WorldWideScience

Sample records for public assistance cost

  1. Costs of medically assisted reproduction treatment at specialized fertility clinics in the Danish public health care system

    DEFF Research Database (Denmark)

    Christiansen, Terkel; Erb, Karin; Rizvanovic, Amra

    2014-01-01

    To examine the costs to the public health care system of couples in medically assisted reproduction.......To examine the costs to the public health care system of couples in medically assisted reproduction....

  2. Costs of medically assisted reproduction treatment at specialized fertility clinics in the Danish public health care system

    DEFF Research Database (Denmark)

    Christiansen, Terkel; Erb, Karin; Rizvanovic, Amra

    2014-01-01

    Objective. To examine the costs to the public health care system of couples in medically assisted reproduction. Design. Longitudinal cohort study of infertile couples initiating medically assisted reproduction treatment. Setting. Specialized public fertility clinics in Denmark. Sample. Seven hund...

  3. Costs of medically assisted reproduction treatment at specialized fertility clinics in the Danish public health care system

    DEFF Research Database (Denmark)

    Christiansen, Terkel; Erb, Karin; Rizvanovic, Amra

    2014-01-01

    Objective. To examine the costs to the public health care system of couples in medically assisted reproduction. Design. Longitudinal cohort study of infertile couples initiating medically assisted reproduction treatment. Setting. Specialized public fertility clinics in Denmark. Sample. Seven...... were abstracted from medical records. Flow diagrams were drawn for different standard treatment cycles and direct costs at each stage in the flow charts were measured and valued by a bottomup procedure. Indirect costs were distributed to each treatment cycle on the basis of number of visits as basis...

  4. 24 CFR Appendix to Part 971 - Methodology of Comparing Cost of Public Housing With Cost of Tenant-Based Assistance

    Science.gov (United States)

    2010-04-01

    ... occupied unit basis. The costs shall be expressed in current dollar terms for the period for which the most... the current per-unit operating cost of the development, then the plan should detail how the... operating costs are lower than current operating costs, the current per-unit operating costs of...

  5. Coste de las técnicas de reproducción asistida en un hospital público Cost of assisted reproduction technology in a public hospital

    Directory of Open Access Journals (Sweden)

    José Luis Navarro Espigares

    2006-10-01

    Full Text Available Objetivos: La mayoría de trabajos sobre costes de las técnicas de reproducción asistida (TRA identifican el coste directo del procedimiento, sin considerar elementos como los costes estructurales o intermedios, de gran importancia. El objetivo de este trabajo es calcular el coste por proceso de las TRA realizadas en un hospital público en 2003 y compararlo con los resultados de 1998 en el mismo centro. Métodos: El estudio se realiza en la Unidad de Reproducción Humana (URH del Hospital Universitario Virgen de las Nieves de Granada en 1998 y 2003. Partiendo de los costes totales de dicha unidad, y mediante una metodología de distribución de costes basada en la estructura de costes, calculamos el coste por proceso de las TRA realizadas en este centro, considerando los costes completos. Resultados: Entre 1998 y 2003, la actividad y los costes de la URH analizada evolucionan de forma distinta. El análisis de la actividad muestra la consolidación de técnicas, como la microinyección espermática (ICSI y la desaparición de otras (ciclo sin reproducción asistida e inseminación artificial conyugal intracervical. En todos los procesos, los costes unitarios por ciclo y por embarazo disminuyen en el período analizado. Conclusiones: Se han producido importantes cambios en la estructura de costes de las TRA de la URH-HUVN entre 1998-2003. Mientras algunos procesos desaparecen, otros se consolidan con una elevada actividad. Los avances técnicos y las innovaciones organizativas, junto con un «efecto aprendizaje», han alterado la estructura de costes de las TRA.Objectives: Most studies on the costs of assisted reproductive technologies (ART identify the total cost of the procedure with the direct cost, without considering important items such as overhead or intermediate costs. The objective of this study was to determine the cost per ART procedure in a public hospital in 2003 and to compare the results with those in the same hospital in 1998

  6. 78 FR 61227 - Public Assistance Cost Estimating Format for Large Projects

    Science.gov (United States)

    2013-10-03

    ... Planning and Review; Executive Order 13563, Improving Regulation and Regulatory Review B. The Paperwork... Grant Acceleration Program HMP Hazard Mitigation Planning HVAC Heating, Ventilation, and Air... construction data warehouse publications, such as RS Means, BNi Costbooks, Marshall & Swift, or Sweets...

  7. Coste de las técnicas de reproducción asistida en un hospital público Cost of assisted reproduction technology in a public hospital

    National Research Council Canada - National Science Library

    José Luis Navarro Espigares; Luis Martínez Navarro; José Antonio Castilla Alcalá; Elisa Hernández Torres

    2006-01-01

    Objetivos: La mayoría de trabajos sobre costes de las técnicas de reproducción asistida (TRA) identifican el coste directo del procedimiento, sin considerar elementos como los costes estructurales o intermedios, de gran importancia...

  8. 45 CFR 286.55 - What types of costs are subject to the administrative cost limit on Tribal Family Assistance...

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 2 2010-10-01 2010-10-01 false What types of costs are subject to the administrative cost limit on Tribal Family Assistance Grant funds? 286.55 Section 286.55 Public Welfare... § 286.55 What types of costs are subject to the administrative cost limit on Tribal Family Assistance...

  9. Coste de las técnicas de reproducción asistida en un hospital público Cost of assisted reproduction technology in a public hospital

    OpenAIRE

    José Luis Navarro Espigares; Luis Martínez Navarro; José Antonio Castilla Alcalá; Elisa Hernández Torres

    2006-01-01

    Objetivos: La mayoría de trabajos sobre costes de las técnicas de reproducción asistida (TRA) identifican el coste directo del procedimiento, sin considerar elementos como los costes estructurales o intermedios, de gran importancia. El objetivo de este trabajo es calcular el coste por proceso de las TRA realizadas en un hospital público en 2003 y compararlo con los resultados de 1998 en el mismo centro. Métodos: El estudio se realiza en la Unidad de Reproducción Humana (URH) del Hospital Univ...

  10. 24 CFR Appendix to Part 972 - Methodology of Comparing Cost of Public Housing With the Cost of Tenant-Based Assistance

    Science.gov (United States)

    2010-04-01

    ... costs (HCC) that HUD publishes as a component of its TDC index series. Subtracted from this HCC figure... percent of the average Total Development Cost (TDC) for the units, the lower of the PHA estimate or a figure based on 10 percent of TDC must be used. Suppose the estimated remediation and demolition...

  11. Daily Public Assistance Grants Award Activity

    Data.gov (United States)

    Department of Homeland Security — Daily activity of Public Assistance Grant Awards, including FEMA Region, State, Disaster Declaration Number, Event description, Mission Assigned agency, Assistance...

  12. Cost overruns in public sector investment projects

    NARCIS (Netherlands)

    Miranda Sarmento, J.J.; Renneboog, Luc

    2017-01-01

    We analyze cost overruns in a large sample of public infrastructural investment projects in Portugal. The average cost deviation relative to the budgeted costs amounts to 24%. The large projects even have a higher cost deviation and a higher probability of cost overruns, which suggests that the

  13. Cost Efficiency in Public Higher Education.

    Science.gov (United States)

    Robst, John

    This study used the frontier cost function framework to examine cost efficiency in public higher education. The frontier cost function estimates the minimum predicted cost for producing a given amount of output. Data from the annual Almanac issues of the "Chronicle of Higher Education" were used to calculate state level enrollments at two-year and…

  14. Understanding the Cost of Public Higher Education

    Science.gov (United States)

    McPherson, Peter; Shulenburger, David

    2010-01-01

    This article explains the cost of education in public research universities. "Price," meaning "tuition," is often incorrectly substituted for "cost," meaning expenditures by the university that make the education possible. University cost is disaggregated to enable readers to distinguish between the costs associated with providing education to…

  15. Understanding the Cost of Public Higher Education

    Science.gov (United States)

    McPherson, Peter; Shulenburger, David

    2010-01-01

    This article explains the cost of education in public research universities. "Price," meaning "tuition," is often incorrectly substituted for "cost," meaning expenditures by the university that make the education possible. University cost is disaggregated to enable readers to distinguish between the costs associated with providing education to…

  16. The marginal cost of public funds

    DEFF Research Database (Denmark)

    Kleven, Henrik Jacobsen; Kreiner, Claus Thustrup

    2006-01-01

    This paper extends the theory and measurement of the marginal cost of public funds (MCF) to account for labor force participation responses. Our work is motivated by the emerging consensus in the empirical literature that extensive (participation) responses are more important than intensive (hours...

  17. 32 CFR 202.13 - Technical assistance for public participation.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 2 2010-07-01 2010-07-01 false Technical assistance for public participation... Reporting Requirements § 202.13 Technical assistance for public participation. Community members of a RAB or TRC may request technical assistance for interpreting scientific and engineering issues with regard to...

  18. The cost of assistive devices for children with mobility limitation.

    Science.gov (United States)

    Korpela, R A; Siirtola, T O; Koivikko, M J

    1992-10-01

    This study evaluated the costs of assistive devices for children with motor limitations at home, in day care, and in school, and the effect of diagnosis and severity of disabilities on costs. 201 children (mean age 7.4 years) who used 1274 various assistive devices (85.7% at home, 6.1% in day care, and 8.2% in school) were studied. The cost per device varied from $8.14 to $8138 with an average value of $539 per device. The distribution of costs per capita was unequal: 52.2% of children used 15.6% of total costs and 4.5% of children used 20.8% of total costs. The severity of motor impairment and the age of the child were the most important indicators associated with the need and cost of assistive devices. Assistive devices for basic needs, such as sitting, mobility, and personal hygiene, had a relatively low effect on costs in comparison with the high-technology devices, like powered wheelchairs and computers. Better cooperation with day care and school professionals, better assessment of needs, follow-up and recirculation of assistive devices are ways to promote rehabilitation services and partly solve the discrepancies between the costs of available technology and the resources to pay for it.

  19. Personal Publication Assistant : Abstract recommendations by a cognitive model

    NARCIS (Netherlands)

    Van Maanen, Leendert; Van Rijn, Hedderik; van Grootel, Maarten; Kemna, Stephanie; Klomp, Martin; Scholtens, Erwin

    This paper discusses an analysis of how scientists select relevant publications, and an application that can assist scientists in this information selection task. The application, called the Personal Publication Assistant, is based on the assumption that successful information selection is driven by

  20. Cost effectiveness and efficiency in assistive technology service delivery.

    Science.gov (United States)

    Warren, C G

    1993-01-01

    In order to develop and maintain a viable service delivery program, the realities of cost effectiveness and cost efficiency in providing assistive technology must be addressed. Cost effectiveness relates to value of the outcome compared to the expenditures. Cost efficiency analyzes how a provider uses available resources to supply goods and services. This paper describes how basic business principles of benefit/cost analysis can be used to determine cost effectiveness. In addition, basic accounting principles are used to illustrate methods of evaluating a program's cost efficiency. Service providers are encouraged to measure their own program's effectiveness and efficiency (and potential viability) in light of current trends. This paper is meant to serve as a catalyst for continued dialogue on this topic.

  1. Cost-Based Decision in Public Sector

    Directory of Open Access Journals (Sweden)

    Carmen Cretu

    2011-10-01

    Full Text Available Management decision must be based on relevant costs (costs that allow for the best measures for business management, recognized by their forecasting characteristics which records hidden or opportunity costs, social costs and outsourced costs. Correctly predicted a profit is to build costs for possible revenue. The cost is a sacrifice, resource consumption. Because decisions aimed at future activities, the management calls in this respect, detailed information on future costs, some of which are not included in accounting data collection system. The power of decision maker on costs is therefore limited.d

  2. Methodological aspects of accounting production cost of public sector entities

    Directory of Open Access Journals (Sweden)

    Людмила Геннадіївна Ловінська

    2015-09-01

    Full Text Available The necessity of obtaining objective information about the activities of the public sector in various areas of the production is defined. It is proved an expediency of development the Project of «Guidelines for the structure of production costs» on the basis of the approved in the public sector NP(SAPS 135 "Costs". The need for accounting costs by type of activity (operational, financial and investment is marked. The composition of production costs is defined

  3. Enhancing public involvement in assistive technology design research.

    Science.gov (United States)

    Williamson, Tracey; Kenney, Laurence; Barker, Anthony T; Cooper, Glen; Good, Tim; Healey, Jamie; Heller, Ben; Howard, David; Matthews, Martin; Prenton, Sarah; Ryan, Julia; Smith, Christine

    2015-05-01

    To appraise the application of accepted good practice guidance on public involvement in assistive technology research and to identify its impact on the research team, the public, device and trial design. Critical reflection and within-project evaluation were undertaken in a case study of the development of a functional electrical stimulation device. Individual and group interviews were undertaken with lay members of a 10 strong study user advisory group and also research team members. Public involvement was seen positively by research team members, who reported a positive impact on device and study designs. The public identified positive impact on confidence, skills, self-esteem, enjoyment, contribution to improving the care of others and opportunities for further involvement in research. A negative impact concerned the challenge of engaging the public in dissemination after the study end. The public were able to impact significantly on the design of an assistive technology device which was made more fit for purpose. Research team attitudes to public involvement were more positive after having witnessed its potential first hand. Within-project evaluation underpins this case study which presents a much needed detailed account of public involvement in assistive technology design research to add to the existing weak evidence base. The evidence base for impact of public involvement in rehabilitation technology design is in need of development. Public involvement in co-design of rehabilitation devices can lead to technologies that are fit for purpose. Rehabilitation researchers need to consider the merits of active public involvement in research.

  4. Cost Underestimation in Public Works Projects

    DEFF Research Database (Denmark)

    Flyvbjerg, Bent; Holm, Mette K. Skamris; Buhl, Søren L.

    This article presents results from the first statistically significant study of cost escalation in transportation infrastructure projects. Based on a sample of 258 transportation infrastructure projects worth $90 billion (U.S.), it is found with overwhelming statistical significance that the cost...... estimates used to decide whether important infrastructure should be built are highly and systematically misleading. The result is continuous cost escalation of billions of dollars. The sample used in the study is the largest of its kind, allowing for the first time statistically valid conclusions regarding...... honest numbers should not trust the cost estimates and cost-benefit analyses produced by project promoters and their analysts. Independent estimates and analyses are needed as are institutional checks and balances to curb deception....

  5. Underestimating Costs in Public Works Projects

    DEFF Research Database (Denmark)

    Flyvbjerg, Bent; Holm, Mette K. Skamris; Buhl, Søren L.

    2002-01-01

    This article presents results from the first statistically significant study of cost escalation in transportation infrastructure projects. Based on a sample of 258 transportation infrastructure projects worth $90 billion (U.S.), it is found with overwhelming statistical significance that the cost...... estimates used to decide whether important infrastructure should be built are highly and systematically misleading. The result is continuous cost escalation of billions of dollars. The sample used in the study is the largest of its kind, allowing for the first time statistically valid conclusions regarding...... honest numbers should not trust the cost estimates and cost-benefit analyses produced by project promoters and their analysts. Independent estimates and analyses are needed as are institutional checks and balances to curb deception....

  6. Cost Underestimation in Public Works Projects

    DEFF Research Database (Denmark)

    Flyvbjerg, Bent; Holm, Mette K. Skamris; Buhl, Søren L.

    This article presents results from the first statistically significant study of cost escalation in transportation infrastructure projects. Based on a sample of 258 transportation infrastructure projects worth $90 billion (U.S.), it is found with overwhelming statistical significance that the cost...... estimates used to decide whether important infrastructure should be built are highly and systematically misleading. The result is continuous cost escalation of billions of dollars. The sample used in the study is the largest of its kind, allowing for the first time statistically valid conclusions regarding...... questions of cost underestimation and escalation for different project types, different geographical regions, and different historical periods. Four kinds of explanation of cost underestimation are examined: technical, economic, psychological, and political. Underestimation cannot be explained by error...

  7. Underestimating Costs in Public Works Projects

    DEFF Research Database (Denmark)

    Flyvbjerg, Bent; Holm, Mette K. Skamris; Buhl, Søren L.

    2002-01-01

    This article presents results from the first statistically significant study of cost escalation in transportation infrastructure projects. Based on a sample of 258 transportation infrastructure projects worth $90 billion (U.S.), it is found with overwhelming statistical significance that the cost...... estimates used to decide whether important infrastructure should be built are highly and systematically misleading. The result is continuous cost escalation of billions of dollars. The sample used in the study is the largest of its kind, allowing for the first time statistically valid conclusions regarding...... questions of cost underestimation and escalation for different project types, different geographical regions, and different historical periods. Four kinds of explanation of cost underestimation are examined: technical, economic, psychological, and political. Underestimation cannot be explained by error...

  8. Immigrants' Access to Public Assistance: Missed Opportunities following Welfare Reform

    Science.gov (United States)

    Crosby, Danielle A.; Hatfield, Bridget E.

    2008-01-01

    The Personal Responsibility and Work Reconciliation Act of 1996 reformed public assistance programs and reduced the safety net of supports for low-income families. Children living in low-income immigrant families face particular challenges in the current policy environment. In this article, the authors consider what these changes have meant for…

  9. EpiAssist: Service-learning in public health education.

    Science.gov (United States)

    Horney, Jennifer A; Bamrara, Sanjana; Macik, Maria Lazo; Shehane, Melissa

    2016-01-01

    Although public health degree programs typically require practica and other field experiences, service-learning courses, with a focus on civic engagement and the application of classroom learning in real world settings, can go beyond these requirements and provide benefits to students and community-based practice partners. The goal of this paper is to assess potential benefits of service-learning programs for both graduate-level public health students and state and local public health agency partners. EpiAssist is a new service-learning program developed at the School of Public Health of the Texas A and M University Health Science Center, USA, in January 2015. EpiAssist was integrated into a new course, Methods in Field Epidemiology. The integration of service-learning was guided by a partnership with the Texas A and M Center for Teaching Excellence. State, regional, and local public health partners requested EpiAssist via email or telephone. A listserv was used to recruit student volunteers to meet requests. 54 of 86 registered EpiAssist students (63%) participated in at least one of ten service-learning and three training activities between January and June, 2015. Service-learning activities included questionnaire development, in-person and telephone data collection, and data analysis. Training topics for students included the Epi Info™ software, community assessment and communicable disease reporting. Students and partner organizations provided generally positive assessments of this service learning program through an online evaluation. Service-learning provides students with enhanced classroom learning through applied public health experience in state, regional and local health departments. These experiences provide both needed surge capacity to public health departments and valuable hands-on field experience to students.

  10. Cost overrun and auction format in public works

    NARCIS (Netherlands)

    A. Bucciol; O. Chillemi; G. Palazzi

    2011-01-01

    We provide an empirical investigation of cost overruns in small public procurement projects, using a panel dataset of auctions held in the Italian Veneto region between 2004 and 2006. We use this sample to study the effect on cost overruns of auction formats (average bid as opposed to first price ru

  11. COST STRUCTURE IN PUBLICLY TRADED COMPANIES IN THE FOOTWEAR SEGMENT

    Directory of Open Access Journals (Sweden)

    Itzhak David Simão Kavesk

    2014-12-01

    Full Text Available The administration costs of an organization composes part of its strategic policy and contribute to the identification of operational risks, that is why strategic cost management and knowledge of fixed and variable costs are critical. Therefore, the objective of this work is to identify the cost structure (fixed costs and variable costs of publicly traded companies in the footwear segment. The research is descriptive, conducted through document analysis and quantitative approach. The sample consists of the publicly traded companies in the footwear segment of the BM&FBovespa, recorded in the period 2009-2011. To perform the study we use the quarterly information disclosed by companies. The results show that the cost structure of companies in the footwear segment are similar, the contribution margin varies from 22 % to 30 % and the costs and expenses vary mostly. According to the evidence, we conclude that the publicly traded companies in the footwear segment have considerable flexibility in their strategies considering that reductions in demand are ccompanied by a reduction of its costs and expenses, favoring positive results even in adverse scenarios.

  12. 13 CFR 302.8 - Pre-approval Investment Assistance costs.

    Science.gov (United States)

    2010-01-01

    ..., DEPARTMENT OF COMMERCE GENERAL TERMS AND CONDITIONS FOR INVESTMENT ASSISTANCE § 302.8 Pre-approval Investment Assistance costs. Project activities carried out before approval of Investment Assistance shall be carried... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Pre-approval Investment...

  13. Public Choices, Private Costs: An Analysis of Spending and Achievement in Ohio Public Schools.

    Science.gov (United States)

    Damask, James; Lawson, Robert

    This report sets up a structure for examining the real costs of public education. It defines three approaches of gathering and reporting cost information: narrow (salaries and current expenditures, excluding capital outlays); generally accepted accounting principles (GAAP) (costs are recorded during the period in which they occur); and broad (all…

  14. 78 FR 52131 - Notice of Funds Availability: Agricultural Management Assistance Organic Certification Cost-Share...

    Science.gov (United States)

    2013-08-22

    ... Agricultural Marketing Service Notice of Funds Availability: Agricultural Management Assistance Organic Certification Cost-Share Program AGENCY: Agricultural Marketing Service, USDA. ACTION: Notice of Funds... Application (Application for Federal Assistance Standard Form 424) to the Agricultural Marketing Service...

  15. 20 CFR 416.1142 - If you live in a public assistance household.

    Science.gov (United States)

    2010-04-01

    ... a public assistance household. (a) Definition. A public assistance household is one in which every... mandatory supplements); (3) The Refugee Act of 1980 (Those payments based on need); (4) The Disaster...

  16. Certificateless Public Auditing with Privacy Preserving for Cloud-Assisted Wireless Body Area Networks

    Directory of Open Access Journals (Sweden)

    Baoyuan Kang

    2017-01-01

    Full Text Available With cloud computing being integrated with wireless body area networks, the digital ecosystem called cloud-assisted WBAN was proposed. In cloud-assisted medical systems, the integrity of the stored data is important. Recently, based on certificateless public key cryptography, He et al. proposed a certificateless public auditing scheme for cloud-assisted WBANs. But He et al.’s scheme is not a scheme with privacy preserving. After many checks on some of the same data blocks, the auditor can derive these data blocks. In this paper, we propose a certificateless public auditing scheme with privacy preserving for cloud-assisted WBANs. In the proof phase of the proposed scheme, the proof information is protected from being directly exposed to the auditor. So, the curious auditor could not derive the data blocks. We also prove that the proposed scheme is secure in the random oracle model under the assumption that the Diffie-Hellman problem is hard, and we give a comparison of the proposed scheme with He et al.’s scheme in terms of security and computation cost.

  17. 32 CFR 203.12 - Technical assistance for public participation provider qualifications.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 2 2010-07-01 2010-07-01 false Technical assistance for public participation... THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS TECHNICAL ASSISTANCE FOR PUBLIC PARTICIPATION (TAPP) IN DEFENSE ENVIRONMENTAL RESTORATION ACTIVITIES § 203.12 Technical assistance for public...

  18. 24 CFR 1000.320 - How is Formula Current Assisted Stock adjusted for local area costs?

    Science.gov (United States)

    2010-04-01

    ... § 1000.320 How is Formula Current Assisted Stock adjusted for local area costs? There are two adjustment... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false How is Formula Current Assisted Stock adjusted for local area costs? 1000.320 Section 1000.320 Housing and Urban Development...

  19. Surgeon and Hospital Level Variation in the Costs of Robot-Assisted Radical Prostatectomy.

    Science.gov (United States)

    Cole, Alexander P; Leow, Jeffrey J; Chang, Steven L; Chung, Benjamin I; Meyer, Christian P; Kibel, Adam S; Menon, Mani; Nguyen, Paul L; Choueiri, Toni K; Reznor, Gally; Lipsitz, Stuart R; Sammon, Jesse D; Sun, Maxine; Trinh, Quoc-Dien

    2016-10-01

    We assessed surgeon and hospital level variation in robot-assisted radical prostatectomy costs and predictors of high and low cost surgery. The study population consisted of a weighted sample of 291,015 men who underwent robot-assisted radical prostatectomy for prostate cancer by 667 surgeons at 197 U.S. hospitals from 2003 to 2013. We evaluated 90-day direct hospital costs (2014 USD) in the Premier Hospital Database. High costs per robot-assisted radical prostatectomy were those above the 90th percentile and low costs were those below the 10th percentile. Mean hospital cost per robot-assisted radical prostatectomy was $11,878 (95% CI $11,804-$11,952). Mean cost was $2,837 (95% CI $2,805-$2,869) in the low cost group vs $25,906 (95% CI $24,702-$25,490) in the high cost group. Nearly a third of the variation in robot-assisted radical prostatectomy cost was attributable to hospital characteristics and more than a fifth was attributable to surgeon characteristics (R-squared 30.43% and 21.25%, respectively). High volume surgeons and hospitals (90th percentile or greater) had decreased odds of high cost surgery (surgeons: OR 0.24, 95% CI 0.11-0.54; hospitals: OR 0.105, 95% CI 0.02-0.46). The performance of robot-assisted radical prostatectomy at a high volume hospital was associated with increased odds of low cost robot-assisted radical prostatectomy (OR 839, 95% CI 122-greater than 999). This study provides insight into the role of surgeons and hospitals in robot-assisted radical prostatectomy costs. Given the substantial variability, identifying and remedying the root cause of outlier costs may yield substantial benefits. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2013-12-01

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

  1. Payment schemes and cost efficiency: evidence from Swiss public hospitals.

    Science.gov (United States)

    Meyer, Stefan

    2015-03-01

    This paper aims at analysing the impact of prospective payment schemes on cost efficiency of acute care hospitals in Switzerland. We study a panel of 121 public hospitals subject to one of four payment schemes. While several hospitals are still reimbursed on a per diem basis for the treatment of patients, most face flat per-case rates-or mixed schemes, which combine both elements of reimbursement. Thus, unlike previous studies, we are able to simultaneously analyse and isolate the cost-efficiency effects of different payment schemes. By means of stochastic frontier analysis, we first estimate a hospital cost frontier. Using the two-stage approach proposed by Battese and Coelli (Empir Econ 20:325-332, 1995), we then analyse the impact of these payment schemes on the cost efficiency of hospitals. Controlling for hospital characteristics, local market conditions in the 26 Swiss states (cantons), and a time trend, we show that, compared to per diem, hospitals which are reimbursed by flat payment schemes perform better in terms of cost efficiency. Our results suggest that mixed schemes create incentives for cost containment as well, although to a lesser extent. In addition, our findings indicate that cost-efficient hospitals are primarily located in cantons with competitive markets, as measured by the Herfindahl-Hirschman index in inpatient care. Furthermore, our econometric model shows that we obtain biased estimates from frontier analysis if we do not account for heteroscedasticity in the inefficiency term.

  2. Costing dental restorations in public sector dental clinics.

    Science.gov (United States)

    Khairiyah, Abdul Muttalib; Razak, Ishak Abdul; Raja-Latifah, Raja Jalludin; Tan, Bee Siew; Norain, Abu Talib; Noor-Aliyah, Ismail; Natifah, Che Salleh; Rauzi, Ismail

    2009-04-01

    The objective of this study is to share cost analysis methodology and to obtain cost estimates for posterior restorations in public sector dental clinics. Two urban and 2 rural dental clinics in Selangor state were selected. Only cases of 1 posterior restoration per visit by dental officers were included over 6 months. One capsulated amalgam type, 1 capsulated tooth-colored, and 1 non-capsulated tooth-colored material were selected. A clinical pathway form was formulated to collect data per patient. Annual capital and recurrent expenditures were collected per clinic. The mean cost of an amalgam restoration was RM 30.96 (sdRM 7.86); and tooth-colored restorations ranged from RM 33.00 (sdRM 8.43) to RM 41.10 (sdRM 10.61). Wherein 1 USD = RM 2.8. Restoration costs were 35% to 55% higher in clinics in rural areas than in urban areas. The findings demonstrate economy of scale for clinic operation and restoration costs with higher patient load. Costs per restoration were higher in rural than in urban dental clinics. More studies are recommended to address the dearth of dental costs data in Malaysia.

  3. Activity-Based Costing in the Public Sector

    Directory of Open Access Journals (Sweden)

    Athanasios Vazakidis

    2010-01-01

    Full Text Available Problem statement: In the modern economic environment, the Public Sector aims at the continuous improvement of quality of the provided services. Thus, detailed information with regard to the cost of services is essential along with capable management to take advantage of this information. Approach: The study discussed the basic beginnings, the processes of activity-based costing and whether this costing method can be applied in the Public Sector, where the need for precise cost estimating information increases continuously. Results: It referred to the structure of a Greek Prefecture, with all the organized divisions and departments. At first, the new method of cost accounting is analyzed as mentioned in the international bibliography. Thereafter, the advantages of this method were pointed and then, follow the application in a specific Department of the prefecture where the results were delivered to the Administration of department under review, for the decision-making. Conclusion: Having analyzed the department of the prefecture, the management can depend on the results to comment on the study done and decide on future plans.

  4. Turtle hunting and tombstone opening. public generosity as costly signaling.

    Science.gov (United States)

    Smith; Bird

    2000-07-01

    Costly signaling theory (CST) offers an explanation of generosity and collective action that contrasts sharply with explanations based on conditional reciprocity. This makes it particularly relevant to situations involving widespread unconditional provisioning of collective goods. We provide a preliminary application of CST to ethnographic data on turtle hunting and public feasting among the Meriam of Torres Strait, Australia. Turtle hunting appears to meet the key conditions specified in CST: it is (1) an honest signal of underlying abilities such as strength, risk-taking, skill, and leadership; (2) costly in ways not subject to reciprocation; (3) an effective means of broadcasting signals, since the collective good (a feast) attracts a large audience; and (4) seems to provide benefits to signalers (turtle hunters) as well as recipients (audience). We conclude with some suggestions as to the broader implications of this research, and the costly signaling paradigm in general, for understanding collective action and generosity in human social groups.

  5. 77 FR 37390 - Notice Inviting Informal Public Comment on Training and Technical Assistance and Disability...

    Science.gov (United States)

    2012-06-21

    ... Disability Inclusion Programming AGENCY: Corporation for National and Community Service. ACTION: Notice Inviting Informal Public Comment on Training and Technical Assistance and Disability Inclusion Programming... Inviting Informal Comment on Training and Technical Assistance and Disability Inclusion Programming...

  6. Renewable Electricity Benefits Quantification Methodology: A Request for Technical Assistance from the California Public Utilities Commission

    Energy Technology Data Exchange (ETDEWEB)

    Mosey, G.; Vimmerstedt, L.

    2009-07-01

    The California Public Utilities Commission (CPUC) requested assistance in identifying methodological alternatives for quantifying the benefits of renewable electricity. The context is the CPUC's analysis of a 33% renewable portfolio standard (RPS) in California--one element of California's Climate Change Scoping Plan. The information would be used to support development of an analytic plan to augment the cost analysis of this RPS (which recently was completed). NREL has responded to this request by developing a high-level survey of renewable electricity effects, quantification alternatives, and considerations for selection of analytic methods. This report addresses economic effects and health and environmental effects, and provides an overview of related analytic tools. Economic effects include jobs, earnings, gross state product, and electricity rate and fuel price hedging. Health and environmental effects include air quality and related public-health effects, solid and hazardous wastes, and effects on water resources.

  7. Multicriteria Cost Assessment and Logistics Modeling for Military Humanitarian Assistance and Disaster Relief Aerial Delivery Operations

    Science.gov (United States)

    2015-03-01

    goal programming model , and we used Excel/ VBA to create an auto- matic, user-friendly interface with the decision maker for model input and analysis of...ARL-TR-7229•MAR 2015 US Army Research Laboratory Multicriteria Cost Assessment and Logistics Modeling for Military Humanitarian Assistance and...Cost Assessment and Logistics Modeling for Military Humanitarian Assistance and Disaster Relief Aerial Delivery Operations by Nathaniel Bastian

  8. 48 CFR 219.7104 - Developmental assistance costs eligible for reimbursement or credit.

    Science.gov (United States)

    2010-10-01

    ... BUSINESS PROGRAMS Pilot Mentor-Protege Program 219.7104 Developmental assistance costs eligible for reimbursement or credit. (a) Developmental assistance provided under an approved mentor-protege agreement is... debarred while performing under an approved mentor-protege agreement, the mentor firm may not be...

  9. Cost Behavior: Mapping and Systemic Analysis of International Publications

    Directory of Open Access Journals (Sweden)

    Fernando Richartz

    2014-12-01

    Full Text Available This article has as objective mapping of scientific researches into costs behavior to identify its current scenario. The research on database provided a selection of relevant bibliographic portfolio, which had as a result 29 articles according to the research criteria defined in the study. From those, the articles from Anderson, Banker e Janakiraman (2003 were highlighted. Furthermore, Banker is considered to be the main author about costs behavior, its importance is noticed not only in the portfolio itself, but also, in its references. The most important periodic, either for its impact, or related to its number of articles publicized, is The Accounting Review. Finally, from the relationship between the most important articles about bibliometric analysis, featuring systemic analysis, the conclusion is that an important article about cost behavior has a quantitative approach (with the use of robust regression, recognize the existence of Sticky Costs (no matter which approach is in use, makes use of a variety of explanations (internal & external and add some variable or information for scientific evolution of the subject.

  10. Terminal costs, improved life expectancy and future public health expenditure.

    Science.gov (United States)

    Bjørner, Thomas Bue; Arnberg, Søren

    2012-06-01

    This paper presents an empirical analysis of public health expenditure on individuals in Denmark. The analysis separates out the individual effects of age and proximity to death (reflecting terminal costs of dying) and employs unique micro data from the period 2000 to 2009, covering a random sample of 10% of the Danish population. Health expenditure includes treatment in hospitals, subsidies to prescribed medication and health care provided by general practitioners and specialists and covers about 80% of public health care expenditure on individuals. The results confirm findings from previous studies showing that proximity to death has a significant impact on health care expenditure. However, it is also found that cohort effects (the baby boom generation) as well as improvements in life expectancy have a substantial effect on future health care expenditure even when proximity to death is controlled for. These results are obtained by combining the empirical estimates with a long term population forecast. When life expectancy increases, terminal costs are postponed but the increases in health expenditure that follow from longer life expectancy are not as large as the increase in the number of elderly persons would suggest (due to "healthy ageing"). Based on the empirical estimates, healthy ageing is expected to reduce the impact of increased life expectancy on real health expenditure by 50% compared to a situation without healthy ageing.

  11. "The Effects of Medical Factors on Transfer Deficits in Public Assistance in Japan: A Quantile Regression Analysis"

    OpenAIRE

    2011-01-01

    In countries where local governments are heavily involved in financing health care for the indigent, regional disparities in local revenues may adversely affect the access of the poor to medical care. It is thus important to examine how central governments provide funds for such local medical needs. In Japan, local governments finance all medical costs for the poor through their Public Assistance (PA) programs. Using the unique mechanism of the Japanese system of central grants, I construct a...

  12. A Mathematical Model for Project Planning and Cost Analysis in Computer Assisted Instruction.

    Science.gov (United States)

    Fitzgerald, William F.

    Computer-assisted instruction (CAI) has become sufficiently widespread to require attention to the relationships between its costs, administration and benefits. Despite difficulties in instituting them, quantifiable cost-effectiveness analyses offer several advantages. They allow educators to specify with precision anticipated instructional loads,…

  13. 76 FR 31356 - Notice of Proposed Information Collection for Public Comment; Technical Assistance Experience...

    Science.gov (United States)

    2011-05-31

    ... URBAN DEVELOPMENT Notice of Proposed Information Collection for Public Comment; Technical Assistance... proposed: The Technical Assistance Experience, Expertise, and Awards Received Matrices will allow the... capacity of applicants applying for technical assistance funding under the FY2011 McKinney-Vento Technical...

  14. Orthotopic heart transplant versus left ventricular assist device: A national comparison of cost and survival

    Science.gov (United States)

    Mulloy, Daniel P.; Bhamidipati, Castigliano M.; Stone, Matthew L.; Ailawadi, Gorav; Kron, Irving L.; Kern, John A.

    2012-01-01

    Objectives Orthotopic heart transplantation is the standard of care for end-stage heart disease. Left ventricular assist device implantation offers an alternative treatment approach. Left ventricular assist device practice has changed dramatically since the 2008 Food and Drug Administration approval of the HeartMate II (Thoratec, Pleasanton, Calif), but at what societal cost? The present study examined the cost and efficacy of both treatments over time. Methods All patients who underwent either orthotopic heart transplantation (n = 9369) or placement of an implantable left ventricular assist device (n = 6414) from 2005 to 2009 in the Nationwide Inpatient Sample were selected. The trends in treatment use, mortality, and cost were analyzed. Results The incidence of orthotopic heart transplantation increased marginally within a 5-year period. In contrast, the annual left ventricular assist device implantation rates nearly tripled. In-hospital mortality from left ventricular assist device implantation decreased precipitously, from 42% to 17%. In-hospital mortality for orthotopic heart transplantation remained relatively stable (range, 3.8%–6.5%). The mean cost per patient increased for both orthotopic heart transplantation and left ventricular assist device placement (40% and 17%, respectively). With the observed increase in both device usage and cost per patient, the cumulative Left ventricular assist device cost increased 232% within 5 years (from $143 million to $479 million). By 2009, Medicare and Medicaid were the primary payers for nearly one half of all patients (orthotopic heart transplantation, 45%; left ventricular assist device, 51%). Conclusions Since Food and Drug Administration approval of the HeartMate II, mortality after left ventricular assist device implantation has decreased rapidly, yet has remained greater than that after orthotopic heart transplantation. The left ventricular assist device costs have continued to increase and have been

  15. Factors Engendering Cost Misrepresentation of Public Sector Projects in Ghana

    Directory of Open Access Journals (Sweden)

    Richard Ohene Asiedu

    2014-10-01

    Full Text Available The main purpose of this research was to identify the core factors that engender construction cost overruns in public buildings in Ghana. Adopting a positivist, realist and value free philosophical approach, the research employs a multiple research strategy emphasized by the funnel technique principle. Twenty two dominant factors generated from a combination of exploratory interviews and extensive literature in the context of GCI was designed into a structured questionnaire targeting 240 clients, consultants and contractors. With a 55% return rate, the response of the participants were analysed using a combination of severity, frequency and relative importance indices. The five most important factors according to all three participants are (1 delay and uncertainty surrounding payment for work done (2 lack of enforcement of contract provisions by parties (3 variations and additional works resulting from changes in site conditions (4 lapses and challenges within PPL (5 excessive material and labour price fluctuations. Even though the Spearman’s rank correlation test showed a strong agreement between clients and consultants, there was however a weak correlation between clients and contractors and consultants and contractors which is normal considering the allegations and counter-allegations regarding each other’s contribution towards cost overruns. However a fair degree of objectivity and validity can be credited to the results considering the average level of experience of the respondents in the GCI.

  16. 75 FR 33421 - Supplemental Nutrition Assistance Program: Quality Control Provisions of Title IV of Public Law...

    Science.gov (United States)

    2010-06-11

    ... Program: Quality Control Provisions of Title IV of Public Law 107-171; Final Rule #0;#0;Federal Register... Assistance Program: Quality Control Provisions of Title IV of Public Law 107-171 AGENCY: Food and Nutrition... ``Food Stamp Program: Non-Discretionary Quality Control Provisions of Title IV of Public Law...

  17. Assisted Housing - Public Housing Authorities - National Geospatial Data Asset (NGDA)

    Data.gov (United States)

    Department of Housing and Urban Development — Public Housing was established to provide decent and safe rental housing for eligible low-income families, the elderly, and persons with disabilities. Public housing...

  18. Assisted Housing - Public Housing Developments - National Geospatial Data Asset (NGDA)

    Data.gov (United States)

    Department of Housing and Urban Development — The general location of an entire Public Housing Development. A distinct address is chosen to represent the general location of an entire Public Housing Development,...

  19. 48 CFR 231.205-1 - Public relations and advertising costs.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Public relations and... PROCEDURES Contracts With Commercial Organizations 231.205-1 Public relations and advertising costs. (e) See... public relations and advertising costs also include monies paid to the Government associated with...

  20. Assessing the Costs of Adequacy in California Public Schools: A Cost Function Approach

    Science.gov (United States)

    Imazeki, Jennifer

    2008-01-01

    In this study, a cost function is used to estimate the costs for California districts to meet the achievement goals set out for them by the state. I calculate estimates of base costs (i.e., per pupil costs in a district with relatively low levels of student need) and marginal costs (i.e., the additional costs associated with specific student…

  1. NPL-PAD (National Priorities List Publication Assistance Database) for Region 7

    Data.gov (United States)

    U.S. Environmental Protection Agency — THIS DATA ASSET NO LONGER ACTIVE: This is metadata documentation for the National Priorities List (NPL) Publication Assistance Databsae (PAD), a Lotus Notes...

  2. East Valley Water District: Public Assistance Worksheets for Damage from 2010 Floods

    Science.gov (United States)

    East Valley Water District (EVWD) in San Bernardino, California had significant damage due to flooding in December 2010. There was a presidentially-declared disaster. EVWD applied to FEMA under the Public Assistance Grant Program.

  3. The Role of Patient Financial Assistance Programs in Reducing Costs for Cancer Patients.

    Science.gov (United States)

    Zullig, Leah L; Wolf, Steven; Vlastelica, Lisa; Shankaran, Veena; Zafar, S Yousuf

    2017-04-01

    Limited transparency exists regarding eligibility and benefits for patient financial assistance programs (PAPs). To describe oral anticancer medication costs, insurance coverage, and the degree of financial assistance provided by PAPs. This was a retrospective study of prescription anticancer medication costs and PAP coverage. The study used data from an academic cancer center's specialty pharmacy. Medication, cost, and coverage data were collected from the specialty pharmacy database for prescriptions filled from January 2013 to November 2015. Prescriptions with missing copayments, insurance, or financial assistance amounts were excluded. Descriptive statistics summarized prescription characteristics. Of 9,388 anticancer medication prescriptions filled, 8,212 (87%) had complete cost data and were included. The 5 most common medications prescribed were capecitabine (20%), temozolomide (13%), enzalutamide (10%), letrozole (6%), and tamoxifen (4%). Most prescriptions were covered by commercial insurance or Part D (41.6%, n = 3,418). The median copayment was $20 per prescription (interquartile range [IQR] = $10.00-$80.30). When considering all prescriptions that received PAP assistance, the median amount of financial assistance provided by PAPs per prescription was $411.0 (IQR = $302.80-$523.40), amounting to 15% of the median prescription cash price. When considering all prescriptions, the median amount of financial assistance provided by PAPs per prescription was $0, and the mean was $79.30 (SD = $389.90). A minority of prescriptions received financial assistance from PAPs. The proportion of financial assistance was small relative to the price billed to insurance. PAPs play a modest role in reducing anticancer prescription-related costs. Support of this project by The Duke Biostatistics Core was made possible by Grant Number UL1TR001117 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH), and

  4. 75 FR 54591 - Notice of Agricultural Management Assistance Organic Certification Cost-Share Program

    Science.gov (United States)

    2010-09-08

    ... Agricultural Marketing Service Notice of Agricultural Management Assistance Organic Certification Cost-Share Program AGENCY: Agricultural Marketing Service, USDA. ACTION: Notice of Funds Availability. Inviting... Organic Foods Production Act of 1990, as amended (7 U.S.C. 6501 et seq.). This program is in addition...

  5. 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 Program AGENCY: Agricultural Marketing Service, USDA. ACTION: Notice of Funds Availability: Inviting... Organic Regulations (7 CFR part 205), which were authorized under the Organic Foods Production Act of...

  6. The costs and consequences of assisted reproductive technology : an economic perspective

    NARCIS (Netherlands)

    Connolly, Mark P.; Hoorens, Stijn; Chambers, Georgina M.

    2010-01-01

    Despite the growing use of assisted reproductive technologies (ART) worldwide, there is only a limited understanding of the economics of ART to inform policy about effective, safe and equitable financing of ART treatment. A review was undertaken of key studies regarding the costs and consequences of

  7. COST-EFFECTIVENESS OF CONTINUOUS-FLOW LEFT VENTRICULAR ASSIST DEVICES

    NARCIS (Netherlands)

    Neyt, Mattias; Van den Bruel, Ann; Smit, Yolba; De Jonge, Nicolaas; Erasmus, Michiel; Van Dijk, Diederik; Vlayen, Joan

    Objectives: Mechanical circulatory support through left ventricular assist devices (LVADs) improves survival and quality of life for patients with end-stage heart failure who are ineligible for cardiac transplantation. Our aim was to calculate the cost-effectiveness of continuous-flow LVADs.

  8. The costs and consequences of assisted reproductive technology : an economic perspective

    NARCIS (Netherlands)

    Connolly, Mark P.; Hoorens, Stijn; Chambers, Georgina M.

    2010-01-01

    Despite the growing use of assisted reproductive technologies (ART) worldwide, there is only a limited understanding of the economics of ART to inform policy about effective, safe and equitable financing of ART treatment. A review was undertaken of key studies regarding the costs and consequences of

  9. Computer assisted design study of a low-cost pressure sensor

    NARCIS (Netherlands)

    Meuwissen, M.H.H.; Veninga, E.P.; Tijdink, M.W.W.J.; Meijerink, M.G.H.

    2005-01-01

    The application of numerical techniques for the design of a low cost pressure sensor is described. The numerical techniques assist in addressing issues related to the thermo-mechanical performance of the sensor. This comprises the selection of the materials and dimensions used for the sensor itself

  10. COST-EFFECTIVENESS OF CONTINUOUS-FLOW LEFT VENTRICULAR ASSIST DEVICES

    NARCIS (Netherlands)

    Neyt, Mattias; Van den Bruel, Ann; Smit, Yolba; De Jonge, Nicolaas; Erasmus, Michiel; Van Dijk, Diederik; Vlayen, Joan

    2013-01-01

    Objectives: Mechanical circulatory support through left ventricular assist devices (LVADs) improves survival and quality of life for patients with end-stage heart failure who are ineligible for cardiac transplantation. Our aim was to calculate the cost-effectiveness of continuous-flow LVADs. Methods

  11. Post-9/11 Veterans Educational Assistance Improvements Act of 2010 (Public Law 111-377)

    Science.gov (United States)

    US Congress, 2011

    2011-01-01

    The Post-9/11 Veterans Educational Assistance Improvements Act of 2010 (Public Law 111-377) was put in place to amend title 38, United States Code, to improve educational assistance for veterans who served in the Armed Forces after September 11, 2001, and for other purposes. The table of contents for this Act is as follows: (1) Sec. 1. Short…

  12. Costs of publicly provided maternity services in Rosario, Argentina

    Directory of Open Access Journals (Sweden)

    Borghi Josephine

    2003-01-01

    Full Text Available OBJECTIVE: This study estimates the costs of maternal health services in Rosario, Argentina. MATERIAL AND METHODS: The provider costs (US$ 1999 of antenatal care, a normal vaginal delivery and a caesarean section, were evaluated retrospectively in two municipal hospitals. The cost of an antenatal visit was evaluated in two health centres and the patient costs associated with the visit were evaluated in a hospital and a health centre. RESULTS: The average cost per hospital day is $114.62. The average cost of a caesarean section ($525.57 is five times greater than that of a normal vaginal delivery ($105.61. A normal delivery costs less at the general hospital and a c-section less at the maternity hospital. The average cost of an antenatal visit is $31.10. The provider cost is lower at the health centre than at the hospital. Personnel accounted for 72-94% of the total cost and drugs and medical supplies between 4-26%. On average, an antenatal visit costs women $4.70. Direct costs are minimal compared to indirect costs of travel and waiting time. CONCLUSIONS: These results suggest the potential for increasing the efficiency of resource use by promoting antenatal care visits at the primary level. Women could also benefit from reduced travel and waiting time. Similar benefits could accrue to the provider by encouraging normal delivery at general hospitals, and complicated deliveries at specialised maternity hospitals.

  13. Institutional Cost Comparison Between Heart Transplants and Left Ventricular Assist Device Implantations.

    Science.gov (United States)

    Chimanji, Neeraj; Kilic, Arman; Hasan, Ayesha; Higgins, Robert S D; Whitson, Bryan A; Kilic, Ahmet

    2016-12-01

    Increased numbers of end-stage heart failure patients and improved technology have led to increased use of left ventricular assist devices as a viable alternative to heart transplants. Given the current economic climate, we compared costs of heart transplant versus device placement. Medical records of patients who received heart transplants or left ventricular assist devices were cross-referenced with institutional financial data. The device cohort was limited to those receiving durable (not temporary) devices. Index admission, 1-year readmission, and overall 1-year charges were compared using standard statistical methods. Of 184 identified patients with end-stage heart failure surgical therapy, 121 received left ventricular assist devices, 43 had heart transplants, and 20 received left ventricular assist devices as bridge to heart transplant; these latter patients were excluded from our analyses. At index admission, mean charges were $863 433 ± $398 427 for device patients and $725 877 ± $488 685 for transplant patients (P = .05). One-year mean readmission rates were similar (4.65/transplant patient and 4.53/device patient; P = .94), with corresponding 1-year survival rates of 87.8% and 78.0% (P = .04). Total readmission charges during year 1 were $169 732 ± $242 366 for device patients and $201 682 ± $297 565 for transplant patients (P = .08), with corresponding overall charges at 1 year of $1 029 732 ± $450 498 and $927 559 ± $562 404 (P = .49). During the first year, heart transplant and left ventricular assist device placement have similar costs. Initial index admission costs seem to favor heart transplant, with device pump costs accounting for some of the difference. From a 1-year survival perspective, heart transplant may be more effective; however, with lack of suitable donors, left ventricular assist devices are valuable in the armamentarium of advanced heart failure surgical options.

  14. How NASA's Space Science Support Network Can Assist DPS Members in Their Public Engagement Efforts

    Science.gov (United States)

    Miner, E. D.; Lowes, L. L.

    2003-12-01

    In her Carl Sagan Medal lecture last year, Heidi Hammel talked of the dos and don'ts of education and public outreach efforts by DPS members. She pointed out a number of misconceptions about what does and does not constitute "good EPO" and encouraged members to consult with "the experts" if they would like to improve their EPO effectiveness and reach. She named the DPS Education and Public Outreach Officer, Larry Lebofsky, his Deputy, Lou Mayo, and the DPS Press Officer, Ellis Miner, who also co-directs NASA's Solar System Exploration EPO Forum with Leslie Lowes. NASA's Space Science Support Network has been in existence for about six years. It has been directed by DPS member Jeff Rosendhal and is now serving as a model for NASA's new Education Enterprise. Members of the Support Network are prepared to assist (and haves been assisting) space scientists throughout the US and abroad in deciding where to spend their EPO efforts most effectively. The service is provided free of cost and includes, among other services, the following: (1) helping to establish partnerships between educators and scientists, (2) helping to link scientists and professional EPO organizations, (3) helping to link scientists to national youth and community groups, (4) providing ready access to EPO electronic and hardcopy products, (5) providing advice and direction in the preparation of EPO proposals to NASA, (6) helping to maintain several national networks of EPO volunteers, (7) encouraging (at home institutions) the broadening of scientist EPO efforts, (8) maintaining self-help websites for scientists interested in EPO.

  15. Measuring Inflation in Public Libraries: A Comparison of Two Approaches, the Input Cost Index and the Cost of Services Index.

    Science.gov (United States)

    Chambers, Jay C.; Vergun, Robert

    1999-01-01

    Presents two approaches to measuring the inflation faced by public libraries: (1) an approach based on a fixed market basket of the prices of library inputs; and (2) an approach based on an econometric model of library services and costs that yields a costs of services index. Discusses uses of both models. (SLD)

  16. Tobacco litter costs and public policy: a framework and methodology for considering the use of fees to offset abatement costs

    OpenAIRE

    Schneider, John E.; Peterson, N. Andrew; Kiss, Noemi; Ebeid, Omar; Doyle, Alexis S

    2011-01-01

    Objectives Growing concern over the costs, environmental impact and safety of tobacco product litter (TPL) has prompted states and cities to undertake a variety of policy initiatives, of which litter abatement fees are part. The present work describes a framework and methodology for calculating TPL costs and abatement fees. Methods Abatement is associated with four categories of costs: (1) mechanical and manual abatement from streets, sidewalks and public places, (2) mechanical and manual aba...

  17. Tobacco litter costs and public policy: a framework and methodology for considering the use of fees to offset abatement costs.

    Science.gov (United States)

    Schneider, John E; Peterson, N Andrew; Kiss, Noemi; Ebeid, Omar; Doyle, Alexis S

    2011-05-01

    Growing concern over the costs, environmental impact and safety of tobacco product litter (TPL) has prompted states and cities to undertake a variety of policy initiatives, of which litter abatement fees are part. The present work describes a framework and methodology for calculating TPL costs and abatement fees. Abatement is associated with four categories of costs: (1) mechanical and manual abatement from streets, sidewalks and public places, (2) mechanical and manual abatement from storm water and sewer treatment systems, (3) the costs associated with harm to the ecosystem and harm to industries dependent on clean and healthy ecosystems, and (4) the costs associated with direct harm to human health. The experiences of the City of San Francisco's recently proposed tobacco litter abatement fee serve as a case study. City and municipal TPL costs are incurred through manual and mechanical clean-up of surfaces and catchment areas. According to some studies, public litter abatement costs to US cities range from US$3 million to US$16 million. TPL typically comprises between 22% and 36% of all visible litter, implying that total public TPL direct abatement costs range from about US$0.5 million to US$6 million for a city the size of San Francisco. The costs of mitigating the negative externalities of TPL in a city the size of San Francisco can be offset by implementing a fee of approximately US$0.20 per pack. Tobacco litter abatement costs to cities can be substantial, even when the costs of potential environmental pollution and tourism effects are excluded. One public policy option to address tobacco litter is levying of fees on cigarettes sold. The methodology described here for calculating TPL costs and abatement fees may be useful to state and local authorities who are considering adoption of this policy initiative.

  18. 48 CFR 31.205-1 - Public relations and advertising costs.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Public relations and... Organizations 31.205-1 Public relations and advertising costs. (a) Public relations means all functions and...; or (2) Maintaining or promoting reciprocal understanding and favorable relations with the public...

  19. Benefits and Costs of For-Profit Public Education

    Directory of Open Access Journals (Sweden)

    Alex Molnar

    2001-04-01

    Full Text Available As a policy initiative, for-profit operation of public schools has not lived up to the claims of its proponents. An examination of issues such as teaching methods, academic achievement, autonomy, local control, and the image and influence of for-profit public schools suggests that "for-profits" are unlikely to succeed in the long term in improving the overall quality of public education. They do, however, seem capable of harming public schools.

  20. PR for Pennies: Low-Cost Library Public Relations.

    Science.gov (United States)

    Baeckler, Virginia Van Wynen

    This manual is designed to demystify a number of public relations techniques for those who wish to start producing their own materials with a minimum of time and money. Chapters focus on public relations; the library stereotype; words, ideas, and pictures; offset printing; creative print distribution; exhibits and posters; public speaking; and the…

  1. Assisted Housing - Public Housing Buildings - National Geospatial Data Asset (NGDA)

    Data.gov (United States)

    Department of Housing and Urban Development — The approximate physical location of each individual Public Housing Building. If the building has more than one entrance or street address, the address of the...

  2. Are Costs of Robot-Assisted Surgery Warranted for Gynecological Procedures?

    Directory of Open Access Journals (Sweden)

    Peter van Dam

    2011-01-01

    Full Text Available The exponential use of robotic surgery is not the result of evidence-based benefits but mainly driven by the manufacturers, patients and enthusiastic surgeons. The present review of the literature shows that robot-assisted surgery is consistently more expensive than video-laparoscopy and in many cases open surgery. The average additional variable cost for gynecological procedures was about 1600 USD, rising to more than 3000 USD when the amortized cost of the robot itself was included. Generally most robotic and laparoscopic procedures have less short-term morbidity, blood loss, intensive care unit, and hospital stay than open surgery. Up to now no major consistent differences have been found between robot-assisted and classic video-assisted procedures for these factors. No comparative data are available on long-term morbidity and oncologic outcome after open, robotic, and laparoscopic gynecologic surgery. It seems that currently only for very complex surgical procedures, such as cardiac surgery, the costs of robotics can be competitive to open surgical procedures. In order to stay viable, robotic programs will need to pay for themselves on a per case basis and the costs of robotic surgery will have to be reduced.

  3. Public Involvement in Decisions to Avoid Costly Consequences Later

    Energy Technology Data Exchange (ETDEWEB)

    Treichel, Judy [Nevada Nuclear Waste Task Force, Las Vegas, NV (United States)

    2006-09-15

    There should be an agreement of goals in any project that could produce harm. Why are we developing this technology? Who benefits and who pays? What would a 'cleanup' entail? There must be consideration of alternatives with a focus on reducing harm rather than just meeting allowable limits or promising that they will be met in the future. When alternatives are weighed, the burden should be on the proponent of the activity to provide truthful information to the public and provide access and resources necessary for participation. There must be a formal, legal obligation or duty to consider science as well as non-scientific information. It should not be up to those harmed to prove the damage and force the responsible parties to make retribution. It should be the burden of the proponents to measure potential risks, and prove that the benefits to everyone outweigh the risks to everyone. The role of government in decision making should also be redefined. The considerations now seem to be limited to whether or not an action is 'legal' or if it is 'safe'. There should also be a determination that it is 'necessary'. That may seem to be a very difficult question but put simply, if there are alternatives then a thing is not 'necessary'. Governmental decision makers would say: 'We acknowledge that our world will never be free from risk. However, any risk that is unnecessary or not freely chosen is not acceptable'. There must be a move away from situations where prior, important decisions resulted in winners and losers; wealthy beneficiaries and underprivileged victims. There must be recognition that decision making needs to be inclusive, extensive and democratic and that the end products and final results are necessary and worthwhile before projects begin. They must be visible, accessible, and must reflect the cost of doing business which includes taking the time, finding the information and involving the people who

  4. 48 CFR 2131.205-1 - Public relations and advertising costs.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Public relations and... REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations 2131.205-1 Public relations and advertising costs. The provisions of FAR 31.205-1 shall be modified to include the...

  5. Computer-Assisted Management of Instruction in Veterinary Public Health

    Science.gov (United States)

    Holt, Elsbeth; And Others

    1975-01-01

    Reviews a course in Food Hygiene and Public Health at the University of Illinois College of Veterinary Medicine in which students are sequenced through a series of computer-based lessons or autotutorial slide-tape lessons, the computer also being used to route, test, and keep records. Since grades indicated mastery of the subject, the course will…

  6. 48 CFR 1631.205-70 - FEHBP public relations and advertising costs.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true FEHBP public relations and advertising costs. 1631.205-70 Section 1631.205-70 Federal Acquisition Regulations System OFFICE OF PERSONNEL... relations and advertising costs. (a) The cost of media messages that are directed at advising current FEHBP...

  7. Experiences related to the role of a cost centre manager in a public ...

    African Journals Online (AJOL)

    Experiences related to the role of a cost centre manager in a public hospital in Limpopo Province, ... Log in or Register to get access to full text downloads. ... The purpose of a cost centre is to control clinical and administrative costs, as well as ...

  8. Cost Accounting as a Possible Solution for Financial Sustainability of Croatian Public Hospitals

    Directory of Open Access Journals (Sweden)

    Ivana Dražić Lutilsky

    2016-12-01

    Full Text Available The purpose of this paper is to present the current usage of cost accounting methodology in Croatian public hospitals through conducted empirical research and to provide opinions of accountants and financial officers regarding possible implementation of cost accounting methodology in public hospitals. In the paper, the authors analyze the accounting system in Croatian public hospitals, identifying the flaws of the current accounting system with regard to the recording and allocation of costs. National healthcare systems of different European countries provide a theoretical background for the usage of accrual accounting basis and cost accounting methodologies, showing better governance and financial sustainability of public hospitals which have introduced cost accounting methodology. The conducted empirical research shows that accountants and financial officers believe that the healthcare system in Croatia is ready for a change in the current accounting system based on the modified accrual basis through the implementation of accrual accounting basis and full costing approach to cost allocation. Full costing approach is also known as activity-based accounting method for cost allocation. The authors also recommend some initial steps for implementation of the new cost accounting system in Croatian public hospitals.

