose threshold for which vaccines stop being more cost-effective than the current vector control program ranged from $50 for mass vaccination requiring 3 doses and only conferring 10 years of immunity to $300 for vaccination requiring 2 doses and conferring lifetime immunity. The thresholds for these vaccine programs to not be cost-effective for Singapore were $100 and $500 per dose respectively. CONCLUSIONS: Dengue illness presents a serious economic and disease burden in Singapore. Dengue vaccines are expected to be cost-effective if reasonably low prices are adopted and will help to reduce the economic and disease burden of dengue in Singapore substantially.

  18. Are school feeding programs in low-income settings sustainable? Insights on the costs of school feeding compared with investments in primary education.

    Science.gov (United States)

    Gelli, Aulo; Daryanani, Roshan

    2013-09-01

    School feeding programs are ubiquitous. Benchmarking expenditures for school feeding is an important component of program accountability and sustainability. To analyze the costs of school feeding and the cost relative to education expenditure and other measures of economic growth. Data on the costs of school feeding were collected from multiple sources, including United Nations databases, gray literature, and published reviews. Relationships between costs of school feeding, costs of education, and GDP per capita were analyzed through standard linear regression. Data on costs of school feeding were obtained for 74 countries, including 12 high-income, 40 middle-income, and 22 in low-income countries. School feeding programs were found to cost US$173 per child per year, ranging from US$54 in low-income countries to US$693 in high-income countries. In high-income countries, school feeding costs per capita were on average equivalent to 11% of the per capita investments in primary education, compared with 19% in middle-income countries and 68% in low-income countries. In middle- and low-income countries, school feeding programs covered on average 18% and 13% of the children enrolled in primary school, respectively. The total budget for school feeding in low-income countries was found to be on average 11% of the estimated total primary school education budget, compared to 4% in middle-income countries. School feeding investments are targeted in low- and middle-income settings, reaching only a portion of primary schoolchildren, with total costs only a fraction of the overall investment in education. As countries get richer, school feeding costs become a much smaller proportion of education costs. The findings of this study provide an updated framework for benchmarking school feeding programs.

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

    Science.gov (United States)

    Parlesak, Alexandr; Tetens, Inge; Dejgård Jensen, Jørgen; Smed, Sinne; Gabrijelčič Blenkuš, Mojca; Rayner, Mike; Darmon, Nicole; Robertson, Aileen

    2016-01-01

    Food-Based Dietary Guidelines (FBDGs) are developed to promote healthier eating patterns, but increasing food prices may make healthy eating less affordable. The aim of this study was to design a range of cost-minimized nutritionally adequate health-promoting food baskets (FBs) that help prevent both micronutrient inadequacy and diet-related non-communicable diseases at lowest cost. Average prices for 312 foods were collected within the Greater Copenhagen area. The cost and nutrient content of five different cost-minimized FBs for a family of four were calculated per day using linear programming. The FBs were defined using five different constraints: cultural acceptability (CA), or dietary guidelines (DG), or nutrient recommendations (N), or cultural acceptability and nutrient recommendations (CAN), or dietary guidelines and nutrient recommendations (DGN). The variety and number of foods in each of the resulting five baskets was increased through limiting the relative share of individual foods. The one-day version of N contained only 12 foods at the minimum cost of DKK 27 (€ 3.6). The CA, DG, and DGN were about twice of this and the CAN cost ~DKK 81 (€ 10.8). The baskets with the greater variety of foods contained from 70 (CAN) to 134 (DGN) foods and cost between DKK 60 (€ 8.1, N) and DKK 125 (€ 16.8, DGN). Ensuring that the food baskets cover both dietary guidelines and nutrient recommendations doubled the cost while cultural acceptability (CAN) tripled it. Use of linear programming facilitates the generation of low-cost food baskets that are nutritionally adequate, health promoting, and culturally acceptable.

  20. The effect of repair costs on the profitability of a ureteroscopy program.

    Science.gov (United States)

    Tosoian, Jeffrey J; Ludwig, Wesley; Sopko, Nikolai; Mullins, Jeffrey K; Matlaga, Brian R

    2015-04-01

    Ureteroscopy (URS) is a common treatment for patients with stone disease. One of the disadvantages of this approach is the great capital expense associated with the purchase and repair of endoscopic equipment. In some cases, these costs can outpace revenues and lead to an unprofitable and unsustainable enterprise. We sought to characterize the profitability of our URS program when accounting for endoscope maintenance and repair costs. We identified all URS cases performed at a single hospital during fiscal year 2013 (FY2013). Charges, collection rates, and fixed and variable costs including annual equipment repair costs were obtained. The net margin and break-even point of URS were derived on a per-case basis. For 190 cases performed in FY2013, total endoscope repair costs totaled $115,000, resulting in an average repair cost of $605 per case. The vast majority of cases (94.2%) were conducted in the outpatient setting, which generated a net margin of $659 per case, while inpatient cases yielded a net loss of $455. URS was ultimately associated with a net positive margin approaching $600 per case. On break-even analysis, URS remained profitable until repair costs reached $1200 per case. Based on these findings, an established URS program can sustain profitability even with large equipment repair costs. Nonetheless, our findings serve to emphasize the importance of controlling costs, particularly in the current setting of decreasing reimbursement. A multifaceted approach, based on improving endoscope durability and exploring digital and disposable platforms, will be critical in maintaining the sustainability of URS.

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

    Directory of Open Access Journals (Sweden)

    Alexandr Parlesak

    Full Text Available Food-Based Dietary Guidelines (FBDGs are developed to promote healthier eating patterns, but increasing food prices may make healthy eating less affordable. The aim of this study was to design a range of cost-minimized nutritionally adequate health-promoting food baskets (FBs that help prevent both micronutrient inadequacy and diet-related non-communicable diseases at lowest cost.Average prices for 312 foods were collected within the Greater Copenhagen area. The cost and nutrient content of five different cost-minimized FBs for a family of four were calculated per day using linear programming. The FBs were defined using five different constraints: cultural acceptability (CA, or dietary guidelines (DG, or nutrient recommendations (N, or cultural acceptability and nutrient recommendations (CAN, or dietary guidelines and nutrient recommendations (DGN. The variety and number of foods in each of the resulting five baskets was increased through limiting the relative share of individual foods.The one-day version of N contained only 12 foods at the minimum cost of DKK 27 (€ 3.6. The CA, DG, and DGN were about twice of this and the CAN cost ~DKK 81 (€ 10.8. The baskets with the greater variety of foods contained from 70 (CAN to 134 (DGN foods and cost between DKK 60 (€ 8.1, N and DKK 125 (€ 16.8, DGN. Ensuring that the food baskets cover both dietary guidelines and nutrient recommendations doubled the cost while cultural acceptability (CAN tripled it.Use of linear programming facilitates the generation of low-cost food baskets that are nutritionally adequate, health promoting, and culturally acceptable.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-04-12

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

  3. The validity of owner-reported property cost as a measure of ...

    African Journals Online (AJOL)

    It does so by testing the validity of 'owner-reported property cost' as a measure of property value. Procedurally, a double log-linear model based on data from Cameroon is used to determine the tenability of 'owner-reported property cost' as a function of known covariates or attributes of property value (e.g., bedrooms, floors, ...

  4. Community Partnership to Address Snack Quality and Cost in After-School Programs

    Science.gov (United States)

    Beets, Michael W.; Tilley, Falon; Turner-McGrievy, Gabrielle; Weaver, Robert G.; Jones, Sonya

    2014-01-01

    Background: Policies call on after-school programs (ASPs) to serve more nutritious snacks. A major barrier for improving snack quality is cost. This study describes the impact on snack quality and expenditures from a community partnership between ASPs and local grocery stores. Methods: Four large-scale ASPs (serving ~500 children, aged 6-12?years,…

  5. Analysis of the Children's Hospital Graduate Medical Education Program Fund Allocations for Indirect Medical Education Costs.

    Science.gov (United States)

    Wynn, Barbara O.; Kawata, Jennifer

    This study analyzed issues related to estimating indirect medical education costs specific to pediatric discharges. The Children's Hospital Graduate Medical Education (CHGNE) program was established to support graduate medical education in children's hospitals. This provision authorizes payments for both direct and indirect medical education…

  6. 78 FR 6140 - Discount Rates for Cost-Effectiveness Analysis of Federal Programs

    Science.gov (United States)

    2013-01-29

    ... BUDGET Discount Rates for Cost-Effectiveness Analysis of Federal Programs AGENCY: Office of Management... and Budget revised Circular A-94 in 1992. The revised Circular specified certain discount rates to be... States Government were changed. These discount rates are found in Appendix C of the revised Circular. The...

  7. 77 FR 1743 - Discount Rates for Cost-Effectiveness Analysis of Federal Programs

    Science.gov (United States)

    2012-01-11

    ... BUDGET Discount Rates for Cost-Effectiveness Analysis of Federal Programs AGENCY: Office of Management... and Budget revised Circular A-94 in 1992. The revised Circular specified certain discount rates to be... States Government were changed. These discount rates are found in Appendix C of the revised Circular. The...

  8. 76 FR 7881 - Discount Rates for Cost-Effectiveness Analysis of Federal Programs

    Science.gov (United States)

    2011-02-11

    ... BUDGET Discount Rates for Cost-Effectiveness Analysis of Federal Programs AGENCY: Office of Management... and Budget revised Circular A-94 in 1992. The revised Circular specified certain discount rates to be... States Government were changed. These discount rates are found in Appendix C of the revised Circular. The...

  9. A Fresh Look at the Benefits and Costs of the US Acid Rain Program

    Science.gov (United States)

    The US Acid Rain Program (Title IV of the 1990 Clean Air Act Amendments) has achieved substantial reductions in emissions of sulfur dioxide (SO2) and nitrogen oxides (NOx) from power plants in the United States. We compare new estimates of the benefits and costs of Title IV to th...

  10. 77 FR 57074 - Indirect Cost Rates for the Damage Assessment, Remediation, and Restoration Program for Fiscal...

    Science.gov (United States)

    2012-09-17

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

  11. Age 26 Cost-Benefit Analysis of the Child-Parent Center Early Education Program

    Science.gov (United States)

    Reynolds, Arthur J.; Temple, Judy A.; White, Barry A. B.; Ou, Suh-Ruu; Robertson, Dylan L.

    2011-01-01

    Using data collected up to age 26 in the Chicago Longitudinal Study, this cost-benefit analysis of the Child-Parent Centers (CPC) is the first for a sustained publicly funded early intervention. The program provides services for low-income families beginning at age 3 in 20 school sites. Kindergarten and school-age services are provided up to age 9…

  12. West Coast tree improvement programs: a break-even, cost-benefit analysis

    Science.gov (United States)

    F. Thomas Ledig; Richard L Porterfield

    1981-01-01

    Three tree improvement programs were analyzed by break-even, cost-benefit technique: one for ponderosa pine in the Pacific Northwest, and two for Douglas-fir in the Pacific Northwest-one of low intensity and the other of high intensity. A return of 8 percent on investment appears feasible by using short rotations or by accompanying tree improvement with thinning....

  13. NATIONAL STORMWATER CALCULATOR: LOW IMPACT DEVELOPMENT STORMWATER CONTROL COST ESTIMATION PROGRAMMING & FUTURE ENHANCEMENTS

    Science.gov (United States)

    National Stormwater Calculator: Low Impact Development Stormwater Control Cost Estimation Programming & Future EnhancementsJason Berner1; Michael Tryby1; Scott Struck2, Dan Pankani2, Marion Deerhake3, Michelle Simon11. USEPA2. GeoSyntec, Inc.3. RTI, Inc.The National Stormwater Ca...

  14. Hospital-centered violence intervention programs: a cost-effectiveness analysis.

    Science.gov (United States)

    Chong, Vincent E; Smith, Randi; Garcia, Arturo; Lee, Wayne S; Ashley, Linnea; Marks, Anne; Liu, Terrence H; Victorino, Gregory P

    2015-04-01

    Hospital-centered violence intervention programs (HVIPs) reduce violent injury recidivism. However, dedicated cost analyses of such programs have not yet been published. We hypothesized that the HVIP at our urban trauma center is a cost-effective means for reducing violent injury recidivism. We conducted a cost-utility analysis using a state-transition (Markov) decision model, comparing participation in our HVIP with standard risk reduction for patients injured because of firearm violence. Model inputs were derived from our trauma registry and published literature. The 1-year recidivism rate for participants in our HVIP was 2.5%, compared with 4% for those receiving standard risk reduction resources. Total per-person costs of each violence prevention arm were similar: $3,574 for our HVIP and $3,515 for standard referrals. The incremental cost effectiveness ratio for our HVIP was $2,941. Our HVIP is a cost-effective means of preventing recurrent episodes of violent injury in patients hurt by firearms. Copyright © 2015 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2009-01-01

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

  16. Fitting of full Cobb-Douglas and full VRTS cost frontiers by solving goal programming problem

    Science.gov (United States)

    Venkateswarlu, B.; Mahaboob, B.; Subbarami Reddy, C.; Madhusudhana Rao, B.

    2017-11-01

    The present research article first defines two popular production functions viz, Cobb-Douglas and VRTS production frontiers and their dual cost functions and then derives their cost limited maximal outputs. This paper tells us that the cost limited maximal output is cost efficient. Here the one side goal programming problem is proposed by which the full Cobb-Douglas cost frontier, full VRTS frontier can be fitted. This paper includes the framing of goal programming by which stochastic cost frontier and stochastic VRTS frontiers are fitted. Hasan et al. [1] used a parameter approach Stochastic Frontier Approach (SFA) to examine the technical efficiency of the Malaysian domestic banks listed in the Kuala Lumpur stock Exchange (KLSE) market over the period 2005-2010. AshkanHassani [2] exposed Cobb-Douglas Production Functions application in construction schedule crashing and project risk analysis related to the duration of construction projects. Nan Jiang [3] applied Stochastic Frontier analysis to a panel of New Zealand dairy forms in 1998/99-2006/2007.

  17. Public health sealant delivery programs: optimal delivery and the cost of practice acts.

    Science.gov (United States)

    Scherrer, Christina R; Griffin, Paul M; Swann, Julie L

    2007-01-01

    The greatest unmet health need for US children is dental care. School-based sealant programs target low-income, high-risk second graders and are effective in preventing caries for as long as the sealant material remains in place. However, it is not clear whether such programs make efficient use of available resources and staffing. The authors used discrete event simulation to determine the optimal combinations of staffing levels and sealant stations for school-based sealant programs. Using data provided by state programs and the literature, they modeled different-sized programs under different practice act constraints and determined times and associated costs. A detailed economic analysis was done for Wisconsin. For general, direct, or indirect supervision, it is optimal to have only 1 dentist or no dentists for no supervision. For general supervision, it is optimal to have the dentist and dental assistant to come on separate days to screen. The cost savings for adding an assistant and chair averaged over all of the program sizes and travel distances ranged from 4.50% (SE= 0.89) to 10.94% (SE= 0.56). Significant cost savings also result from reducing the required supervision level (8.72% [SE = 1.61] to 29.96% [SE= 1.67]). The cost of the practice act for the state of Wisconsin for 2003 was from USD 83,041 to USD 346,156, significantly more than its annual budget. States could save money by relaxing restrictions on the type of personnel who can deliver sealants in public health settings and by productivity gains through proper consideration of staffing. The savings could be used to improve access to sealant programs and further reduce disparities in oral health.

  18. Cost-Effectiveness of a Family Planning Voucher Program in Rural Pakistan

    Directory of Open Access Journals (Sweden)

    Edward Ivor Broughton

    2017-09-01

    Full Text Available IntroductionThis study reports on the effectiveness and efficiency from the program funder’s perspective of the Suraj Social Franchise (SSF voucher program in which private health-care providers in remote rural areas were identified, trained, upgraded, and certified to deliver family planning services to underserved women of reproductive age in 29 districts of Sindh and 3 districts of Punjab province, Pakistan between October 2013 and June 2016.MethodA decision tree compared the cost of implementing SSF to the program funder and its effects of providing additional couple years of protection (CYPs to targeted women, compared to business-as-usual. Costs included vouchers given to women to receive a free contraceptive method of their choice from the SSF provider. The vouchers were then reimbursed to the SSF provider by the program.ResultsA total of 168,206 married women of reproductive age (MWRA received SSF vouchers between October 2013 and June 2016, costing $3,278,000 ($19.50/recipient. The average effectiveness of the program per voucher recipient was an additional 1.66 CYPs, giving an incremental cost-effectiveness of the program of $4.28 per CYP compared to not having the program (95% CI: $3.62–5.31.ConclusionThe result compares favorably to other interventions with similar objectives and appears affordable for the Pakistan national health-care system. It is therefore recommended to help address the unmet need for contraception among MWRA in these areas of Pakistan and is worthy of trial implementation in the country more widely.

  19. Assessing Programming Costs of Explicit Memory Localization on a Large Scale Shared Memory Multiprocessor

    Directory of Open Access Journals (Sweden)

    Silvio Picano

    1992-01-01

    Full Text Available We present detailed experimental work involving a commercially available large scale shared memory multiple instruction stream-multiple data stream (MIMD parallel computer having a software controlled cache coherence mechanism. To make effective use of such an architecture, the programmer is responsible for designing the program's structure to match the underlying multiprocessors capabilities. We describe the techniques used to exploit our multiprocessor (the BBN TC2000 on a network simulation program, showing the resulting performance gains and the associated programming costs. We show that an efficient implementation relies heavily on the user's ability to explicitly manage the memory system.

  20. Cost analysis of a domiciliary program of supportive and palliative care for patients with hematologic malignancies.

    Science.gov (United States)

    Cartoni, Claudio; Brunetti, Gregorio Antonio; D'Elia, Gianna Maria; Breccia, Massimo; Niscola, Pasquale; Marini, Maria Giulia; Nastri, Antonio; Alimena, Giuliana; Mandelli, Franco; Foà, Robin

    2007-05-01

    The costs of home care (HC) programs may be tailored to the specific needs of patients with hematological malignancies. The aim of this study was to analyze the use of resources and the costs of a program of HC for four different prognostic groups of patients subdivided according to disease status. Over 2 years, 144 patients with hematological malignancies were assisted at home. Patients were subdivided according to disease status and life expectancy in the following groups: (i) terminal phase, with a life expectancy of 3 months or less; (ii) advanced phase, with a life expectancy of 6 months or less; (iii) chronic phase, with a life expectancy of more than 6 months; (iv) discharged early from the hospital with curable disease, following anticancer chemotherapy. Median mean monthly costs (MMC) in Euro (x) have been compared with the costs of hospitalization (DRG). Among the 4 groups of patients, those discharged early and in terminal phase required the highest mean monthly number of home visits (27.2 and 24.1), transfusions (6.1 and 6.8) and days of care (22.8 and 19.7) respectively. MMC were affected by the following variables: disease status and transfusion requirements. MMC for terminal patients (4,232.50x) and those discharged early (3,986.40x) were higher than those for advanced (2,303.80x) and chronic patients (1,488,30x). The cost of HC was lower than the corresponding DRG charges, but exceeded the district fares for HC of cancer patients. In hematological patients, the costs of HC differ according to disease status and transfusion requirements. For some categories of patients, costs of HC are lower than those of hospitalization, although higher than the current national fares for HC programs.

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

    Science.gov (United States)

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

    2008-03-01

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

  2. Heritage assets measurement: application of travel cost method and contingent valuation method in Memorial Darcy Ribeiro

    Directory of Open Access Journals (Sweden)

    Luiz Carlos de Carvalho Júnior

    2016-05-01

    Full Text Available This research aims to apply the Contingent Valuation Method (CVM and the Travel Cost Method (TCM at Memorial Darcy Ribeiro, known Beijódromo, located in Brasilia, to assess its economic value. The study of heritage assets measurement is justified because of the need to know the economic value of the Brazilian cultural heritage for management purposes. In addition, it allows evaluation mechanisms are improved assisting managers in the formulation of public policies. In May 2014, 72 questionnaires were applied to visitors and tourists Beijódromo to get the value of the Memorial.  In conclusion, although the indirect economic valuation methodologies are shown as an alternative to measurement of heritage assets, the value found in TCM does not differ from that of the CVM. The economic estimate was much lower than that invested in the construction of the Memorial. The lack of adequate information on the origin and the number of visitors and tourists influenced the outcome. It shows that the record and monitored of tourists is an important piece for the economic value of Memorial to be properly represented, as well as attraction of programs of visitors and tourists.

  3. Costs and benefits of personalized healthcare for patients with chronic heart failure in the care and education program "Telemedicine for the Heart".

    Science.gov (United States)

    Sohn, Stefan; Helms, Thomas M; Pelleter, Jörg T; Müller, Axel; Kröttinger, Annett I; Schöffski, Oliver

    2012-04-01

    A health economic analysis was conducted to evaluate the program "Telemedicine for the Heart," which the German Foundation for the Chronically Ill organizes for the Techniker Krankenkasse, one of the biggest German statutory health insurance funds. The program consists of nurse-calls to motivate patients to perform regular self-measurements (blood pressure, pulse, weight) with either their own or telemedical measuring devices provided by the program. In the case of measured values outside of set limits, calls to treating physicians were placed to allow for the initiation of therapy adjustments where applicable. To evaluate the program, a retrospective matched-pairs analysis was performed. Program participants (n=281) and regularly insured patients (n=843) were matched for demographics and morbidity status and compared according to their use of resources. Significant cost differences in favor of the study group of up to 25% in relation to total costs could be detected, particularly in the group of New York Heart Association (NYHA) classification II patients (persons with mild symptoms and slight limitation according to the NYHA classification for the extent of heart failure). In the more severe NYHA stages III and IV the cost relation differed and showed a slight cost disadvantage for the program group. Mortality was 35.1% lower in the program group than in the control group. Quality of life measures were almost constant over the observation time, compatible with a positive impact of the program on the highly impaired patient group. The findings suggest that, besides a reduction of costs, by participating in "Telemedicine for the Heart" patients with chronic heart failure experienced a reduced number of hospital stays, optimized medical therapy, better quality of life, and reduced mortality.

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

    Science.gov (United States)

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

    2016-01-01

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

  5. The Cost of Crime to Society: New Crime-Specific Estimates for Policy and Program Evaluation

    Science.gov (United States)

    French, Michael T.; Fang, Hai

    2010-01-01

    Estimating the cost to society of individual crimes is essential to the economic evaluation of many social programs, such as substance abuse treatment and community policing. A review of the crime-costing literature reveals multiple sources, including published articles and government reports, which collectively represent the alternative approaches for estimating the economic losses associated with criminal activity. Many of these sources are based upon data that are more than ten years old, indicating a need for updated figures. This study presents a comprehensive methodology for calculating the cost of society of various criminal acts. Tangible and intangible losses are estimated using the most current data available. The selected approach, which incorporates both the cost-of-illness and the jury compensation methods, yields cost estimates for more than a dozen major crime categories, including several categories not found in previous studies. Updated crime cost estimates can help government agencies and other organizations execute more prudent policy evaluations, particularly benefit-cost analyses of substance abuse treatment or other interventions that reduce crime. PMID:20071107

  6. 48 CFR 819.7114 - Measurement of program success.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Measurement of program success. 819.7114 Section 819.7114 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS... success. The overall success of the VA Mentor-Protégé Program encompassing all participating mentors and...

  7. 48 CFR 519.7005 - Measurement of program success.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Measurement of program success. 519.7005 Section 519.7005 Federal Acquisition Regulations System GENERAL SERVICES ADMINISTRATION... success. The overall success of the GSA Mentor-Protégé Program encompassing all participating mentors and...

  8. Computer programs for capital cost estimation, lifetime economic performance simulation, and computation of cost indexes for laser fusion and other advanced technology facilities

    Energy Technology Data Exchange (ETDEWEB)

    Pendergrass, J.H.

    1978-01-01

    Three FORTRAN programs, CAPITAL, VENTURE, and INDEXER, have been developed to automate computations used in assessing the economic viability of proposed or conceptual laser fusion and other advanced-technology facilities, as well as conventional projects. The types of calculations performed by these programs are, respectively, capital cost estimation, lifetime economic performance simulation, and computation of cost indexes. The codes permit these three topics to be addressed with considerable sophistication commensurate with user requirements and available data.

  9. Costs and cost-effectiveness of hypertension screening and treatment in adults with hypertension in rural Nigeria in the context of a health insurance program

    NARCIS (Netherlands)

    Rosendaal, N.T.A. (Nicole T. A.); M.E. Hendriks (Marleen); Verhagen, M.D. (Mark D.); O.A. Bolarinwa (Oladimeji Akeem); Sanya, E.O. (Emmanuel O.); Kolo, P.M. (Philip M.); P. Adenusi (Peju); K. Agbede (Kayode); Van Eck, D. (Diederik); S.S. Tan (Siok Swan); T.M. Akande (Tanimola); W.K. Redekop (Ken); C. Schultsz (Constance); Gomez, G.B. (Gabriela B.)