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

    Science.gov (United States)

    Blank, Jos L T; van Hulst, Bart

    2015-01-01

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

  10. e-Government – Assisting Reformed Public Administration in Romania

    Directory of Open Access Journals (Sweden)

    Andreea GATMAN

    2011-06-01

    Full Text Available The adoption of web-based technologies in order to deliver government services has become a global trend in public administration. e-Government also means that governments have to act as a private entity and compete for best delivered services towards citizens due to the societal challenges and shifting relations. But such transformation has significant implications, such as answering in a collaborative, intelligent manner to the needs and demands of the citizens, to the different categories of users including the elderly, women, men, youngsters, or disadvantaged groups. The construction and management of the virtual space becomes an essential element of modern public administration. The assumption is that Governments become more efficient in an electronic “version”. In order to evaluate their e-Government projects governments’ need to point towards the value added that technology is bringing in terms of impact. To conduct such an evaluation one needs to include also the effort put forth in such projects - in terms of financial, human resources, and policy. All three dimensions are equally important and complementary.

  11. Magnitude of Construction Cost and Schedule Overruns in Public Work Projects

    OpenAIRE

    Pramen P. Shrestha; Burns, Leslie A.; Shields, David R.

    2013-01-01

    This study analyzed 363 Clark County Department of Public Works (CCDPW) projects to determine construction cost and schedule overruns in various types and sizes of the projects. The sample projects were constructed from 1991 to 2008, with a total construction cost of $1.85 billion, equivalent to 2012 cost. A one-factor ANOVA test was conducted to determine whether construction cost and schedule overruns significantly varied based on types and sizes of the projects. The study showed that lar...

  12. Estimated costs of advanced lung cancer care in a public reference hospital.

    Science.gov (United States)

    Knust, Renata Erthal; Portela, Margareth Crisóstomo; Pereira, Claudia Cristina de Aguiar; Fortes, Guilherme Bastos

    2017-08-17

    To estimate the direct medical costs of advanced non-small cell lung cancer care. We assessed a cohort of 277 patients treated in the Brazilian National Cancer Institute in 2011. The costs were estimated from the perspective of the hospital as a service provider of reference for the Brazilian Unified Health System. The materials and procedures used were identified and quantified, per patient, and we assigned to them monetary values, consolidated in phases of the assistance defined. The analyses had a descriptive character with costs in Real (R$). Overall, the cohort represented a cost of R$2,473,559.91, being 71.5% related to outpatient care and 28.5% to hospitalizations. In the outpatient care, costs with radiotherapy (34%) and chemotherapy (22%) predominated. The results pointed to lower costs in the initial phase of treatment (7.2%) and very high costs in the maintenance phase (61.6%). Finally, we identified statistically significant differences of average cost by age groups, education levels, physical performance, and histological type. This study provides a current, useful, and relevant picture of the costs of patients with non-small cell lung cancer treated in a public hospital of reference and it provides information on the magnitude of the problem of cancer in the context of public health. The results confirm the importance of radiation treatment and hospitalizations as the main components of the cost of treatment. Despite some losses of follow-up, we assess that, for approximately 80% of the patients included in the study, the estimates presented herein are satisfactory for the care of the disease, from the perspective of a service provider of reference of the Brazilian Unified Health System, as it provides elements for the management of the service, as well as for studies that result in more rational forms of resource allocation. Estimar os custos médicos diretos da assistência ao câncer de pulmão não pequenas células avançado. Foi avaliada uma

  13. Cost Sharing in Zambia's Public Universities: Prospects and Challenges

    Science.gov (United States)

    Masaiti, Gift; Shen, Hong

    2013-01-01

    This research paper explores the concept of "cost sharing" which became more prominent in Zambia education with the advent of democratic form of governance in 1991. As a way of responding to the ever diminishing tax revenues, government through the education policy of 1996, allowed higher education institutions including public…

  14. Strengthening Cost-Effectiveness Analysis for Public Health Policy.

    Science.gov (United States)

    Russell, Louise B; Sinha, Anushua

    2016-05-01

    Although the U.S. spends more on medical care than any country in the world, Americans live shorter lives than the citizens of other high-income countries. Many important opportunities to improve this record lie outside the health sector and involve improving the conditions in which Americans live and work: safe design and maintenance of roads, bridges, train tracks, and airports; control of environmental pollutants; occupational safety; healthy buildings; a safe and healthy food supply; safe manufacture of consumer products; a healthy social environment; and others. Faced with the overwhelming array of possibilities, U.S. decision makers need help identifying those that can contribute the most to health. Cost-effectiveness analysis is designed to serve that purpose, but has mainly been used to assess interventions within the health sector. This paper briefly reviews the objective of cost-effectiveness analysis and its methodologic evolution and discusses the issues that arise when it is used to evaluate interventions that fall outside the health sector under three headings: structuring the analysis, quantifying/measuring benefits and costs, and valuing benefits and costs.

  15. A Simple Exoskeleton That Assists Plantarflexion Can Reduce the Metabolic Cost of Human Walking

    Science.gov (United States)

    Malcolm, Philippe; Derave, Wim; Galle, Samuel; De Clercq, Dirk

    2013-01-01

    Background Even though walking can be sustained for great distances, considerable energy is required for plantarflexion around the instant of opposite leg heel contact. Different groups attempted to reduce metabolic cost with exoskeletons but none could achieve a reduction beyond the level of walking without exoskeleton, possibly because there is no consensus on the optimal actuation timing. The main research question of our study was whether it is possible to obtain a higher reduction in metabolic cost by tuning the actuation timing. Methodology/Principal Findings We measured metabolic cost by means of respiratory gas analysis. Test subjects walked with a simple pneumatic exoskeleton that assists plantarflexion with different actuation timings. We found that the exoskeleton can reduce metabolic cost by 0.18±0.06 W kg−1 or 6±2% (standard error of the mean) (p = 0.019) below the cost of walking without exoskeleton if actuation starts just before opposite leg heel contact. Conclusions/Significance The optimum timing that we found concurs with the prediction from a mathematical model of walking. While the present exoskeleton was not ambulant, measurements of joint kinetics reveal that the required power could be recycled from knee extension deceleration work that occurs naturally during walking. This demonstrates that it is theoretically possible to build future ambulant exoskeletons that reduce metabolic cost, without power supply restrictions. PMID:23418524

  16. A simple exoskeleton that assists plantarflexion can reduce the metabolic cost of human walking.

    Directory of Open Access Journals (Sweden)

    Philippe Malcolm

    Full Text Available BACKGROUND: Even though walking can be sustained for great distances, considerable energy is required for plantarflexion around the instant of opposite leg heel contact. Different groups attempted to reduce metabolic cost with exoskeletons but none could achieve a reduction beyond the level of walking without exoskeleton, possibly because there is no consensus on the optimal actuation timing. The main research question of our study was whether it is possible to obtain a higher reduction in metabolic cost by tuning the actuation timing. METHODOLOGY/PRINCIPAL FINDINGS: We measured metabolic cost by means of respiratory gas analysis. Test subjects walked with a simple pneumatic exoskeleton that assists plantarflexion with different actuation timings. We found that the exoskeleton can reduce metabolic cost by 0.18±0.06 W kg(-1 or 6±2% (standard error of the mean (p = 0.019 below the cost of walking without exoskeleton if actuation starts just before opposite leg heel contact. CONCLUSIONS/SIGNIFICANCE: The optimum timing that we found concurs with the prediction from a mathematical model of walking. While the present exoskeleton was not ambulant, measurements of joint kinetics reveal that the required power could be recycled from knee extension deceleration work that occurs naturally during walking. This demonstrates that it is theoretically possible to build future ambulant exoskeletons that reduce metabolic cost, without power supply restrictions.

  17. Process-Based Governance in Public Administrations Using Activity-Based Costing

    Science.gov (United States)

    Becker, Jörg; Bergener, Philipp; Räckers, Michael

    Decision- and policy-makers in public administrations currently lack on missing relevant information for sufficient governance. In Germany the introduction of New Public Management and double-entry accounting enable public administrations to get the opportunity to use cost-centered accounting mechanisms to establish new governance mechanisms. Process modelling in this case can be a useful instrument to help the public administrations decision- and policy-makers to structure their activities and capture relevant information. In combination with approaches like Activity-Based Costing, higher management level can be supported with a reasonable data base for fruitful and reasonable governance approaches. Therefore, the aim of this article is combining the public sector domain specific process modelling method PICTURE and concept of activity-based costing for supporting Public Administrations in process-based Governance.

  18. Economics of Sustainable Technologies : Private and Public Costs and Benefits

    NARCIS (Netherlands)

    Krozer, Yoram; Abraham, Martin

    2017-01-01

    This article is focused on the economics of sustainable technologies from the mainstream and heterodox perspectives. The aim is to present major concepts, methodologies, and debates for public use. The paper is focused on decision making aiming at the development and use of sustainable technologies.

  19. 45 CFR 1355.57 - Cost allocation.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Cost allocation. 1355.57 Section 1355.57 Public... MAINTENANCE PAYMENTS, ADOPTION ASSISTANCE, AND CHILD AND FAMILY SERVICES GENERAL § 1355.57 Cost allocation. (a... maintenance payments or adoption assistance payments may be made under the State plan. (b) Cost allocation...

  20. 45 CFR 95.519 - Cost disallowance.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Cost disallowance. 95.519 Section 95.519 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION GENERAL ADMINISTRATION-GRANT PROGRAMS (PUBLIC ASSISTANCE, MEDICAL ASSISTANCE AND STATE CHILDREN'S HEALTH INSURANCE PROGRAMS) Cost...

  1. USSD technology a low cost asset in complementing public health workers’ work processes

    CSIR Research Space (South Africa)

    Zhou, M

    2015-04-01

    Full Text Available Lowering costs and easy access to health information is important to public healthcare workers (PHWs) and patients who are both offline and online to improve equitable access to healthcare information. Harnessing mobile health (mHealth) improves...

  2. 28 CFR 55.13 - Language used for oral assistance and publicity.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Language used for oral assistance and publicity. 55.13 Section 55.13 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) IMPLEMENTATION OF.... Some languages, for example, Chinese, have several dialects. Where a jurisdiction is obligated...

  3. 76 FR 47231 - Redelegation of Authority to the Deputy Assistant Secretaries for Public and Indian Housing

    Science.gov (United States)

    2011-08-04

    ... URBAN DEVELOPMENT Redelegation of Authority to the Deputy Assistant Secretaries for Public and Indian... redelegation of authority. SUMMARY: Section 7(d) of the Department of Housing and Urban Development Act, as amended, authorizes the Secretary to delegate functions, powers, and duties as the Secretary deems...

  4. 32 CFR Appendix A to Part 203 - Technical Assistance for Public Participation Request Form

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 2 2010-07-01 2010-07-01 false Technical Assistance for Public Participation Request Form A Appendix A to Part 203 National Defense Department of Defense (Continued) OFFICE OF THE... DEFENSE ENVIRONMENTAL RESTORATION ACTIVITIES Pt. 203, App. A Appendix A to Part 203—Technical...

  5. A Computer-Assisted Instruction in Teaching Abstract Statistics to Public Affairs Undergraduates

    Science.gov (United States)

    Ozturk, Ali Osman

    2012-01-01

    This article attempts to demonstrate the applicability of a computer-assisted instruction supported with simulated data in teaching abstract statistical concepts to political science and public affairs students in an introductory research methods course. The software is called the Elaboration Model Computer Exercise (EMCE) in that it takes a great…

  6. 75 FR 5808 - Publication of Model Notice for Employers to Use Regarding Eligibility for Premium Assistance...

    Science.gov (United States)

    2010-02-04

    ... Insurance Program (CHIP). The Department of Labor (Department) is required to provide the model notice to... Benefits Security Administration Publication of Model Notice for Employers to Use Regarding Eligibility for Premium Assistance Under Medicaid or the Children's Health Insurance Program, Notice AGENCY:...

  7. Low-Income Parental Profiles of Coping, Resource Adequacy, and Public Assistance Receipt: Links to Parenting

    Science.gov (United States)

    Maupin, Angela N.; Brophy-Herb, Holly E.; Schiffman, Rachel F.; Bocknek, Erika L.

    2010-01-01

    Variation in perceptions of resources and in coping strategies among low-income parents likely influences parenting. The purposes of this study were to identify differences in parental profiles, as indicated by receipt of public assistance, perceptions of adequacy of resources, and coping strategies, and to examine these profiles relative to…

  8. 38 CFR 3.714 - Improved pension elections-public assistance beneficiaries.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Improved pension elections-public assistance beneficiaries. 3.714 Section 3.714 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS ADJUDICATION Pension, Compensation, and Dependency and Indemnity Compensation...

  9. Federal Assistance to Public Black Colleges and Universities: Robin Hood Unleashed or Collusion on the Potomac.

    Science.gov (United States)

    Jones, Lewis L.

    Issues concerning federal assistance to public black colleges and universities are addressed. Attention is directed to the question of whether federal subsidies, given the role of state controlling agencies, automatically benefit black colleges in a meaningful, lasting manner. A second question is whether federal aid to black institutions, in its…

  10. Estimated cost of universal public coverage of prescription drugs in Canada

    Science.gov (United States)

    Morgan, Steven G.; Law, Michael; Daw, Jamie R.; Abraham, Liza; Martin, Danielle

    2015-01-01

    Background: With the exception of Canada, all countries with universal health insurance systems provide universal coverage of prescription drugs. Progress toward universal public drug coverage in Canada has been slow, in part because of concerns about the potential costs. We sought to estimate the cost of implementing universal public coverage of prescription drugs in Canada. Methods: We used published data on prescribing patterns and costs by drug type, as well as source of funding (i.e., private drug plans, public drug plans and out-of-pocket expenses), in each province to estimate the cost of universal public coverage of prescription drugs from the perspectives of government, private payers and society as a whole. We estimated the cost of universal public drug coverage based on its anticipated effects on the volume of prescriptions filled, products selected and prices paid. We selected these parameters based on current policies and practices seen either in a Canadian province or in an international comparator. Results: Universal public drug coverage would reduce total spending on prescription drugs in Canada by $7.3 billion (worst-case scenario $4.2 billion, best-case scenario $9.4 billion). The private sector would save $8.2 billion (worst-case scenario $6.6 billion, best-case scenario $9.6 billion), whereas costs to government would increase by about $1.0 billion (worst-case scenario $5.4 billion net increase, best-case scenario $2.9 billion net savings). Most of the projected increase in government costs would arise from a small number of drug classes. Interpretation: The long-term barrier to the implementation of universal pharmacare owing to its perceived costs appears to be unjustified. Universal public drug coverage would likely yield substantial savings to the private sector with comparatively little increase in costs to government. PMID:25780047

  11. Public versus Private Incentives to Invest in Green Roofs: A Cost Benefit Analysis for Flanders.

    OpenAIRE

    Claus, Karla; Rousseau, Sandra

    2010-01-01

    By means of a cost benefit analysis, we compare public and private incentives to invest in extensive green roofs in urban areas. From the comparison of these public and private incentives we find that subsidies for green roofs are socially desirable and that subsidies are actually needed to convince potential private investors to construct green roofs. Specifically, we estimate the costs and benefits associated with an investment project in Groot-Bijgaarden (Belgium) where a real estate inves...

  12. Magnitude of Construction Cost and Schedule Overruns in Public Work Projects

    Directory of Open Access Journals (Sweden)

    Pramen P. Shrestha

    2013-01-01

    Full Text Available This study analyzed 363 Clark County Department of Public Works (CCDPW projects to determine construction cost and schedule overruns in various types and sizes of the projects. The sample projects were constructed from 1991 to 2008, with a total construction cost of $1.85 billion, equivalent to 2012 cost. A one-factor ANOVA test was conducted to determine whether construction cost and schedule overruns significantly varied based on types and sizes of the projects. The study showed that large, long-duration projects had significantly higher cost and schedule overruns than smaller, short-duration projects.

  13. Assessment of Costs for a Global Climate Fund Against Public Sector Disaster Risks

    Science.gov (United States)

    Hochrainer-Stigler, Stefan; Mechler, Reinhard; Pflug, Georg; Williges, Keith

    2013-04-01

    National governments are key actors in managing climate variability and change, yet, many countries, faced with exhausted tax bases, high levels of indebtedness and limited donor assistance, have been unable to raise sufficient and timely capital to replace or repair damaged assets and restore livelihoods following major disasters exacerbating the impacts of disaster shocks on poverty and development. For weather extremes, which form a subset of the adaptation challenge and are supposed to increase in intensity and frequency with a changing climate, we conduct an assessment of the costs of managing and financing today's public sector risks on a global scale for more than 180 countries. A countries financial vulnerability is defined as a function of its financial resilience and its exposure to disaster risk. While disaster risk is estimated in terms of asset loss distributions based on catastrophe modeling approaches, financial resilience is operationalized as the public sector's ability to pay for relief to the affected population and support the reconstruction of affected assets and infrastructure for a given event. We consider governments financially vulnerable to disasters if they cannot access sufficient funding after a disaster to cover their liabilities. We operationalize this concept by the term resource gap, which we define the net loss associated with a disaster event after exhausting all possible ex-post and ex ante financing sources. Extending this approach for all possible disaster events, the risk that a resource gap will occur over a given time-span can be calculated for each country individually and dependent on the risk level different risk instruments may have to be applied. Furthermore, our estimates may inform decisions pertaining to a "climate insurance fund" absorbing "high level" country risks exceeding the ability of any given country to pay in the case of an extreme event. Our estimates relate to today's climate, yet we suggest that

  14. Low-cost assistive device for hand gesture recognition using sEMG

    Science.gov (United States)

    Kainz, Ondrej; Cymbalák, Dávid; Kardoš, Slavomír.; Fecil'ak, Peter; Jakab, František

    2016-07-01

    In this paper a low-cost solution for surface EMG (sEMG) signal retrieval is presented. The principal goal is to enable reading the temporal parameters of muscles activity by a computer device, with its further processing. Paper integrates design and deployment of surface electrodes and amplifier following the prior researches. Bearing in mind the goal of creating low-cost solution, the Arduino micro-controller was utilized for analog-to-digital conversion and communication. The software part of the system employs support vector machine (SVM) to classify the EMG signal, as acquired from sensors. Accuracy of the proposed solution achieves over 90 percent for six hand movements. Proposed solution is to be tested as an assistive device for several cases, involving people with motor disabilities and amputees.

  15. U.S. pharmacy policy: a public health perspective on safety and cost.

    Science.gov (United States)

    Rosenau, Pauline Vaillancourt; Lal, Lincy S; Glasser, Jay H

    2009-01-01

    A public health perspective based on social justice and a population health point of view emphasizes pharmacy policy innovations regarding safety and costs. Such policies that effectively reduce costs include controlling profits, establishing profit targets, extending prescription providers, revising prescription classification schemes, emphasizing generic medications, and establishing formularies. Public education and universal programs may reduce costs, but co-pays and "cost-sharing" do not. Switching medications to over-the-counter (OTC) status, pill splitting, and importing medication from abroad are poor substitutes for authentic public health pharmacy policy. Where policy changes yield savings, public health insists that these savings should be used to increase access and improve population health. In the future, pharmacy policies may emphasize public health accountability more than individual liberty because of potential cost savings to society. Fear of litigation, as an informal mechanism of focusing manufacturer's attention on safety, is inefficient; public health pharmacy policy regarding safety looks toward a more active regulatory role on the part of government. A case study of direct-to-consumer advertising illustrates the complexity of public health pharmacy policy.

  16. 77 FR 53903 - Notice of Proposed Information Collection for Public Comment: OneCPD Technical Assistance and...

    Science.gov (United States)

    2012-09-04

    ... INFORMATION CONTACT: Julie Hovden, Director, Technical Assistance Division, Office of Technical Assistance and... responses. This Notice also lists the following information: Title of Proposal: OneCPD Technical Assistance... URBAN DEVELOPMENT Notice of Proposed Information Collection for Public Comment: OneCPD Technical...

  17. Assisted dying: the influence of public opinion in an increasingly diverse society.

    Science.gov (United States)

    Badcott, David

    2010-11-01

    Attitudes to questions of whether physician-assisted dying should be legalised in the UK, reflect one of the greatest challenges to moral stance in health care for both individuals and professional bodies, not least as indicated by public opinion. However, public opinion is a seductively deceptive notion, seemingly readily identifiable but in practice multifarious. At best, consensus regarding public opinion and assisted dying is illusory, sometimes transient and what is relevant in this matter is a comprehension of both majority (popular) opinion and vocal dissent, but which do not them selves have a simple relationship with Parliamentary attitudes and legislation. Arguably, an increasingly important consideration to take account of is the influence of increasing population diversity.

  18. Health resource utilization and costs during the first 90 days following robot-assisted hysterectomy.

    Science.gov (United States)

    Dandolu, Vani; Pathak, Prathamesh

    2017-08-07

    To compare health resource utilization, costs and readmission rates between robot-assisted and non-robot-assisted hysterectomy during the 90 days following surgery. The study used 2008-2012 Truven Health MarketScan data. All patients admitted as inpatients with a CPT code for hysterectomy between January 2008 and September 2012 were identified and the first hysterectomy-related admission in each patient was included. Patients were categorized based on the route of their hysterectomy and the use of laparoscopy as: total abdominal hysterectomy, vaginal hysterectomy (VH), laparoscopy-assisted supracervical hysterectomy, laparoscopy-assisted vaginal hysterectomy' and total laparoscopic hysterectomy (TLH). Hospitalization costs, including hospital, physician, pharmacy and facility costs, were calculated for the index admissions and for the 90-day follow-up periods. Health resource utilization was determined in terms of inpatient readmissions, outpatient visits, and emergency room visits, RESULTS: There were 302,923 hysterectomies performed over 5 years for benign indications in the inpatient setting (55% abdominal, 17% vaginal, and 28% laparoscopic). Concurrent use of robot assistance steadily increased and was reported in 50% of TLH procedures in 2012. The rates of readmission overall were 4.9% for robot-assisted procedures and 4.3% for procedures without robot assistance (OR 0.89, CI 0.82-0.97). Readmission rates were lowest for VH (3.2%) and highest for TLH (5.6%). Following robot-assisted hysterectomy and VH, 8.3% and 4.6% of patients, respectively, had more than ten outpatient visits in the 90-day follow-up period. The average total cost for 90 days was $16,820 for robot-assisted hysterectomy and $13,031 for procedures without robot assistance. Of the additional costs for robot-assisted surgery, 25% were incurred in the 90-day follow-up period. The study using private insurance data found that robot-assisted hysterectomy was associated with higher health

  19. Performance management and cost effectiveness of public services : empirical evidence from Dutch municipalities

    NARCIS (Netherlands)

    Groot, de H.; Hulst, van B.L.

    2011-01-01

    The performance of public organizations is one of the key topics in public administration research. Cost-effectiveness as a dimension of performance has hardly been studied in this literature, however. Many governments currently are cutting budgets on an unprecedented scale after the world-wide fina

  20. A Cost Assessment of the Dayton Public Schools Vehicle Routing Problem

    Science.gov (United States)

    2009-03-01

    A COST ASSESMENT OF THE DAYTON PUBLIC SCHOOLS VEHICLE ROUTING PROBLEM THESIS...PUBLIC SCHOOLS VEHICLE ROUTING PROBLEM THESIS Presented to the Faculty Department of Operational Sciences Graduate School of... VEHICLE ROUTING PROBLEM Frankie L. Woods Jr., BS Captain, USAF Approved: ____________________________________ Dr

  1. The influence of proprietary disclosure costs on the decision to go public

    NARCIS (Netherlands)

    Marra, T.A.

    2001-01-01

    This thesis studies the influence of proprietary disclosure costs related to informing product market competitors on management communication with investors. In doing so it focuses on the firm's decision to go public. A firm that goes public not only experiences a change in its financial and governa

  2. Targeting the probability versus cost of feared outcomes in public speaking anxiety.

    Science.gov (United States)

    Nelson, Elizabeth A; Deacon, Brett J; Lickel, James J; Sy, Jennifer T

    2010-04-01

    Cognitive-behavioral theory suggests that social phobia is maintained, in part, by overestimates of the probability and cost of negative social events. Indeed, empirically supported cognitive-behavioral treatments directly target these cognitive biases through the use of in vivo exposure or behavioral experiments. While cognitive-behavioral theories and treatment protocols emphasize the importance of targeting probability and cost biases in the reduction of social anxiety, few studies have examined specific techniques for reducing probability and cost bias, and thus the relative efficacy of exposure to the probability versus cost of negative social events is unknown. In the present study, 37 undergraduates with high public speaking anxiety were randomly assigned to a single-session intervention designed to reduce either the perceived probability or the perceived cost of negative outcomes associated with public speaking. Compared to participants in the probability treatment condition, those in the cost treatment condition demonstrated significantly greater improvement on measures of public speaking anxiety and cost estimates for negative social events. The superior efficacy of the cost treatment condition was mediated by greater treatment-related changes in social cost estimates. The clinical implications of these findings are discussed.

  3. 41 CFR 102-75.1020 - Are public bodies ever required to pay the disposal costs associated with donated property?

    Science.gov (United States)

    2010-07-01

    ... required to pay the disposal costs associated with donated property? 102-75.1020 Section 102-75.1020 Public... Bodies Disposal Costs § 102-75.1020 Are public bodies ever required to pay the disposal costs associated... property must pay the disposal costs associated with the donation, such as dismantling, removal, and the...

  4. 75 FR 55341 - Recovery Policy, RP 9523.6, Mutual Aid Agreements for Public Assistance and Fire Management...

    Science.gov (United States)

    2010-09-10

    ... SECURITY Federal Emergency Management Agency Recovery Policy, RP 9523.6, Mutual Aid Agreements for Public... comments on Recovery Policy, RP 9523.6, Mutual Aid Agreements for Public Assistance and Fire Management Assistance. This is an existing policy that is scheduled for review to ensure that Recovery...

  5. The impact of antipsychotic polytherapy costs in the public health care in Sao Paulo, Brazil.

    Directory of Open Access Journals (Sweden)

    Denise Razzouk

    Full Text Available Guidelines for the treatment of psychoses recommend antipsychotic monotherapy. However, the rate of antipsychotic polytherapy has increased over the last decade, reaching up to 60% in some settings. Studies evaluating the costs and impact of antipsychotic polytherapy in the health system are scarce.To estimate the costs of antipsychotic polytherapy and its impact on public health costs in a sample of subjects with psychotic disorders living in residential facilities in the city of Sao Paulo, Brazil.A cross-sectional study that used a bottom-up approach for collecting costs data in a public health provider's perspective. Subjects with psychosis living in 20 fully-staffed residential facilities in the city of Sao Paulo were assessed for clinical and psychosocial profile, severity of symptoms, quality of life, use of health services and pharmacological treatment. The impact of polytherapy on total direct costs was evaluated.147 subjects were included, 134 used antipsychotics regularly and 38% were in use of antipsychotic polytherapy. There were no significant differences in clinical and psychosocial characteristics between polytherapy and monotherapy groups. Four variables explained 30% of direct costs: the number of antipsychotics, location of the residential facility, time living in the facility and use of olanzapine. The costs of antipsychotics corresponded to 94.4% of the total psychotropic costs and to 49.5% of all health services use when excluding accommodation costs. Olanzapine costs corresponded to 51% of all psychotropic costs.Antipsychotic polytherapy is a huge economic burden to public health service, despite the lack of evidence supporting this practice. Great variations on antipsychotic costs explicit the need of establishing protocols for rational antipsychotic prescriptions and consequently optimising resource allocation. Cost-effectiveness studies are necessary to estimate the best value for money among antipsychotics, especially

  6. 75 FR 68669 - Loan Guaranty: Assistance to Eligible Individuals in Acquiring Specially Adapted Housing; Cost-of...

    Science.gov (United States)

    2010-11-08

    .... DATES: Effective Date: October 1, 2010. FOR FURTHER INFORMATION CONTACT: William White, Acting Assistant... annually based on a residential home cost-of-construction index. The Secretary uses the Turner Building Cost Index for this purpose. During the most recent calendar year for which the Turner Building...

  7. Cost-Benefit Analysis for Energy Management in Public Buildings: Four Italian Case Studies

    Directory of Open Access Journals (Sweden)

    Davide Astiaso Garcia

    2016-07-01

    Full Text Available Improving energy efficiency in public buildings is one of the main challenges for a sustainable requalification of energy issues and a consequent reduction of greenhouse gas (GHG emissions. This paper aims to provide preliminary information about economic costs and energy consumption reductions (benefits of some considered interventions in existing public buildings. Methods include an analysis of some feasible interventions in four selected public buildings. Energy efficiency improvements have been assessed for each feasible intervention. The difference of the building global energy performance index (EPgl has been assessed before and after each intervention. Economic costs of each intervention have been estimated by averaging the amount demanded by different companies for the same intervention. Results obtained show economic costs and the EPgl percentage improvement for each intervention, highlighting and allowing for the comparison of energy consumption reduction and relative economic costs. The research results come from data gathered from four public buildings, and as such they could not be used to generically identify cost-beneficial energy efficiency interventions for every context or building type. However, the data reveals useful cost based considerations for selecting energy efficiency interventions in other public buildings.

  8. 76 FR 39474 - Monthly Median Cost of Funds Reporting, and Publication of Cost of Funds Indices

    Science.gov (United States)

    2011-07-06

    ... Mae) and to the Federal Home Loan Mortgage Corporation (FHLMC or Freddie Mac) that use these indices... determine, after notice and opportunity for comment, that (A) the new indices are based upon data... values and changes of 17 publicly available indices on a monthly basis from January 1990 through...

  9. The cost effectiveness of vacuum-assisted versus core-needle versus surgical biopsy of breast lesions.

    Science.gov (United States)

    Fernández-García, P; Marco-Doménech, S F; Lizán-Tudela, L; Ibáñez-Gual, M V; Navarro-Ballester, A; Casanovas-Feliu, E

    To determine the cost effectiveness of breast biopsy by 9G vacuum-assisted guided by vertical stereotaxy or ultrasonography in comparison with breast biopsy by 14G core-needle biopsy and surgical biopsy. We analyzed a total of 997 biopsies (181 vacuum-assisted, 626 core, and 190 surgical biopsies). We calculated the total costs (indirect and direct) of the three types of biopsy. We did not calculate intangible costs. We measured the percentage of correct diagnoses obtained with each technique. To identify the most cost-effective option, we calculated the mean ratios for the three types of biopsies. Total costs were €225.09 for core biopsy, €638.90 for vacuum-assisted biopsy, and €1780.01 for surgical biopsy. The overall percentage of correct diagnoses was 91.81% for core biopsy, 94.03% for vacuum-assisted biopsy, and 100% for surgical biopsy; however, these differences did not reach statistical significance (p=0.3485). For microcalcifications, the percentage of correct diagnoses was 50% for core biopsy and 96.77% for vacuum-assisted biopsy (p<0.0001). For nodules, there were no significant differences among techniques. The mean cost-effectiveness ratio considering all lesions was 2.45 for core biopsy, 6.79 for vacuum-assisted biopsy, and 17.80 for surgical biopsy. Core biopsy was the dominant option for the diagnosis of suspicious breast lesions in general. However, in cases with microcalcifications, the low percentage of correct diagnoses achieved by core biopsy (50%) advises against its use in this context, where vacuum-assisted biopsy would be the technique of choice because it is more cost-effective than surgical biopsy, the other technique indicated for biopsying microcalcifications. Copyright © 2016 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. Low cost assistive technology to support educational activities for adolescents with cerebral palsy.

    Science.gov (United States)

    da Silva, Alan Patricio; Bulle Oliveira, Acary Souza; Pinheiro Bezerra, Italla Maria; Pedrozo Campos Antunes, Thaiany; Guerrero Daboin, Blanca Elena; Raimundo, Rodrigo Daminello; Dos Santos, Vagner Rogério; de Abreu, Luiz Carlos

    2017-08-30

    The concept of assistive technology covers several areas of action; one of them is communication with the elaboration of accessible solutions to overcome daily difficulties. It contributes to the resumption of functional abilities, expanding and facilitating inclusion and independent living. To analyze the usability of a low cost prototype device to support educational activities of adolescents with cerebral palsy. A descriptive observational study. The evaluation of a prototype device was made through a validated questionnaire, Quest Version 2.0, on the level of the user's satisfaction with an assistive technology, composed of 12 evaluation items. The questionnaire was filled out by the educator based on the observation of four wheelchair-bound participants diagnosed with cerebral palsy according to the international classification of diseases and health-related problems, ICD-10, who attend a coexistence and teaching institution in the state of São Paulo, Brazil. The device developed was considered an assistive technology, which provided an experience with a positive level of satisfaction for the participants. The tested prototype contributes to communication and interaction allowing adolescents with cerebral palsy to participate in educational activities. Implications for Rehabilitation The device assists the individual in the educational activities and can positively influence their development, observe the individual number 5, who has an important limitation in coordination and fine movements, placing the role of the task in the vertical position offers a new perspective to perform the task, this stimulates him to try to perform the work, so the challenge was adjusted to the demands of each individual which can contribute to its neuromotor development, the amplitude of the distal movements and the manual ability, since it must look for alternatives to complete the task requested.

  11. Cost analysis of periodontitis management in public sector specialist dental clinics.

    Science.gov (United States)

    Mohd-Dom, Tuti; Ayob, Rasidah; Mohd-Nur, Amrizal; Abdul-Manaf, Mohd R; Ishak, Noorlin; Abdul-Muttalib, Khairiyah; Aljunid, Syed M; Ahmad-Yaziz, Yuhaniz; Abdul-Aziz, Hanizah; Kasan, Noordin; Mohd-Asari, Ahmad S

    2014-05-20

    The objective of this paper is to quantify the cost of periodontitis management at public sector specialist periodontal clinic settings and analyse the distribution of cost components. Five specialist periodontal clinics in the Ministry of Health represented the public sector in providing clinical and cost data for this study. Newly-diagnosed periodontitis patients (N = 165) were recruited and followed up for one year of specialist periodontal care. Direct and indirect costs from the societal viewpoint were included in the cost analysis. They were measured in 2012 Ringgit Malaysia (MYR) and estimated from the societal perspective using activity-based and step-down costing methods, and substantiated by clinical pathways. Cost of dental equipment, consumables and labour (average treatment time) for each procedure was measured using activity-based costing method. Meanwhile, unit cost calculations for clinic administration, utilities and maintenance used step-down approach. Patient expenditures and absence from work were recorded via diary entries. The conversion from MYR to Euro was based on the 2012 rate (1€ = MYR4). A total of 2900 procedures were provided, with an average cost of MYR 2820 (€705) per patient for the study year, and MYR 376 (€94) per outpatient visit. Out of this, 90% was contributed by provider cost and 10% by patient cost; 94% for direct cost and 4% for lost productivity. Treatment of aggressive periodontitis was significantly higher than for chronic periodontitis (t-test, P = 0.003). Higher costs were expended as disease severity increased (ANOVA, P = 0.022) and for patients requiring surgeries (ANOVA, P economic burden of periodontitis management and performing economic evaluation of the specialist periodontal programme.

  12. [Pharmaceutical procurement by the public sector: the quality/cost relationship].

    Science.gov (United States)

    Luiza, V L; Castro, C G; Nunes, J M

    1999-01-01

    The authors discuss procurement and provision of pharmaceutical products from the perspective of supply management in the public health sector, focusing on two main aspects: quality and cost. The article analyzes issues to be considered by buyers when evaluating drug quality, especially formulation stability, bioequivalence, and the role of generics. Also discussed are factors involving costs and cost management in relation to technological innovations and consumer demands. New alternatives and suggestions are examined and presented for procurement of high-quality, cost-effective drug products.

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

    Directory of Open Access Journals (Sweden)

    Bert D. Stoneberg

    2015-07-01

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

  14. Assisted vaginal deliveries in mothers admitted as public or private patients in Western Australia.

    Directory of Open Access Journals (Sweden)

    Kristjana Einarsdóttir

    Full Text Available BACKGROUND: Mothers delivering as private patients in Australia have a high rate of assisted deliveries, which could lead to adverse infant outcomes in this group of patients. We investigated whether the risk of adverse infant outcomes after assisted deliveries was different for mothers admitted as public or private patients for delivery, when compared with unassisted deliveries. METHODS AND FINDINGS: We included 158,241 vaginal, singleton, term birth admissions in our study where the infant was live born and without birth defects. The study population was identified from statutory birth and hospital data collections held by the Western Australian (WA Department of Health. We estimated odds ratios and confidence intervals using logistic regression models adjusted for a range of maternal demographic, pregnancy and birth characteristics. Interaction was assessed by including interaction terms in the models. Outcomes included low Apgar scores at five minutes (< 7, neonatal resuscitation and special care admission. Mothers delivering as private patients had an increased risk of assisted vaginal delivery compared with public patients (adjusted OR 1.74, 95% CI  =  1.68-1.80. Compared with unassisted vaginal deliveries, assisted deliveries were associated with increased risk of Apgar scores at five minutes below 7 (OR 1.25, 1.08-1.45, neonatal resuscitation (OR  =  1.69, 1.42-2.00 and admission to special care nursery (OR  =  1.64, 1.53-1.76. The increased risk of neonatal resuscitation was higher for mothers admitted as private patients for delivery (OR  =  2.13 than public patients (OR  = 1 .55, p(interaction  =  0.03. CONCLUSIONS: Our results suggested that the high risk of neonatal resuscitation following assisted vaginal deliveries compared to unassisted is higher in private patients than public patients. Whether this phenomenon is due to the twofold higher rate of assisted vaginal deliveries in this group of patients or a

  15. Trends in childhood vaccine purchase costs in the US public sector: 1996-2014.

    Science.gov (United States)

    Chen, Weiwei; Messonnier, Mark; Zhou, Fangjun

    2016-09-07

    While vaccination remains as one of the most cost-effective preventive strategies, the cost of fully immunizing a child has grown considerably over the last few decades. This study examines trends in non-influenza childhood vaccine purchase costs in the public sector from 1996 to 2014. Non-influenza vaccine purchase cost per child for children aged 0 through 18years was calculated based on public-sector purchase prices. Purchase cost changes were then decomposed into changes attributable to recommendation updates and changes attributable to price variation. The study analyzed the growth rate of combination vaccine prices separately and compared these prices with the sum of prices of component vaccines. It is found that the average annual growth rate of non-influenza vaccine purchase cost per child during 1996-2014 was 12.6%. The growth rate attributable to price changes was 1.0% on average. Combination vaccine prices showed greater variation. The study concludes that vaccine price variation was one but a minor reason for purchase cost changes. Recommendation updates, particularly the introduction of new vaccines, played a much larger role in raising the purchase costs. If the 12.6% annual growth rate found during 1996-2014 in the study continues to apply, the purchase costs of childhood vaccines may more than double by 2020.

  16. Motivating Citizens to Participate in Public Policymaking: Identification, Trust and Cost-Benefit Analyses

    Directory of Open Access Journals (Sweden)

    Matteo Antonini

    2015-10-01

    Full Text Available Under what conditions do citizens of nations and states comply with governmental requests to participate in public policymaking? Drawing on the dual pathway model of collective action (Stürmer & Simon, 2004 but with a focus on compliance with the status quo, rather than participation in collective protest, two studies examined citizens’ motivation to participate in public policymaking. Study 1 (N = 169 was an MTurk hosted survey that recruited participants from California, while Study 2 (N = 198 was a field experiment that recruited participants in Sardinia, Italy. Study 1 measured cost-benefit analyses, societal identification, and willingness to participate in public policymaking. Study 2 repeated the same procedures, with the exception that we manipulated costs of participation, and also measured participants’ trust in government. Study 1 confirmed our initial hypotheses – fewer costs predicted more willingness to participate, as did stronger state identification. However, Study 2 found an interactive effect of costs, identification, and trust on willingness to participate in public policymaking. Results confirm our hypotheses by showing that both costs and identification independently influence willingness to participate in public policymaking. Results also add to the literature by showing that these additive pathways can be influenced by trust in the source of governance.

  17. Indirect costs of diabetes and its impact on the public finance: the case of Poland.

    Science.gov (United States)

    Torój, Andrzej; Mela, Aneta

    2017-08-31

    Growing public and private expenditure on healthcare results i.a. from the spreading of chronic diseases. Diabetes belongs to the most frequent ones, beyond neoplasms and cardiological diseases, and hence generates a significant burden for the public finance in terms of the direct costs. However, the economy suffers also from the indirect cost of diabetes that manifests itself in the loss in Gross Domestic Product (GDP) and general government revenues. This paper aims to measure this indirect cost, both in terms of GDP drop (social perspective) and public revenue drop (public finance perspective), in the case of Poland in 2012-2014. We use a modified human capital approach and unique dataset provided by the Social Security institution in Poland and the Polish Central Statistical Office. Diabetes is a substantial and growing burden for the Polish economy. In the years 2012, 2013 and 2014 the indirect cost (output loss) amounted to 1.85 bn USD, 1.94 bn USD and 2.00 bn USD respectively. Estimated indirect cost of diabetes can be a useful input for health technology analyses of drugs or economic impact assessments of public health programmes.

  18. The design and implementation of a public policy approach differential service, repair assistance and integral Colombia

    OpenAIRE

    Camilo Alberto Madariaga Orozco; Patricia del Socorro Martínez Meza; Marco Alfredo Cervantes Mendoza

    2014-01-01

    Objective: To analyze the strategies used by victims of forced displacement in Colombia women and the strategies employed by the institutions to participate and / or promote participation in the design of public policy of the state of attention, assistance and reparations.Method: The sample was represented by 47 women that belong to organizations, victims and officials of institutions. The techniques used were: focus groups, surveys and interviews.Results: The results show that institutional ...

  19. [Conceptions of nurses from a public university hospital regarding the cost management report].

    Science.gov (United States)

    de Oliveira, William Tiago; Rodrigues, Ana Vanessa Deffaccio; Haddad, Maria do Carmo Lourenço; Vannuch, Marli Terezinha Oliveira; Taldivo, Meire Aparecida

    2012-10-01

    This exploratory-descriptive study was performed with a qualitative approach, on the theoretical construct in the field of phenomenology, with the objective to identify the understanding of nurses of a public university hospital regarding the cost management report. Data collection was performed from August of 2009 to March of 2010, with 59 nurses, and consisted of three guiding questions: What is the meaning of cost management? How do you use the cost management report? What is the contribution of cost management reports? Results showed that nurses do not use this report in their practice, because they focus on the care issues, and justify this by the fact that they did not receive academic training in relation to cost management and also because they do not understand the report. The report, however, though little explored, contributes with the practice of nurses who hold a management position, in terms of cost management and control.

  20. Vehicle Tracking for an Evasive Manoeuvres Assistant Using Low-Cost Ultrasonic Sensors

    Directory of Open Access Journals (Sweden)

    Felipe Jiménez

    2014-11-01

    Full Text Available Many driver assistance systems require knowledge of the vehicle environment. As these systems are increasing in complexity and performance, this knowledge of the environment needs to be more complete and reliable, so sensor fusion combining long, medium and short range sensors is now being used. This paper analyzes the feasibility of using ultrasonic sensors for low cost vehicle-positioning and tracking in the lane adjacent to the host vehicle in order to identify free areas around the vehicle and provide information to an automatic avoidance collision system that can perform autonomous braking and lane change manoeuvres. A laser scanner is used for the early detection of obstacles in the direction of travel while two ultrasonic sensors monitor the blind spot of the host vehicle. The results of tests on a test track demonstrate the ability of these sensors to accurately determine the kinematic variables of the obstacles encountered, despite a clear limitation in range.

  1. Vehicle tracking for an evasive manoeuvres assistant using low-cost ultrasonic sensors.

    Science.gov (United States)

    Jiménez, Felipe; Naranjo, José E; Gómez, Oscar; Anaya, José J

    2014-11-28

    Many driver assistance systems require knowledge of the vehicle environment. As these systems are increasing in complexity and performance, this knowledge of the environment needs to be more complete and reliable, so sensor fusion combining long, medium and short range sensors is now being used. This paper analyzes the feasibility of using ultrasonic sensors for low cost vehicle-positioning and tracking in the lane adjacent to the host vehicle in order to identify free areas around the vehicle and provide information to an automatic avoidance collision system that can perform autonomous braking and lane change manoeuvres. A laser scanner is used for the early detection of obstacles in the direction of travel while two ultrasonic sensors monitor the blind spot of the host vehicle. The results of tests on a test track demonstrate the ability of these sensors to accurately determine the kinematic variables of the obstacles encountered, despite a clear limitation in range.

  2. Financial costs and personal consequences of research misconduct resulting in retracted publications.

    Science.gov (United States)

    Stern, Andrew M; Casadevall, Arturo; Steen, R Grant; Fang, Ferric C

    2014-08-14

    The number of retracted scientific articles has been increasing. Most retractions are associated with research misconduct, entailing financial costs to funding sources and damage to the careers of those committing misconduct. We sought to calculate the magnitude of these effects. Data relating to retracted manuscripts and authors found by the Office of Research Integrity (ORI) to have committed misconduct were reviewed from public databases. Attributable costs of retracted manuscripts, and publication output and funding of researchers found to have committed misconduct were determined. We found that papers retracted due to misconduct accounted for approximately $58 million in direct funding by the NIH between 1992 and 2012, less than 1% of the NIH budget over this period. Each of these articles accounted for a mean of $392,582 in direct costs (SD $423,256). Researchers experienced a median 91.8% decrease in publication output and large declines in funding after censure by the ORI. Copyright © 2014, Stern et al.

  3. Cost-effectiveness of varicocele surgery in the era of assisted reproductive technology

    Directory of Open Access Journals (Sweden)

    Kelly A Chiles

    2016-01-01

    Full Text Available The advent of innovative techniques for addressing infertility has made for exciting times in the arena of andrology. The success of microTESE for retrieving sperm has enabled azoospermic men to have the opportunity to father biological children when it was previously impossible. The ability to offer a variety of assisted reproductive techniques that includes intracytoplasmic sperm injection has opened the door for couples with male factor infertility who were otherwise untreatable. With the multitude of options available to infertile couples, however, comes an unsurprising degree of controversy regarding what treatments should be offered and when. Complicating the picture is the question of if and when varicocele repair should be undertaken, and the financial implications of the treatment decisions that are made. The infertile couple with varicocele warrants careful consideration. The overall efficacy of varicocele repair as well as cost-effectiveness of repair compared to immediate microTESE in azoospermic men and assisted reproductive technology in men with suboptimal semen parameters will be reviewed.

  4. Cost-effectiveness of varicocele surgery in the era of assisted reproductive technology.

    Science.gov (United States)

    Chiles, Kelly A; Schlegel, Peter N

    2016-01-01

    The advent of innovative techniques for addressing infertility has made for exciting times in the arena of andrology. The success of microTESE for retrieving sperm has enabled azoospermic men to have the opportunity to father biological children when it was previously impossible. The ability to offer a variety of assisted reproductive techniques that includes intracytoplasmic sperm injection has opened the door for couples with male factor infertility who were otherwise untreatable. With the multitude of options available to infertile couples, however, comes an unsurprising degree of controversy regarding what treatments should be offered and when. Complicating the picture is the question of if and when varicocele repair should be undertaken, and the financial implications of the treatment decisions that are made. The infertile couple with varicocele warrants careful consideration. The overall efficacy of varicocele repair as well as cost-effectiveness of repair compared to immediate microTESE in azoospermic men and assisted reproductive technology in men with suboptimal semen parameters will be reviewed.

  5. Vacuum-assisted wound closure in vascular surgery - clinical and cost benefits in a developing country

    Directory of Open Access Journals (Sweden)

    Končar Igor

    2016-01-01

    Full Text Available Background/Aim. Surgical and chronic wounds in vascular patients might contribute to limb loss and death. Vacuum-assisted closure (VAC - Kinetic Concepts, Inc. (KCI, has been increasingly used in Western Europe and the USA clinical practice for 15 years. Advantages of this method are faster wound healing, wound approximation, lower wound related treatment costs and improved quality of life during treatment. Evidence related to the usage of VAC therapy in vascular patients and cost effectiveness of VAC therapy in a developing country are lacking. The aim of this study was to explore results of VAC therapy in vascular surgery comparing to conventional methods and to test cost effects in a developing country like Serbia. Methods. All patients with wound infection or dehiscence operated at the tertiary vascular university clinic in the period from January 2011 - January 2012, were treated with VAC therapy. The primary endpoint was wound closure, while secondary endpoints were hospital stay, the number of weekly dressings, costs of wound care, working time of medical personnel. The patients were divided into groups according to the wound type and location: wound with exposed synthetic vascular implant (25%, laparotomy (13%, foot amputation (29%, major limb amputation (21%, fasciotomy (13%. The results of primary and secondary endpoint were compared with the results of conventional treatment during the previous year. Results. There was one death (1/42, 2.38% and one limb loss (1/12, 2.38% in the VAC group, and 8 deaths (8/38, 21.05% and 5 (5/38, 13.15% limb losses in the patients treated with conventional therapy. In the VAC group there was one groin bleeding (1/12, 2.38%, one groin reinfection (1/12, 2.38% and one resistance to therapy with a consequent limb loss. Costs of hospital stay (p < 0.001 and nursing time (p < 0.001 were reduced with VAC therapy in the group with exposed graft. Conclusion. VAC therapy is the effective method for care of

  6. External Cost Assessment of Nuclear Power Plant Accident considering Public Risk Aversion Behavior: the Korean Case

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Hun; Kang, Hyun Gook [KAIST, Daejeon (Korea, Republic of)

    2016-05-15

    The conventional approach for monetary valuation of NPP accident consequence consists of calculating the expected value of various accident scenarios. However, the main criticism of the conventional approach is that there is a discrepancy between the social acceptability of the risk and the estimated expected value of NPP accident. Therefore, an integrated framework for the estimation of the external cost associated with an NPP accident considering the public risk aversion behavior was proposed in this study based on the constructed theoretical framework for estimating both the value of statistical life (VSL) and the risk aversion coefficient associated with an NPP accident to take account of the accident cost into the unit electricity generation cost of NPP. To estimate both parameters, an individual-level survey was conducted on a sample of 1,364 participants in Korea. Based on the collected survey responses, both parameters were estimated based on the proposed framework and the external cost of NPP accident was estimated based on the consequence analysis and considering the direct cost factors for NPP accident. Internalization of external costs into the comprehensive energy production cost has been considered as a potentially efficient policy instrument for a more sustainable energy supply and use. However, the internalization of externalities, such as public health damage, have raised a number of generic policy issues in a nuclear energy sector, with specific challenges resulting from the distinct characteristics of external cost estimation. Especially, the major challenge remained to address the public safety concerns regarding a nuclear accident, which can be specified as low-probability high-consequence accident, driven by the aspects of public risk aversion.

  7. Utilities Cost Comparison Analysis between a Public Work Center and the Non-DoD Sector

    Science.gov (United States)

    1992-12-01

    construction, consider innovative financing and 14 management arrangements (e.g. cost-sharing, public-private venture, leasing). Integrate...and services by financing all incurred costs. 27 Cash is put back into the working capital fund when customers pay cash from their O&M,N funds for the...firms, and other significantly sized business firms. The actual participants of the study may or may not be included in this listing. Disneyland was

  8. 45 CFR 96.88 - Administrative costs.

    Science.gov (United States)

    2010-10-01

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

  9. Costs of genetic testing: Supporting Brazilian Public Policies for the incorporating of molecular diagnostic technologies

    Directory of Open Access Journals (Sweden)

    Rosane Paixão Schlatter

    2015-09-01

    Full Text Available This study identifies and describes the operating costs associated with the molecular diagnosis of diseases, such as hereditary cancer. To approximate the costs associated with these tests, data informed by Standard Operating Procedures for various techniques was collected from hospital software and a survey of market prices. Costs were established for four scenarios of capacity utilization to represent the possibility of suboptimal use in research laboratories. Cost description was based on a single site. The results show that only one technique was not impacted by rising costs due to underutilized capacity. Several common techniques were considerably more expensive at 30% capacity, including polymerase chain reaction (180%, microsatellite instability analysis (181%, gene rearrangement analysis by multiplex ligation probe amplification (412%, non-labeled sequencing (173%, and quantitation of nucleic acids (169%. These findings should be relevant for the definition of public policies and suggest that investment of public funds in the establishment of centralized diagnostic research centers would reduce costs to the Public Health System.

  10. Public Low-Cost Housing in Malaysia: Case Studies on PPR Low-Cost Flats in Kuala Lumpur

    Directory of Open Access Journals (Sweden)

    Goh, Ai Tee

    2011-06-01

    Full Text Available This paper examines the design quality of People's Housing Project (Program Perumahan Rakyat or PPR low cost high rise flats developed by the National Housing Department (Jabatan Perumahan Negara or JPN in Kuala Lumpur since the 1998. Quality Function Deployment method is used as a tool to analyze the current status and to prioritize the demanded quality from the selected PPR low-cost high rise flats' users. The study revealed that factors in determining a quality low-cost high-rise flat arranged in descending degrees of importance are house safety, provision of public amenities, unit internal environment, maintenance and surrounding environment, location, sanitary fittings, unit size, type of house, material used, unit internal layout, quality of workmanship, structure of the house and appearance. A Quality Chart for PPR low-cost high-rise flats in Kuala Lumpur was presented. Authority (47 per cent has the highest relative degree of importance in determining the quality of PPR flats, followed by Design Element (34 per cent and Quality of Living (19 per cent. Accordingly, the success of the schemes relies strongly on effective control and enforcement by the authorities. However, it can be improved by tackling on the Design Element (Architectural, whereby a revised typical unit layout plan and typical details have been proposed at the last section of the paper.

  11. Hands-On Experiences in Deploying Cost-Effective Ambient-Assisted Living Systems

    Directory of Open Access Journals (Sweden)

    Athanasios Dasios

    2015-06-01

    Full Text Available Older adults’ preferences to remain independent in their own homes along with the high costs of nursing home care have motivated the development of Ambient Assisted Living (AAL technologies which aim at improving the safety, health conditions and wellness of the elderly. This paper reports hands-on experiences in designing, implementing and operating UbiCare, an AAL based prototype system for elderly home care monitoring. The monitoring is based on the recording of environmental parameters like temperature and light intensity as well as micro-level incidents which allows one to infer daily activities like moving, sitting, sleeping, usage of electrical appliances and plumbing components. The prototype is built upon inexpensive, off-the-shelf hardware (e.g., various sensors, Arduino microcontrollers, ZigBee-compatible wireless communication modules and license-free software, thereby ensuring low system deployment costs. The network comprises nodes placed in a house’s main rooms or mounted on furniture, one wearable node, one actuator node and a centralized processing element (coordinator. Upon detecting significant deviations from the ordinary activity patterns of individuals and/or sudden falls, the system issues automated alarms which may be forwarded to authorized caregivers via a variety of communication channels. Furthermore, measured environmental parameters and activity incidents may be monitored through standard web interfaces.

  12. The High Cost of Failing to Reform Public Education in Indiana. School Choice Issues in the State

    Science.gov (United States)

    Gottlob, Brian J.

    2006-01-01

    This study documents the public costs of high school dropouts in Indiana, and examines how school choice would provide large public benefits by increasing the graduation rate in Indiana public schools. It calculates the annual cost of high school dropouts in Indiana due to lower state income tax payments, increased reliance on Medicaid, and…

  13. Cost analysis for efficient management: diabetes treatment at a public district hospital in Thailand.

    Science.gov (United States)

    Riewpaiboon, Arthorn; Chatterjee, Susmita; Piyauthakit, Piyanuch

    2011-10-01

    OBJECTIVE  The study estimated cost of illness from the provider's perspective for diabetic patients who received treatment during the fiscal year 2008 at Waritchaphum Hospital, a 30-bed public district hospital in Sakhon Nakhon province in northeastern Thailand. METHODS  This retrospective, prevalence-based cost-of-illness study looked at 475 randomly selected diabetic patients, identified by the World Health Organization's International Classification of Diseases, 10th revision, codes E10-E14. Data were collected from the hospital financial records and medical records of each participant and were analysed with a stepwise multiple regression. KEY FINDINGS  The study found that the average public treatment cost per patient per year was US$94.71 at 2008 prices. Drug cost was the highest cost component (25% of total cost), followed by inpatient cost (24%) and outpatient visit cost (17%). A cost forecasting model showed that length of stay, hospitalization, visits to the provincial hospital, duration of disease and presence of diabetic complications (e.g. diabetic foot complications and nephropathy) were the significant predictor variables (adjusted R(2) = 0.689). CONCLUSIONS  According to the fitted model, avoiding nephropathy and foot complications would save US$19 386 and US$39 134 respectively per year. However, these savings are missed savings for the study year and the study hospital only and not projected savings, as that would depend on the number of diabetic patients managed in the year, the ratio of complicated to non-complicated cases and effectiveness of the prevention programmes. Nonetheless, given the high avoidable cost associated with complications of diabetes, healthcare providers in Thailand should focus on initiatives that delay the progression of complications in diabetic patients.

  14. Use of a consultant to assist a dietetic association in its media and public relations efforts.

    Science.gov (United States)

    Visocan, B J; Lazin, B

    1989-04-01

    During 1987, the Philadelphia Dietetic Association (PDA) enlisted the aid of a public relations consultant to increase media contacts and thereby accomplish a threefold goal of (a) establishing the dietetic association and its registered dietitian members as the local nutrition experts; (b) distributing reliable, current nutrition information; and (c) marketing the PDA's DIAL-A-DIETITIAN service. Through the advice of the consultant, a media tipsheet, published monthly, was created. This publication, the Nutrition Informationist, effectively increased media contacts from two in 1986 to 19 in 1987 and resulted in a total of 8 hours of air time. Weight reduction, fad diets, and sports nutrition proved to be the most popular topics. Public service announcements (PSAs) concerning the DIAL-A-DIETITIAN program were developed by the consultant to assist the public in gaining access to local registered dietitians. Calls to that service increased 75% (from an average of 47.5 to 83.0 calls) the month following the distribution of PSAs to radio stations. The positive outcome of this collaborative effort shows that public relations consultants can be a useful resource for local dietetic associations, aiding them in their efforts to reach the media and the public and to improve their image.

  15. Control costs, enhance quality, and increase revenue in three top general public hospitals in Beijing, China.

    Directory of Open Access Journals (Sweden)

    Lue-Ping Zhao

    Full Text Available BACKGROUND: With market-oriented economic and health-care reform, public hospitals in China have received unprecedented pressures from governmental regulations, public opinions, and financial demands. To adapt the changing environment and keep pace of modernizing healthcare delivery system, public hospitals in China are expanding clinical services and improving delivery efficiency, while controlling costs. Recent experiences are valuable lessons for guiding future healthcare reform. Here we carefully study three teaching hospitals, to exemplify their experiences during this period. METHODS: We performed a systematic analysis on hospitalization costs, health-care quality and delivery efficiencies from 2006 to 2010 in three teaching hospitals in Beijing, China. The analysis measured temporal changes of inpatient cost per stay (CPS, cost per day (CPD, inpatient mortality rate (IMR, and length of stay (LOS, using a generalized additive model. FINDINGS: There were 651,559 hospitalizations during the period analyzed. Averaged CPS was stable over time, while averaged CPD steadily increased by 41.7% (P<0.001, from CNY 1,531 in 2006 to CNY 2,169 in 2010. The increasing CPD seemed synchronous with the steady rising of the national annual income per capita. Surgical cost was the main contributor to the temporal change of CPD, while medicine and examination costs tended to be stable over time. From 2006 and 2010, IMR decreased by 36%, while LOS reduced by 25%. Increasing hospitalizations with higher costs, along with an overall stable CPS, reduced IMR, and shorter LOS, appear to be the major characteristics of these three hospitals at present. INTERPRETATIONS: These three teaching hospitals have gained some success in controlling costs, improving cares, adopting modern medical technologies, and increasing hospital revenues. Effective hospital governance and physicians' professional capacity plus government regulations and supervisions may have played a role

  16. Low-Cost National Media-Based Surveillance System for Public Health Events, Bangladesh.

    Science.gov (United States)

    Ao, Trong T; Rahman, Mahmudur; Haque, Farhana; Chakraborty, Apurba; Hossain, M Jahangir; Haider, Sabbir; Alamgir, A S M; Sobel, Jeremy; Luby, Stephen P; Gurley, Emily S

    2016-04-01

    We assessed a media-based public health surveillance system in Bangladesh during 2010-2011. The system is a highly effective, low-cost, locally appropriate, and sustainable outbreak detection tool that could be used in other low-income, resource-poor settings to meet the capacity for surveillance outlined in the International Health Regulations 2005.

  17. The cost of acquiring public hunting access on family forests lands

    Science.gov (United States)

    Michael A. Kilgore; Stephanie A. Snyder; Joesph M. Schertz; Steven J. Taff

    2008-01-01

    To address the issue of declining access to private forest land in the United States for hunting, over 1,000 Minnesota family forest owners were surveyed to estimate the cost of acquiring non-exclusive public hunting access rights. The results indicate landowner interest in selling access rights is extremely modest. Using binary logistic regression, the mean annual...

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

    Science.gov (United States)

    Stoneberg, Bert D.

    2015-01-01

    Public school critics often point to rising expenditures and relatively flat test scores to justify their school reform agendas. The claims are flawed because their analyses fail to account for the difference in data types between dollars (ratio) and test scores (interval). A cost-benefit analysis using dollars as a common metric for both costs…

  19. 78 FR 63974 - Student Assistance General Provisions-Subpart K-Cash Management; Extension of Public Comment...

    Science.gov (United States)

    2013-10-25

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF EDUCATION Student Assistance General Provisions--Subpart K--Cash Management; Extension of Public Comment Period..., ``Student Assistance General Provisions--Subpart K--Cash Management''. ED is extending the comment period...

  20. Uniform nanoparticles by flame-assisted spray pyrolysis (FASP) of low cost precursors

    Science.gov (United States)

    Rudin, Thomas; Wegner, Karsten; Pratsinis, Sotiris E.

    2011-07-01

    A new flame-assisted spray pyrolysis (FASP) reactor design is presented, which allows the use of inexpensive precursors and solvents (e.g., ethanol) for synthesis of nanoparticles (10-20 nm) with uniform characteristics. In this reactor design, a gas-assisted atomizer generates the precursor solution spray that is mixed and combusted with externally fed inexpensive fuel gases (acetylene or methane) at a defined height above the atomizing nozzle. The gaseous fuel feed can be varied to control the combustion enthalpy content of the flame and onset of particle formation. This way, the enthalpy density of the flame is decoupled from the precursor solution composition. Low enthalpy content precursor solutions are prone to synthesis of non-uniform particles (e.g., bimodal particle size distribution) by standard flame spray pyrolysis (FSP) processes. For example, metal nitrates in ethanol typically produce nanosized particles by gas-to-particle conversion along with larger particles by droplet-to-particle conversion. The present FASP design facilitates the use of such low enthalpy precursor solutions for synthesis of homogeneous nanopowders by increasing the combustion enthalpy density of the flame with low-cost, gaseous fuels. The effect of flame enthalpy density on product properties in the FASP configuration is explored by the example of Bi2O3 nanoparticles produced from bismuth nitrate in ethanol. Product powders were characterized by nitrogen adsorption, X-ray diffraction, X-ray disk centrifuge, and transmission electron microscopy. Homogeneous Bi2O3 nanopowders were produced both by increasing the gaseous fuel content and, most notably, by cutting the air entrainment prior to ignition of the spray.

  1. Public health and economic costs of investigating a suspected outbreak of Legionnaires' disease.

    Science.gov (United States)

    Lock, K; Millett, C; Heathcock, R; Joseph, C A; Harrison, T G; Lee, J V; Rao, G; Surman-Lee, S

    2008-10-01

    This paper provides one of the first assessments of the burden of both the public health investigation and the economic costs associated with an apparent outbreak of Legionnaires' disease (LD) in South East London. In addition to epidemiological, microbiological and environmental investigations, we collected data on the staff time and resources committed by the 11 main organizations responsible for managing the outbreak. Of the overall estimated costs of 455,856 pounds, only 14% (64,264 pounds) was spent on investigation and control of the outbreak compared with 86% (391,592 pounds) spent on the hospital treatment of the patients. The time and money spent on public health services in this investigation appear to represent good value for money considering the potential costs of a major outbreak, including the high case-fatality rate in LD generally and the high health-care costs. Further research is needed to determine optimum strategies for the cost-effective use of health system resources in investigations of LD. Whether the threshold for investigation of cases should be based on observed incidence rates or the cost-effectiveness of investigations, or both, should be debated further.

  2. Niche public transport operational and capital investment strategies to minimize fares in the light of increased energy costs

    CSIR Research Space (South Africa)

    Letebele, MO

    2009-07-01

    Full Text Available Fuel costs are a significant component of a public transport fare. It is therefore of critical importance for measures aimed at containing household public transport expenditure to explore alternative ways of reducing fuel consumption or fuel...

  3. Food Assistance: Financial Information on WIC Nutrition Services and Administrative Costs. United States General Accounting Office Report to Congressional Committees.

    Science.gov (United States)

    Robertson, Robert E.

    The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a federally funded nutrition assistance program administered by the Department of Agriculture's (USDA) Food and Nutrition Service (FNS). Responding to Congressional requests for information regarding program costs, this report provides information on: (1) funding…

  4. Assistance Focus: Africa (Brochure)

    Energy Technology Data Exchange (ETDEWEB)

    2014-12-01

    The Clean Energy Solutions Center Ask an Expert service connects governments seeking policy information and advice with one of more than 30 global policy experts who can provide reliable and unbiased quick-response advice and information. The service is available at no cost to government agency representatives from any country and the technical institutes assisting them. This publication presents summaries of assistance provided to African governments, including the benefits of that assistance.

  5. Present-value analysis: A systems approach to public decisionmaking for cost effectiveness

    Science.gov (United States)

    Herbert, T. T.

    1971-01-01

    Decision makers within Governmental agencies and Congress must evaluate competing (and sometimes conflicting) proposals which seek funding and implementation. Present value analysis can be an effective decision making tool by enabling the formal evaluation of the effects of competing proposals on efficient national resource utilization. A project's costs are not only its direct disbursements, but its social costs as well. How much does it cost to have those funds diverted from their use and economic benefit by the private sector to the public project? Comparisons of competing projects' social costs allow decision makers to expand their decision bases by quantifying the projects' impacts upon the economy and the efficient utilization of the country's limited national resources. A conceptual model is established for the choosing of the appropriate discount rate to be used in evaluation decisions through the technique.

  6. A cost management model for hospital food and nutrition in a public hospital.

    Science.gov (United States)

    Neriz, Liliana; Núñez, Alicia; Ramis, Francisco

    2014-11-13

    In Chile, the use of costing systems in the public sector is limited. The Ministry of Health requires hospitals to manage themselves with the aim of decentralizing health care services and increasing their quality. However, self-management with a lack of accounting information is almost impossible. On the other hand, nutrition department costs have barely been studied before, and there are no studies specifically for activity based costing (ABC) systems. ABC focuses on the process and traces health care activities to gain a more accurate measurement of the object costs and the financial performance of an organization. This paper uses ABC in a nutrition unit of a public hospital of high complexity to determine costs associated with the different meals for inpatients. The paper also provides an activity based management (ABM) analysis for this unit. The results show positive effects on the reduction of costs for the nutrition department after implementing ABC/ABM. Therefore, there are opportunities to improve the profitability of the area and the results could also be replicated to other areas in the hospital. ABC shed light on the amount of nutritionist time devoted to completing paperwork, and as a result, system changes were introduced to reduce this burden and allow them to focus on more relevant activities. Additional efficiencies were achieved through the elimination of non-value adding activities and automation of reports. ABC reduced the cost of the nutrition department and could produce similar results in other areas of the hospital. This is a practical application of a financial management tool, ABC, which would be useful for hospital managers to reduce costs and improve the management of the unit. This paper takes ABC and examines its use in an area, which has had little exposure to the benefits of this tool.

  7. A Better Engineering Design: Low Cost Assistance Kit for Manual Wheelchair Users with Enhanced Obstacle Detection

    Directory of Open Access Journals (Sweden)

    Dryvendra

    2015-09-01

    Full Text Available This paper proposes a better engineering design of an assistance kit for manual wheelchair users. The design is aimed to enhance the detection of obstacles in the travelling path of the wheelchair user at low cost. This is facilitated by microcontroller and sensor technologies. The proposed design provides the intended user with obstacle detection, light detection, a light emitting diode (LED emergency light system, and an emergency alarm system. The microcontroller is the main controller that receives input from the sensors and produces output to the light crystal display (LCD screen, the LED emergency light system, and the emergency alarm system. An ultrasonic sensor is used to detect the presence of obstacles directly behind the wheelchair. If any obstacle exists behind the wheelchair within a set range, the system will alert the wheelchair user through different alarm sounds. In the case of absence of light, the LED emergency light system is activated and turns on a light source, which is attached to the wheelchair to provide a bright and clear path for the user. The distance between the obstacle and the wheelchair, and the status of the LED emergency light system are displayed on the LCD screen.

  8. Facile and cost-effective fabrication of patternable superhydrophobic surfaces via salt dissolution assisted etching

    Science.gov (United States)

    Choi, Dongwhi; Yoo, Jaewon; Park, Sang Min; Kim, Dong Sung

    2017-01-01

    Superhydrophobic surfaces with extremely low wettability have attracted attention globally along with their remarkable characteristics such as anti-icing, anti-sticking, and self-cleaning. In this study, a facile and cost-effective approach of fabricating patternable superhydrophobic surfaces, which can be applied on various substrates (including large area and 3D curvilinear substrates), is proposed with a salt-dissolution-assisted etching process. This novel proposal is environmentally benign (entirely water-based and fluorine-free process). The only required ingredients to realize superhydrophobic surfaces are commercially available salt particles, polydimethylsiloxane (PDMS), and water. No expensive equipment or complex process control is needed. The fabricated superhydrophobic surface shows high static contact angle (∼151°) and a low sliding angle (∼6°), which correspond to the standards of superhydrophobicity. This surface also shows corrosive liquids (acid/alkali)-resistant characteristics. Moreover, the self-cleaning ability of the fabricated surfaces is explored. As a proof-of-concept application of the present approach, the spatially controllable superhydrophobic patterns on flat/curvilinear substrates are directly drawn with a minimum feature size of 500 μm without the use of expensive tooling, dies, or lithographic masks.

  9. The costs of breast cancer in a Mexican public health institution

    Science.gov (United States)

    Gómez-Rico, Jacobo Alejandro; Altagracia-Martínez, Marina; Kravzov-Jinich, Jaime; Cárdenas-Elizalde, Rosario; Rubio-Poo, Consuelo

    2008-01-01

    Breast cancer (BC) is the second leading cause of death as a result of neoplasia in Mexico. This study aimed to identify the direct and indirect costs of treating female outpatients diagnosed with BC at a Mexican public hospital. A cross-sectional, observational, analytical study was conducted. A total of 506 medical records were analyzed and 102 were included in the cost analysis. The micro-costing process was used to estimate treatment costs. A 17-item questionnaire was used to obtain information on direct and indirect costs. Of the 102 women with BC included in the study, 92.2% (94) were at Stage II, and only 7.8% at Stage I. Total direct costs over six months for the 82 women who had modified radical mastectomy (MRM) surgury were US$733,821.15. Total direct costs for the 15 patients with conservative surgery (CS) were US$138,190.39. We found that the total economic burden in the study population was much higher for patients with MRM than for patients with CS. PMID:22312199

  10. Indirect and direct costs of treating patients with ankylosing spondylitis in the Brazilian public health system

    Directory of Open Access Journals (Sweden)

    Valderilio Feijó Azevedo

    2016-04-01

    Full Text Available ABSTRACT Introduction: Patients with Ankylosing Spondylitis (AS require a team approach from multiple professionals, various treatment modalities for continuous periods of time, and can lead to the loss of labour capacity in a young population. So, it is necessary to measure its socio-economic impact. Objectives: To describe the use of public resources to treat AS in a tertiary hospital after the use of biological medications was approved for treating spondyloarthritis in the Health Public System, establishing approximate values for the direct and indirect costs of treating this illness in Brazil. Material and methods: 93 patients selected from the ambulatory spondyloarthritis clinic at the Hospital de Clínicas of the Federal University of Paraná between September 2011 and September 2012 had their direct costs indirect treatment costs estimation. Results: 70 patients (75.28% were male and 23 (24.72% female. The mean age was 43.95 years. The disease duration was calculated based on the age of diagnosis and the mean was 8.92 years (standard deviation: 7.32; 63.44% were using anti-TNF drugs. Comparing male and female patients the mean BASDAI was 4.64 and 5.49 while the mean BASFI was 5.03 and 6.35 respectively. Conclusions: The Brazilian public health system's spending related to ankylosing spondylitis has increased in recent years. An important part of these costs is due to the introduction of new, more expensive health technologies, as in the case of nuclear magnetic resonance and, mainly, the incorporation of anti-TNF therapy into the therapeutic arsenal. The mean annual direct and indirect cost to the Brazilian public health system to treat a patient with ankylosing spondylitis, according to our findings, is US$ 23,183.56.

  11. Costs and efficacy of public health interventions to reduce aflatoxin–induced human disease

    Science.gov (United States)

    Khlangwiset, Pornsri; Wu, Felicia

    2010-01-01

    This study reviews available information on the economics and efficacy of aflatoxin risk-reduction interventions, and provides an approach for analysis of the cost-effectiveness of public health interventions to reduce aflatoxin-induced human disease. Many strategies have been developed to reduce aflatoxin or its adverse effects in the body. However, a question that has been under-addressed is how likely these strategies will be adopted in the countries that need them most to improve public health. This study evaluates two aspects crucial to adoption of new technologies and methods: the costs and the efficacy of different strategies. First, we describe and categorize different aflatoxin risk-reduction strategies into preharvest, postharvest, dietary, and clinical settings. Then we compile and discuss relevant data on the costs and efficacy of each strategy, in reducing either aflatoxin in food or its metabolites in the body. In addition, we describe which crops are affected by each intervention, who is likely to pay for the control strategy, and who is likely to benefit. A framework is described for how to evaluate cost-effectiveness of strategies according to World Health Organization standards. Finally, we discuss which strategies are likely to be cost-effective and helpful under different conditions worldwide of regulations, local produce and soil ecology, and potential health emergencies. PMID:20419532

  12. Cost and efficiency of public sector sexually transmitted infection clinics in Andhra Pradesh, India

    Directory of Open Access Journals (Sweden)

    Ramesh YK

    2005-11-01

    Full Text Available Abstract Background Control of sexually transmitted infections (STIs is an important part of the effort to reduce the risk of HIV/AIDS. STI clinics in the government hospitals in India provide services predominantly to the poor. Data on the cost and efficiency of providing STI services in India are not available to help guide efficient use of public resources for these services. Methods Standardised methods were used to obtain detailed cost and output data for the 2003–2004 fiscal year from written records and interviews in 14 government STI clinics in the Indian state of Andhra Pradesh. The economic cost per patient receiving STI treatment was calculated, and the variations of total and unit costs across the STI clinics analysed. Multivariate regression technique was used to estimate incremental unit costs. The optimal number of STIs that could be handled by the clinics was estimated. Results 18807 STIs were diagnosed and treated at the 14 STI clinics in fiscal year 2003–2004 (range 323–2784, median 1199. The economic cost of treating each STI varied 5-fold from Indian Rupees (INR 225.5 (US$ 4.91 to INR 1201.5 (US$ 26.15 between 13 clinics, with one other clinic having a very high cost of INR 2478.5 (US$ 53.94. The average cost per STI treated for all 14 clinics combined was INR 729.5 (US$ 15.88. Personnel salaries made up 76.2% of the total cost. The number of STIs treated per doctor full-time equivalent and cost-efficiency for each STI treated had a significant direct non-linear relation (p 2 = 0.81; power function. With a multiple regression model, apart from the fixed costs, the incremental cost for each STI detected and cost of treatment was INR 55.57 (US$ 1.21 and for each follow-up visit was INR 3.75 (US$ 0.08. Based on estimates of optimal STI cases that could be handled without compromising quality by each doctor full-time equivalent available, it was projected that at 8 of the 14 clinics substantially more STI cases could be

  13. Public assistance, drug testing, and the law: the limits of population-based legal analysis.

    Science.gov (United States)

    Player, Candice T

    2014-01-01

    In Populations, Public Health and the Law, legal scholar Wendy Parmet urges courts to embrace population-based legal analysis, a public health inspired approach to legal reasoning. Parmet contends that population-based legal analysis offers a way to analyze legal issues--not unlike law and economics--as well as a set of values from which to critique contemporary legal discourse. Population-based analysis has been warmly embraced by the health law community as a bold new way of analyzing legal issues. Still, population-based analysis is not without its problems. At times, Parmet claims too much territory for the population perspective. Moreover, Parmet urges courts to recognize population health as an important norm in legal reasoning. What should we do when the insights of public health and conventional legal reasoning conflict? Still in its infancy, population-based analysis offers little in the way of answers to these questions. This Article applies population-based legal analysis to the constitutional problems that arise when states condition public assistance benefits on passing a drug test, thereby highlighting the strengths of the population perspective and exposing its weaknesses.

  14. Support of Publication Costs, Atlantic Meridional Overturning Circulation Special Issue of Deep Sea Research II Journal

    Energy Technology Data Exchange (ETDEWEB)

    Amy Honchar

    2012-11-12

    The contribution of funds from DOE supported publication costs of a special issue of Deep Sea Research arising from presentations at the First U.S. Atlantic Meridional Overturning Circulation (AMOC) Meeting held 4-6 May, 2009 to review the US implementation plan and its coordination with other monitoring activities. The special issue includes a total of 16 papers, including publications from three DOE-supported investigators (ie Sevellec, F., and A.V. Fedorov; Hu et. al., and Wan et. al.,). The special issue addresses DOE interests in understanding and simulation/modeling of abrupt climate change.

  15. Costs of vaginal delivery and Caesarean section at a tertiary level public hospital in Islamabad, Pakistan

    Directory of Open Access Journals (Sweden)

    Zaman Shakila

    2010-01-01

    Full Text Available Abstract Background Public hospitals in developing countries, rather than the preventive and primary healthcare sectors, are the major consumers of healthcare resources. Imbalances in rational, equitable and efficient allocation of scarce resources lie in the scarcity of research & information on economic aspects of health care. The objective of this study was to determine the average cost of a spontaneous vaginal delivery and Caesarean section in a tertiary level government hospital in Islamabad, Pakistan and to estimate the out of pocket expenditures to households using these services. Methods This hospital based cost accounting cross sectional study determines the average cost of vaginal delivery and Caesarean section from two perspectives, the patient's and the hospital. From the patient's perspective direct and indirect expenditures of 133 post-partum mothers (65 delivered by Caesarean section & 68 by spontaneous vaginal delivery admitted in the maternity general ward were determined. From the hospital perspective the step down methodology was adopted, capital and recurrent costs were determined from inputs and cost centers. Results The average cost for a spontaneous vaginal delivery from the hospital's side was 40 US$ (2688 rupees and from the patient's perspective was 79 US$ (5278 rupees. The average cost for a Caesarean section from the hospital side was 162 US$ (10868 rupees and 204 US$ (13678 rupees from the patient's side. Average monthly household income was 141 ± 87 US$ for spontaneous vaginal delivery and 168 ± 97 US$ for Caesarean section. Three fourth (74% of households had a monthly income of less than 149 US$ (10000 rupees. Conclusion The apparently "free" maternity care at government hospitals involves substantial hidden and unpredicted costs. The anticipated fear of these unpredicted costs may be major factor for many poor households to seek cheaper alternate maternity healthcare.

  16. The indirect costs of agency nurses in South Africa: a case study in two public sector hospitals

    Directory of Open Access Journals (Sweden)

    Laetitia C. Rispel

    2015-05-01

    Full Text Available Background: Globally, flexible work arrangements – through the use of temporary nursing staff – are an important strategy for dealing with nursing shortages in hospitals. Objective: The objective of the study was to determine the direct and indirect costs of agency nurses, as well as the advantages and the problems associated with agency nurse utilisation in two public sector hospitals in South Africa. Methods: Following ethical approval, two South African public sector hospitals were selected purposively. Direct costs were determined through an analysis of hospital expenditure information for a 5-year period from 2005 until 2010, obtained from the national transversal Basic Accounting System database. At each hospital, semi-structured interviews were conducted with the chief executive officer, executive nursing services manager, the maternity or critical care unit nursing manager, the human resource manager, and the finance manager. Indirect costs measured were the time spent on pre-employment checks, and nurse recruitment, orientation, and supervision. All expenditure is expressed in South African Rands (R: 1 USD=R7, 2010 prices. Results: In the 2009/10 financial year, Hospital 1 spent R38.86 million (US$5.55 million on nursing agencies, whereas Hospital 2 spent R10.40 million (US$1.49 million. The total estimated time spent per week on indirect cost activities at Hospital 1 was 51.5 hours, and 60 hours at Hospital 2. The estimated monetary value of this time at Hospital 1 was R962,267 (US$137,467 and at Hospital 2 the value was R300,121 (US$42,874, thus exceeding the weekly direct costs of nursing agencies. Agency nurses assisted the selected hospitals in dealing with problems of nurse recruitment, absenteeism, shortages, and skills gaps in specialised clinical areas. The problems experienced with agency nurses included their perceived lack of commitment, unreliability, and providing sub-optimal quality of patient care. Conclusion

  17. The indirect costs of agency nurses in South Africa: a case study in two public sector hospitals.

    Science.gov (United States)

    Rispel, Laetitia C; Moorman, Julia

    2015-01-01

    Globally, flexible work arrangements - through the use of temporary nursing staff - are an important strategy for dealing with nursing shortages in hospitals. The objective of the study was to determine the direct and indirect costs of agency nurses, as well as the advantages and the problems associated with agency nurse utilisation in two public sector hospitals in South Africa. Following ethical approval, two South African public sector hospitals were selected purposively. Direct costs were determined through an analysis of hospital expenditure information for a 5-year period from 2005 until 2010, obtained from the national transversal Basic Accounting System database. At each hospital, semi-structured interviews were conducted with the chief executive officer, executive nursing services manager, the maternity or critical care unit nursing manager, the human resource manager, and the finance manager. Indirect costs measured were the time spent on pre-employment checks, and nurse recruitment, orientation, and supervision. All expenditure is expressed in South African Rands (R: 1 USD=R7, 2010 prices). In the 2009/10 financial year, Hospital 1 spent R38.86 million (US$5.55 million) on nursing agencies, whereas Hospital 2 spent R10.40 million (US$1.49 million). The total estimated time spent per week on indirect cost activities at Hospital 1 was 51.5 hours, and 60 hours at Hospital 2. The estimated monetary value of this time at Hospital 1 was R962,267 (US$137,467) and at Hospital 2 the value was R300,121 (US$42,874), thus exceeding the weekly direct costs of nursing agencies. Agency nurses assisted the selected hospitals in dealing with problems of nurse recruitment, absenteeism, shortages, and skills gaps in specialised clinical areas. The problems experienced with agency nurses included their perceived lack of commitment, unreliability, and providing sub-optimal quality of patient care. Hospital managers and policy-makers need to address the effective

  18. The potential to forgo social welfare gains through overrelianceon cost effectiveness/cost utility analyses in the evidence base for public health.

    Science.gov (United States)

    Cohen, D R; Patel, N

    2009-01-01

    Economic evaluations of clinical treatments most commonly take the form of cost effectiveness or cost utility analyses. This is appropriate since the main-sometimes the only-benefit of such interventions is increased health. The majority of economic evaluations in public health, however, have also been assessed using these techniques when arguably cost benefit analyses would in many cases have been more appropriate, given its ability to take account of nonhealth benefits as well. An examination of the nonhealth benefits from a sample of studies featured in a recent review of economic evaluations in public health illustrates how overfocusing on cost effectiveness/cost utility analyses may lead to forgoing potential social welfare gains from programmes in public health. Prior to evaluation, programmes should be considered in terms of the potential importance of nonhealth benefits and where these are considerable would be better evaluated by more inclusive economic evaluation techniques.

  19. Managerial performance and cost efficiency of Japanese local public hospitals: a latent class stochastic frontier model.

    Science.gov (United States)

    Besstremyannaya, Galina

    2011-09-01

    The paper explores the link between managerial performance and cost efficiency of 617 Japanese general local public hospitals in 1999-2007. Treating managerial performance as unobservable heterogeneity, the paper employs a panel data stochastic cost frontier model with latent classes. Financial parameters associated with better managerial performance are found to be positively significant in explaining the probability of belonging to the more efficient latent class. The analysis of latent class membership was consistent with the conjecture that unobservable technological heterogeneity reflected in the existence of the latent classes is related to managerial performance. The findings may support the cause for raising efficiency of Japanese local public hospitals by enhancing the quality of management. Copyright © 2011 John Wiley & Sons, Ltd.

  20. Health status and health care costs for publicly funded patients with schizophrenia started on clozapine.

    Science.gov (United States)

    Blieden, N; Flinders, S; Hawkins, K; Reid, M; Alphs, L D; Arfken, C L

    1998-12-01

    The study examined the effect of clozapine treatment on the health care costs and health status of people with schizophrenia who are supported by public funds. Thirty-three patients with schizophrenia hospitalized in a state facility were interviewed within one week of starting clozapine and six months later. Health status was assessed with four clinical rating scales measuring severity of psychopathology, negative symptoms, depression, and quality of life. Cost and health care utilization data were collected for the six months before and after initiation of clozapine. Only 52 percent of the subjects stayed on clozapine for six months. Subjects who continued on clozapine were more likely to be discharged within six months than those who did not continue. Six months after clozapine was started, health care costs showed a sayings of $11,464 per person, even after adjustment for pretreatment costs, and health status was improved. For subjects who continued on clozapine for six months, clozapine treatment was associated with reduced days of psychiatric hospital care, reduced overall costs despite increased outpatient treatment and residential costs, and improved health status.

  1. Personalised medicine: Priority setting and opportunity costs in European public health care systems

    OpenAIRE

    Vollmann, Jochen

    2015-01-01

    “Personalised medicine” is currently attracting considerable attention and raising high hopes and expectations in modern medicine. The term “personalised medicine” denotes the use of genetic or other biomarker information, and it does not focus on a more personal patient-doctor relationship. Furthermore, personalised medicine is associated with ethical problems like priority setting and opportunity costs in solidarity-based public health care systems. Personalised medicine provides modern,...

  2. The costs of breast cancer in a Mexican public health institution

    Directory of Open Access Journals (Sweden)

    Jacobo Alejandro Gómez-Rico

    2008-11-01

    Full Text Available Jacobo Alejandro Gómez-Rico1, Marina Altagracia-Martínez1, Jaime Kravzov-Jinich1, Rosario Cárdenas-Elizalde1, Consuelo Rubio-Poo21Universidad Autónoma Metropolitano–Xochimilco (UAM-X, Departments: Biological Systems and Healthcare, Biological and Health Sciences Division (DCBS; 2Universidad Nacional Autónoma de México (UNAM, Faculty of Professional Studies-Zaragoza (FES-ZaragozaAbstract: Breast cancer (BC is the second leading cause of death as a result of neoplasia in Mexico. This study aimed to identify the direct and indirect costs of treating female outpatients diagnosed with BC at a Mexican public hospital. A cross-sectional, observational, analytical study was conducted. A total of 506 medical records were analyzed and 102 were included in the cost analysis. The micro-costing process was used to estimate treatment costs. A 17-item questionnaire was used to obtain information on direct and indirect costs. Of the 102 women with BC included in the study, 92.2% (94 were at Stage II, and only 7.8% at Stage I. Total direct costs over six months for the 82 women who had modified radical mastectomy (MRM surgury were US$733,821.15. Total direct costs for the 15 patients with conservative surgery (CS were US$138,190.39. We found that the total economic burden in the study population was much higher for patients with MRM than for patients with CS.Keywords: breast cancer, Mexican women, direct and indirect costs

  3. 45 CFR 205.150 - Cost allocation.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 2 2010-10-01 2010-10-01 false Cost allocation. 205.150 Section 205.150 Public... ASSISTANCE PROGRAMS § 205.150 Cost allocation. A State plan under title I, IV-A, X, XIV, or XVI (AABD) of the Social Security Act must provide that the State agency will have an approved cost allocation plan on...

  4. An urban strategy in time of crisis: Mobility management and low-cost public space design

    Directory of Open Access Journals (Sweden)

    Papagiannakis Apostolos

    2015-01-01

    Full Text Available This research underlines the importance of mobility management tools and small-scale targeted interventions of public space upgrades in order to encourage conscious sustainable mobility behaviour. The paper reviews tools and tactics of soft transport policy measures, as well as of small-scale and low-cost public space design approaches and strategies in the USA and Europe to assess their characteristics and results. It will then focus on Thessaloniki (Greece presenting 1 the main findings of a trip survey concerning the impact of the economic crisis on mobility behaviour and 2 the shift to low-cost street scale urban design projects which have emerged during the crisis. The paper states that quality public space and urban transport constitute conditions necessary to attain long-term change in mobility behaviour. While the importance of hard transport policy measures should not be underestimated, the strategy for achieving sustainable urban mobility and public space design adapted to the economic crisis-specific conditions is discussed.

  5. Public opinion towards supervised injection facilities and heroin-assisted treatment in Ontario, Canada.

    Science.gov (United States)

    Cruz, Michelle Firestone; Patra, Jayadeep; Fischer, Benedikt; Rehm, Jürgen; Kalousek, Kate

    2007-01-01

    In recent years, controversial interventions such as 'heroin-assisted treatment' (HAT) and 'supervised injection facilities' (SIFs) have been established in attempts to minimise the high morbidity and mortality consequences of illicit drug use. This paper examines public opinion towards HAT and SIF using data from the 2003 Centre for Addiction and Mental Health (CAMH) Monitor, a representative population survey conducted among adults residing in Ontario, Canada. Data relating specifically to SIFs and HAT were isolated from the main database (n=885); agreement scores were collapsed to create a scale and analysed using independent sample t-tests and ANOVAs. Results revealed that 60 percent (n=530) of the sample agreed that SIFs should be made available to injection drug users, while 40 percent (n=355) disagreed. When asked about the provision of HAT, a similar pattern emerged. Variables significantly associated with positive opinions toward SIFs and HAT were: income; higher education; the use of cocaine or cannabis within the last 12 months; being in favour of cannabis decriminalisation; support of needle exchange in prison; view of illicit drug users as ill people; and agreement that drug users are in need of public support. Given the current political climate and the tentative position of SIFs and HAT in Canada, understanding the public's opinion is crucial for the feasibility and long-term sustainability of these interventions.

  6. Logistics Costs Analysis as an Assisting Tool to Achieve Competitive Advantage for Agricultural Enterprises

    OpenAIRE

    Wajszczuk, Karol

    2005-01-01

    An attempt of evaluation of level and structure of logistics costs in chosen great area agricultural enterprises was shown in the paper. Results of research have shown, that great area agricultural enterprises have got high share costs of logistics both in total costs of production 42,2%, and in selling value of products and services 27,5%. Costs of physical flow of materials predominate in the structure of total logistics costs of great area agricultural enterprises 86,5%.

  7. [Evaluation of financial status of public hospitals considering the updated costs of their services].

    Science.gov (United States)

    Cid P, Camilo; Bastías S, Gabriel

    2014-02-01

    In 2011 the Chilean National Health Fund (FONASA) commissioned a study to assess the costs of the 120 most relevant hospital care services with an established fee, in a large sample of public hospitals. We herein report the cost evaluation results of such study, considering the financial condition of those hospitals in the year of the study. Based on the premise that the expenses derived from the provision of institutional and appraised hospital services should be identical to the billing of hospitals to FONASA, the prices are undervalued, since they cover only 56% of billing, generating a gap between expenses and invoicing. This gap shows an important limitation of tariffs, since their prices do not cover the real costs. However not all hospitals behave in the same way. While the provision of services of some hospitals is even higher than their billing, most hospitals do not completely justify their invoicing. These assumptions would imply that, generally speaking, hospital debts are justified by the costs incurred. However, hospitals have heterogeneous financial situations that need to be analyzed carefully. In particular, nothing can be said about their relative efficiency if cost estimations are not adjusted by the complexity of patients attended and comparison groups are not defined.

  8. Estimating cost-effectiveness in public health: a summary of modelling and valuation methods.

    Science.gov (United States)

    Marsh, Kevin; Phillips, Ceri J; Fordham, Richard; Bertranou, Evelina; Hale, Janine

    2012-09-03

    It is acknowledged that economic evaluation methods as they have been developed for Health Technology Assessment do not capture all the costs and benefits relevant to the assessment of public health interventions. This paper reviews methods that could be employed to measure and value the broader set of benefits generated by public health interventions. It is proposed that two key developments are required if this vision is to be achieved. First, there is a trend to modelling approaches that better capture the effects of public health interventions. This trend needs to continue, and economists need to consider a broader range of modelling techniques than are currently employed to assess public health interventions. The selection and implementation of alternative modelling techniques should be facilitated by the production of better data on the behavioural outcomes generated by public health interventions. Second, economists are currently exploring a number of valuation paradigms that hold the promise of more appropriate valuation of public health interventions outcomes. These include the capabilities approach and the subjective well-being approach, both of which offer the possibility of broader measures of value than the approaches currently employed by health economists. These developments should not, however, be made by economists alone. These questions, in particular what method should be used to value public health outcomes, require social value judgements that are beyond the capacity of economists. This choice will require consultation with policy makers, and perhaps even the general public. Such collaboration would have the benefit of ensuring that the methods developed are useful for decision makers.

  9. Youth's Awareness of and Reactions to The Real Cost National Tobacco Public Education Campaign.

    Directory of Open Access Journals (Sweden)

    Jennifer C Duke

    Full Text Available In 2014, the Food and Drug Administration (FDA launched its first tobacco-focused public education campaign, The Real Cost, aimed at reducing tobacco use among 12- to 17-year-olds in the United States. This study describes The Real Cost message strategy, implementation, and initial evaluation findings. The campaign was designed to encourage youth who had never smoked but are susceptible to trying cigarettes (susceptible nonsmokers and youth who have previously experimented with smoking (experimenters to reassess what they know about the "costs" of tobacco use to their body and mind. The Real Cost aired on national television, online, radio, and other media channels, resulting in high awareness levels. Overall, 89.0% of U.S. youth were aware of at least one advertisement 6 to 8 months after campaign launch, and high levels of awareness were attained within the campaign's two targeted audiences: susceptible nonsmokers (90.5% and experimenters (94.6%. Most youth consider The Real Cost advertising to be effective, based on assessments of ad perceived effectiveness (mean = 4.0 on a scale from 1.0 to 5.0. High levels of awareness and positive ad reactions are requisite proximal indicators of health behavioral change. Additional research is being conducted to assess whether potential shifts in population-level cognitions and/or behaviors are attributable to this campaign. Current findings demonstrate that The Real Cost has attained high levels of ad awareness which is a critical first step in achieving positive changes in tobacco-related attitudes and behaviors. These data can also be used to inform ongoing message and media strategies for The Real Cost and other U.S. youth tobacco prevention campaigns.

  10. The design and implementation of a public policy approach differential service, repair assistance and integral Colombia

    Directory of Open Access Journals (Sweden)

    Camilo Alberto Madariaga Orozco

    2014-01-01

    Full Text Available Objective: To analyze the strategies used by victims of forced displacement in Colombia women and the strategies employed by the institutions to participate and / or promote participation in the design of public policy of the state of attention, assistance and reparations.Method: The sample was represented by 47 women that belong to organizations, victims and officials of institutions. The techniques used were: focus groups, surveys and interviews.Results: The results show that institutional logics hinder participation; women use the following strategies: the creation of organizations and make concrete proposals to gain the respect of the entities. However lack of training. One of the biggest impacts mentioned by women was sexual violence, little psychosocial support and implement actions to eliminate or remedy the situation.

  11. Heroin-assisted treatment as a response to the public health problem of opiate dependence.

    Science.gov (United States)

    Fischer, Benedikt; Rehm, Jürgen; Kirst, Maritt; Casas, Miguel; Hall, Wayne; Krausz, Michael; Metrebian, Nicky; Reggers, Jean; Uchtenhagen, Ambros; van den Brink, Wim; van Ree, Jan M

    2002-09-01

    Injection drug use (involving the injection of illicit opiates) poses serious public health problems in many countries. Research has indicated that injection drug users are at higher risk for morbidity in the form of HIV/AIDS and Hepatitis B and C, and drug-related mortality, as well as increased criminal activity. Methadone maintenance treatment is the most prominent form of pharmacotherapy treatment for illicit opiate dependence in several countries, and its application varies internationally with respect to treatment regulations and delivery modes. In order to effectively treat those patients who have previously been resistant to methadone maintenance treatment, several countries have been studying and/or considering heroin-assisted treatment as a complementary form of opiate pharmacotherapy treatment. This paper provides an overview of the prevalence of injection drug use and the opiate dependence problem internationally, the current opiate dependence treatment landscape in several countries, and the status of ongoing or planned heroin-assisted treatment trials in Australia, Canada and certain European countries.

  12. Insurance, Public Assistance, and Household Flood Risk Reduction: A Comparative Study of Austria, England, and Romania.

    Science.gov (United States)

    Hanger, Susanne; Linnerooth-Bayer, Joanne; Surminski, Swenja; Nenciu-Posner, Cristina; Lorant, Anna; Ionescu, Radu; Patt, Anthony

    2017-08-17

    In light of increasing losses from floods, many researchers and policymakers are looking for ways to encourage flood risk reduction among communities, business, and households. In this study, we investigate risk-reduction behavior at the household level in three European Union Member States with fundamentally different insurance and compensation schemes. We try to understand if and how insurance and public assistance influence private risk-reduction behavior. Data were collected using a telephone survey (n = 1,849) of household decisionmakers in flood-prone areas. We show that insurance overall is positively associated with private risk-reduction behavior. Warranties, premium discounts, and information provision with respect to risk reduction may be an explanation for this positive relationship in the case of structural measures. Public incentives for risk-reduction measures by means of financial and in-kind support, and particularly through the provision of information, are also associated with enhancing risk reduction. In this study, public compensation is not negatively associated with private risk-reduction behavior. This does not disprove such a relationship, but the negative effect may be mitigated by factors related to respondents' capacity to implement measures or social norms that were not included in the analysis. The data suggest that large-scale flood protection infrastructure creates a sense of security that is associated with a lower level of preparedness. Across the board there is ample room to improve both public and private policies to provide effective incentives for household-level risk reduction. © 2017 The Authors Risk Analysis published by Wiley Periodicals, Inc. on behalf of Society for Risk Analysis.

  13. Costs of achieving live birth from assisted reproductive technology: a comparison of sequential single and double embryo transfer approaches.

    Science.gov (United States)

    Crawford, Sara; Boulet, Sheree L; Mneimneh, Allison S; Perkins, Kiran M; Jamieson, Denise J; Zhang, Yujia; Kissin, Dmitry M

    2016-02-01

    To assess treatment and pregnancy/infant-associated medical costs and birth outcomes for assisted reproductive technology (ART) cycles in a subset of patients using elective double embryo (ET) and to project the difference in costs and outcomes had the cycles instead been sequential single ETs (fresh followed by frozen if the fresh ET did not result in live birth). Retrospective cohort study using 2012 and 2013 data from the National ART Surveillance System. Infertility treatment centers. Fresh, autologous double ETs performed in 2012 among ART patients younger than 35 years of age with no prior ART use who cryopreserved at least one embryo. Sequential single and double ETs. Actual live birth rates and estimated ART treatment and pregnancy/infant-associated medical costs for double ET cycles started in 2012 and projected ART treatment and pregnancy/infant-associated medical costs if the double ET cycles had been performed as sequential single ETs. The estimated total ART treatment and pregnancy/infant-associated medical costs were $580.9 million for 10,001 double ETs started in 2012. If performed as sequential single ETs, estimated costs would have decreased by $195.0 million to $386.0 million, and live birth rates would have increased from 57.7%-68.0%. Sequential single ETs, when clinically appropriate, can reduce total ART treatment and pregnancy/infant-associated medical costs by reducing multiple births without lowering live birth rates. Published by Elsevier Inc.

  14. Moderation of the Relation of County-Level Cost of Living to Nutrition by the Supplemental Nutrition Assistance Program

    Science.gov (United States)

    Wimer, Christopher; Seligman, Hilary

    2016-01-01

    Objectives. To examine the association of county-level cost of living with nutrition among low-income Americans. Methods. We used the National Household Food Acquisition and Purchase Survey (2012–2013; n = 14 313; including 5414 persons in households participating in the Supplemental Nutrition Assistance Program [SNAP]) to examine associations between county-level cost-of-living metrics and both food acquisitions and the Healthy Eating Index, with control for individual-, household-, and county-level covariates and accounting for unmeasured confounders influencing both area of living and food acquisition. Results. Living in a higher-cost county—particularly one with high rent costs—was associated with significantly lower volume of acquired vegetables, fruits, and whole grains; greater volume of acquired refined grains, fats and oils, and added sugars; and an 11% lower Healthy Eating Index score. Participation in SNAP was associated with nutritional improvements among persons living in higher-cost counties. Conclusions. Living in a higher-cost county (particularly with high rent costs) is associated with poorer nutrition among low-income Americans, and SNAP may mitigate the negative nutritional impact of high cost of living. PMID:27631742

  15. Financing and cost-effectiveness analysis of public-private partnerships: provision of tuberculosis treatment in South Africa

    Directory of Open Access Journals (Sweden)

    Kumaranayake Lilani

    2006-06-01

    Full Text Available Abstract Background Public-private partnerships (PPP could be effective in scaling up services. We estimated cost and cost-effectiveness of different PPP arrangements in the provision of tuberculosis (TB treatment, and the financing required for the different models from the perspective of the provincial TB programme, provider, and the patient. Methods Two different models of TB provider partnerships are evaluated, relative to sole public provision: public-private workplace (PWP and public-private non-government (PNP. Cost and effectiveness data were collected at six sites providing directly observed treatment (DOT. Effectiveness for a 12-month cohort of new sputum positive patients was measured using cure and treatment success rates. Provider and patient costs were estimated, and analysed according to sources of financing. Cost-effectiveness is estimated from the perspective of the provider, patient and society in terms of the cost per TB case cured and cost per case successfully treated. Results Cost per case cured was significantly lower in PNP (US $354–446, and comparable between PWP (US $788–979 and public sites (US $700–1000. PPP models could significantly reduce costs to the patient by 64–100%. Relative to pure public sector provision and financing, expansion of PPPs could reduce government financing required per TB patient treated from $609–690 to $130–139 in PNP and $36–46 in PWP. Conclusion There is a strong economic case for expanding PPP in TB treatment and potentially for other types of health services. Where PPPs are tailored to target groups and supported by the public sector, scaling up of effective services could occur at much lower cost than solely relying on public sector models.

  16. Simulating Ideal Assistive Devices to Reduce the Metabolic Cost of Running

    Science.gov (United States)

    Uchida, Thomas K.; Seth, Ajay; Pouya, Soha; Dembia, Christopher L.; Hicks, Jennifer L.; Delp, Scott L.

    2016-01-01

    Tools have been used for millions of years to augment the capabilities of the human body, allowing us to accomplish tasks that would otherwise be difficult or impossible. Powered exoskeletons and other assistive devices are sophisticated modern tools that have restored bipedal locomotion in individuals with paraplegia and have endowed unimpaired individuals with superhuman strength. Despite these successes, designing assistive devices that reduce energy consumption during running remains a substantial challenge, in part because these devices disrupt the dynamics of a complex, finely tuned biological system. Furthermore, designers have hitherto relied primarily on experiments, which cannot report muscle-level energy consumption and are fraught with practical challenges. In this study, we use OpenSim to generate muscle-driven simulations of 10 human subjects running at 2 and 5 m/s. We then add ideal, massless assistive devices to our simulations and examine the predicted changes in muscle recruitment patterns and metabolic power consumption. Our simulations suggest that an assistive device should not necessarily apply the net joint moment generated by muscles during unassisted running, and an assistive device can reduce the activity of muscles that do not cross the assisted joint. Our results corroborate and suggest biomechanical explanations for similar effects observed by experimentalists, and can be used to form hypotheses for future experimental studies. The models, simulations, and software used in this study are freely available at simtk.org and can provide insight into assistive device design that complements experimental approaches. PMID:27656901

  17. 77 FR 24667 - TANF Assistance and Electronic Benefit Transfer Transactions; Request for Public Comment

    Science.gov (United States)

    2012-04-25

    ... adequate access to their cash assistance, including policies that provide access to assistance with no fees or charges or current approaches to imposing fees or charges in connection with receipt of assistance... to ensuring access to cash assistance with minimal fees or charges, including opportunities to...

  18. Are Public-Private Partnerships an Appropriate Governance Structure for Power Plants? A Transaction Cost Analysis

    Science.gov (United States)

    Ho, S. Ping; Hsu, Yaowen

    2015-04-01

    In order to meet the requirements of the rapid economic growth, many countries demand an increasing number of power plants to meet the increasing electricity usage. Since high capital requirements of power plants present a big issue for these countries, PPPs have been considered an alternative to provide power plant infrastructure. In particular, in emerging or developing countries, PPPs may be the fastest way to provide the infrastructure needed. However, while PPPs are a promising alternative to providing various types of infrastructure, many failed power plant PPP projects have made it evident that PPPs, under certain situations, can be very costly or even a wrong choice of governance structure. While the higher efficiency due to better pooling of resources is greatly emphasized in Public-Private Partnerships (PPPs), the embedded transaction inefficiencies are often understated or even ignored. Through the lens of Transaction Cost Economics (TCE), this paper aims to answer why and when PPPs may become a costly governance structure for power plants. Specifically, we develop a TCE-based theory of PPPs as a governance structure. This theory suggests that three major opportunism problems embedded in infrastructure PPPs are possible to cause substantial transaction costs and render PPPs a costly governance structure. The three main opportunism problems are principal-principal problem, firm's hold-up problem, and government-led hold-up problem. Moreover, project and institutional characteristics that may lead to opportunism problems are identified. Based on these characteristics, an opportunism-focused transaction cost analysis (OTCA) for PPPs as a governance structure is proposed to supplement the current practice of PPP feasibility analysis. As a part of theory development, a case study of PPP power plants is performed to evaluate the proposed theory and to illustrate how the proposed OTCA can be applied in practice. Policies and administration strategies for power

  19. Determinants of the direct cost of heart failure hospitalization in a public tertiary hospital.

    Science.gov (United States)

    Parissis, John; Athanasakis, Kostas; Farmakis, Dimitrios; Boubouchairopoulou, Nadia; Mareti, Christina; Bistola, Vasiliki; Ikonomidis, Ignatios; Kyriopoulos, John; Filippatos, Gerasimos; Lekakis, John

    2015-02-01

    Heart failure (HF) is the first reason for hospital admission in the elderly and represents a major financial burden, the greatest part of which results from hospitalization costs. We sought to analyze current HF hospitalization-related expenditure and identify predictors of cost in a public tertiary hospital in Europe. We performed a retrospective chart review of 197 consecutive patients, aged 56±16years, 80% male, with left ventricular ejection fraction (LVEF) of 30±10%, hospitalized for HF in a major university hospital in Athens, Greece. The survey involved the number of hospitalization days, laboratory investigations and medical therapies. Patients who were hospitalized in CCU/ICU or underwent interventional procedures or device implantations were excluded from analysis. Costs were estimated based on the Greek healthcare system perspective in 2013. Patients were hospitalized for a median of 7 days with a total direct cost of €3198±3260/patient. The largest part of the expenses (79%) was attributed to hospitalization (ward), while laboratory investigations and medical treatment accounted for 17% and 4%, respectively. In multivariate analysis, pre-admission New York Heart Association NYHA class (p=0.001), serum creatinine (p=0.003) and NT-proBNP (p=0.004) were significant independent predictors of hospitalization cost. Direct cost of HF hospitalization is high particularly in patients with more severe symptoms, profound neurohormonal activation and renal dysfunction. Strategies to lower hospitalization rates are warranted in the current setting of financial constraints faced by many European countries. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  20. The appeal to nature implicit in certain restrictions on public funding for assisted reproductive technology.

    Science.gov (United States)

    Carter, Drew; Braunack-Mayer, Annette

    2011-10-01

    Certain restrictions on public funding for assisted reproductive technology (ART) are articulated and defended by recourse to a distinction between medical infertility and social infertility. We propose that underlying the prioritization of medical infertility is a vision of medicine whose proper role is to restore but not to improve upon nature. We go on to mark moral responses that speak of investments many continue to make in nature as properly an object of reverence and gratitude and therein (sometimes) a source of moral guidance. We draw on the work of Ludwig Wittgenstein in arguing for the plausibility of an appeal to nature in opposition to the charge that it must contain a logical fallacy. We also invite consideration of the moral plausibility of some appeal to nature. Finally, we examine what follows in the case of ART. Should medicine respect as natural limits that should not be overcome: the need for a man and a woman in reproduction; menopause; and even declining fertility with age? We must first ask ourselves to what degree we should defer to nature in the conduct of medicine, at least in the particular if not the general case. This will involve also asking ourselves what we think is natural and in what instances and spirit might we defy nature. Divergent opinions and policies concerning who should receive ART treatment and public funding are more easily understood in view of the centrality, complexity and fundamental nature of these questions.

  1. Compendium of publicly available reports on procurement and financial assistance awards

    Energy Technology Data Exchange (ETDEWEB)

    1978-07-01

    The public has shown a particular interest in the Department of Energy's procurement, contracting, and financial assistance programs. Procurement systems reports involve extensive information on over 6,000 active prime contracts, grants, loan guarantees and agreements of several types, plus over 30,000 small purchase transactions. This Compendium eliminates some confusion and will serve the needs of most of the people who wonder what kind of procurement systems reports are available from the Department of Energy. This Compendium has three major sections. The Published Reports section includes computer-generated reports, which will be published annually with a cumulative monthly update. The annual reports will be published as of September 30, the end of the Federal Fiscal Year. Alongside each report is a summary of the report showing the data elements included in the report. When available, these reports can be obtained from your nearest Energy Extension Service office. A list of the Department of Energy's ten Energy Extension Service offices is included in this publication. The Unpublished Reports section is comprised of available, computer-generated reports with a summary of each report and a listing of data elements included in the report. Unpublished reports are reformats or subsets of information available in the published reports and are generated on a limited basis for repetitive Departmental needs. The Special Reports section contains formats or subsets of information on energy or energy-related projects. (MCW)

  2. Impact of Vice President Cheney on public interest in left ventricular assist devices and heart transplantation.

    Science.gov (United States)

    Pandey, Ambarish; Abdullah, Kazeen; Drazner, Mark H

    2014-05-01

    Although celebrity illnesses attract a significant amount of media attention in the United States, there are few studies that have looked at how celebrity health conditions impact the awareness of the illness in the general population. Recently, Vice President Cheney underwent left ventricular assist device (LVAD) implantation and subsequently a cardiac transplant. The aim of this study was to determine whether there was evidence of increased interest in these 2 procedures as assessed by social media. We determined the relative frequency of Google searches for LVAD and heart transplantation from 2004 to 2013 using Google trends. We also counted the number of YouTube videos and Twitter messages posted monthly concerning LVADs over a 7-year time frame. There was a significant spike in the Google search interest for LVAD and heart transplantation in the month when Vice President Cheney underwent the respective procedure. Similarly, there was a large increase in YouTube videos and Twitter messages concerning LVADs shortly after he was implanted. In total, these data support the concept that a public figure's illness can significantly influence the public's interest in that condition and its associated therapies.

  3. 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.

  4. Hospital cost flexibility in the presence of many outputs: a public-private comparison.

    Science.gov (United States)

    Crémieux, Pierre-Yves; Ouellette, Pierre; Rimbaud, François; Vigeant, Stéphane

    2005-05-01

    This paper develops flexibility measures in the context of a multi-firm output based on a generalized average cost function. We then apply this methodology to assess and compare the relative flexibility of hospital services in Québec and California based on two very complete data sets. Results indicate that there is no clear distinction between private and public institutions and that there is no clear distinction between Québec and California hospitals. However, there are clear differences in flexibility among different outputs. This last result suggests that there are bottlenecks in the health care system and calls for a targeted approach on the part of hospital administrators, whether public or private, in Québec or California.

  5. COST OF NURSING ASSISTENCE IN INTENSIVE-CARE UNIT OF AN UNIVERSITY HOSPITAL

    Directory of Open Access Journals (Sweden)

    Vivian Schutz

    2012-02-01

    Full Text Available Objetivos: Estimar o custo da intervenção da Assistência de Enfermagem em pacientes da UTI de um Hospital Universitário; identificar o tempo médio da assistência de enfermagem ao paciente da UTI em cada plantão. Método: Trata-se de uma pesquisa de campo, prospectiva, de abordagem quantitativa, do tipo descritivo-exploratória. A partir dos dados coletados e quantificados, utilizou-se a expressão: “CD/d = 0.35 x ND x S + 0.35 x NM x S x k". Resultados: Os custos com a Assistência de Enfermagem representam uma fatia significativa no orçamento de qualquer hospital, existindo discrepâncias de custos da assistência entre o serviço diurno e o serviço noturno, sendo o maior valor do custo médio observado no serviço diurno. Uma maneira de solucionar tal problema poderia ser a otimização da rotina de Enfermagem, tanto na assistência, com a adoção da Sistematização da Assistência de Enfermagem (SAE, como no processo de trabalho, através da formulação de protocolos de atendimento para este tipo de cliente. Conclusão: Este estudo possibilitou a elaboração de uma metodologia de cálculo de custos, que se mostrou ser válida para a aplicação prática e para contribuir na diminuição da carência de estudos nessa área. Descritores:: Alocação de custos, Unidades de Terapia Intensiva, Assistência de Enfermagem

  6. Summary of Benefits under the Educational Assistance Test Program Section 901 of Public Law 96-342. Revised

    Science.gov (United States)

    US Department of Veterans Affairs, 2003

    2003-01-01

    Section 901 is an Educational Assistance Test Program created by the Department of Defense Authorization Act of 1981 (Public Law 96-342) to individuals who entered on active duty after September 30, 1980, and before October 1, 1981 (or before October 1, 1982, if entry was under a delayed enlistment contract signed between September 30, 1980, and…

  7. Teaching the Importance and Use of Web-Based Services to Assist Clients in Obtaining Public Benefits

    Science.gov (United States)

    Eamon, Mary Keegan; Wu, Chi-Fang; Moroney, Gabriela; Cundari, Melissa

    2013-01-01

    Research suggests that social work students and practitioners are not particularly sensitive to assessing clients' economic hardship, nor when needed to assist clients in accessing relevant resources such as public benefits. To enhance students' understanding of the importance of engaging in these activities, this article provides…

  8. 78 FR 34666 - Section 8 Housing Assistance Payments Program-Fiscal Year (FY) 2013 Inflation Factors for Public...

    Science.gov (United States)

    2013-06-10

    ... URBAN DEVELOPMENT Section 8 Housing Assistance Payments Program--Fiscal Year (FY) 2013 Inflation Factors... Voucher (HCV) Program of each PHA. For FY 2011 and FY 2010, renewal funding was based on annual adjustment.... Dennis, Director, Housing Voucher Programs, Office of Public Housing and Voucher Programs, Office...

  9. Public Assistance Receipt among Native-Born Children of Immigrants. Policy Brief. Welfare, Children & Families: A Three-City Study.

    Science.gov (United States)

    Cherlin, Andrew; Fomby, Paula; Angel, Ronald; Henrici, Jane

    The 1996 welfare reform law restricted immigrants' eligibility for public assistance, although many states have at least partially restored their eligibility. However, about three-fourths of the children of non-citizen immigrants were born in the United States and are therefore eligible for all government benefits. This brief examines whether…

  10. Collaboration across private and public sector primary health care services: benefits, costs and policy implications.

    Science.gov (United States)

    McDonald, Julie; Powell Davies, Gawaine; Jayasuriya, Rohan; Fort Harris, Mark

    2011-07-01

    Ongoing care for chronic conditions is best provided by interprofessional teams. There are challenges in achieving this where teams cross organisational boundaries. This article explores the influence of organisational factors on collaboration between private and public sector primary and community health services involved in diabetes care. It involved a case study using qualitative methods. Forty-five participants from 20 organisations were purposively recruited. Data were collected through semi-structured interviews and from content analysis of documents. Thematic analysis was used employing a two-level coding system and cross case comparisons. The patterns of collaborative patient care were influenced by a combination of factors relating to the benefits and costs of collaboration and the influence of support mechanisms. Benefits lay in achieving common or complementary health or organisational goals. Costs were incurred in bridging differences in organisational size, structure, complexity and culture. Collaboration was easier between private sector organisations than between private and public sectors. Financial incentives were not sufficient to overcome organisational barriers. To achieve more coordinated primary and community health care structural changes are also needed to better align funding mechanisms, priorities and accountabilities of the different organisations.

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

    NARCIS (Netherlands)

    Römer, Gerardus Richardus, Bernardus, Engelina; Stuyt, Harry J.A.; Peters, Albér

    2005-01-01

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

  12. Cost analysis of robot-assisted choledochotomy and common bile duct exploration as an option for complex choledocholithiasis.

    Science.gov (United States)

    Almamar, Ahmed; Alkhamesi, Nawar A; Davies, Ward T; Schlachta, Christopher M

    2017-08-15

    The aim of this study is to evaluate the clinical outcomes and cost-effectiveness of elective, robot-assisted choledochotomy and common bile duct exploration (RCD/CBDE) compared to open surgery for ERCP refractory choledocholithiasis. A prospective database of all RCD/CBDE has been maintained since our first procedure in April 2007 though April 2016. With ethics approval, this database was compared with all contemporaneous elective open procedures (OCD/CBDE) performed since March 2005. Emergency procedures were excluded from analysis. Cost analysis was calculated using a micro-costing approach. Outcomes were analyzed on the basis of intent-to-treat. A p value of 0.05 denoted statistical significance. A total of 80 cases were performed since 2005 compromising 50 consecutive, unselected RCD/CBDE and 30 OCD/CBDE. Comparing RCD/CBDE to OCD/CBDE there were no significant differences between groups with respect to age (65 ± 20 vs. 67 ± 18 years, p = 0.09), gender (14/30 vs. 16/25 male/female, p = 0.52), ASA class or co-morbidities. The mean duration of surgery for RCD/CBDE trended longer compared to OCD/CBDE (205 ± 70 min vs. 174 ± 73 min, p = 0.08). However, there was significant reduction in postoperative complications with RCD/CBDE versus OCD/CBDE (22% vs. 56%, p = 0.002). Median hospital stay was also significantly reduced (6 vs 12 days, p = 0.01). The net overall hospital cost for RCD/CBDE was lower ($8449.88 CAD vs. $11671.2 CAD). In this single-centre, cohort study, robotic-assisted CD/CBDE for ERCP refractory common bile duct stones provides the dominating strategy of improved patient outcomes with a reduction of overall cost.