    2016-01-01

    textabstractBackground: High blood pressure is a leading risk factor for death and disability in sub-Saharan Africa (SSA). We evaluated the costs and cost-effectiveness of hypertension care provided within the Kwara State Health Insurance (KSHI) program in rural Nigeria. Methods: A Markov model was

  10. Adoption of robotics in a general surgery residency program: at what cost?

    Science.gov (United States)

    Mehaffey, J Hunter; Michaels, Alex D; Mullen, Matthew G; Yount, Kenan W; Meneveau, Max O; Smith, Philip W; Friel, Charles M; Schirmer, Bruce D

    2017-06-01

    Robotic technology is increasingly being utilized by general surgeons. However, the impact of introducing robotics to surgical residency has not been examined. This study aims to assess the financial costs and training impact of introducing robotics at an academic general surgery residency program. All patients who underwent laparoscopic or robotic cholecystectomy, ventral hernia repair (VHR), and inguinal hernia repair (IHR) at our institution from 2011-2015 were identified. The effect of robotic surgery on laparoscopic case volume was assessed with linear regression analysis. Resident participation, operative time, hospital costs, and patient charges were also evaluated. We identified 2260 laparoscopic and 139 robotic operations. As the volume of robotic cases increased, the number of laparoscopic cases steadily decreased. Residents participated in all laparoscopic cases and 70% of robotic cases but operated from the robot console in only 21% of cases. Mean operative time was increased for robotic cholecystectomy (+22%), IHR (+55%), and VHR (+61%). Financial analysis revealed higher median hospital costs per case for robotic cholecystectomy (+$411), IHR (+$887), and VHR (+$1124) as well as substantial associated fixed costs. Introduction of robotic surgery had considerable negative impact on laparoscopic case volume and significantly decreased resident participation. Increased operative time and hospital costs are substantial. An institution must be cognizant of these effects when considering implementing robotics in departments with a general surgery residency program. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Telemedicine-based diabetic retinopathy screening programs: an evaluation of utility and cost-effectiveness

    Directory of Open Access Journals (Sweden)

    Cuadros JA

    2015-06-01

    Full Text Available Jorge A Cuadros Optometry/Vision Science, University of California, Berkeley, CA, USA Abstract: Diabetes is the main cause of blindness among working age adults, although treatment is highly effective in preventing vision loss. Eye examinations are recommended on a yearly basis for most patients for timely detection of retinal disease. Telemedicine-based diabetic retinopathy screening (TMDRS programs have been developed to identify patients with sight-threatening diabetic eye disease because patients are often noncompliant with recommended live eye examinations. This article reviews the cost-effectiveness of the various forms of TMDRS. A review of relevant articles, mostly published since 2008, shows that societal benefits generally outweigh the costs of TMDRS. However, advances in technology to improve efficacy, lower costs, and broaden screening to other sight-threatening conditions, such as glaucoma and refractive error, are necessary to improve the sustainability of TMDRS within health care organizations. Patient satisfaction with these telemedicine programs is generally high. New models of shared care with primary care providers and staff are emerging to improve patient engagement and follow-up care when individuals are found to have sight-threatening eye disease. TMDRS programs are growing and provide valuable clinical benefit. The cost-utility is currently well proven in locations with limited access to regular eye care services, such as rural areas, poor communities, and prison systems; however, improvements over time are necessary for these programs to be cost-effective in mainstream medical settings in the future. Keywords: telemedicine, diabetes, retinopathy, retinal imaging

  12. Benefits and costs of intensive lifestyle modification programs for symptomatic coronary disease in Medicare beneficiaries.

    Science.gov (United States)

    Zeng, Wu; Stason, William B; Fournier, Stephen; Razavi, Moaven; Ritter, Grant; Strickler, Gail K; Bhalotra, Sarita M; Shepard, Donald S

    2013-05-01

    This study reports outcomes of a Medicare-sponsored demonstration of two intensive lifestyle modification programs (LMPs) in patients with symptomatic coronary heart disease: the Cardiac Wellness Program of the Benson-Henry Mind Body Institute (MBMI) and the Dr Dean Ornish Program for Reversing Heart Disease® (Ornish). This multisite demonstration, conducted between 2000 and 2008, enrolled Medicare beneficiaries who had had an acute myocardial infarction or a cardiac procedure within the preceding 12 months or had stable angina pectoris. Health and economic outcomes are compared with matched controls who had received either traditional or no cardiac rehabilitation following similar cardiac events. Each program included a 1-year active intervention of exercise, diet, small-group support, and stress reduction. Medicare claims were used to examine 3-year outcomes. The analysis includes 461 elderly, fee-for-service, Medicare participants and 1,795 controls. Cardiac and non-cardiac hospitalization rates were lower in participants than controls in each program and were statistically significant in MBMI (P < .01). Program costs of $3,801 and $4,441 per participant for the MBMI and Ornish Programs, respectively, were offset by reduced health care costs yielding non-significant three-year net savings per participant of about $3,500 in MBMI and $1,000 in Ornish. A trend towards lower mortality compared with controls was observed in MBMI participants (P = .07). Intensive, year-long LMPs reduced hospitalization rates and suggest reduced Medicare costs in elderly beneficiaries with symptomatic coronary heart disease. Copyright © 2013 Mosby, Inc. All rights reserved.

  13. SIRHEN : a data reduction program for photonic Doppler velocimetry measurements.

    Energy Technology Data Exchange (ETDEWEB)

    Dolan, Daniel H., III; Ao, Tommy

    2010-06-01

    SIRHEN (Sandia InfraRed HEtrodyne aNalysis) is a program for reducing data from photonic Doppler velocimetry (PDV) measurements. SIRHEN uses the short-time Fourier transform method to extract velocity information. The program can be run in MATLAB (2008b or later) or as a Windows executable. This report describes the new Sandia InfraRed HEtrodyne aNalysis program (SIRHEN; pronounced 'siren') that has been developed for efficient and robust analysis of PDV data. The program was designed for easy use within Sandia's dynamic compression community.

  14. Costs of climate measures in Norway; Kostnader ved klimatiltak i Norge

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-08-22

    This report calculates the potential for emission reductions and the costs of measures for reducing the national emissions of greenhouse gases in Norway. The measures are analysed with respect to their influence on the global emissions. It is found that with little or no expenses Norway can contribute much more to the global emission reductions by increased export of electricity and gas than by increased national costs. In the oil and gas sector the potential for emission reduction is large, but the measures are expensive. In the transport sector the potential is relatively small and the measures expensive. In the industrial sector the potential is considerable and the measures moderately expensive, but the measures will probably make the production unprofitable if the companies must bear the costs themselves. Increased fixation of CO{sub 2} through measures in the forestry sector have a large potential and at low costs. Like previous macro economic analyses, the present analysis strongly indicates that the costs of stabilizing the emissions will be much higher in Norway than in other countries. 59 refs., 17 refs., 8 tabs.

  15. Cost-benefit analysis of a micronutrient supplementation and early childhood stimulation program in Nicaragua.

    Science.gov (United States)

    Lopez Boo, Florencia; Palloni, Giordano; Urzua, Sergio

    2014-01-01

    This paper estimates the cost-benefit ratio for an integrated early childhood development program in Nicaragua (PAININ). Using longitudinal data, we estimate the average treatment effects of PAININ including micronutrient sprinkles on the prevalence of anemia and hemoglobin levels among disadvantaged children aged 6-36 months. We also estimate the effects of PAININ excluding sprinkles on cognitive outcomes among children aged 2.5-5 years. In the younger age group the program reduced anemia by 4 percentage points after 8 months and nearly 6 percentage points after 1 year; the latter is a 26% decrease in anemia. In the older age group, the program improved verbal and numeric memory after a year and a half, but the effects were modest (0.13 SD). When analyzing its potential impact on earnings, we conclude that the discounted annual costs of the program per child are less than the discounted annual increase in beneficiary earnings. Specifically, we estimate a cost-benefit ratio of 1.50 from the PAININ plus sprinkles package. Our sensitivity analysis suggests a range for this ratio between 1.30 and 2.30. © 2014 New York Academy of Sciences.

  16. 78 FR 5781 - Cost-Sharing Rates for Pharmacy Benefits Program of the TRICARE Program

    Science.gov (United States)

    2013-01-28

    ... benefits program as $5 for generic medications, $17 for formulary medications and $44 for non-formulary medications for not more than a 30-day supply obtained through retail pharmacies, and $0 for generic medications, $13 for formulary medications, and $43 for non-formulary medications for not more than a 90-day...

  17. Defense Acquisitions: Better Approach Needed to Account for Number, Cost, and Performance of Non-Major Programs

    Science.gov (United States)

    2015-03-01

    and equipment. About 40 percent of that total is for major defense acquisition programs or ACAT I programs. DOD also invests in other, non-major... ACAT II and III programs that are generally less costly at the individual program level. These programs typically have fewer reporting requirements...and are overseen at lower organizational levels than ACAT I programs, although they may have annual funding needs that are just as significant

  18. Costs and effectiveness of hearing conservation programs at 14 US metal manufacturing facilities.

    Science.gov (United States)

    Sayler, Stephanie K; Rabinowitz, Peter M; Cantley, Linda F; Galusha, Deron; Neitzel, Richard L

    2017-12-07

    This study characterised overall and specific costs associated with hearing conservation programmes (HCPs) at US metal manufacturing sites, and examined the association between these costs and several noise-induced hearing loss (NIHL) outcomes. We interviewed personnel and reviewed records at participating facilities. We also measured noise for comparison to the ten-year average of measurements made by each facility. NIHL outcomes assessed included rates of standard threshold shifts (STS) and high-frequency hearing loss, as well as prevalence of hearing impairment, for each participating facility. We used linear regression to identify per-person HCP costs that best predicted the NIHL outcomes. We evaluated 14 US metal manufacturing facilities operated by a single company. Annual HCP costs ranged from roughly $67,000 to $397,000 (average $308 ± 80 per worker). Our full-shift noise measurements (mean 83.1 dBA) showed good agreement with the facilities' measurements (mean 82.6 dBA). Hearing impairment prevalence was about 15% overall. Higher expenditures for training and hearing protector fit-testing were significantly associated with reduced STS prevalence. Higher training expenditures were also related to lower hearing impairment prevalence and high-frequency hearing loss rates. HCP costs were substantial and variable. Increased workplace spending on training and fit-testing may help minimise NIHL.

  19. The High/Scope Perry Preschool Program: Cost-Benefit Analysis Using Data from the Age-40 Followup

    Science.gov (United States)

    Belfield, Clive R.; Nores, Milagros; Barnett, Steve; Schweinhart, Lawrence

    2006-01-01

    This paper presents an updated cost-benefit analysis of the High/Scope Perry preschool Program, using data on individuals aged 40. Children were randomly assigned to a treatment or control group. Program costs are compared against treatment impacts on educational resources, earnings, criminal activity, and welfare receipt. Net present values are…

  20. A stump-to-truck cost estimating program for cable logging young-growth Douglas-fir

    Science.gov (United States)

    Chris B. LeDoux

    1989-01-01

    WCOST is a computer program designed to estimate the stump-to-truck logging cost of cable logging young-growth Douglas-fir. The program uses data from stand inventory, cruise data, and the logging plan for the tract in question to produce detailed stump-to-truck cost estimates for specific proposed timber sales. These estimates are then used, in combination with...

  1. Satellite data sets for the atmospheric radiation measurement (ARM) program

    Energy Technology Data Exchange (ETDEWEB)

    Shi, L.; Bernstein, R.L. [SeaSpace Corp., San Diego, CA (United States)

    1996-04-01

    This abstract describes the type of data obtained from satellite measurements in the Atmospheric Radiation Measurement (ARM) program. The data sets have been widely used by the ARM team to derive cloud-top altitude, cloud cover, snow and ice cover, surface temperature, water vapor, and wind, vertical profiles of temperature, and continuoous observations of weather needed to track and predict severe weather.

  2. Cost-Effectiveness of Disease Management Programs for Cardiovascular Risk and COPD in The Netherlands.

    Science.gov (United States)

    Tsiachristas, Apostolos; Burgers, Laura; Rutten-van Mölken, Maureen P M H

    2015-12-01

    Disease management programs (DMPs) for cardiovascular risk (CVR) and chronic obstructive pulmonary disease (COPD) are increasingly implemented in The Netherlands to improve care and patient's health behavior. The aim of this study was to provide evidence about the (cost-) effectiveness of Dutch DMPs as implemented in daily practice. We compared the physical activity, smoking status, quality-adjusted life-years, and yearly costs per patient between the most and the least comprehensive DMPs in four disease categories: primary CVR prevention, secondary CVR prevention, both types of CVR prevention, and COPD (N = 1034). Propensity score matching increased comparability between DMPs. A 2-year cost-utility analysis was performed from the health care and societal perspectives. Sensitivity analysis was performed to estimate the impact of DMP development and implementation costs on cost-effectiveness. Patients in the most comprehensive DMPs increased their physical activity more (except for primary CVR prevention) and had higher smoking cessation rates. The incremental QALYs ranged from -0.032 to 0.038 across all diseases. From a societal perspective, the most comprehensive DMPs decreased costs in primary CVR prevention (certainty 57%), secondary CVR prevention (certainty 88%), and both types of CVR prevention (certainty 98%). Moreover, the implementation of comprehensive DMPs led to QALY gains in secondary CVR prevention (certainty 92%) and COPD (certainty 69%). The most comprehensive DMPs for CVR and COPD have the potential to be cost saving, effective, or cost-effective compared with the least comprehensive DMPs. The challenge for Dutch stakeholders is to find the optimal mixture of interventions that is most suited for each target group. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  3. A Methodology to Measure Synergy Among Energy-Efficiency Programs at the Program Participant Level

    Energy Technology Data Exchange (ETDEWEB)

    Tonn, B.E.

    2003-11-14

    This paper presents a methodology designed to measure synergy among energy-efficiency programs at the program participant level (e.g., households, firms). Three different definitions of synergy are provided: strong, moderate, and weak. Data to measure synergy can be collected through simple survey questions. Straightforward mathematical techniques can be used to estimate the three types of synergy and explore relative synergistic impacts of different subsets of programs. Empirical research is needed to test the concepts and methods and to establish quantitative expectations about synergistic relationships among programs. The market for new energy-efficient motors is the context used to illustrate all the concepts and methods in this paper.

  4. Trade-offs limiting the evolution of coloniality: ecological displacement rates used to measure small costs.

    Science.gov (United States)

    Yokota, Kiyoko; Sterner, Robert W

    2011-02-07

    Multicellular organisms that benefit from division of labour are presumably descended from colonial species that initially derived benefits from larger colony size, before the evolution of specialization. Life in a colony can have costs as well as benefits, but these can be hard to measure. We measured physiological costs to life in a colony using a novel method based on population dynamics, comparing growth rates of unicells and kairomone-induced colonies of a green alga Desmodesmus subspicatus against a reference co-occurring species. Coloniality negatively affected growth during the initial log growth phase, while no adverse effect was detected under nutrient-limited competitive conditions. The results point to costs associated with traits involved in rapid growth rather than those associated with efficient growth under resource scarcity. Some benefits of coloniality (e.g. defence from herbivory) may be different from when this trait evolved, but our approach shows how costs would have depended on conditions.

  5. Assessing the Costs and Benefits of the Superior Energy Performance Program

    Energy Technology Data Exchange (ETDEWEB)

    Therkelsen, Peter; McKane, Aimee; Sabouini, Ridah; Evans, Tracy

    2013-07-01

    Industrial companies are seeking to manage energy consumption and costs, mitigate risks associated with energy, and introduce transparency into reports of their energy performance achievements. Forty industrial facilities are participating in the U.S. DOE supported Superior Energy Performance (SEP) program in which facilities implement an energy management system based on the ISO 50001 standard, and pursue third-party verification of their energy performance improvements. SEP certification provides industrial facilities recognition for implementing a consistent, rigorous, internationally recognized business process for continually improving energy performance and achievement of established energy performance improvement targets. This paper focuses on the business value of SEP and ISO 50001, providing an assessment of the costs and benefits associated with SEP implementation at nine SEP-certified facilities across a variety of industrial sectors. These cost-benefit analyses are part of the U.S. DOE?s contribution to the Global Superior Energy Performance (GSEP) partnership, a multi-country effort to demonstrate, using facility data, that energy management system implementation enables companies to improve their energy performance with a greater return on investment than business-as-usual (BAU) activity. To examine the business value of SEP certification, interviews were conducted with SEP-certified facilities. The costs of implementing the SEP program, including internal facility staff time, are described and a marginal payback of SEP certification has been determined. Additionally, more qualitative factors with regard to the business value and challenges related to SEP and ISO 50001 implementation are summarized.

  6. Spatial analyses of cost efficient measures to reduce N-leaching

    DEFF Research Database (Denmark)

    Jacobsen, Brian H.; Abildtrup, Jens; Ørum, Jens Erik

    The Nitrate Directive has only been implemented satisfactorily in a few EU countries. The Commission have accepted the Danish implementation of the directive based on the Plan for the Aquatic Environment II. The costs of this plan has been calculated to 70 million € or 2,0 € per kg N in reduced...... leaching. The farmers have paid 60% of the costs. The paper then describes an example of a regional analysis covering the River Basin of Ringkøbing Fjord in Denmark, which indicates the type of calculations needed to find the measures and costs in order to comply with parts of the Water Framework Directive...

  7. Social network analysis of public health programs to measure partnership.

    Science.gov (United States)

    Schoen, Martin W; Moreland-Russell, Sarah; Prewitt, Kim; Carothers, Bobbi J

    2014-12-01

    In order to prevent chronic diseases, community-based programs are encouraged to take an ecological approach to public health promotion and involve many diverse partners. Little is known about measuring partnership in implementing public health strategies. We collected data from 23 Missouri communities in early 2012 that received funding from three separate programs to prevent obesity and/or reduce tobacco use. While all of these funding programs encourage partnership, only the Social Innovation for Missouri (SIM) program included a focus on building community capacity and enhancing collaboration. Social network analysis techniques were used to understand contact and collaboration networks in community organizations. Measurements of average degree, density, degree centralization, and betweenness centralization were calculated for each network. Because of the various sizes of the networks, we conducted comparative analyses with and without adjustment for network size. SIM programs had increased measurements of average degree for partner collaboration and larger networks. When controlling for network size, SIM groups had higher measures of network density and lower measures of degree centralization and betweenness centralization. SIM collaboration networks were more dense and less centralized, indicating increased partnership. The methods described in this paper can be used to compare partnership in community networks of various sizes. Further research is necessary to define causal mechanisms of partnership development and their relationship to public health outcomes. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. The Cost and Threshold Analysis of Retention in Care (RiC): A Multi-Site National HIV Care Program.

    Science.gov (United States)

    Maulsby, Catherine; Jain, Kriti M; Weir, Brian W; Enobun, Blessing; Riordan, Maura; Charles, Vignetta E; Holtgrave, David R

    2017-03-01

    Persons diagnosed with HIV but not retained in HIV medical care accounted for the majority of HIV transmissions in 2009 in the United States (US). There is an urgent need to implement and disseminate HIV retention in care programs; however little is known about the costs associated with implementing retention in care programs. We assessed the costs and cost-saving thresholds for seven Retention in Care (RiC) programs implemented in the US using standard methods recommended by the US Panel on Cost-effectiveness in Health and Medicine. Data were gathered from accounting and program implementation records, entered into a standardized RiC economic analysis spreadsheet, and standardized to a 12 month time frame. Total program costs for from the societal perspective ranged from $47,919 to $423,913 per year or $146 to $2,752 per participant. Cost-saving thresholds ranged from 0.13 HIV transmissions averted to 1.18 HIV transmission averted per year. We estimated that these cost-saving thresholds could be achieved through 1 to 16 additional person-years of viral suppression. Across a range of program models, retention in care interventions had highly achievable cost-saving thresholds, suggesting that retention in care programs are a judicious use of resources.

  9. Valuing urban open space using the travel-cost method and the implications of measurement error.

    Science.gov (United States)

    Hanauer, Merlin M; Reid, John

    2017-08-01

    Urbanization has placed pressure on open space within and adjacent to cities. In recent decades, a greater awareness has developed to the fact that individuals derive multiple benefits from urban open space. Given the location, there is often a high opportunity cost to preserving urban open space, thus it is important for both public and private stakeholders to justify such investments. The goals of this study are twofold. First, we use detailed surveys and precise, accessible, mapping methods to demonstrate how travel-cost methods can be applied to the valuation of urban open space. Second, we assess the degree to which typical methods of estimating travel times, and thus travel costs, introduce bias to the estimates of welfare. The site we study is Taylor Mountain Regional Park, a 1100-acre space located immediately adjacent to Santa Rosa, California, which is the largest city (∼170,000 population) in Sonoma County and lies 50 miles north of San Francisco. We estimate that the average per trip access value (consumer surplus) is $13.70. We also demonstrate that typical methods of measuring travel costs significantly understate these welfare measures. Our study provides policy-relevant results and highlights the sensitivity of urban open space travel-cost studies to bias stemming from travel-cost measurement error. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. A Web-Based Computer-Tailored Alcohol Prevention Program for Adolescents: Cost-Effectiveness and Intersectoral Costs and Benefits

    National Research Council Canada - National Science Library

    st, Ruben M. W. A; Paulus, Agnes; Jander, Astrid F; Mercken, Liesbeth; de Vries, Hein; Ruwaard, Dirk; Evers, Silvia M. A. A

    2016-01-01

    .... Computer tailoring can be both effective and cost-effective for working with many lifestyle behaviors, yet the available information on the cost-effectiveness of computer tailoring for reducing...

  11. Resource and cost adjustment in the design of allocation funding formulas in public health programs.

    Science.gov (United States)

    Buehler, James W; Bernet, Patrick M; Ogden, Lydia L

    2012-01-01

    Multiple federal public health programs use funding formulas to allocate funds to states. To characterize the effects of adjusting formula-based allocations for differences among states in the cost of implementing programs, the potential for generating in-state resources, and income disparities, which might be associated with disease risk. Fifty US states and the District of Columbia. Formula-based funding allocations to states for 4 representative federal public health programs were adjusted using indicators of cost (average salaries), potential within-state revenues (per-capita income, the Federal Medical Assistance Percentage, per-capita aggregate home values), and income disparities (Theil index). Percentage of allocation shifted by adjustment, the number of states and the percentage of US population living in states with a more than 20% increase or decrease in funding, maximum percentage increase or decrease in funding. Each adjustor had a comparable impact on allocations across the 4 program allocations examined. Approximately 2% to 8% of total allocations were shifted, with adjustments for variations in income disparity and housing values having the least and greatest effects, respectively. The salary cost and per-capita income adjustors were inversely correlated and had offsetting effects on allocations. With the exception of the housing values adjustment, fewer than 10 states had more than 20% increases or decreases in allocations, and less than 10% of the US population lived in such states. Selection of adjustors for formula-based funding allocations should consider the impacts of different adjustments, correlations between adjustors and other data elements in funding formulas, and the relationship of formula inputs to program objectives.

  12. Age-26 Cost-Benefit Analysis of the Child-Parent Center Early Education Program

    Science.gov (United States)

    Reynolds, Arthur J.; Temple, Judy A.; White, Barry A.; Ou, Suh-Ruu; Robertson, Dylan L.