  13. Universal public finance of tuberculosis treatment in India: an extended cost-effectiveness analysis.

    Science.gov (United States)

    Verguet, Stéphane; Laxminarayan, Ramanan; Jamison, Dean T

    2015-03-01

    Universal public finance (UPF)-government financing of an intervention irrespective of who is receiving it-for a health intervention entails consequences in multiple domains. First, UPF increases intervention uptake and hence the extent of consequent health gains. Second, UPF generates financial consequences including the crowding out of private expenditures. Finally, UPF provides insurance either by covering catastrophic expenditures, which would otherwise throw households into poverty or by preventing diseases that cause them. This paper develops a method-extended cost-effectiveness analysis (ECEA)-for evaluating the consequences of UPF in each of these domains. It then illustrates ECEA with an evaluation of UPF for tuberculosis treatment in India. Using plausible values for key parameters, our base case ECEA concludes that the health gains and insurance value of UPF would accrue primarily to the poor. Reductions in out-of-pocket expenditures are more uniformly distributed across income quintiles. A variant on our base case suggests that lowering costs of borrowing for the poor could potentially achieve some of the health gains of UPF, but at the cost of leaving the poor more deeply in debt.

  14. The implementation of the Quality Costs Methodology in the Public Transport Enterprise in Macedonia

    Directory of Open Access Journals (Sweden)

    Elizabeta Mitreva

    2017-02-01

    Full Text Available The implementation of TQM (Total Quality Management strategy in the public transport enterprises in Macedonia means improving the quality of services through examination of business processes not just in terms of defining, improvement and design of the process, but also improvement of productivity and optimization of the costs of quality. The purpose of this study is to point out the importance of determining the quality of the transport services, its methods, and techniques for measurement of the optimization of business processes in particular. The analysis of the quality costs when providing transport services can help managers to understand the impact of poor quality on the financial results and the bad image it gives to the enterprise. In this study, we proposed and applied the model for better performance and higher efficiency of the transport enterprise, through the optimization of business processes, change in the corporate culture and use of the complete business potentials. The need for this methodology was imposed as a result of the analysis made in the company in terms of whether is it doing an analysis on the costs of quality or not. The benefits from the utilization of this model will not only lead to increasing the business performance of the transport enterprise, but this model will also serve as a driving force for continuous improvements to the satisfaction of all stakeholders.

  15. 76 FR 60031 - Notice of Order: Revisions to Enterprise Public Use Database Incorporating High-Cost Single...

    Science.gov (United States)

    2011-09-28

    ... AGENCY Notice of Order: Revisions to Enterprise Public Use Database Incorporating High-Cost Single-Family... contains Enterprise single-family and multifamily mortgage loan-level data reported to FHFA by the... data characteristics of single-family high-cost loans purchased and securitized by the Enterprises...

  16. 76 FR 77533 - Notice of Order: Revisions to Enterprise Public Use Database Incorporating High-Cost Single...

    Science.gov (United States)

    2011-12-13

    ... AGENCY Notice of Order: Revisions to Enterprise Public Use Database Incorporating High-Cost Single-Family... matrices to include certain data fields for high-cost single-family loans purchased and securitized by the... rate spread field has been corrected in the Single Family Census Tract Data Set. Both files...

  17. 77 FR 49004 - Notice of Proposed Information Collection for Public Comment; Rental Assistance Demonstration...

    Science.gov (United States)

    2012-08-15

    ...), Rental Assistance Payment (RAP) and Mod Rehab properties upon contract expiration or termination, to convert Tenant Protection Vouchers (TPVs) to Project Based Vouchers (PBVs). Participation in the... Supplement (Rent Supp), Rental Assistance Payment (RAP), and Mod Rehab properties, upon contract...

  18. Public finance of rotavirus vaccination in India and Ethiopia: an extended cost-effectiveness analysis.

    Science.gov (United States)

    Verguet, Stéphane; Murphy, Shane; Anderson, Benjamin; Johansson, Kjell Arne; Glass, Roger; Rheingans, Richard

    2013-10-01

    An estimated 4% of global child deaths (approximately 300,000 deaths) were attributed to rotavirus in 2010. About a third of these deaths occurred in India and Ethiopia. Public finance of rotavirus vaccination in these two countries could substantially decrease child mortality and also reduce rotavirus-related hospitalizations, prevent health-related impoverishment and bring significant cost savings to households. We use a methodology of 'extended cost-effectiveness analysis' (ECEA) to evaluate a hypothetical publicly financed program for rotavirus vaccination in India and Ethiopia. We measure program impact along four dimensions: 1) rotavirus deaths averted; 2) household expenditures averted; 3) financial risk protection afforded; 4) distributional consequences across the wealth strata of the country populations. In India and Ethiopia, the program would lead to a substantial decrease in rotavirus deaths, mainly among the poorer; it would reduce household expenditures across all income groups and it would effectively provide financial risk protection, mostly concentrated among the poorest. Potential indirect benefits of vaccination (herd immunity) would increase program benefits among all income groups, whereas potentially decreased vaccine efficacy among poorer households would reduce the equity benefits of the program. Our approach incorporates financial risk protection and distributional consequences into the systematic economic evaluation of vaccine policy, illustrated here with the case study of public finance for rotavirus vaccination. This enables selection of vaccine packages based on the quantitative inclusion of information on equity and on how much financial risk protection is being bought per dollar expenditure on vaccine policy, in addition to how much health is being bought. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. Cost comparison between private and public collection of residual household waste: Multiple case studies in the Flemish region of Belgium

    Energy Technology Data Exchange (ETDEWEB)

    Jacobsen, R., E-mail: ray.jacobsen@ugent.be [Department of Agricultural Economics, Ghent University, Coupure Links 653, B-9000 Ghent (Belgium); Buysse, J., E-mail: j.buysse@ugent.be [Department of Agricultural Economics, Ghent University, Coupure Links 653, B-9000 Ghent (Belgium); Gellynck, X., E-mail: xavier.gellynck@ugent.be [Department of Agricultural Economics, Ghent University, Coupure Links 653, B-9000 Ghent (Belgium)

    2013-01-15

    Highlights: Black-Right-Pointing-Pointer The goal is to compare collection costs for residual household waste. Black-Right-Pointing-Pointer We have clustered all municipalities in order to find mutual comparable pairs. Black-Right-Pointing-Pointer Each pair consists of one private and one public operating waste collection program. Black-Right-Pointing-Pointer All cases show that private service has lower costs than public service. Black-Right-Pointing-Pointer Municipalities were contacted to identify the deeper causes for the waste management program. - Abstract: The rising pressure in terms of cost efficiency on public services pushes governments to transfer part of those services to the private sector. A trend towards more privatizing can be noticed in the collection of municipal household waste. This paper reports the findings of a research project aiming to compare the cost between the service of private and public collection of residual household waste. Multiple case studies of municipalities about the Flemish region of Belgium were conducted. Data concerning the year 2009 were gathered through in-depth interviews in 2010. In total 12 municipalities were investigated, divided into three mutual comparable pairs with a weekly and three mutual comparable pairs with a fortnightly residual waste collection. The results give a rough indication that in all cases the cost of private service is lower than public service in the collection of household waste. Albeit that there is an interest in establishing whether there are differences in the costs and service levels between public and private waste collection services, there are clear difficulties in establishing comparisons that can be made without having to rely on a large number of assumptions and corrections. However, given the cost difference, it remains the responsibility of the municipalities to decide upon the service they offer their citizens, regardless the cost efficiency: public or private.

  20. Analyzing the Cost-Effectiveness of Instruction Expenditures towards High School Completion among Oahu's Public School Districts

    Science.gov (United States)

    Ng, Larson S. W. M.

    2011-01-01

    The following study attempted to ascertain the instructional cost-effectiveness of public high school teachers towards high school completion through a financially based econometric analysis. Essentially, public high school instruction expenditures and completer data were collected from 2000 to 2007 and bivariate interaction analyzed through a…

  1. The High Cost of Failing to Reform Public Education in Texas. School Choice Issues in the State

    Science.gov (United States)

    Gottlob, Brian J.

    2008-01-01

    Research has documented a crisis in Texas high school graduation rates. Only 67 percent of Texas students graduate from high school, and some large urban districts have graduation rates of 50 percent or lower. This study documents the public costs of high school dropouts in Texas and examines how school choice could provide large public benefits…

  2. Cost Analysis of U.S. Navy Humanitarian Assistance and Disaster Relief Missions

    Science.gov (United States)

    2014-12-01

    underwater topography of the area. This situation would strongly increase the value in sending a Hydrographic Survey Ship (T-AGS) to investigate the...such as drones may be valuable assets in the HA/DR mission. Providing a model for how many may be required may assist future planners in their

  3. Cost-analysis of robotic-assisted laparoscopic hysterectomy versus total abdominal hysterectomy for women with endometrial cancer and atypical complex hyperplasia

    DEFF Research Database (Denmark)

    Herling, Suzanne Forsyth; Palle, Connie; Møller, Ann M

    2016-01-01

    INTRODUCTION: The aim of this study was to analyse the hospital cost of treatment with robotic-assisted laparoscopic hysterectomy and total abdominal hysterectomy for women with endometrial cancer or atypical complex hyperplasia and to identify differences in resource use and cost. MATERIAL...... AND METHODS: This cost analysis was based on two cohorts: women treated with robotic-assisted laparoscopic hysterectomy (n = 202) or with total abdominal hysterectomy (n = 158) at Copenhagen University Hospital, Herlev, Denmark. We conducted an activity-based cost analysis including consumables and healthcare...... professionals' salaries. As cost-drivers we included severe complications, duration of surgery, anesthesia and stay at the post-anesthetic care unit, as well as number of hospital bed-days. Ordinary least-squares regression was used to explore the cost variation. The primary outcome was cost difference...

  4. Higher Education Cost Measurement: Public Policy Issues, Options, and Strategies. A Compilation of Background Papers Prepared for a Seminar on Cost Measurement and Management. The New Millennium Project on Higher Education Costs, Pricing, and Productivity.

    Science.gov (United States)

    Wellman, Jane, Comp.; O'Brien, Colleen, Comp.

    This collection of papers is the result of a project by the Institute for Higher Education Policy designed to explore the public policy aspects of higher education cost measurement (expenditure analysis). Papers come from a 1-day seminar in 1999 that brought together individuals knowledgeable about cost measurement with institutional leaders and…

  5. Utilisation and costs of nursing agencies in the South African public health sector, 2005–2010

    Directory of Open Access Journals (Sweden)

    Laetitia C. Rispel

    2014-12-01

    Full Text Available Background: Globally, insufficient information exists on the costs of nursing agencies, which are temporary employment service providers that supply nurses to health establishments and/or private individuals. Objective: The aim of the study was to determine the utilisation and direct costs of nursing agencies in the South African public health sector. Design: A survey of all nine provincial health departments was conducted to determine utilisation and management of nursing agencies. The costs of nursing agencies were assumed to be equivalent to expenditure. Provincial health expenditure was obtained for five financial years (2005/6–2009/10 from the national Basic Accounting System database, and analysed using Microsoft Excel. Each of the 166,466 expenditure line items was coded. The total personnel and nursing agency expenditure was calculated for each financial year and for each province. Nursing agency expenditure as a percentage of the total personnel expenditure was then calculated. The nursing agency expenditure for South Africa is the total of all provincial expenditure. The 2009/10 annual government salary scales for different categories of nurses were used to calculate the number of permanent nurses who could have been employed in lieu of agency expenditure. All expenditure is expressed in South African rands (R; US$1 ∼ R7, 2010 prices. Results: Only five provinces reported utilisation of nursing agencies, but all provinces showed agency expenditure. In the 2009/10 financial year, R1.49 billion (US$212.64 million was spent on nursing agencies in the public health sector. In the same year, agency expenditure ranged from a low of R36.45 million (US$5.20 million in Mpumalanga Province (mixed urban-rural to a high of R356.43 million (US$50.92 million in the Eastern Cape Province (mixed urban-rural. Agency expenditure as a percentage of personnel expenditure ranged from 0.96% in KwaZulu-Natal Province (mixed urban-rural to 11.96% in the

  6. Costs of Public Pharmaceutical Services in Rio de Janeiro Compared to Farmácia Popular Program.

    Science.gov (United States)

    Silva, Rondineli Mendes da; Caetano, Rosângela

    2016-12-22

    To analyze the costs of public pharmaceutical services compared to Farmácia Popular Program (Popular Pharmacy Program). Comparison between prices paid by Aqui Tem Farmácia Popular Program (Farmácia Popular is available here) with the full costs of medicine provision by the Municipal Health Department of Rio de Janeiro. The comparison comprised 25 medicines supplied by both the municipal pharmaceutical service and Aqui Tem Farmácia Popular Program. Calculating the cost per pharmaceutical unit of each medicine included expenditure by Municipal Health Department of Rio de Janeiro with procurement (price), logistics, and local dispensation. The reference price of medicines paid by Aqui Tem Farmácia Popular was taken from the Brazilian Ministry of Health standard in force in 2012. Comparisons included full reference price; reference price minus 10.0% copayment by users; and maximum reference paid by the Ministry of Health (minus copayment and taxes). Simulations were carried out of the differences between the costs of Municipal Health Department of Rio de Janeiro with the common medicines and those potentially incurred based on the reference price of Aqui Tem Farmácia Popular. The Municipal Health Department of Rio de Janeiro spent R$28,526,526.57 with 25 medicines of the common list in 2012; 58.7% accounted for direct procurement costs. The estimated costs of the Health Department were generally lower than the reference prices of the Aqui Tem Farmácia Popular Program for 20 medicines, regardless of reference prices. The potential costs incurred by Health Department if expenditure of its consumption pattern were based on the reference prices of Aqui Tem Farmácia Popular would be R$124,170,777.76, considering the best scenario of payment by the Brazilian Ministry of Health (90.0% of the reference price, minus taxes). The difference in costs between public provision by Municipal Health Department of Rio de Janeiro and Farmácia Popular Program indicates that some

  7. Allocating Risks in Public-Private Partnerships Using a Transaction Cost Economic Approach: A Case Study

    Directory of Open Access Journals (Sweden)

    Xioa-Hua Jin

    2012-11-01

    Full Text Available Public-private partnership (PPP projects are often characterisedby increased complexity and uncertainty due to their idiosyncrasyin the management and delivery processes such as long-termlifecycle, incomplete contracting, and the multitude of stakeholders.An appropriate risk allocation is particularly crucial to achievingproject success. This paper focuses on the risk allocation in PPPprojects and argues that the transaction cost economics (TCEtheory can integrate the economics part, which is currently missing,into the risk management research. A TCE-based approach isproposed as a logical framework for allocating risks between publicand private sectors in PPP projects. A case study of the SouthernCross Station redevelopment project in Australia is presented toillustrate the approach. The allocation of important risks is putunder scrutiny. Lessons learnt are discussed and alternativemanagement approaches drawing on TCE theory are proposed.

  8. Punish, but not too hard: How costly punishment spreads in the spatial public goods game

    CERN Document Server

    Helbing, Dirk; Perc, Matjaz; Szabo, Gyorgy

    2010-01-01

    We study the evolution of cooperation in spatial public goods games where, besides the classical strategies of cooperation (C) and defection (D), we consider punishing cooperators (PC) or punishing defectors (PD) as an additional strategy. Using a minimalist modeling approach, our goal is to separately clarify and identify the consequences of the two punishing strategies. Since punishment is costly, punishing strategies loose the evolutionary competition in case of well-mixed interactions. When spatial interactions are taken into account, however, the outcome can be strikingly different, and cooperation may spread. The underlying mechanism depends on the character of the punishment strategy. In case of cooperating punishers, increasing the fine results in a rising cooperation level. In contrast, in the presence of the PD strategy, the phase diagram exhibits a reentrant transition as the fine is increased. Accordingly, the level of cooperation shows a non-monotonous dependence on the fine. Remarkably, punishin...

  9. Modifiable factors to decrease the cost of robotic-assisted procedures.

    Science.gov (United States)

    Nayeemuddin, Mohammed; Daley, Susan C; Ellsworth, Pamela

    2013-10-01

    In 2000, the US Food and Drug Administration approved the da Vinci Surgical System® for use in the United States. Since that time, the number of surgical robotic systems throughout the United States has continued to grow. The costs for using the system include the initial purchase ($1 million to $2.3 million) plus annual maintenance fees ($100,000 to $150,000) and the cost of limited-use or disposable instruments. Increasing the number of procedures that are performed using the robotic system can decrease the per-procedure costs. Two modifiable factors that contribute to increasing the annual caseload are increasing the number of surgeons capable of using the system and having a properly educated perioperative nursing team. An educated surgical team decreases turnover time, facilitates proper flow of each surgical procedure, and is able to actively and passively solve intraoperative problems.

  10. Hearing Assistive Technology

    Science.gov (United States)

    ... for the Public / Hearing and Balance Hearing Assistive Technology Hearing Assistive Technology: FM Systems | Infrared Systems | Induction ... Assistive Technology Systems Solutions What are hearing assistive technology systems (HATS)? Hearing assistive technology systems (HATS) are ...

  11. DRIE and Bonding Assisted Low Cost MEMS Processing of In-plane HAR Inertial Sensors

    NARCIS (Netherlands)

    Rajaraman, V.; Makinwa, K.A.A.; French, P.J.

    2008-01-01

    We present a simple, flexible and low cost MEMS fabrication process, developed using deep reactive ion etching (DRIE) and wafer bonding technologies, for manufacturing in-plane high aspect ratio (HAR) inertial sensors. Among examples, the design and fabrication results of a two axis inertial device

  12. 78 FR 5164 - Notice of Agricultural Management Assistance Organic Certification Cost-Share Program

    Science.gov (United States)

    2013-01-24

    ... Patricia Atkins, Agricultural Marketing Specialist, National Organic Program, USDA/AMS/NOP, Room 2648-South... CONTACT: Patricia Atkins, Agricultural Marketing Specialist, NOP, USDA/AMS/NOP, Room 2648-South, Ag Stop...: Patricia.Atkins@ams.usda.gov . SUPPLEMENTARY INFORMATION: This Organic Certification Cost-Share Program...

  13. DRIE and Bonding Assisted Low Cost MEMS Processing of In-plane HAR Inertial Sensors

    NARCIS (Netherlands)

    Rajaraman, V.; Makinwa, K.A.A.; French, P.J.

    2008-01-01

    We present a simple, flexible and low cost MEMS fabrication process, developed using deep reactive ion etching (DRIE) and wafer bonding technologies, for manufacturing in-plane high aspect ratio (HAR) inertial sensors. Among examples, the design and fabrication results of a two axis inertial device

  14. Application and importance of cost-benefit analysis in energy efficiency projects implemented in public buildings: The case of Serbia

    Directory of Open Access Journals (Sweden)

    Đurovic Dejan M.

    2012-01-01

    Full Text Available The main objective of this paper is to present the advantages of using Cost-Benefit analysis in energy efficiency projects implemented in public buildings, and to prove the hypothesis that Cost-Benefit analysis boosts the effectiveness and efficiency of the said type of projects. The paper offers theoretical and practical explanation of the implementation of Cost-Benefit analysis in the relevant area. Since energy efficiency projects in public buildings usually represent a part of a broader portfolio of similar projects and their implementation demands allocation of substantial financial resources, communities are often be interested in achieving maximal economic and non-economic benefits. This paper aims to demonstrate that Cost-Benefit analysis can represent an excellent contribution when attempting to select the projects for implementation within a broader portfolio of energy efficiency projects in public buildings. This hypothesis was demonstrated by putting a greater emphasis on non-economic benefits and the costs arising from implementation of the aforementioned types of projects. In addition, a practical test of this hypothesis was performed through the implementation of an energy efficiency portfolio in public buildings, worth several tens of millions of dollars - the Serbian Energy Efficiency Project. The paper concludes that the use of Cost-Benefit analysis can help us to effectively evaluate and manage projects of this type aimed at achieving maximum benefits for the community in question.

  15. A Low-Cost Launch Assistance System for Orbital Launch Vehicles

    Directory of Open Access Journals (Sweden)

    Oleg Nizhnik

    2012-01-01

    Full Text Available The author reviews the state of art of nonrocket launch assistance systems (LASs for spaceflight focusing on air launch options. The author proposes an alternative technologically feasible LAS based on a combination of approaches: air launch, high-altitude balloon, and tethered LAS. Proposed LAS can be implemented with the existing off-the-shelf hardware delivering 7 kg to low-earth orbit for the 5200 USD per kg. Proposed design can deliver larger reduction in price and larger orbital payloads with the future advances in the aerostats, ropes, electrical motors, and terrestrial power networks.

  16. Costs Systems: Relevance, Feasibility And Usefulness According To Public Officials In The State Of Paraná (Brazil

    Directory of Open Access Journals (Sweden)

    Luciane Maria Gonçalves Franco

    2013-06-01

    Full Text Available The aim in this study is to get to know the level of understanding and adoption of cost systems in cities in the State of Paraná. A descriptive study with a qualitative approach was undertaken. Data were collected through the application of a questionnaire in 67 cities in the State of Paraná. Descriptive analysis was used and Spearman’s correlation coefficient was applied to achieve the research objective. Among the study results, the following stand out: the incipient nature of knowledge about the relevance, feasibility and usefulness of a cost system; resulting from public officials’ limited knowledge, mainly about topics related to the budgetary and financial feasibility of adopting cost systems; an environment for the cost system, implemented costs systems and operating systems; although the answers obtained to proposals about cost information and control were significantly coherent.

  17. 75 FR 24962 - Notice of Proposed Information Collection for Public Comment: Disaster Assistance Program...

    Science.gov (United States)

    2010-05-06

    .... ADDRESSES: Interest persons are invited to submit comments regarding this proposal. Comments should refer to... proposed use: To assist households displaced by Hurricane Katrina in 2005, the Disaster Housing Assistance... displaced families from September 1, 2007, through February 28, 2009. DHAP was implemented in phases,...

  18. Initial Energy Logistics Cost Analysis for Stationary, Quasi-Dynamic, and Dynamic Wireless Charging Public Transportation Systems

    Directory of Open Access Journals (Sweden)

    Young Jae Jang

    2016-06-01

    Full Text Available This paper presents an initial investment cost analysis of public transportation systems operating with wireless charging electric vehicles (EVs. There are three different types of wireless charging systems, namely, stationary wireless charging (SWC, in which charging happens only when the vehicle is parked or idle, quasi-dynamic wireless charging (QWC, in which power is transferred when a vehicle is moving slowly or in stop-and-go mode, and dynamic wireless charging (DWC, in which power can be supplied even when the vehicle is in motion. This analysis compares the initial investment costs for these three types of charging systems for a wireless charging-based public transportation system. In particular, this analysis is focused on the energy logistics cost in transportation, which is defined as the cost of transferring and storing the energy needed to operate the transportation system. Performing this initial investment analysis is complicated, because it involves considerable tradeoffs between the costs of batteries in the EV fleet and different kinds of battery-charging infrastructure. Mathematical optimization models for each type of EV and infrastructure system are used to analyze the initial costs. The optimization methods evaluate the minimum initial investment needed to deploy the public transportation system for each type of EV charging solution. To deal with the variable cost estimates for batteries and infrastructure equipment in the current market, a cost-sensitivity analysis is performed. The goal of this analysis is to identify the market cost conditions that are most favorable for each type of wireless charging solution. Furthermore, the cost analysis quantitatively verifies the qualitative comparison of the three different wireless charging types conducted in the previous research.

  19. 43 CFR 12.62 - Allowable costs.

    Science.gov (United States)

    2010-10-01

    ... Public Lands: Interior Office of the Secretary of the Interior ADMINISTRATIVE AND AUDIT REQUIREMENTS AND COST PRINCIPLES FOR ASSISTANCE PROGRAMS Uniform Administrative Requirements for Grants and Cooperative... increment above allowable costs) to the grantee or subgrantee. (b) Applicable cost principles. For each...

  20. A Public Health Nursing Model Assists Women Receiving Temporary Assistance for Needy Families Benefits to Identify a Usual Source of Primary Care.

    Science.gov (United States)

    Cook, Christa L; Hall, Allyson G; Garvan, Cynthia S; Kneipp, Shawn M

    2015-01-01

    Women enrolled in Florida's Temporary Assistance for Needy Families (TANF) program experience high rates of chronic health problems and often lack a usual source of care. Thus, in this study, we aimed to identify variables related to being in a usual source of care at time of study enrollment and determine whether a public health nursing case management intervention affected the obtainment of a usual source of care. To achieve these aims, we conducted a secondary analysis of a randomized controlled trial of a public health nursing case management intervention, which included women with chronic health conditions enrolled in TANF (n = 432). Results indicated 35% of the women did not identify a usual source of care at time of study enrollment, and the public health nursing intervention was effective in helping women obtain a usual source of care (OR = 2.5, 95% CI 1.004-6.491). Thus, a public health nursing case management intervention is an effective way to connect TANF participants to a usual source of care, which may lead to improved health outcomes in this vulnerable population of women.

  1. Robot-assisted surgery in gynecological oncology: current status and controversies on patient benefits, cost and surgeon conditions - a systematic review.

    Science.gov (United States)

    Kristensen, Steffen E; Mosgaard, Berit J; Rosendahl, Mikkel; Dalsgaard, Tórur; Bjørn, Signe F; Frøding, Ligita P; Kehlet, Henrik; Høgdall, Claus K; Lajer, Henrik

    2017-03-01

    Robot-assisted surgery has become more widespread in gynecological oncology. The purpose of this systematic review is to present current knowledge on robot-assisted surgery, and to clarify and discuss controversies that have arisen alongside the development and deployment. A database search in PubMed and EMBASE was performed up until 4 March 2016. The search strategy was developed in collaboration with an information specialist, and by application of the PRISMA guidelines. Human participants and English language were the only restrictive filters applied. Selection was performed by screening of titles and abstracts, and by full text scrutiny. From 2001 to 2016, a total of 76 references were included. Robot-assisted surgery in gynecological oncology has increased, and current knowledge supports that the oncological safety is similar, compared with previous surgical methods. Controversies arise because current knowledge does not clearly document the benefit of robot-assisted surgery, on perioperative outcome compared with the increased costs of the acquisition and application. The rapid development in robot-assisted surgery calls for long-term detailed prospective cohorts or randomized controlled trials. The costs associated with acquisition, application, and maintenance have an unfavorable impact on cost-benefit evaluations, especially when compared with laparoscopy. Future developments in robot-assisted surgery will hopefully lead to competition in the market, which will decrease costs. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

  2. The metabolic cost of passive walking during robotics-assisted treadmill exercise.

    Science.gov (United States)

    Jack, L P; Purcell, M; Allan, D B; Hunt, K J

    2011-01-01

    We are investigating the potential of robotics-assisted treadmill technology as a mode of exercise in people with spinal cord injury (SCI). People with incomplete SCI can actively contribute to this form of exercise, but in the clinical setting they often walk passively in the system. It is not known whether in doing so they are meeting the recommended guidelines for increasing cardiopulmonary fitness. The aims of this study were twofold: to characterise the intensity of passive walking during robotics-assisted treadmill exercise (RATE) in incomplete SCI; and to determine if this intensity meets the recommended guidelines for cardiopulmonary training in this population. 10 subjects with incomplete SCI twice performed an exercise test on a robotics-assisted treadmill. The test comprised a period of passive walking and a ramp phase to the limit of tolerance. Oxygen uptake VO(2) heart rate (HR) were continuously measured. VO(2) during passive exercise was on average 1.4 times higher than resting VO(2R), but this was only 29% of peak VO(2) (VO(2 peak))(range 16-43%). Relative to rest, passive VO(2) (VO(2P) was only 12% of VO(2 peak). HR did not increase from rest to passive walking (81 ± 10 bpm to 81 ± 13 bpm respectively). The HR associated with passive walking was on average 50% of peak HR (HR(peak)) (161 ± 13 bpm). Test-retest reliability was moderate for VO(2R) (R=0.62) and resting HR (HR(R)) (R=0.68), high for VO(2P) (R=0.81), passive HR (HR(P)) (R=0.87) and HR(peak) (R=0.88), and very high (R=0.95) for VO(2 peak). Only HR(p) differed significantly between tests (p=0.029). The intensity of passive walking during RATE is low and is insufficient to increase cardiopulmonary fitness in people with SCI. Subjects must actively contribute to the exercise in order to achieve the recommended training intensity.

  3. Burnout syndrome in nursing assistants of a public hospital in the state of São Paulo.

    Science.gov (United States)

    Ferreira, Naiza do Nascimento; de Lucca, Sergio Roberto

    2015-01-01

    The burnout syndrome is a psychosocial phenomenon that arises as a response to chronic interpersonal stressors present at work. There are many aspects that make nursing assistants vulnerable to chronic stress situations that may lead to burnout, highlighting the low degree of autonomy in the healthcare staff and spending more in direct contact with patients. To assess the prevalence of the burnout syndrome in nursing assistants in a public hospital, as well as its association with socio-demographic and professional variables. A socio-demographic and professional questionnaire and the Maslach Burnout Inventory (MBI-SS) were applied to 534 nursing assistants. The prevalence of burnout syndrome among nursing assistants was 5.9%. High emotional exhaustion was observed in 23.6%, 21.9% showed high depersonalization, and 29.9% low professional achievement. It was found statistically significant associations between emotional exhaustion, job sector and marital status; depersonalization, having children and health problems; low professional achievement and job sector and number of jobs. There was association between job satisfaction and the three dimensions. Professionals working in the health area must pay intense and extended attention to people who are dependent upon others. The intimate contact of the nursing assistants with hard-to-handle patients, as well as being afraid to make mistakes in healthcare are additional chronic stress factors and burnout syndrome cases related in this study.

  4. Costing the supply chain for delivery of ACT and RDTs in the public sector in Benin and Kenya.

    Science.gov (United States)

    Shretta, Rima; Johnson, Brittany; Smith, Lisa; Doumbia, Seydou; de Savigny, Don; Anupindi, Ravi; Yadav, Prashant

    2015-02-05

    Studies have shown that supply chain costs are a significant proportion of total programme costs. Nevertheless, the costs of delivering specific products are poorly understood and ballpark estimates are often used to inadequately plan for the budgetary implications of supply chain expenses. The purpose of this research was to estimate the country level costs of the public sector supply chain for artemisinin-based combination therapy (ACT) and rapid diagnostic tests (RDTs) from the central to the peripheral levels in Benin and Kenya. A micro-costing approach was used and primary data on the various cost components of the supply chain was collected at the central, intermediate, and facility levels between September and November 2013. Information sources included central warehouse databases, health facility records, transport schedules, and expenditure reports. Data from document reviews and semi-structured interviews were used to identify cost inputs and estimate actual costs. Sampling was purposive to isolate key variables of interest. Survey guides were developed and administered electronically. Data were extracted into Microsoft Excel, and the supply chain cost per unit of ACT and RDT distributed by function and level of system was calculated. In Benin, supply chain costs added USD 0.2011 to the initial acquisition cost of ACT and USD 0.3375 to RDTs (normalized to USD 1). In Kenya, they added USD 0.2443 to the acquisition cost of ACT and USD 0.1895 to RDTs (normalized to USD 1). Total supply chain costs accounted for more than 30% of the initial acquisition cost of the products in some cases and these costs were highly sensitive to product volumes. The major cost drivers were found to be labour, transport, and utilities with health facilities carrying the majority of the cost per unit of product. Accurate cost estimates are needed to ensure adequate resources are available for supply chain activities. Product volumes should be considered when costing supply chain

  5. Determinants of Public Attitudes towards Euthanasia in Adults and Physician-Assisted Death in Neonates in Austria: A National Survey.

    Directory of Open Access Journals (Sweden)

    Erwin Stolz

    Full Text Available Euthanasia remains a controversial topic in both public discourses and legislation. Although some determinants of acceptance of euthanasia and physician-assisted death have been identified in previous studies, there is still a shortage of information whether different forms of euthanasia are supported by the same or different sub-populations and whether authoritarian personality dispositions are linked to attitudes towards euthanasia.A large, representative face-to-face survey was conducted in Austria in 2014 (n = 1,971. Respondents faced three scenarios of euthanasia and one of physician assisted death differing regarding the level of specificity, voluntariness and subject, requiring either approval or rejection: (1 abstract description of euthanasia, (2 abstract description of physician-assisted suicide, (3 the case of euthanasia of a terminally-ill 79-year old cancer patient, and (4 the case of non-voluntary, physician assisted death of a severely disabled or ill neonate. A number of potential determinants for rejection ordered in three categories (socio-demographic, personal experience, orientations including authoritarianism were tested via multiple logistic regression analyses.Rejection was highest in the case of the neonate (69% and lowest for the case of the older cancer patient (35%. A consistent negative impact of religiosity on the acceptance across all scenarios and differential effects for socio-economic status, area of residence, religious confession, liberalism, and authoritarianism were found. Individuals with a stronger authoritarian personality disposition were more likely to reject physician-assisted suicide for adults but at the same time also more likely to approve of physician-assisted death of a disabled neonate.Euthanasia in adults was supported by a partially different sub-population than assisted death of disabled neonates.

  6. Determinants of Public Attitudes towards Euthanasia in Adults and Physician-Assisted Death in Neonates in Austria: A National Survey.

    Science.gov (United States)

    Stolz, Erwin; Burkert, Nathalie; Großschädl, Franziska; Rásky, Éva; Stronegger, Willibald J; Freidl, Wolfgang

    2015-01-01

    Euthanasia remains a controversial topic in both public discourses and legislation. Although some determinants of acceptance of euthanasia and physician-assisted death have been identified in previous studies, there is still a shortage of information whether different forms of euthanasia are supported by the same or different sub-populations and whether authoritarian personality dispositions are linked to attitudes towards euthanasia. A large, representative face-to-face survey was conducted in Austria in 2014 (n = 1,971). Respondents faced three scenarios of euthanasia and one of physician assisted death differing regarding the level of specificity, voluntariness and subject, requiring either approval or rejection: (1) abstract description of euthanasia, (2) abstract description of physician-assisted suicide, (3) the case of euthanasia of a terminally-ill 79-year old cancer patient, and (4) the case of non-voluntary, physician assisted death of a severely disabled or ill neonate. A number of potential determinants for rejection ordered in three categories (socio-demographic, personal experience, orientations) including authoritarianism were tested via multiple logistic regression analyses. Rejection was highest in the case of the neonate (69%) and lowest for the case of the older cancer patient (35%). A consistent negative impact of religiosity on the acceptance across all scenarios and differential effects for socio-economic status, area of residence, religious confession, liberalism, and authoritarianism were found. Individuals with a stronger authoritarian personality disposition were more likely to reject physician-assisted suicide for adults but at the same time also more likely to approve of physician-assisted death of a disabled neonate. Euthanasia in adults was supported by a partially different sub-population than assisted death of disabled neonates.

  7. The Real Cost of "Cosmetic Tourism" Cost Analysis Study of "Cosmetic Tourism" Complications Presenting to a Public Hospital.

    Science.gov (United States)

    Livingston, Ryan; Berlund, Paul; Eccles-Smith, Jade; Sawhney, Raja

    2015-01-01

    "Cosmetic Tourism," the process of traveling overseas for cosmetic procedures, is an expanding global phenomenon. The model of care by which these services are delivered can limit perioperative assessment and postoperative follow-up. Our aim was to establish the number and type of complications being treated by a secondary referral hospital resulting from "cosmetic tourism" and the cost that has been incurred by the hospital in a 1-year period. Retrospective cost analysis and chart review of patients admitted to the hospital between the financial year of 2012 and 2013 were performed. Twelve "cosmetic tourism" patients presented to the hospital, requiring admission during the study period. Breast augmentation was the most common procedure and infected prosthesis was the most common complication (n = 4). Complications ranged from infection, pulmonary embolism to penile necrosis. The average cost of treating these patients was $AUD 12 597.71. The overall financial burden of the complication to the hospital was AUD$151 172.52. The "cosmetic tourism" model of care appears to be, in some cases, suboptimal for patients and their regional hospitals. In the cases presented in this study, it appears that care falls on the patient local hospital and home country to deal with the complications from their surgery abroad. This incurs a financial cost to that hospital in addition to redirecting medical resources that would otherwise be utilized for treating noncosmetic complications, without any remuneration to the local provider.

  8. Cost of Delivering Health Care Services in Public Sector Primary and Community Health Centres in North India

    Science.gov (United States)

    Gupta, Aditi; Verma, Ramesh; Bahuguna, Pankaj; Kumar, Dinesh; Kaur, Manmeet; Kumar, Rajesh

    2016-01-01

    Background With the commitment of the national government to provide universal healthcare at cheap and affordable prices in India, public healthcare services are being strengthened in India. However, there is dearth of cost data for provision of health services through public system like primary & community health centres. In this study, we aim to bridge this gap in evidence by assessing the total annual and per capita cost of delivering the package of health services at PHC and CHC level. Secondly, we determined the per capita cost of delivering specific health services like cost per antenatal care visit, per institutional delivery, per outpatient consultation, per bed-day hospitalization etc. Methods We undertook economic costing of fourteen public health facilities (seven PHCs and CHCs each) in three North-Indian states viz., Haryana, Himachal Pradesh and Punjab. Bottom-up costing method was adopted for collection of data on all resources spent on delivery of health services in selected health facilities. Analysis was undertaken using a health system perspective. The joint costs like human resource, capital, and equipment were apportioned as per the time value spent on a particular service. Capital costs were discounted and annualized over the estimated life of the item. Mean annual costs and unit costs were estimated along with their 95% confidence intervals using bootstrap methodology. Results The overall annual cost of delivering services through public sector primary and community health facilities in three states of north India were INR 8.8 million (95% CI: 7,365,630–10,294,065) and INR 26.9 million (95% CI: 22,225,159.3–32,290,099.6), respectively. Human resources accounted for more than 50% of the overall costs at both the level of PHCs and CHCs. Per capita per year costs for provision of complete package of preventive, curative and promotive services at PHC and CHC were INR 170.8 (95% CI: 131.6–208.3) and INR162.1 (95% CI: 112–219

  9. Laparoscopic and robot-assisted hysterectomy for uterine cancer: a comparison of costs and complications.

    Science.gov (United States)

    Zakhari, Andrew; Czuzoj-Shulman, Nicholas; Spence, Andrea R; Gotlieb, Walter H; Abenhaim, Haim A

    2015-11-01

    Increasingly, robotic surgery is being used for total hysterectomy, bilateral salpingo-oophorectomy, and lymph node dissection for uterine cancer. The purpose of this study was to compare the costs and complications among women undergoing robotic and laparoscopic hysterectomy for uterine cancer. We carried out a cohort study using the Nationwide Inpatient Sample (NIS) database between 2008 and 2012 on all women diagnosed with uterine cancer, classifying women as either laparoscopically or robotically treated, excluding laparotomies or vaginal approaches. Logistic regression analyses were used to evaluate the adjusted effect of surgical approach on complication rates. There were 10,347 women who underwent hysterectomies for uterine cancer either laparoscopically (39%) or robotically (61%). The rate of robotic surgery consistently increased over the 5 year period. Women undergoing robotic surgery had more comorbid conditions (diabetes, hypertension, cardiovascular disease, renal disease, obesity or morbid obesity, and pulmonary disease). In adjusted analyses, women undergoing robotic surgery were more likely to have a lymph node dissection (73.01% vs 66.04%; P laparoscopic surgery. The composite endpoint of any complication was similar between both cohorts (20.56% robotic vs 21.00% laparoscopy). In overall and subset analyses, robotic surgery was more costly, with median charges of $38,161.00 compared with $31,476.00 in those undergoing laparoscopic surgery (P < .0001). Despite the considerably greater burden of comorbidities in those undergoing robotic surgery compared with laparoscopy, the former have shorter hospital admissions, a greater rate of lymph node dissection, and similar postoperative morbidity and mortality, albeit at greater total cost. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Estimating study costs for use in VOI, a study of dutch publicly funded drug related research

    NARCIS (Netherlands)

    Van Asselt, A.D.; Ramaekers, B.L.; Corro Ramos, I.; Joore, M.A.; Al, M.J.; Lesman-Leegte, I.; Postma, M.J.; Vemer, P.; Feenstra, T.F.

    2016-01-01

    Objectives: To perform value of information (VOI) analyses, an estimate of research costs is needed. However, reference values for such costs are not available. This study aimed to analyze empirical data on research budgets and, by means of a cost tool, provide an overview of costs of several types

  11. Use of a home vacuum-assisted closure device in the burn population is both cost-effective and efficacious.

    Science.gov (United States)

    Mushin, Oren P; Bogue, Jarrod T; Esquenazi, Mica D; Toscano, Nicole; Bell, Derek E

    2017-05-01

    The vacuum assisted closure device (VAC) improves wound-healing when utilized as a bolster to secure split thickness skin grafts (STSG). Patients typically remain hospitalized for VAC therapy; however, home VACs (hVAC) are now available. Limited studies examine burns treated with hVAC as a STSG bolster. A retrospective study of records from an ABA verified regional burn center was conducted over 23 months. Patients included STSGs for burn. Data points included demographics, burn mechanism and location, graft characteristics, hospital length of stay (LOS), and time to heal. Fifty patients were included, with average age of 39 years (range hVAC over the same period. The hVAC is a cost-effective STSG bolster in the burn population for appropriate candidates. Excellent graft-take and low morbidity rates imply that this is an efficacious alternative for STSG bolster. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  12. United States Navy Humanitarian Assistance and Disaster Relief (HADR) Costs: A Preliminary Study

    Science.gov (United States)

    2015-08-26

    concentration in Chinese and Japanese Buddhism from Temple University. Dr. Keenan D. Yoho Graduate School of Business & Public Policy Naval Postgraduate...December 26, 2004, an undersea earthquake of 9.1 magnitude earthquake struck off the west coast of the island of Sumatra in Indonesia . Seven days after...reports) >20,000 >10,000 Displaced >1,500,000 >1,100,000 >300,000 1. In Indonesia , more than 25% of Aceh Province’s villages were destroyed 1

  13. Arizona Archaeology Week: Promoting the Past to the Public. Archeological Assistance Program Technical Brief No. 2.

    Science.gov (United States)

    Hoffman, Teresa L.; Lerner, Shereen

    The federal archaeological community has identified a need for an organized and comprehensive public outreach effort at the national level that can provide a framework for regional and local public support for archaeological resources. This document presents one part of the program and provides guidance in developing public awareness. Arizona…

  14. The cost of power outages in the business and public sectors in Israel: Revealed preference vs. subjective evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Beenstock, M.; Goldin, E.; Haitovsky, Y. [Hebrew Univ. of Jerusalem, Mount Scopus (Israel)

    1997-05-01

    The economic cost of power outages is a central parameter in the cost-benefit analysis of electric power reliability and the design of electric power systems. The authors present a new methodology for estimating the cost of power outages in the business and public sections and illustrate with data for Israel. The methodology is based on the principle of revealed preference, the cost of an outage may be inferred from the actions taken by consumers to mitigate losses induced by unsupplied electricity. If outages impose costs on businesses, managers are likely to invest in back-up power to mitigate the losses that are incurred when electricity is not supplied. Investment in back-up generators may then be used to impute the mitigated and unmitigated damage from outages. 12 refs., 3 figs., 7 tabs.

  15. Costs and benefits of communicating product safety information to the public via the Internet.

    Science.gov (United States)

    Saoutert, Erwan; Andreasen, Ina

    2006-04-01

    Procter & Gamble (P&G) developed Science-in-the-Box (SIB; www.scienceinthebox.com) after discussions with their stakeholders as to how the consumer products company could better communicate key environmental performance and safety information to the public. A series of workshops enabled P&G to understand that consumers and other key business decision makers wanted meaningful information about the science behind P&G products. In addition, it was clear that making such information available would produce business benefits by encouraging long-term relationships with decision makers ranging from consumers and retailers to policy makers and nongovernmental organizations. These benefits were not necessarily quantifiable in the short term, but they still had to be balanced by the costs in terms of resource commitment and potential intellectual property issues. Since its inception in September 2002, SIB has successfully reached key target audiences and built improved credibility and confidence in P&G products and approaches. The website is now available in English, French, Spanish, German, and Italian and is used by consumers, journalists, teachers, scientists, and policy makers. Several user surveys carried out during the initial developmental period, together with unsolicited e-mail feedback, have demonstrated that SIB has successfully created a platform for continuous dialogue with consumers and other interested parties.

  16. Computing what the public wants: some issues in road safety cost-benefit analysis.

    Science.gov (United States)

    Hauer, Ezra

    2011-01-01

    In road safety, as in other fields, cost-benefit analysis (CBA) is used to justify the investment of public money and to establish priority between projects. It amounts to a computation by which 'few' - the CB analysts - aim to determine what the 'many' - those on behalf of which the choice is to be made - would choose. The question is whether there are grounds to believe that the tool fits the aim. I argue that the CBA tool is deficient. First, because estimates of the value of statistical life and injury on which the CBA computation rests are all over the place, inconsistent with the value of time estimates, and government guidance on the matter appears to be arbitrary. Second, because the premises of New Welfare Economics on which the CBA is founded apply only in circumstances which, in road safety, are rare. Third, because the CBA requires the computation of present values which must be questioned when the discounting is of future lives and of time. Because time savings are valued too highly when compared to life and because discounting tends to unjustifiably diminish the value of lives saved in the future, the CBA tends to bias decisions against investment in road safety.

  17. Punish, but not too hard: how costly punishment spreads in the spatial public goods game

    Science.gov (United States)

    Helbing, Dirk; Szolnoki, Attila; Perc, Matjaž; Szabó, György

    2010-08-01

    We study the evolution of cooperation in spatial public goods games where, besides the classical strategies of cooperation (C) and defection (D), we consider punishing cooperators (PC) or punishing defectors (PD) as an additional strategy. Using a minimalist modeling approach, our goal is to separately clarify and identify the consequences of the two punishing strategies. Since punishment is costly, punishing strategies lose the evolutionary competition in case of well-mixed interactions. When spatial interactions are taken into account, however, the outcome can be strikingly different, and cooperation may spread. The underlying mechanism depends on the character of the punishment strategy. In the case of cooperating punishers, increasing the fine results in a rising cooperation level. In contrast, in the presence of the PD strategy, the phase diagram exhibits a reentrant transition as the fine is increased. Accordingly, the level of cooperation shows a non-monotonous dependence on the fine. Remarkably, punishing strategies can spread in both cases, but based on largely different mechanisms, which depend on the cooperativeness (or not) of punishers.

  18. Disinvestment policy and the public funding of assisted reproductive technologies: outcomes of deliberative engagements with three key stakeholder groups.

    Science.gov (United States)

    Hodgetts, Katherine; Hiller, Janet E; Street, Jackie M; Carter, Drew; Braunack-Mayer, Annette J; Watt, Amber M; Moss, John R; Elshaug, Adam G

    2014-05-05

    Measures to improve the quality and sustainability of healthcare practice and provision have become a policy concern. In addition, the involvement of stakeholders in health policy decision-making has been advocated, as complex questions arise around the structure of funding arrangements in a context of limited resources. Using a case study of assisted reproductive technologies (ART), deliberative engagements with a range of stakeholder groups were held on the topic of how best to structure the distribution of Australian public funding in this domain. Deliberative engagements were carried out with groups of ART consumers, clinicians and community members. The forums were informed by a systematic review of ART treatment safety and effectiveness (focusing, in particular, on maternal age and number of treatment cycles), as well as by international policy comparisons, and ethical and cost analyses. Forum discussions were transcribed and subject to thematic analysis. Each forum demonstrated stakeholders' capacity to understand concepts of choice under resource scarcity and disinvestment, and to countenance options for ART funding not always aligned with their interests. Deliberations in each engagement identified concerns around 'equity' and 'patient responsibility', culminating in a broad preference for (potential) ART subsidy restrictions to be based upon individual factors rather than maternal age or number of treatment cycles. Community participants were open to restrictions based upon measures of body mass index (BMI) and smoking status, while consumers and clinicians saw support to improve these factors as part of an ART treatment program, as distinct from a funding criterion. All groups advocated continued patient co-payments, with measures in place to provide treatment access to those unable to pay (namely, equity of access). Deliberations yielded qualitative, socially-negotiated evidence required to inform ethical, accountable policy decisions in the specific

  19. Robot-assisted versus other types of radical prostatectomy: population-based safety and cost comparison in Japan, 2012-2013.

    Science.gov (United States)

    Sugihara, Toru; Yasunaga, Hideo; Horiguchi, Hiromasa; Matsui, Hiroki; Fujimura, Tetsuya; Nishimatsu, Hiroaki; Fukuhara, Hiroshi; Kume, Haruki; Changhong, Yu; Kattan, Michael W; Fushimi, Kiyohide; Homma, Yukio

    2014-11-01

    In 2012, Japanese national insurance started covering robot-assisted surgery. We carried out a population-based comparison between robot-assisted and three other types of radical prostatectomy to evaluate the safety of robot-assisted prostatectomy during its initial year. We abstracted data for 7202 open, 2483 laparoscopic, 1181 minimal incision endoscopic, and 2126 robot-assisted radical prostatectomies for oncological stage T3 or less from the Diagnosis Procedure Combination database (April 2012-March 2013). Complication rate, transfusion rate, anesthesia time, postoperative length of stay, and cost were evaluated by pairwise one-to-one propensity-score matching and multivariable analyses with covariants of age, comorbidity, oncological stage, hospital volume, and hospital academic status. The proportion of robot-assisted radical prostatectomies dramatically increased from 8.6% to 24.1% during the first year. Compared with open, laparoscopic, and minimal incision endoscopic surgery, robot-assisted surgery was generally associated with a significantly lower complication rate (odds ratios, 0.25, 0.20, 0.33, respectively), autologous transfusion rate (0.04, 0.31, 0.10), homologous transfusion rate (0.16, 0.48, 0.14), lower cost excluding operation (differences, -5.1%, -1.8% [not significant], -10.8%) and shorter postoperative length of stay (-9.1%, +0.9% [not significant], -18.5%, respectively). However, robot-assisted surgery also resulted in a + 42.6% increase in anesthesia time and +52.4% increase in total cost compared with open surgery (all P robotic surgery led to a dynamic change in prostate cancer surgery. Even in its initial year, robot-assisted radical prostatectomy was carried out with several favorable safety aspects compared to the conventional surgeries despite its having the longest anesthesia time and the highest cost.

  20. Development of a Low Cost Assistive Listening System for Hearing-Impaired Student Classroom

    Directory of Open Access Journals (Sweden)

    Setha Pan-ngum

    2013-01-01

    Full Text Available This paper describes the design, development, and tests of a low cost ALS. It was designed for hearing-impaired student classrooms. It utilised digital wireless technology and was aimed to be an alternative to a popular FM ALS. Key specifications include transmitting in 2.4 GHz ISM band with eight selectable transmission channels, battery operated and chargeable, pocket size, and ranged up to thirty metres. Audio characteristics and user tests show that it is comparable to a commercial system, currently employed in our partner school. The results also show that wearing an ALS clearly improves hearing of hearing-impaired students. Long-term usage by school children will be monitored to evaluate the system robustness and durability.

  1. Simulation assisted characterization of kaolinite–methanol intercalation complexes synthesized using cost-efficient homogenization method

    Energy Technology Data Exchange (ETDEWEB)

    Makó, Éva, E-mail: makoe@almos.vein.hu [Institute of Materials Engineering, University of Pannonia, P.O. Box 158, H-8201 Veszprém (Hungary); Kovács, András, E-mail: andree0717@gmail.com [Institute of Materials Engineering, University of Pannonia, P.O. Box 158, H-8201 Veszprém (Hungary); Ható, Zoltán, E-mail: zoltanhato@gmail.com [Institute of Chemistry, Department of Physical Chemistry, University of Pannonia, P.O. Box 158, H-8201 Veszprém (Hungary); Kristóf, Tamás, E-mail: kristoft@almos.vein.hu [Institute of Chemistry, Department of Physical Chemistry, University of Pannonia, P.O. Box 158, H-8201 Veszprém (Hungary)

    2015-12-01

    Graphical abstract: - Highlights: • The possible wet and dry kaolinite–methanol intercalation complexes were studied. • Pre-intercalation complexes were synthesized by cost-efficient homogenization methods. • The compositions of wet and dry kaolinite–methanol complexes were revealed by molecular simulations. • The behavior of methoxy-modified kaolinites is influenced by the degree of methoxy functionalization. • The 0.83-nm methoxy-modified kaolinite can easily be intercalated by liquid methanol. - Abstract: Recent experimental and simulation findings with kaolinite–methanol intercalation complexes raised the question of the existence of more stable structures in wet and dry state, which has not been fully cleared up yet. Experimental and molecular simulation analyses were used to investigate different types of kaolinite–methanol complexes, revealing their real structures. Cost-efficient homogenization methods were applied to synthesize the kaolinite–dimethyl sulfoxide and kaolinite–urea pre-intercalation complexes of the kaolinite–methanol ones. The tested homogenization method required an order of magnitude lower amount of reagents than the generally applied solution method. The influence of the type of pre-intercalated molecules and of the wetting or drying (at room temperature and at 150 °C) procedure on the intercalation was characterized experimentally by X-ray diffraction and thermal analysis. Consistent with the suggestion from the present simulations, 1.12-nm and 0.83-nm stable kaolinite–methanol complexes were identified. For these complexes, our molecular simulations predict either single-layered structures of mobile methanol/water molecules or non-intercalated structures of methoxy-functionalized kaolinite. We found that the methoxy-modified kaolinite can easily be intercalated by liquid methanol.

  2. Unit cost of healthcare services at 200-bed public hospitals in Myanmar: what plays an important role of hospital budgeting?

    Science.gov (United States)

    Than, Thet Mon; Saw, Yu Mon; Khaing, Moe; Win, Ei Mon; Cho, Su Myat; Kariya, Tetsuyoshi; Yamamoto, Eiko; Hamajima, Nobuyuki

    2017-09-19

    Cost information is important for efficient allocation of healthcare expenditure, estimating future budget allocation, and setting user fees to start new financing systems. Myanmar is in political transition, and trying to achieve universal health coverage by 2030. This study assessed the unit cost of healthcare services at two public hospitals in the country from the provider perspective. The study also analyzed the cost structure of the hospitals to allocate and manage the budgets appropriately. A hospital-based cross-sectional study was conducted at 200-bed Magway Teaching Hospital (MTH) and Pyinmanar General Hospital (PMN GH), in Myanmar, for the financial year 2015-2016. The step-down costing method was applied to calculate unit cost per inpatient day and per outpatient visit. The costs were calculated by using Microsoft Excel 2010. The unit costs per inpatient day varied largely from unit to unit in both hospitals. At PMN GH, unit cost per inpatient day was 28,374 Kyats (27.60 USD) for pediatric unit and 1,961,806 Kyats (1908.37 USD) for ear, nose, and throat unit. At MTH, the unit costs per inpatient day were 19,704 Kyats (19.17 USD) for medicine unit and 168,835 Kyats (164.24 USD) for eye unit. The unit cost of outpatient visit was 14,882 Kyats (14.48 USD) at PMN GH, while 23,059 Kyats (22.43 USD) at MTH. Regarding cost structure, medicines and medical supplies was the largest component at MTH, and the equipment was the largest component at PMN GH. The surgery unit of MTH and the eye unit of PMN GH consumed most of the total cost of the hospitals. The unit costs were influenced by the utilization of hospital services by the patients, the efficiency of available resources, type of medical services provided, and medical practice of the physicians. The cost structures variation was also found between MTH and PMN GH. The findings provided the basic information regarding the healthcare cost of public hospitals which can apply the efficient utilization of the

  3. THE EFFICIENCY OF PUBLIC SERVICE OBLIGATION FOR FOOD SUBSIDY IN INDONESIA: REVIEW OF COST STRUCTURE ANALYSIS

    Directory of Open Access Journals (Sweden)

    ASRI LAKSMI RIANI

    2011-01-01

    Full Text Available The paper reviews the efficiency of food subsidy in Indonesia based on cost structure analysis. Using the comparison between cost of good of government and cost of good of National Logistics Board appointed to manage and channel the subsidy. The level of efficiency has decreased in the recent years because of increase in costs of exploitation, management cost and interest expense. It is suggested that government has to determine the cut-off point as a feasibility assessment of cost of subsidy

  4. Robot-assisted laparoscopic prostatectomy: a costs and break-even point analysis for decision-making in a university hospital and a regional healthcare system in Northern Italy

    Directory of Open Access Journals (Sweden)

    Elisa Fabbro

    2014-12-01

    Full Text Available BACKGROUND: Robotic Assisted Radical Prostatectomy (RALP is one of the most expensive urological innovations. Prices of the “Da Vinci System” range from € 761.105 to € 1.902.762 for each unit, without taking into account the cost of maintenance and the use of additional devices. We evaluated outcomes, and costs retrospectively, comparing RALP to open retro-pubic radical prostatectomy (RRP performed in our hospital between December 2009 and December 2010.METHODS: We compared 53 RALP, and 50 RRP in terms of costs, and clinical outcomes. We also implemented a Break Even Analysis in order to evaluate if the public reimbursement covered the total cost of RALP.RESULTS: According to our analysis, RALP showed lower hospitalization (p < 0,0001, higher early continence rate  (p < 0,0001, better potency rate in nerve sparing procedures  (p < 0,0142, and required no transfusions. Excluding the cost of purchasing and maintenance, single case costs were € 6.046,08 for RALP and € 4.834,11 for RRP, respectively. Considering the affordability of the technology, the point where the total revenue is sufficient to cover the total costs is an average of 60 cases performed per year, only in presence of additional reimbursement.CONCLUSIONS: Although our clinical analysis shows better results in favour of RALP, the economical analysis shows that RALP's costs are consistently higher than RRP. Considering also the purchasing costs, we demonstrate that the health gain of the technology does not necessarily offset the higher costs, even in a large, university hospital (1.000 beds. 

  5. An analysis of the cost of incomplete abortion to the public health ...

    African Journals Online (AJOL)

    abortions.....1 In this analysis we estimate the cost of treatment for all incomplete ... include all 'hotel' functions of care, administrative overheads, rent ..... with existing medical technology.13 The costs reported in this analysis represent ...

  6. Incorporation of future costs in health economic analysis publications: current situation and recommendations for the future.

    Science.gov (United States)

    Gros, Blanca; Soto Álvarez, Javier; Ángel Casado, Miguel

    2015-06-01

    Future costs are not usually included in economic evaluations. The aim of this study was to assess the extent of published economic analyses that incorporate future costs. A systematic review was conducted of economic analyses published from 2008 to 2013 in three general health economics journals: PharmacoEconomics, Value in Health and the European Journal of Health Economics. A total of 192 articles met the inclusion criteria, 94 of them (49.0%) incorporated future related medical costs, 9 (4.2%) also included future unrelated medical costs and none of them included future nonmedical costs. The percentage of articles including future costs increased from 2008 (30.8%) to 2013 (70.8%), and no differences were detected between the three journals. All relevant costs for the perspective considered should be included in economic evaluations, including related or unrelated, direct or indirect future costs. It is also advisable that pharmacoEconomic guidelines are adapted in this sense.

  7. Supporting assisted suicide. How do the public and physicians feel about aiding in death?

    Science.gov (United States)

    Bachman, J G; Brody, H; Alcser, K H; Lichtenstein, R L; Doukas, D J; Corning, A D

    1997-04-01

    In January 1997, the Michigan State Medical Society began a series of interdisciplinary forums to discuss guidelines and safeguards for physician-assisted suicide as part of its ongoing analysis of that vexing issue. The forums derive from the minority statement in the MSMS official position, from physicians who would approve of assisting suicide in a limited number of cases, but only upon the patient's voluntary request and as a last resort. Is it possible to develop guidelines which would succeed in limiting the practice of physician-assisted suicide to that small group of patients? Or, as opponents charge, would guidelines predictably fail to contain the practice and lead to the feared slippery slope?

  8. Direct variable cost of the topical treatment of stages III and IV pressure injuries incurred in a public university hospital.

    Science.gov (United States)

    Chacon, Julieta M F; Blanes, Leila; Borba, Luis G; Rocha, Luis R M; Ferreira, Lydia M

    2017-05-01

    to estimate the direct variable costs of the topical treatment of stages III and IV pressure injuries of hospitalized patients in a public university hospital, and assess the correlation between these costs and hospitalization time. Forty patients of both sexes who had been admitted to the São Paulo Hospital, São Paulo, SP, Brazil, from 2011 to 2012, with pressure injuries in the sacral, ischial or trochanteric region were included. The patients had a total of 57 pressure injuries in the selected regions, and the lesions were monitored daily until patient release, transfer or death. The quantities and types of materials, as well as the amount of professional labor time spent on each procedure and each patient were recorded. The unit costs of the materials and the hourly costs of the professional labor were obtained from the hospital's purchasing and human resources departments, respectively. Spearman's correlation coefficient and the Mann-Whitney and Kruskal-Wallis tests were used for the statistical analyses. The mean topical treatment costs for stages III and IV PIs were significantly different (US$ 854.82 versus US$ 1785.35; p = 0.004). The mean topical treatment cost of stages III and IV pressure injuries per patient was US$ 1426.37. The mean daily topical treatment cost per patient was US$ 40.83. There was a significant correlation between hospitalization time and the total costs of labor and materials (p < 0.05). There was no significant difference between hospitalization time periods for stages III and IV pressure injuries (40.80 days and 45.01 days, respectively; p = 0.834). The mean direct variable cost of the topical treatment for stages III and IV pressure injuries per patient in this public university hospital was US$ 1426.37. Copyright © 2016. Published by Elsevier Ltd.

  9. REDUCING COSTS OF TAX COMPLIANCE AND INVESTMENTS IN PUBLIC SYSTEM OF DIGITAL BOOKKEEPING – SPED – IN BRAZIL

    Directory of Open Access Journals (Sweden)

    Edson Sampaio de Lima

    2016-04-01

    Full Text Available The Public System of Digital Bookkeeping – SPED was developed with the intention of further integration between the tax administrations themselves, then between them and the taxpayers, through the use of technology and, consequently, socioeconomic data standard, in a single environment, raising the tax collection efficiency and reducing the costs of administration and compliance. This article intends to contribute to the analysis of public investments directed to the establishment and maintenance of the project, effectively resulted in a reduction in the costs of tax compliance, temporary and permanent. Survey method was used as a non-random mechanism for data collection, with a developed questionnaire containing 22 questions based on the prediction model regulatory impact developed and applied by the Australian Taxation Office – ATO in your country, adapted to identify cost reduction compliance related to three specific organizational aspects: People, Technology and Procurement of Consulting Services. The questionnaire was emailed to 20 people with executive position or managers directly involved in the project in SPED size businesses and distinct segment. Responded to the survey 20 of the 20 companies. The data collected were analyzed through descriptive and exploratory, in the latter case using the cluster analysis. The survey approach has met both the qualitative and the quantitative research. The results indicate that the SPED caused an increase in compliance costs temporary and permanent, mainly due to the implementation strategy defined and applied solely by the public administration. The analysis also allowed evidence that even if public investments directed to the implementation and maintenance of SPED are not comparatively similar to private investments directed to the same end, it shows a tendency to shift costs of administration for compliance costs for taxpayers.

  10. Research Costs Investigated: A Study Into the Budgets of Dutch Publicly Funded Drug-Related Research

    NARCIS (Netherlands)

    T. van Asselt (Thea); B.L.T. Ramaekers (Bram); I. Corro Ramos (Isaac); M.A. Joore (Manuela); M.J. Al (Maiwenn); Lesman-Leegte, I. (Ivonne); M.J. Postma (Maarten); P. Vemer (Pepijn); T.L. Feenstra (Talitha)

    2017-01-01

    textabstractBackground: The costs of performing research are an important input in value of information (VOI) analyses but are difficult to assess. Objective: The aim of this study was to investigate the costs of research, serving two purposes: (1) estimating research costs for use in VOI analyses;

  11. Public Auditing with Privacy Protection in a Multi-User Model of Cloud-Assisted Body Sensor Networks.

    Science.gov (United States)

    Li, Song; Cui, Jie; Zhong, Hong; Liu, Lu

    2017-05-05

    Wireless Body Sensor Networks (WBSNs) are gaining importance in the era of the Internet of Things (IoT). The modern medical system is a particular area where the WBSN techniques are being increasingly adopted for various fundamental operations. Despite such increasing deployments of WBSNs, issues such as the infancy in the size, capabilities and limited data processing capacities of the sensor devices restrain their adoption in resource-demanding applications. Though providing computing and storage supplements from cloud servers can potentially enrich the capabilities of the WBSNs devices, data security is one of the prevailing issues that affects the reliability of cloud-assisted services. Sensitive applications such as modern medical systems demand assurance of the privacy of the users' medical records stored in distant cloud servers. Since it is economically impossible to set up private cloud servers for every client, auditing data security managed in the remote servers has necessarily become an integral requirement of WBSNs' applications relying on public cloud servers. To this end, this paper proposes a novel certificateless public auditing scheme with integrated privacy protection. The multi-user model in our scheme supports groups of users to store and share data, thus exhibiting the potential for WBSNs' deployments within community environments. Furthermore, our scheme enriches user experiences by offering public verifiability, forward security mechanisms and revocation of illegal group members. Experimental evaluations demonstrate the security effectiveness of our proposed scheme under the Random Oracle Model (ROM) by outperforming existing cloud-assisted WBSN models.

  12. Direct costs of dengue hospitalization in Brazil: public and private health care systems and use of WHO guidelines.

    Directory of Open Access Journals (Sweden)

    Alessandra A Vieira Machado

    2014-09-01

    Full Text Available Dengue, an arboviral disease, is a public health problem in tropical and subtropical regions worldwide. In Brazil, epidemics have become increasingly important, with increases in the number of hospitalizations and the costs associated with the disease. This study aimed to describe the direct costs of hospitalized dengue cases, the financial impact of admissions and the use of blood products where current protocols for disease management were not followed.To analyze the direct costs of dengue illness and platelet transfusion in Brazil based on the World Health Organization (WHO guidelines, we conducted a retrospective cross-sectional census study on hospitalized dengue patients in the public and private Brazilian health systems in Dourados City, Mato Grosso do Sul State, Brazil. The analysis involved cases that occurred from January through December during the 2010 outbreak. In total, we examined 8,226 mandatorily reported suspected dengue cases involving 507 hospitalized patients. The final sample comprised 288 laboratory-confirmed dengue patients, who accounted for 56.8% of all hospitalized cases. The overall cost of the hospitalized dengue cases was US $210,084.30, in 2010, which corresponded to 2.5% of the gross domestic product per capita in Dourados that year. In 35.2% of cases, blood products were used in patients who did not meet the blood transfusion criteria. The overall median hospitalization cost was higher (p = 0.002 in the group that received blood products (US $1,622.40 compared with the group that did not receive blood products (US $550.20.The comparative costs between the public and the private health systems show that both the hospitalization of and platelet transfusion in patients who do not meet the WHO and Brazilian dengue guidelines increase the direct costs, but not the quality, of health care.

  13. Direct costs of dengue hospitalization in Brazil: public and private health care systems and use of WHO guidelines.

    Science.gov (United States)

    Vieira Machado, Alessandra A; Estevan, Anderson Oliveira; Sales, Antonio; Brabes, Kelly Cristina da Silva; Croda, Júlio; Negrão, Fábio Juliano

    2014-09-01

    Dengue, an arboviral disease, is a public health problem in tropical and subtropical regions worldwide. In Brazil, epidemics have become increasingly important, with increases in the number of hospitalizations and the costs associated with the disease. This study aimed to describe the direct costs of hospitalized dengue cases, the financial impact of admissions and the use of blood products where current protocols for disease management were not followed. To analyze the direct costs of dengue illness and platelet transfusion in Brazil based on the World Health Organization (WHO) guidelines, we conducted a retrospective cross-sectional census study on hospitalized dengue patients in the public and private Brazilian health systems in Dourados City, Mato Grosso do Sul State, Brazil. The analysis involved cases that occurred from January through December during the 2010 outbreak. In total, we examined 8,226 mandatorily reported suspected dengue cases involving 507 hospitalized patients. The final sample comprised 288 laboratory-confirmed dengue patients, who accounted for 56.8% of all hospitalized cases. The overall cost of the hospitalized dengue cases was US $210,084.30, in 2010, which corresponded to 2.5% of the gross domestic product per capita in Dourados that year. In 35.2% of cases, blood products were used in patients who did not meet the blood transfusion criteria. The overall median hospitalization cost was higher (p = 0.002) in the group that received blood products (US $1,622.40) compared with the group that did not receive blood products (US $550.20). The comparative costs between the public and the private health systems show that both the hospitalization of and platelet transfusion in patients who do not meet the WHO and Brazilian dengue guidelines increase the direct costs, but not the quality, of health care.

  14. 75 FR 54898 - Notice of Proposed Information Collection for Public Comment: Restrictions on Assistance to...

    Science.gov (United States)

    2010-09-09

    ... hearing or speech impairments may access this number through TTY by calling the toll-free Federal..., telephone numbers are not toll-free.) FOR FURTHER INFORMATION CONTACT: Arlette Mussington, Office of Policy...-Dixon, Acting Deputy Assistant Secretary, Office of Policy, Program and Legislative Initiatives....

  15. School Superintendents' Perceptions of Schools Assisting Students in Obtaining Public Health Insurance

    Science.gov (United States)

    Rickard, Megan L.; Price, James H.; Telljohann, Susan K.; Dake, Joseph A.; Fink, Brian N.

    2011-01-01

    Background: Superintendents' perceptions regarding the effect of health insurance status on academics, the role schools should play in the process of obtaining health insurance, and the benefits/barriers to assisting students in enrolling in health insurance were surveyed. Superintendents' basic knowledge of health insurance, the link between…

  16. Cost estimate of hospital stays for premature newborns in a public tertiary hospital in Brazil

    Directory of Open Access Journals (Sweden)

    Claudia Maria Desgualdo

    2011-01-01

    Full Text Available OBJECTIVES: To estimate the direct costs of hospital stays for premature newborns in the Interlagos Hospital and Maternity Center in São Paulo, Brazil and to assess the difference between the amount reimbursed to the hospital by the Unified Health System and the real cost of care for each premature newborn. METHODS: A cost-estimate study in which hospital and professional costs were estimated for premature infants born at 22 to 36 weeks gestation during the calendar year of 2004 and surviving beyond one hour of age. Direct costs included hospital services, professional care, diagnoses and therapy, orthotics, prosthetics, special materials, and blood products. Costs were estimated using tables published by the Unified Health System and the Brasindice as well as the list of medical procedures provided by the Brazilian Classification of Medical Procedures. RESULTS: The average direct cost of care for initial hospitalization of a premature newborn in 2004 was $2,386 USD. Total hospital expenses and professional services for all premature infants in this hospital were $227,000 and $69,500 USD, respectively. The costs for diagnostic testing and blood products for all premature infants totaled $22,440 and $1,833 USD. The daily average cost of a premature newborn weighing less than 1,000 g was $115 USD, and the daily average cost of a premature newborn weighing more than 2,500 g was $89 USD. Amounts reimbursed to the hospital by the Unified Health System corresponded to only 27.42% of the real cost of care. CONCLUSIONS: The cost of hospital stays for premature newborns was much greater than the amount reimbursed to the hospital by the Unified Health System. The highest costs corresponded to newborns with lower birth weight. Hospital costs progressively and discretely decreased as the newborns' weight increased.

  17. Pharmaceutical assistance in local public health services in Santa Catarina (Brazil: characteristics of its organization

    Directory of Open Access Journals (Sweden)

    Ana Paula Veber

    2011-03-01

    Full Text Available This study outlines the diagnosis stage of 201 Municipal Pharmaceutical Assistance Plans sent to the Directorate of Pharmaceutical Assistance of the State Secretariat for Health of Santa Catarina (DIAF-SES/SC between November 12, 2005 and July 6, 2006. Multiple Correspondence Analysis was used in conjunction with SPAD 3.5 software, followed by hypothesis testing. The variables "pharmacist presence" and "population" were those which most contributed to the formation of the three clusters of municipalities observed. The number of drugs contained in the Municipal Lists of Essential Drugs (REMUMEs ranged from 15 to 413. A total of 67 towns had between 101 and 200 drugs- a range considered ideal in this study according to the 2006 National List of Essential Drugs. No tendency toward correlation between number of drugs listed in the REMUMES and municipality population size was found. Results confirmed the known disparity in Pharmaceutical Assistance among municipalities of different sizes and highlighted the need for structuring the activities of Pharmaceutical Assistance in the municipalities studied. There is also a need for greater commitment from all management spheres so that activities of Pharmaceutical Assistance at a local level ensure access to quality drugs and services, while fostering rational use.Este estudo retrata a etapa de diagnóstico de 201 Planos Municipais de Assistência Farmacêutica enviados entre 12 de novembro de 2005 a 06 de julho de 2006 à Diretoria de Assistência Farmacêutica da Secretaria de Estado da Saúde de Santa Catarina (DIAF-SES/SC. Utilizou-se a Análise de Correspondência Múltipla, através do programa SPAD 3.5 e posteriormente realizou-se teste de hipótese. As variáveis "presença de farmacêutico" e "população" foram as que mais contribuíram para a formação dos três agrupamentos de municípios evidenciados. O número de medicamentos constantes das Relações Municipais de Medicamentos Essenciais

  18. [Quality management (TQM) in public health-care (PHC): principles for cost-performance calculations and cost reductions with better quality].

    Science.gov (United States)

    Bergholz, W

    2008-11-01

    In many high-tech industries, quality management (QM) has enabled improvements of quality by a factor of 100 or more, in combination with significant cost reductions. Compared to this, the application of QM methods in health care is in its initial stages. It is anticipated that stringent process management, embedded in an effective QM system will lead to significant improvements in health care in general and in the German public health service in particular. Process management is an ideal platform for controlling in the health care sector, and it will significantly improve the leverage of controlling to bring down costs. Best practice sharing in industry has led to quantum leap improvements. Process management will enable best practice sharing also in the public health service, in spite of the highly diverse portfolio of services that the public health service offers in different German regions. Finally, it is emphasised that "technical" QM, e.g., on the basis of the ISO 9001 standard is not sufficient to reach excellence. It is necessary to integrate soft factors, such as patient or employee satisfaction, and leadership quality into the system. The EFQM model for excellence can serve as proven tool to reach this goal.

  19. Post-bariatric surgery body contouring treatment in the public health system: cost study and perception by patients.

    Science.gov (United States)

    Vilà, Jordi; Balibrea, José María; Oller, Benjamí; Alastrué, Antonio; Poyatos, Jordi Vilà; Balibrea del Castillo, José María; Sales, Benjamí Oller; Vidal, Antonio Alastrué

    2014-09-01

    Post-bariatric, body contouring surgery to treat the sequelae of massive weight loss is an undervalued topic by patients and in most of the literature. The objective of this study was to determine the mean cost per patient of this treatment in a public morbid obesity unit, and compare it with the perception by the patients. Costs were estimated using a specific Diagnosis-Related Group-based method and a questionnaire in a sample of 100 patients who had completed body contouring treatment. This study included 23 men and 77 women with a mean age of 48.5 years, a mean reduction of body mass index of 20.77 kg/m, and a median follow-up of 58 months. These patients had undergone surgery, as needed, as follows: on the lower part of the trunk (109 operations; mean cost, &OV0556;6348.6), cruroplasty (43 operations; mean cost, &OV0556;3490), brachioplasty (28 operations; mean cost &OV0556;3150), and the upper part of the trunk (10 operations; mean cost, &OV0556;4290). The rate of complications has been high (up to 50 percent) and, although the more severe complications are rare (10.5 percent Clavien grade IIIb), these represent high costs (mean, &OV0556;24462.6). Forty-five patients answered the questionnaire. Although they think that this surgery improves their quality of life, they have undervalued its total cost (17.58 percent; &OV0556;2034) (p = 0.16). The average cost of post-bariatric surgery body contouring treatment in this unit is &OV0556;8263.95 (1.66 operations per patient). The severe complications increase by 2.96 times the average cost per patient.

  20. A Cost-Effectiveness Analysis of India’s 2008 Prohibition of Smoking in Public Places in Gujarat

    Directory of Open Access Journals (Sweden)

    Bhavesh Modi

    2011-04-01

    Full Text Available Tobacco smoking and exposure to secondhand tobacco smoke are associated with disability and premature mortality in low and middle-income countries. The aim of this study was to assess the cost-effectiveness of implementing India’s Prohibition of Smoking in Public Places Rules in the state of Gujarat, compared to implementation of a complete smoking ban. Using standard cost-effectiveness analysis methods, the cost of implementing the alternatives was evaluated against the years of life saved and cases of acute myocardial infarction averted by reductions in smoking prevalence and secondhand smoke exposure. After one year, it is estimated that a complete smoking ban in Gujarat would avert 17,000 additional heart attacks and gain 438,000 life years (LY. A complete ban is highly cost-effective when key variables including legislation effectiveness were varied in the sensitivity analyses. Without including medical treatment costs averted, the cost-effectiveness ratio ranges from $2 to $112 per LY gained and $37 to $386 per acute myocardial infarction averted. Implementing a complete smoking ban would be a cost saving alternative to the current partial legislation in terms of reducing tobacco-attributable disease in Gujarat.

  1. Demonstrating Cost-Effective Marker Assisted Selection for Biomass Yield in Red Clover (Trifolium pratense L.) – Part 1: Paternity Testing

    Science.gov (United States)

    Many methods have been proposed to incorporate molecular markers into breeding programs. Presented is a cost effective marker assisted selection (MAS) methodology that utilizes individual plant phenotypes, seed production-based knowledge of maternity, and molecular marker-determined paternity. Proge...

  2. Peculiarities of Calculating the Cost of Public Goods (from the Necessary to the Desired: Domestic Realities and European Experience

    Directory of Open Access Journals (Sweden)

    Aleksieieva N. I.

    2015-11-01

    Full Text Available Social needs and instruments for their satisfaction — public goods — have been studied. Attention is drawn to the fact that social needs are composed of individual and collective needs of economic entities. They are interrelated and complementary. An important difference between individual and collective needs is in their personification (individualization and divisibility. Proper consideration has been paid to concepts related to the needs of society — the public interest (as a form of social needs, public goods (all the goods, services that can satisfy social needs. For studying social needs and benefits in this work there was taken one of the most popular of their classification, which lies in their division into primary and secondary ones. Emphasis is placed on importance of its use in determining the priority of financing public goods. The focus is on the approach to calculating the cost of public goods. It is regarded as one of the stages in satisfying social needs (along with planning and analysis of the degree for their satisfaction. An approach to determining the structure of financing the total volume of public goods, calculating minimum admissible and desired volume of financing has been presented. The current interest in the European experience prompted the authors to analyze the cost and structure of financing public goods in France, the available statistical base allowing it to be implemented. The determined dependence between the indicators enabled conducting calculations of the desired volumes of financing the public needs per person according to three scenarios: optimistic, satisfactory and critical relevant to phases of the economic cycle. This simulation is aimed at being used in management decisionmaking, development of social and economic policy, etc. There have been noted serious shortcomings related to the lack of quality and reliable statistical information on Ukraine, which hamper the calculation and consideration

  3. Development of a Selection Measure for Access to Public Employment Assistance Programs.

    Science.gov (United States)

    Peterson, Gary W.

    1986-01-01

    Provides a prototype measure of employability to be used as a tool in public employment programs. Considers political and ethical implications pertaining to the use of such a selection instrument for welfare recipients. (Author/ABB)

  4. Assistance Focus: Latin America/Caribbean (Brochure)

    Energy Technology Data Exchange (ETDEWEB)

    2015-01-01

    The Clean Energy Solutions Center Ask an Expert service connects governments seeking policy information and advice with one of more than 30 global policy experts who can provide reliable and unbiased quick-response advice and information. The service is available at no cost to government agency representatives from any country and the technical institutes assisting them. This publication presents summaries of assistance provided to African governments, including the benefits of that assistance.

  5. Assistance Focus: Asia/Pacific Region (Brochure)

    Energy Technology Data Exchange (ETDEWEB)

    2015-01-01

    The Clean Energy Solutions Center Ask an Expert service connects governments seeking policy information and advice with one of more than 30 global policy experts who can provide reliable and unbiased quick-response advice and information. The service is available at no cost to government agency representatives from any country and the technical institutes assisting them. This publication presents summaries of assistance provided to governments in the Asia/Pacific region, including the benefits of that assistance.

  6. A Low-Cost iPhone-Assisted Augmented Reality Solution for the Localization of Intracranial Lesions.

    Directory of Open Access Journals (Sweden)

    YuanZheng Hou

    Full Text Available Precise location of intracranial lesions before surgery is important, but occasionally difficult. Modern navigation systems are very helpful, but expensive. A low-cost solution that could locate brain lesions and their surface projections in augmented reality would be beneficial. We used an iPhone to partially achieve this goal, and evaluated its accuracy and feasibility in a clinical neurosurgery setting.We located brain lesions in 35 patients, and using an iPhone, we depicted the lesion's surface projection onto the skin of the head. To assess the accuracy of this method, we pasted computed tomography (CT markers surrounding the depicted lesion boundaries on the skin onto 15 patients. CT scans were then performed with or without contrast enhancement. The deviations (D between the CT markers and the actual lesion boundaries were measured. We found that 97.7% of the markers displayed a high accuracy level (D ≤ 5mm. In the remaining 20 patients, we compared our iPhone-based method with a frameless neuronavigation system. Four check points were chosen on the skin surrounding the depicted lesion boundaries, to assess the deviations between the two methods. The integrated offset was calculated according to the deviations at the four check points. We found that for the supratentorial lesions, the medial offset between these two methods was 2.90 mm and the maximum offset was 4.2 mm.This low-cost, image-based, iPhone-assisted, augmented reality solution is technically feasible, and helpful for the localization of some intracranial lesions, especially shallow supratentorial intracranial lesions of moderate size.

  7. 45 CFR 95.705 - Equipment costs-Federal financial participation.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Equipment costs-Federal financial participation. 95.705 Section 95.705 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION GENERAL ADMINISTRATION-GRANT PROGRAMS (PUBLIC ASSISTANCE, MEDICAL ASSISTANCE AND STATE CHILDREN'S HEALTH...

  8. 45 CFR 95.515 - Effective date of a cost allocation plan amendment.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Effective date of a cost allocation plan amendment. 95.515 Section 95.515 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION GENERAL ADMINISTRATION-GRANT PROGRAMS (PUBLIC ASSISTANCE, MEDICAL ASSISTANCE AND STATE CHILDREN'S HEALTH...

  9. 45 CFR 95.511 - Approval of the cost allocation plan or plan amendment.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Approval of the cost allocation plan or plan amendment. 95.511 Section 95.511 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION GENERAL ADMINISTRATION-GRANT PROGRAMS (PUBLIC ASSISTANCE, MEDICAL ASSISTANCE AND STATE CHILDREN'S...

  10. 45 CFR 95.509 - Cost allocation plan amendments and certifications.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Cost allocation plan amendments and certifications. 95.509 Section 95.509 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION GENERAL ADMINISTRATION-GRANT PROGRAMS (PUBLIC ASSISTANCE, MEDICAL ASSISTANCE AND STATE CHILDREN'S HEALTH...

  11. Applicability of the World Commission on Dams' recommendations for public financial institutions: a case for Japanese yen loan assistance

    Science.gov (United States)

    Fujikura, Ryo; Nakayama, Mikiyasu; Mori, Katsuhiko

    2003-10-01

    The World Commission on Dams (WCD) published Dams and Development as its only and final report in November 2000. Identifying core values and strategic priorities, the report proposed internationally acceptable criteria and standards. Despite the fact that the WCD itself did not intend that the report be used as a blueprint, many non-governmental organizations strongly support the report and the criteria and guidelines recommended in the report, and demand that they be adopted in their current form by funding organizations. The WCD criteria and guidelines were found to have several methodological problems, and it appears impossible to apply the recommended criteria and guidelines as they stand. This study examines the applicability of the WCD criteria and guidelines for public financing institutes involved in overseas development assistance and proposes necessary measures to increase their applicability in order to realize core values and strategic priorities. The character of and relationships among key decision points, strategic priorities, criteria, and guidelines should be clarified. Then, this study examines the applicability of the WCD recommendations for Japanese public financial institutions, as Japan has nearly become the sole bilateral donor providing financial assistance (loans) for large dam construction projects. The public financial institution can only be mandated to check the legal status of the decisions made regarding Stages 1 and 2 which are the first two of the five successive stages from the planning to the operation of the dam project. Needs assessment and alternative selection are expected to be conducted at Stage 1 and 2 respectively. The Japan Bank for International Cooperation (JBIC), which deals with the Japanese concessional yen loan, and the Japan International Cooperation Agency (JICA), which is in charge of technical assistance, are featured in this study. As for the Japanese concessional yen loan assistance, there are other inherent

  12. Costs associated with implementation of computer-assisted clinical decision support system for antenatal and delivery care: case study of Kassena-Nankana district of northern Ghana.

    Directory of Open Access Journals (Sweden)

    Maxwell Ayindenaba Dalaba

    Full Text Available OBJECTIVE: This study analyzed cost of implementing computer-assisted Clinical Decision Support System (CDSS in selected health care centres in Ghana. METHODS: A descriptive cross sectional study was conducted in the Kassena-Nankana district (KND. CDSS was deployed in selected health centres in KND as an intervention to manage patients attending antenatal clinics and the labour ward. The CDSS users were mainly nurses who were trained. Activities and associated costs involved in the implementation of CDSS (pre-intervention and intervention were collected for the period between 2009-2013 from the provider perspective. The ingredients approach was used for the cost analysis. Costs were grouped into personnel, trainings, overheads (recurrent costs and equipment costs (capital cost. We calculated cost without annualizing capital cost to represent financial cost and cost with annualizing capital costs to represent economic cost. RESULTS: Twenty-two trained CDSS users (at least 2 users per health centre participated in the study. Between April 2012 and March 2013, users managed 5,595 antenatal clients and 872 labour clients using the CDSS. We observed a decrease in the proportion of complications during delivery (pre-intervention 10.74% versus post-intervention 9.64% and a reduction in the number of maternal deaths (pre-intervention 4 deaths versus post-intervention 1 death. The overall financial cost of CDSS implementation was US$23,316, approximately US$1,060 per CDSS user trained. Of the total cost of implementation, 48% (US$11,272 was pre-intervention cost and intervention cost was 52% (US$12,044. Equipment costs accounted for the largest proportion of financial cost: 34% (US$7,917. When economic cost was considered, total cost of implementation was US$17,128-lower than the financial cost by 26.5%. CONCLUSIONS: The study provides useful information in the implementation of CDSS at health facilities to enhance health workers' adherence to practice

  13. Public policy intervention in freight transport costs: effects on printed media logistics in the Netherlands

    NARCIS (Netherlands)

    Runhaar, H.A.C.; Heijden, R. van der

    2005-01-01

    Trends in contemporary logistics management have led to an increased transport-intensity of production and distribution activities. Transport costs are increasingly traded off against other logistical costs and seem to have lost importance in strategic decision-making. At the same time, in Europe,

  14. Public policy intervention in freight transport costs: effects on printed media logistics in the Netherlands

    NARCIS (Netherlands)

    Runhaar, H.A.C.; Heijden, R. van der

    2005-01-01

    Trends in contemporary logistics management have led to an increased transport-intensity of production and distribution activities. Transport costs are increasingly traded off against other logistical costs and seem to have lost importance in strategic decision-making. At the same time, in Europe, t

  15. An Introduction to Cost-of-Living Adjustments in Public Retirement Plans: Details Matter

    Science.gov (United States)

    Jennings, Penelope R.; Jennings, William P.; Phillips, G. Michael

    2016-01-01

    While financial planning students are expected to be able to understand client retirement plans, subtle differences in cost-of-living adjustments can have major impact on the success of client retirement plans. This teaching note compares the cost-of-living adjustments in the largest government sponsored retirement systems and a hypothetical…

  16. Shrouded costs of government: The political economy of state and local public pensions

    OpenAIRE

    Glaeser, Edward L.; Giacomo A.M. Ponzetto

    2012-01-01

    Why are public-sector workers so heavily compensated with pensions and other non-pecuniary benefits? In this paper, we present a political economy model of shrouded compensation in which politicians compete for taxpayers' and public employees' votes by promising compensation packages, but some voters cannot evaluate every aspect of compensation. If pension packages are "shrouded," meaning that public-sector workers better understand their value than ordinary taxpayers, then compensation will ...

  17. Using public control genotype data to increase power and decrease cost of case-control genetic association studies.

    Science.gov (United States)

    Ho, Lindsey A; Lange, Ethan M

    2010-12-01

    Genome-wide association (GWA) studies are a powerful approach for identifying novel genetic risk factors associated with human disease. A GWA study typically requires the inclusion of thousands of samples to have sufficient statistical power to detect single nucleotide polymorphisms that are associated with only modest increases in risk of disease given the heavy burden of a multiple test correction that is necessary to maintain valid statistical tests. Low statistical power and the high financial cost of performing a GWA study remains prohibitive for many scientific investigators anxious to perform such a study using their own samples. A number of remedies have been suggested to increase statistical power and decrease cost, including the utilization of free publicly available genotype data and multi-stage genotyping designs. Herein, we compare the statistical power and relative costs of alternative association study designs that use cases and screened controls to study designs that are based only on, or additionally include, free public control genotype data. We describe a novel replication-based two-stage study design, which uses free public control genotype data in the first stage and follow-up genotype data on case-matched controls in the second stage that preserves many of the advantages inherent when using only an epidemiologically matched set of controls. Specifically, we show that our proposed two-stage design can substantially increase statistical power and decrease cost of performing a GWA study while controlling the type-I error rate that can be inflated when using public controls due to differences in ancestry and batch genotype effects.

  18. Legal assistance on the application of public procurement rules in the waste sector

    DEFF Research Database (Denmark)

    Andrecka, Marta

    2016-01-01

    The report presents the results of a study investigating the application of public procurement rules in the municipal waste sector across the European Union conducted by Ramboll Management Consulting for the European Commission (DG GROW). The study is part of a process launched by the European...... Commission to analyse the application of public procurement rules in different market sectors. The scope of the study was set by the definition of municipal [solid] waste as presented in the Waste Framework Directive.1 The geographical scope of data collection was focused on seven Member States: Germany...

  19. Research Costs Investigated: A Study Into the Budgets of Dutch Publicly Funded Drug-Related Research.

    Science.gov (United States)

    van Asselt, Thea; Ramaekers, Bram; Corro Ramos, Isaac; Joore, Manuela; Al, Maiwenn; Lesman-Leegte, Ivonne; Postma, Maarten; Vemer, Pepijn; Feenstra, Talitha

    2017-09-20

    The costs of performing research are an important input in value of information (VOI) analyses but are difficult to assess. The aim of this study was to investigate the costs of research, serving two purposes: (1) estimating research costs for use in VOI analyses; and (2) developing a costing tool to support reviewers of grant proposals in assessing whether the proposed budget is realistic. For granted study proposals from the Netherlands Organization for Health Research and Development (ZonMw), type of study, potential cost drivers, proposed budget, and general characteristics were extracted. Regression analysis was conducted in an attempt to generate a 'predicted budget' for certain combinations of cost drivers, for implementation in the costing tool. Of 133 drug-related research grant proposals, 74 were included for complete data extraction. Because an association between cost drivers and budgets was not confirmed, we could not generate a predicted budget based on regression analysis, but only historic reference budgets given certain study characteristics. The costing tool was designed accordingly, i.e. with given selection criteria the tool returns the range of budgets in comparable studies. This range can be used in VOI analysis to estimate whether the expected net benefit of sampling will be positive to decide upon the net value of future research. The absence of association between study characteristics and budgets may indicate inconsistencies in the budgeting or granting process. Nonetheless, the tool generates useful information on historical budgets, and the option to formally relate VOI to budgets. To our knowledge, this is the first attempt at creating such a tool, which can be complemented with new studies being granted, enlarging the underlying database and keeping estimates up to date.

  20. Government regulation and public opposition create high additional costs for field trials with GM crops in Switzerland.

    Science.gov (United States)

    Bernauer, Thomas; Tribaldos, Theresa; Luginbühl, Carolin; Winzeler, Michael

    2011-12-01

    Field trials with GM crops are not only plant science experiments. They are also social experiments concerning the implications of government imposed regulatory constraints and public opposition for scientific activity. We assess these implications by estimating additional costs due to government regulation and public opposition in a recent set of field trials in Switzerland. We find that for every Euro spent on research, an additional 78 cents were spent on security, an additional 31 cents on biosafety, and an additional 17 cents on government regulatory supervision. Hence the total additional spending due to government regulation and public opposition was around 1.26 Euros for every Euro spent on the research per se. These estimates are conservative; they do not include additional costs that are hard to monetize (e.g. stakeholder information and dialogue activities, involvement of various government agencies). We conclude that further field experiments with GM crops in Switzerland are unlikely unless protected sites are set up to reduce these additional costs.

  1. Toward a treaty on safety and cost-effectiveness of pharmaceuticals and medical devices: enhancing an endangered global public good

    Directory of Open Access Journals (Sweden)

    Faunce Thomas

    2006-03-01

    Full Text Available Abstract • Expert evaluations of the safety, efficacy and cost-effectiveness of pharmaceutical and medical devices, prior to marketing approval or reimbursement listing, collectively represent a globally important public good. The scientific processes involved play a major role in protecting the public from product risks such as unintended or adverse events, sub-standard production and unnecessary burdens on individual and governmental healthcare budgets. • Most States now have an increasing policy interest in this area, though institutional arrangements, particularly in the area of cost-effectiveness analysis of medical devices, are not uniformly advanced and are fragile in the face of opposing multinational industry pressure to recoup investment and maintain profit margins. • This paper examines the possibility, in this context, of States commencing negotiations toward bilateral trade agreement provisions, and ultimately perhaps a multilateral Treaty, on safety, efficacy and cost-effectiveness analysis of pharmaceuticals and medical devices. Such obligations may robustly facilitate a conceptually interlinked, but endangered, global public good, without compromising the capacity of intellectual property laws to facilitate local product innovations.

  2. Toward a treaty on safety and cost-effectiveness of pharmaceuticals and medical devices: enhancing an endangered global public good.

    Science.gov (United States)

    Faunce, Thomas Alured

    2006-03-28

    Expert evaluations of the safety, efficacy and cost-effectiveness of pharmaceutical and medical devices, prior to marketing approval or reimbursement listing, collectively represent a globally important public good. The scientific processes involved play a major role in protecting the public from product risks such as unintended or adverse events, sub-standard production and unnecessary burdens on individual and governmental healthcare budgets. Most States now have an increasing policy interest in this area, though institutional arrangements, particularly in the area of cost-effectiveness analysis of medical devices, are not uniformly advanced and are fragile in the face of opposing multinational industry pressure to recoup investment and maintain profit margins. This paper examines the possibility, in this context, of States commencing negotiations toward bilateral trade agreement provisions, and ultimately perhaps a multilateral Treaty, on safety, efficacy and cost-effectiveness analysis of pharmaceuticals and medical devices. Such obligations may robustly facilitate a conceptually interlinked, but endangered, global public good, without compromising the capacity of intellectual property laws to facilitate local product innovations.

  3. 77 FR 64890 - Transmission Planning and Cost Allocation by Transmission Owning and Operating Public Utilities

    Science.gov (United States)

    2012-10-24

    ... are optimal given those expected changes in resources and load.\\60\\ AEP argues that Public Policy..., including consideration of changes driven by public policies (such as renewable portfolio standards, new... analyses to determine what transmission investments are optimal given these anticipated changes.\\65\\ It...

  4. Utilization of assistive devices for students with disabilities in the public schools

    Directory of Open Access Journals (Sweden)

    Carolina Bastos Plotegher

    2013-04-01

    Full Text Available Introduction: Assistive technology is an area of expanding knowledge in Brazil. Its use in school can help students with disabilities in performing important tasks to participate in different activities. Objectives: to report the experience of using assistive devices in the academic achievement of students with disabilities included in the regular school system of the municipality of Sao Carlos, state of Sao Paulo. Method: it was developed from an extension project conducted in 2010. Thirteen students with various types of disabilities participated in the project. The interventions were based on the School Function Assessment with the teachers to know the students’ difficulties. The students were also observed performing school tasks. Results: Forty-seven adaptations were made: thickeners, rings for zippers, slants, communication boards, non-slip mats, among others. Besides the adjustments, orientation regarding use of the devices was provided for teachers and persons responsible for the students. Conclusion: we believe that the project benefited the students, because it produced higher academic achievement and provided better school conditions for their school inclusion. For the undergraduate students of Occupational Therapy, the project enabled the dealing with real issues of inclusion and school interventions, thus approaching theory to practice.

  5. Benefit Cost Analysis of Three Skin Cancer Public Education Mass-Media Campaigns Implemented in New South Wales, Australia.

    Science.gov (United States)

    Doran, Christopher M; Ling, Rod; Byrnes, Joshua; Crane, Melanie; Shakeshaft, Anthony P; Searles, Andrew; Perez, Donna

    2016-01-01

    Public education mass media campaigns are an important intervention for influencing behaviour modifications. However, evidence on the effectiveness of such campaigns to encourage the population to reduce sun exposure is limited. This study investigates the benefits and costs of three skin cancer campaigns implemented in New South Wales from 2006-2013. This analysis uses Australian dollars (AUD) and 2010-11 as the currency and base year, respectively. Historical data on skin cancer were used to project skin cancer rates for the period 2006-2020. The expected number of skin cancer cases is derived by combining skin cancer rates, sunburn rates and relative risk of skin cancers due to sun exposure. Counterfactual estimates are based on sunburn exposure in the absence of the campaigns. Monetary values are attached to direct (treatment) and indirect (productivity) costs saved due to fewer skin cancer cases. Monetary benefits are compared with the cost of implementing the campaigns and are presented in the form of a benefit-cost ratio. Relative to the counterfactual (i.e., no campaigns) there are an estimated 13,174 fewer skin cancers and 112 averted deaths over the period 2006-2013. The net present value of these benefits is $60.17 million and the campaign cost is $15.63 million. The benefit cost ratio is 3.85, suggesting that for every $1 invested a return of $3.85 is achieved. Skin cancer public education mass media campaigns are a good investment given the likely extent to which they reduce the morbidity, mortality and economic burden of skin cancer.

  6. School Nurses' Perceptions and Practices of Assisting Students in Obtaining Public Health Insurance

    Science.gov (United States)

    Rickard, Megan L.; Hendershot, Candace; Khubchandani, Jagdish; Price, James H.; Thompson, Amy

    2010-01-01

    Background: From January through June 2009, 6.1 million children were uninsured in the United States. On average, students with health insurance are healthier and as a result are more likely to be academically successful. Some schools help students obtain health insurance with the help of school nurses. Methods: This study assessed public school…

  7. School Nurses' Perceptions and Practices of Assisting Students in Obtaining Public Health Insurance

    Science.gov (United States)

    Rickard, Megan L.; Hendershot, Candace; Khubchandani, Jagdish; Price, James H.; Thompson, Amy

    2010-01-01

    Background: From January through June 2009, 6.1 million children were uninsured in the United States. On average, students with health insurance are healthier and as a result are more likely to be academically successful. Some schools help students obtain health insurance with the help of school nurses. Methods: This study assessed public school…

  8. SCHIP Directors' Perception of Schools Assisting Students in Obtaining Public Health Insurance

    Science.gov (United States)

    Price, James H.; Rickard, Megan

    2009-01-01

    Background: Health insurance coverage increases access to health care. There has been an erosion of employer-based health insurance and a concomitant rise in children covered by public health insurance programs, yet more than 8 million children are still without health insurance coverage. Methods: This study was a national survey to assess the…

  9. 77 FR 71439 - Regulatory and Administrative Waivers Granted for Public and Indian Housing Programs To Assist...

    Science.gov (United States)

    2012-11-30

    ....S.C. 5305(a)(8)) authorizes the use of ICDBG grant funds for public services, including but not... services. Upon the granting of this waiver, ICDBG grantees may expend up to 100% of their ICDBG grant funds... Community Development Block Grants (ICDBG) Program Notice of Funding Availability (NOFA) (Grant Ceilings for...

  10. The performance and publication of cost-utility analyses in plastic surgery: Making our specialty relevant.

    Science.gov (United States)

    Thoma, Achilleas; Ignacy, Teegan A; Ziolkowski, Natalia; Voineskos, Sophocles

    2012-01-01

    Increased spending and reduced funding for health care is forcing decision makers to prioritize procedures and redistribute funds. Decision making is based on reliable data regarding the costs and benefits of medical and surgical procedures; such a study design is known as an economic evaluation. The onus is on the plastic surgery community to produce high-quality economic evaluations that support the cost effectiveness of the procedures that are performed. The present review focuses on the cost-utility analysis and its role in deciding whether a novel technique/procedure/technology should be accepted over one that is prevalent. Additionally, the five steps in undertaking a cost-utility (effectiveness) analysis are outlined.

  11. Public and private hospital services reform using data envelopment analysis to measure technical, scale, allocative, and cost efficiencies.

    Science.gov (United States)

    Sheikhzadeh, Yaghoub; Roudsari, Abdul V; Vahidi, Reza Gholi; Emrouznejad, Ali; Dastgiri, Saeed

    2012-01-01

    The aim of this study was to suggest a suitable context to develop efficient hospital systems while maintaining the quality of care at minimum expenditures. This research aimed to present a model of efficiency for selected public and private hospitals of East Azerbaijani Province of Iran by making use of Data Envelopment Analysis approach in order to recognize and suggest the best practice standards. Among the six inefficient hospitals, 2 (33%) had a technical efficiency score of less than 50% (both private), 2 (33%) between 51 and 74% (one private and one public) and the rest (2, 33%) between 75 and 99% (one private and one public). In general, the public hospitals are relatively more efficient than private ones; it is recommended for inefficient hospitals to make use of the followings: transferring, selling, or renting idle/unused beds; transferring excess doctors and nurses to the efficient hospitals or other health centers; pensioning off, early retirement clinic officers, technicians/technologists, and other technical staff. The saving obtained from the above approaches could be used to improve remuneration for remaining staff and quality of health care services of hospitals, rural and urban health centers, support communities to start or sustain systematic risk and resource pooling and cost sharing mechanisms for protecting beneficiaries against unexpected health care costs, compensate the capital depreciation, increasing investments, and improve diseases prevention services and facilities in the provincial level.

  12. Reducing the gap between the economic costs of tobacco and funds for tobacco training in schools of public health.

    Science.gov (United States)

    Rovniak, Liza S; Johnson-Kozlow, Marilyn F; Hovell, Melbourne F

    2006-01-01

    Tobacco use costs approximately dollar 167 billion annually in the U.S., but few tobacco education opportunities are available in schools of public health. Reasons for the discrepancy between the costs of tobacco use and the creation of tobacco training opportunities have not been well explored. Based on the Behavioral Ecological Model, we present 10 recommendations for increasing tobacco training in schools of public health. Six recommendations focus on policy changes within the educational, legislative, and health care systems that influence funds for tobacco training, and four recommendations focus on strategies to mobilize key social groups that can advocate for change in tobacco control education and related policies. In addition, we present a model tobacco control curriculum to equip public health students with the skills needed to advocate for these recommended policy changes. Through concurrent changes in the ecological systems affecting tobacco control training, and through the collaborative action of legislators, the public, the media, and health professionals, tobacco control training can be moved to a higher priority in educational settings.

  13. Integrating open-source technologies to build low-cost information systems for improved access to public health data

    Directory of Open Access Journals (Sweden)

    Oberle Mark W

    2008-06-01

    Full Text Available Abstract Effective public health practice relies on the availability of public health data sources and assessment tools to convey information to investigators, practitioners, policy makers, and the general public. Emerging communication technologies on the Internet can deliver all components of the "who, what, when, and where" quartet more quickly than ever with a potentially higher level of quality and assurance, using new analysis and visualization tools. Open-source software provides the opportunity to build low-cost information systems allowing health departments with modest resources access to modern data analysis and visualization tools. In this paper, we integrate open-source technologies and public health data to create a web information system which is accessible to a wide audience through the Internet. Our web application, "EpiVue," was tested using two public health datasets from the Washington State Cancer Registry and Washington State Center for Health Statistics. A third dataset shows the extensibility and scalability of EpiVue in displaying gender-based longevity statistics over a twenty-year interval for 3,143 United States counties. In addition to providing an integrated visualization framework, EpiVue's highly interactive web environment empowers users by allowing them to upload their own geospatial public health data in either comma-separated text files or MS Excel™ spreadsheet files and visualize the geospatial datasets with Google Maps™.

  14. The Cost of Medicaid Savings: The Potential Detrimental Public Health Impact of Neonatal Circumcision Defunding

    Directory of Open Access Journals (Sweden)

    Annie L. Andrews

    2012-01-01

    Full Text Available Objective. To project the increased incidence of HIV and subsequent costs resulting from the expected decreased rate of circumcision due to Medicaid defunding in one southeastern state. Methods. Using 2009 South Carolina (SC Medicaid birth cohort (n=29,316, we calculated expected heterosexually acquired HIV cases at current circumcision rates. To calculate age/race/gender specific HIV incidence rates, we used 2009 South Carolina Department of Health and Environmental Control reported gender and race specific HIV cases, CDC reported age distribution of HIV cases, and 2009 S.C. population data. Accounting for current circumcision rates, we calculated the change in incidence of heterosexually acquired HIV assuming circumcision provides 60% protection against HIV transmission to males and 46% protection against male to female transmission. Published lifetime cost of HIV was used to calculate the cost of additional HIV cases. Results. Assuming Medicaid circumcision rates decrease from current nationally reported levels to zero secondary to defunding, we project an additional 55 male cases of HIV and 47 female cases of HIV among this birth cohort. The total cost discounted to time of infection of these additional HIV cases is $20,924,400 for male cases and $17,711,400 for female cases. The cost to circumcise males in this birth cohort at currently reported rates is $4,856,000. Conclusions. For every year of decreased circumcision rates due to Medicaid defunding, we project over 100 additional HIV cases and $30,000,000 in net medical costs.

  15. Hidden costs of antiretroviral treatment: the public health efficiency of drug packaging.

    Science.gov (United States)

    Andreu-Crespo, Àngels; Llibre, Josep M; Cardona-Peitx, Glòria; Sala-Piñol, Ferran; Clotet, Bonaventura; Bonafont-Pujol, Xavier

    2015-01-01

    While the overall percentage of unused antiretroviral medicines returned to the hospital pharmacy is low, their cost is quite high. Adverse events, treatment failure, pharmacokinetic interactions, pregnancy, or treatment simplification are common reasons for unplanned treatment changes. Socially inefficient antiretroviral packages prevent the reuse of drugs returned to the hospital pharmacy. We defined antiretroviral package categories based on the excellence of drug packaging and analyzed the number of pills and costs of drugs returned during a period of 1 year in a hospital-based HIV unit attending to 2,413 treated individuals. A total of 6,090 pills (34% of all returned antiretrovirals) - with a cost of 47,139.91 € - would be totally lost, mainly due to being packed up in the lowest efficiency packages. Newer treatments are packaged in low-excellence categories of packages, thus favoring the maintenance of these hidden costs in the near future. Therefore, costs of this low-efficiency drug packaging, where medication packages are started but not completed, in high-cost medications are substantial and should be properly addressed. Any improvement in the packaging by the manufacturer, and favoring the choice of drugs supplied through efficient packages (when efficacy, toxicity, and convenience are similar), should minimize the treatment expenditures paid by national health budgets.

  16. Feasibility of developing low-cost measures of demand for public transportation in rural areas. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Byrne, B.F.; Neumann, E.S.

    1976-12-01

    The Appalachian region has many rural areas of limited accessibility. To improve the accessibility of the rural carless (poor, elderly, young, infirm) public transportation has often been suggested. The objective of the research is to develop a low-cost methodology for determining latent demand for public transportation in rural areas, i.e., to develop a data base of key socio-economic, highway network, and geographic variables which can be used to estimate latent demand along possible rural-transit routes. Data were collected on existing rural-transit operations in Planning Region VI of West Virginia (Monongalia, Taylor, Marion, Harrison, Doddridge, and Preston counties) by means of an on-off survey and an on-board questionnaire survey. Using these as indicators of demand, this information will be related to census data for the affected region to determine if a simplified modeling approach to estimate rural public transportation demand is feasible.

  17. Airport and Airway Costs Allocated to the Public Sector 1985-1997.

    Science.gov (United States)

    1986-12-01

    of the nature of public goods, see: i r i . Solberq, Intermediate Microeconomics, ( Plano , TX, h .e,; Publications, Inc., 1982), pp. 546-47, and...technical treatment can be found in Richard W. Ii,- b, Public Finance: A Normative Theory, ( Plano , TX, Business 1’,kbl icat ions, Inc., 1981), Chapter...FL 6.32 OPF, FL MIA, FL 14.62 TMB, FL MIAFI, FL 10.30 ORL, FL MCO, FL 9.36 PNS, FL NPA, FL 12.15 SPG, FL PIE , FL 12.30 PIE , FL TPA, FL 9.68 FTY, GA

  18. 43 CFR 12.927 - Allowable costs.

    Science.gov (United States)

    2010-10-01

    ... Public Lands: Interior Office of the Secretary of the Interior ADMINISTRATIVE AND AUDIT REQUIREMENTS AND COST PRINCIPLES FOR ASSISTANCE PROGRAMS Uniform Administrative Requirements for Grants and Agreements... Circular A-87, Cost Principles for State and Local Governments. Non-profit organization OMB Circular...

  19. Costs and effects of two public sector delivery channels for long-lasting insecticidal nets in Uganda

    Directory of Open Access Journals (Sweden)

    Strachan Daniel

    2010-04-01

    Full Text Available Abstract Background In Uganda, long-lasting insecticidal nets (LLIN have been predominantly delivered through two public sector channels: targeted campaigns or routine antenatal care (ANC services. Their combination in a mixed-model strategy is being advocated to quickly increase LLIN coverage and maintain it over time, but there is little evidence on the efficiency of each system. This study evaluated the two delivery channels regarding LLIN retention and use, and estimated the associated costs, to contribute towards the evidence-base on LLIN delivery channels in Uganda. Methods Household surveys were conducted 5-7 months after LLIN distribution, combining questionnaires with visual verification of LLIN presence. Focus groups and interviews were conducted to further investigate determinants of LLIN retention and use. Campaign distribution was evaluated in Jinja and Adjumani while ANC distribution was evaluated only in the latter district. Costs were calculated from the provider perspective through retrospective analysis of expenditure data, and effects were estimated as cost per LLIN delivered and cost per treated-net-year (TNY. These effects were calculated for the total number of LLINs delivered and for those retained and used. Results After 5-7 months, over 90% of LLINs were still owned by recipients, and between 74% (Jinja and 99% (ANC Adjumani were being used. Costing results showed that delivery was cheapest for the campaign in Jinja and highest for the ANC channel, with economic delivery cost per net retained and used of USD 1.10 and USD 2.31, respectively. Financial delivery costs for the two channels were similar in the same location, USD 1.04 for campaign or USD 1.07 for ANC delivery in Adjumani, but differed between locations (USD 0.67 for campaign delivery in Jinja. Economic cost for ANC distribution were considerably higher (USD 2.27 compared to campaign costs (USD 1.23 in Adjumani. Conclusions Targeted campaigns and routine ANC

  20. Hidden costs of antiretroviral treatment: the public health efficiency of drug packaging

    Directory of Open Access Journals (Sweden)

    Andreu-Crespo À

    2015-08-01

    Full Text Available Àngels Andreu-Crespo,1,* Josep M Llibre,2,3,* Glòria Cardona-Peitx,1 Ferran Sala-Piñol,1 Bonaventura Clotet,2,4 Xavier Bonafont-Pujol1 1Pharmacy Department, 2HIV Unit and “Lluita contra la SIDA” Foundation, University Hospital Germans Trias i Pujol, Badalona, 3Universitat Autònoma de Barcelona, 4Universitat de Vic-Universitat Central de Catalunya (UVIC-UCC, Vic, Barcelona, Spain *These authors contributed equally to the work Abstract: While the overall percentage of unused antiretroviral medicines returned to the hospital pharmacy is low, their cost is quite high. Adverse events, treatment failure, pharmacokinetic interactions, pregnancy, or treatment simplification are common reasons for unplanned treatment changes. Socially inefficient antiretroviral packages prevent the reuse of drugs returned to the hospital pharmacy. We defined antiretroviral package categories based on the excellence of drug packaging and analyzed the number of pills and costs of drugs returned during a period of 1 year in a hospital-based HIV unit attending to 2,413 treated individuals. A total of 6,090 pills (34% of all returned antiretrovirals – with a cost of 47,139.91€ – would be totally lost, mainly due to being packed up in the lowest efficiency packages. Newer treatments are packaged in low-excellence categories of packages, thus favoring the maintenance of these hidden costs in the near future. Therefore, costs of this low-efficiency drug packaging, where medication packages are started but not completed, in high-cost medications are substantial and should be properly addressed. Any improvement in the packaging by the manufacturer, and favoring the choice of drugs supplied through efficient packages (when efficacy, toxicity, and convenience are similar, should minimize the treatment expenditures paid by national health budgets. Keywords: antiretroviral treatment, cost efficacy, drug packaging, treatment change

  1. Shrouded Costs of Government: Political Economy of State and Local Public Pensions Data

    OpenAIRE

    Glaeser, Edward L.; Giacomo A.M. Ponzetto

    2013-01-01

    Why do public-sector workers receive so much of their compensation in the form of pensions and other benefits? This paper presents a political economy model in which politicians compete for taxpayers' 'and government employees' votes by promising compensation packages, but some voters cannot evaluate every aspect of promised compensation. If pension packages are "shrouded," so that public-sector workers better understand their value than ordinary taxpayers, then compensation will be highly ba...

  2. A cost-effective add-on-value card-assisted firewall over Taiwan's NHI VPN framework.

    Science.gov (United States)

    Huang, Jyh-Win; Hou, Ting-Wei

    2007-06-01

    Besides the overall budget for building the infrastructure of a healthcare-service-based virtual private network (VPN) in Taiwan, two issues were considered critical for its acceptance by the country's 17,000 plus medical institutions. One was who was to pay for the network (ADSL or modem) connection fee; the other was who was to pay for the firewall/anti-virus software. This paper addresses the second issue by proposing an efficient freeware firewall, named card-assisted firewall (CAF), for NHI VPN edge-hosts, which is also an add-on-value application of the National Healthcare IC card that every insurant and medical professional has. The innovative concept is that any NHI VPN site (edge-host) can establish diversified secure-authenticated connections with other sites only by an authentication mechanism, which requires a NHI Java card state machine and the Access Control List of the host. It is different from two-factor authentication cards in four ways: (1) a PIN code is not a must; (2) it requires authentication with the remote IC card Data Centre; (3) the NHI cards are already available, no modification is needed, and there is no further cost for the deployment of the cards; (4) although the cards are in the reader, the communication cannot start unless the cards are in the corresponding states; i.e. the states allow communication. An implementation, on a Microsoft Windows XP platform, demonstrated the system's feasibility over an emulation of the NHI VPN framework. It maintained a high line speed, the driver took up 39 KB of disk space, installation was simple, not requiring any extra hardware or software, and the average packet processing time of the CAF driver measured was 0.3084 ms. The average overhead in comparing the Access Control List predefined routing in card, in an FTP testing experiment, was 5.7 micros (receiving) and 8 micros (sending).

  3. 公立医院成本核算现状分析%Analysis of Cost Accounting in Public Hospitals

    Institute of Scientific and Technical Information of China (English)

    夏海萍; 张晓斌; 郭丽晶

    2016-01-01

    自2009年深化医改的提出到2012年新的《医院财务制度》的实施,公立医院的经营环境发生了很大的变化,公立医院的经营管理方式也面临着新的挑战。新的制度对公立医院的成本核算提出了更高的要求。几年来公立医院成本核算取得了一定的成绩,但也存在不少问题。该文通过对成本核算的现状分析,提出一些改进措施,希望具有借鉴意义。%Since the2009deepening health reform to the implementation of the 2012new hospital financial system, the oper-ating environment of public hospital has had great changes,the operation and management of public hospitals is also facing new challenges. The new system puts forward higher requirements for the cost accounting of public hospitals.In recent years, the public hospital cost accounting has made some achievements,but there are many problems.In this paper, through the analysis of the current situation of cost accounting,and put forward some improvement measures,hope to have reference sig-nificance.

  4. Cost Analysis of Implementing Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry Plus Real-Time Antimicrobial Stewardship Intervention for Bloodstream Infections.

    Science.gov (United States)

    Patel, Twisha S; Kaakeh, Rola; Nagel, Jerod L; Newton, Duane W; Stevenson, James G

    2017-01-01

    Studies evaluating rapid diagnostic testing plus stewardship intervention have consistently demonstrated improved clinical outcomes for patients with bloodstream infections. However, the cost of implementing new rapid diagnostic testing can be significant, and such testing usually does not generate additional revenue. There are minimal data evaluating the impact of adding matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) for rapid organism identification and dedicating pharmacy stewardship personnel time on the total hospital costs. A cost analysis was performed utilizing patient data generated from the hospital cost accounting system and included additional costs of MALDI-TOF equipment, supplies and personnel, and dedicated pharmacist time for blood culture review and of making interventions to antimicrobial therapy. The cost analysis was performed from a hospital perspective for 3-month blocks before and after implementation of MALDI-TOF plus stewardship intervention. A total of 480 patients with bloodstream infections were included in the analysis: 247 in the preintervention group and 233 in the intervention group. Thirty-day mortality was significantly improved in the intervention group (12% versus 21%, P cost per bloodstream infection was lower in the intervention group ($42,580 versus $45,019). Intensive care unit cost per bloodstream infection accounted for the largest share of the total costs in each group and was also lower in the intervention group ($10,833 versus $13,727). Implementing MALDI-TOF plus stewardship review and intervention decreased mortality for patients with bloodstream infections. Despite the additional costs of implementing MALDI-TOF and of dedicating pharmacy stewardship personnel time to interventions, the total hospital costs decreased by $2,439 per bloodstream infection, for an approximate annual cost savings of $2.34 million. Copyright © 2016 American Society for Microbiology.

  5. Investigating the In-Vehicle Crowding Cost Functions for Public Transit Modes

    Directory of Open Access Journals (Sweden)

    Feifei Qin

    2014-01-01

    Full Text Available In the densely populated metropolitan area, empirical studies have found that overcrowding inside transit vehicles has become substantially worse and worse over recent years. Chronic in-vehicle crowding is not only caused by a lack of physical infrastructure, but also triggered by inadequate service provisions. Given the prevalence of overcrowded transit vehicles, this paper conducts both quantitative and qualitative studies, especially focusing on remodeling the in-vehicle crowding cost functions for different transit modes. Three numerical case studies show that applying distinct in-vehicle crowding cost functions to different transit modes has implications not only for the cost structure of transit systems and the magnitude of optimal service provisions but also for the presence of economies of scale in consumption.