    2013-01-01

    We conducted a cost-benefit analysis of the Child-Parent Center (CPC) early childhood intervention. Using data collected up to age 26 on health and well-being, the study is the first adult economic analysis of a sustained large-scale and publicly-funded intervention. As part of the Chicago Longitudinal Study, a complete cohort of 900 low-income children who enrolled in 20 CPCs beginning at age 3 were compared to 500 well-matched low-income children who participated in the usual educational interventions for the economically disadvantaged in Chicago schools. School-age services were provided up to age 9 (third grade). Findings indicated that the three components of CPC had economic benefits in 2007 dollars that exceeded costs. The preschool program provided a total return to society of $10.83 per dollar invested (net benefits per participant of $83,708). Benefits to the public (other than program participants and families) were $7.20 per dollar invested. The primary sources of benefits were increased earnings and tax revenues, averted criminal justice system and victim costs, and savings for child welfare, special education, and grade retention. The school-age program had a societal return of $3.97 per dollar invested and a $2.11 public return. The extended intervention program (4 to 6 years of participation) had a societal return of $8.24 and public return of $5.21. Estimates were robust across a wide range of discount rates and alternative assumptions, and were consistent with the results of Monte Carlo simulations. Males, 1-year preschool participants, and children from higher risk families had greater economic benefits. Findings provide strong evidence that sustained early childhood programs can contribute to well-being for individuals and society. PMID:21291448

  13. The cost-effectiveness of the Olweus Bullying Prevention Program: Results from a modelling study.

    Science.gov (United States)

    Beckman, Linda; Svensson, Mikael

    2015-12-01

    Exposure to bullying affects around 3-5 percent of adolescents in secondary school and is related to various mental health problems. Many different anti-bullying programmes are currently available, but economic evaluations are lacking. The aim of this study is to identify the cost effectiveness of the Olweus Bullying Prevention Program (OBPP). We constructed a decision-tree model for a Swedish secondary school, using a public payer perspective, and retrieved data on costs and effects from the published literature. Probabilistic sensitivity analysis to reflect the uncertainty in the model was conducted. The base-case analysis showed that using the OBPP to reduce the number of victims of bullying costs 131,250 Swedish kronor (€14,470) per victim spared. Compared to a relevant threshold of the societal value of bullying reduction, this indicates that the programme is cost-effective. Using a relevant willingness-to-pay threshold shows that the OBPP is a cost-effective intervention. Copyright © 2015 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

    Eiferman, Daniel; Bhakta, Ankur; Khan, Safdar

    2015-10-01

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

  15. Measuring Community Programs and Policies in the Healthy Communities Study

    Science.gov (United States)

    Fawcett, Stephen B.; Collie-Akers, Vicki L.; Schultz, Jerry A.; Kelley, Melinda

    2015-01-01

    Childhood obesity is a challenging public health issue facing communities throughout the U.S. Local efforts are believed to be essential to assuring environments that support physical activity and healthy food/beverage consumption among children and their families. However, little is known about how broadly and intensively communities are implementing combinations of programs and policies that address childhood nutrition, physical activity, and weight control. The Healthy Communities Study is a nationwide scientific study in diverse communities to identify characteristics of communities and programs that may be associated with childhood obesity. Data collection occurred in 2013–2015; data analysis will be completed in 2016. As part of the Healthy Communities Study, researchers designed a measurement system to assess the number and scope of community programs and policies and to examine possible associations between calculated “intensity” scores for these programs and policies and behavioral and outcome measures related to healthy weight among children. This report describes the protocol used to capture and code instances of community programs and policies, to characterize attributes of community programs and policies related to study hypotheses, and to calculate the intensity of combinations of community programs and policies (i.e., using the attributes of change strategy, duration, and reach). PMID:26384934

  16. Sustainable Cost Models for mHealth at Scale: Modeling Program Data from m4RH Tanzania.

    Science.gov (United States)

    Mangone, Emily R; Agarwal, Smisha; L'Engle, Kelly; Lasway, Christine; Zan, Trinity; van Beijma, Hajo; Orkis, Jennifer; Karam, Robert

    2016-01-01

    There is increasing evidence that mobile phone health interventions ("mHealth") can improve health behaviors and outcomes and are critically important in low-resource, low-access settings. However, the majority of mHealth programs in developing countries fail to reach scale. One reason may be the challenge of developing financially sustainable programs. The goal of this paper is to explore strategies for mHealth program sustainability and develop cost-recovery models for program implementers using 2014 operational program data from Mobile for Reproductive Health (m4RH), a national text-message (SMS) based health communication service in Tanzania. We delineated 2014 m4RH program costs and considered three strategies for cost-recovery for the m4RH program: user pay-for-service, SMS cost reduction, and strategic partnerships. These inputs were used to develop four different cost-recovery scenarios. The four scenarios leveraged strategic partnerships to reduce per-SMS program costs and create per-SMS program revenue and varied the structure for user financial contribution. Finally, we conducted break-even and uncertainty analyses to evaluate the costs and revenues of these models at the 2014 user volume (125,320) and at any possible break-even volume. In three of four scenarios, costs exceeded revenue by $94,596, $34,443, and $84,571 at the 2014 user volume. However, these costs represented large reductions (54%, 83%, and 58%, respectively) from the 2014 program cost of $203,475. Scenario four, in which the lowest per-SMS rate ($0.01 per SMS) was negotiated and users paid for all m4RH SMS sent or received, achieved a $5,660 profit at the 2014 user volume. A Monte Carlo uncertainty analysis demonstrated that break-even points were driven by user volume rather than variations in program costs. These results reveal that breaking even was only probable when all SMS costs were transferred to users and the lowest per-SMS cost was negotiated with telecom partners. While this

  17. Sustainable Cost Models for mHealth at Scale: Modeling Program Data from m4RH Tanzania.

    Directory of Open Access Journals (Sweden)

    Emily R Mangone

    Full Text Available There is increasing evidence that mobile phone health interventions ("mHealth" can improve health behaviors and outcomes and are critically important in low-resource, low-access settings. However, the majority of mHealth programs in developing countries fail to reach scale. One reason may be the challenge of developing financially sustainable programs. The goal of this paper is to explore strategies for mHealth program sustainability and develop cost-recovery models for program implementers using 2014 operational program data from Mobile for Reproductive Health (m4RH, a national text-message (SMS based health communication service in Tanzania.We delineated 2014 m4RH program costs and considered three strategies for cost-recovery for the m4RH program: user pay-for-service, SMS cost reduction, and strategic partnerships. These inputs were used to develop four different cost-recovery scenarios. The four scenarios leveraged strategic partnerships to reduce per-SMS program costs and create per-SMS program revenue and varied the structure for user financial contribution. Finally, we conducted break-even and uncertainty analyses to evaluate the costs and revenues of these models at the 2014 user volume (125,320 and at any possible break-even volume.In three of four scenarios, costs exceeded revenue by $94,596, $34,443, and $84,571 at the 2014 user volume. However, these costs represented large reductions (54%, 83%, and 58%, respectively from the 2014 program cost of $203,475. Scenario four, in which the lowest per-SMS rate ($0.01 per SMS was negotiated and users paid for all m4RH SMS sent or received, achieved a $5,660 profit at the 2014 user volume. A Monte Carlo uncertainty analysis demonstrated that break-even points were driven by user volume rather than variations in program costs.These results reveal that breaking even was only probable when all SMS costs were transferred to users and the lowest per-SMS cost was negotiated with telecom partners

  18. Study on measuring social cost of water pollution: concentrated on Han River water system

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kwang Im; Min, Dong Gee; Chung, Hoe Seong; Lim, Hyun Jeong; Kim, Mee Sook [Korea Environment Institute, Seoul (Korea)

    1999-12-01

    Following the economic development and the progress of urbanization, the damage on water pollution has been more serious but a social cost caused by water pollution cannot be measured. Although the need of water quality preservation is emphasized, a base material for public investment on enhancing water quality preservation is not equipped yet due to the absence of economic values of water resource. Therefore it measured a cost generated by leaving pollution not treated water quality in this study. To measure the usable value of water resource or the cost of water pollution all over the country should include a national water system, but this study is limited on the mainstream of Han River water system from North Han River through Paldang to Chamsil sluice gates. Further study on Nakdong River and Keum River water systems should be done. 74 refs., 4 figs., 51 tabs.

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

    Science.gov (United States)

    O'Donnell, Michael P; Roizen, Michael F

    2011-01-01

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

  20. The cost of a pediatric neurocritical care program for traumatic brain injury: a retrospective cohort study.

    Science.gov (United States)

    Howard, Steven W; Zhang, Zidong; Buchanan, Paula; Bernell, Stephanie L; Williams, Christine; Pearson, Lindsey; Huetsch, Michael; Gill, Jeff; Pineda, Jose A

    2018-01-12

    Inpatient care for children with severe traumatic brain injury (sTBI) is expensive, with inpatient charges averaging over $70,000 per case (Hospital Inpatient, Children Only, National Statistics. Diagnoses- clinical classification software (CCS) principal diagnosis category 85 coma, stupor, and brain damage, and 233 intracranial injury. Diagnoses by Aggregate charges [ https://hcupnet.ahrq.gov/#setup ]). This ranks sTBI in the top quartile of pediatric conditions with the greatest inpatient costs (Hospital Inpatient, Children Only, National Statistics. Diagnoses- clinical classification software (CCS) principal diagnosis category 85 coma, stupor, and brain damage, and 233 intracranial injury. Diagnoses by Aggregate charges [ https://hcupnet.ahrq.gov/#setup ]). The Brain Trauma Foundation developed sTBI intensive care guidelines in 2003, with revisions in 2012 (Kochanek, Carney, et. al. PCCM 3:S1-S2, 2012). These guidelines have been widely disseminated, and are associated with improved health outcomes (Pineda, Leonard. et. al. LN 12:45-52, 2013), yet research on the cost of associated hospital care is limited. The objective of this study was to assess the costs of providing hospital care to sTBI patients through a guideline-based Pediatric Neurocritical Care Program (PNCP) implemented at St. Louis Children's Hospital, a pediatric academic medical center in the Midwest United States. This is a retrospective cohort study. We used multi-level regression to estimate pre-/post-implementation effects of the PNCP program on inflation adjusted total cost of in-hospital sTBI care. The study population included 58 pediatric patient discharges in the pre-PNCP implementation group (July 15, 1999 - September 17, 2005), and 59 post-implementation patient discharges (September 18, 2005 - January 15, 2012). Implementation of the PNCP was associated with a non-significant difference in the cost of care between the pre- and post-implementation periods (eβ = 1.028, p = 0

  1. The Swift Project Contamination Control Program: A Case Study of Balancing Cost, Schedule and Risk

    Science.gov (United States)

    Hansen, Patricia A.; Day, Diane T.; Secunda, Mark S.; Rosecrans, Glenn P.

    2004-01-01

    The Swift Observatory will be launched in early 2004 to examine the dynamic process of gamma ray burst (GRB) events. The multi-wavelength Observatory will study the GRB afterglow characteristics, which will help to answer fundamental questions about both the structure and the evolution of the universe. The Swift Observatory Contamination Control Program has been developed to aid in ensuring the success of the on-orbit performance of two of the primary instruments: the Ultraviolet and Optical Telescope (UVOT) and the X-Ray Telescope (XRT). During the design phase of the Observatory, the contamination control program evolved and trade studies were performed to assess the risk of contaminating the sensitive UVOT and XRT optics during both pre-launch testing and on-orbit operations, within the constraints of the overall program cost and schedule.

  2. Improving Maternal Care through a State-Wide Health Insurance Program: A Cost and Cost-Effectiveness Study in Rural Nigeria.

    Science.gov (United States)

    Gomez, Gabriela B; Foster, Nicola; Brals, Daniella; Nelissen, Heleen E; Bolarinwa, Oladimeji A; Hendriks, Marleen E; Boers, Alexander C; van Eck, Diederik; Rosendaal, Nicole; Adenusi, Peju; Agbede, Kayode; Akande, Tanimola M; Boele van Hensbroek, Michael; Wit, Ferdinand W; Hankins, Catherine A; Schultsz, Constance

    2015-01-01

    While the Nigerian government has made progress towards the Millennium Development Goals, further investments are needed to achieve the targets of post-2015 Sustainable Development Goals, including Universal Health Coverage. Economic evaluations of innovative interventions can help inform investment decisions in resource-constrained settings. We aim to assess the cost and cost-effectiveness of maternal care provided within the new Kwara State Health Insurance program (KSHI) in rural Nigeria. We used a decision analytic model to simulate a cohort of pregnant women. The primary outcome is the incremental cost effectiveness ratio (ICER) of the KSHI scenario compared to the current standard of care. Intervention cost from a healthcare provider perspective included service delivery costs and above-service level costs; these were evaluated in a participating hospital and using financial records from the managing organisations, respectively. Standard of care costs from a provider perspective were derived from the literature using an ingredient approach. We generated 95% credibility intervals around the primary outcome through probabilistic sensitivity analysis (PSA) based on a Monte Carlo simulation. We conducted one-way sensitivity analyses across key model parameters and assessed the sensitivity of our results to the performance of the base case separately through a scenario analysis. Finally, we assessed the sustainability and feasibility of this program's scale up within the State's healthcare financing structure through a budget impact analysis. The KSHI scenario results in a health benefit to patients at a higher cost compared to the base case. The mean ICER (US$46.4/disability-adjusted life year averted) is considered very cost-effective compared to a willingness-to-pay threshold of one gross domestic product per capita (Nigeria, US$ 2012, 2,730). Our conclusion was robust to uncertainty in parameters estimates (PSA: median US$49.1, 95% credible interval 21

  3. Cost-effective early childhood development programs from preschool to third grade.

    Science.gov (United States)

    Reynolds, Arthur J; Temple, Judy A

    2008-01-01

    Although findings on the positive effects of early childhood development programs have been widely disseminated, less attention has been given to program impacts across the entire period of early childhood. This review summarizes evidence on the effects and cost-effectiveness of programs and services from ages 3 to 9. The major focus is preschool programs for 3- and 4-year-olds, full-day kindergarten, school-age programs including reduced class sizes, and preschool-to-third-grade interventions. Participation in preschool programs was found to have relatively large and enduring effects on school achievement and child well-being. High-quality programs for children at risk produce strong economic returns ranging from about $4 per dollar invested to over $10 per dollar invested. Relative to half-day kindergarten, the positive effects of full-day kindergarten have been found to be relatively small and generally do not last for more than a year. Although no formal economic analyses have been conducted, the economic return per dollar invested would be expected to be close to zero. Among early-school-age programs, preschool plus school-age interventions (PK-3) for children at risk are linked to higher levels of school performance into adolescence. The Child-Parent Center PK-3 Program shows a return of $6 to $9 per dollar invested. Class-size reductions show evidence of positive effects, with economic returns of roughly $3 per dollar invested. The causal mechanisms of long-term effects are discussed. Key principles to promote intervention effectiveness are offered.

  4. Cost-Sensitive Feature Selection of Numeric Data with Measurement Errors

    Directory of Open Access Journals (Sweden)

    Hong Zhao

    2013-01-01

    Full Text Available Feature selection is an essential process in data mining applications since it reduces a model’s complexity. However, feature selection with various types of costs is still a new research topic. In this paper, we study the cost-sensitive feature selection problem of numeric data with measurement errors. The major contributions of this paper are fourfold. First, a new data model is built to address test costs and misclassification costs as well as error boundaries. It is distinguished from the existing models mainly on the error boundaries. Second, a covering-based rough set model with normal distribution measurement errors is constructed. With this model, coverings are constructed from data rather than assigned by users. Third, a new cost-sensitive feature selection problem is defined on this model. It is more realistic than the existing feature selection problems. Fourth, both backtracking and heuristic algorithms are proposed to deal with the new problem. Experimental results show the efficiency of the pruning techniques for the backtracking algorithm and the effectiveness of the heuristic algorithm. This study is a step toward realistic applications of the cost-sensitive learning.

  5. Ranking the dermatology programs based on measurements of academic achievement.

    Science.gov (United States)

    Wu, Jashin J; Ramirez, Claudia C; Alonso, Carol A; Berman, Brian; Tyring, Stephen K

    2007-07-13

    The only dermatology rankings in the past were based on National Institutes of Health (NIH) funding and journal citations. To determine the highest ranking academic dermatology programs based on 5 outcome measures and on an overall ranking scale. To the best of our knowledge, this is the first report to rank the dermatology programs on 4 of the following outcome measures of academic achievement and with an overall ranking. We collected extensive 2001 to 2004 data ranging from total publications to grant funding on 107 U.S. dermatology programs and their full-time faculty. Data from part-time and volunteer faculty were not used. Publications in 2001 to 2004; NIH funding in 2004; Dermatology Foundation grants in 2001 to 2004; faculty lectures in 2004 delivered at national conferences; number of full-time faculty members who were on the editorial boards of the top 3 U.S. dermatology journals and the top 4 subspecialty journals We used the 5 outcome measures to tabulate the highest ranking programs in each category. Using a weighted ranking system, we also tabulated the overall top 30 dermatology programs based on these 5 outcome measures. We were not able to determine the total amount of NIH funding in dollars of the dermatology divisions. The impact factors of the journal in which these publications appeared was not factored into our calculations. Since faculty members may collaborate on the same publication, some publications may have been double-counted. In descending order, the 5 highest ranked academic programs are the University of Pennsylvania; University of California, San Francisco; Yale-New Haven Medical Center; New York University; and University of Michigan. This ranking system may allow residents and faculty to improve the academic achievements at their respective programs.

  6. Assessing the Potential of Low-Cost 3D Cameras for the Rapid Measurement of Plant Woody Structure

    Directory of Open Access Journals (Sweden)

    Charles Nock

    2013-11-01

    Full Text Available Detailed 3D plant architectural data have numerous applications in plant science, but many existing approaches for 3D data collection are time-consuming and/or require costly equipment. Recently, there has been rapid growth in the availability of low-cost, 3D cameras and related open source software applications. 3D cameras may provide measurements of key components of plant architecture such as stem diameters and lengths, however, few tests of 3D cameras for the measurement of plant architecture have been conducted. Here, we measured Salix branch segments ranging from 2–13 mm in diameter with an Asus Xtion camera to quantify the limits and accuracy of branch diameter measurement with a 3D camera. By scanning at a variety of distances we also quantified the effect of scanning distance. In addition, we also test the sensitivity of the program KinFu for continuous 3D object scanning and modeling as well as other similar software to accurately record stem diameters and capture plant form (<3 m in height. Given its ability to accurately capture the diameter of branches >6 mm, Asus Xtion may provide a novel method for the collection of 3D data on the branching architecture of woody plants. Improvements in camera measurement accuracy and available software are likely to further improve the utility of 3D cameras for plant sciences in the future.

  7. Water vapor measurement system in global atmospheric sampling program, appendix

    Science.gov (United States)

    Englund, D. R.; Dudzinski, T. J.

    1982-01-01

    The water vapor measurement system used in the NASA Global Atmospheric Sampling Program (GASP) is described. The system used a modified version of a commercially available dew/frostpoint hygrometer with a thermoelectrically cooled mirror sensor. The modifications extended the range of the hygrometer to enable air sample measurements with frostpoint temperatures down to -80 C at altitudes of 6 to 13 km. Other modifications were made to permit automatic, unattended operation in an aircraft environment. This report described the hygrometer, its integration with the GASP system, its calibration, and operational aspects including measurement errors. The estimated uncertainty of the dew/frostpoint measurements was + or - 1.7 Celsius.

  8. A fuzzy inventory model with unit production cost, time depended holding cost, with-out shortages under a space constraint: a parametric geometric programming approach

    OpenAIRE

    Sahidul Islam; Wasim Akram Mandal

    2017-01-01

    In this paper, an Inventory model with unit production cost, time depended holding cost, with-out shortages is formulated and solved. We have considered here a single objective inventory model. In most real world situation, the objective and constraint function of the decision makers are imprecise in nature, hence the coefficients, indices, the objective function and constraint goals are imposed here in fuzzy environment. Geometric programming provides a powerful tool for solving a variety of...

  9. Costs and Cost-Effectiveness of Hypertension Screening and Treatment in Adults with Hypertension in Rural Nigeria in the Context of a Health Insurance Program.

    Directory of Open Access Journals (Sweden)

    Nicole T A Rosendaal

    Full Text Available High blood pressure is a leading risk factor for death and disability in sub-Saharan Africa (SSA. We evaluated the costs and cost-effectiveness of hypertension care provided within the Kwara State Health Insurance (KSHI program in rural Nigeria.A Markov model was developed to assess the costs and cost-effectiveness of population-level hypertension screening and subsequent antihypertensive treatment for the population at-risk of cardiovascular disease (CVD within the KSHI program. The primary outcome was the incremental cost per disability-adjusted life year (DALY averted in the KSHI scenario compared to no access to hypertension care. We used setting-specific and empirically-collected data to inform the model. We defined two strategies to assess eligibility for antihypertensive treatment based on 1 presence of hypertension grade 1 and 10-year CVD risk of >20%, or grade 2 hypertension irrespective of 10-year CVD risk (hypertension and risk based strategy and 2 presence of hypertension in combination with a CVD risk of >20% (risk based strategy. We generated 95% confidence intervals around the primary outcome through probabilistic sensitivity analysis. We conducted one-way sensitivity analyses across key model parameters and assessed the sensitivity of our results to the performance of the reference scenario.Screening and treatment for hypertension was potentially cost-effective but the results were sensitive to changes in underlying assumptions with a wide range of uncertainty. The incremental cost-effectiveness ratio for the first and second strategy respectively ranged from US$ 1,406 to US$ 7,815 and US$ 732 to US$ 2,959 per DALY averted, depending on the assumptions on risk reduction after treatment and compared to no access to antihypertensive treatment.Hypertension care within a subsidized private health insurance program may be cost-effective in rural Nigeria and public-private partnerships such as the KSHI program may provide opportunities

  10. Validity and reliability of a simple, low cost measure to quantify children’s dietary intake in afterschool settings

    Science.gov (United States)

    Davison, Kirsten K.; Austin, S. Bryn; Giles, Catherine; Cradock, Angie L.; Lee, Rebekka M.; Gortmaker, Steven L.

    2017-01-01

    Interest in evaluating and improving children’s diets in afterschool settings has grown, necessitating the development of feasible yet valid measures for capturing children’s intake in such settings. This study’s purpose was to test the criterion validity and cost of three unobtrusive visual estimation methods compared to a plate-weighing method: direct on-site observation using a 4-category rating scale and off-site rating of digital photographs taken on-site using 4- and 10-category scales. Participants were 111 children in grades 1–6 attending four afterschool programs in Boston, MA in December 2011. Researchers observed and photographed 174 total snack meals consumed across two days at each program. Visual estimates of consumption were compared to weighed estimates (the criterion measure) using intra-class correlations. All three methods were highly correlated with the criterion measure, ranging from 0.92–0.94 for total calories consumed, 0.86–0.94 for consumption of pre-packaged beverages, 0.90–0.93 for consumption of fruits/vegetables, and 0.92–0.96 for consumption of grains. For water, which was not pre-portioned, coefficients ranged from 0.47–0.52. The photographic methods also demonstrated excellent inter-rater reliability: 0.84–0.92 for the 4-point and 0.92–0.95 for the 10-point scale. The costs of the methods for estimating intake ranged from $0.62 per observation for the on-site direct visual method to $0.95 per observation for the criterion measure. This study demonstrates that feasible, inexpensive methods can validly and reliably measure children’s dietary intake in afterschool settings. Improving precision in measures of children’s dietary intake can reduce the likelihood of spurious or null findings in future studies. PMID:25596895

  11. What cost components are relevant for economic evaluations of palliative care, and what approaches are used to measure these costs? A systematic review.

    Science.gov (United States)

    Gardiner, Clare; Ingleton, Christine; Ryan, Tony; Ward, Sue; Gott, Merryn

    2017-04-01

    It is important to understand the costs of palliative and end-of-life care in order to inform decisions regarding cost allocation. However, economic research in palliative care is very limited and little is known about the range and extent of the costs that are involved in palliative care provision. To undertake a systematic review of the health and social care literature to determine the range of financial costs related to a palliative care approach and explore approaches used to measure these costs. A systematic review of empirical literature with thematic synthesis. Study quality was evaluated using the Weight of Evidence Framework. The databases CINAHL, Cochrane, PsycINFO and Medline were searched from 1995 to November 2015 for empirical studies which presented data on the financial costs associated with palliative care. A total of 38 papers met our inclusion criteria. Components of palliative care costs were incurred within four broad domains: hospital care, community or home-based care, hospice care and informal care. These costs could be considered from the economic viewpoint of three providers: state or government, insurers/third-party/not-for-profit organisations and patient and family and/or society. A wide variety of costing approaches were used to derive costs. The evidence base regarding the economics of palliative care is sparse, particularly relating to the full economic costs of palliative care. Our review provides a framework for considering these costs from a variety of economic viewpoints; however, further research is required to develop and refine methodologies.

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

    Science.gov (United States)

    1976-04-01

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

  13. Community partnership to address snack quality and cost in after-school programs.

    Science.gov (United States)

    Beets, Michael W; Tilley, Falon; Turner-McGrievy, Gabrielle; Weaver, Robert G; Jones, Sonya

    2014-08-01

    Policies call on after-school programs (ASPs) to serve more nutritious snacks. A major barrier for improving snack quality is cost. This study describes the impact on snack quality and expenditures from a community partnership between ASPs and local grocery stores. Four large-scale ASPs (serving ˜500 children, aged 6-12 years, each day) and a single local grocery store chain participated in this study. The nutritional quality of snacks served was recorded preintervention (18 weeks spring/fall 2011) and postintervention (7 weeks spring 2012) via direct observation, along with cost/child/snack/day. Preintervention snacks were low-nutrient-density salty snacks (eg, chips, 3.0 servings/week), sugar-sweetened beverages (eg, powdered-lemonade, 1.9 servings/week), and desserts (eg, cookies, 2.1 servings/week), with only 0.4 servings/week of fruits and no vegetables. By postintervention, fruits (3.5 servings/week) and vegetables (1.2 servings/week) were increased, whereas sugar-sweetened beverages and desserts were eliminated. Snack expenditures were $0.26 versus $0.24 from preintervention to postintervention. Partnership savings versus purchasing snacks at full retail cost was 24.5% or $0.25/serving versus $0.34/serving. This innovative partnership can serve as a model in communities where ASPs seek to identify low-cost alternatives to providing nutritious snacks. © 2014, American School Health Association.

  14. The Efficacy of Stuttering Measurement Training: Evaluating Two Training Programs

    Science.gov (United States)

    Bainbridge, Lauren A.; Stavros, Candace; Ebrahimian, Mineh; Wang, Yuedong; Ingham, Roger J.

    2015-01-01

    Purpose: Two stuttering measurement training programs currently used for training clinicians were evaluated for their efficacy in improving the accuracy of total stuttering event counting. Method: Four groups, each with 12 randomly allocated participants, completed a pretest-posttest design training study. They were evaluated by their counts of…

  15. Testing the Feasibility of a Low-Cost Network Performance Measurement Infrastructure

    Energy Technology Data Exchange (ETDEWEB)

    Chevalier, Scott [Indiana Univ., Bloomington, IN (United States). International Networks; Schopf, Jennifer M. [Indiana Univ., Bloomington, IN (United States). International Networks; Miller, Kenneth [Pennsylvania State Univ., University Park, PA (United States). Telecommunications and Networking Services; Zurawski, Jason [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Energy Sciences Network

    2016-07-01

    Todays science collaborations depend on reliable, high performance networks, but monitoring the end-to-end performance of a network can be costly and difficult. The most accurate approaches involve using measurement equipment in many locations, which can be both expensive and difficult to manage due to immobile or complicated assets. The perfSONAR framework facilitates network measurement making management of the tests more reasonable. Traditional deployments have used over-provisioned servers, which can be expensive to deploy and maintain. As scientific network uses proliferate, there is a desire to instrument more facets of a network to better understand trends. This work explores low cost alternatives to assist with network measurement. Benefits include the ability to deploy more resources quickly, and reduced capital and operating expenditures. Finally, we present candidate platforms and a testing scenario that evaluated the relative merits of four types of small form factor equipment to deliver accurate performance measurements.

  16. Dynamic Programming and Error Estimates for Stochastic Control Problems with Maximum Cost

    Energy Technology Data Exchange (ETDEWEB)

    Bokanowski, Olivier, E-mail: boka@math.jussieu.fr [Laboratoire Jacques-Louis Lions, Université Paris-Diderot (Paris 7) UFR de Mathématiques - Bât. Sophie Germain (France); Picarelli, Athena, E-mail: athena.picarelli@inria.fr [Projet Commands, INRIA Saclay & ENSTA ParisTech (France); Zidani, Hasnaa, E-mail: hasnaa.zidani@ensta.fr [Unité de Mathématiques appliquées (UMA), ENSTA ParisTech (France)

    2015-02-15

    This work is concerned with stochastic optimal control for a running maximum cost. A direct approach based on dynamic programming techniques is studied leading to the characterization of the value function as the unique viscosity solution of a second order Hamilton–Jacobi–Bellman (HJB) equation with an oblique derivative boundary condition. A general numerical scheme is proposed and a convergence result is provided. Error estimates are obtained for the semi-Lagrangian scheme. These results can apply to the case of lookback options in finance. Moreover, optimal control problems with maximum cost arise in the characterization of the reachable sets for a system of controlled stochastic differential equations. Some numerical simulations on examples of reachable analysis are included to illustrate our approach.