  6. Cost-effectiveness of HPV-based cervical cancer screening in the public health system in Nicaragua.

    Science.gov (United States)

    Campos, Nicole G; Mvundura, Mercy; Jeronimo, Jose; Holme, Francesca; Vodicka, Elisabeth; Kim, Jane J

    2017-06-15

    To evaluate the cost-effectiveness of human papillomavirus (HPV) DNA testing (versus Papanicolaou (Pap)-based screening) for cervical cancer screening in Nicaragua. A previously developed Monte Carlo simulation model of the natural history of HPV infection and cervical cancer was calibrated to epidemiological data from Nicaragua. Cost data inputs were derived using a micro-costing approach in Carazo, Chontales and Chinandega departments; test performance data were from a demonstration project in Masaya department. Nicaragua's public health sector facilities. Women aged 30-59 years. Screening strategies included (1) Pap testing every 3 years, with referral to colposcopy for women with an atypical squamous cells of undetermined significance or worse result ('Pap'); (2) HPV testing every 5 years, with referral to cryotherapy for HPV-positive eligible women (HPV cryotherapy or 'HPV-Cryo'); (3) HPV testing every 5 years, with referral to triage with visual inspection with acetic acid (VIA) for HPV-positive women ('HPV-VIA'); and (4) HPV testing every 5 years, with referral to Pap testing for HPV-positive women ('HPV-Pap'). Reduction in lifetime risk of cancer and incremental cost-effectiveness ratios (ICER; 2015 US$ per year of life saved (YLS)). HPV-based screening strategies were more effective than Pap testing. HPV-Cryo was the least costly and most effective strategy, reducing lifetime cancer risk by 29.5% and outperforming HPV-VIA, HPV-Pap and Pap only, which reduced cancer risk by 19.4%, 12.2% and 10.8%, respectively. With an ICER of US$320/YLS, HPV-Cryo every 5 years would be very cost-effective using a threshold based on Nicaragua's per capita gross domestic product of US$2090. Findings were robust across sensitivity analyses on test performance, coverage, compliance and cost parameters. HPV testing is very cost-effective compared with Pap testing in Nicaragua, due to higher test sensitivity and the relatively lower number of visits required. Increasing

  7. 43 CFR 12.64 - Matching or cost sharing.

    Science.gov (United States)

    2010-10-01

    ....64 Public Lands: Interior Office of the Secretary of the Interior ADMINISTRATIVE AND AUDIT REQUIREMENTS AND COST PRINCIPLES FOR ASSISTANCE PROGRAMS Uniform Administrative Requirements for Grants and... (usually as indirect costs) in accordance with the cost principles specified in § 12.62, in the same way...

  8. Poverty, Public Assistance and Single Mothers : A Comparative Look at Norway, Russia and the U.S

    Directory of Open Access Journals (Sweden)

    Pamela A. Brown

    2015-03-01

    Full Text Available This article presents some of the perceptions and experiences of mothers on public assistance and their social workers in three countries—Norway, Russia and the US. Based on in-depth interviews in each country with social workers and the women, five themes emerged that will be presented here. The mothers spoke of the inadequacy of economic support to meet their needs, a life of poverty that sometimes involved discrimination of them as mothers, and a loss of hope that their lives could be different. Two themes that stood out in the interviews with social workers was the lack of resources needed to help their clients and the dilemma faced as an agent of social welfare institutions balanced with being an advocate for the mothers’ needs.

  9. Cost-effectiveness analysis comparing continuation of assisted reproductive technology with conversion to intrauterine insemination in patients with low follicle numbers.

    Science.gov (United States)

    Yu, Bo; Mumford, Sunni; Royster, G Donald; Segars, James; Armstrong, Alicia Y

    2014-08-01

    To compare the cost effectiveness of proceeding with oocyte retrieval vs. converting to intrauterine insemination (IUI) in patients with ≤4 mature follicles during assisted reproductive technology (ART) cycles. Probabilistic decision analysis. The cost effectiveness of completing ART cycles in poor responders was compared to that for converting the cycles to IUI. Not applicable. Not applicable. Cost-effectiveness analysis. Cost effectiveness, which was defined as the average direct medical costs per ongoing pregnancy. In patients with 1-3 mature follicles, completing ART was more cost effective if the cost of a single ART cycle was between $10,000 and $25,000. For patients with 4 mature follicles, if an ART cycle costcost effective to continue with oocyte retrieval than to convert to IUI. In patients with ≤4 mature follicles following ovarian stimulation in ART cycles, it was on average more cost effective to proceed with oocyte retrieval rather than convert to IUI. However, important factors, such as age, prior ART failures, other fertility factors, and medications used in each individual case need to be considered before this analysis model can be adapted by individual practices. Copyright © 2014 American Society for Reproductive Medicine. All rights reserved.

  10. Squeeze Play 2009: The Public's Views on College Costs Today--Public Agenda and the National Center for Public Policy and Higher Education

    Science.gov (United States)

    Immerwahr, John; Johnson, Jean

    2012-01-01

    For increasing numbers of Americans, a crucial facet of the American Dream appears to be at risk. A solid majority consider a college degree an indispensable ticket to the middle class. At the same time, even more people believe college is financially out-of-reach for many qualified students. This is the message from new public opinion research by…

  11. [Myocardial perfusion scintigraphy. Exact and cost-effective coronary disease imaging - secondary publication

    DEFF Research Database (Denmark)

    Hesse, B.; Petersen, C.L.; Marcassa, C.

    2008-01-01

    Mortality rates due to coronary arterial disease (CAD) have declined as result of improved prevention, diagnosis and management, but CAD remains the leading cause of death. Myocardial perfusion scintigraphy (MPS) provides a cost-effective tool for early detection of CAD in symptomatic individuals...

  12. Cardiac Surgery Costs According to the Preoperative Risk in the Brazilian Public Health System

    Directory of Open Access Journals (Sweden)

    David Provenzale Titinger

    2015-01-01

    Full Text Available Abstract Background: Heart surgery has developed with increasing patient complexity. Objective: To assess the use of resources and real costs stratified by risk factors of patients submitted to surgical cardiac procedures and to compare them with the values reimbursed by the Brazilian Unified Health System (SUS. Method: All cardiac surgery procedures performed between January and July 2013 in a tertiary referral center were analyzed. Demographic and clinical data allowed the calculation of the value reimbursed by the Brazilian SUS. Patients were stratified as low, intermediate and high-risk categories according to the EuroSCORE. Clinical outcomes, use of resources and costs (real costs versus SUS were compared between established risk groups. Results: Postoperative mortality rates of low, intermediate and high-risk EuroSCORE risk strata showed a significant linear positive correlation (EuroSCORE: 3.8%, 10%, and 25%; p < 0.0001, as well as occurrence of any postoperative complication EuroSCORE: 13.7%, 20.7%, and 30.8%, respectively; p = 0.006. Accordingly, length-of-stay increased from 20.9 days to 24.8 and 29.2 days (p < 0.001. The real cost was parallel to increased resource use according to EuroSCORE risk strata (R$ 27.116,00 ± R$ 13.928,00 versus R$ 34.854,00 ± R$ 27.814,00 versus R$ 43.234,00 ± R$ 26.009,00, respectively; p < 0.001. SUS reimbursement also increased (R$ 14.306,00 ± R$ 4.571,00 versus R$ 16.217,00 ± R$ 7.298,00 versus R$ 19.548,00 ± R$935,00; p < 0.001. However, as the EuroSCORE increased, there was significant difference (p < 0.0001 between the real cost increasing slope and the SUS reimbursement elevation per EuroSCORE risk strata. Conclusion: Higher EuroSCORE was related to higher postoperative mortality, complications, length of stay, and costs. Although SUS reimbursement increased according to risk, it was not proportional to real costs.

  13. 77 FR 32183 - Transmission Planning and Cost Allocation by Transmission Owning and Operating Public Utilities

    Science.gov (United States)

    2012-05-31

    .... Framework To Evaluate Transmission Projects 431 Submitted for Selection in the Regional Plan for Purposes of... Commission required all public utility transmission providers to adopt a framework that requires, among other... Motor Vehicles Mfrs. Ass'n of U.S. v. State Farm Mut. Auto Ins. Co., 463 U.S. 29, 43 (1983) (State Farm...

  14. Containing costs in public sector hospitals a strategy for the future

    African Journals Online (AJOL)

    1990-08-04

    Aug 4, 1990 ... about expenditure in the public and the private health care sectors. ... Groote Schuur Hospital and Department of Community .... from 1985/86 is due to expenditure on equipment (non- .... much work is still required to correct the methodological .... and Eric Wilson, Miss D. McIntyre, and Messrs Renee Trmer,.

  15. Regional Public Health Cost Estimates of Contaminated Coastal Waters: A Case Study of Gastroenteritis at Southern California Beaches

    Science.gov (United States)

    Given, S.; Pendleton, L.; Boehm, A.

    2007-05-01

    We present estimates of annual public health impacts, both illnesses and cost of illness,attributable to excess gastrointestinal illnesses caused by swimming in contaminated coastal waters at beaches in southern California, USA. Beach-specific enterococci densities are used as inputs to two epidemiological dose-response models to predict the risk of gastrointestinal illness at 28 beaches spanning 160 km of coastline in Los Angeles and Orange Counties. We use attendance data along with the health cost of gastrointestinal illness to estimate the number of illnesses among swimmers . We estimate that between 627,800 and 1,479,200 excess gastrointestinal illnesses occur at beaches in Los Angeles and Orange Counties each year. Using a conservative health cost of gastroenteritis, this corresponds to an annual economic loss of 21 or 51 million depending upon the underlying epidemiological model used (in year 2000 dollars). Results demonstrate that improving coastal water quality could result in a reduction of gastrointestinal illnesses locally and a concurrent savings in expenditures on related health care costs.

  16. 76 FR 35231 - Notice of Proposed Information Collection for Public Comment; McKinney-Vento Technical Assistance...

    Science.gov (United States)

    2011-06-16

    ...Kinney-Vento Technical Assistance Narrative, Matrices, and Reporting Requirements. Description of the need for the information proposed: McKinney- Vento Technical Assistance (MV-TA) Narrative, Matrices... assistance funding under the FY2011 McKinney-Vento Technical Assistance Notice of Funding Availability (NOFA...

  17. FUNDAMENTAL RIGHT TO PUBLIC EDUCATION QUALITY: EFFECTIVENESS ACCORDING TO THE PARAMETERS OF STUDENT COST INITIAL QUALITY

    OpenAIRE

    2016-01-01

    The right to education, despite being present in the Brazilian legislation, still suffers on being applied. This article deals with the dimensions of the education quality, which are at the same time understandable to the population and judicially enforceable.  It analyzes the relevant legislation, and based on different authors, discusses the fundamental right to education and the pattern of the quality in Student Cost Initial Quality (CAQi) in Portuguese acronym). It also discusses the righ...

  18. Exploring No-Cost Opportunities for Public Sector Information Systems Energy Efficiency: A Tennessee Application

    Directory of Open Access Journals (Sweden)

    Kendra Abkowitz Brooks

    2015-11-01

    Full Text Available The Tennessee Department of Environment and Conservation (TDEC completed a pilot project within its Central Office spaces to test the utilization of computer power management (CPM technologies to implement power saving settings on state-owned, network-connected computer equipment. Currently, the State of Tennessee has no clear protocol regarding energy-conserving power settings on state-owned machines. Activation of monitor sleep modes and system standby and hibernation modes on 615 Central Office computers over an 18-month period reduced energy consumption by an estimated 8093 kWh and $526 per month, amounting to approximately $6312 in cost savings for Tennessee annually. If implemented throughout State of Tennessee executive agencies across the state, energy cost savings could amount to an estimated $323,341 annually. The research endeavored to understand both positive and negative impacts that strategic power management approaches can have on energy consumption, worker productivity, network security, and state budgets. Nearly all impacts discussed were positive. Based on successful results within TDEC Central Office spaces in Tennessee Tower, and considering the potential cost savings that could be achieved, expansion of the implementation of computer power management policies to machines in offices across the state was recommended.

  19. Public availability of a genotyped, segregating population may foster marker assisted breeding (MAB) and quantitative trait loci (QTL) discovery: An example using strawberry

    Science.gov (United States)

    Much of the cost associated with marker discovery for marker assisted breeding (MAB) can be eliminated if a diverse, segregating population is generated, genotyped and made available to the global breeding community. Herein, we present an example of a hybrid, wild-derived family of the octoploid str...

  20. Micro-costing in public health economics: steps towards a standardized framework, using the incredible years toddler parenting program as a worked example.

    Science.gov (United States)

    Charles, J M; Edwards, R T; Bywater, T; Hutchings, J

    2013-08-01

    Complex interventions, such as parenting programs, are rarely evaluated from a public sector, multi-agency perspective. An exception is the Incredible Years (IY) Basic Parenting Program; which has a growing clinical and cost-effectiveness evidence base for preventing or reducing children's conduct problems. The aim of this paper was to provide a micro-costing framework for use by future researchers, by micro-costing the 12-session IY Toddler Parenting Program from a public sector, multi-agency perspective. This micro-costing was undertaken as part of a community-based randomized controlled trial of the program in disadvantaged Flying Start areas in Wales, U.K. Program delivery costs were collected by group leader cost diaries. Training and supervision costs were recorded. Sensitivity analysis assessed the effects of a London cost weighting and group size. Costs were reported in 2008/2009 pounds sterling. Direct program initial set-up costs were £3305.73; recurrent delivery costs for the program based on eight parents attending a group were £752.63 per child, falling to £633.61 based on 10 parents. Under research contexts (with weekly supervision) delivery costs were £1509.28 per child based on eight parents, falling to £1238.94 per child based on 10 parents. When applying a London weighting, overall program costs increased in all contexts. Costs at a micro-level must be accurately calculated to conduct meaningful cost-effectiveness/cost-benefit analysis. A standardized framework for assessing costs is needed; this paper outlines a suggested framework. In prevention science it is important for decision makers to be aware of intervention costs in order to allocate scarce resources effectively.

  1. Public and Private Hospital Services Reform Using Data Envelopment Analysis to Measure Technical, Scale, Allocative, and Cost Efficiencies

    Directory of Open Access Journals (Sweden)

    Ali Emrouznejad

    2012-07-01

    Full Text Available Background: The aim of this study was to suggest a suitable context to develop efficient hospitalsystems while maintaining the quality of care at minimum expenditures.Methods: This research aimed to present a model of efficiency for selected public and privatehospitals of East Azerbaijani Province of Iran by making use of Data Envelopment Analysis approachin order to recognize and suggest the best practice standards.Results: Among the six inefficient hospitals, 2 (33% had a technical efficiency score of lessthan 50% (both private, 2 (33% between 51 and 74% (one private and one public and the rest(2, 33% between 75 and 99% (one private and one public.Conclusion: In general, the public hospitals are relatively more efficient than private ones; it isrecommended for inefficient hospitals to make use of the followings: transferring, selling, orrenting idle/unused beds; transferring excess doctors and nurses to the efficient hospitals orother health centers; pensioning off, early retirement clinic officers, technicians/technologists,and other technical staff. The saving obtained from the above approaches could be used to improveremuneration for remaining staff and quality of health care services of hospitals, rural andurban health centers, support communities to start or sustain systematic risk and resource poolingand cost sharing mechanisms for protecting beneficiaries against unexpected health carecosts, compensate the capital depreciation, increasing investments, and improve diseases preventionservices and facilities in the provincial level.

  2. Assisted Living

    Science.gov (United States)

    ... if needs change. Assisted living costs less than nursing home care. It is still fairly expensive. Older people or their families usually pay for it. Health and long-term care insurance policies may cover ...

  3. The Cost of War on Public Health: An Exploratory Method for Understanding the Impact of Conflict on Public Health in Sri Lanka.

    Science.gov (United States)

    Johnson, Sandy A

    2017-01-01

    The direct impact of protracted conflict on population health and development is well understood. However, the extent of a war's impact on long-term health, and the opportunity costs, are less well understood. This research sought to overcome this gap by asking whether or not health outcomes in Sri Lanka would have been better in the absence of a 26-year war than they were in the presence of war. A counterfactual model of national and district-level health outcomes was created for Sri Lanka for the period 1982 to 2002. At the national level, the model examined life expectancy, infant mortality rate (IMR), and maternal mortality ratios (MMR). At the district level, it looked at IMR and MMR. The model compared outcomes generated by the counterfactual model to actual obtained health outcomes. It looked at the rate of change and absolute values. The analysis demonstrated that war altered both rate of change and absolute health outcomes for the worse. The impact was most clearly evident at the district level. IMR was poorer than predicted in 10 districts; of these 8 were outside of the conflict zone. The MMR was worse than expected in 11 districts of which 9 were not in the conflict zone. Additionally, the rate of improvement in IMR slowed as a result of war in 16 districts whereas the rate of improvement in MMR slowed in 9. This project showed that protracted conflict degraded the trajectory of public health in Sri Lanka and hurt population health outside of the conflict zone. It further provided a novel methodology with which to better understand the indirect impact of conflict on population health by comparing what is to what could have been achieved in the absence of war. In so doing, this research responded to two public health challenges by providing a tool through which to better understand the human and opportunity costs of war and by answering a call for new methodologies.

  4. What is the real cost of our food? Implications for the environment, society and public health nutrition.

    Science.gov (United States)

    O'Kane, Gabrielle

    2012-02-01

    The current, globalised food system supplies 'cheap' food to a large proportion of the world's population, but with significant social, environmental and health costs that are poorly understood. The present paper examines the nature and extent of these costs for both rural and urban communities, by illustrating the financial pressures on food producers and manufacturers to produce cheap food, the disconnection people experience with how and where their food is produced, and the rise in obesity levels that plague the globe. The paper then proposes that community food systems may play an important role in mitigating the adverse environmental, economic and social effects of the dominant food system, by the use of more sustainable food production methods, the development of local economies and enabling closer connections between farmers and consumers. There are many opportunities for public health nutritionists to contribute to the local food system literature to ascertain whether these systems improve inequities, provide better access to healthy food and help stem the tide of rising global obesity levels. Public health nutritionists can play a key role in supporting people to become food citizens and to advocate for democratic and sustainable food systems.

  5. Stakeholder Engagement and Knowledge Co-Creation in Water Planning: Can Public Participation Increase Cost-Effectiveness?

    Directory of Open Access Journals (Sweden)

    Morten Graversgaard

    2017-03-01

    Full Text Available In 2014, a radical shift took place in Danish water planning. Following years of a top-down water planning approach, 23 regional water councils were established to co-create and provide input to Danish authorities on the development of River Basin Management Plans (RBMP. The water councils advised local authorities on the application of measures to improve the physical conditions in Danish streams within a given economic frame. The paper shows the difference the use of water councils (public participation made by comparing the final water council proposal included in the 2015 RBMP to the RBMPs proposed by the central government (Nature Agency in 2014. The study concludes that the measures proposed by the water councils will generally deliver better results than the proposed Nature Agency plans, which do not include the same level of participation. Specifically, the water councils with stakeholder involvement proposed a much longer network of streams (3800 km, yielding a better ecological outcome than the shorter stream network (1615 km proposed by the Nature Agency for the same budget. Having a structured and fixed institutional frame around public participation (top-down meeting bottom-up can produce cost-effective results, but the results show that cost-effectiveness was not the only deciding factor, and that local circumstances like the practicalities of implementing the measures were also considered when developing the Programmes of Measures. The findings suggest that the use of water councils in water planning has significant advantages, including the fact that the knowledge of local conditions helps to identify efficient solutions at lower costs, which can be useful for administrators, policy-makers, and other stakeholders implementing the Water Framework Directive in years to come.

  6. Fee-Free Public or Low-Fee Private Basic Education in Rural Ghana: How Does the Cost Influence the Choice of the Poor?

    Science.gov (United States)

    Akaguri, Luke

    2014-01-01

    The paper uses data from a household survey of three rural communities and interviews in the Mfantseman Municipality in the Central Region of Ghana to investigate the costs incurred by households that choose either fee-free public schools or low-fee private schools. The paper shows that both provisions impose costs that place those with lower…

  7. Cost-Efficacy Analysis of Out-of-District Special Education Placements: An Evaluative Measure of Behavior Support Intervention in Public Schools.

    Science.gov (United States)

    Putnam, Robert F.; Luiselli, James K.; Sennett, Kenneth; Malonson, Joanne

    2002-01-01

    Evaluation of out-of-district special education placement costs in the 15 largest Massachusetts public school districts found the criterion school district (which had developed a system-wide approach to behavioral intervention) had the lowest per capita cost, lowest percentage of total school budget consumed by out-of-district placements, and the…

  8. The public promotion of wind energy in Spain from the transaction costs perspective 1986-2007

    Energy Technology Data Exchange (ETDEWEB)

    Perez, Yannick [Universite Paris-Sud 11, Groupe Reseaux Jean-Monnet ADIS, Bureau C 310, 27 Avenue Lombart, Fontenay aux Roses F92260 (France); Ramos-Real, Francisco Javier [Departamento de Analisis Economico, Facultad de Ciencias Economicas y Empresariales, Campus de Guajara, Universidad de La Laguna, La Laguna, S/C de Tenerife 38071 (Spain)

    2009-06-15

    This paper analyzes the success of wind energy in Spain from 1986 to 2007. Certain special characteristics have emerged in Spain that provide credibility to the feed-in tariff (FIT) device to promote this energy source. To explain this success, the analysis will focus on the intrinsic characteristics of FIT using the concepts of the transaction cost theory (TCE). Nevertheless, in this framework, special attention is placed on the role that specific political and institutional factors have played in providing stability to this instrument. Thanks to an early start and an on-going and generous FIT device, wind energy promotion for electricity has become a political success story in Spain. The main implication of this analysis is that this success is mainly due to the trade-off between stability and flexibility in the use of Spanish FIT. (author)

  9. Limiting the public cost of stationary battery deployment by combining applications

    Science.gov (United States)

    Stephan, A.; Battke, B.; Beuse, M. D.; Clausdeinken, J. H.; Schmidt, T. S.

    2016-07-01

    Batteries could be central to low-carbon energy systems with high shares of intermittent renewable energy sources. However, the investment attractiveness of batteries is still perceived as low, eliciting calls for policy to support deployment. Here we show how the cost of battery deployment can potentially be minimized by introducing an aspect that has been largely overlooked in policy debates and underlying analyses: the fact that a single battery can serve multiple applications. Batteries thereby can not only tap into different value streams, but also combine different risk exposures. To address this gap, we develop a techno-economic model and apply it to the case of lithium-ion batteries serving multiple stationary applications in Germany. Our results show that batteries could be attractive for investors even now if non-market barriers impeding the combination of applications were removed. The current policy debate should therefore be refocused so as to encompass the removal of such barriers.

  10. Assisted Living Facilities, Licensed Health Care Facilities - assisted living facility type identified in attributes, Published in 2007, Iowa Dept. of Public Health.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Assisted Living Facilities dataset, was produced all or in part from Published Reports/Deeds information as of 2007. It is described as 'Licensed Health Care...

  11. Short-term costs of conventional vs laparoscopic assisted surgery in patients with colorectal cancer (MRC CLASICC trial)

    Science.gov (United States)

    Franks, P J; Bosanquet, N; Thorpe, H; Brown, J M; Copeland, J; Smith, A M H; Quirke, P; Guillou, P J

    2006-01-01

    The short-term clinical results of the CLASICC trial indicated that clinical outcomes were similar between laparoscopic and open approaches. This study presents the short-term (3 month) cost analysis undertaken on a subset of patients entered into the CLASICC trial (682 of 794 patients). As expected the costs associated with the operation were higher in the 452 patients randomised to laparoscopic surgery (lap) compared with the 230 randomised to open procedure (open), £1703 vs £1386. This was partially offset by the other hospital (nontheatre) costs, which were lower in the lap group (£2930 vs £3176). The average cost to individuals for reoperations was higher in the lap group (£762 vs £553). Overall costs were slightly higher in the lap group (£6899 vs £6631), with mean difference of £268 (95%CI −689 to 1457). Sensitivity analysis made little difference to these results. The cost of rectal surgery was higher than for colon, for lap (£8259 vs £5586) and open procedures (£7820 vs £5503). The short-term cost analysis for the CLASICC trial indicates that the costs of either laparoscopic or open procedure were similar, lap surgery costing marginally more on average than open surgery. PMID:16755298

  12. NOISE INDUCED HEARING LOSS IN CHINA:A POTENTIALLY COSTLY PUB-LIC HEALTH LSSUE

    Institute of Scientific and Technical Information of China (English)

    Shi Yongbing; William Hal Martin

    2013-01-01

    Hearing loss and tinnitus are among the most common consequences of long term noise exposure and re-main an under-addressed heath issue in most developing nations including China. The rapid industrializa-tion and life style changes in China increase the concern over noise exposure and noise induced hearing loss (NIHL). Research on NIHL in China is limited. The current paper reviews studies published in English and Chinese language literatures regarding noise exposure and NIHL in China. Their implication on the Chi-nese population is discussed. The possible utility of a research model such as the Dangerous Decibels® as a means to increase understanding of the scope of NIHL among the Chinese population, to educate the gener-al public in China (especially the young) about NIHL and its prevention, and to study effects of language and cultural factors on international information dissemination and behavioral interventions is proposed.

  13. 24 CFR 5.615 - Public housing program and Section 8 tenant-based assistance program: How welfare benefit...

    Science.gov (United States)

    2010-04-01

    ... 8 tenant-based assistance program: How welfare benefit reduction affects family income. 5.615... assistance program: How welfare benefit reduction affects family income. (a) Applicability. This section... purposes of this section: Covered families. Families who receive welfare assistance or other...

  14. The Public Role of Perm Province in Assisting the Sick and Wounded Soldiers During the First World War

    Directory of Open Access Journals (Sweden)

    Kaydysheva Natalya

    2014-11-01

    Full Text Available On the example of Perm province the public activity on helping the sick and wounded soldiers during the World War I is analyzed. On the basis of wide scope of sources, the author investigates the participants, the scales and the forms of social help. The accent is made on the sources of financing organizations which carried out this activity. It is shown that all population layers in Perm province took part in rendering help to sick and wounded soldiers. The society often took the initiative in providing the charity events created by authorized structures that revealed the civil activity. The civil charity initiative gets further development during the war in mining plants. The state was interested and contributed to the civil independent actions, and it was caused by the wartime conditions. The author also determines the peculiarities of the assistance to sick and wounded soldiers in Perm province. All-Russian State Union became the body through which this help got better organized official registration during the war. It attracted major human resources and accumulated considerable monetary and clothing donations to the benefit of sick and wounded soldiers, thus providing the state with the possibility to control and coordinate this activity in the province.

  15. Cost-Benefit Performance of Robotic Surgery Compared with Video-Assisted Thoracoscopic Surgery under the Japanese National Health Insurance System.

    Science.gov (United States)

    Kajiwara, Naohiro; Patrick Barron, James; Kato, Yasufumi; Kakihana, Masatoshi; Ohira, Tatsuo; Kawate, Norihiko; Ikeda, Norihiko

    2015-01-01

    Medical economics have significant impact on the entire country. The explosion in surgical techniques has been accompanied by questions regarding actual improvements in outcome and cost-effectiveness, such as the da Vinci(®) Surgical System (dVS) compared with conventional video-assisted thoracic surgery (VATS). To establish a medical fee system for robot-assisted thoracic surgery (RATS), which is a system not yet firmly established in Japan. This study examines the cost benefit performance (CBP) based on medical fees compared with VATS and RATS under the Japanese National Health Insurance System (JNHIS) introduced in 2012. The projected (but as yet undecided) price in the JNHIS would be insufficient if institutions have less than even 200 dVS cases per year. Only institutions which perform more than 300 dVS operations per year would obtain a positive CBP with the projected JNHIS reimbursement. Thus, under the present conditions, it is necessary to perform at least 300 dVS operations per year in each institution with a dVS system to avoid financial deficit with current robotic surgical management. This may hopefully encourage a downward price revision of the dVS equipment by the manufacture which would result in a decrease in the cost per procedure.

  16. 40 CFR 35.6585 - Cost and price analysis.

    Science.gov (United States)

    2010-07-01

    ... ASSISTANCE STATE AND LOCAL ASSISTANCE Cooperative Agreements and Superfund State Contracts for Superfund Response Actions Procurement Requirements Under A Cooperative Agreement § 35.6585 Cost and price analysis... quantities to the general public, or on prices set by law or regulation. (2) Price analysis. In all...

  17. Integrating and rationalizing public healthcare services as a source of cost containment in times of economic crises.

    Science.gov (United States)

    Pettoello-Mantovani, Massimo; Namazova-Baranova, Leyla; Ehrich, Jochen

    2016-02-24

    Serious concern has been raised about the sustainability of public health care systems of European Nations and ultimately about the health of European citizens, as a result of the economic crisis that has distressed Europe since 2008. The severe economic crisis of the Euro zone, which is still afflicting Europe in 2016, has in fact threatened to equally impact public health services of nations presenting either a weak or a strong domestic growth. On behalf of the European Paediatric Association, the Union of National European Societies and Associations, the authors of the Commentary debates the relationship between the effects of economic instability and health, through the report on an article recently published in the Italian Journal of Pediatrics, which emphasized the importance of integrating existing public health care services, otherwise independently provided by public hospitals, and Primary Care Paediatric networks. The interconnections between the effects of economic instability and health are briefly commented, following the observation that these two factors are not yet fully understood, and that the definition of proper solutions to be applied in circumstances, where health is negatively impacted by periods of economic distress, is still open for discussion. Furthermore it is noted that the pressure to "deliver more for less" often seems to be the driving force forging the political strategic decisions in the area of pediatric healthcare, rather than social, cultural, and economic sensitivity and competences. Thus, the delivery of appropriate pediatric healthcare seems not to be related exclusively to motivations aimed to the benefit of children, but more often to other intervening factors, including economic, and political rationales. The conclusions emphasize that local European experiences suggest that positive and cost effective healthcare programs are possible, and they could serve as a model in the development of effective cross-border regional

  18. Demandas judiciais e assistência terapêutica no Sistema Único de Saúde Judicial demands and therapeutic assistance in the Brazilian Public Health System

    Directory of Open Access Journals (Sweden)

    Fabiola Sulpino Vieira

    2009-01-01

    , based on a sample of diseases referred to in lawsuits against the city of São Paulo Municipal Office for Health, in 2005. A search of the standards that set forth therapeutic policies, as well as recommended therapeutic resources (surgical procedures and drugs, was performed. The database Diseasedex, part of the Micromedex system, was used as the basis for therapeutic procedures used to treat those diseases. A reference summary table was prepared to facilitate comparison between recommendations in public policies and the Diseasedex database. RESULTS: Therapeutic public policy covers the major part (n = 26 of the diseases analyzed, either by public policies for primary care or public policies for rare diseases and/or high cost treatment diseases. This represents 96% of the sample analyzed (n = 27. Only 3 of the 27 diseases in the sample are contemplated by limited therapeutic policies. This means that public policies do not offer full first-line therapy, which corresponds to 11% of the sample. There was only one disease that was not covered by public therapeutic policies: attention deficit hyperactivity disorder. CONCLUSION: There were limitations in the qualitative coverage of treatment of some diseases from the sample analyzed, which may jeopardize the comprehensiveness of therapeutic assistance and health care in some cases.

  19. Assisted reproduction and distributive justice.

    Science.gov (United States)

    Panitch, Vida

    2015-02-01

    The Canadian province of Quebec recently amended its Health Insurance Act to cover the costs of In Vitro Fertilization (IVF). The province of Ontario recently de-insured IVF. Both provinces cited cost-effectiveness as their grounds, but the question as to whether a public health insurance system ought to cover IVF raises the deeper question of how we should understand reproduction at the social level, and whether its costs should be a matter of individual or collective responsibility. In this article I examine three strategies for justifying collective provisions in a liberal society and assess whether public reproductive assistance can be defended on any of these accounts. I begin by considering, and rejecting, rights-based and needs-based approaches. I go on to argue that instead we ought to address assisted reproduction from the perspective of the contractarian insurance-based model for public health coverage, according to which we select items for inclusion based on their unpredictability in nature and cost. I argue that infertility qualifies as an unpredictable incident against which rational agents would choose to insure under ideal conditions and that assisted reproduction is thereby a matter of collective responsibility, but only in cases of medical necessity or inability to pay. The policy I endorse by appeal to this approach is a means-tested system of coverage resembling neither Ontario nor Quebec's, and I conclude that it constitutes a promising alternative worthy of serious consideration by bioethicists, political philosophers, and policy-makers alike.

  20. Employment Assistance for Reserve Component Members

    Science.gov (United States)

    2015-01-01

    legal issues; assistance with entrepreneurship ; internships, assistance, and training; financial assistance; and access to information and tools...assistance to other federal departments whose missions more closely align with providing employment assistance or social services could save costs

  1. Theoretical analysis of the cumulative costs of different diesel bus alternatives for a public transport in the city of Belgrade

    Directory of Open Access Journals (Sweden)

    Jovanović Stevan S.

    2017-01-01

    Full Text Available This paper includes comparative analysis of the environmental, energetic, and financial costs of different bus propulsion, possibly applied on the public transport in the city of Belgrade. It considers the modern diesel bus, the trolleybus, the natural gas bus with the spark ignition engine, the electric bus using LiFePO4 battery, and the electric bus with ultra-capacitor. The results are presented according to the real data and the real electro-energetic situation in Serbia, with the dominantly used lignite coal as primary fuel. This model gives the exact exhaust emission of electric vehicles at the thermal power plant, enables its comparison to the internal combustion engine vehicles. The result in analysis shows that the natural gas bus is the most cost efficient in economical way with overall exploitation price of $87 per 100 km. The trolleybus is more economical then the natural gas powered bus only at high departures rate, higher than 230 per workday.

  2. The cost-effectiveness of a NSCLC patient assistance program for pemetrexed maintenance therapy in People’s Republic of China

    Science.gov (United States)

    Shi, Qiang; Hu, Shanlian; Furnback, Wesley E; Guzauskas, Gregory F; Shen, Jiejing; Wang, Bruce CM

    2017-01-01

    Background Eli Lilly and the China Primary Health Care Foundation are currently implementing a patient assistance program (PAP) in China, which allows first-line nonsquamous non-small-cell lung cancer (NSCLC) patients who complete four cycles of pemetrexed induction therapy to receive free, continuous pemetrexed maintenance therapy. Objective To estimate the cost-effectiveness of pemetrexed maintenance therapy vs basic standard care (BSC) and the economic impacts of providing a PAP for pemetrexed maintenance therapy to NSCLC patients who have completed pemetrexed induction therapy in a Chinese health care setting. Methods We developed a novel decision-analytic model to evaluate the long-term costs and clinical efficacy of pemetrexed plus BSC vs BSC alone. We utilized a three-state (progression-free survival, progressed disease, and dead) partition survival model for both the clinical and economic aspects of the analysis. Cost and health utility estimates were derived from the literature. We performed a scenario analysis to estimate the real-world impact of introducing the PAP in China by comparing the use of the PAP vs non-PAP. Model uncertainty was evaluated using one-way and multivariate probabilistic sensitivity analysis. Results Compared to BSC, pemetrexed plus BSC resulted in a gain of 0.22 years of life (95% credible range [CR]: 0.04–0.46) and 0.13 quality-adjusted life years (95% CR: 0.04–0.26) per patient, at an increased cost of $28,105 (95% CR: −$22,720 to $48,646) without a PAP and $3,068 (95% CR: −$1,263 to $9,163) with a PAP. The incremental cost-effectiveness ratio for pemetrexed plus BSC vs BSC alone was cost-prohibitive at $222,700 for non-PAP, but cost-effective at $24,319 with a PAP. Conclusion Our study suggests that maintenance pemetrexed therapy following pemetrexed induction for patients with advanced NSCLC is likely to be highly non-cost-effective in the absence of a PAP, but the pending implementation of the PAP promises to make it

  3. Comparison of minimally invasive parathyroidectomy under local anaesthesia and minimally invasive video-assisted parathyroidectomy for primary hyperparathyroidism: a cost analysis

    Science.gov (United States)

    MELFA, G.I.; RASPANTI, C.; ATTARD, M.; COCORULLO, G.; ATTARD, A.; MAZZOLA, S.; SALAMONE, G.; GULOTTA, G.; SCERRINO, G.

    2016-01-01

    Background Primary hyperparathyroidism (PHPT) origins from a solitary adenoma in 70–95% of cases. Moreover, the advances in methods for localizing an abnormal parathyroid gland made minimally invasive techniques more prominent. This study presents a micro-cost analysis of two parathyroidectomy techniques. Patients and methods 72 consecutive patients who underwent minimally invasive parathyroidectomy, video-assisted (MIVAP, group A, 52 patients) or “open” under local anaesthesia (OMIP, group B, 20 patients) for PHPT were reviewed. Operating room, consumable, anaesthesia, maintenance costs, equipment depreciation and surgeons/anaesthesiologists fees were evaluated. The patient’s satisfaction and the rate of conversion to conventional parathyroidectomy were investigated. T-Student’s, Kolmogorov-Smirnov tests and Odds Ratio were used for statistical analysis. Results 1 patient of the group A and 2 of the group B were excluded from the cost analysis because of the conversion to the conventional technique. Concerning the remnant patients, the overall average costs were: for Operative Room, 1186,69 € for the MIVAP group (51 patients) and 836,11 € for the OMIP group (p<0,001); for the Team, 122,93 € (group A) and 90,02 € (group B) (p<0,001); the other operative costs were 1388,32 € (group A) and 928,23 € (group B) (p<0,001). The patient’s satisfaction was very strongly in favour of the group B (Odds Ratio 20,5 with a 95% confidence interval). Conclusions MIVAP is more expensive compared to the “open” parathyroidectomy under local anaesthesia due to the costs of general anaesthesia and the longer operative time. Moreover, the patients generally prefer the local anaesthesia. Nevertheless, the rate of conversion to the conventional parathyroidectomy was relevant in the group of the local anaesthesia compared to the MIVAP, since the latter allows a four-gland exploration. PMID:27381690

  4. A Systematic Review of Cost-Sharing Strategies Used within Publicly-Funded Drug Plans in Member Countries of the Organisation for Economic Co-Operation and Development

    Science.gov (United States)

    Barnieh, Lianne; Clement, Fiona; Harris, Anthony; Blom, Marja; Donaldson, Cam; Klarenbach, Scott; Husereau, Don; Lorenzetti, Diane; Manns, Braden

    2014-01-01

    Background Publicly-funded drug plans vary in strategies used and policies employed to reduce continually increasing pharmaceutical expenditures. We systematically reviewed the utilization of cost-sharing strategies and physician-directed prescribing regulations in publicly-funded formularies within member nations of the Organization of Economic Cooperation and Development (OECD). Methods & Findings Using the OECD nations as the sampling frame, a search for cost-sharing strategies and physician-directed prescribing regulations was done using published and grey literature. Collected data was verified by a system expert within the prescription drug insurance plan in each country, to ensure the accuracy of key data elements across plans. Significant variation in the use of cost-sharing mechanisms was seen. Copayments were the most commonly used cost-containment measure, though their use and amount varied for those with certain conditions, most often chronic diseases (in 17 countries), and by socio-economic status (either income or employment status), or with age (in 15 countries). Caps and deductibles were only used by five systems. Drug cost-containment strategies targeting physicians were also identified in 24 countries, including guideline-based prescribing, prescription monitoring and incentive structures. Conclusions There was variable use of cost-containment strategies to limit pharmaceutical expenditures in publicly funded formularies within OECD countries. Further research is needed to determine the best approach to constrain costs while maintaining access to pharmaceutical drugs. PMID:24618721

  5. A systematic review of cost-sharing strategies used within publicly-funded drug plans in member countries of the organisation for economic co-operation and development.

    Directory of Open Access Journals (Sweden)

    Lianne Barnieh

    Full Text Available BACKGROUND: Publicly-funded drug plans vary in strategies used and policies employed to reduce continually increasing pharmaceutical expenditures. We systematically reviewed the utilization of cost-sharing strategies and physician-directed prescribing regulations in publicly-funded formularies within member nations of the Organization of Economic Cooperation and Development (OECD. METHODS & FINDINGS: Using the OECD nations as the sampling frame, a search for cost-sharing strategies and physician-directed prescribing regulations was done using published and grey literature. Collected data was verified by a system expert within the prescription drug insurance plan in each country, to ensure the accuracy of key data elements across plans. Significant variation in the use of cost-sharing mechanisms was seen. Copayments were the most commonly used cost-containment measure, though their use and amount varied for those with certain conditions, most often chronic diseases (in 17 countries, and by socio-economic status (either income or employment status, or with age (in 15 countries. Caps and deductibles were only used by five systems. Drug cost-containment strategies targeting physicians were also identified in 24 countries, including guideline-based prescribing, prescription monitoring and incentive structures. CONCLUSIONS: There was variable use of cost-containment strategies to limit pharmaceutical expenditures in publicly funded formularies within OECD countries. Further research is needed to determine the best approach to constrain costs while maintaining access to pharmaceutical drugs.

  6. A Review of the Public Contests Evaluations Promoted by Brazilian Federal Universities for the Post of Executive Assistant in the Perspective of Competencies Management

    Directory of Open Access Journals (Sweden)

    Fernanda Geremias Leal

    2014-12-01

    Full Text Available This article presents an analysis of the evaluations of public contests promoted by Brazilian Federal Universities (IFES, during the period of 2010-2014, to fill the post of executive assistant. The goal was to understand whether the tests applied have covered contents related to in the job description, profession regulation law, guidelines and the curriculums of Executive Assistant undergraduate programs, in order to verify if the tests were able to select professionals with competencies to meet the needs of these institutions. The data, obtained from a predominantly quantitative analysis, demonstrated that the IFES have not considered the curriculums of the executive assistant undergraduate programs significantly while elaborating the contests nor have prepared questions directly related to the job description. We concluded that, in general, the contests covered by the research did not measured the knowledge required for the proper performance of these professionals, as well as they did not use instruments that allowed to assess their abilities and behaviors.

  7. The Cost Burden to Minnesota K-12 when Children Are Unprepared for Kindergarten. [Summary

    Science.gov (United States)

    Chase, Richard; Coffee-Borden, Brandon; Anton, Paul; Moore, Christopher; Valorose, Jennifer

    2008-01-01

    This summary presents highlights of "The Cost Burden to Minnesota K-12 when Children Are Unprepared for Kindergarten" [ED511612]. A number of studies document the long-term public and societal benefits of early childhood education, including the reduced costs associated with child welfare, public assistance, crime and incarceration, and…

  8. The Cost Burden to Minnesota K-12 when Children Are Unprepared for Kindergarten

    Science.gov (United States)

    Chase, Richard; Coffee-Borden, Brandon; Anton, Paul; Moore, Christopher; Valorose, Jennifer

    2008-01-01

    Most of the studies of the return on investment in early childhood education have focused on the big payoffs in reduced public and societal costs associated with child welfare, public assistance, crime and incarceration, and benefits related to increased education and earnings. Several studies focus specifically on costs and benefits within the…

  9. The Ethical Appeals and Values of Public Assistance Advertisement%公益救助广告的伦理诉求及其价值

    Institute of Scientific and Technical Information of China (English)

    宫立明; 刘雨姝

    2012-01-01

    Public assistance ads aim at propagating humanitarian aid and ethical concern towards vulnerable groups in the public relief activities. Chinag public assistance ads focus on highlighting the public assistance to help the poor, to respect the old and care for the young, and the pursuit of fairness , justice and moral fights, playing a huge role in public aid development and the building of a harmonious society. Safeguarding the moral fights of vulnerable groups, guiding the public to the practice of moral obligation, achieving the unity of humanitarian aid and ethical concern, promoting the happiness and overall development of human being, promoting social harmony and progress have become its unique ethical values.%公益救助广告旨在宣传公益救助活动中对弱势群体应采取的人道救助与伦理关怀。我国公益救助广告集中凸现了扶贫济困、尊老爱幼、公平正义、道德权利等伦理诉求,在公益救助事业发展及和谐社会的建设中发挥着巨大的作用。维护弱势群体的道德权利、引导社会公众实践道德义务、实现人道救助与伦理关怀的统一、促进入的幸福和全面发展、推动社会和谐与进步已成为其独有的伦理价值。

  10. Self-reported use of Supplemental Nutrition Assistance Program benefits to purchase soda in a public health center population: Los Angeles County, California, 2012.

    Science.gov (United States)

    Barragan, Noel; Gase, Lauren; Butler, Rebecca; Smith, Lisa; Simon, Paul; Kuo, Tony

    2015-01-01

    To better inform local program planning for the Supplemental Nutrition Assistance Program (SNAP), the Los Angeles County Department of Public Health used self-reported data from a public health center population to examine the prevalence of benefits used to purchase soda. We performed statistical analyses, including multivariable regression modeling, using data from a local health and nutrition examination survey. The survey response rate was 69% (n=1,503). More than one-third of survey participants reported receiving, or living in a household where someone receives, nutrition assistance benefits. When asked, 33% (n=170) reported using these benefits to purchase soda "sometimes" and 18% (n=91) reported "often" or "always," suggesting that the use of program benefits to purchase soda was not uncommon in this subpopulation. These findings have meaningful policy and planning implications, as they contribute to ongoing dialogue about strategies for optimizing nutrition among SNAP recipients.

  11. 77 FR 24215 - Section 8 Housing Assistance Payments Program-Fiscal Year (FY) 2012 Inflation Factors for Public...

    Science.gov (United States)

    2012-04-23

    ... URBAN DEVELOPMENT Section 8 Housing Assistance Payments Program--Fiscal Year (FY) 2012 Inflation Factors...'' to adjust FY 2012 renewal funding for the tenant-based rental assistance voucher program or housing choice voucher (HCV) program of each PHA. For FY 2011 and FY 2010, renewal funding was based on...

  12. Why do bacteria regulate public goods by quorum sensing?-How the shapes of cost and benefit functions determine the form of optimal regulation.

    Science.gov (United States)

    Heilmann, Silja; Krishna, Sandeep; Kerr, Benjamin

    2015-01-01

    Many bacteria secrete compounds which act as public goods. Such compounds are often under quorum sensing (QS) regulation, yet it is not understood exactly when bacteria may gain from having a public good under QS regulation. Here, we show that the optimal public good production rate per cell as a function of population size (the optimal production curve, OPC) depends crucially on the cost and benefit functions of the public good and that the OPC will fall into one of two categories: Either it is continuous or it jumps from zero discontinuously at a critical population size. If, e.g., the public good has accelerating returns and linear cost, then the OPC is discontinuous and the best strategy thus to ramp up production sharply at a precise population size. By using the example of public goods with accelerating and diminishing returns (and linear cost) we are able to determine how the two different categories of OPSs can best be matched by production regulated through a QS signal feeding back on its own production. We find that the optimal QS parameters are different for the two categories and specifically that public goods which provide accelerating returns, call for stronger positive signal feedback.

  13. 43 CFR 12.923 - Cost sharing or matching.

    Science.gov (United States)

    2010-10-01

    ... 12.923 Public Lands: Interior Office of the Secretary of the Interior ADMINISTRATIVE AND AUDIT REQUIREMENTS AND COST PRINCIPLES FOR ASSISTANCE PROGRAMS Uniform Administrative Requirements for Grants and... cost principles. (5) Are not paid by the Federal Government under another award, except...

  14. Managing the Cost of Enhanced Oil Recovery Gérer le coût de la récupération assistée

    Directory of Open Access Journals (Sweden)

    Simandoux P.

    2006-11-01

    Full Text Available The drop in crude-oil prices has caused a worldwide slowing down of the growth of enhanced-recovery activities and a recentering on less costly processes. The technical costs of implementing such methods have diminished, mainly because of the decrease in the cost of services, but insufficiently to ensure the economic viability of many projects. Therefore, today even more than yesterday, it is of prime importance to search for all ways of reducing the cost of enhanced recovery. It is thus indispensable to improve our mastery of process, the knowledge and management of reservoirs, and to use the appropriate indicators to follow the evolution of costs. Likewise, synergisms resulting from the use of horizontal drain holes at the same time as steam or polymer flooding must be systematically sought for. Lastly, only sustained activity in the field of pilot projects can enable these goals to be reached. La baisse du prix du brut a provoqué au plan mondial un ralentissement de la croissance de l'activité de la récupération assistée et un recentrage sur les procédés les moins onéreux. Les coûts techniques de mise en oeuvre de ces méthodes ont diminué, essentiellement grâce à la baisse du coût des services, mais de façon insuffisante pour assurer la viabilité économique de nombreux projets. En conséquence, aujourd'hui encore plus qu'hier, il est de première importance de rechercher toutes les voies de réduction des coûts offertes par la récupération assistée. Dans ce sens, il est indispensable d'améliorer la maîtrise des procédés, la connaissance et la gestion des réservoirs, et de suivre avec des indicateurs appropriés l'évolution des coûts. De même, les synergies résultant de l'utilisation de drains horizontaux simultanément avec une injection de vapeur ou de polymères doivent être systématiquement recherchées. Enfin, seule une activité soutenue en terme de pilotes peut permettre d'atteindre ces objectifs.

  15. 42 CFR 21.42 - Examinations; junior assistant, assistant, or senior assistant grade.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Examinations; junior assistant, assistant, or senior assistant grade. 21.42 Section 21.42 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES PERSONNEL COMMISSIONED OFFICERS Appointment § 21.42 Examinations; junior assistant...

  16. The Analysis about the Cost of Public Participation in Decision Making of Public Investment Projects%公众参与公共投资建设项目决策的决策成本分析

    Institute of Scientific and Technical Information of China (English)

    杨宇; 姚倩

    2011-01-01

    The public participation in decision-making of public investment projects will change public investment projects' traditional decision mode and related procedures in a certain extent, causing increased the decision-making cost of public investment projects, this is also one reason why the public participation in decision-making of public investment projects subjects to many limitations.From the angle of the cost about the decision-making of public investment projects, this essay analyzed their main components and mutual relations, elaborated the influence factors about the decision-making cost of public investment projects, finally, proposed the corresponding measures to control the decision-making cost.%公众参与公共投资建设项目决策将在一定程度上改变公共投资建设项目传统的决策模式和相关程序,导致公共投资建设项目决策成本增加,这也成为国内公众参与公共投资建设项目决策受到诸多限制的重要原因之一.基于公共投资建设项目决策成本的角度,分析了在公众参与的前提下公共投资建设项目决策成本的主要构成要素及相互关系,阐述了影响公众参与公共投资建设项目决策的决策成本因素,并提出了相应的决策成本控制措施.

  17. Public telesurveillance service for frail elderly living at home, outcomes and cost evolution: a quasi experimental design with two follow-ups

    Directory of Open Access Journals (Sweden)

    Deaudelin Isabelle

    2006-07-01

    Full Text Available Abstract Background Telesurveillance is a technologically based modality that allows the surveillance of patients in the natural setting, mainly home. It is based on communication technologies to relay information between a patient and a central call center where services are coordinated. Different types of telesurveillance systems have been implemented, some being staffed with non-health professionals and others with health professional, mainly nurses. Up to now, only telesurveillance services staffed with non-health professionals have been shown to be effective and efficient. The objective of this study was to document outcomes and cost evolution of a nurse-staffed telesurveillance system for frail elderly living at home. Methods A quasi experimental design over a nine-month period was done. Patients (n = 38 and caregivers (n = 38 were selected by health professionals from two local community health centers. To be eligible, elders had to be over 65, live at home with a permanent physical, slight cognitive or motor disability or both and have a close relative (the caregiver willing to participate to the study. These disabilities had to hinder the accomplishment of daily life activities deemed essential to continue living at home safely. Three data sources were used: patient files, telesurveillance center's quarterly reports and personal questionnaires (Modified Mini-Mental State, Functional Autonomy Measurement System, Life Event Checklist, SF-12, Life-H, Quebec User Evaluation of Satisfaction with Assistive Technology, Caregiver Burden. The telesurveillance technology permitted, among various functionalities, bi-directional communication (speaker-receiver between the patient and the response center. Results A total of 957 calls for 38 registered clients over a 6-month period was recorded. Only 48 (5.0% of the calls were health-related. No change was reported in the elders' quality of life and daily activity abilities. Satisfaction was very

  18. Assisted Living Facilities, Published in 2009, 1:600 (1in=50ft) scale, DCH, Division of Public Health.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Assisted Living Facilities dataset, published at 1:600 (1in=50ft) scale, was produced all or in part from Other information as of 2009. Data by this publisher...

  19. Interconnection Assessment Methodology and Cost Benefit Analysis for High-Penetration PV Deployment in the Arizona Public Service System

    Energy Technology Data Exchange (ETDEWEB)

    Baggu, Murali; Giraldez, Julieta; Harris, Tom; Brunhart-Lupo, Nicholas; Lisell, Lars; Narang, David

    2015-06-14

    In an effort to better understand the impacts of high penetrations of photovoltaic (PV) generators on distribution systems, Arizona Public Service and its partners completed a multi-year project to develop the tools and knowledge base needed to safely and reliably integrate high penetrations of utility- and residential-scale PV. Building upon the APS Community Power Project-Flagstaff Pilot, this project investigates the impact of PV on a representative feeder in northeast Flagstaff. To quantify and catalog the effects of the estimated 1.3 MW of PV that will be installed on the feeder (both smaller units at homes and large, centrally located systems), high-speed weather and electrical data acquisition systems and digital 'smart' meters were designed and installed to facilitate monitoring and to build and validate comprehensive, high-resolution models of the distribution system. These models are being developed to analyze the impacts of PV on distribution circuit protection systems (including coordination and anti-islanding), predict voltage regulation and phase balance issues, and develop volt/VAr control schemes. This paper continues from a paper presented at the 2014 IEEE PVSC conference that described feeder model evaluation and high penetration advanced scenario analysis, specifically feeder reconfiguration. This paper presents results from Phase 5 of the project. Specifically, the paper discusses tool automation; interconnection assessment methodology and cost benefit analysis.

  20. Medical-device risk management and public safety: using cost-benefit as a measurement of effectiveness

    Science.gov (United States)

    Hughes, Allen A.

    1994-12-01

    Public safety can be enhanced through the development of a comprehensive medical device risk management. This can be accomplished through case studies using a framework that incorporates cost-benefit analysis in the evaluation of risk management attributes. This paper presents a framework for evaluating the risk management system for regulatory Class III medical devices. The framework consists of the following sixteen attributes of a comprehensive medical device risk management system: fault/failure analysis, premarket testing/clinical trials, post-approval studies, manufacturer sponsored hospital studies, product labeling, establishment inspections, problem reporting program, mandatory hospital reporting, medical literature surveillance, device/patient registries, device performance monitoring, returned product analysis, autopsy program, emergency treatment funds/interim compensation, product liability, and alternative compensation mechanisms. Review of performance histories for several medical devices can reveal the value of information for many attributes, and also the inter-dependencies of the attributes in generating risk information flow. Such an information flow network is presented as a starting point for enhancing medical device risk management by focusing on attributes with high net benefit values and potential to spur information dissemination.

  1. Analysis of Cost Price and Net Profit of Paraclinic Services in Private and Public Sectors: A Case Study of Kerman City 2014

    Directory of Open Access Journals (Sweden)

    Mohammad Jafari Sirizi

    2015-10-01

    Full Text Available Introduction: Cost is becoming a growing concern for the managers of health and treatment institutes both in private and public sectors. Based on the opinions of pathology and radiology specialists and experts, one private and one public center for radiology and laboratory were selected to study in Kerman City. Method: This is a cross-sectional and applied study. The two centers were similar in frequency of their services, different tests they were conducting, and their number of personnel. Afterwards, the costs of services in both fields were determined using the activity-based costing method. This study was carried out from March 21 to September 22, 2014. The costs of services in both private and public sectors were compared to the tariffs of the Ministry of Health in 2014. Results: Laboratory results indicated that the costs in all the selected tests were higher than the tariffs and the largest difference (app. 84,930 Rls was observed in the TSH test while the smallest difference was observed in the ferritin test (11,940 Rls. However in the private sector, vitamin D and FBS tests were not profitable with differences of about 5500 and 6500 Rls, respectively. In other tests, the costs in the private sector were lower than the tariffs for the private sector. In the private sector radiology center, only the MRI services were not profitable but the other services were. The cost of MRI services in the private sector studied in this research was 190,000 Rls higher than the private sector tariffs. Conclusion: In this study, the results showed that CT scan services were the most profitable services and the price difference was about 203,000 Rls per service. However, all of the radiology services were unprofitable in the public sector and the largest price difference was seen in MRI services which was about 590,000 Rls per service.

  2. Unit Cost Analysis of PET-CT at an Apex Public Sector Health Care Institute in India

    Science.gov (United States)

    Gajuryal, SH; Daga, A; Siddharth, V; Bal, CS; Satpathy, S

    2017-01-01

    Context: PET/CT scan service is one of the capital intensive and revenue-generating centres of a tertiary care hospital. The cost associated with the provisioning of PET services is dependent upon the unit costs of the resources consumed. Aims: The study aims to determine the cost of providing PET/CT Scan services in a hospital. Methods and Material: This descriptive and observational study was conducted in the Department of Nuclear Medicine at a tertiary apex teaching hospital in New Delhi, India in the year 2014-15. Traditional costing methodology was used for calculating the unit cost of PET/CT scan service. The cost was calculated under two heads that is capital and operating cost. Annualized cost of capital assets was calculated using methodology prescribed by WHO and operating costs was taken on an actual basis. Results: Average number of PET/CT scan performed in a day is 30. The annual cost of providing PET/CT scan services was calculated to be 65,311,719 Indian Rupees (INR) (US$ 1,020,496), while the unit cost of PET scan was calculated to be 9625.92 INR (US$ 150). 3/4th cost was spent on machinery and equipment (75.3%) followed by healthcare personnel (11.37%), electricity (5%), consumables and supplies (4%) engineering maintenance (3.24%), building, furniture and HVAC capital cost (0.76%), and manifold cost (0.05%). Of the total cost, 76% was capital cost while the remaining was operating cost. Conclusions: Total cost for establishing PET/CT scan facility with cyclotron and chemistry module and PET/CT scan without cyclotron and chemistry module was calculated to be INR 610,873,517 (US$9944899) and 226,745,158 (US$3542893), respectively. (US$ 1=INR 64) PMID:28242974

  3. Unit Cost Analysis of PET-CT at an Apex Public Sector Health Care Institute in India.

    Science.gov (United States)

    Gajuryal, S H; Daga, A; Siddharth, V; Bal, C S; Satpathy, S

    2017-01-01

    PET/CT scan service is one of the capital intensive and revenue-generating centres of a tertiary care hospital. The cost associated with the provisioning of PET services is dependent upon the unit costs of the resources consumed. The study aims to determine the cost of providing PET/CT Scan services in a hospital. This descriptive and observational study was conducted in the Department of Nuclear Medicine at a tertiary apex teaching hospital in New Delhi, India in the year 2014-15. Traditional costing methodology was used for calculating the unit cost of PET/CT scan service. The cost was calculated under two heads that is capital and operating cost. Annualized cost of capital assets was calculated using methodology prescribed by WHO and operating costs was taken on an actual basis. Average number of PET/CT scan performed in a day is 30. The annual cost of providing PET/CT scan services was calculated to be 65,311,719 Indian Rupees (INR) (US$ 1,020,496), while the unit cost of PET scan was calculated to be 9625.92 INR (US$ 150). 3/4th cost was spent on machinery and equipment (75.3%) followed by healthcare personnel (11.37%), electricity (5%), consumables and supplies (4%) engineering maintenance (3.24%), building, furniture and HVAC capital cost (0.76%), and manifold cost (0.05%). Of the total cost, 76% was capital cost while the remaining was operating cost. Total cost for establishing PET/CT scan facility with cyclotron and chemistry module and PET/CT scan without cyclotron and chemistry module was calculated to be INR 610,873,517 (US$9944899) and 226,745,158 (US$3542893), respectively. (US$ 1=INR 64).

  4. Apply the SWOT to analyze the cost control model of urban medical assistance%城市医疗救助费用控制模式SWOT分析

    Institute of Scientific and Technical Information of China (English)

    高文凤; 尹文强; 张宜民; 黄冬梅; 于倩倩

    2009-01-01

    Make use of SWOT analysis scientific principles to understand the cost control model of urban medical assistance based on community health services's advantages and disadvantages of internal and external opportunities and threats. Use SWOT matrix portfolio analysis (SO, ST, WO, WT strategy) to carry out systematic analysis to find the best strategies.%利用SWOT分析法,客观地分析了以社区卫生服务为基础的城市医疗救助费用控制模式的内部优、劣势及外部环境的机会与威胁.并用SWOT的矩阵组合(SO、ST、WO、WT策略)进行了系统分析,旨在寻求最佳的发展战略和策略.

  5. 浙江省公立医院慈善医疗救助现状与政策建议%Current Situation and Countermeasures of Charitable Medical Assistance in Public Hospitals in Zhejiang Province

    Institute of Scientific and Technical Information of China (English)

    郭美亮; 厉芬芬; 郑思思; 梁雲洁; 陈浩; 曾春燕

    2016-01-01

    In the context that medical and health system reform is furthering, the voice that hospitals should return to public welfare nature and embody medical humanism is growing. The investment of public hospital in charity work is also increasing. To learn the current situation of charitable medical assistance work in some public hospitals in Zhejiang and promote it to a better development, the research group has investigated Health and Family Planning Commission of Zhejiang Province and more than ten large public hospitals in Hangzhou, Wenzhou, Taizhou and some other cities. On the basis of a number of interviews records and fully understanding of the process, funding sources and rescue objects of the current public hospital charity medical assistance, main problems of current charitable medical assistance system were discussed and analyzed. Existing difficulties in the process of public hospital charitable medical assistance were summarized, such as there are many chores in assistance work and the assistance coverage is small. Several targeted suggestions were put forward from the perspective of government and public hospitals including strengthening policy guidance, refining laws and regulations, establishing a charity department and improving the management system of charity fund.

  6. 78 FR 11232 - Notification of a Public Meeting on the Use of Cost Comparisons in Federal Procurement

    Science.gov (United States)

    2013-02-15

    ... being performed by a small business, to what extent, if any, should costing procedures and methodologies... performed by a small business concern to performance by a Federal employee. Interested parties may offer... current sector performing the work is the more cost-effective source. Where this is not the case, the cost...

  7. 公共品成本均衡化实证探讨%Demonstration Discussion on Equivalent of Public Goods Cost

    Institute of Scientific and Technical Information of China (English)

    王向成

    2012-01-01

    The cost of public goods is not determined by market directly but by government procurement costs and contrast relationship, and tax is the main source of the cost of public goods. The high cost of public goods will occupy scarce social economic resources, leading to losing equilibrium relationship between public goods and common goods. Through the data statistics of 4 factors including national GDP, fiscal revenue, entity profits and labor wage income in 1996 -2009 years and total contrast between institutions unit and enterprise employee in 1991 -2008 years, this paper respectively makes empirical analysis on allocation relationship and structure elements of public goods cost. The results show that the fiscal revenue growth is far higher than GDP growth, wage income growth is most slow; and labor costs of public goods production are significantly greater than that of enterprise, leading to that public goods cost is more than the average product cost. For realizing the balance of supply between public goods and common product, public goods definition should not be too wide, public services need to reduce the number of head; economic growth should take precedence over the government public goods income and improve worker wage income.%公共品成本不由市场直接决定,而是通过政府采购成本和对比关系决定,税收是公共品成本的主要来源。公共品成本过高将挤占稀缺的社会经济资源,导致公共品与普通品总量失去均衡关系。通过1996-2009年国民生产总值、财政收入、实体利润和劳动力工资收入4个因素总量以及1991-2008年事业机关单位与企业用工总量对比的数据统计,分别对公共品成本分配关系与构成要素进行实证分析,研究发现财政收入增速远远高于GDP增速,工资收入增长最为缓慢;公共品生产的劳动力成本明显大于企业劳动力成本,导致公共品的成本高于普通品的成本。为实现公共品与普

  8. The costs of the electronuclear sector. Thematic public report - January 2012; Les couts de la filiere electronucleaire. Rapport public thematique - Janvier 2012

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-01-15

    This report first proposes an analysis of the past expenses in the electronuclear sector (physical investments, research expenses from 1945 to 2010, the case of Superphenix), of the current expenses (operation costs for EDF, other types expenses), of the future expenses (dismantling of nuclear installations, management of used fuels, management of radioactive wastes), of expense provisions and actualization, of dedicated assets (regulatory and legal framework, application modalities of asset management for EDF, AREVA and the CEA), of the possible evolutions of future expenses (effect of reactor operation lifetime, future researches, EPR costs, scenarios), of costs which are difficult to precisely assess (externalities, nuclear risk and insurance)

  9. Introducing systematic dispatcher-assisted cardiopulmonary resuscitation (telephone-CPR) in a non-Advanced Medical Priority Dispatch System (AMPDS): implementation process and costs.

    Science.gov (United States)

    Dami, Fabrice; Fuchs, Vincent; Praz, Laurent; Vader, John-Paul

    2010-07-01

    In order to improve the quality of our Emergency Medical Services (EMS), to raise bystander cardiopulmonary resuscitation rates and thereby meet what is becoming a universal standard in terms of quality of emergency services, we decided to implement systematic dispatcher-assisted or telephone-CPR (T-CPR) in our medical dispatch center, a non-Advanced Medical Priority Dispatch System. The aim of this article is to describe the implementation process, costs and results following the introduction of this new "quality" procedure. This was a prospective study. Over an 8-week period, our EMS dispatchers were given new procedures to provide T-CPR. We then collected data on all non-traumatic cardiac arrests within our state (Vaud, Switzerland) for the following 12 months. For each event, the dispatchers had to record in writing the reason they either ruled out cardiac arrest (CA) or did not propose T-CPR in the event they did suspect CA. All emergency call recordings were reviewed by the medical director of the EMS. The analysis of the recordings and the dispatchers' written explanations were then compared. During the 12-month study period, a total of 497 patients (both adults and children) were identified as having a non-traumatic cardiac arrest. Out of this total, 203 cases were excluded and 294 cases were eligible for T-CPR. Out of these eligible cases, dispatchers proposed T-CPR on 202 occasions (or 69% of eligible cases). They also erroneously proposed T-CPR on 17 occasions when a CA was wrongly identified (false positive). This represents 7.8% of all T-CPR. No costs were incurred to implement our study protocol and procedures. This study demonstrates it is possible, using a brief campaign of sensitization but without any specific training, to implement systematic dispatcher-assisted cardiopulmonary resuscitation in a non-Advanced Medical Priority Dispatch System such as our EMS that had no prior experience with systematic T-CPR. The results in terms of T-CPR delivery

  10. The Acceptability of In-vehicle Intelligent Speed Assistance (ISA) Systems: from Trial Support to Public Support

    NARCIS (Netherlands)

    Vlassenroot, S.H.M.

    2011-01-01

    Speed management is a set of measures to limit negative effects of speed in a transport system. One of the solutions to solve speeding is making the road transport system more intelligent by implementing intelligent speed assistance (ISA). This thesis provides more insight in the factors that can de

  11. Effect on arm function and cost of robot-assisted group therapy in subacute patients with stroke and a moderately to severely affected arm: a randomized controlled trial.

    Science.gov (United States)

    Hesse, Stefan; Heß, Anke; Werner C, Cordula; Kabbert, Nadine; Buschfort, Rüdiger

    2014-07-01

    To evaluate the effectiveness and efficiency of robot-assisted arm group therapy (RAGT) versus individual arm therapy (IAT) to restore motor function in the moderately to severely affected patient after stroke. Single blind randomized controlled trial. Two in-patient neurological rehabilitation centers. Fifty first time subacute patients with stroke and a non-functional hand. The patients practiced either 30 minutes of RAGT + 30 minutes of IAT (group A) or 2x30 minutes of IAT (group B), per workday for four weeks. The RAGT consisted of six workstations enabling repetitive practice of finger, wrist, forearm and shoulder movements. Patients practiced according to their impairment level on at least two workstations per session. The IAT followed the Motor Relearning Programme, enriched by elements of the impairment-oriented training. Changes of the Fugl Meyer Score (FM, 0-66) between baseline and after 4 weeks, incremental cost effectiveness. Patients were homogeneous at study onset. All patients improved their upper limb motor function over time, but there were no between group differences. The initial (terminal) FM scores were 14.6±9.4 (25.7±16.5) in group A and 16.5±9.8 (31.1±19.1) in group B. The treatment of a single patient with RAGT cost 4.15 €, compared to 10.00 € for a patient to receive IAT. RAGT in combination with IAT was equally effective as a double session of IAT regarding the restoration of upper limb motor functions in moderate to severely affected subacute patients with stroke. The treatment costs for RAGT were less. © The Author(s) 2014.

  12. A cognitive approach to social assistance instruments: how public assistance recipients represent and interpret the anti-poverty progra m Familias en Acción

    Directory of Open Access Journals (Sweden)

    Valeria Ayola Betancourt

    2016-06-01

    Full Text Available This article considers the contribution of the cognitive framework of public policy and the instrument approach to understanding poverty regulation in Colombia through its instruments. We analyze the relationship between the ideological frame of the Familias en Acción program and the recipient’s construction of representations, meanings and interpretations about it. It describes the manner in which the beneficiaries are interpreting the State intervention, but it also describes some social effects arising from the implementation of the programs, taking into account the local scope. For this we use qualitative research techniques and stand out the semi-structured interview as method. Our fieldwork, is based on a comparison between Cartagena city and the San Jacinto’s rural zone.

  13. Costing RTS,S introduction in Burkina Faso, Ghana, Kenya, Senegal, Tanzania, and Uganda: A generalizable approach drawing on publicly available data.

    Science.gov (United States)

    Galactionova, Katya; Bertram, Melanie; Lauer, Jeremy; Tediosi, Fabrizio

    2015-11-27

    Recent results from the phase 3 trial of RTS,S/AS01 malaria vaccine show that the vaccine induced partial protection against clinical malaria in infants and children; given the high burden of the disease it is currently considered for use in malaria endemic countries. To inform adoption decisions the paper proposes a generalizable methodology to estimate the cost of vaccine introduction using routinely collected and publicly available data from the cMYP, UNICEF, and WHO-CHOICE. Costing is carried out around a set of generic activities, assumptions, and inputs for delivery of immunization services adapted to a given country and deployment modality to capture among other factors the structure of the EPI program, distribution model, geography, and demographics particular to the setting. The methodology is applied to estimate the cost of RTS,S introduction in Burkina Faso, Ghana, Kenya, Senegal, Tanzania, and Uganda. At an assumed vaccine price of $5 per dose and given our assumptions on coverage and deployment strategy, we estimate total economic program costs for a 6-9 months cohort within $23.11-$28.28 per fully vaccinated child across the 6 countries. Net of procurement, costs at country level are substantial; for instance in Tanzania these could add as much as $4.2 million per year or an additional $2.4 per infant depending on the level of spare capacity in the system. Differences in cost of vaccine introduction across countries are primarily driven by differences in cost of labour. Overall estimates generated with the methodology result in costs within the ranges reported for other new vaccines introduced in SSA and capture multiple sources of heterogeneity in costs across countries. Further validation with data from field trials will support use of the methodology while also serving as a validation for cMYP and WHO-CHOICE as resources for costing health interventions in the region.

  14. The Cost of Health Service Waste Management of (HSWM: A Case Study of Intensive Care Unit of Infectious Diseases at a Public Hospital in São Paulo.

    Directory of Open Access Journals (Sweden)

    Chennyfer Dobbins Paes da Rosa

    2015-08-01

    Full Text Available The Health Service Waste Management is a set of technical and legal procedures for waste management in any type of health facilities. It is known about the limited resources, so reducing environmental costs can contribute to the management of hospital costs. The objective was to estimate the cost of the phases of HSWM to the Intensive Care Unit for public service. Data collecting was done through a script of questions and observations on site at the Emilio Ribas Infectious Diseases Institute in Sao Paulo. The ABC costing method was used. The most costly step was wrapping (40.68%, followed by segregation (40.17%, which is justified by both being associated with health workers’ salaries. The daily cost of the management of health care waste from segregation to final disposal in the ICU was R$ 4,288.81 a day, being R$ 314.80/bed-patient/day. To know the cost of an activity allows for the analysis of strategies for price negotiation. Health care waste is little remembered when pricing a daily ICU, many managers believe this value to be irrelevant; but< if not measured, it may bring losses to the institution.

  15. Costing framework for International Health Regulations (2005).

    Science.gov (United States)

    Katz, Rebecca; Haté, Vibhuti; Kornblet, Sarah; Fischer, Julie E

    2012-07-01

    The revised International Health Regulations (IHR [2005]) conferred new responsibilities on member states of the World Health Organization, requiring them to develop core capacities to detect, assess, report, and respond to public health emergencies. Many countries have not yet developed these capacities, and poor understanding of the associated costs have created a barrier to effectively marshaling assistance. To help national and international decision makers understand the inputs and associated costs of implementing the IHR (2005), we developed an IHR implementation strategy to serve as a framework for making preliminary estimates of fixed and operating costs associated with developing and sustaining IHR core capacities across an entire public health system. This tool lays the groundwork for modeling the costs of strengthening public health systems from the central to the peripheral level of an integrated health system, a key step in helping national health authorities define necessary actions and investments required for IHR compliance.

  16. [Objective evaluation and comparison of the scientific publication from the departments of the Assistance publique-Hôpitaux de Paris: analysis of the SIGAPS score].

    Science.gov (United States)

    Lefèvre, J H; Faron, M; Drouin, S J; Glanard, A; Chartier-Kastler, E; Parc, Y; Rouprêt, M

    2013-06-01

    To analyze the results of the bibliometric system (SIGAPS score) of scientific publications in the Assistance publique-Hôpitaux de Paris (AP-HP) and to compare the scientific production among the various medical and surgical specialties of the academic hospitals of Paris. All the publications imported from Pubmed between 2006 and 2008 were included. The following data were taken into account and analysed: the hospital department of origin, the number of articles published, the number of full-time physicians, the SIGAPS score. Thirty-eight thousand, seven hundred and nine publications were included. The departments were consisted of 747 full-time practitioners 5719 (1895 Professors [33.1%], 2772 Assistant Professors [48.4%] and 1052 fellows [18.4%]). The average number of full-time practitioner by department was 7.7±6.7 (range 1-69). The average total number of articles published in a department was 51.8±49.4 (range 1-453). The average SIGAPS score was more important in medicine than in surgery (621.2±670.1 vs. 401±382.2; P=0.01) but not the average number of article per practitioner (8.1±8.3 vs. 6.6±6.2; P=0.0797). The mean number of publication by full-time practitioner was 7.9±7.8 (1-45), or an average of 2.7±2.6 for each full-time practitioner each year. Academic hospitals in Paris have a reasonably scientific output but with a mean of 2.7 articles per full-time practitioner per year. No major differences between medical and surgical disciplines were observed. Copyright © 2012 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

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

    Science.gov (United States)

    An, Ruopeng

    2015-12-01

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

  18. 加强公立医院成本管理的对策%Countermeasures for Strengthening Cost Management in Public Hospitals

    Institute of Scientific and Technical Information of China (English)

    鲁献忠; 徐红伟; 许梦雅; 金红; 赵要军

    2015-01-01

    With the constant deepening of the new round of reform on medical health system,the compensating channel is narrowing,which sets higher requirements for the operation and management in public hospitals,especially cost management. With the entry point of development history and the current situation of hospital cost management, the au-thors,referring to PDCA management,basing on the cycle of cost accounting,cost analysis,cost prediction,cost control and cost evaluation and use,and taking idea change of hospital cost management,establishment of organization system,cost a-nalysis and prediction management,cost practice and control,cost improvement as the main line,put forward the counter-measures for optimizing hospital cost management,which acts as the reference for strengthening hospital cost management.%随着新一轮医药卫生体制改革的不断深化,公立医院补偿渠道逐渐收窄,对我国公立医院的经营管理水平提出了更高的要求,尤其是成本管理. 笔者从我国公立医院成本管理发展历史及现状为切入点,借鉴PDCA管理理念,在遵循成本核算-成本分析-成本预测-成本控制-成本评价应用这一循环的基础上,以医院成本管理观念转变,组织体系构建,成本分析预测管理、成本实施与控制、成本改进与提升等为主线,提出优化公立医院成本管理的对策建议,为加强我国公立医院成本管理提供借鉴.

  19. Using Disability-Adjusted Life Years and Cost-Effectiveness Analysis to define Priorities for the Public Health Care Sector in Zimbabwe

    DEFF Research Database (Denmark)

    Hansen, Kristian Schultz

    There is not much knowledge at present of the relative cost-effectiveness of health services offered in the Zimbabwean public health care sector. In addition, the information on the relative importance of diseases is less than complete. Such information may however be useful for assessing...... was utilised to calculate the burden of disease as measured by DALYs lost. HIV infection emerged from the information collected as the single most serious public health problem in Zimbabwe responsible for 49% of the total disease burden.In order to confirm some of the findings of the above study component......, a small population survey was designed to estimate the population prevalence of serious health problems in an urban area of Zimbabwe through the application of verbal autopsy and morbidity interview techniques. The survey confirmed to some extent the pattern of diseases found in the nationwide study.Cost...

  20. Electricity generation cost issues - public authorities and power generation companies points of view; Approches du cout de production du KWH: vision publique et vision producteur

    Energy Technology Data Exchange (ETDEWEB)

    Lermusieau, Ph. [Electrabel France, 75 - Paris (France); Leban, R. [Conservatoire National des Arts et Metiers (CNAM), 75 - Paris (France); Percebois, J. [Montpellier-1 Univ., 34 (France); Centre de Recherche en Economie et Droit de l' Energie (CREDEN), 34 - Montpellier (France); Regent, A. [Ambassade de France a Londres (United Kingdom); Ged, A. [Solving France, 75 - Paris (France); Boulanger, Ph. [ENDESA France (France); Dallemagne, G. [Societe Generale (France); Favennec, J.P. [AEE-France, 92 6 Rueil-Malmaison (France); Gonnot, F.M. [Depute de l' Oise, 95 (France); Percebois, J. [Centre de Recherche en Economie et Droit de l' Energie (CREDEN), 34 - Montpellier (France)

    2008-07-15

    This dossier is dedicated to the cost of the production of electricity. As for any investment, we have to consider the future income the investment will give, this income depends on a list of parameters from which we can highlight for nuclear power in Europe: the opening of the market to competitors, the inter-connection of the national markets, the oscillation of prices between long-term and short-term costs. We have to consider also the structure of the cost (CO{sub 2}, fuel, operation and maintenance) and the issue of risk management for the investor (delay, civil liability, dismantlement). It appears that nuclear investments require long term cooperation between companies deeply involved in the power industry but the structures allowing such cooperation have to be defined. A competitive market will produce results that match public interest if social and environmental costs are included in the production costs and if the assessment of complete costs of every energy source using the best available technology are regularly published. The United-Kingdom is the first country to launch a massive program concerning nuclear energy that is backed by private investors. (A.C.)

  1. Synthesis of the public opinion on the calculation methods of avoided costs; Synthese de la consultation publique sur les methodes de calcul des couts evites

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2002-05-01

    The CRE began the 22 october 2001 a public opinion on the avoided costs calculation methods, to determine the charges amount of the electric utilities. The main questions dealt with the general position of the actors towards the two calculation methods proposed by the CRE; the modalities of these methods implementing; the alternative and possible methods; the case of the non national distributors. The answers are detailed and analyzed. (A.L.B.)

  2. Stakeholder Engagement and Knowledge Co-Creation in Water Planning: Can Public Participation Increase Cost-Effectiveness?

    DEFF Research Database (Denmark)

    Graversgaard, Morten; Jacobsen, Brian; Kjeldsen, Chris

    2017-01-01

    -up) can produce cost-effective results, but the results show that cost-effectiveness was not the only deciding factor, and that local circumstances like the practicalities of implementing the measures were also considered when developing the Programmes of Measures. The findings suggest that the use...... of water councils in water planning has significant advantages, including the fact that the knowledge of local conditions helps to identify efficient solutions at lower costs, which can be useful for administrators, policy-makers, and other stakeholders implementing the Water Framework Directive in years...

  3. Asset management perspective on the duration of public-private partnership contracts: cost-control trade-off?

    NARCIS (Netherlands)

    Buiten, van M.; Hartmann, A.

    2015-01-01

    The risk-incentive model of principal-agent relations and its extensions to infrastructural public-private partnerships outline the efficiency implications of parameters such as contract duration. The predominant focus on individual contracts is of limited use for public agencies that need to alloca

  4. The art of alignment transaction cost economics and the provision of public services at the local level

    NARCIS (Netherlands)

    van Genugten, M.L.

    2008-01-01

    This book is situated against the background of the debate on recent institutional changes in the public sector. These changes concern the privatization, liberalization and autonomization of different kinds of public services. The main incentives for introducing such new modes of governance were,

  5. Probability Analysis on Deviation of Cost Accounting in Public Hospitals%公立医院成本核算失真的可能性分析

    Institute of Scientific and Technical Information of China (English)

    农圣

    2016-01-01

    在现行的公立医院管理体制下,试图以公立医院成本核算为抓手推进公立医院补偿机制改革,最终实现公立医院“提高质量、重塑公益、控制费用”的改革目标是一个举步维艰的困局。原因在于,医院成本核算是合理补偿医院的核心,成本核算在现行体制下面临“激励不相容、信息不可靠、结果不适用”三种阻力,目前貌似科学完善的成本核算实际上是形式完整而实质虚无的偏离,公立医院治理制度改革是公立医院改革次序优先的选择。%Under the current management system in public hospitals, the progress in reform goals of "quality improvement, public benefits restoration and expense control" is stagnant, while the public hospitals attempt to push forward the reform on the compensation mechanism in public hospitals by performing cost accounting. The reason lies in the fact that cost accounting, as the core of reasonable compensation mechanism in hospitals, turns out to be "incompatible with incentives, unreliable in terms of information and inapplicable in terms of results" under the current system. Although it seems scientific and correct, cost accounting represents deviation with complete form and void essence. The governance reform should be first choice in reform on public hospitals.

  6. Assistance Focus: Asia/Pacific Region; Clean Energy Solutions Center (CESC)

    Energy Technology Data Exchange (ETDEWEB)

    None

    2015-05-11

    The Clean Energy Solutions Center Ask an Expert service connects governments seeking policy information and advice with one of more than 30 global policy experts who can provide reliable and unbiased quick-response advice and information. The service is available at no cost to government agency representatives from any country and the technical institutes assisting them. This publication presents summaries of assistance provided to governments in the Asia/Pacific region, including the benefits of that assistance.

  7. Cost-effectiveness of modified-release prednisone in the treatment of moderate to severe rheumatoid arthritis with morning stiffness based on directly elicited public preference values

    Directory of Open Access Journals (Sweden)

    Dunlop W

    2013-10-01

    -prednisone. Furthermore, utility benefits were not captured in the clinical setting. Conclusion: This analysis demonstrates that, based on the CAPRA-1 trial and directly elicited public preference values, MR-prednisone is a cost-effective treatment option when compared with IR-prednisone for RA patients with morning stiffness over one year, according to commonly applied UK thresholds (£20,000–£30,000 per QALY. Further research into the costs of morning stiffness in RA is required. Keywords: modified-release prednisone, rheumatoid arthritis, morning stiffness, cost-effectiveness analysis, cost utility analysis, quality of life

  8. Mesoporous Bi₂S₃ nanorods with graphene-assistance as low-cost counter-electrode materials in dye-sensitized solar cells.

    Science.gov (United States)

    Guo, Sheng-qi; Jing, Tian-zeng; Zhang, Xiao; Yang, Xiao-bing; Yuan, Zhi-hao; Hu, Fang-zhong

    2014-11-06

    In this work, we report the synthesis of mesoporous Bi₂S₃ nanorods under hydrothermal conditions without additives, and investigated their catalytic activities as the CE in DSCs by I-V curves and tested conversion efficiency. To further improve their power conversion efficiency, we added different amounts of reduced graphene by simple physical mixing. With the addition of 9 wt% reduced graphene (rGO), the short-circuit current density, open-circuit voltage and fill factor were Jsc = 15.33 mA cm(-2), Voc = 0.74 V and FF = 0.609. More importantly, the conversion efficiency reached 6.91%, which is slightly inferior to the commercial Pt counter electrode (7.44%). Compared to the conventional Pt counter electrodes of solar cells, this new material has the advantages of low-cost, facile synthesis and high efficiency with graphene assistance. To the best of our knowledge, this Bi₂S₃ + 9 wt% rGO system has the best performance ever recorded in all Bi₂S₃-based CEs in the DSCs system.

  9. Costs of publicly provided maternity services in Rosario, Argentina Los costos de servicios maternos públicos en Rosario, Argentina

    Directory of Open Access Journals (Sweden)

    Josephine Borghi

    2003-01-01

    Full Text Available OBJECTIVE: This study estimates the costs of maternal health services in Rosario, Argentina. MATERIAL AND METHODS: The provider costs (US$ 1999 of antenatal care, a normal vaginal delivery and a caesarean section, were evaluated retrospectively in two municipal hospitals. The cost of an antenatal visit was evaluated in two health centres and the patient costs associated with the visit were evaluated in a hospital and a health centre. RESULTS: The average cost per hospital day is $114.62. The average cost of a caesarean section ($525.57 is five times greater than that of a normal vaginal delivery ($105.61. A normal delivery costs less at the general hospital and a c-section less at the maternity hospital. The average cost of an antenatal visit is $31.10. The provider cost is lower at the health centre than at the hospital. Personnel accounted for 72-94% of the total cost and drugs and medical supplies between 4-26%. On average, an antenatal visit costs women $4.70. Direct costs are minimal compared to indirect costs of travel and waiting time. CONCLUSIONS: These results suggest the potential for increasing the efficiency of resource use by promoting antenatal care visits at the primary level. Women could also benefit from reduced travel and waiting time. Similar benefits could accrue to the provider by encouraging normal delivery at general hospitals, and complicated deliveries at specialised maternity hospitals.OBJETIVO: En este artículo se presenta una estimación de los costos de los servicios maternos en Rosario, Argentina. MATERIAL Y MÉTODOS: Evaluamos retrospectivamente el costo (US$ 1999 en dos hospitales municipales, de un parto normal vaginal, y de una cesárea y de una visita prenatal. El costo de atención prenatal fue evaluado en dos centros de salud y los costos asumidos por las pacientes fueron evaluados en un hospital y un centro de salud. RESULTADOS: El costo promedio por día-cama es de $114.62. El costo promedio de una ces

  10. The costs of overweight and obesity-related diseases in the Brazilian public health system: cross-sectional study

    Directory of Open Access Journals (Sweden)

    Bahia Luciana

    2012-06-01

    Full Text Available Abstract Background Obesity is a major global epidemic and a burden to society and health systems. It is well known risk factor for a number of chronic medical conditions with high morbidity and mortality. This study aimed to provide an estimate of the direct costs associated to outpatient and inpatient care of overweight and obesity related diseases in the perspective of the Brazilian Health System (SUS. Methods Population attributable risk (PAR was calculated for selected diseases related to overweight and obesity and with the following parameters: Relative risk (RR ≥ 1.20 or RR ≥1.10 and  Results The estimated total costs in one year with all diseases related to overweight and obesity are US$ 2,1 billion; US$ 1,4 billion (68.4% of total costs due to hospitalizations and US$ 679 million due to ambulatory procedures. Approximately 10% of these cost is attributable to overweight and obesity. Conclusion The results confirm that overweight and obesity carry a great economic burden for Brazilian health system and for the society. The knowledge of these costs will be useful for future economic analysis of preventive and treatment interventions.

  11. Modelling the cost-effectiveness of public awareness campaigns for the early detection of non-small-cell lung cancer

    Science.gov (United States)

    Hinde, S; McKenna, C; Whyte, S; Peake, M D; Callister, M E J; Rogers, T; Sculpher, M

    2015-01-01

    Background: Survival rates in lung cancer in England are significantly lower than in many similar countries. A range of Be Clear on Cancer (BCOC) campaigns have been conducted targeting lung cancer and found to improve the proportion of diagnoses at the early stage of disease. This paper considers the cost-effectiveness of such campaigns, evaluating the effect of both the regional and national BCOC campaigns on the stage distribution of non-small-cell lung cancer (NSCLC) at diagnosis. Methods: A natural history model of NSCLC was developed using incidence data, data elicited from clinical experts and model calibration techniques. This structure is used to consider the lifetime cost and quality-adjusted survival implications of the early awareness campaigns. Incremental cost-effectiveness ratios (ICERs) in terms of additional costs per quality-adjusted life-years (QALYs) gained are presented. Two scenario analyses were conducted to investigate the role of changes in the ‘worried-well' population and the route of diagnosis that might occur as a result of the campaigns. Results: The base-case theoretical model found the regional and national early awareness campaigns to be associated with QALY gains of 289 and 178 QALYs and ICERs of £13 660 and £18 173 per QALY gained, respectively. The scenarios found that increases in the ‘worried-well' population may impact the cost-effectiveness conclusions. Conclusions: Subject to the available evidence, the analysis suggests that early awareness campaigns in lung cancer have the potential to be cost-effective. However, significant additional research is required to address many of the limitations of this study. In addition, the estimated natural history model presents previously unavailable estimates of the prevalence and rate of disease progression in the undiagnosed population. PMID:26010412

  12. Cost-effectiveness study of oral hypoglycemic agents in the treatment of outpatients with type 2 diabetes attending a public primary care clinic in Mexico City

    Directory of Open Access Journals (Sweden)

    Cárdenas-Elizalde MR

    2012-03-01

    Full Text Available Christian Díaz de León-Castañeda, Marina Altagracia-Martínez, Jaime Kravzov-Jinich, Ma del Rosario Cárdenas-Elizalde, Consuelo Moreno-Bonett, Juan Manuel Martínez-NúñezDepartment of Biological Systems and Health Care, Biological and Health Sciences Division, Universidad Autónoma Metropolitana-Xochimilco, Mexico DF, MexicoIntroduction: Worldwide, diabetes mellitus presents a high burden for individuals and society. In Latin America, many people with diabetes have limited access to health care, which means that indirect costs may exceed direct health care cost. Diabetes is Mexico's leading cause of death.Purpose: To evaluate the cost-effectiveness ratios of the most used oral hypoglycemic agents (OHA in the treatment of outpatients with type 2 diabetes attending a public primary care clinic in Mexico City.Design: A cross-sectional and analytic study was conducted in Mexico City.Methodology: Twenty-seven adult outpatients with type 2 diabetes who were treated either with metformin or glibenclamide were included. Acarbose was used as an alternative strategy. The study was carried out from the perspective of Mexican society. Direct medical and nonmedical costs as well as indirect costs were evaluated using a structured questionnaire. Efficacies of all drug treatments were evaluated retrospectively. A systematic search was conducted to select published randomized clinical trials based on predetermined inclusion criteria, and treatment success was defined as glycosylated hemoglobin factor ≤ 7%. Efficacy data of each drug and/or combination were analyzed using meta-analysis. The Monte Carlo Markov model was used. Quality-adjusted life-years (QALY were used as the unit of effectiveness; incremental and sensitive analyses were performed and a 5% discount rate was calculated. A hypothetical cohort of 10,000 patients was modeled.Results: The odds ratios of the success of each drug treatment were obtained from the meta-analyses, and were the

  13. The impact of cost and network topology on urban mobility: a study of public bicycle usage in 2 U.S. cities.

    Directory of Open Access Journals (Sweden)

    Raja Jurdak

    Full Text Available Understanding the drivers of urban mobility is vital for epidemiology, urban planning, and communication networks. Human movements have so far been studied by observing people's positions in a given space and time, though most recent models only implicitly account for expected costs and returns for movements. This paper explores the explicit impact of cost and network topology on mobility dynamics, using data from 2 city-wide public bicycle share systems in the USA. User mobility is characterized through the distribution of trip durations, while network topology is characterized through the pairwise distances between stations and the popularity of stations and routes. Despite significant differences in station density and physical layout between the 2 cities, trip durations follow remarkably similar distributions that exhibit cost sensitive trends around pricing point boundaries, particularly with long-term users of the system. Based on the results, recommendations for dynamic pricing and incentive schemes are provided to positively influence mobility patterns and guide improved planning and management of public bicycle systems to increase uptake.

  14. The impact of cost and network topology on urban mobility: a study of public bicycle usage in 2 U.S. cities.

    Science.gov (United States)

    Jurdak, Raja

    2013-01-01

    Understanding the drivers of urban mobility is vital for epidemiology, urban planning, and communication networks. Human movements have so far been studied by observing people's positions in a given space and time, though most recent models only implicitly account for expected costs and returns for movements. This paper explores the explicit impact of cost and network topology on mobility dynamics, using data from 2 city-wide public bicycle share systems in the USA. User mobility is characterized through the distribution of trip durations, while network topology is characterized through the pairwise distances between stations and the popularity of stations and routes. Despite significant differences in station density and physical layout between the 2 cities, trip durations follow remarkably similar distributions that exhibit cost sensitive trends around pricing point boundaries, particularly with long-term users of the system. Based on the results, recommendations for dynamic pricing and incentive schemes are provided to positively influence mobility patterns and guide improved planning and management of public bicycle systems to increase uptake.

  15. Computer assisted instruction: two decades in perspective

    OpenAIRE

    Hoskins, Thomas J. Jr.; Orrell, Janet D.

    1987-01-01

    Approved for public release; distribution is unlimited This thesis examines the changes that have occurred in Computer Assisted Instruction (CAD over the past 20 years. Numerous literature sources were reviewed and the information extracted was utilized to describe the history of CAI; provide a brief description of other types of computer-based education that are often grouped under the heading of CAI; examine the changes in hardware and software costs; describe the in...

  16. Cross-Sectional Relationships Between Household Food Insecurity and Child BMI, Feeding Behaviors, and Public Assistance Utilization Among Head Start Children From Predominantly Hispanic and American Indian Communities in the CHILE Study.

    Science.gov (United States)

    Trappmann, Jessica L; Jimenez, Elizabeth Yakes; Keane, Patricia C; Cohen, Deborah A; Davis, Sally M

    Associations between food insecurity and overweight/obesity, feeding behaviors, and public food assistance utilization have been explored to a greater extent among adults and adolescents than among young children. This cross-sectional study examines a subset of pre-intervention implementation data (n = 347) among families participating in the Child Health Initiative for Lifelong Eating and Exercise (CHILE) study conducted in rural New Mexico among predominantly Hispanic and American Indian Head Start centers. No significant relationships emerged between food insecurity and child overweight/obesity, certain feeding behaviors, or public food assistance utilization. Additional research is necessary to understand relationships between food insecurity and child overweight/obesity status, use of public assistance benefits, and certain feeding behaviors among rural preschool-aged children in predominantly Hispanic and American Indian communities.

  17. The impact of assumptions regarding vaccine-induced immunity on the public health and cost-effectiveness of hepatitis A vaccination: Is one dose sufficient?

    Science.gov (United States)

    Curran, Desmond; de Ridder, Marc; Van Effelterre, Thierry

    2016-11-01

    Hepatitis A vaccination stimulates memory cells to produce an anamnestic response. In this study, we used a mathematical model to examine how long-term immune memory might convey additional protection against clinical/icteric infections. Dynamic and decision models were used to estimate the expected number of cases, and the costs and quality-adjusted life-years (QALYs), respectively. Several scenarios were explored by assuming: (1) varying duration of vaccine-induced immune memory, (2) and/or varying levels of vaccine-induced immune memory protection (IMP), (3) and/or varying levels of infectiousness in vaccinated individuals with IMP. The base case analysis assumed a time horizon of 25 y (2012 - 2036), with additional analyses over 50 and 75 y. The analyses were conducted in the Mexican public health system perspective. In the base case that assumed no vaccine-induced IMP, the 2-dose hepatitis A vaccination strategy was cost-effective compared with the 1-dose strategy over the 3 time horizons. However, it was not cost-effective if we assumed additional IMP durations of at least 10 y in the 25-y horizon. In the 50- and 75-y horizons, the 2-dose strategy was always cost-effective, except when 100% reduction in the probability of icteric Infections, 75% reduction in infectiousness, and mean durations of IMP of at least 50 y were assumed. This analysis indicates that routine vaccination of toddlers against hepatitis A virus would be cost-effective in Mexico using a single-dose vaccination strategy. However, the cost-effectiveness of a second dose depends on the assumptions of additional protection by IMP and the time horizon over which the analysis is performed.

  18. Cost-effectiveness study of oral hypoglycemic agents in the treatment of outpatients with type 2 diabetes attending a public primary care clinic in Mexico City

    Science.gov (United States)

    de León-Castañeda, Christian Díaz; Altagracia-Martínez, Marina; Kravzov-Jinich, Jaime; Cárdenas-Elizalde, Ma del Rosario; Moreno-Bonett, Consuelo; Martínez-Núñez, Juan Manuel

    2012-01-01

    Introduction Worldwide, diabetes mellitus presents a high burden for individuals and society. In Latin America, many people with diabetes have limited access to health care, which means that indirect costs may exceed direct health care cost. Diabetes is Mexico’s leading cause of death. Purpose To evaluate the cost-effectiveness ratios of the most used oral hypoglycemic agents (OHA) in the treatment of outpatients with type 2 diabetes attending a public primary care clinic in Mexico City. Design A cross-sectional and analytic study was conducted in Mexico City. Methodology Twenty-seven adult outpatients with type 2 diabetes who were treated either with metformin or glibenclamide were included. Acarbose was used as an alternative strategy. The study was carried out from the perspective of Mexican society. Direct medical and nonmedical costs as well as indirect costs were evaluated using a structured questionnaire. Efficacies of all drug treatments were evaluated retrospectively. A systematic search was conducted to select published randomized clinical trials based on predetermined inclusion criteria, and treatment success was defined as glycosylated hemoglobin factor ≤ 7%. Efficacy data of each drug and/or combination were analyzed using meta-analysis. The Monte Carlo Markov model was used. Quality-adjusted life-years (QALY) were used as the unit of effectiveness; incremental and sensitive analyses were performed and a 5% discount rate was calculated. A hypothetical cohort of 10,000 patients was modeled. Results The odds ratios of the success of each drug treatment were obtained from the meta-analyses, and were the following: 5.82 (glibenclamide), 3.86 (metformin), 3.5 (acarbose), and 6.76 (metformin–glibenclamide). The cost-effectiveness ratios found were US$272.63/QALY (glibenclamide), US$296.48/QALY (metformin), and US$409.86/QALY (acarbose). Sensitivity analysis did not show changes for the most cost-effective therapy when the effectiveness probabilities or

  19. The High Cost of Failing to Reform Public Education in Missouri. School Choice Issues in the State

    Science.gov (United States)

    Gottlob, Brian J.

    2006-01-01

    As a large body of high-quality research has emerged in the past few years showing that school choice benefits the students who use it, much of the debate has shifted to the "public" or "social" effects of school choice. This study examines how school choice in Missouri would raise high school graduation rates, and measures the…

  20. Cost-benefit analysis of the energy conservation scheme of a regional public utility; Kosten-Nutzen-Analyse des Energiespar-Programms eines regionalen Energieversorgers

    Energy Technology Data Exchange (ETDEWEB)

    Engel, H. [Energie-Versorgung Schwaben AG, Stuttgart (Germany). Abt. Sondervertragskunden; Karel, A. [Heag Versorgungs-AG, Darmstadt (Germany). Abt. Anwendungsberatung; Setzer, M. [Technische Hochschule Darmstadt (Germany). Inst. fuer Volkswirtschaftslehre

    1996-04-22

    Public utilities increasingly advocate energy conservation, not additional power consumption. With this regard, Heag AG, in its ``energy conservation scheme 2000``, offers a broad range of possibilities. It includes incentives for energy conservation and renewable energy use. As an instrument of analysis for this scheme, cost-benefit analysis was chosen. The authors describe the scheme and test the applicability of cost-benefit analysis. (orig.) [Deutsch] Die EVU setzen sich zunehmend fuer das Energieeinsparen ein, statt fuer zusaetzlichen Stromabsatz. Die Heag Versorgungs-AG bietet dazu ein breit angelegtes Foerderprogramm: `Energiespar-Aktion 2000`. Im Rahmen dieser Aktion werden Massnahmen zur Energieeinsparung und Nutzung regenerativer Energie finanziell gefoerdert. Als Analyseinstrument fuer die Energiespar-Aktion wurde die Kosten-Nutzen-Analyse gewaehlt. Die Verfasser erlaeutern die Energiespar-Aktion und pruefen auch die Anwendbarkeit der Kosten-Nutzen-Analyse. (orig.)

  1. 全面深化公安改革背景下加强警辅队伍建设和整合的探索--以上海市公安局嘉定分局为例%Discussion on the Building and Potency of Public-Security Managerial Assistants--Take for Example of Jiading Branch of Shanghai Public Security Bureau

    Institute of Scientific and Technical Information of China (English)

    姚方盛

    2015-01-01

    As the capable helper, the public-security managerial assistant has given great assistance to the public security organ in the public-security managerial process. At present, the public-security managerial assistants have become the new emerging forces to safeguard the public order. In the new situation, the public security organ should play a big role in the public order management and make the best possible use of public-security managerial assistants.%警辅队伍是指由《人民警察法》等法律法规规定的,政府认可并出资保障,由公安机关直接领导、管理的安全防范组织或在公安机关协助处理外部警务活动的组织。目前,警辅队伍已成为维护社会治安不可或缺的力量。在新的形势下,我们要进一步发挥警辅队伍的工作效能,激发其潜在活力,实现警力的无增长改善。

  2. Cost-Effective Large-Scale Occupancy-Abundance Monitoring of Invasive Brushtail Possums (Trichosurus Vulpecula on New Zealand's Public Conservation Land.

    Directory of Open Access Journals (Sweden)

    Andrew M Gormley

    Full Text Available There is interest in large-scale and unbiased monitoring of biodiversity status and trend, but there are few published examples of such monitoring being implemented. The New Zealand Department of Conservation is implementing a monitoring program that involves sampling selected biota at the vertices of an 8-km grid superimposed over the 8.6 million hectares of public conservation land that it manages. The introduced brushtail possum (Trichosurus Vulpecula is a major threat to some biota and is one taxon that they wish to monitor and report on. A pilot study revealed that the traditional method of monitoring possums using leg-hold traps set for two nights, termed the Trap Catch Index, was a constraint on the cost and logistical feasibility of the monitoring program. A phased implementation of the monitoring program was therefore conducted to collect data for evaluating the trade-off between possum occupancy-abundance estimates and the costs of sampling for one night rather than two nights. Reducing trapping effort from two nights to one night along four trap-lines reduced the estimated costs of monitoring by 5.8% due to savings in labour, food and allowances; it had a negligible effect on estimated national possum occupancy but resulted in slightly higher and less precise estimates of relative possum abundance. Monitoring possums for one night rather than two nights would provide an annual saving of NZ$72,400, with 271 fewer field days required for sampling. Possums occupied 60% (95% credible interval; 53-68 of sampling locations on New Zealand's public conservation land, with a mean relative abundance (Trap Catch Index of 2.7% (2.0-3.5. Possum occupancy and abundance were higher in forest than in non-forest habitats. Our case study illustrates the need to evaluate relationships between sampling design, cost, and occupancy-abundance estimates when designing and implementing large-scale occupancy-abundance monitoring programs.

  3. Value for Money and Policy Review of the Economic Cost and Charges Associated with Private and Semi-Private Treatment Services in Public Hospitals - Final Report

    OpenAIRE

    Department of Health

    2010-01-01

    This Value for Money and Policy Review (VFM&PR) of the Economic Cost and Charges Associated with Private and Semi-Private Treatment Services in Public Hospitals was initiated by the Department of Health and Children in June 2009 and was conducted under the auspices of the Governmentâ?Ts Value for Money & Policy Review Initiative 2009-2011. The Review was overseen by an independently chaired National Steering Group comprised of senior representatives from the Department of Health and Children...

  4. Climate change and rising energy costs will change everything: a new mindset and action plan for 21st century public health.

    Science.gov (United States)

    McCartney, G; Hanlon, P; Romanes, F

    2008-07-01

    Western governments currently prioritize economic growth and the pursuit of profit above alternative goals of sustainability, health and equality. Climate change and rising energy costs are challenging this consensus. The realization of the transformation required to meet these challenges has provoked denial and conflict, but could lead to a more positive response which leads to a health dividend; enhanced well-being, less overconsumption and greater equality. This paper argues that public health can make its best contribution by adopting a new mindset, discourse, methodology and set of tasks.

  5. Can pharmacy assistants play a greater role in public health programs in community pharmacies? Lessons from a chlamydia screening study in Canberra, Australia.

    Science.gov (United States)

    Deeks, Louise S; Cooper, Gabrielle M; Currie, Marian J; Martin, Sarah J; Parker, Rhian M; Del Rosario, Rendry; Hocking, Jane S; Bowden, Francis J

    2014-01-01

    Little is known about the engagement of pharmacy assistants (PA) in public health service provision. To explore the experiences of PA participating in a study to determine whether a cash reward, offered to consumers and pharmacy businesses, increased participation in community pharmacy-based chlamydia screening. PA experience of the study education and training package, participant recruitment and conducting screening (providing information about chlamydia, specimen collection and handling urine samples) were evaluated using knowledge assessment, a questionnaire and focus groups. Twenty PA participated in the study: 15 (75%) completed all education and training components, 20 (100%) completed the questionnaire and 10 (50%) attended a focus group. PA rated all education and training components as effective (mean visual analog scale scores >8.5). Most PA (13/18, 72.2%) did not support/were unsure about continuing the program, citing the 25% repeat testing rate (presumed to relate to the cash reward) and privacy/confidentiality issues as reasons. Qualitative analysis suggested that minimizing repeat testing, improved workload management and recognition of, and remuneration for, education and training would make this model more acceptable to PA. Findings from this study support the assertion that PA can play a significant role in public health initiatives. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Estimating the Costs and Benefits of Providing Free Public Transit Passes to Students in Los Angeles County: Lessons Learned in Applying a Health Lens to Decision-Making

    Directory of Open Access Journals (Sweden)

    Lauren N. Gase

    2014-10-01

    Full Text Available In spite of increased focus by public health to engage and work with non-health sector partners to improve the health of the general as well as special populations, only a paucity of studies have described and disseminated emerging lessons and promising practices that can be used to undertake this work. This article describes the process used to conduct a Health Impact Assessment of a proposal to provide free public transportation passes to students in Los Angeles County. This illustrative case example describes opportunities and challenges encountered in working with an array of cross-sector partners and highlights four important lessons learned: (1 the benefits and challenges associated with broad conceptualization of public issues; (2 the need for more comprehensive, longitudinal data systems and dynamic simulation models to inform decision-making; (3 the importance of having a comprehensive policy assessment strategy that considers health impacts as well as costs and feasibility; and (4 the need for additional efforts to delineate the interconnectivity between health and other agency priorities. As public health advances cross-sector work in the community, further development of these priorities will help advance meaningful collaboration among all partners.

  7. Implementing a routine outcome assessment procedure to evaluate the quality of assistive technology service delivery for children with physical or multiple disabilities: Perceived effectiveness, social cost, and user satisfaction.

    Science.gov (United States)

    Desideri, Lorenzo; Bizzarri, Martina; Bitelli, Claudio; Roentgen, Uta; Gelderblom, Gert-Jan; de Witte, Luc

    2016-01-01

    There is a lack of evidence on the effects and quality of assistive technology service delivery (ATSD). This study presents a quasi-experimental 3-months follow-up using a pre-test/post-test design aimed at evaluating outcomes of assistive technology (AT) interventions targeting children with physical and multiple disabilities. A secondary aim was to evaluate the feasibility of the follow-up assessment adopted in this study with a view to implement the procedure in routine clinical practice. Forty-five children aged 3-17 years were included. Parents were asked to complete the Individual Prioritised Problem Assessment (IPPA) for AT effectiveness; KWAZO (Kwaliteit van Zorg [Quality of Care]) and Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST) 2.0 for satisfaction with ATSD; Siva Cost Analysis Instrument (SCAI) for estimating the social cost of AT interventions. At follow-up, 25 children used the AT recommended. IPPA effect sizes ranged from 1.4 to 0.7, showing a large effect of AT interventions. Overall, parents were satisfied with ATSD, but Maintenance, Professional Services, and AT Delivery were rated not satisfactory. SCAI showed more resources spent for AT intervention compared to human assistance without technological supports. AT may be an effective intervention for children with disabilities. Issues concerning responsiveness and feasibility of the IPPA and the SCAI instruments are discussed with a view to inform routine clinical practice.

  8. 静脉输液实际消耗成本核算研究%Actual cost consumption accounting of venous transfusion in public medical institutions

    Institute of Scientific and Technical Information of China (English)

    苏全志; 韩修英; 崔立敏; 于兰贞

    2012-01-01

    Objectives:To calculate the actual cost consumption of venous transfusion accurately in public medical institutions in Binzhou and to provide data evidence for formulating reasonable charging standard of nursing projects. Methods:Three public medical institutions in Binzhou,each one from First-Grade, Second-Grade and Third-Grade public medical institutions respectively, were selected by representative sampling.We collected the related data in 2010 of each institution, calculated the actual cost consumption of different infusion methods using the project cost accounting, method, analyzed cost construction, and compared the difference between actual cost and current valorization. Results: The actual cost consumption of normal steel needle method, indwelling needle method, P1CC method, and Central Venous Catheter(CVC) method of venous transfusion in Third-Grade public medical institution were 25.46, 24.54, 36.87, and 35.88 yuan respectively. The actual cost consumption of normal steel needle method and indwelling needle method in Second-Grade institution were 19.80 and 19.39 yuan respectively.. The actual cost consumption of normal steel needle method in First-Grade institution was 15.55 yuan. The price gaps between actual cost consumption and valorization were 12.60-30.87 yuan and the cost compensation rates were only 11.78~30.94%. The highest proportion of total venous transfusion cost was the nursing human costs which ranged from 39.05% to 53.25%. Conclusion: There are enormous gaps between actual cost consumption of venous transfusion and current valorization. The government should adjust current charging standard based on scientific project cost accounting of venous transfusion.%目的:准确核算滨州市公立医疗机构静脉输液实际消耗成本,为制定合理的护理项目收费标准提供数据支持.方法:采用便利抽样方法,分别选取滨州市一、二、三级公立医疗机构各一家,收集其2010年的相关资料;运用项目成

  9. Measuring cost efficiency in the Nordic hospitals--a cross-sectional comparison of public hospitals in 2002

    DEFF Research Database (Denmark)

    Linna, Miika; Häkkinen, Unto; Peltola, Mikko

    2010-01-01

    were collected using harmonized definitions of inputs and outputs for 184 hospitals and data envelopment analysis was used to calculate Farrell efficiency estimates for the year 2002. Results suggest that there were marked differences in the average hospital efficiency between Nordic countries. In 2002......, average efficiency was markedly higher in Finland compared to Norway and Sweden. This study found differences in cost efficiency that cannot be explained by input prices or differences in coding practices. More analysis is needed to reveal the causes of large efficiency disparities between Nordic...

  10. Level of satisfaction of clients of public pharmacies dispensing high-cost drugs in Espírito Santo, Brazil

    Directory of Open Access Journals (Sweden)

    Karla Oliveira dos Santos Cassaro

    Full Text Available ABSTRACT The aim of this study was to evaluate the level of satisfaction of pharmaceutical services and to determine the socioeconomic profile of public pharmacy clients. This is a cross-sectional observational study using a quantitative approach. The sample was calculated from the monthly number of patients seen in pharmacies and was stratified for each pharmacy. Data were analysed using SPSS 11.5 software and by observing the simple relative frequencies for qualitative variables. For the quantitative variables, the analysis of variance (ANOVA and post-hoc Fisher tests were performed. Data are expressed as mean ± standard deviation (SD. The results show that, in general, patients at "Farmácias cidadãs" are satisfied with the services. However, when stratified, we found that the greatest satisfaction was related only to structural and organizational aspects, while the pharmaceutical services are unsatisfactory. When relating satisfaction to the socioeconomic characteristics, a difference between waiting time (39.07 ± 19.53, attendance by pharmacist (8.91 ± 5.14 and education was observed. It is concluded that users are satisfied with the services of state "Farmácias cidadãs" of Espírito Santo, but there should be improvements in relation to pharmaceutical services and the interpersonal relationships between health professionals and users of the public health system in Brazil.

  11. On cost management of municipal public engineering construction programs%谈市政公用工程施工项目成本管理

    Institute of Scientific and Technical Information of China (English)

    任海林

    2014-01-01

    结合孝义市新安街东延道排工程,依据成本管理的基本原则,主要介绍了在确保文明施工及施工质量和安全的前提下,实施市政公用工程项目成本管理的方法,以最大限度地降低工程成本,追求自身经济效益的最大化,切实提高施工企业的综合效益。%Combining with the project at the east extension road rows of Xin’an Street in Xiaoyi,the paper mainly introduces the cost manage-ment methods for the municipal public engineering program with the premise of ensuring the civilized construction,construction quality and safety by referring to the basic principle for the cost management,so as to reduce the engineering cost maximally,maximize self economic benefits and promote the comprehensive benefits of construction enterprises.

  12. Public health costs accounting of inorganic PM2.5 pollution in metropolitan areas of the United States using a risk-based source-receptor model.

    Science.gov (United States)

    Heo, Jinhyok; Adams, Peter J; Gao, H Oliver

    2017-09-01

    In order to design effective strategies to reduce the public health burden of ambient fine particulate matter (PM2.5) imposed in an area, it is necessary to identify the emissions sources affecting that location and quantify their contributions. However, it is challenging because PM2.5 travels long distances and most constituents are the result of complex chemical processes. We developed a reduced-form source-receptor model for estimating locations and magnitudes of downwind health costs from a source or, conversely, the upwind sources that contribute to health costs at a receptor location. Built upon outputs from a state-of-the-art air quality model, our model produces comprehensive risk-based source apportionment results with trivial computational costs. Using the model, we analyzed all the sources contributing to the inorganic PM2.5 health burden in 14 metropolitan statistical areas (MSAs) in the United States. Our analysis for 12 source categories shows that 80-90% of the burden borne by these areas originates from emissions sources outside of the area and that emissions sources up to 800 km away need to be included to account for 80% of the burden. Conversely, 60-80% of the impacts of an MSA's emissions occurs outside of that MSA. The results demonstrate the importance of regionally coordinated measures to improve air quality in metropolitan areas. Copyright © 2017. Published by Elsevier Ltd.

  13. Family Assistance for Older Adults in Puerto Rico

    Directory of Open Access Journals (Sweden)

    Paul-Jesús Fericelli

    2013-09-01

    Full Text Available Global aging is a growing issue in most countries, including Puerto Rico. The well being of the older adult population depends mainly on a collaborative government initiative that uses both public assistance and the engagement of family members. Puerto Rican policymakers are searching for alternatives to care for the expanding elderly population as well as to protect the country’s economy, avoid the financial cliff, and reduce the high cost of public assistance. The purpose of this article is to analyze The Act for the Improvement of the Family Assistance and for the Support of the Elderly, Act No. 193 of 2002, under the criteria-based model (Gallagher & Haskins, 1984 with a value-critical appraisal (Chambers & Wedel, 2009. I suggest Act No. 193 of 2002 as a model for policymakers who are seeking ways to improve assistance for older adults, by promoting the following values: fairness, familism, fraternity, and accountability.

  14. Public Health Impact and Economic Costs of Volkswagen’s Lack of Compliance with the United States’ Emission Standards

    Directory of Open Access Journals (Sweden)

    Lifang Hou

    2016-09-01

    Full Text Available The U.S. Environmental Protection Agency (EPA recently issued a notice of violation against Volkswagen (VW for installing a defective device in certain models of diesel cars to circumvent emission tests for nitrogen oxides (NOx. We quantified the health and economic impacts of extra NOx emissions attributable to non-compliant vehicles in the U.S. using the EPA’s Co-Benefits Risk Assessment model. We estimated that the total extra NOx emitted over one year of operation would result in 5 to 50 premature deaths, 687 to 17,526 work days with restricted activity, and economic costs of $43,479,189 to $423,268,502, based on various assumptions regarding emission scenarios and risks. This study highlights the potential impacts of VW vehicles’ lack of compliance on the health and well-being of the U.S. population.

  15. Public Health Impact and Economic Costs of Volkswagen's Lack of Compliance with the United States' Emission Standards.

    Science.gov (United States)

    Hou, Lifang; Zhang, Kai; Luthin, Moira A; Baccarelli, Andrea A

    2016-09-08

    The U.S. Environmental Protection Agency (EPA) recently issued a notice of violation against Volkswagen (VW) for installing a defective device in certain models of diesel cars to circumvent emission tests for nitrogen oxides (NOx). We quantified the health and economic impacts of extra NOx emissions attributable to non-compliant vehicles in the U.S. using the EPA's Co-Benefits Risk Assessment model. We estimated that the total extra NOx emitted over one year of operation would result in 5 to 50 premature deaths, 687 to 17,526 work days with restricted activity, and economic costs of $43,479,189 to $423,268,502, based on various assumptions regarding emission scenarios and risks. This study highlights the potential impacts of VW vehicles' lack of compliance on the health and well-being of the U.S.

  16. Public Health Impact and Economic Costs of Volkswagen’s Lack of Compliance with the United States’ Emission Standards

    Science.gov (United States)

    Hou, Lifang; Zhang, Kai; Luthin, Moira A.; Baccarelli, Andrea A.

    2016-01-01

    The U.S. Environmental Protection Agency (EPA) recently issued a notice of violation against Volkswagen (VW) for installing a defective device in certain models of diesel cars to circumvent emission tests for nitrogen oxides (NOx). We quantified the health and economic impacts of extra NOx emissions attributable to non-compliant vehicles in the U.S. using the EPA’s Co-Benefits Risk Assessment model. We estimated that the total extra NOx emitted over one year of operation would result in 5 to 50 premature deaths, 687 to 17,526 work days with restricted activity, and economic costs of $43,479,189 to $423,268,502, based on various assumptions regarding emission scenarios and risks. This study highlights the potential impacts of VW vehicles’ lack of compliance on the health and well-being of the U.S. population. PMID:27618076

  17. Understanding the nature of health: New perspectives for medicine and public health. Improved wellbeing at lower costs [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Johannes Bircher

    2016-02-01

    Full Text Available Background: Current dilemmas of health care systems call for a new look at the nature of health. This is offered by the Meikirch model. We explore its hypothetical benefit for the future of medicine and public health. Meikirch model: It states: “Health is a dynamic state of wellbeing emergent from conducive interactions between individuals’ potentials, life’s demands, and social and environmental determinants.” “Throughout the life course health results when an individuals’ biologically given potential (BGP and his or her personally acquired potential (PAP, interacting with social and environmental determinants, satisfactorily respond to the demands of life.” Methods: We explored the Meikirch model’s possible applications for personal and public health care. Results: The PAP of each individual is the most modifiable component of the model. It responds to constructive social interactions and to personal growth. If an individual’s PAP is nurtured to develop further, it likely will contribute much more to health than without fostering. It may also compensate for losses of the BGP. An ensuing new culture of health may markedly improve health in the society. The rising costs of health care presumably are due in part to the tragedy of the commons and to moral hazard. Health as a complex adaptive system offers new possibilities for patient care, particularly for general practitioners. Discussion: Analysis of health systems by the Meikirch model reveals that in many areas more can be done to improve people’s health and to reduce health care costs than is done today. The Meikirch model appears promising for individual and public health in low and high income countries. Emphasizing health instead of disease the Meikirch model reinforces article 12 of the International Covenant on Economic, Social and Cultural Rights of the United Nations – that abandons the WHO definition - and thereby may contribute to its reinterpretation.