  17. Development of the Community Impact Scale Measuring Community Organization Perceptions of Partnership Benefits and Costs

    Science.gov (United States)

    Srinivas, Tejaswinhi; Meenan, Chelsea E.; Drogin, Elizabeth; DePrince, Anne P.

    2015-01-01

    This article describes the development and psychometric properties of the Community Impact Scale (CIS), a measure of benefits and costs of community-university partnerships across a range of outcomes as perceived by community partners. Scale development was carried out in two phases: (a) item generation, through which the research team, in close…

  18. Quick-Scan Appraisal Method to Determine Cost-Effectiveness of Traffic and Demand Management Measures

    NARCIS (Netherlands)

    Meurs, H.J.; Wee, B. van; Perdok, J.; Hoogendoorn, S.

    2013-01-01

    This paper presents a quick-scan approach to assess the cost-effectiveness of smaller and poorly demarcated transportation measures; the approach can be used as an initial scan while packages are established to solve specific transportation problems. This paper adds to the available evaluation

  19. Supply chain risk model for quantifying the cost-effectiveness of phytosanitary measures

    NARCIS (Netherlands)

    Benninga, J.; Hennen, W.H.G.J.; Schans, J.

    2012-01-01

    A chain risk model (CRM) has been developed to calculate the cost-effectiveness of phytosanitary measures. The CRM is a quantitative model for phytosanitary assessments of all kinds of agricultural product chains. In the CRM, chain stages are connected by the product volume streams at which

  20. The influence of risk mitigation measures on the risks, costs and routing of CO2 pipelines

    NARCIS (Netherlands)

    Knoope, M. M J; Raben, I. M E; Ramírez, A.; Spruijt, M. P N; Faaij, A. P C

    2014-01-01

    The aim of this study was to analyze whether, and if so, in what way risks would influence the design, costs and routing of CO2 pipelines. This article assesses locational and societal risks of CO2 pipeline transport and analyses whether rerouting or implementing additional risk mitigation measures

  1. The influence of risk mitigation measures on the risks, costs and routing of CO 2pipelines

    NARCIS (Netherlands)

    Knoope, M.M.J.; Raben. I.M.E.; Ramírez, A.; Spruijt, M.P.N.; Faaij, A.P.C.

    2014-01-01

    The aim of this study was to analyze whether, and if so, in what way risks would influence the design,costs and routing of CO2pipelines. This article assesses locational and societal risks of CO2pipelinetransport and analyses whether rerouting or implementing additional risk mitigation measures is

  2. A systematic review of the cost-effectiveness of worksite physical activity and/or nutrition programs.

    Science.gov (United States)

    van Dongen, Johanna M; Proper, Karin I; van Wier, Marieke F; van der Beek, Allard J; Bongers, Paulien M; van Mechelen, Willem; van Tulder, Maurits W

    2012-09-01

    The aim of this study was to appraise and summarize the evidence on the cost-effectiveness of worksite physical activity and/or nutrition programs. We searched EMBASE, MEDLINE, SportDiscus, PsycInfo, NIOSHTIC-2, NHSEED, HTA, and Econlit for studies published up to 14 January 2011. Additionally, we searched for articles by reviewing references, searching authors' databases, and contacting authors of included studies. Two researchers independently selected articles. Articles had to include a cost-effectiveness and/or cost-utility analysis comparing a worksite physical activity and/or nutrition program to usual care or an abridged version of the program. Data were extracted on study characteristics and results. Two researchers independently assessed the risk of bias using the Consensus on Health Economic Criteria list (CHEC-list). Ten studies (18 programs) were included. More than 50% of the studies fulfilled 11 (58%) of the 19 CHEC-list items. From various perspectives, worksite nutrition and worksite physical activity and nutrition programs (N=6) were more costly and more effective in reducing body weight than usual care. When only intervention costs were considered, most worksite nutrition (N=4/5) and worksite physical activity and nutrition programs (N=5/6) were more costly and more effective in reducing cholesterol level and cardiovascular disease risks, respectively. The cost-effectiveness of more costly and more effective programs depends on the "willingness to pay" for their effects. It is unknown how much decision-makers are willing to pay for reductions in body weight, cholesterol level, and cardiovascular disease risks. Therefore, conclusions about the cost-effectiveness of worksite physical activity and/or nutrition programs cannot be made. There is substantial need for improvement of the methodological quality of studies and particular emphasis should be placed on the handling of uncertainty.

  3. Cost-effective ERT technique for oil-in-water measurement for offshore hydrocyclone installations

    DEFF Research Database (Denmark)

    Durdevic, Petar; Hansen, Leif; Mai, Christian

    2015-01-01

    The goal of this paper is to introduce and design a cost-effective Oil-in-Water (OiW) measuring instrument, which will be investigated for its value in increasing the efficiency of a deoiling hydrocyclone. The technique investigated is based on Electrical Resistivity Tomography (ERT), which basic...... principle is to measure the resistivity of substances from multiple electrodes and from these measurements create a 2-D image of the oil and gas component in the water. This technique requires the measured components to have different electrical resistances, such as seawater which has a lower electrical...

  4. Cost-Effective ERT Technique for Oil-in-Water Measurement for Offshore Hydrocyclone Installations

    DEFF Research Database (Denmark)

    Løhndorf, Petar Durdevic; Hansen, Leif; Mai, Christian

    2015-01-01

    The goal of this paper is to introduce and design a cost-effective Oil-in-Water (OiW) measuring instrument, which will be investigated for its value in increasing the efficiency of a deoiling hydrocyclone. The technique investigated is based on Electrical Resistivity Tomography (ERT), which basic...... principle is to measure the resistivity of substances from multiple electrodes and from these measurements create a 2-D image of the oil and gas component in the water. This technique requires the measured components to have different electrical resistances, such as seawater which has a lower electrical...

  5. NEWBORN CONDITION AND ANTHROPOMETRIC MEASURES IN BABY FRIENDLY PROGRAM

    Directory of Open Access Journals (Sweden)

    Momcilo Djordjevic

    2008-01-01

    Full Text Available Mother’s breast milk is the best product that the new born infant could be fed with. It contains nutritious matters necessary for growth and progress of the new born infants, ideally adapted for the baby. This is not only the food. It provides the support for protection against infections.The aim of the investigation was to establish whether the newborn condition right after the birth and anthropometric measures affect entering the baby friendly program. The study was conducted during 2003 in OGC CC Kragujevac and included 216 new born infants included in baby friendly program and 216 new born infants outside the program.The following parameters in newborn infants were observed: Apgar score, body mass, body length, head circumference.Significantly most often in both examined groups (73 up to 75%, the value of Apgar score of the new born infants was in the interval 9 – 10 and it did not affect the selection into baby friendly program.New born infants from baby friendly program statistically had significantly greater weight than the infants outside the program-on average for about 80 g. The greater weight positively affects entering the baby friendly program.Body length and infant head circumference did not statistically significantly differed between the examined groups.Statistically important difference in body mass can be justified by higher surveillance of pregnant women from the program. The treatment should reflect in controlled nourishment, avoidance of all harmful causes like consumption of cigarettes and alcoholic drinks, which are proven risks for the newborn infants from such pregnancies to have lesser body mass. The advantage of greater body mass lies in the fact that after the childbirth, the relative loss of the body weight is lesser compared to the infants outside the program.

  6. Low-cost small action cameras in stereo generates accurate underwater measurements of fish

    OpenAIRE

    Letessier, T. B.; Juhel, Jean-Baptiste; Vigliola, Laurent; Meeuwig, J. J.

    2015-01-01

    Small action cameras have received interest for use in underwater videography because of their low-cost, standardised housing, widespread availability and small size. Here, we assess the capacity of GoPro action cameras to provide accurate stereo-measurements of fish in comparison to the Sony handheld cameras that have traditionally been used for this purpose. Standardised stereo-GoPro and Sony systems were employed to capture measurements of known-length targets in a pool to explore the infl...

  7. Cost-effectiveness of rapid syphilis screening in prenatal HIV testing programs in Haiti.

    Directory of Open Access Journals (Sweden)

    Bruce R Schackman

    2007-05-01

    Full Text Available New rapid syphilis tests permit simple and immediate diagnosis and treatment at a single clinic visit. We compared the cost-effectiveness, projected health outcomes, and annual cost of screening pregnant women using a rapid syphilis test as part of scaled-up prenatal testing to prevent mother-to-child HIV transmission in Haiti.A decision analytic model simulated health outcomes and costs separately for pregnant women in rural and urban areas. We compared syphilis syndromic surveillance (rural standard of care, rapid plasma reagin test with results and treatment at 1-wk follow-up (urban standard of care, and a new rapid test with immediate results and treatment. Test performance data were from a World Health Organization-Special Programme for Research and Training in Tropical Diseases field trial conducted at the GHESKIO Center Groupe Haitien d'Etude du Sarcome de Kaposi et des Infections Opportunistes in Port-au-Prince. Health outcomes were projected using historical data on prenatal syphilis treatment efficacy and included disability-adjusted life years (DALYs of newborns, congenital syphilis cases, neonatal deaths, and stillbirths. Cost-effectiveness ratios are in US dollars/DALY from a societal perspective; annual costs are in US dollars from a payer perspective. Rapid testing with immediate treatment has a cost-effectiveness ratio of $6.83/DALY in rural settings and $9.95/DALY in urban settings. Results are sensitive to regional syphilis prevalence, rapid test sensitivity, and the return rate for follow-up visits. Integrating rapid syphilis testing into a scaled-up national HIV testing and prenatal care program would prevent 1,125 congenital syphilis cases and 1,223 stillbirths or neonatal deaths annually at a cost of $525,000.In Haiti, integrating a new rapid syphilis test into prenatal care and HIV testing would prevent congenital syphilis cases and stillbirths, and is cost-effective. A similar approach may be beneficial in other resource

  8. Cost-effectiveness of rapid syphilis screening in prenatal HIV testing programs in Haiti.

    Science.gov (United States)

    Schackman, Bruce R; Neukermans, Christopher P; Fontain, Sandy N Nerette; Nolte, Claudine; Joseph, Patrice; Pape, Jean W; Fitzgerald, Daniel W

    2007-05-01

    New rapid syphilis tests permit simple and immediate diagnosis and treatment at a single clinic visit. We compared the cost-effectiveness, projected health outcomes, and annual cost of screening pregnant women using a rapid syphilis test as part of scaled-up prenatal testing to prevent mother-to-child HIV transmission in Haiti. A decision analytic model simulated health outcomes and costs separately for pregnant women in rural and urban areas. We compared syphilis syndromic surveillance (rural standard of care), rapid plasma reagin test with results and treatment at 1-wk follow-up (urban standard of care), and a new rapid test with immediate results and treatment. Test performance data were from a World Health Organization-Special Programme for Research and Training in Tropical Diseases field trial conducted at the GHESKIO Center Groupe Haitien d'Etude du Sarcome de Kaposi et des Infections Opportunistes in Port-au-Prince. Health outcomes were projected using historical data on prenatal syphilis treatment efficacy and included disability-adjusted life years (DALYs) of newborns, congenital syphilis cases, neonatal deaths, and stillbirths. Cost-effectiveness ratios are in US dollars/DALY from a societal perspective; annual costs are in US dollars from a payer perspective. Rapid testing with immediate treatment has a cost-effectiveness ratio of $6.83/DALY in rural settings and $9.95/DALY in urban settings. Results are sensitive to regional syphilis prevalence, rapid test sensitivity, and the return rate for follow-up visits. Integrating rapid syphilis testing into a scaled-up national HIV testing and prenatal care program would prevent 1,125 congenital syphilis cases and 1,223 stillbirths or neonatal deaths annually at a cost of $525,000. In Haiti, integrating a new rapid syphilis test into prenatal care and HIV testing would prevent congenital syphilis cases and stillbirths, and is cost-effective. A similar approach may be beneficial in other resource-poor countries

  9. Online Advertising to Reach and Recruit Latino Smokers to an Internet Cessation Program: Impact and Costs

    Science.gov (United States)

    Fang, Ye; Moreno, Jose L; Streiff, Shawn L; Villegas, Jorge; Muñoz, Ricardo F; Tercyak, Kenneth P; Mandelblatt, Jeanne S; Vallone, Donna M

    2012-01-01

    Background Tobacco cessation among Latinos is a public health priority in the United States, particularly given the relatively high growth of this population segment. Although a substantial percentage of American Latinos use the Internet, they have not engaged in Web-based cessation programs as readily as other racial/ethnic subgroups. A lack of culturally specific advertising efforts may partly explain this disparity. Objective Phase I of this study focused on the development of four Spanish-language online banner advertisements to promote a free Spanish-language smoking cessation website (es.BecomeAnEX.org). Phase II examined the relative effectiveness of the four banner ads in reaching and recruiting Latino smokers to the cessation website. Methods In Phase I, 200 Spanish-speaking Latino smokers completed an online survey to indicate their preference for Spanish-language banner ads that incorporated either the cultural value of family (familismo) or fatalism (fatalismo). Ads included variations on message framing (gain vs loss) and depth of cultural targeting (surface vs deep). In Phase II, a Latin square design evaluated the effectiveness of the four preferred ads from Phase I. Ads were systematically rotated across four popular Latino websites (MySpace Latino, MSN Latino, MiGente, and Yahoo! en Español) over four months from August to November 2009. Tracking software recorded ad clicks and registrants on the cessation website. Negative binomial regression and general linear modeling examined the main and interacting effects of message framing and depth of cultural targeting for four outcomes: number of clicks, click-through rate, number of registrants, and cost per registrant. Results In Phase I, smokers preferred the four ads featuring familismo. In Phase II, 24,829,007 impressions were placed, yielding 24,822 clicks, an overall click-through rate of 0.10%, and 500 registrants (2.77% conversion rate). Advertising costs totaled US $104,669.49, resulting in an

  10. Online advertising to reach and recruit Latino smokers to an internet cessation program: impact and costs.

    Science.gov (United States)

    Graham, Amanda L; Fang, Ye; Moreno, Jose L; Streiff, Shawn L; Villegas, Jorge; Muñoz, Ricardo F; Tercyak, Kenneth P; Mandelblatt, Jeanne S; Vallone, Donna M

    2012-08-27

    Tobacco cessation among Latinos is a public health priority in the United States, particularly given the relatively high growth of this population segment. Although a substantial percentage of American Latinos use the Internet, they have not engaged in Web-based cessation programs as readily as other racial/ethnic subgroups. A lack of culturally specific advertising efforts may partly explain this disparity. Phase I of this study focused on the development of four Spanish-language online banner advertisements to promote a free Spanish-language smoking cessation website (es.BecomeAnEX.org). Phase II examined the relative effectiveness of the four banner ads in reaching and recruiting Latino smokers to the cessation website. In Phase I, 200 Spanish-speaking Latino smokers completed an online survey to indicate their preference for Spanish-language banner ads that incorporated either the cultural value of family (familismo) or fatalism (fatalismo). Ads included variations on message framing (gain vs loss) and depth of cultural targeting (surface vs deep). In Phase II, a Latin square design evaluated the effectiveness of the four preferred ads from Phase I. Ads were systematically rotated across four popular Latino websites (MySpace Latino, MSN Latino, MiGente, and Yahoo! en Español) over four months from August to November 2009. Tracking software recorded ad clicks and registrants on the cessation website. Negative binomial regression and general linear modeling examined the main and interacting effects of message framing and depth of cultural targeting for four outcomes: number of clicks, click-through rate, number of registrants, and cost per registrant. In Phase I, smokers preferred the four ads featuring familismo. In Phase II, 24,829,007 impressions were placed, yielding 24,822 clicks, an overall click-through rate of 0.10%, and 500 registrants (2.77% conversion rate). Advertising costs totaled US $104,669.49, resulting in an overall cost per click of US $4

  11. 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.

  12. Duration of hospitalization as a measure of cost on Children's Cancer Group acute lymphoblastic leukemia studies.

    Science.gov (United States)

    Gaynon, P S; Bostrom, B C; Hutchinson, R J; Lange, B J; Nachman, J B; Steinherz, P G; Sensel, M G; Lee, M K; Stram, D O; Sather, H N

    2001-04-01

    We used duration of hospitalization as a surrogate for cost and event-free survival as a measure of effectiveness to estimate the cost-effectiveness ratios of various treatment regimens on Children's Cancer Group trials for acute lymphoblastic leukemia. The analyses included 4,986 children (2 to 21 years of age) with newly diagnosed acute lymphoblastic leukemia enrolled onto risk-adjusted protocols between 1988 and 1995. Analyses were based on a model of 100 patients. The marginal cost-effectiveness ratio (hospital days per additional patient surviving event-free) was the difference in total duration of hospitalization divided by the difference in number of event-free survivors at 5 years for two regimens. Relapse-adjusted marginal cost of frontline therapy was the difference in total duration of hospitalization for frontline therapy plus relapse therapy divided by the difference in number of event-free survivors at 5 years on the frontline therapy for two regimens. One or two delayed intensification (DI) phases, augmented therapy, and dexamethasone all improved outcome. Marginal cost-effectiveness of these regimens compared with the control regimens was 133 days per patient for DI, 117 days per patient for double DI, and 41 days per patient for augmented therapy. Dexamethasone resulted in 17 fewer days per patient. Relapse-adjusted marginal costs were 68 days per patient for DI and 52 days for double DI. Augmented therapy and dexamethasone-based therapy resulted in 16 and 82 fewer hospital days, respectively. The estimated cost-effectiveness for treating any first relapse was 250 days per patient. DI, double DI, augmented therapy, and dexamethasone-based therapy are cost-effective strategies compared with current treatment of first relapse.

  13. Joint pricing and production management: a geometric programming approach with consideration of cubic production cost function

    Science.gov (United States)

    Sadjadi, Seyed Jafar; Hamidi Hesarsorkh, Aghil; Mohammadi, Mehdi; Bonyadi Naeini, Ali

    2014-08-01

    Coordination and harmony between different departments of a company can be an important factor in achieving competitive advantage if the company corrects alignment between strategies of different departments. This paper presents an integrated decision model based on recent advances of geometric programming technique. The demand of a product considers as a power function of factors such as product's price, marketing expenditures, and consumer service expenditures. Furthermore, production cost considers as a cubic power function of outputs. The model will be solved by recent advances in convex optimization tools. Finally, the solution procedure is illustrated by numerical example.

  14. The sensitivity of capital services measurement : Measure all assets and the cost of capital

    NARCIS (Netherlands)

    Inklaar, R.

    The measurement of capital inputs is still a contentious issue: many choices have to be made that have potentially large effects on the resulting capital input series. This paper compares a large number of methodological choices and their impact on U.S. capital services at the industry and aggregate

  15. The Sensitivity of Capital Services Measurement : Measure all assets and the cost of capital

    NARCIS (Netherlands)

    Inklaar, Robert

    2008-01-01

    The measurement of capital inputs is still a contentious issue: many choices have to be made that have potentially large effects on the resulting capital input series, some entailing differing assumptions about firm behaviour. This paper compares a large number of methodological choices and their

  16. Did we get our money's worth? Bridging economic and behavioral measures of program success in adolescent drug prevention.

    Science.gov (United States)

    Griffith, Kevin N; Scheier, Lawrence M

    2013-11-08

    The recent U.S. Congressional mandate for creating drug-free learning environments in elementary and secondary schools stipulates that education reform rely on accountability, parental and community involvement, local decision making, and use of evidence-based drug prevention programs. By necessity, this charge has been paralleled by increased interest in demonstrating that drug prevention programs net tangible benefits to society. One pressing concern is precisely how to integrate traditional scientific methods of program evaluation with economic measures of "cost efficiency". The languages and methods of each respective discipline don't necessarily converge on how to establish the true benefits of drug prevention. This article serves as a primer for conducting economic analyses of school-based drug prevention programs. The article provides the reader with a foundation in the relevant principles, methodologies, and benefits related to conducting economic analysis. Discussion revolves around how economists value the potential costs and benefits, both financial and personal, from implementing school-based drug prevention programs targeting youth. Application of heterogeneous costing methods coupled with widely divergent program evaluation findings influences the feasibility of these techniques and may hinder utilization of these practices. Determination of cost-efficiency should undoubtedly become one of several markers of program success and contribute to the ongoing debate over health policy.

  17. Did We Get Our Money’s Worth? Bridging Economic and Behavioral Measures of Program Success in Adolescent Drug Prevention

    Science.gov (United States)

    Griffith, Kevin N.; Scheier, Lawrence M.

    2013-01-01

    The recent U.S. Congressional mandate for creating drug-free learning environments in elementary and secondary schools stipulates that education reform rely on accountability, parental and community involvement, local decision making, and use of evidence-based drug prevention programs. By necessity, this charge has been paralleled by increased interest in demonstrating that drug prevention programs net tangible benefits to society. One pressing concern is precisely how to integrate traditional scientific methods of program evaluation with economic measures of “cost efficiency”. The languages and methods of each respective discipline don’t necessarily converge on how to establish the true benefits of drug prevention. This article serves as a primer for conducting economic analyses of school-based drug prevention programs. The article provides the reader with a foundation in the relevant principles, methodologies, and benefits related to conducting economic analysis. Discussion revolves around how economists value the potential costs and benefits, both financial and personal, from implementing school-based drug prevention programs targeting youth. Application of heterogeneous costing methods coupled with widely divergent program evaluation findings influences the feasibility of these techniques and may hinder utilization of these practices. Determination of cost-efficiency should undoubtedly become one of several markers of program success and contribute to the ongoing debate over health policy. PMID:24217178

  18. Did We Get Our Money’s Worth? Bridging Economic and Behavioral Measures of Program Success in Adolescent Drug Prevention

    Directory of Open Access Journals (Sweden)

    Lawrence M. Scheier

    2013-11-01

    Full Text Available The recent U.S. Congressional mandate for creating drug-free learning environments in elementary and secondary schools stipulates that education reform rely on accountability, parental and community involvement, local decision making, and use of evidence-based drug prevention programs. By necessity, this charge has been paralleled by increased interest in demonstrating that drug prevention programs net tangible benefits to society. One pressing concern is precisely how to integrate traditional scientific methods of program evaluation with economic measures of “cost efficiency”. The languages and methods of each respective discipline don’t necessarily converge on how to establish the true benefits of drug prevention. This article serves as a primer for conducting economic analyses of school-based drug prevention programs. The article provides the reader with a foundation in the relevant principles, methodologies, and benefits related to conducting economic analysis. Discussion revolves around how economists value the potential costs and benefits, both financial and personal, from implementing school-based drug prevention programs targeting youth. Application of heterogeneous costing methods coupled with widely divergent program evaluation findings influences the feasibility of these techniques and may hinder utilization of these practices. Determination of cost-efficiency should undoubtedly become one of several markers of program success and contribute to the ongoing debate over health policy.

  19. Recruitment strategies and costs for a community-based physical activity program.

    Science.gov (United States)

    Peck, Lara E; Sharpe, Patricia A; Burroughs, Ericka L; Granner, Michelle L

    2008-04-01

    A community-based participatory research project using social marketing strategies was implemented to promote physical activity among women aged 35 to 54 who were insufficiently active or completely inactive. A variety of media were used to disseminate messages about how to enroll in Step Up. Step Out! This article describes the effectiveness and cost of the recruitment strategies and lessons learned in recruiting the women. Of the total inquiries (n = 691), 430 women were eligible and enrolled in the program. Based on data from questionnaires, the most effective method of recruiting women into Step Up. Step Out! was word of mouth (36%). Newspaper ads accounted for 29% of the women's responses. The least effective method was billboards. Mass media was not as effective in recruiting women for the program as interpersonal efforts such as word of mouth. Interpersonal efforts are a valuable and possibly underrated recruitment and promotion tool.

  20. Uses Of Infrared Thermography In The Low-Cost Solar Array Program

    Science.gov (United States)

    Glazer, Stuart D.

    1982-03-01

    The Jet Propulsion Laboratory has used infrared thermography extensively in the Low-Cost Solar Array (LSA) photovoltaics program. A two-dimensional scanning infrared radiometer has been used to make field inspections of large free-standing photovoltaic arrays and smaller demonstration sites consisting of integrally mounted rooftop systems. These field inspections have proven especially valuable in the research and early development phases of the program, since certain types of module design flaws and environmental degradation manifest themselves in unique thermal patterns. The infrared camera was also used extensively in a series of laboratory tests on photovoltaic cells to obtain peak cell temperatures and thermal patterns during off-design operating conditions. The infrared field inspections and the laboratory experiments are discussed, and sample results are presented.

  1. Life cycle cost optimization of biofuel supply chains under uncertainties based on interval linear programming.

    Science.gov (United States)

    Ren, Jingzheng; Dong, Liang; Sun, Lu; Goodsite, Michael Evan; Tan, Shiyu; Dong, Lichun

    2015-01-01

    The aim of this work was to develop a model for optimizing the life cycle cost of biofuel supply chain under uncertainties. Multiple agriculture zones, multiple transportation modes for the transport of grain and biofuel, multiple biofuel plants, and multiple market centers were considered in this model, and the price of the resources, the yield of grain and the market demands were regarded as interval numbers instead of constants. An interval linear programming was developed, and a method for solving interval linear programming was presented. An illustrative case was studied by the proposed model, and the results showed that the proposed model is feasible for designing biofuel supply chain under uncertainties. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Inertial measurement unit–based iterative pose compensation algorithm for low-cost modular manipulator

    Directory of Open Access Journals (Sweden)

    Yunhan Lin

    2016-01-01

    Full Text Available It is a necessary mean to realize the accurate motion control of the manipulator which uses end-effector pose correction method and compensation method. In this article, first, we established the kinematic model and error model of the modular manipulator (WUST-ARM, and then we discussed the measurement methods and precision of the inertial measurement unit sensor. The inertial measurement unit sensor is mounted on the end-effector of modular manipulator, to get the real-time pose of the end-effector. At last, a new inertial measurement unit–based iterative pose compensation algorithm is proposed. By applying this algorithm in the pose compensation experiment of modular manipulator which is composed of low-cost rotation joints, the results show that the inertial measurement unit can obtain a higher precision when in static state; it will accurately feedback to the control system with an accurate error compensation angle after a brief delay when the end-effector moves to the target point, and after compensation, the precision errors of roll angle, pitch angle, and yaw angle are reached at 0.05°, 0.01°, and 0.27° respectively. It proves that this low-cost method provides a new solution to improve the end-effector pose of low-cost modular manipulator.

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

    Science.gov (United States)

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

    2017-09-01

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

  4. Measurement of the economic-financial impacts of trade-offs between inventory carrying costs and transport costs

    OpenAIRE

    Juliana Ventura Amaral; Reinaldo Guerreiro

    2014-01-01

    The economic-financial performance is affected by logistics and, thus, the logistics area seeks solutions that best address the balance between incurred costs and services offered. This balance is achieved only when the potential logistics results are exploited with an evaluation that assesses total cost and cost trade-offs. As logistics research is used to emphasizing operational aspects of trade-offs, this paper attempted to deal with another dimension: the economic-financial one. In this c...

  5. 78 FR 956 - National Vaccine Injury Compensation Program: Revised Amount of the Average Cost of a Health...

    Science.gov (United States)

    2013-01-07

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

  6. Modelling the effects of environmental and individual variability when measuring the costs of first reproduction

    Directory of Open Access Journals (Sweden)

    Barbraud, C.

    2004-06-01

    Full Text Available How do animals balance their investment in young against their own chances to survive and reproduce in the future? This life–history trade–off, referred to as the cost of reproduction (Williams, 1966, holds a central place in life–history theory (Roff, 1992; Stearns, 1992; McNamara & Houston, 1996. Because individuals can only acquire a limited amount of energy, reproduction and survival as well as current and future reproduction are considered as functions competing for the same resources. In this framework, individuals may optimise life–history decisions. If the reproductive effort in one year leads to a loss in future reproductive output through decreased adult survival or reduced fecundity, then the optimal effort in the current season is less than the effort that would maximize the number of offspring produced in that season (Charnov & Krebs, 1974. There are at least two kinds of factors likely to confound the measurement of the costs of reproduction in the wild. First, there could be differences in the amount of energy individuals acquire and allocate to various functions. This phenotypic heterogeneity can mask or exacerbate individual allocation patterns when trends are averaged across a population (Vaupel & Yashin, 1985; McDonald et al., 1996; Cam & Monnat, 2000. Second, there could be variations in resource availability affecting energy acquisition and allocation. Theoretical models examining the optimal phenotypic balance between reproduction and survival under variable breeding conditions have investigated the influence of environmental stochasticity on the cost of reproduction in birds (Erikstad et al., 1998; Orzack & Tuljapurkar, 2001. However, there is little empirical evidence supporting these theoretical models. Here, we present analysis of the influence of experience, but also of the differential effects of environmental and individual variation on survival and future breeding probability. We address the question of the

  7. Impact of shrinking measurement error budgets on qualification metrology sampling and cost

    Science.gov (United States)

    Sendelbach, Matthew; Sarig, Niv; Wakamoto, Koichi; Kim, Hyang Kyun (Helen); Isbester, Paul; Asano, Masafumi; Matsuki, Kazuto; Vaid, Alok; Osorio, Carmen; Archie, Chas

    2014-04-01

    When designing an experiment to assess the accuracy of a tool as compared to a reference tool, semiconductor metrologists are often confronted with the situation that they must decide on the sampling strategy before the measurements begin. This decision is usually based largely on the previous experience of the metrologist and the available resources, and not on the statistics that are needed to achieve acceptable confidence limits on the final result. This paper shows a solution to this problem, called inverse TMU analysis, by presenting statistically-based equations that allow the user to estimate the needed sampling after providing appropriate inputs, allowing him to make important "risk vs. reward" sampling, cost, and equipment decisions. Application examples using experimental data from scatterometry and critical dimension scanning electron microscope (CD-SEM) tools are used first to demonstrate how the inverse TMU analysis methodology can be used to make intelligent sampling decisions before the start of the experiment, and then to reveal why low sampling can lead to unstable and misleading results. A model is developed that can help an experimenter minimize the costs associated both with increased sampling and with making wrong decisions caused by insufficient sampling. A second cost model is described that reveals the inadequacy of current TEM (Transmission Electron Microscopy) sampling practices and the enormous costs associated with TEM sampling that is needed to provide reasonable levels of certainty in the result. These high costs reach into the tens of millions of dollars for TEM reference metrology as the measurement error budgets reach angstrom levels. The paper concludes with strategies on how to manage and mitigate these costs.

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

    Directory of Open Access Journals (Sweden)

    Xian Li

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

  9. The NCI Patient Navigation Research Program Methods, Protocol and Measures

    Science.gov (United States)

    Freund, Karen M; Battaglia, Tracy A; Calhoun, Elizabeth; Dudley, Donald J.; Fiscella, Kevin; Paskett, Electra; Raich, Peter C.; Roetzheim, Richard G.

    2009-01-01

    Background Patient, provider, and systems barriers contribute to delays in cancer care, lower quality of care, and poorer outcomes in vulnerable populations, including low income, underinsured, and racial/ethnic minority populations. Patient navigation is emerging as an intervention to address this problem, but navigation requires a clear definition and a rigorous testing of its effectiveness. Pilot programs have provided some evidence of benefit, but have been limited by evaluation of single-site interventions and varying definitions of navigation. To overcome these limitations, a nine-site National Cancer Institute Patient Navigation Research Program (PNRP) was initiated. Methods The PNRP is charged with designing, implementing and evaluating a generalizable patient navigation program targeting vulnerable populations. Through a formal committee structure, the PNRP has developed a definition of patient navigation and metrics to assess the process and outcomes of patient navigation in diverse settings, compared with concurrent continuous control groups. Results The PNRP defines patient navigation as support and guidance offered to vulnerable persons with abnormal cancer screening or a cancer diagnosis, with the goal of overcoming barriers to timely, quality care. Primary outcomes of the PNRP are (1) time to diagnostic resolution, (2) time to initiation of cancer treatment, (3) patient satisfaction with care, and (4) cost effectiveness, for breast, cervical, colon/rectum, and/or prostate cancer. Conclusions The metrics to assess the processes and outcomes of patient navigation have been developed for the NCI-sponsored Patient Navigator Research Program. If the metrics are found to be valid and reliable, they may prove useful to other investigators. PMID:18951521

  10. The cost of ventilation in birds measured via unidirectional artificial ventilation.

    Science.gov (United States)

    Markley, Jessamyn S; Carrier, David R

    2010-02-01

    The highly derived mechanism birds use to ventilate their lungs relies on dorsoventral excursions of their heavily muscled sternum and abdominal viscera. Our expectation of the level of mechanical work involved in this mechanism led us to hypothesize that the metabolic cost of breathing is higher in birds than in other tetrapods. To test this theory, we used unidirectional artificial ventilation (UDV) to stop normal ventilatory movements in guinea fowl (Numida meleagris L.) at rest and during treadmill locomotion at three speeds. Oxygen consumption was measured during normal breathing and UDV, and the difference was used to approximate the cost of ventilation. Contrary to our prediction, metabolism increased when ventilatory movements ceased during UDV at rest. Although we do not understand why this occurred we suspect that UDV induced a homeostatic mechanism to counteract the loss of carbon dioxide. Nevertheless, across all running speeds, metabolism decreased significantly with UDV, indicating a minimum cost of ventilation during running of 1.43+/-0.62% of total running metabolism or 0.48+/-0.21 mL O(2) (L ventilated)(-1). These results suggest that the metabolic cost of ventilation is low in birds and that it is within the range of costs reported previously for other amniotes. Elsevier Inc.

  11. Salty or Sweet? Nutritional quality, consumption, and cost of snacks served in afterschool programs

    Science.gov (United States)

    Beets, Michael W.; Weaver, R. Glenn; Tilley, Falon; Turner-McGrievy, Brie; Huberty, Jennifer; Ward, Dianne S.; Freedman, Darcy A.

    2015-01-01

    BACKGROUND Snacks served in afterschool programs (ASPs, 3–6pm) represent an important opportunity to promote healthy eating. ASP policies suggest a fruit/vegetable is served daily, while sugar-sweetened foods/beverages and artificially-flavored snacks are eliminated. Limited information exists on the types of snacks served in ASPs, if snacks meet existing nutrition policies, whether children eat the snacks, and their cost. METHODS Direct observation of snacks served and consumed was collected in 20 ASPs serving over 1,700 elementary-age children. The number of days snacks were served/week was evaluated for compliance with nutrition policies. Costs of snacks were collected via receipts. RESULTS Programs served desserts and artificially-flavored salty-snacks on 2.7 and 2.1 days/week. Fruits and vegetables were served 0.6 and 0.1 days/wk, respectively. Sugar-sweetened-beverages were served 1.8 days/wk. Of the children (N=383) observed, 75–100% consumed the snack served, with 95% and 100% of served fruits/vegetables consumed. No ASP served fruit/vegetables daily, 18 served sugar-sweetened foods, 16 served artificially-flavored snacks, and 14 served sugar-sweetened-beverages. Desserts and salty-snacks cost $0.27–$0.32/snack vs. $0.38–$0.40/snack for vegetables/fruits. CONCLUSIONS The quality of snacks failed to meet nutrition policies and consists of predominately high-sugar and artificially-flavored options. Strategies to improve snack offerings in ASPs while addressing price barriers are required. PMID:25564980

  12. Salty or sweet? Nutritional quality, consumption, and cost of snacks served in afterschool programs.

    Science.gov (United States)

    Beets, Michael W; Weaver, Robert G; Tilley, Falon; Turner-McGrievy, Gabrielle; Huberty, Jennifer; Ward, Dianne S; Freedman, Darcy A

    2015-02-01

    Snacks served in afterschool programs (ASPs, 3-6 pm) represent an important opportunity to promote healthy eating. ASP policies suggest a fruit/vegetable is served daily, while sugar-sweetened foods/beverages and artificially flavored snacks are eliminated. Limited information exists on the types of snacks served in ASPs, if snacks meet existing nutrition policies, whether children eat the snacks, and their cost. Direct observation of snacks served and consumed was collected in 20 ASPs serving over 1700 elementary age children. The number of days that snacks were served/week was evaluated for compliance with nutrition policies. Costs of snacks were collected via receipts. Programs served desserts and artificially flavored salty snacks on 2.7 and 2.1 days/week. Fruits and vegetables were served 0.6 and 0.1 days/week, respectively. Sugar-sweetened beverages were served 1.8 days/week. Of the children (N = 383) observed, 75% to 100% consumed the snack served, with 95% and 100% of served fruits/vegetables consumed. No ASP served fruit/vegetables daily, 18 served sugar-sweetened foods, 16 served artificially flavored snacks, and 14 served sugar-sweetened beverages. Desserts and salty snacks cost $0.27-$0.32/snack vs $0.38-$0.40/snack for vegetables/fruits. The quality of snacks failed to meet nutrition policies and consists of predominately high-sugar and artificially flavored options. Strategies to improve snack offerings in ASPs while addressing price barriers are required. © 2015, American School Health Association.

  13. Penempatan Optimal Phasor Measurement Unit (PMU) dengan Integer Programming

    OpenAIRE

    Yunan Helmy Amrulloh

    2013-01-01

    Phasor Measurement Unit (PMU) merupakan peralatan yang mampu memberikan pengukuran fasor tegangan dan arus secara real-time. PMU dapat digunakan untuk monitoring, proteksi dan kontrol pada sistem tenaga listrik. Tugas akhir ini membahas penempatan PMU secara optimal berdasarkan topologi jaringan sehingga sistem tenaga listrik  dapat diobservasi. Penempatan optimal PMU dirumuskan sebagai masalah Binary Integer Programming (BIP) yang akan memberikan variabel dengan pilihan nilai (0,1) yang menu...

  14. Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model: A Web-based program designed to evaluate the cost-effectiveness of disease management programs in heart failure.

    Science.gov (United States)

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

    2015-11-01

    Heart failure disease management programs can influence medical resource use and quality-adjusted survival. Because projecting long-term costs and survival is challenging, a consistent and valid approach to extrapolating short-term outcomes would be valuable. We developed the Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model, a Web-based simulation tool designed to integrate data on demographic, clinical, and laboratory characteristics; use of evidence-based medications; and costs to generate predicted outcomes. Survival projections are based on a modified Seattle Heart Failure Model. Projections of resource use and quality of life are modeled using relationships with time-varying Seattle Heart Failure Model scores. The model can be used to evaluate parallel-group and single-cohort study designs and hypothetical programs. Simulations consist of 10,000 pairs of virtual cohorts used to generate estimates of resource use, costs, survival, and incremental cost-effectiveness ratios from user inputs. The model demonstrated acceptable internal and external validity in replicating resource use, costs, and survival estimates from 3 clinical trials. Simulations to evaluate the cost-effectiveness of heart failure disease management programs across 3 scenarios demonstrate how the model can be used to design a program in which short-term improvements in functioning and use of evidence-based treatments are sufficient to demonstrate good long-term value to the health care system. The Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model provides researchers and providers with a tool for conducting long-term cost-effectiveness analyses of disease management programs in heart failure. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Community Partnership to Address Snack Quality and Cost in Afterschool Programs

    Science.gov (United States)

    Tilley, Falon; Turner-McGrievy, Gabrielle; Weaver, Robert Glenn; Jones, Sonya

    2014-01-01

    Background Policies call on afterschool programs (ASPs) to serve more nutritious snacks. A major barrier for improving snack quality is cost. This study describes the impact on snack quality and expenditures from a community-partnership between ASPs and local grocery stores. Methods Four large-scale ASPs (serving ∼500 children aged 6-12 years each day) and a single local grocery store chain participated in the study. The nutritional quality of snacks served was recorded pre-intervention (18 weeks spring/fall 2011) and post-intervention (7 weeks spring 2012) via direct observation, along with cost/child/snack/day. Results Pre-intervention snacks were low-nutrient-density salty snacks (eg, chips, 3.0 servings/week), sugar-sweetened beverages (eg, powdered-lemonade, 1.9 servings/week), and desserts (eg, cookies, 2.1servings/week), with only 0.4 servings/week of fruits and no vegetables. By post-intervention, fruits (3.5 servings/week) and vegetables (1.2 servings/week) increased, while sugar-sweetened beverages and desserts were eliminated. Snack expenditures were $0.26 versus $0.24 from pre-intervention to post-intervention. Partnership savings versus purchasing snacks at full retail cost was 24.5% or $0.25/serving versus $0.34/serving. Conclusions This innovative partnership can serve as a model in communities where ASPs seek to identify low-cost alternatives to providing nutritious snacks. PMID:25040123

  16. Evidence for the long term cost effectiveness of home care reablement programs

    Directory of Open Access Journals (Sweden)

    Lewin GF

    2013-10-01

    Full Text Available Gill F Lewin,1,2 Helman S Alfonso,3 Janine J Alan41Faculty of Health Sciences, Curtin University, Perth, WA, Australia; 2Research Department, Silver Chain Group, Perth, WA, Australia; 3School of Population Health, University of Western Australia, Perth, WA, Australia; 4Faculty of Health Sciences, Curtin University, Perth, WA, AustraliaBackground: The objectives of this study were to determine whether older individuals who participated in a reablement (restorative program rather than immediately receiving conventional home care services had a reduced need for ongoing support and lower home care costs over the next 57 months (nearly 5 years.Materials and methods: Data linkage was used to examine retrospectively the service records of older individuals who had received a reablement service versus a conventional home care service to ascertain their use of home care services over time.Results: Individuals who had received a reablement service were less likely to use a personal care service throughout the follow-up period or any other type of home care over the next 3 years. This reduced use of home care services was associated with median cost savings per person of approximately AU $12,500 over nearly 5 years.Conclusion: The inclusion of reablement as the starting point for individuals referred for home care within Australia's reformed aged care system could increase the system's cost effectiveness and ensure that all older Australians have the opportunity to maximize their independence as they age.Keywords: restorative, older adults, community dwelling, service costs

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

    Science.gov (United States)

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

    2008-09-01

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

  18. Impact of an Integrated Hip Fracture Inpatient Program on Length of Stay and Costs.

    Science.gov (United States)

    Soong, Christine; Cram, Peter; Chezar, Ksenia; Tajammal, Faiqa; Exconde, Kathleen; Matelski, John; Sinha, Samir K; Abrams, Howard B; Fan-Lun, Christopher; Fabbruzzo-Cota, Christina; Backstein, David; Bell, Chaim M

    2016-12-01

    Hip fractures are associated with significant morbidity and mortality. Co-management models pairing orthopaedic surgeons with hospitalists or geriatricians may be effective at improving processes of care and outcomes such as length of stay (LOS) and cost. We set out to determine the effect of an integrated hip fracture co-management model on LOS, cost, and process measures. We conducted a single-center pre-post study of 571 patients admitted to an academic medical center with hip fractures between January 2009 and December 2013. The group receiving an integrated medical-surgical co-management incorporating continuous improvement methodology was compared with a control population. Primary outcome was LOS. Secondary outcomes included cost per case, time to surgery, osteoporosis (OP) treatment, preoperative echocardiogram utilization, mortality, and readmission. LOS decreased from 18.2 (1.1) to 11.9 (1.5) days, a reduction of 6.3 days (P < 0.001). Mean cost decreased by $4953 (P < 0.001) per case. Mean time to surgery decreased from 45.8 (66.8) to 29.7 (17.9) hours (P < 0.001). Initiation of OP treatment increased from 55.8% to 96.4% (P < 0.001). Preoperative echocardiogram use decreased from 15.8% to 9.1% (P < 0.05). There was a nonsignificant difference in mortality rate (5.0% vs. 2.1%, P = 0.06). Readmission rate remained unchanged (4.6% vs. 6.0%, P = 0.56). An integrated medical-surgical co-management model incorporating continuous improvement methodology was associated with reduced LOS, costs, time to surgery, and increased initiation of appropriate OP treatment. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

  19. Design and Build of an Electrical Machines’ High Speed Measurement System at Low Cost

    Directory of Open Access Journals (Sweden)

    Constantinos C. Kontogiannis

    2014-01-01

    Full Text Available The principal objective of this paper is to demonstrate the capability of high speed measurement and acquisition equipment design and build in the laboratory at a very low cost. The presented architecture employees highly integrated market components eliminating thus the complexity of the hardware and software stack. The key element of the proposed system is a Hi-Speed USB to Serial/FIFO development module that is provided with full software and driver support for most popular operating systems. This module takes over every single task needed to get the data from the A/D to the user software gluelessly and transparently, solving this way the most difficult problem in data acquisition systems which is the fast and reliable communication with a host computer. Other ideas tested and included in this document offer Hall Effect measuring solutions using some excellent features and very low cost ICs widely available on the market today.

  20. NASA's MEaSUREs Program Serving the Earth Science Community

    Science.gov (United States)

    Ramapriyan, H. K.; Tsaoussi, L.; Olding, S. W.

    2014-12-01

    A major need stated by the NASA Earth science research strategy is to develop long-term, consistent, and calibrated data and products that are valid across multiple missions and satellite sensors. NASA has invested in the creation of consistent time series satellite data sets over decades, through both mission science team-based and measurement-based data product reprocessing and through solicitations for merged data products. The NOAA/NASA Pathfinder Program, carried out in the mid-1990's, resulted in the reprocessing of four long time-series datasets from existing archives. The Research, Education and Applications Solutions Network (REASoN) Program, initiated in 2002, consisted of several projects that provided data products, information systems and services capabilities, and/or advanced data systems technologies, to address strategic needs in Earth science research, applications, and education. The Program named Making Earth System data records for Use in Research for Earth Science, or MEaSUREs has had two requests for proposals, the first in 2006 and the second in 2012. With this Program, the Earth Science Division has focused on generating datasets for particular Earth science research measurement needs, and refers to such datasets as Earth System Data Records (ESDRs). Climate Data Records (CDRs) are a particular case of ESDRs. An ESDR is defined as a unified and coherent set of observations of a given parameter of the Earth system, which is optimized to meet specific requirements in addressing science questions. Most of the MEaSUREs projects are five years long. They produce ESDRs using mature, peer-reviewed algorithms. The products are vetted by the user community in the respective scientific disciplines. They are made available publicly by the projects during their execution period. Before the projects end, the ESDRs are transferred to one of the NASA-assigned Distributed Active Archive Centers for longer-term archiving and distribution. Tens of millions of

  1. An intervention program with the aim to improve and maintain work productivity for workers with rheumatoid arthritis: design of a randomized controlled trial and cost-effectiveness study.

    Science.gov (United States)

    van Vilsteren, Myrthe; Boot, Cécile R L; Steenbeek, Romy; van Schaardenburg, Dirkjan; Voskuyl, Alexandre E; Anema, Johannes R

    2012-07-02

    Workers with rheumatoid arthritis (RA) often experience restrictions in functioning at work and participation in employment. Strategies to maintain work productivity exist, but these interventions do not involve the actual workplace. Therefore the aim of this study is to investigate the (cost)effectiveness of an intervention program at the workplace on work productivity for workers with RA. This study is a randomized controlled trial (RCT) in specialized rheumatology treatment centers in or near Amsterdam, the Netherlands. Randomisation to either the control or the intervention group is performed at patient level. Both groups will receive care as usual by the rheumatologist, and patients in the intervention group will also take part in the intervention program. The intervention program consists of two components; integrated care, including a participatory workplace intervention. Integrated care involves a clinical occupational physician, who will act as care manager, to coordinate the care. The care manager has an intermediate role between clinical and occupational care. The participatory workplace intervention will be guided by an occupational therapist, and involves problem solving by the patient and the patients' supervisor. The aim of the workplace intervention is to achieve consensus between patient and supervisor concerning feasible solutions for the obstacles for functioning at work. Data collection will take place at baseline and after 6 and 12 months by means of a questionnaire. The primary outcome measure is work productivity, measured by hours lost from work due to presenteeism. Secondary outcome measures include sick leave, quality of life, pain and fatigue. Cost-effectiveness of the intervention program will be evaluated from the societal perspective. Usual care of primary and outpatient health services is not aimed at improving work productivity. Therefore it is desirable to develop interventions aimed at improving functioning at work. If the

  2. Analysis of Uncertainty in a Middle-Cost Device for 3D Measurements in BIM Perspective.

    Science.gov (United States)

    Sánchez, Alonso; Naranjo, José-Manuel; Jiménez, Antonio; González, Alfonso

    2016-09-22

    Medium-cost devices equipped with sensors are being developed to get 3D measurements. Some allow for generating geometric models and point clouds. Nevertheless, the accuracy of these measurements should be evaluated, taking into account the requirements of the Building Information Model (BIM). This paper analyzes the uncertainty in outdoor/indoor three-dimensional coordinate measures and point clouds (using Spherical Accuracy Standard (SAS) methods) for Eyes Map, a medium-cost tablet manufactured by e-Capture Research & Development Company, Mérida, Spain. To achieve it, in outdoor tests, by means of this device, the coordinates of targets were measured from 1 to 6 m and cloud points were obtained. Subsequently, these were compared to the coordinates of the same targets measured by a Total Station. The Euclidean average distance error was 0.005-0.027 m for measurements by Photogrammetry and 0.013-0.021 m for the point clouds. All of them satisfy the tolerance for point cloud acquisition (0.051 m) according to the BIM Guide for 3D Imaging (General Services Administration); similar results are obtained in the indoor tests, with values of 0.022 m. In this paper, we establish the optimal distances for the observations in both, Photogrammetry and 3D Photomodeling modes (outdoor) and point out some working conditions to avoid in indoor environments. Finally, the authors discuss some recommendations for improving the performance and working methods of the device.

  3. Analysis of Uncertainty in a Middle-Cost Device for 3D Measurements in BIM Perspective

    Directory of Open Access Journals (Sweden)

    Alonso Sánchez

    2016-09-01

    Full Text Available Medium-cost devices equipped with sensors are being developed to get 3D measurements. Some allow for generating geometric models and point clouds. Nevertheless, the accuracy of these measurements should be evaluated, taking into account the requirements of the Building Information Model (BIM. This paper analyzes the uncertainty in outdoor/indoor three-dimensional coordinate measures and point clouds (using Spherical Accuracy Standard (SAS methods for Eyes Map, a medium-cost tablet manufactured by e-Capture Research & Development Company, Mérida, Spain. To achieve it, in outdoor tests, by means of this device, the coordinates of targets were measured from 1 to 6 m and cloud points were obtained. Subsequently, these were compared to the coordinates of the same targets measured by a Total Station. The Euclidean average distance error was 0.005–0.027 m for measurements by Photogrammetry and 0.013–0.021 m for the point clouds. All of them satisfy the tolerance for point cloud acquisition (0.051 m according to the BIM Guide for 3D Imaging (General Services Administration; similar results are obtained in the indoor tests, with values of 0.022 m. In this paper, we establish the optimal distances for the observations in both, Photogrammetry and 3D Photomodeling modes (outdoor and point out some working conditions to avoid in indoor environments. Finally, the authors discuss some recommendations for improving the performance and working methods of the device.

  4. Low-cost compact thermal imaging sensors for body temperature measurement

    Science.gov (United States)

    Han, Myung-Soo; Han, Seok Man; Kim, Hyo Jin; Shin, Jae Chul; Ahn, Mi Sook; Kim, Hyung Won; Han, Yong Hee

    2013-06-01

    This paper presents a 32x32 microbolometer thermal imaging sensor for human body temperature measurement. Waferlevel vacuum packaging technology allows us to get a low cost and compact imaging sensor chip. The microbolometer uses V-W-O film as sensing material and ROIC has been designed 0.35-um CMOS process in UMC. A thermal image of a human face and a hand using f/1 lens convinces that it has a potential of human body temperature for commercial use.

  5. A simulation model to estimate cost-offsets for a disease-management program for chronic kidney disease.

    Science.gov (United States)

    Gandjour, Afschin; Tschulena, Ulrich; Steppan, Sonja; Gatti, Emanuele

    2015-04-01

    The aim of this paper is to develop a simulation model that analyzes cost-offsets of a hypothetical disease management program (DMP) for patients with chronic kidney disease (CKD) in Germany compared to no such program. A lifetime Markov model with simulated 65-year-old patients with CKD was developed using published data on costs and health status and simulating the progression to end-stage renal disease (ESRD), cardiovascular disease and death. A statutory health insurance perspective was adopted. This modeling study shows considerable potential for cost-offsets from a DMP for patients with CKD. The potential for cost-offsets increases with relative risk reduction by the DMP and baseline glomerular filtration rate. Results are most sensitive to the cost of dialysis treatment. This paper presents a general 'prototype' simulation model for the prevention of ESRD. The model allows for further modification and adaptation in future applications.

  6. Costs of Low-Scale Distance Learning Programs: A Case of Distance Learning Courses in the Aegean Islands.

    Directory of Open Access Journals (Sweden)

    Costas Tsolakidis

    2010-03-01

    Full Text Available The advance of Information and Communication Technology (ICT and the reduction of cost in digital applications motivate course designers to develop new application of distance learning programs so as to meet the increasing educational needs in the knowledge-based society. As a consequence, distance learning courses are increasing in number, credibility and acceptability all over the world. The question is whether these programs are efficient in terms of costs. The main theme of this work is to investigate cost behaviour and estimate cost efficiency of distance learning courses applied in low-inhabited, remote islands. The target group consists of high school students of Grade I. The distance learning course that is designed uses several scenarios of the “what-if form” and reaches the conclusion that cost of such solutions is far lower than that of any traditional course, even at the absence of scale economies.

  7. The Social Cost of Trading: Measuring the Increased Damages from Sulfur Dioxide Trading in the United States

    Science.gov (United States)

    Henry, David D., III; Muller, Nicholas Z.; Mendelsohn, Robert O.

    2011-01-01

    The sulfur dioxide (SO[subscript 2]) cap and trade program established in the 1990 Clean Air Act Amendments is celebrated for reducing abatement costs ($0.7 to $2.1 billion per year) by allowing emissions allowances to be traded. Unfortunately, places with high marginal costs also tend to have high marginal damages. Ton-for-ton trading reduces…

  8. Measuring under-five mortality: validation of new low-cost methods.

    Directory of Open Access Journals (Sweden)

    Julie Knoll Rajaratnam

    2010-04-01

    Full Text Available There has been increasing interest in measuring under-five mortality as a health indicator and as a critical measure of human development. In countries with complete vital registration systems that capture all births and deaths, under-five mortality can be directly calculated. In the absence of a complete vital registration system, however, child mortality must be estimated using surveys that ask women to report the births and deaths of their children. Two survey methods exist for capturing this information: summary birth histories and complete birth histories. A summary birth history requires a minimum of only two questions: how many live births has each mother had and how many of them have survived. Indirect methods are then applied using the information from these two questions and the age of the mother to estimate under-five mortality going back in time prior to the survey. Estimates generated from complete birth histories are viewed as the most accurate when surveys are required to estimate under-five mortality, especially for the most recent time periods. However, it is much more costly and labor intensive to collect these detailed data, especially for the purpose of generating small area estimates. As a result, there is a demand for improvement of the methods employing summary birth history data to produce more accurate as well as subnational estimates of child mortality.We used data from 166 Demographic and Health Surveys (DHS to develop new empirically based methods of estimating under-five mortality using children ever born and children dead data. We then validated them using both in- and out-of-sample analyses. We developed a range of methods on the basis of three dimensions of the problem: (1 approximating the average length of exposure to mortality from a mother's set of children using either maternal age or time since first birth; (2 using cohort and period measures of the fraction of children ever born that are dead; and (3

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

    Science.gov (United States)

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

    2016-12-01

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

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

    Science.gov (United States)

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

    2014-01-01

    Objective The Helping Babies Breathe” (HBB) program is an evidence-based curriculum in basic neonatal care and resuscitation, utilizing simulation-based training to educate large numbers of birth attendants in low-resource countries. We analyzed its cost-effectiveness at a faith-based Haydom Lutheran Hospital (HLH) in rural Tanzania. Methods Data about early neonatal mortality and fresh stillbirth rates were drawn from a linked observational study during one year before and one year after full implementation of the HBB program. Cost data were provided by the Tanzanian Ministry of Health and Social Welfare (MOHSW), the research department at HLH, and the manufacturer of the training material Lærdal Global Health. Findings Costs per life saved were USD 233, while they were USD 4.21 per life year gained. Costs for maintaining the program were USD 80 per life saved and USD 1.44 per life year gained. Costs per disease adjusted life year (DALY) averted ranged from International Dollars (ID; a virtual valuta corrected for purchasing power world-wide) 12 to 23, according to how DALYs were calculated. Conclusion The HBB program is a low-cost intervention. Implementation in a very rural faith-based hospital like HLH has been highly cost-effective. To facilitate further global implementation of HBB a cost-effectiveness analysis including government owned institutions, urban hospitals and district facilities is desirable for a more diverse analysis to explore cost-driving factors and predictors of enhanced cost-effectiveness. PMID:25006802

  11. Simple, cost effective & result oriented framework for supplier performance measurement in sports goods manufacturing industry

    Directory of Open Access Journals (Sweden)

    2011-09-01

    Full Text Available The emergences of global markets have increased competition worldwide. For the Sports Goods Manufacturing Industry which is considered to be an intensive supplier base industry with limited resources to sustain in what is already a very competitive market there is a need for the entire supply chain viz. raw material and machinery suppliers and manufacturers to measure their supplier's performance to reduce business risks and revenue losses. How to design & execute a simple, cost effective & result oriented Framework for Supplier Performance Measurement for sports goods manufacturing small - medium enterprises is the main aim of this research paper.

  12. Measurement and evaluation of national family planning programs.

    Science.gov (United States)

    Mauldin, W P

    1967-03-01

    ) segura de traducir las estadísticas de servicio en práticas y tal vez aún datos sobre suministro comercial en datos sabre tasas de natalidad. Esto incluye, par ejemplo, los esfuerzos para consolidar observaciones coma "cinco años-mujer de usa de IUD, a 400 condones equivalen a la prevención de un nacimiento," y esfuerzos como los de Pakistán de calcular tasas coma "años de protección de una pareja contra el embarazo."In the belief that a decrease in the rate of population growth will increase economic development, more than ten countries have inaugurated family planning programs in the past fifteen years. To provide a model for measuring the immediate, intermediate, and long-term effects of any such program, the authors use the Taiwan evaluation.The model suggests that a good system of evaluation should include monthly statistics on (1) participants, who are grouped by characteristics; (2) the distribution of supplies, reported at first by the characteristics of recipients, but after by gross volume only; (3) family planning activities of private physicians to measure the catalytic effect on the private sector; (4) new contacts and amount of advertising in mass media; (5) costs broken down by areas and by cost categories; and (6) distribution of commercial supplies. In addition, the program should conduct 300-400 interviews every 6-12 months to learn the rates of continuation and the rates and reasons for discontinuation. Finally, a KAP survey should be conducted every two years.The administration of the evaluation should be close to the director for policy decisions and for the ultimate work of evaluation-the finding of new ways to measure the main goal of change in fertility by the translation of statistics on Services provided and commercial supplies into birth rate data.

  13. FIELD TEST PROGRAM TO DEVELOP COMPREHENSIVE DESIGN, OPERATING, AND COST DATA FOR MERCURY CONTROL SYSTEMS

    Energy Technology Data Exchange (ETDEWEB)

    Michael D. Durham

    2004-10-01

    PG&E NEG Salem Harbor Station Unit 1 was successfully tested for applicability of activated carbon injection as a mercury control technology. Test results from this site have enabled a thorough evaluation of mercury control at Salem Harbor Unit 1, including performance, estimated cost, and operation data. This unit has very high native mercury removal, thus it was important to understand the impacts of process variables on native mercury capture. The team responsible for executing this program included plant and PG&E headquarters personnel, EPRI and several of its member companies, DOE, ADA, Norit Americas, Inc., Hamon Research-Cottrell, Apogee Scientific, TRC Environmental Corporation, Reaction Engineering, as well as other laboratories. The technical support of all of these entities came together to make this program achieve its goals. Overall the objectives of this field test program were to determine the mercury control and balance-of-plant impacts resulting from activated carbon injection into a full-scale ESP on Salem Harbor Unit 1, a low sulfur bituminous-coal-fired 86 MW unit. It was also important to understand the impacts of process variables on native mercury removal (>85%). One half of the gas stream was used for these tests, or 43 MWe. Activated carbon, DARCO FGD supplied by NORIT Americas, was injected upstream of the cold side ESP, just downstream of the air preheater. This allowed for approximately 1.5 seconds residence time in the duct before entering the ESP. Conditions tested in this field evaluation included the impacts of the Selective Non-Catalytic Reduction (SNCR) system on mercury capture, of unburned carbon in the fly ash, of adjusting ESP inlet flue gas temperatures, and of boiler load on mercury control. The field evaluation conducted at Salem Harbor looked at several sorbent injection concentrations at several flue gas temperatures. It was noted that at the mid temperature range of 322-327 F, the LOI (unburned carbon) lost some of its

  14. FIELD TEST PROGRAM TO DEVELOP COMPREHENSIVE DESIGN, OPERATING, AND COST DATA FOR MERCURY CONTROL SYSTEMS

    Energy Technology Data Exchange (ETDEWEB)

    Michael D. Durham

    2005-03-17

    Brayton Point Unit 1 was successfully tested for applicability of activated carbon injection as a mercury control technology. Test results from this site have enabled a thorough evaluation of the impacts of future mercury regulations to Brayton Point Unit 1, including performance, estimated cost, and operation data. This unit has variable (29-75%) native mercury removal, thus it was important to understand the impacts of process variables and activated carbon on mercury capture. The team responsible for executing this program included: (1) Plant and PG&E National Energy Group corporate personnel; (2) Electric Power Research Institute (EPRI); (3) United States Department of Energy National Energy Technology Laboratory (DOE/NETL); (4) ADA-ES, Inc.; (5) NORIT Americas, Inc.; (6) Apogee Scientific, Inc.; (7) TRC Environmental Corporation; (8) URS Corporation; (9) Quinapoxet Solutions; (10) Energy and Environmental Strategies (EES); and (11) Reaction Engineering International (REI). The technical support of all of these entities came together to make this program achieve its goals. Overall, the objectives of this field test program were to determine the impact of activated carbon injection on mercury control and balance-of-plant processes on Brayton Point Unit 1. Brayton Point Unit 1 is a 250-MW unit that fires a low-sulfur eastern bituminous coal. Particulate control is achieved by two electrostatic precipitators (ESPs) in series. The full-scale tests were conducted on one-half of the flue gas stream (nominally 125 MW). Mercury control sorbents were injected in between the two ESPs. The residence time from the injection grid to the second ESP was approximately 0.5 seconds. In preparation for the full-scale tests, 12 different sorbents were evaluated in a slipstream of flue gas via a packed-bed field test apparatus for mercury adsorption. Results from these tests were used to determine the five carbon-based sorbents that were tested at full-scale. Conditions of interest

  15. Effective seismic acceleration measurements for low-cost Structural Health Monitoring

    Science.gov (United States)

    Pentaris, Fragkiskos; Makris, John P.

    2015-04-01

    There is increasing demand on cost effective Structural Health Monitoring systems for buildings as well as important and/or critical constructions. The front end for all these systems is the accelerometer. We present a comparative study of two low cost MEMS accelaration sensors against a very sensitive, high dynamic range strong motion accelerometer of force balance type but much more expensive. A real experiment was realized by deploying the three sesnors in a reinforced concrete building of the premises of TEI of Crete at Chania Crete, an earthquake prone region. The analysis of the collected accelararion data from many seismic events indicates that all sensors are able to efficiently reveal the seismic response of the construction in terms of PSD. Furthermore, it is shown that coherence diagrams between excitation and response of the building under study, depict structural characteristics but also the seismic energy distribution. This work is supported by the Archimedes III Program of the Ministry of Education of Greece, through the Operational Program "Educational and Lifelong Learning", in the framework of the project entitled "Interdisciplinary Multi-Scale Research of Earthquake Physics and Seismotectonics at the front of the Hellenic Arc (IMPACT-ARC)" and is co-financed by the European Union (European Social Fund) and Greek national funds.

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

    Science.gov (United States)

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

    1984-01-01

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

  17. Good research practices for measuring drug costs in cost effectiveness analyses: an industry perspective: the ISPOR Drug Cost Task Force report--Part V.

    Science.gov (United States)

    Mycka, Jack M; Dellamano, Renato; Kolassa, Eugene Mick; Wonder, Michael; Ghosh, Sabyasachi; Hay, Joel W; Smeeding, Jim

    2010-01-01

    The industry perspective on drug costs should be framed by the need for decision-makers to use actual and relevant costs, and to inform real-world decisions regarding medication selection and use. The objective of this report is to provide guidance and recommendations on how manufacturers should approach the use of drug costs. The Task Force was appointed with the advice and consent of the ISPOR Board of Directors. Members were experienced developers or users of drug cost information working in academia and industry, and came from several countries. Following the core assumptions developed and outlined by the Task Force, a draft report was prepared. Comments were solicited on the outline and several draft reports both from a core group of external reviewers and more broadly from the ISPOR membership of ISPOR via the ISPOR Web site. The industry should always strive for: 1) a focus on drug value and not just cost; 2) credibility-that is correct and consistent costs; 3) transparency-by disclosing the prices and costs, and ensuring that they reflect the actual cost of the drug whenever possible; and 4) providing actionable results that help customers comprehend the value offered by a drug therapy and to use products more efficiently and effectively. Understanding and accounting for all costs and consequences of the use of a medical treatment is in the best interests of all parties involved in the prescribing, consuming, reimbursement, selling, and manufacturing of bio/pharmaceuticals. Transparency, consistency, and clear communication of costs and value are essential for appropriate decision-making and should be important goals for all parties.

  18. An Assessment of Cost, Quality and Outcomes for Five HIV Prevention Youth Peer Education Programs in Zambia

    Science.gov (United States)

    Burke, H. M.; Pedersen, K. F.; Williamson, N. E.

    2012-01-01

    Youth peer education (YPE) programs are a popular strategy for HIV prevention in sub-Saharan Africa. However, research on the effectiveness of YPE programs is scarce and the wide variation in programs makes it difficult to generalize research findings. Measuring quality and comparing program effectiveness require the use of standardized…

  19. Effectiveness of Human Research Protection Program Performance Measurements.

    Science.gov (United States)

    Tsan, Min-Fu; Nguyen, Yen

    2017-10-01

    We analyzed human research protection program performance metric data of all Department of Veterans Affairs research facilities obtained from 2010 to 2016. Among a total of 25 performance metrics, 21 (84%) showed improvement, four (16%) remained unchanged, and none deteriorated during the study period. The overall improvement from these 21 performance metrics was 81.1% ± 18.7% (mean ± SD), with a range of 30% to 100%. The four performance metrics that did not show improvement all had initial noncompliance/incidence rates of performance metrics that showed improvement ranged from 0.05% to 60%. However, of the 21 performance metrics that showed improvement, 10 had initial noncompliance/incidence rates of performance measurement is an effective tool in improving the performance of human research protection programs.

  20. Cost-effective ERT technique for oil-in-water measurement for offshore hydrocyclone installations

    DEFF Research Database (Denmark)

    Durdevic, Petar; Hansen, Leif; Mai, Christian

    2015-01-01

    resistance than hydrocarbon oil and gas. This work involves construction of a pilot plant, for testing the feasibility of ERT for OiW measurements, and further exploring if this measured signal can be applied as a reliable feedback signal in optimization of the hydrocyclone's efficiency. Different algorithms......The goal of this paper is to introduce and design a cost-effective Oil-in-Water (OiW) measuring instrument, which will be investigated for its value in increasing the efficiency of a deoiling hydrocyclone. The technique investigated is based on Electrical Resistivity Tomography (ERT), which basic...... for creating 2-D images and the feasibility of estimating OiW concentrations are studied and evaluated. From both steady state and continuous laminate flow perspectives, with respect to the objective which is to use this measurement for feedback control purposes....

  1. Miniaturisation of Pressure-Sensitive Paint Measurement Systems Using Low-Cost, Miniaturised Machine Vision Cameras

    Directory of Open Access Journals (Sweden)

    Mark Kenneth Quinn

    2017-07-01

    Full Text Available Measurements of pressure-sensitive paint (PSP have been performed using new or non-scientific imaging technology based on machine vision tools. Machine vision camera systems are typically used for automated inspection or process monitoring. Such devices offer the benefits of lower cost and reduced size compared with typically scientific-grade cameras; however, their optical qualities and suitability have yet to be determined. This research intends to show relevant imaging characteristics and also show the applicability of such imaging technology for PSP. Details of camera performance are benchmarked and compared to standard scientific imaging equipment and subsequent PSP tests are conducted using a static calibration chamber. The findings demonstrate that machine vision technology can be used for PSP measurements, opening up the possibility of performing measurements on-board small-scale model such as those used for wind tunnel testing or measurements in confined spaces with limited optical access.

  2. Miniaturisation of Pressure-Sensitive Paint Measurement Systems Using Low-Cost, Miniaturised Machine Vision Cameras.

    Science.gov (United States)

    Quinn, Mark Kenneth; Spinosa, Emanuele; Roberts, David A

    2017-07-25

    Measurements of pressure-sensitive paint (PSP) have been performed using new or non-scientific imaging technology based on machine vision tools. Machine vision camera systems are typically used for automated inspection or process monitoring. Such devices offer the benefits of lower cost and reduced size compared with typically scientific-grade cameras; however, their optical qualities and suitability have yet to be determined. This research intends to show relevant imaging characteristics and also show the applicability of such imaging technology for PSP. Details of camera performance are benchmarked and compared to standard scientific imaging equipment and subsequent PSP tests are conducted using a static calibration chamber. The findings demonstrate that machine vision technology can be used for PSP measurements, opening up the possibility of performing measurements on-board small-scale model such as those used for wind tunnel testing or measurements in confined spaces with limited optical access.

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

    Science.gov (United States)

    1985-01-01

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

  4. Development of a Low-Cost, Noninvasive, Portable Visual Speech Recognition Program.

    Science.gov (United States)

    Kohlberg, Gavriel D; Gal, Ya'akov Kobi; Lalwani, Anil K

    2016-09-01

    Loss of speech following tracheostomy and laryngectomy severely limits communication to simple gestures and facial expressions that are largely ineffective. To facilitate communication in these patients, we seek to develop a low-cost, noninvasive, portable, and simple visual speech recognition program (VSRP) to convert articulatory facial movements into speech. A Microsoft Kinect-based VSRP was developed to capture spatial coordinates of lip movements and translate them into speech. The articulatory speech movements associated with 12 sentences were used to train an artificial neural network classifier. The accuracy of the classifier was then evaluated on a separate, previously unseen set of articulatory speech movements. The VSRP was successfully implemented and tested in 5 subjects. It achieved an accuracy rate of 77.2% (65.0%-87.6% for the 5 speakers) on a 12-sentence data set. The mean time to classify an individual sentence was 2.03 milliseconds (1.91-2.16). We have demonstrated the feasibility of a low-cost, noninvasive, portable VSRP based on Kinect to accurately predict speech from articulation movements in clinically trivial time. This VSRP could be used as a novel communication device for aphonic patients. © The Author(s) 2016.

  5. Hybrid Pooled—Unpooled Design for Cost-Efficient Measurement of Biomarkers

    Science.gov (United States)

    Schisterman, Enrique F.; Vexler, Albert; Mumford, Sunni L.; Perkins, Neil J.

    2009-01-01

    Summary Evaluating biomarkers in epidemiological studies can be expensive and time consuming. Many investigators use techniques such as random sampling or pooling biospecimens in order to cut costs and save time on experiments. Commonly, analyses based on pooled data are strongly restricted by distributional assumptions that are challenging to validate because of the pooled biospecimens. Random sampling provides data that can be easily analyzed. However, random sampling methods are not optimal cost-efficient designs for estimating means. We propose and examine a cost-efficient hybrid design that involves taking a sample of both pooled and unpooled data in an optimal proportion in order to efficiently estimate the unknown parameters of the biomarker distribution. In addition, we find that this design can be utilized to estimate and account for different types of measurement and pooling error, without the need to collect validation data or repeated measurements. We show an example where application of the hybrid design leads to minimization of a given loss function based on variances of the estimators of the unknown parameters. Monte Carlo simulation and biomarker data from a study on coronary heart disease are used to demonstrate the proposed methodology. PMID:20049693

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

    Science.gov (United States)

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

    2016-07-01

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

  7. Dutch elm disease control: performance and costs

    Science.gov (United States)

    William N., Jr. Cannon; David P. Worley

    1976-01-01

    Municipal programs to suppress Dutch elm disease have had highly variable results. Performance as measured by tree mortality was unrelated to control strategies. Costs for control programs were 37 to 76 percent less than costs without control programs in the 15-year time-span of the study. Only those municipalities that conducted a high-performance program could be...

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

    Science.gov (United States)

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

    2017-02-20

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

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

    Science.gov (United States)

    Fiedler, John L; Semakula, Richard

    2014-03-01

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

  10. Measuring snow liquid water content with low-cost GPS receivers.

    Science.gov (United States)

    Koch, Franziska; Prasch, Monika; Schmid, Lino; Schweizer, Jürg; Mauser, Wolfram

    2014-11-06

    The amount of liquid water in snow characterizes the wetness of a snowpack. Its temporal evolution plays an important role for wet-snow avalanche prediction, as well as the onset of meltwater release and water availability estimations within a river basin. However, it is still a challenge and a not yet satisfyingly solved issue to measure the liquid water content (LWC) in snow with conventional in situ and remote sensing techniques. We propose a new approach based on the attenuation of microwave radiation in the L-band emitted by the satellites of the Global Positioning System (GPS). For this purpose, we performed a continuous low-cost GPS measurement experiment at the Weissfluhjoch test site in Switzerland, during the snow melt period in 2013. As a measure of signal strength, we analyzed the carrier-to-noise power density ratio (C/N0) and developed a procedure to normalize these data. The bulk volumetric LWC was determined based on assumptions for attenuation, reflection and refraction of radiation in wet snow. The onset of melt, as well as daily melt-freeze cycles were clearly detected. The temporal evolution of the LWC was closely related to the meteorological and snow-hydrological data. Due to its non-destructive setup, its cost-efficiency and global availability, this approach has the potential to be implemented in distributed sensor networks for avalanche prediction or basin-wide melt onset measurements.

  11. Measuring Snow Liquid Water Content with Low-Cost GPS Receivers

    Directory of Open Access Journals (Sweden)

    Franziska Koch

    2014-11-01

    Full Text Available The amount of liquid water in snow characterizes the wetness of a snowpack. Its temporal evolution plays an important role for wet-snow avalanche prediction, as well as the onset of meltwater release and water availability estimations within a river basin. However, it is still a challenge and a not yet satisfyingly solved issue to measure the liquid water content (LWC in snow with conventional in situ and remote sensing techniques. We propose a new approach based on the attenuation of microwave radiation in the L-band emitted by the satellites of the Global Positioning System (GPS. For this purpose, we performed a continuous low-cost GPS measurement experiment at the Weissfluhjoch test site in Switzerland, during the snow melt period in 2013. As a measure of signal strength, we analyzed the carrier-to-noise power density ratio (C/N0 and developed a procedure to normalize these data. The bulk volumetric LWC was determined based on assumptions for attenuation, reflection and refraction of radiation in wet snow. The onset of melt, as well as daily melt-freeze cycles were clearly detected. The temporal evolution of the LWC was closely related to the meteorological and snow-hydrological data. Due to its non-destructive setup, its cost-efficiency and global availability, this approach has the potential to be implemented in distributed sensor networks for avalanche prediction or basin-wide melt onset measurements.

  12. Measurement of costs and scales for outcome evaluation in health economic studies of Parkinson's disease.

    Science.gov (United States)

    Dodel, Richard; Jönsson, Bengt; Reese, Jens Peter; Winter, Yaroslav; Martinez-Martin, Pablo; Holloway, Robert; Sampaio, Cristina; Růžička, Evžen; Hawthorne, Graeme; Oertel, Wolfgang; Poewe, Werner; Stebbins, Glenn; Rascol, Oliver; Goetz, Christopher G; Schrag, Anette

    2014-02-01

    Health economic studies in Parkinson's disease (PD) have become increasingly common in recent years. Because several methodologies and instruments have been used to assess cost and outcomes in PD, the Movement Disorder Society (MDS) commissioned a Task Force to assess their properties and make recommendations regarding their use. A systematic literature review was conducted to explore the use of those instruments in PD and to determine which should be selected for this review. We assessed approaches to evaluate cost of illness (COI), cost effectiveness, and cost utilities, which include the use of direct (standard gamble, time trade-off. and visual analogue scales) and indirect instruments to measure health status and utilities. No validated instruments/models were identified for the evaluation of COI or cost-effectiveness in patients with PD; therefore, no instruments in this group are recommended. Among utility instruments, only a few of these outcome instruments have been used in the PD population, and only limited psychometric data are available for these instruments with respect to PD. Because psychometric data for further utility instruments in conditions other than PD already exist, the standard gamble and time trade-off methods and the EQ-5D (a European quality-of-life health states instrument) and Health Utility Index instruments met the criteria for scales that are "recommended (with limitations)," but only the EQ-5D has been assessed in detail in PD patients. The MDS Task Force recommends further study of these instruments in the PD population to establish core psychometric properties. For the assessment of COI, the Task Force considers the development of a COI instrument specifically for PD, like that available for Alzheimer's disease. © 2013 Movement Disorder Society.

  13. Outcomes of continuous process improvement of a nutritional care program incorporating TTR measurement.

    Science.gov (United States)

    Mears, Elia

    2002-12-01

    Early assessment of protein calorie malnutrition (PCM) can improve the outcome for hospitalized patients by allowing the initiation of nutrition support if required. In addition, monitoring nutritional status during the hospital stay can identify a decline in or improvement of PCM so that alterations to treatment regimens can be made if needed. The visceral protein albumin is the traditional laboratory indicator of PCM. In the past decade another protein has been lauded as a superior marker that can be used in conjunction. We undertook several studies to test the effectiveness of TTR as an aid in nutritional assessment. We found TTR to be a sensitive measure of nutritional status, allowing for earlier assessment and intervention, thus reducing length of stay and other hospital associated costs. Based on these findings, our hospital generated and implemented a multidisciplinary nutrition care program. Transthyretin is an integral portion of this program; levels are determined on admission and repeated twice weekly until discharge.

  14. A validation study of a new instrument for low cost bite force measurement.

    Science.gov (United States)

    Testa, Marco; Di Marco, Anna; Pertusio, Raffaele; Van Roy, Peter; Cattrysse, Erik; Roatta, Silvestro

    2016-10-01

    Quantitative assessment of force in masticatory muscles is not a routine clinical test, probably due to the lack of an "easy-to-use" device. Aim of this study is (1) to present a low cost bite force instrument located in a custom-made housing, designed to guarantee a comfortable and effective bite action, (2) to evaluate its mechanical characteristics, in order to implement it in clinical settings and in experimental setups. Linearity, repeatability and adaptation over time were assessed on a set of four different sensors in bare and housed condition. Application of the housing to the transducer may appreciably alter the transducer's response. Calibration of the housed transducer is thus necessary in order to correctly record real bite force. This solution may represent a low cost and reliable option for biting force measurement and objective assessment of individual force control in the scientific and clinical setting. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. On Measurement of Avoidable and Unavoidable Cost of Alcohol: An Application of Method for Estimating Costs Due To Prior Consumption

    Science.gov (United States)

    Jarl, Johan; Gerdtham, Ulf-G; Ludbrook, Anne; Petrie, Dennis

    2010-01-01

    This study estimates the avoidable and unavoidable costs of alcohol-related, liver cirrhosis inpatient care, controlling for the lag structure and period of decline in disease risk. Lag structures with different lengths are applied to the exposure to risk from alcohol consumption, which allows for differentiation between avoidable and unavoidable cases due to prior consumption. A lag length of 20 (men) and 23 (women) years (expected remaining life years) gives a total cost of 592 million SEK. Given alcohol consumption is reduced to zero, 72% of cost could potentially be avoided. It is important to account for the length and structure of the risk decline following a consumption change as this substantially affects the estimates. PMID:20717547

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

    Science.gov (United States)

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

    2010-02-01

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

  17. Formulas for estimating the costs averted by sexually transmitted infection (STI prevention programs in the United States

    Directory of Open Access Journals (Sweden)

    Koski Kathryn

    2008-05-01

    Full Text Available Abstract Background Sexually transmitted infection (STI prevention programs can mitigate the health and economic burden of STIs. A tool to estimate the economic benefits of STI programs could prove useful to STI program personnel. Methods We developed formulas that can be applied to estimate the direct medical costs and indirect costs (lost productivity averted by STI programs in the United States. Costs and probabilities for these formulas were based primarily on published studies. Results We present a series of formulas that can be used to estimate the economic benefits of STI prevention (in 2006 US dollars, using data routinely collected by STI programs. For example, the averted sequelae costs associated with treating women for chlamydia is given as (Cw(0.16(0.925(0.70($1,995, where Cw is the number of infected women treated for chlamydia, 0.16 is the absolute reduction in the probability of pelvic inflammatory disease (PID as a result of treatment, 0.925 is an adjustment factor to prevent double-counting of PID averted in women with both chlamydia and gonorrhea, 0.70 is an adjustment factor to account for the possibility of re-infection, and $1,995 is the average cost per case of PID, based on published sources. Conclusion The formulas developed in this study can be a useful tool for STI program personnel to generate evidence-based estimates of the economic impact of their program and can facilitate the assessment of the cost-effectiveness of their activities.

  18. Cost-effectiveness of the strong African American families-teen program: 1-year follow-up.

    Science.gov (United States)

    Ingels, Justin B; Corso, Phaedra S; Kogan, Steve M; Brody, Gene H

    2013-12-01

    Alcohol use poses a major threat to the health and well being of rural African American adolescents by negatively impacting academic performance, health, and safety. However, rigorous economic evaluations of prevention programs targeting this population are scarce. Cost-effectiveness analyses were conducted of SAAF-T relative to an attention-control intervention (ACI), as part of a randomized prevention trial. Outcomes of interest were the number of alcohol use and binge drinking episodes prevented, one year following the intervention. Incremental cost-effectiveness ratios (ICERs) and cost-effectiveness acceptability curves (CEACs) were used to determine the cost-effectiveness of SAAF-T compared to the ACI intervention. For the 473 participating youth completing baseline and follow-up assessments, the incremental per participant costs were $168, while the incremental per participant effects were 3.39 episodes of alcohol use prevented and 1.36 episodes of binge drinking prevented. Compared to the ACI intervention, the SAAF-T program cost $50 per reduction in an alcohol use episode and $123 per reduced episode of binge drinking. For the CEACs, at thresholds of $100 and $440, SAAF-T has at least a 90% probability of being cost-effective, relative to the ACI, for reductions in alcohol use and binge drinking episodes, respectively. The SAAF-T intervention provides a potentially cost-effective means for reducing the African American youths' alcohol use and binge drinking episodes. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  19. Low-cost Citizen Science Balloon Platform for Measuring Air Pollutants to Improve Satellite Retrieval Algorithms

    Science.gov (United States)

    Potosnak, M. J.; Beck-Winchatz, B.; Ritter, P.

    2016-12-01

    High-altitude balloons (HABs) are an engaging platform for citizen science and formal and informal STEM education. However, the logistics of launching, chasing and recovering a payload on a 1200 g or 1500 g balloon can be daunting for many novice school groups and citizen scientists, and the cost can be prohibitive. In addition, there are many interesting scientific applications that do not require reaching the stratosphere, including measuring atmospheric pollutants in the planetary boundary layer. With a large number of citizen scientist flights, these data can be used to constrain satellite retrieval algorithms. In this poster presentation, we discuss a novel approach based on small (30 g) balloons that are cheap and easy to handle, and low-cost tracking devices (SPOT trackers for hikers) that do not require a radio license. Our scientific goal is to measure air quality in the lower troposphere. For example, particulate matter (PM) is an air pollutant that varies on small spatial scales and has sources in rural areas like biomass burning and farming practices such as tilling. Our HAB platform test flight incorporates an optical PM sensor, an integrated single board computer that records the PM sensor signal in addition to flight parameters (pressure, location and altitude), and a low-cost tracking system. Our goal is for the entire platform to cost less than $500. While the datasets generated by these flights are typically small, integrating a network of flight data from citizen scientists into a form usable for comparison to satellite data will require big data techniques.

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

    Science.gov (United States)

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

    2002-12-01

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

  1. A PC program to optimize system configuration for desired reliability at minimum cost

    Science.gov (United States)

    Hills, Steven W.; Siahpush, Ali S.

    1994-01-01

    High reliability is desired in all engineered systems. One way to improve system reliability is to use redundant components. When redundant components are used, the problem becomes one of allocating them to achieve the best reliability without exceeding other design constraints such as cost, weight, or volume. Systems with few components can be optimized by simply examining every possible combination but the number of combinations for most systems is prohibitive. A computerized iteration of the process is possible but anything short of a super computer requires too much time to be practical. Many researchers have derived mathematical formulations for calculating the optimum configuration directly. However, most of the derivations are based on continuous functions whereas the real system is composed of discrete entities. Therefore, these techniques are approximations of the true optimum solution. This paper describes a computer program that will determine the optimum configuration of a system of multiple redundancy of both standard and optional components. The algorithm is a pair-wise comparative progression technique which can derive the true optimum by calculating only a small fraction of the total number of combinations. A designer can quickly analyze a system with this program on a personal computer.

  2. The cost and impact of the interim federal health program cuts on child refugees in Canada.

    Science.gov (United States)

    Evans, Andrea; Caudarella, Alexander; Ratnapalan, Savithiri; Chan, Kevin

    2014-01-01

    On June 30, 2012, Interim Federal Health Program (IFHP) funding was cut for refugee claimant healthcare. The potential financial and healthcare impacts of these cuts on refugee claimants are unknown. We conducted a one-year retrospective chart review spanning 6 months before and after IFHP funding cuts at The Hospital for Sick Children, a tertiary care children's hospital in Toronto. We analyzed emergency room visits characteristics, admission rates, reasons for admission, and financial records including billing from Medavie Blue Cross. There were 173 refugee children visits to the emergency room in the six months before and 142 visits in the six months after funding cuts. The total amount billed to the IFHP program during the one-year of this study was $131,615. Prior to the IFHP cuts, 46% of the total emergency room bills were paid by IFHP compared to 7% after the cuts (pSick Children was unable to obtain federal health coverage for the vast majority of refugee claimant children registered under the IFHP. This preliminary analysis showed that post-IFHP cuts healthcare costs at the largest tertiary pediatric institution in the country increased.

  3. The cost and impact of the interim federal health program cuts on child refugees in Canada.

    Directory of Open Access Journals (Sweden)

    Andrea Evans

    Full Text Available INTRODUCTION: On June 30, 2012, Interim Federal Health Program (IFHP funding was cut for refugee claimant healthcare. The potential financial and healthcare impacts of these cuts on refugee claimants are unknown. METHODS: We conducted a one-year retrospective chart review spanning 6 months before and after IFHP funding cuts at The Hospital for Sick Children, a tertiary care children's hospital in Toronto. We analyzed emergency room visits characteristics, admission rates, reasons for admission, and financial records including billing from Medavie Blue Cross. RESULTS: There were 173 refugee children visits to the emergency room in the six months before and 142 visits in the six months after funding cuts. The total amount billed to the IFHP program during the one-year of this study was $131,615. Prior to the IFHP cuts, 46% of the total emergency room bills were paid by IFHP compared to 7% after the cuts (p<0.001. INTERPRETATION: After the cuts to the IFHP, The Hospital for Sick Children was unable to obtain federal health coverage for the vast majority of refugee claimant children registered under the IFHP. This preliminary analysis showed that post-IFHP cuts healthcare costs at the largest tertiary pediatric institution in the country increased.

  4. Large scale intender test program to measure sub gouge displacements

    Energy Technology Data Exchange (ETDEWEB)

    Been, Ken; Lopez, Juan [Golder Associates Inc, Houston, TX (United States); Sancio, Rodolfo [MMI Engineering Inc., Houston, TX (United States)

    2011-07-01

    The production of submarine pipelines in an offshore environment covered with ice is very challenging. Several precautions must be taken such as burying the pipelines to protect them from ice movement caused by gouging. The estimation of the subgouge displacements is a key factor in pipeline design for ice gouged environments. This paper investigated a method to measure subgouge displacements. An experimental program was implemented in an open field to produce large scale idealized gouges on engineered soil beds (sand and clay). The horizontal force required to produce the gouge, the subgouge displacements in the soil and the strain imposed by these displacements were monitored on a buried model pipeline. The results showed that for a given keel, the gouge depth was inversely proportional to undrained shear strength in clay. The subgouge displacements measured did not show a relationship with the gouge depth, width or soil density in sand and clay tests.

  5. Atmospheric radiation measurement unmanned aerospace vehicle (ARM-UAV) program

    Energy Technology Data Exchange (ETDEWEB)

    Bolton, W.R. [Sandia National Laboratories, Livermore, CA (United States)

    1996-11-01

    ARM-UAV is part of the multi-agency U.S. Global Change Research Program and is addressing the largest source of uncertainty in predicting climatic response: the interaction of clouds and the sun`s energy in the Earth`s atmosphere. An important aspect of the program is the use of unmanned aerospace vehicles (UAVs) as the primary airborne platform. The ARM-UAV Program has completed two major flight series: The first series conducted in April, 1994, using an existing UAV (the General Atomics Gnat 750) consisted of eight highly successful flights at the DOE climate site in Oklahoma. The second series conducted in September/October, 1995, using two piloted aircraft (Egrett and Twin Otter), featured simultaneous measurements above and below clouds and in clear sky. Additional flight series are planned to continue study of the cloudy and clear sky energy budget in the Spring and Fall of 1996 over the DOE climate site in Oklahoma. 3 refs., 4 figs., 1 tab.

  6. Measures and programs for preventing violence in school

    Directory of Open Access Journals (Sweden)

    Gašić-Pavišić Slobodanka Ž.

    2004-01-01

    Full Text Available In many countries across the world schools are no longer a safe place for both students and school staff. Violence in school is an issue scarcely studied in Serbia and there are few articles in domestic professional literature. At national and local level there are not developed strategies nor programs for preventing violence among students in our schools. There are no data about planned, systematic and organized prevention of violence in the practice of our schools. The data obtained by investigations indicate that it is necessary to apply adequate programs for preventing violence among students in our schools, despite the finding that violence in school is not that much conspicuous and serious problem like in other countries (USA Israel, Japan, Austria, Germany. On the basis of relevant literature review the present paper high­lights some very popular and less notorious measures and prevention programs applied in various countries. The aim of the paper is to transmit basic and essential pieces of information so as to gain insight into diverse existing approaches to prevention of violent behavior in school hopefully to encourage our schools to pay more attention to preventing violence in school as soon as possible before it is too late.

  7. Combining Time-Driven Activity-Based Costing with Clinical Outcome in Cost-Effectiveness Analysis to Measure Value in Treatment of Depression.

    Science.gov (United States)

    El Alaoui, Samir; Lindefors, Nils

    2016-01-01

    A major challenge of mental health care is to provide safe and effective treatment with limited resources. The main purpose of this study was to examine a value-based approach in clinical psychiatry when evaluating a process improvement initiative. This was accomplished by using the relatively new time driven activity based costing (TDABC) method within the more widely adopted cost-effectiveness analysis framework for economic evaluation of healthcare technologies. The objective was to evaluate the cost-effectiveness of allowing psychologists to perform post-treatment assessment previously performed by psychiatrists at an outpatient clinic treating depression using internet-based cognitive-behavioral therapy (ICBT). Data was collected from 568 adult patients treated with ICBT for depression during 2013-2014. The TDABC methodology was used to estimate total healthcare costs, including development of process maps for the complete cycle of care and estimation of resource use and minute costs of staff, hospital space and materials based on their relative proportions used. Clinical outcomes were measured using the Patient Health Questionnaire depression scale (PHQ-9) before and after treatment and at 6-month follow-up. Cost-effectiveness analyses (CEA) was performed and the results presented as incremental net benefits (INB), cost-effectiveness acceptability curves (CEACs) and confidence ellipses to demonstrate uncertainty around the value of the organizational intervention. Taking into account the complete healthcare process (from referral to follow-up assessment), treatment costs decreased from $709 (SD = $130) per patient in 2013 to $659 (SD = $134) in 2014 while treatment effectiveness was maintained; 27% had achieved full remission from depression after treatment (PHQ-9 cost-effectiveness plane at both post-treatment and at follow-up, indicating that the ICBT treatment was less costly and equally effective after staff reallocation. Treating patients to the target

  8. Combining Time-Driven Activity-Based Costing with Clinical Outcome in Cost-Effectiveness Analysis to Measure Value in Treatment of Depression.

    Directory of Open Access Journals (Sweden)

    Samir El Alaoui

    Full Text Available A major challenge of mental health care is to provide safe and effective treatment with limited resources. The main purpose of this study was to examine a value-based approach in clinical psychiatry when evaluating a process improvement initiative. This was accomplished by using the relatively new time driven activity based costing (TDABC method within the more widely adopted cost-effectiveness analysis framework for economic evaluation of healthcare technologies. The objective was to evaluate the cost-effectiveness of allowing psychologists to perform post-treatment assessment previously performed by psychiatrists at an outpatient clinic treating depression using internet-based cognitive-behavioral therapy (ICBT.Data was collected from 568 adult patients treated with ICBT for depression during 2013-2014. The TDABC methodology was used to estimate total healthcare costs, including development of process maps for the complete cycle of care and estimation of resource use and minute costs of staff, hospital space and materials based on their relative proportions used. Clinical outcomes were measured using the Patient Health Questionnaire depression scale (PHQ-9 before and after treatment and at 6-month follow-up. Cost-effectiveness analyses (CEA was performed and the results presented as incremental net benefits (INB, cost-effectiveness acceptability curves (CEACs and confidence ellipses to demonstrate uncertainty around the value of the organizational intervention.Taking into account the complete healthcare process (from referral to follow-up assessment, treatment costs decreased from $709 (SD = $130 per patient in 2013 to $659 (SD = $134 in 2014 while treatment effectiveness was maintained; 27% had achieved full remission from depression after treatment (PHQ-9 < 5 during both 2013 and 2014 and an additional 35% and 33% had achieved partial remission in 2013 and 2014, respectively. At follow-up, 42% were in full remission after treatment during

  9. Combining Time-Driven Activity-Based Costing with Clinical Outcome in Cost-Effectiveness Analysis to Measure Value in Treatment of Depression

    Science.gov (United States)

    Lindefors, Nils

    2016-01-01

    Background A major challenge of mental health care is to provide safe and effective treatment with limited resources. The main purpose of this study was to examine a value-based approach in clinical psychiatry when evaluating a process improvement initiative. This was accomplished by using the relatively new time driven activity based costing (TDABC) method within the more widely adopted cost-effectiveness analysis framework for economic evaluation of healthcare technologies. The objective was to evaluate the cost-effectiveness of allowing psychologists to perform post-treatment assessment previously performed by psychiatrists at an outpatient clinic treating depression using internet-based cognitive-behavioral therapy (ICBT). Methods Data was collected from 568 adult patients treated with ICBT for depression during 2013–2014. The TDABC methodology was used to estimate total healthcare costs, including development of process maps for the complete cycle of care and estimation of resource use and minute costs of staff, hospital space and materials based on their relative proportions used. Clinical outcomes were measured using the Patient Health Questionnaire depression scale (PHQ-9) before and after treatment and at 6-month follow-up. Cost-effectiveness analyses (CEA) was performed and the results presented as incremental net benefits (INB), cost-effectiveness acceptability curves (CEACs) and confidence ellipses to demonstrate uncertainty around the value of the organizational intervention. Outcomes Taking into account the complete healthcare process (from referral to follow-up assessment), treatment costs decreased from $709 (SD = $130) per patient in 2013 to $659 (SD = $134) in 2014 while treatment effectiveness was maintained; 27% had achieved full remission from depression after treatment (PHQ-9 cost-effectiveness plane at both post-treatment and at follow-up, indicating that the ICBT treatment was less costly and equally effective after staff reallocation

  10. The effect of the California tobacco control program on smoking prevalence, cigarette consumption, and healthcare costs: 1989-2008.

    Science.gov (United States)

    Lightwood, James; Glantz, Stanton A

    2013-01-01

    Previous research has shown that tobacco control funding in California has reduced per capita cigarette consumption and per capita healthcare expenditures. This paper refines our earlier model by estimating the effect of California tobacco control funding on current smoking prevalence and cigarette consumption per smoker and the effect of prevalence and consumption on per capita healthcare expenditures. The results are used to calculate new estimates of the effect of the California Tobacco Program. Using state-specific aggregate data, current smoking prevalence and cigarette consumption per smoker are modeled as functions of cumulative California and control states' per capita tobacco control funding, cigarette price, and per capita income. Per capita healthcare expenditures are modeled as a function of prevalence of current smoking, cigarette consumption per smoker, and per capita income. One additional dollar of cumulative per capita tobacco control funding is associated with reduction in current smoking prevalence of 0.0497 (SE.00347) percentage points and current smoker cigarette consumption of 1.39 (SE.132) packs per smoker per year. Reductions of one percentage point in current smoking prevalence and one pack smoked per smoker are associated with $35.4 (SE $9.85) and $3.14 (SE.786) reductions in per capita healthcare expenditure, respectively (2010 dollars), using the National Income and Product Accounts (NIPA) measure of healthcare spending. Between FY 1989 and 2008 the California Tobacco Program cost $2.4 billion and led to cumulative NIPA healthcare expenditure savings of $134 (SE $30.5) billion.

  11. User Delay Cost Model and Facilities Maintenance Cost Model for a Terminal Control Area : Volume 2. User's Manual and Program Documentation for the User Delay Cost Model

    Science.gov (United States)

    1978-05-01

    The User Delay Cost Model (UDCM) is a Monte Carlo simulation of certain classes of movement of air traffic in the Boston Terminal Control Area (TCA). It incorporates a weather module, an aircraft generation module, a facilities module, and an air con...

  12. Investigation of the impact of low cost traffic engineering measures on road safety in urban areas.

    Science.gov (United States)

    Yannis, George; Kondyli, Alexandra; Georgopoulou, Xenia

    2014-01-01

    This paper investigates the impact of low cost traffic engineering measures (LCTEMs) on the improvement of road safety in urban areas. A number of such measures were considered, such as speed humps, woonerfs, raised intersections and other traffic calming measures, which have been implemented on one-way, one-lane roads in the Municipality of Neo Psychiko in the Greater Athens Area. Data were analysed using the before-and-after safety analysis methodology with large control group. The selected control group comprised of two Municipalities in the Athens Greater Area, which present similar road network and land use characteristics with the area considered. The application of the methodology showed that the total number of crashes presented a statistically significant reduction, which can be possibly attributed to the introduction of LCTEMs. This reduction concerns passenger cars and single-vehicle crashes and is possibly due to the behavioural improvement of drivers of 25 years old or more. The results of this research are very useful for the identification of the appropriate low cost traffic engineering countermeasures for road safety problems in urban areas.

  13. Safety effects of low-cost engineering measures. An observational study in a Portuguese multilane road.

    Science.gov (United States)

    Vieira Gomes, Sandra; Cardoso, João Lourenço

    2012-09-01

    Single carriageway multilane roads are not, in general, a very safe type of road, mainly because of the high number of seriously injured victims in head-on collisions, when compared with dual carriageway multilane roads, with a median barrier. In this paper the results of a study on the effect of the application of several low cost engineering measures, aimed at road infrastructure correction and road safety improvement on a multilane road (EN6), are presented. The study was developed by the National Laboratory of Civil Engineering (LNEC) for the Portuguese Road Administration and involved a comparison of selected aspects of motorized traffic behaviour (traffic volumes and speeds) measured in several sections of EN6, as well as monitoring of road safety developments in the same road. The applied low cost engineering measures allowed a reduction of 10% in the expected annual number of personal injury accidents and a 70% decrease in the expected annual number of head-on collisions; the expected annual frequency of accidents involving killed and seriously injured persons was reduced by 26%. Copyright © 2012 Elsevier Ltd. All rights reserved.

  14. Evaluation of low-cost methods for discharge measurements in rivers

    Directory of Open Access Journals (Sweden)

    Luiz Henrique Maldonado

    2015-04-01

    Full Text Available Increasing rates of pollution and over-exploitation have reduced the availability of water in many regions of the world. In this context, the qualitative and quantitative management of available water resources becomes paramount. Thus, this study evaluated the applicability of two low-cost discharge measurement methods that are adequately precise: the electromagnetic method and the culvert method. The methods were applied in the field (Ribeirão da Onça Basin in order to assess their advantages and disadvantages with reference to the conventional method of discharge measurement. Compared with the traditional method, the electromagnetic method resulted in a deviation of -5%, but allowed velocity measurements in the turbulent conditions caused by the channel’s side walls. The culvert method resulted in discharge deviations of 2.1%; however, it had limitations in high water situations. The two low-cost methods showed good results in determining the rate of discharge, but it is crucial to understand their operational limitations.

  15. Giving and receiving: measuring the carbon cost of mycorrhizas in the green orchid, Goodyera repens.

    Science.gov (United States)

    Cameron, Duncan D; Johnson, Irene; Read, David J; Leake, Jonathan R

    2008-01-01

    Direct measurement of the carbon (C) 'cost' of mycorrhizas is problematic. Although estimates have been made for arbuscular and ectomycorrhizal symbioses, these are based on incomplete budgets or indirect measurements. Furthermore, the conventional model of unidirectional plant-to-fungus C flux is too simplistic. Net fungus-to-plant C transfer supports seedling establishment in c. 10% of plant species, including most orchids, and bidirectional C flows occur in ectomycorrhiza utilizing soil amino acids. Here, the C cost of mycorrhizas to the green orchid Goodyera repens was determined by measurement of simultaneous bidirectional fluxes of 14C labelled sources using a monoxenic system with the fungus Ceratobasidium cornigerum. Transfer of C from fungus to plant ('up-flow') occurs in the photosynthesizing orchid G. repens (max. 0.06 microg) whereas over five times more current assimilate (min. 0.355 microg) is simultaneously allocated in the reverse direction to the mycorrhizal fungus ('down-flow') after 8 d. Carbon is transferred rapidly, being detected in plant-fungal respiration within 31 h of labelling. This study provides the most complete C budget for an orchid-mycorrhizal symbiosis, and clearly shows net plant-to-fungus C flux. The rapidity of bidirectional C flux is indicative of dynamic transfer at an interfacial apoplast as opposed to reliance on digestion of fungal pelotons.

  16. Cost Accounting and Accountability for Early Education Programs for Handicapped Children.

    Science.gov (United States)

    Gingold, William

    The paper offers some basic information for making decisions about allocating and accounting for resources provided to young handicapped children. Sections address the following topics: reasons for costing, audiences for cost accounting and accountability information, and a process for cost accounting and accountability (defining cost categories,…

  17. Systematic review of model-based analyses reporting the cost-effectiveness and cost-utility of cardiovascular disease management programs.

    Science.gov (United States)

    Maru, Shoko; Byrnes, Joshua; Whitty, Jennifer A; Carrington, Melinda J; Stewart, Simon; Scuffham, Paul A

    2015-02-01

    The reported cost effectiveness of cardiovascular disease management programs (CVD-MPs) is highly variable, potentially leading to different funding decisions. This systematic review evaluates published modeled analyses to compare study methods and quality. Articles were included if an incremental cost-effectiveness ratio (ICER) or cost-utility ratio (ICUR) was reported, it is a multi-component intervention designed to manage or prevent a cardiovascular disease condition, and it addressed all domains specified in the American Heart Association Taxonomy for Disease Management. Nine articles (reporting 10 clinical outcomes) were included. Eight cost-utility and two cost-effectiveness analyses targeted hypertension (n=4), coronary heart disease (n=2), coronary heart disease plus stoke (n=1), heart failure (n=2) and hyperlipidemia (n=1). Study perspectives included the healthcare system (n=5), societal and fund holders (n=1), a third party payer (n=3), or was not explicitly stated (n=1). All analyses were modeled based on interventions of one to two years' duration. Time horizon ranged from two years (n=1), 10 years (n=1) and lifetime (n=8). Model structures included Markov model (n=8), 'decision analytic models' (n=1), or was not explicitly stated (n=1). Considerable variation was observed in clinical and economic assumptions and reporting practices. Of all ICERs/ICURs reported, including those of subgroups (n=16), four were above a US$50,000 acceptability threshold, six were below and six were dominant. The majority of CVD-MPs was reported to have favorable economic outcomes, but 25% were at unacceptably high cost for the outcomes. Use of standardized reporting tools should increase transparency and inform what drives the cost-effectiveness of CVD-MPs. © The European Society of Cardiology 2014.

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

    Science.gov (United States)

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

    2010-07-01

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

  19. Challenges in measuring and valuing productivity costs, and their relevance in mood disorders.

    Science.gov (United States)

    Lensberg, Benedikte R; Drummond, Michael F; Danchenko, Natalya; Despiégel, Nicolas; François, Clément

    2013-01-01

    Lost productivity is often excluded from economic evaluations, which may lead to an underestimation of the societal benefits of treatment. However, there are multiple challenges in reliably estimating and reporting productivity losses. This article explores the main challenges, ie, selecting an appropriate valuation method (ie, human capital, friction cost, or multiplier), avoiding double counting, and accounting for equity. It also discusses the use of presenteeism instruments and their application in clinical trials, with a specific focus on their relevance in individuals with mood disorders. Further research and discussion is required on the development of reliable techniques for measuring and valuing productivity changes due to presenteeism.

  20. Challenges in measuring and valuing productivity costs, and their relevance in mood disorders

    Science.gov (United States)

    Lensberg, Benedikte R; Drummond, Michael F; Danchenko, Natalya; Despiégel, Nicolas; François, Clément

    2013-01-01

    Lost productivity is often excluded from economic evaluations, which may lead to an underestimation of the societal benefits of treatment. However, there are multiple challenges in reliably estimating and reporting productivity losses. This article explores the main challenges, ie, selecting an appropriate valuation method (ie, human capital, friction cost, or multiplier), avoiding double counting, and accounting for equity. It also discusses the use of presenteeism instruments and their application in clinical trials, with a specific focus on their relevance in individuals with mood disorders. Further research and discussion is required on the development of reliable techniques for measuring and valuing productivity changes due to presenteeism. PMID:24273412

  1. A cost-effective measurement-device-independent quantum key distribution system for quantum networks

    Science.gov (United States)

    Valivarthi, Raju; Zhou, Qiang; John, Caleb; Marsili, Francesco; Verma, Varun B.; Shaw, Matthew D.; Nam, Sae Woo; Oblak, Daniel; Tittel, Wolfgang

    2017-12-01

    We experimentally realize a measurement-device-independent quantum key distribution (MDI-QKD) system. It is based on cost-effective and commercially available hardware such as distributed feedback lasers and field-programmable gate arrays that enable time-bin qubit preparation and time-tagging, and active feedback systems that allow for compensation of time-varying properties of photons after transmission through deployed fiber. We examine the performance of our system, and conclude that its design does not compromise performance. Our demonstration paves the way for MDI-QKD-based quantum networks in star-type topology that extend over more than 100 km distance.

  2. A New Information Measure Based on Example-Dependent Misclassification Costs and Its Application in Decision Tree Learning

    Directory of Open Access Journals (Sweden)

    Fritz Wysotzki

    2009-01-01

    Full Text Available This article describes how the costs of misclassification given with the individual training objects for classification learning can be used in the construction of decision trees for minimal cost instead of minimal error class decisions. This is demonstrated by defining modified, cost-dependent probabilities, a new, cost-dependent information measure, and using a cost-sensitive extension of the CAL5 algorithm for learning decision trees. The cost-dependent information measure ensures the selection of the (local next best, that is, cost-minimizing, discriminating attribute in the sequential construction of the classification trees. This is shown to be a cost-dependent generalization of the classical information measure introduced by Shannon, which only depends on classical probabilities. It is therefore of general importance and extends classic information theory, knowledge processing, and cognitive science, since subjective evaluations of decision alternatives can be included in entropy and the transferred information. Decision trees can then be viewed as cost-minimizing decoders for class symbols emitted by a source and coded by feature vectors. Experiments with two artificial datasets and one application example show that this approach is more accurate than a method which uses class dependent costs given by experts a priori.

  3. Implementing the Water Framework Directive: Contract Design and the Cost of Measures to Reduce Nitrogen Pollution from Agriculture

    Science.gov (United States)

    Bartolini, Fabio; Gallerani, Vittorio; Raggi, Meri; Viaggi, Davide

    2007-10-01

    The performance of different policy design strategies is a key issue in evaluating programmes for water quality improvement under the Water Framework Directive (60/2000). This issue is emphasised by information asymmetries between regulator and agents. Using an economic model under asymmetric information, the aim of this paper is to compare the cost-effectiveness of selected methods of designing payments to farmers in order to reduce nitrogen pollution in agriculture. A principal-agent model is used, based on profit functions generated through farm-level linear programming. This allows a comparison of flat rate payments and a menu of contracts developed through mechanism design. The model is tested in an area of Emilia Romagna (Italy) in two policy contexts: Agenda 2000 and the 2003 Common Agricultural Policy (CAP) reform. The results show that different policy design options lead to differences in policy costs as great as 200-400%, with clear advantages for the menu of contracts. However, different policy scenarios may strongly affect such differences. Hence, the paper calls for greater attention to the interplay between CAP scenarios and water quality measures.

  4. Implementing the water framework directive: contract design and the cost of measures to reduce nitrogen pollution from agriculture.

    Science.gov (United States)

    Bartolini, Fabio; Gallerani, Vittorio; Raggi, Meri; Viaggi, Davide

    2007-10-01

    The performance of different policy design strategies is a key issue in evaluating programmes for water quality improvement under the Water Framework Directive (60/2000). This issue is emphasised by information asymmetries between regulator and agents. Using an economic model under asymmetric information, the aim of this paper is to compare the cost-effectiveness of selected methods of designing payments to farmers in order to reduce nitrogen pollution in agriculture. A principal-agent model is used, based on profit functions generated through farm-level linear programming. This allows a comparison of flat rate payments and a menu of contracts developed through mechanism design. The model is tested in an area of Emilia Romagna (Italy) in two policy contexts: Agenda 2000 and the 2003 Common Agricultural Policy (CAP) reform. The results show that different policy design options lead to differences in policy costs as great as 200-400%, with clear advantages for the menu of contracts. However, different policy scenarios may strongly affect such differences. Hence, the paper calls for greater attention to the interplay between CAP scenarios and water quality measures.

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

    Science.gov (United States)

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

    2017-03-01

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

  6. A Low-Cost Fluorescent Sensor for pCO2 Measurements

    Directory of Open Access Journals (Sweden)

    Xudong Ge

    2014-04-01

    Full Text Available Global warming is believed to be caused by increasing amounts of greenhouse gases (mostly CO2 discharged into the environment by human activity. In addition to an increase in environmental temperature, an increased CO2 level has also led to ocean acidification. Ocean acidification and rising temperatures have disrupted the water’s ecological balance, killing off some plant and animal species, while encouraging the overgrowth of others. To minimize the effect of global warming on local ecosystem, there is a strong need to implement ocean observing systems to monitor the effects of anthropogenic CO2 and the impacts thereof on ocean biological productivity. Here, we describe the development of a low-cost fluorescent sensor for pCO2 measurements. The detector was exclusively assembled with low-cost optics and electronics, so that it would be affordable enough to be deployed in great numbers. The system has several novel features, such as an ideal 90° separation between excitation and emission, a beam combiner, a reference photodetector, etc. Initial tests showed that the system was stable and could achieve a high resolution despite the low cost.

  7. Joint amplitude MEMS based measurement platform for low cost and high accessibility telerehabilitation: Elbow case study.

    Science.gov (United States)

    Callejas-Cuervo, Mauro; Gutierrez, Rafael M; Hernandez, Andres I

    2017-07-01

    This paper, presents an inertial and magnetic sensor based technological platform, intended for articular amplitude monitoring and telerehabilitation processes considering an efficient cost/technical considerations compromise. The particularities of our platform offer possibilities of a high social impact by making telerehabilitation accessible to large population sectors in marginal socio-economic sectors, especially in underdeveloped countries where, in contrast to developed countries, specialists are scarce and high technology is not available or inexistent. This platform integrates high resolution low cost inertial and magnetic sensors with adequate user interfaces and communication protocols to perform a diagnostic service through the web, or other available communication networks. Elbow amplitude information is generated by sensors and then transferred to a computing device with adequate interfaces to make it accessible to inexperienced personnel, providing a high social value at a low cost. Experimental methodology includes two different sets of tests: the first one uses flexion - extension movements on a robotic arm to validate our platform (IMOCAP) articular amplitude measurements, against the robotic positioning system. The second set of tests was carried out on human patients to test IMOCAP in real operational conditions; results were validated with an optical positioning system. This paper presents experimental results showing the platform applicability to telerehabilitation processes. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Evaluation of a low cost wireless heat ratio method system for measuring transpiration

    Science.gov (United States)

    Eiriksson, D.; Boyer, B.; Aishlin, P. S.; Bowling, D. R.

    2016-12-01

    For decades, environmental measurements in remote locations have consisted of sensors hard wired to loggers that send data to central servers via radio, satellite, or cellular telemetry. This model of data collection is effective when all sensors are located in close proximity to the central data logger, such as on a weather station. Frequently, however, in order to adequately capture the spatial heterogeneity associated with environmental processes (e.g., transpiration, soil moisture, or snow depth), it is necessary to install many sensors 10's to 100's of meters from a central data logging station. This presents a practical and financial obstacle when considering the cost of cabling and conduit, in addition to the potential data collection and data quality problems associated with long cable runs. We offer a solution to this persistent challenge with a hybrid datalogging system that combines the power and reliability of Campbell Scientific logging and telemetry equipment with low cost Xbee radios and Arduino based data logging platforms. To evaluate the promise of this hybrid datalogging concept we developed a new generation of low cost, homemade heat ratio sapflux sensors and tested them at a forested site in the Wasatch Mountains, near Salt Lake City, Utah. We present data from this test site, heat ratio method sensor construction details, and example code that merges the capabilities of Arduino and Campbell Scientific datalogging systems.

  9. Quantum measurement and the first law of thermodynamics: the energy cost of measurement is the work value of the acquired information.

    Science.gov (United States)

    Jacobs, Kurt

    2012-10-01

    The energy cost of measurement is an important fundamental question, and may have profound implications for quantum technologies. In the context of Maxwell's demon, it is often stated that measurement has no minimum energy cost, while information has a work value. However, as we elucidate, the first of these statements does not refer to the cost paid by the measuring device. Here we show that it is only when a measuring device has access to a zero-temperature reservoir-that is, never-that measurement requires no energy. To obtain a given amount of information, all measuring devices must pay a cost equal to that which a heat engine would pay to obtain the equivalent work value of that information.

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

    DEFF Research Database (Denmark)

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

    2007-01-01

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

  11. Cost allocation plans for municipalities for internal management and grant programs

    OpenAIRE

    Benroth, Barron Ray; Fremont, Robert Francis, III

    1981-01-01

    Approved for public release; distribution is unlimited This thesis is a discussion of and presentation of cost allocation plans for municipal governments for internal management and Federal grant reimbursement purposes. The authors present information concerning the current state of the art in cost accounting for cost allocation including classification of cost, responsibility accounting and various cost allocation methodologies. The authors discuss the application of Federal rules, regu...

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

    Science.gov (United States)

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

    2016-01-01

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

  13. 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.

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

    Science.gov (United States)

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

    2016-01-01

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

  15. International-Aerial Measuring System (I-AMS) Training Program

    Energy Technology Data Exchange (ETDEWEB)

    Wasiolek, Piotre T. [National Security Technologies, LLC; Malchor, Russell L. [National Security Technologies, LLC; Maurer, Richard J. [National Security Technologies, LLC; Adams, Henry L. [National Security Technologies, LLC

    2015-10-01

    Since the Fukushima reactor accident in 2011, there has been an increased interest worldwide in developing national capabilities to rapidly map and assess ground contamination resulting from nuclear reactor accidents. The capability to rapidly measure the size of the contaminated area, determine the activity level, and identify the radionuclides can aid emergency managers and decision makers in providing timely protective action recommendations to the public and first responders. The development of an aerial detection capability requires interagency coordination to assemble the radiation experts, detection system operators, and aviation aircrews to conduct the aerial measurements, analyze and interpret the data, and provide technical assessments. The Office of International Emergency Management and Cooperation (IEMC) at the U.S. Department of Energy, National Nuclear Security Administration (DOE/NNSA) sponsors an International - Aerial Measuring System (I-AMS) training program for partner nations to develop and enhance their response to radiological emergencies. An initial series of courses can be conducted in the host country to assist in developing an aerial detection capability. As the capability develops and expands, additional experience can be gained through advanced courses with the opportunity to conduct aerial missions over a broad range of radiation environments.

  16. A low cost apparatus for measuring the xylem hydraulic conductance in plants

    Directory of Open Access Journals (Sweden)

    Luciano Pereira

    2012-01-01

    Full Text Available Plant yield and resistance to drought are directly related to the efficiency of the xylem hydraulic conductance and the ability of this system to avoid interrupting the flow of water. In this paper we described in detail the assembling of an apparatus proposed by TYREE et al. (2002, and its calibration, as well as low cost adaptations that make the equipment accessible for everyone working in this research area. The apparatus allows measuring the conductance in parts of roots or shoots (root ramifications or branches, or in the whole system, in the case of small plants or seedlings. The apparatus can also be used to measure the reduction of conductance by embolism of the xylem vessels. Data on the hydraulic conductance of eucalyptus seedlings obtained here and other reports in the literature confirm the applicability of the apparatus in physiological studies on the relationship between productivity and water stress.

  17. A simple, low cost and fast improved fluorimetric method for Histamine measurement

    Directory of Open Access Journals (Sweden)

    Poorpak Z

    2001-11-01

    Full Text Available The well-known fluorimetric method for histamine measurement which is one of the common methods in diagnostic laboratories was modified to accelerate and facilitate measurement of serum histamine levels and decrease the costs and restrictions. The modified method needs only 1 ml of whole blood (or serum instead of about 10 ml in original method which is difficult almost or impossible specially for children. In addition, very small amounts of the expensive materials are needed and the samples are saved for about 15 days in -20°C which makes no significant changes. Because in most cases, sample can not be read at sampling day, the saving possibility is an advantage for improved method.

  18. Low-cost standalone multi-sensor thermometer for long time measurements

    Science.gov (United States)

    Kumchaiseemak, Nakorn; Hormwantha, Tongchai; Wungmool, Piyachat; Suwanatus, Suchat; Kanjai, Supaporn; Lertkitthaworn, Thitima; Jutamanee, Kanapol; Luengviriya, Chaiya

    2017-09-01

    We present a portable device for long-time recording of the temperature at multiple measuring points. Thermocouple wires are utilized as the sensors attached to the objects. To minimize the production cost, the measured voltage signals are relayed via a multiplexer to a set of amplifiers and finally to a single microcontroller. The observed temperature and the corresponding date and time, obtained from a real-time clock circuit, are recorded in a memory card for further analysis. The device is powered by a rechargeable battery and placed in a rainproof container, thus it can operate under outdoor conditions. A demonstration of the device usage in a mandarin orange cultivation field of the Royal project, located in the northern Thailand, is illustrated.

  19. Low-cost chlorophyll meter (LCCM): portable measuring device for leaf chlorophyll

    Science.gov (United States)

    Hutomo E. P., Evan; Adibawa, Marcelinus Alfasisurya S.; Prilianti, Kestrilia R.; Heriyanto, Heriyanto; Brotosudarmo, Tatas H. P.

    2016-11-01

    Portable leaf chlorophyll meter, named low-cost chlorophyll meter (LCCM), has been created. This device was created to help farmer determining the health condition of plant based on the greenness level of leaf surface. According to previous studies, leaf greenness with a certain amount of chlorophyll level has a direct correlation with the amount of nitrogen in the leaf that indicates health of the plant and this fact needed to provide an estimate of further measures to keep the plants healthy. Device that enables to measure the leaf color change is soil plant analysis development (SPAD) meter 502 from Konica Minolta but it is relatively expensive. To answer the need of low-cost chlorophyll scanner device, this research conducted experiment using light reflectance as the base mechanism. Reflectance system from LCCM consists of near-infrared light emitting diode (LED) and red LED as light resources and photodiode. The output from both of light resources calculated using normalized difference vegetation index (NDVI) formula as the results fetched and displayed on the smartphone application using Bluetooth communication protocol. Finally, the scanner has been made as well as the Android application named NDVI Reader. The LCCM system which has been tested on 20 sample of cassava leaf with SPAD meter as a variable control showed coefficient of determination 0.9681 and root-mean-square error (RMSE) 0.014.

  20. Low-cost teleoperator-controlled vehicle for damage assessment and radiation dose measurement

    Energy Technology Data Exchange (ETDEWEB)

    Tyree, W.H.

    1991-01-01

    A low-cost, disposable, radio-controlled, remote-reading, ionizing radiation and surveillance teleoperator re-entry vehicle has been built. The vehicle carries equipment, measures radiation levels, and evaluates building conditions. The basic vehicle, radio control with amplifiers, telemetry, elevator, and video camera with monitor cost less than $2500. Velcro-mounted alpha, beta-gamma, and neutron sensing equipment is used in the present system. Many types of health physics radiation measuring equipment may be substituted on the vehicle. The system includes a black-and-white video camera to observe the environment surrounding the vehicle. The camera is mounted on a vertical elevator extendible to 11 feet above the floor. The present vehicle uses a video camera with an umbilical cord between the vehicle and the operators. Preferred operation would eliminate the umbilical. Video monitoring equipment is part of the operator control system. Power for the vehicle equipment is carried on board and supplied by sealed lead-acid batteries. Radios are powered by 9-V alkaline batteries. The radio control receiver, servo drivers, high-power amplifier and 49-MHz FM transceivers were irradiated at moderate rates with neutron and gamma doses to 3000 Rem and 300 Rem, respectively, to ensure system operation.

  1. Measuring the environmental costs of tidal power plant construction. A choice experiment study

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Joo-Suk; Yoo, Seung-Hoon [Department of International Area Studies, Hoseo University, 268 Anseo-Dong, Cheonan, Chungnam 330-713 (Korea)

    2009-12-15

    Korea is considering the construction of a tidal power plant (TPP) at Garolim Bay. However, as the construction of the Garolim TPP (GTPP) is expected to entail some environmental damage, it has become an increasingly important topic for public debate. Using a choice experiment (CE) approach, this study attempts to measure the economic cost that results from the environmental damage caused by the construction of GTPP. The CE is used to measure the environmental costs of individual attributes, including the reduction in the area of the tidal flat, the degradation of seawater quality, and the destruction of marine life. The results indicate that the annual willingness to pay (WTP) per household for mitigating the environmental damage that results from the worst-possible situation in relation to the present situation is about 96,042 Korean won (USD 101.1) in the seven biggest cities (off-site regions) and 18,584 Korean won (USD 19.6) in Seosan and Taean (on-site regions). This study is expected to provide policy-makers with quantitative information that will be useful to decide whether or not GTPP should be constructed. (author)

  2. Measuring the environmental costs of tidal power plant construction: A choice experiment study

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Joo-Suk, E-mail: leejoosuk@hoseo.ed [Department of International Area Studies, Hoseo University, 268 Anseo-Dong, Cheonan, Chungnam 330-713 (Korea, Republic of); Yoo, Seung-Hoon, E-mail: shyoo@hoseo.ed [Department of International Area Studies, Hoseo University, 268 Anseo-Dong, Cheonan, Chungnam 330-713 (Korea, Republic of)

    2009-12-15

    Korea is considering the construction of a tidal power plant (TPP) at Garolim Bay. However, as the construction of the Garolim TPP (GTPP) is expected to entail some environmental damage, it has become an increasingly important topic for public debate. Using a choice experiment (CE) approach, this study attempts to measure the economic cost that results from the environmental damage caused by the construction of GTPP. The CE is used to measure the environmental costs of individual attributes, including the reduction in the area of the tidal flat, the degradation of seawater quality, and the destruction of marine life. The results indicate that the annual willingness to pay (WTP) per household for mitigating the environmental damage that results from the worst-possible situation in relation to the present situation is about 96,042 Korean won (USD 101.1) in the seven biggest cities (off-site regions) and 18,584 Korean won (USD 19.6) in Seosan and Taean (on-site regions). This study is expected to provide policy-makers with quantitative information that will be useful to decide whether or not GTPP should be constructed.

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

    Directory of Open Access Journals (Sweden)

    David B Lindenmayer

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

  4. Penempatan Optimal Phasor Measurement Unit (PMU dengan Integer Programming

    Directory of Open Access Journals (Sweden)

    Yunan Helmy Amrulloh

    2013-09-01

    Full Text Available Phasor Measurement Unit (PMU merupakan peralatan yang mampu memberikan pengukuran fasor tegangan dan arus secara real-time. PMU dapat digunakan untuk monitoring, proteksi dan kontrol pada sistem tenaga listrik. Tugas akhir ini membahas penempatan PMU secara optimal berdasarkan topologi jaringan sehingga sistem tenaga listrik  dapat diobservasi. Penempatan optimal PMU dirumuskan sebagai masalah Binary Integer Programming (BIP yang akan memberikan variabel dengan pilihan nilai (0,1 yang menunjukkan tempat yang harus dipasang PMU. Dalam tugas akhir ini, BIP diterapkan untuk menyelesaikan masalah penempatan PMU secara optimal pada sistem tenaga listrik  Jawa-Bali 500 KV yang selanjutnya diterapkan dengan penambahan konsep incomplete observability. Hasil simulasi menunjukkan bahwa penerapan BIP pada sistem dengan incomplete observability memberikan jumlah PMU yang lebih sedikit dibandingkan dengan sistem tanpa konsep incomplete observability.

  5. Sustained employability of workers in a production environment: design of a stepped wedge trial to evaluate effectiveness and cost-benefit of the POSE program

    Directory of Open Access Journals (Sweden)

    van Holland Berry J

    2012-11-01

    Full Text Available Abstract Background Sustained employability and health are generating awareness of employers in an aging and more complex work force. To meet these needs, employers may offer their employees health surveillance programs, to increase opportunities to work on health and sustained employability. However, evidence for these health surveillance programs is lacking. The FLESH study (Functional Labour Evaluation for Sustained Health and employment was developed to evaluate a comprehensive workers’ health promotion program on its effectiveness, cost-benefit, and process of the intervention. Methods The study is designed as a cluster randomised stepped wedge trial with randomisation at company plant level and is carried out in a large meat processing company. Every contracted employee is offered the opportunity to participate in the POSE program (Promotion Of Sustained Employability. The main goals of the POSE program are 1 providing employee’s insight into their current employability and health status, 2 offering opportunities to improve employability and decrease health risks and 3 improving employability and health sustainably in order to keep them healthy at work. The program consists of a broad assessment followed by a counselling session and, if needed, a tailored intervention. Measurements will be performed at baseline and will be followed up at 20, 40, 60, 80, 106 and 132 weeks. The primary outcome measures are work ability, productivity and absenteeism. Secondary outcomes include health status, vitality, and psychosocial workload. A cost-benefit study will be conducted from the employers’ perspective. A process evaluation will be conducted and the satisfaction of employer and employees with the program will be assessed. Discussion This study provides information on the effectiveness of the POSE program on sustained employment. When the program proves to be effective, employees benefit by improved work ability, and health. Employers benefit

  6. Sustained employability of workers in a production environment: design of a stepped wedge trial to evaluate effectiveness and cost-benefit of the POSE program.

    Science.gov (United States)

    van Holland, Berry J; de Boer, Michiel R; Brouwer, Sandra; Soer, Remko; Reneman, Michiel F

    2012-11-20

    Sustained employability and health are generating awareness of employers in an aging and more complex work force. To meet these needs, employers may offer their employees health surveillance programs, to increase opportunities to work on health and sustained employability. However, evidence for these health surveillance programs is lacking. The FLESH study (Functional Labour Evaluation for Sustained Health and employment) was developed to evalu