  18. Factors associated with cesarean delivery during labor in primiparous women assisted in the Brazilian Public Health System: data from a National Survey

    Directory of Open Access Journals (Sweden)

    Marcos Augusto Bastos Dias

    2016-10-01

    Full Text Available Abstract Background The rate of cesarean delivery (CD in Brazil has increased over the past 40 years. The CD rate in public services is three times above the World Health Organization recommended values. Among strategies to reduce CD, the most important is reduction of primary cesarean. This study aimed to describe factors associated with CD during labor in primiparous women with a single cephalic pregnancy assisted in the Brazilian Public Health System (SUS. Methods This study is part of the Birth in Brazil survey, a national hospital-based study of 23,894 postpartum women and their newborns. The rate of CD in primiparous women was estimated. Univariate and multivariable logistic regression was performed to analyze factors associated with CD during labor in primiparous women with a single cephalic pregnancy, including estimation of crude and adjusted odds ratios and their respective 95 % confidence intervals. Results The analyzed data are related to the 2814 eligible primiparous women who had vaginal birth or CD during labor in SUS hospitals. In adjusted analyses, residing in the Southeast region was associated with lower CD during labor. Occurrence of clinical and obstetric conditions potentially related to obstetric emergencies before delivery, early admission with < 4 cm of dilatation, a decision late in pregnancy for CD, and the use of analgesia were associated with a greater risk for CD. Favorable advice for vaginal birth during antenatal care, induction of labor, and the use of any good practices during labor were protective factors for CD. The type of professional who attended birth was not significant in the final analyses, but bivariate analysis showed a higher use of good practices and a smaller proportion of epidural analgesia in women cared for by at least one nurse midwife. Conclusions The CD rate in primiparous women in SUS in Brazil is extremely high and can compromise the health of these women and their newborns

  19. Modelling public transport passenger flows in the era of intelligent transport systems COST Action TU1004 (TransITs)

    CERN Document Server

    Noekel, Klaus

    2016-01-01

    This book shows how transit assignment models can be used to describe and predict the patterns of network patronage in public transport systems. It provides a fundamental technical tool that can be employed in the process of designing, implementing and evaluating measures and/or policies to improve the current state of transport systems within given financial, technical and social constraints. The book offers a unique methodological contribution to the field of transit assignment because, moving beyond “traditional” models, it describes more evolved variants that can reproduce: • intermodal networks with high- and low-frequency services; • realistic behavioural hypotheses underpinning route choice; • time dependency in frequency-based models; and • assumptions about the knowledge that users have of network conditions that are consistent with the present and future level of information that intelligent transport systems (ITS) can provide. The book also considers the practical perspective of practit...

  20. Report: Costs Claimed by the Tribal Association on Solid Waste and Emergency Response Under EPA Assistance Agreement No. CR827181-01

    Science.gov (United States)

    Report #2003-4-00119, September 19, 2003. We questioned the total Federal share claimed of $2,357,376 as unsupported, because the Association did not comply with the Federal rules, regulations, and terms of the assistance agreement.

  1. Comparative cost-effectiveness of robot-assisted and standard laparoscopic prostatectomy as alternatives to open radical prostatectomy for treatment of men with localised prostate cancer: a health technology assessment from the perspective of the UK National Health Service.

    Science.gov (United States)

    Close, Andrew; Robertson, Clare; Rushton, Stephen; Shirley, Mark; Vale, Luke; Ramsay, Craig; Pickard, Robert

    2013-09-01

    Robot-assisted laparoscopic prostatectomy is increasingly used compared with a standard laparoscopic technique, but it remains uncertain whether potential benefits offset higher costs. To determine the cost-effectiveness of robotic prostatectomy. We conducted a care pathway description and model-based cost-utility analysis. We studied men with localised prostate cancer able to undergo either robotic or laparoscopic prostatectomy for cure. We used data from a meta-analysis, other published literature, and costs from the UK National Health Service and commercial sources. Care received by men for 10 yr following radical prostatectomy was modelled. Clinical events, their effect on quality of life, and associated costs were synthesised assuming 200 procedures were performed annually. Over 10 yr, robotic prostatectomy was on average (95% confidence interval [CI]) £1412 (€1595) (£1304 [€1473] to £1516 [€1713]) more costly than laparoscopic prostatectomy but more effective with mean (95% CI) gain in quality-adjusted life-years (QALYs) of 0.08 (0.01-0.15). The incremental cost-effectiveness ratio (ICER) was £18 329 (€20 708) with an 80% probability that robotic prostatectomy was cost effective at a threshold of £30 000 (€33 894)/QALY. The ICER was sensitive to the throughput of cases and the relative positive margin rate favouring robotic prostatectomy. Higher costs of robotic prostatectomy may be offset by modest health gain resulting from lower risk of early harms and positive margin, provided >150 cases are performed each year. Considerable uncertainty persists in the absence of directly comparative randomised data. Copyright © 2013 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  2. Defending public interests in private lands: compliance, costs and potential environmental consequences of the Brazilian Forest Code in Mato Grosso.

    Science.gov (United States)

    Stickler, Claudia M; Nepstad, Daniel C; Azevedo, Andrea A; McGrath, David G

    2013-06-01

    Land-use regulations are a critical component of forest governance and conservation strategies, but their effectiveness in shaping landholder behaviour is poorly understood. We conducted a spatial and temporal analysis of the Brazilian Forest Code (BFC) to understand the patterns of regulatory compliance over time and across changes in the policy, and the implications of these compliance patterns for the perceived costs to landholders and environmental performance of agricultural landscapes in the southern Amazon state of Mato Grosso. Landholdings tended to remain in compliance or not according to their status at the beginning of the study period. The perceived economic burden of BFC compliance on soya bean and beef producers (US$3-5.6 billion in net present value of the land) may in part explain the massive, successful campaign launched by the farm lobby to change the BFC. The ecological benefits of compliance (e.g. greater connectivity and carbon) with the BFC are diffuse and do not compete effectively with the economic benefits of non-compliance that are perceived by landholders. Volatile regulation of land-use decisions that affect billions in economic rent that could be captured is an inadequate forest governance instrument; effectiveness of such regulations may increase when implemented in tandem with positive incentives for forest conservation.

  3. Prevalence of psoriatic arthritis and costs generated by treatment of psoriatic arthritis patients in the public health system – the case of Poland

    Science.gov (United States)

    Raciborski, Filip; Śliwczyński, Andrzej; Kwiatkowska, Brygida; Brzozowska, Melania; Tłustochowicz, Małgorzata

    2016-01-01

    Objective The objective of the study was to analyse the prevalence of psoriatic arthritis (PsA) in Poland and to assess the costs generated by treatment of PsA patients in the system of public healthcare. Material and methods The analysis was based on the database of the public payer, the National Health Fund (NFZ). PsA was defined by the diagnostic ICD-10 codes M07 (Enteropathic arthropathies) and L40.5 (Psoriatic arthropathies). The estimate of the costs was based on the reports submitted to the NFZ by health service providers. The prevalence rates were calculated using the NFZ data and the population estimates from the Central Statistical Office of Poland (GUS). Results In 2015, the prevalence of PsA (ICD-10: L40.5 and M07) in Poland was 3.2 per 10 000 population (3.7 in women and 2.6 in men). In 2015, nearly 7.3 thousand patients with the diagnosis of M07 and 6.3 thousand patients with the diagnosis of L40.5 received healthcare benefits. Women accounted for 60.6% of those patients. Nearly three fourths of PsA patients were aged 40 to 69 years with the median age of 54 years (56 years in women and 50 years in men). Between 2008 and 2015 the NFZ expenditure on the treatment of PsA increased from 6.6 million Polish zloty (PLN) (1.9 million EUR) to PLN 50.8 million (12.1 million EUR). In the same period, the number of PsA patients increased from 3.4 thousand to 11.9 thousand. In 2015, the mean cost of treatment per PsA patient was PLN 3.8 thousand. Conclusions The PsA prevalence rates estimated by the authors from the NFZ database are clearly lower than those derived from studies in other European countries, which may suggest that the actual number of PsA patients in Poland may be underestimated. Still the number of patients treated for PsA increased nearly 3.5-fold during 2008–2015, when the cost of PsA treatment rose more than 7 times. PMID:28115777

  4. An exploration of the socio-economic profile of women and costs of receiving abortion services at public health facilities of Madhya Pradesh, India.

    Science.gov (United States)

    Banerjee, Sushanta K; Kumar, Rakesh; Warvadekar, Janardan; Manning, Vinoj; Andersen, Kathryn Louise

    2017-03-21

    Maternal mortality, which primarily burdens developing countries, reflects the greatest health divide between rich and poor. This is especially pronounced for access to safe abortion services which alone avert 1 of every 10 maternal deaths in India. Primarily due to confidentiality concerns, poor women in India prefer private services which are often offered by untrained providers and may be expensive. In 2006 the state government of Madhya Pradesh (population 73 million) began a concerted effort to ensure access to safe abortion services at public health facilities to both rural and urban poor women. This study aims to understand the socio-economic profile of women seeking abortion services in public health facilities across this state and out of pocket cost accessing abortion services. In particular, we examine the level of access that poor women have to safe abortion services in Madhya Pradesh. This study consisted of a cross-sectional client follow-up design. A total of 19 facilities were selected using two-stage random sampling and 1036 women presenting to chosen facilities with abortion and post-abortion complications were interviewed between May and December 2014. A structured data collection tool was developed. A composite wealth index computed using principal component analysis derived weights from consumer durables and asset holding and classified women into three categories, poor, moderate, and rich. Findings highlight that overall 57% of women who received abortion care at public health facilities were poor, followed by 21% moderate and 22% rich. More poor women sought care at primary level facilities (58%) than secondary level facilities and among women presenting for postabortion complications (67%) than induced abortion. Women reported spending no money to access abortion services as abortion services are free of cost at public facilities. However, poor women spend INR 64 (1 USD) while visiting primary level facilities and INR 256 (USD 4) while

  5. Evaluation of pharmaceutical assistance in public primary care in Brasília, Brazil Avaliação da assistência farmacêutica na atenção primária no Distrito Federal

    Directory of Open Access Journals (Sweden)

    Janeth de Oliveira Silva Naves

    2005-04-01

    Full Text Available OBJECTIVE: Pharmaceutical assistance is essential in health care and a right of citizens according to Brazilian law and drug policies. The study purpose was to evaluate aspects of pharmaceutical assistance in public primary health care. METHODS: A cross-sectional study using WHO drug indicators was carried out in Brasília in 2001. From a random sample of 15 out of 62 centers thirty exiting patients per center were interviewed. RESULTS: Only 18.7% of the patients fully understood the prescription, 56.3% could read it, 61.2% of the prescribed drugs were actually dispensed, and mean duration of pharmaceutical dispensing was 53.2 seconds. Each visit lasted on average 9.4 minutes. Of prescribed and non-dispensed drugs, 85.3% and 60.6% were on the local essential drug list (EDL respectively. On average 83.2% of 40 essential drugs were in stock, and only two centers had a pharmacist in charge of the pharmacy. The mean number of drugs per prescription was 2.3, 85.3% of prescribed drugs were on the EDL, 73.2% were prescribed using the generic denomination, 26.4% included antibiotics and 7.5% were injectables. The most prescribed groups were: cardiovascular drugs (26.8%, anti-infective drugs (13.1%, analgesics (8.9%, anti-asthmatic drugs (5.8%, anti-diabetic drugs (5.3%, psychoactive drugs (3.7%, and combination drugs (2.7%. CONCLUSIONS: Essential drugs were only moderately available almost 30 years after the first Brazilian EDL was formulated. While physician use of essential drugs and generic names was fairly high, efficiency was impaired by the poor quality of pharmaceutical care, resulting in very low patient understanding and insufficient guarantee of supply, particularly for chronic diseases.OBJETIVO: O acesso a medicamentos e seus serviços é indispensável às ações de saúde e um direito do cidadão segundo a política de medicamentos e a legislação brasileira. O objetivo do estudo foi avaliar aspectos da assistência farmacêutica na aten

  6. Research on the Historical Evolution and Development Trends of Public Hospitals'Cost Accounting in China%我国公立医院成本核算的历史演进与发展趋势研究

    Institute of Scientific and Technical Information of China (English)

    郑大喜

    2011-01-01

    介绍科室成本核算、项目成本核算、病种成本核算等方法,指出其适应范围和存在的问题,提出公立医院成本核算的发展趋势是与政府财政补偿、医疗服务支付制度改革、绩效评价体系相结合,以便体现公益性质.%The article introduces several cost accounting methods of public hospitals, such as department cost accounting, item cost accounting and disease cost accounting, and discusses the application and issues of all the methods.The trends of cost accounting are the integration between govemment finance compensation, medical service payment system reform and payment system based on public welfare.

  7. Initial public offerings in Brazil (2004-2006: Valuation with the use of multiples and discounting of cash flows using the appropriate cost of equity

    Directory of Open Access Journals (Sweden)

    Luiz Felipe Jacques da Motta

    2008-10-01

    Full Text Available The pricing process of new shares in IPOs has been under study in several countries. This paper initially looks at the valuation process using multiples and seeks to classify the new shares under two categories: underpriced or overpriced at the time of the IPOs. Analysis of the cost of equity, comparing betas at the time of the offerings (usually calculated as the betas of comparable companies and the betas of the companies after 12 months of trading, is also carried out. Companies in the sample are those that went public between 2004 and 2006. Results indicated that companies were not undervalued, even after some high short-term returns. However there is no statistical evidence that they were overvalued. Finally, results indicated that betas after twelve months of trading are significantly higher than the comparable companies’ betas used at the time of the IPOs.

  8. A Study of the Importance of Education and Cost Incentives on Individual Food Choices at the Harvard School of Public Health Cafeteria

    Science.gov (United States)

    Michels, Karin B.; Bloom, Barry R.; Riccardi, Paul; Rosner, Bernard A.; Willett, Walter C.

    2013-01-01

    Objectives To investigate the importance of cost and awareness of health- or disease-promoting properties of foods and meals for choices by customers of a cafeteria. Design A non-randomized intervention study. Setting A medium size cafeteria in the Harvard School of Public Health. Participants Customers of the cafeteria mainly consisting of public health students, faculty, and school staff and workers from the medical campus. Intervention The purchase of healthy foods and dishes was subsidized and their prices reduced by 20%. This promotion was accompanied by the distribution of educational material. Main Outcome Measures Change in consumption of healthy and less healthy foods. Analysis The geometric mean was used to calculate the change in consumption. Results During the intervention, we observed a 6% increase in the consumption of healthy foods (95% confidence interval [CI]; 5% to 8%), and a 2% decline in the consumption of less-healthy foods (95% CI; −1% to −4%). After the prices returned to their original levels, the consumption of healthy foods increased further to 17% (95% CI; 13% to 20%) and a 2% decline in the consumption of less-healthy foods (95% CI; % 1 to −5%) persisted. Conclusions Subsidizing healthful meals and educating consumers about the importance of a healthy diet can result in a modest increase in the selection of healthy foods and meals that can be maintained beyond the periods of subsidy and promotion. PMID:18460476

  9. Technology-assisted Interventions for Parents of Young Children: Emerging Practices, Current Research, and Future Directions

    OpenAIRE

    Hall, Cristin M.; Bierman, Karen L.

    2015-01-01

    Technology can potentially expand the reach and cut the costs of providing effective, evidence-based interventions. This paper reviews existing publications that describe the application and evaluation of technology-assisted interventions for parents of young children. A broad review of the early childhood literature revealed 48 studies describing technology-assisted parent education and interventions. Across these studies, multiple forms of technology were used, including web-based platforms...

  10. Prospective cost-benefit analysis of a two-dimensional barcode for vaccine production, clinical documentation, and public health reporting and tracking.

    Science.gov (United States)

    O'Connor, Alan C; Kennedy, Erin D; Loomis, Ross J; Haque, Saira N; Layton, Christine M; Williams, Warren W; Amoozegar, Jacqueline B; Braun, Fern M; Honeycutt, Amanda A; Weinbaum, Cindy

    2013-06-28

    In the United States recording accurate vaccine lot numbers in immunization records is required by the National Childhood Vaccine Injury Act and is necessary for public health surveillance and implementation of vaccine product recalls. However, this information is often missing or inaccurate in records. The Food and Drug Administration (FDA) requires a linear barcode of the National Drug Code (NDC) on vaccine product labels as a medication verification measure, but lot number and expiration date must still be recorded by hand. Beginning in 2011, FDA permitted manufacturers to replace linear barcodes with two-dimensional (2D) barcodes on unit-of-use product labels. A 2D barcode can contain the NDC, expiration date, and lot number in a symbol small enough to fit on a unit-of-use label. All three data elements could be scanned into a patient record. To assess 2D barcodes' potential impacts, a mixed-methods approach of time-motion data analysis, interview and survey data collection, and cost-benefit analysis was employed. Analysis of a time-motion study conducted at 33 practices suggests scanning 2D-barcoded vaccines could reduce immunization documentation time by 36-39 s per dose. Data from an internet survey of primary care providers and local health officials indicate that 60% of pediatric practices, 54% of family medicine practices, and 39% of health departments would use the 2D barcode, with more indicating they would do so if they used electronic health records. Inclusive of manufacturer and immunization provider costs and benefits, we forecast lower-bound net benefits to be $310-334 million between 2011 and 2023 with a benefit-to-cost ratio of 3.1:1-3.2:1. Although we were unable to monetize benefits for expected improved immunization coverage, surveillance, or reduced medication errors, based on our findings, we expect that using 2D barcodes will lower vaccine documentation costs, facilitate data capture, and enhance immunization data quality. Copyright © 2013

  11. COMPLEAT (Community-Oriented Model for Planning Least-Cost Energy Alternatives and Technologies): A planning tool for publicly owned electric utilities. [Community-Oriented Model for Planning Least-Cost Energy Alternatives and Technologies (Compleat)

    Energy Technology Data Exchange (ETDEWEB)

    1990-09-01

    COMPLEAT takes its name, as an acronym, from Community-Oriented Model for Planning Least-Cost Energy Alternatives and Technologies. It is an electric utility planning model designed for use principally by publicly owned electric utilities and agencies serving such utilities. As a model, COMPLEAT is significantly more full-featured and complex than called out in APPA's original plan and proposal to DOE. The additional complexity grew out of a series of discussions early in the development schedule, in which it became clear to APPA staff and advisors that the simplicity characterizing the original plan, while highly desirable in terms of utility applications, was not achievable if practical utility problems were to be addressed. The project teams settled on Energy 20/20, an existing model developed by Dr. George Backus of Policy Assessment Associates, as the best candidate for the kinds of modifications and extensions that would be required. The remainder of the project effort was devoted to designing specific input data files, output files, and user screens and to writing and testing the compute programs that would properly implement the desired features around Energy 20/20 as a core program. This report presents in outline form, the features and user interface of COMPLEAT.

  12. Cross-Sectional Relationships Between Household Food Insecurity and Child BMI, Feeding Behaviors, and Public Assistance Utilization Among Head Start Children From Predominantly Hispanic and American Indian Communities in the CHILE Study

    OpenAIRE

    Trappmann, Jessica L.; Jimenez, Elizabeth Yakes; Keane, Patricia C.; Deborah A. Cohen; Davis, Sally M

    2015-01-01

    Associations between food insecurity and overweight/obesity, feeding behaviors, and public food assistance utilization have been explored to a greater extent among adults and adolescents than among young children. This cross-sectional study examines a subset of pre-intervention implementation data (n = 347) among families participating in the Child Health Initiative for Lifelong Eating and Exercise (CHILE) study conducted in rural New Mexico among predominantly Hispanic and American Indian He...

  13. Evaluation of the cost effectiveness model being developed for the component improvement programs of the Air Force and the Navy

    OpenAIRE

    Crowder, Gerald L.

    1992-01-01

    Approved for public release; distribution is unlimited This thesis examines the Cost Effectiveness Analysis (CEA) model used by the Air Force to assist with the decision making process of their Component Improvement Program (CIP). The emphasis was on studying the model for its use in the Naval Component Improvement Program. With an example provided by General Electric, a sensitivity analysis was performed to determine the cost drivers of the model. For the example, the major cost driver...

  14. INPO Assistance Activities: Human Resources

    Energy Technology Data Exchange (ETDEWEB)

    Wheelock, J.T.

    1999-11-14

    The Institute of Nuclear Power Operations (INPO) has a number of ongoing activities designed to provide assistance to our members in the human resources area. These include the Educational Assistance Program and the ongoing facilitation of information exchange through Nuclear Network and INPO publications. INPO will continue to seek ways to assist its member utilities.

  15. 76 FR 35319 - Competitive and Noncompetitive Non-Formula Federal Assistance Programs-Specific Administrative...

    Science.gov (United States)

    2011-06-17

    ... impact of concentration and globalization; basic livestock and crop farming practices; the acquisition... Officer of funds to an eligible grantee to assist in meeting the costs of conducting for the benefit of... conducting for the benefit of the public, an identified project which is intended and designed to accomplish...

  16. Plant breeding with marker-assisted selection in Brazil

    Directory of Open Access Journals (Sweden)

    Ney Sussumu Sakiyama

    2014-03-01

    Full Text Available Over the past three decades, molecular marker studies reached extraordinary advances, especially for sequencing and bioinformatics techniques. Marker-assisted selection became part of the breeding program routines of important seed companies, in order to accelerate and optimize the cultivar developing processes. Private seed companies increasingly use marker-assisted selection, especially for the species of great importance to the seed market, e.g. corn, soybean, cotton, and sunflower. In the Brazilian public institutions few breeding programs use it efficiently. The possible reasons are: lack of know-how, lack of appropriate laboratories, few validated markers, high cost, and lack of urgency in obtaining cultivars. In this article we analyze the use and the constraints of marker-assisted selection in plant breeding programs of Brazilian public institutes

  17. Sustentabilidade empresarial e o impacto no custo de capital próprio das empresas de capital aberto Sustainable development and consequences for equity costs in public companies

    Directory of Open Access Journals (Sweden)

    Lílian Simone Aguiar da Silva

    2006-12-01

    Full Text Available Este trabalho apresenta o impacto no custo de capital próprio para as empresas brasileiras de capital aberto face à adoção dos princípios de sustentabilidade. O conceito de desenvolvimento sustentável tem se aprimorado num processo contínuo de reavaliação da relação existente entre: crescimento econômico, a sociedade civil e o meio ambiente. O triple-bottom-line das dimensões econômica, ambiental e social da sustentabilidade tem emergido como um modelo de interpretação pelas empresas, embora cada uma dessas dimensões represente um grande desafio. O segmento corporativo vem atendendo às demandas cada vez maiores da sociedade frente a essas questões, ficando a dúvida quanto à legitimidade dessas ações e o questionamento relativo ao papel das empresas na economia e na sociedade. Para avaliar o impacto no custo de capital próprio, foi implementado um modelo de decomposição do beta em medidas contábeis de risco, incluindo uma variável referente à sustentabilidade. O resultado confirma a expectativa de que ao aderir aos padrões de sustentabilidade a empresa reduz o risco corporativo medido pelo risco sistemático, determinando a redução do custo de capital e aumento do valor econômico.This article provides an analysis of equity costs in Brazilian public companies regarding the adoption of sustainability principles. The concept of sustainable development has evolved considering the relation among economic growth, the society and the environment. The triple-bottom-line of economic, environmental, and social dimensions has emerged as an interpretation model by companies, although each of these dimensions may present a challenge. The corporate sector has faced an increasing demand from society regarding these sustainability concepts, though the actions and the role to be played by companies within this context are still being questioned. Equity costs were analyzed by a multivariate regression of beta on accounting measures

  18. Atendimento de puérperas pela fisioterapia em uma maternidade pública humanizada Postpartum women assisted by physical therapy at a humanized public maternity house

    Directory of Open Access Journals (Sweden)

    Mariana Tirolli Rett

    2008-12-01

    Full Text Available O objetivo foi descrever o perfil de puérperas atendidas pela fisioterapia em uma maternidade pública de Betim, MG, e o atendimento a elas prestado, visando contribuir para a assistência fisioterapêutica obstétrica. Foi feito um levantamento de 215 fichas de avaliação fisioterapêutica de puérperas, contendo dados demográficos e clínicos, além dos registros específicos da fisioterapia. A maioria da puérperas era jovem, do lar, casadas, multíparas e de Betim. Quanto à avaliação das mamas, a maioria apresentou mamas simétricas, secretantes, mamilos protrusos, tendo sido observados poucos traumas mamilares ou dificuldade na amamentação; 62,3% das puérperas apresentavam diafragma normocinético, 85,1% som timpânico à percussão abdominal, involução uterina dentro da normalidade, 87,9% contração do assoalho pélvico presente, 30,3% edema em membros inferiores; a diástase dos músculos reto-abdominais foi de 2±1 e 1±1 dedos supra e infra-umbilical, respectivamente. As condutas adotadas foram: exercícios respiratórios diafragmáticos, abdominais isométricos, contração do assoalho pélvico; exercícios circulatórios de membros inferiores, manobras de eliminação de flatos, deambulação e orientação. O perfil das puérperas atendidas correspondeu ao esperado, encontrando-se elas em estado de recuperação puerperal. A conduta proposta pela fisioterapia foi realizada pela grande maioria das puérperas.The aim was to describe the profile of postpartum women attended to at the physical therapy service in a public maternity house in Betim, MG, as well as the treatment they received. The study drew on a total of 215 medical charts of postpartum women, contaning personal, clinic and physical therapy data. Most women were young, married, housewives, multiparous, and from Betim. As to breast evaluation, most women had simetric and secretive breast, protruded nipples, few nipple traumas or breast-feeding difficulty having

  19. A cost evaluation methodology for surgical technologies.

    Science.gov (United States)

    Ismail, Imad; Wolff, Sandrine; Gronfier, Agnes; Mutter, Didier; Swanström, Lee L; Swantröm, Lee L

    2015-08-01

    To create and validate a micro-costing methodology that surgeons and hospital administrators can use to evaluate the cost of implementing innovative surgical technologies. Our analysis is broken down into several elements of fixed and variable costs which are used to effectively and easily calculate the cost of surgical operations. As an example of application, we use data from 86 robot assisted gastric bypass operations made in our hospital. To validate our methodology, we discuss the cost reporting approaches used in 16 surgical publications with respect to 7 predefined criteria. Four formulas are created which allow users to import data from their health system or particular situation and derive the total cost. We have established that the robotic surgical system represents 97.53 % of our operating room's medical device costs which amounts to $4320.11. With a mean surgery time of 303 min, personnel cost per operation amounts to $1244.73, whereas reusable instruments and disposable costs are, respectively, $1539.69 and $3629.55 per case. The literature survey demonstrates that the cost of surgery is rarely reported or emphasized, and authors who do cover this concept do so with variable methodologies which make their findings difficult to interpret. Using a micro-costing methodology, it is possible to identify the cost of any new surgical procedure/technology using formulas that can be adapted to a variety of operations and healthcare systems. We hope that this paper will provide guidance for decision makers and a means for surgeons to harmonise cost reporting in the literature.

  20. 77 FR 1946 - Agency Information Collection Activities: Submission for OMB Review; Comment Request, Public...

    Science.gov (United States)

    2012-01-12

    ... Review; Comment Request, Public Assistance Customer Satisfaction Survey AGENCY: Federal Emergency... Title: Public Assistance Customer Satisfaction Survey. Type of information collection: Revision of a... T, Public Assistance Customer Satisfaction Survey (Telephone); FEMA Form 519-0-1 INT, Public...

  1. [Cost analysis of18F-FDG PET-CT from the perspective of the Brazilian Unified National Health System as healthcare provider: a study in a public healthcare center in Rio de Janeiro, Brazil].

    Science.gov (United States)

    Caetano, Rosângela; Schluckebier, Luciene Fontes; Bastos, Cláudia Regina Garcia; Silva, Rondineli Mendes da; Carneiro, Michel Pontes; Silva, Jorge Wagner Esteves da; Biz, Aline Navega

    2014-02-01

    Positron emission tomography (PET) has been introduced recently in Brazil and requires costs analysis to support economic evaluation studies on its use. The current study analyzed the use of 18 F-FDG PET-CT and estimated its costs from the perspective of a public healthcare provider. The micro-costing technique was used, identifying, quantifying, and valuing all the inputs used to perform the procedure. Cost estimates considered 85 tests performed at the Brazilian National Cancer Institute from March to June 2012. Reference cases were defined as adult cancer patients, output of five tests per day, and one dose of 18 F-FDG per patient. Unit cost for the procedure was BRL 3,150.30 based on career wages under the Ministry of Science and Technology and BRL 2,927.19 based on Ministry of Health career wages. The factor with the heaviest cost impact was daily output of tests. Other factors that could impact the test's cost in public healthcare institutions were also examined.

  2. Assisted Living Facilities, Licensed Health Care Facilities - long term care facility type identified in attributes, Published in 2007, Iowa Dept. of Public Health.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Assisted Living Facilities dataset, was produced all or in part from Published Reports/Deeds information as of 2007. It is described as 'Licensed Health Care...

  3. Dental Assistants

    Science.gov (United States)

    ... Z INDEX | OOH SITE MAP | EN ESPAÑOL Healthcare > Dental Assistants PRINTER-FRIENDLY EN ESPAÑOL Summary What They ... of workers and occupations. What They Do -> What Dental Assistants Do About this section Assistants prepare and ...

  4. Surgical Assisting

    Science.gov (United States)

    ... Insert and remove Foley urinary bladder catheter Place pneumatic tourniquet Confirm procedure with surgeon Drape patient within ... Technology and Surgical Assisting (NBSTSA) offers the CertifiedSurgical First Assistant (CSFA) credential, and the National Surgical Assistant ...

  5. Developments in Public Accounting in Portugal

    Directory of Open Access Journals (Sweden)

    Maria José da Silva Fernandes

    2009-12-01

    Full Text Available In Portugal we are assisting, since the nineties, to the reform of all public accounting, having as main innovations the utilization of double entry system and the obligatoryness to implement three accounting systems: budget accounting, patrimonial and cost accounting. In the systems of patrimonial and cost accounting, it will be used the accrual systems. The publication of the first Public Accounting Plan (POCP in 1997 identifies the change from a traditional public accounting, which main objective was the execution and budgetary control to a modern public accounting with economical, financial and patrimonial information that serves as basis to the decision making and to the evaluation of public entities concerning the efficient, effective utilization and economy of the public resources, contributing, this way, to the implementation of the New Public Management. The objective of this work has two perspectives: to describe and analyze the situation in Portugal concerning the public accounting reform and to present some results consequent to twelve years of implementation.

  6. Geothermal direct-heat utilization assistance

    Science.gov (United States)

    The report summarizes activities of the Geo-Heat Center (GHC) at Oregon Institute of Technology for the first quarter of Fiscal Year 1995. It describes contacts with parties during this period related to assistance with geothermal direct heat projects. Areas dealt with include geothermal heat pumps, space heating, greenhouses, aquaculture, resources and equipment. Research is also being conducted on geothermal energy cost evaluation, low-temperature geothermal resource assessment, use of silica waste from the Cerro Prieto geothermal field as construction materials and geothermal heat pumps. Outreach activities include the publication of a quarterly bulletin on direct heat applications and dissemination of information on low-temperature geothermal resources and utilization.

  7. Cross-sectional study of morbidity, morbidity-associated factors and cost of treatment in Ngaoundere, Cameroon, with implications for health policy in developing countries and development assistance policy

    Directory of Open Access Journals (Sweden)

    Holtedahl Knut

    2002-04-01

    Full Text Available Abstract Background In a population-based epidemiological study in Ngaoundere, Cameroon, we studied cross-sectional child morbidity and the cost of necessary investigation and treatment. Methods Three teams of two to three health workers visited haphazardly selected households in all major housing quarters. We asked permission to enter for a health survey. Children with cough, fever or weight loss as well as sick adults were offered free-of-charge local hospital examination and treatment. Results From 177 households with 1777 persons, 51 (2.9% persons were referred. Thirty-five of them had an undiagnosed disease threatening individual health and in many cases also public health. Seven were hospitalised, including three adults with tuberculosis. Malnutrition was diagnosed in nine small children. Four patients had AIDS, seven had malaria. Average total cost for ambulant patients was 15 USD, for hospitalised patients 110 USD. In the households, almost half of the women 16–50 years of age had no schooling. Two per cent of women and nine per cent of men were daily smokers. Coughing children were more likely than non-coughing children to live in a household with at least one smoker (OR = 3.58, 95% CI 1.72 to 7.46, and they generally lived in more poor households (P = 0.018. Twelve of 16 children with weight loss were referred from households with a high poverty score. Conclusions Adult smoking and poverty affect children's health. The cost of hospitalisation or long-lasting therapy is beyond the means of most ordinary families. Diseases with severe consequences for public health, like tuberculosis, AIDS and malaria should have national programs with free, decentralised examination and treatment. Access to generic drugs is important. A major educational effort is needed to improve public health.

  8. [Cost-effectiveness of the clinical treatment of Grave's disease in a public University Hospital: a retrospective analysis and prospective projection for a therapeutic approach].

    Science.gov (United States)

    Lima, Nicolau; Knobel, Meyer; Camargo, Rosalinda Y; Tomimori, Eduardo; Medeiros-Neto, Geraldo

    2005-08-01

    The aim of the present study was to evaluate a new proposal for increasing compliance to the clinical management of patients with Graves' disease (GD) in a large and public University Hospital. The patients were carefully selected (no previous GD treatment, goiter volume less than 6 mL must be living in the metro area of São Paulo), received medication at no cost, were contacted frequently by the social worker and alerted for the date of consultation and only referred to a single endocrinologist during all phases of treatment. We recruited 229 patients with GD that were initially treated with methimazole (MMI--60 mg q.d) in a single daily dose followed by a combination of MMI (20 mg) plus L-T4 (100 microg) daily for 24 months. Only 83 patients (36.2%) completed the protocol and were subdivided in: Group 1 (n= 34) that were in remission for 3 years after discontinuation of the MMI and Group 2 (n= 49) that presented recurrence of GD between 2 and 36 months without MMI. Predictive factors associated with remission were: decrease of the glandular volume, serum TG< 40 ng/mL and normal TRAb values. We concluded that in spite of a careful protocol planned to increase compliance, more than 60% of patients with GD did not complete the therapeutic trial and were referred for radioiodine treatment. The solution for this low therapeutic success for GD should be the possible identification of factors that would indicate patients that are not inclined to follow a long period of clinical therapy.

  9. 44 CFR 204.63 - Allowable costs.

    Science.gov (United States)

    2010-10-01

    ... HOMELAND SECURITY DISASTER ASSISTANCE FIRE MANAGEMENT ASSISTANCE GRANT PROGRAM Grant Administration § 204... will reimburse direct costs for the administration of a fire management assistance grant under 44 CFR part 13. (b) We will reimburse indirect costs for the administration of a fire management...

  10. 42 CFR 50.209 - Use of Federal financial assistance.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Use of Federal financial assistance. 50.209 Section 50.209 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS POLICIES....209 Use of Federal financial assistance. (a) Federal financial assistance adminstered by the Public...

  11. 34 CFR 300.105 - Assistive technology.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false Assistive technology. 300.105 Section 300.105 Education... DISABILITIES State Eligibility Other Fape Requirements § 300.105 Assistive technology. (a) Each public agency must ensure that assistive technology devices or assistive technology services, or both, as those terms...

  12. Gestão de custos aplicada a hospitais universitários públicos: a experiência do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da USP Cost management applied to public university hospitals

    Directory of Open Access Journals (Sweden)

    Carlos Alberto Grespan Bonacim

    2010-08-01

    Full Text Available Este artigo apresenta a experiência de implantação da metodologia de custos baseada em atividades (ABC do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, por meio de um estudo de caso, num período de cinco anos. As características dos hospitais universitários de alta tecnologia, tais como atividades docente-assistenciais e serviços básicos de saúde, fazem com que seus custos sejam mais elevados do que os de hospitais não universitários. Na sua trajetória institucional, o HCFMRP-USP não possuía uma metodologia consistente de mensuração e avaliação dos custos de sua atividade assistencial. No entanto, dificuldades de financiamento de suas atividades, associadas a uma completa reestruturação em seu modelo de atendimento vinculado ao Sistema Único de Saúde, impulsionaram a adoção do mapeamento de custos por atividades, para demonstrar, de forma adequada, como pode ser mensurado o impacto do ensino nos custos assistenciais, visto que a agenda democrática nacional tem reivindicado transparência, accountability e, fundamentalmente, eficiência na gestão dos recursos públicosThis paper presents the experience of implementing the methodology of cost-based activities (ABC at The Ribeirão Preto Medical School Clinics Hospital of the University of São Paulo (HCFMRP-USP, through a case study over a period of five years. Characteristics of high technology university hospitals, such as teaching and assistance, make their costs higher than those of non-university hospitals. In its institutional history, HCFMRP-USP lacked a consistent methodology for measuring and assessing the costs of its assistance activities. However, difficulties in financing these activities, associated with a complete restructuring in the hospital's healthcare model linked to the National Health System, have furthered the adoption of cost mapping, in order to assess adequately the impact of teaching activities

  13. 财政法的经济学根基——交易成本公共物品理论的提出%Economic Roots of Fiscal Law Proposal of Transaction-cost Public-goods Theory

    Institute of Scientific and Technical Information of China (English)

    邢会强

    2012-01-01

    Traditionally, studies of public finance and fiscal law hold that the necessity of public finance is justified by the theory of externality and the derived traditional public goods theory. Meanwhile, the transaction-cost public-goods theory maintains that economic roots of public finance lie not in externality, but in transaction costs of externality. The government is expected to provide public goods at a lower transaction cost and the purpose of provi- ding public goods is to reduce transaction costs of the whole society. Thus, the major function of public finance and fiscal law should be to cut down transaction costs of the entire society, but not the dogmatic "public goods providing". Monopoly has been covered under the excuse that "private individuals are not willing to provide public goods", which led to the increase of transaction costs of public goods. Therefore, when deciding the provider of certain public goods, the government is suggested to take into consideration the questions as follows: Should this type of public goods be provided by private individuals or the government? Which approach can better reduce the transaction costs? How can the government cut down the transaction costs?%传统上,财政学和财政法均认为财政存在的必要性在于外部性理论以及在此基础上提出的传统公共物品理论。而交易成本公共物品理论则主张,财政法的经济学根基不在于外部性,而在于解决外部性的交易成本的高低。政府应以更低的交易费用来提供公共物品,提供公共物品的目的是为了降低整个社会的交易费用。财政和财政法的主要职能是降低整个社会的交易费用,而不是所谓的教务式的“提供公共物品”。借“私人不愿提供公共物品”之名而行垄断之实,其结果往往导致该物品的交易费用增加。因此,在决定一类物品由谁提供时,政府应该这样思考:该物品由私人提供

  14. Cost Estimating Handbook for Environmental Restoration

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1990-09-01

    Environmental restoration (ER) projects have presented the DOE and cost estimators with a number of properties that are not comparable to the normal estimating climate within DOE. These properties include: An entirely new set of specialized expressions and terminology. A higher than normal exposure to cost and schedule risk, as compared to most other DOE projects, due to changing regulations, public involvement, resource shortages, and scope of work. A higher than normal percentage of indirect costs to the total estimated cost due primarily to record keeping, special training, liability, and indemnification. More than one estimate for a project, particularly in the assessment phase, in order to provide input into the evaluation of alternatives for the cleanup action. While some aspects of existing guidance for cost estimators will be applicable to environmental restoration projects, some components of the present guidelines will have to be modified to reflect the unique elements of these projects. The purpose of this Handbook is to assist cost estimators in the preparation of environmental restoration estimates for Environmental Restoration and Waste Management (EM) projects undertaken by DOE. The DOE has, in recent years, seen a significant increase in the number, size, and frequency of environmental restoration projects that must be costed by the various DOE offices. The coming years will show the EM program to be the largest non-weapons program undertaken by DOE. These projects create new and unique estimating requirements since historical cost and estimating precedents are meager at best. It is anticipated that this Handbook will enhance the quality of cost data within DOE in several ways by providing: The basis for accurate, consistent, and traceable baselines. Sound methodologies, guidelines, and estimating formats. Sources of cost data/databases and estimating tools and techniques available at DOE cost professionals.

  15. Evaluation of the TSC Dolphin Computer Assisted Instructional System in the Chapter 1 Program of the District of Columbia Public Schools. Final Report 85-9.

    Science.gov (United States)

    Harris, Carolyn DeMeyer; And Others

    Dolphin is a computer-assisted instruction system used to teach and reinforce skills in reading, language arts, and mathematics. An evaluation of this system was conducted to provide information to TSC Division of Houghton Mifflin regarding its effectiveness and possible modifications to the system. The general design of the evaluation was to…

  16. Expanding Technical Assistance Consultation to Public Schools: District-Wide Evaluation of Instructional and Behavior Support Practices for Students with Developmental Disabilities.

    Science.gov (United States)

    Putnam, Robert F.; Luiselli, James K.; Jefferson, Gretchen, L.

    2002-01-01

    Describes consultation to a public school district in the form of a systems-wide evaluation of instructional and behavior support practices for students with developmental disabilities. The format of the evaluative model, respective findings, suggested remedies, and implications for large-scale public school consultation are provided. (Contains 22…

  17. Renewable Energy Cost Modeling: A Toolkit for Establishing Cost-Based Incentives in the United States; March 2010 -- March 2011

    Energy Technology Data Exchange (ETDEWEB)

    Gifford, J. S.; Grace, R. C.; Rickerson, W. H.

    2011-05-01

    This report is intended to serve as a resource for policymakers who wish to learn more about establishing cost-based incentives. The report will identify key renewable energy cost modeling options, highlight the policy implications of choosing one approach over the other, and present recommendations on the optimal characteristics of a model to calculate rates for cost-based incentives, feed-in tariffs (FITs), or similar policies. These recommendations will be utilized in designing the Cost of Renewable Energy Spreadsheet Tool (CREST). Three CREST models will be publicly available and capable of analyzing the cost of energy associated with solar, wind, and geothermal electricity generators. The CREST models will be developed for use by state policymakers, regulators, utilities, developers, and other stakeholders to assist them in current and future rate-setting processes for both FIT and other renewable energy incentive payment structures and policy analyses.

  18. CONSIDERING PEER ASSISTED LEARNING METHODS IN NEW ZEALAND’S SPECIAL NEEDS EDUCATION SECTOR

    Directory of Open Access Journals (Sweden)

    Donna IYER

    2011-09-01

    Full Text Available With the cuts to the public spending in the education sector extending to even students with special needs, the early childhood education sector and the public school system in New Zealand are under significant financial pressure. Elsewhere in the world, peer assisted learning methods have been identified as cost effective instruments with proven efficacy in improving the educational and social outcomes of children with disabilities. In New Zealand, peer assisted learning methods have been relatively slow on the uptake. The aim of this paper is to suggest peer assisted learning methods that can be potentially considered and utilised by the New Zealand’s early childhood education sector to support students with special needs. Based on a review of the international literature, peer tutoring and cross-age tutoring methods appear viable options. It is observed that peer assisted learning methods can complement conventional teaching methods.

  19. Identification of blood culture isolates directly from positive blood cultures by use of matrix-assisted laser desorption ionization-time of flight mass spectrometry and a commercial extraction system: analysis of performance, cost, and turnaround time.

    Science.gov (United States)

    Lagacé-Wiens, Philippe R S; Adam, Heather J; Karlowsky, James A; Nichol, Kimberly A; Pang, Paulette F; Guenther, Jodi; Webb, Amanda A; Miller, Crystal; Alfa, Michelle J

    2012-10-01

    Matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry represents a revolution in the rapid identification of bacterial and fungal pathogens in the clinical microbiology laboratory. Recently, MALDI-TOF has been applied directly to positive blood culture bottles for the rapid identification of pathogens, leading to reductions in turnaround time and potentially beneficial patient impacts. The development of a commercially available extraction kit (Bruker Sepsityper) for use with the Bruker MALDI BioTyper has facilitated the processing required for identification of pathogens directly from positive from blood cultures. We report the results of an evaluation of the accuracy, cost, and turnaround time of this method for 61 positive monomicrobial and 2 polymicrobial cultures representing 26 species. The Bruker MALDI BioTyper with the Sepsityper gave a valid (score, >1.7) identification for 85.2% of positive blood cultures with no misidentifications. The mean reduction in turnaround time to identification was 34.3 h (P blood cultures and 26.5 h in a more practical setting where conventional identification or identification from subcultures was required for isolates that could not be directly identified by MALDI-TOF. Implementation of a MALDI-TOF-based identification system for direct identification of pathogens from blood cultures is expected to be associated with a marginal increase in operating costs for most laboratories. However, the use of MALDI-TOF for direct identification is accurate and should result in reduced turnaround time to identification.

  20. Review of the safety, efficacy, costs and patient acceptability of recombinant follicle-stimulating hormone for injection in assisting ovulation induction in infertile women

    Directory of Open Access Journals (Sweden)

    Marleen Nahuis

    2009-11-01

    Full Text Available Marleen Nahuis1,2,3, Fulco van der Veen1, Jur Oosterhuis2, Ben Willem Mol1, Peter Hompes3, Madelon van Wely11Center for Reproductive Medicine, Department of Obstetrics and Gynaecology (H4-205, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; 2Department of Obstetrics and Gynaecology, Medisch Spectrum Twente, Enschede, The Netherlands; 3Department of Obstetrics and Gynaecology, Free Medical University, Amsterdam, The NetherlandsAbstract: Anovulation is a common cause of female subfertility. Treatment of anovulation is aimed at induction of ovulation. In women with clomiphene-citrate resistant WHO group II anovulation, one of the treatment options is ovulation induction with exogenous follicle-stimulating hormone (FSH or follitropin. FSH is derived from urine or is produced as recombinant FSH. Two forms of recombinant FSH are available – follitropin alpha and follitropin beta. To evaluate the efficacy, safety, costs and acceptability of recombinant FSH, we performed a review to compare recombinant FSH with urinary-derived FSH products. Follitropin alpha, beta and urinary FSH products appeared to be equally effective in terms of pregnancy rates. Patient safety was also found to be comparable, as the incidence of side effects including multiple pregnancies was similar for all FSH products. In practice follitropin alpha and beta may be more convenient to use due to the ease of self-administration, but they are also more expensive than the urinary products.Keywords: follitropin apha, follitropin beta, urinary gonadotropins, polycystic ovary syndrome

  1. Fast microwave-assisted preparation of a low-cost and recyclable carboxyl modified lignocellulose-biomass jute fiber for enhanced heavy metal removal from water.

    Science.gov (United States)

    Du, Zhaolin; Zheng, Tong; Wang, Peng; Hao, Linlin; Wang, Yanxia

    2016-02-01

    A low-cost and recyclable biosorbent derived from jute fiber was developed for high efficient adsorption of Pb(II), Cd(II) and Cu(II) from water. The jute fiber was rapidly pretreated and grafted with metal binding groups (COOH) under microwave heating (MH). The adsorption behavior of carboxyl-modified jute fiber under MH treatment (CMJFMH) toward heavy metal ions followed Langmuir isotherm model (R(2)>0.99) with remarkably high adsorption capacity (157.21, 88.98 and 43.98mg/g for Pb(II), Cd(II) and Cu(II), respectively). Also, CMJFMH showed fast removal ability for heavy metals in a highly significant correlation with pseudo second-order kinetics model. Besides, CMJFMH can be easily regenerated with EDTA-2Na solution and reused up to at least four times with equivalent high adsorption capacity. Overall, cheap and abundant production, rapid and facile preparation, fast and efficient adsorption of heavy metals and high regeneration ability can make the CMJFMH a preferred biosorbent for heavy metal removal from water.

  2. Conflicts of assisted reproduction in the public sphere: an analysis in the agenda-setting on the television program Fantastico/Globo TV

    Directory of Open Access Journals (Sweden)

    Alba Lívia Tallon Bozi

    2012-07-01

    Full Text Available This article intends to analyse the role of massmedia in structuring the discussions in society about the advances in biotechnology and the possibilities of intervention in human reproduction. It analyzes the agenda-setting of the matter in the television program Fantastico, Globo TV, that motivated the public to comment about the right of the maternity in cases of egg donation and replacement uterus. The article indicates the complexity of the relationship of the public and private routing of personal conflicts but related to moral and ethical issues of the society, they need, because it, a broad and pluralistic debate in the public sphere.

  3. “成本—收益”视角下公共参与的影响因素分析%The influence factors of public participation in the"Cost-Benefit" perspective

    Institute of Scientific and Technical Information of China (English)

    杨涛

    2012-01-01

    Public participation is of great significance for improving the performance of social governance. Whether the actors choose to participate in public affairs and how they are motivated depend on how actors understand, judge and calculate the cost and benefits of public participation. The costs of public participation consist of those of material, opportunity, transaction, negative psychological experience, transferred cost due to others ~ not choosing participation, risks in participation as well as not choosing participation and quitting participation. The benefits involve those of material, reproduction of public products and the positive experience of participation as well. And the influence factors include remedy, acknowledgement, efficiency, free-riding, selective motivation, community social capital, and the institutionalization and organization of public participation. If we want to analyze public participation, the framework of "cost-benefit" ought to be combined with the factors affecting public participation.%公共参与对于社会治理绩效的提升具有重要的意义。行动者是否选择参与及其参与动力的高低,取决于行动者对参与成本与参与收益的解读、计算和比较。参与成本包括物质成本、机会成本、交易成本、负面的心理体验、他人不参与而被转移的成本、参与中所承受的参与风险以及"不参与成本"和退出参与的成本。参与收益包括物质上的收益、公共产品的再生产以及对参与过程本身的积极体验。公共参与的影响因素有参与补偿、参与认知与参与效能感、搭便车、选择性激励、共同体社会资本以及参与的制度化和组织化。对公共参与的分析,需要将"成本—收益"的分析框架和公共参与的影响因素结合起来。

  4. A psicologia nos centros de referência de assistência social (CRAS: um panorama das publicações científicas brasileiras de 2004 a 2014 / Psychology in social assistance reference centers (CRAS: a review in brazilian scientific publications between 2004 and 2014

    Directory of Open Access Journals (Sweden)

    Roberta Fin Motta

    2015-12-01

    Full Text Available RESUMO O artigo apresenta uma revisão narrativa de estudos sobre a publicação em periódicos da área da Psicologia a respeito da presença dos (as psicólogos (as no campo da Assistência Social, com ênfase na sua relação com Centros de Referências de Assistência Social (CRAS. A pesquisa realizou-se entre os meses de Agosto de 2014 a Maio de 2015, com consulta às bases de dados bibliográficos eletrônicos da BVS - Psi e da CAPES, no período de 2004 a 2014. Usou-se as palavras-chave: «Centro de Referência de Assistência Social», associadas ao descritor psicologia, totalizando 20 textos selecionados. Percebe-se o envolvimento e o investimento que têm sido feitos na área em relação a esta temática nos últimos anos. Além disso, a Assistência Social tem colaborado para a expansão e interiorização da profissão e o desenvolvimento de diferentes práticas das tradicionais, contudo, a clínica tradicional responde a demandas que extrapolam as atribuições do CRAS.ABSTRACT The article presents a narrative review of studies about publications in psychology journals with regard to the presence of psychologists in the Social Assistance field, with emphasis on its relationship with the Social Assistance Reference Centers (CRAS. The research was conducted between the months of August 2014 to May 2015, consulting electronic bibliographic databases from BVS-Psi and CAPES, during the period 2004-2014. We used the keywords «Social Assistance Reference Center», associated with the psychology descriptor – in total 20 selected texts. Development and investment that has been made in recent years is perceived in the area related to this topic. In addition, social assistance has contributed to the expansion and assimilation of the profession, and the development of different traditional practices; however, the traditional clinic responds to the demands that extrapolates the powers of the CRAS.

  5. Quality Computer Assisted Mobile Learning (CAML) and Distance Education Leadership in Managing Technology Enhanced Learning Management System (TELMS) in the Malaysian Public Tertiary Education

    OpenAIRE

    Lee Tan Luck

    2009-01-01

    Abstract - The success in the implementation of a quality computer assisted mobile learning and distance education in a Technology Enhanced Learning Management System is highly rely on the academic leadership in managing and application of Information and Communication Technology (ICT) in the tertiary level. The effectiveness of its leadership, knowledge, application and management of ICT and learning management system is of utmost important. Successful application and management includes qua...

  6. Assistance Focus: Africa

    Energy Technology Data Exchange (ETDEWEB)

    2017-05-18

    The Clean Energy Solutions Center, an initiative of the Clean Energy Ministerial, helps countries throughout the world create policies and programs that advance the deployment of clean energy technologies. Through the Solutions Center's no-cost Ask an Expert service, a team of international experts has delivered assistance to countries in all regions of the world, including Africa.

  7. Cost Accounting of Public Hospitals from the Perspective of Activity-Based Costing%作业成本法视角下医院成本核算问题分析

    Institute of Scientific and Technical Information of China (English)

    朱梦嘉

    2016-01-01

    在竞争日渐激烈的市场环境下,医院要具备较强的竞争力,必须要加强成本管理,建立更合理、更科学、更具有可操作性的新的成本核算方法。作为更科学、更准确的核算方式,作业成本法不但能够适应医院的自身业务特征,同时还能满足成本核算中不断发展的要求。医院在实施作业成本法时应遵循成本效益原则和具体适用的原则,使用全面引进和局部分步实施的方法,力求保证平稳衔接,满足管理者需求,逐步推进。医院全体职工参与其中,确定成本核算目标,遵守成本效益的原则,这样在实际应用中,作业成本法才能发挥出它真正的优势。%Facing the market with increasingly fierce competition, hospitals need to improve the competitiveness by enhancing cost man-agement and create more reasonable, scientific and operable cost accounting method. As a more scientific and accurate accounting method, activity-based costing could not only adapt to the service characteristics of hospitals, but also meet the developmental demand of cost ac-counting. When carrying out activity-based costing, hospitals should abide by the cost-effective principle and applicative principle with both overall introduction and step-by-step implementation in ways that ensure stable connection and meet the demand of management. The staff of hospitals should participate in the cost accounting, determine the target of cost accounting, comply with the cost-benefit principle. In so doing, activity-based costing could exert its real strength in practices.

  8. Audiology Assistants in Private Practice.

    Science.gov (United States)

    Hamill, Teri A; Andrews, Julia P

    2016-11-01

    Using audiology assistants allows a practice to meet the expected increase in patient demand in a cost-effective manner, without compromise to quality of patient care. Assistants are particularly valuable in private practice settings that have an emphasis in amplification, as many of the tasks involved do not require the unique skills of the doctor of audiology. Regulatory considerations, methods of training, and scope of practice of the assistant are discussed.

  9. Cost-effectiveness of using Quantiferon Gold (QFT-G)® versus tuberculin skin test (TST) among U.S. and foreign born populations at a public health department clinic with a low prevalence of tuberculosis.

    Science.gov (United States)

    Iqbal, Ayesha Z; Leighton, Jenelle; Anthony, John; Knaup, Richard C; Peters, Eleanor B; Bailey, Thomas C

    2014-01-01

    The purpose of this study was to determine the cost benefit to routinely using QFT-G versus the standard TST for screening U.S. and foreign born populations at a public health department clinic with a low prevalence of tuberculosis. A comparative cost analysis of the monetization between QFT-G and TST was conducted: Data from the health department's Chest Clinic patients seen in 2007 were used to model cost predictions. The net costs of screening, x-rays, the standard 9 months of latent tuberculosis infection treatment, laboratory, and administration for U.S. born patients and foreign born patients were investigated. There are no apparent cost savings for U.S. born individuals, but due to the higher specificity of QFT-G for foreign born BCG-vaccinated individuals, there are unnecessary expenditures associated with the higher number of false positives incurred when using TST compared with QFT-G on 1,000 foreign born individuals (69%, 18%). QFT-G is cost-effective and should be used at local health department clinics that want to achieve savings in screening and treating those suspected of having TB infection, especially for high-risk populations such as foreign born individuals. © 2013 Wiley Periodicals, Inc.

  10. Cost impact assessment of cost accounting practice changes

    OpenAIRE

    Anderson, James S.

    1980-01-01

    Approved for public release; distribution unlimited This thesis represents the results of research on cost impact assessment of cost accounting practice changes to Cost Account Standards- covered contracts. The objectives of the research were to explore the current environment in which cost impact is measured and to develop a structured approach to aid the decision-maker in the assessment. The requirements of the Cost Accounting Standards and Administration of Cost Accoun...

  11. Zika virus and Assisted Reproductive Technology: to test or not to test, that is the question. Is it an unnecessary cost? The first two months of mandatory testing in an outbreak area in Rio de Janeiro, Brazil.

    Science.gov (United States)

    Souza, Maria do Carmo B de; Raupp, Veronica; Sobrinho, Fernanda; Menezes, Mariana; Panaino, Tatiana R; Tamm, Maria A; Mancebo, Ana C A; Costa, Ana L R; Antunes, Roberto A

    2016-12-01

    Infection by the Zika virus is a Public Health Emergency of International Concern as defined by the World Health Organization. Resolution no. 72, issued by the Collegiate Board of the Brazilian Health Surveillance Agency (ANVISA) on March 30, 2016, made ZKV testing mandatory prior to procedures involving germ cells and tissues. This paper aims to discuss the aforementioned Resolution from the standpoint of evidence and cost-effectiveness of the measures taken within the first two months of mandatory testing. The medical staff at the clinic looked into the steps needed to comply with the new rules and checked laboratories in the city to perform the tests with their lead times and costs, health insurance refunds, data maintenance capabilities, how to contact patients, decision-making processes in ongoing cases, deadlines for implementation, in addition to exchanging ideas with other clinics and gathering information from the guidelines being produced. A SWOT analysis was performed. A total of 152 tests were performed within the first two months of mandatory testing, in five different clinical situations: one previously symptomatic woman with a negative PCR test before starting the cycle; two asymptomatic women had positive IgM (1.3%) and negative PCR tests on days 25 and 60; one husband enrolled as a suspect with a negative RT-PCR on day 13 and another untested suspected case; a couple decided to have their oocytes cryopreserved because the husband's test result was not available on pickup day. The mean cost of USD 200 per couple is equivalent to 1.2 day of the stimulation protocol. The staff worked more efficiently and was able to respond promptly to the increased demand for ZKV testing; however, the tests failed to reassure patients of the safety of the procedure and increased costs. The testing requirement for asymptomatic patients prior to ART should be reviewed.

  12. Comparative health technology assessment of robotic-assisted, direct manual laparoscopic and open surgery: a prospective study

    OpenAIRE

    Turchetti, Giuseppe; Pierotti, Francesca; Palla, Ilaria; Manetti, Stefania; Freschi, Cinzia; Ferrari, Vincenzo; Cuschieri, Alfred

    2016-01-01

    Background Despite many publications reporting on the increased hospital cost of robotic-assisted surgery (RAS) compared to direct manual laparoscopic surgery (DMLS) and open surgery (OS), the reported health economic studies lack details on clinical outcome, precluding valid health technology assessment (HTA). Methods The present prospective study reports total cost analysis on 699 patients undergoing general surgical, gynecological and thoracic operations between 2011 and 2014 in the Italia...

  13. Cost-effectiveness analysis of introducing RDTs for malaria diagnosis as compared to microscopy and presumptive diagnosis in central and peripheral public health facilities in Ghana

    DEFF Research Database (Denmark)

    Ansah, Evelyn K; Epokor, Michael; Whitty, Christopher J M

    2013-01-01

    Cost-effectiveness information on where malaria rapid diagnostic tests (RDTs) should be introduced is limited. We developed incremental cost-effectiveness analyses with data from rural health facilities in Ghana with and without microscopy. In the latter, where diagnosis had been presumptive......, the introduction of RDTs increased the proportion of patients who were correctly treated in relation to treatment with antimalarials, from 42% to 65% at an incremental societal cost of Ghana cedis (GHS)12.2 (US$8.3) per additional correctly treated patients. In the "microscopy setting" there was no advantage...

  14. Assistive Technology

    Science.gov (United States)

    ... Page Resize Text Printer Friendly Online Chat Assistive Technology Assistive technology (AT) is any service or tool that helps ... be difficult or impossible. For older adults, such technology may be a walker to improve mobility or ...

  15. Accessibility and assistive products

    Science.gov (United States)

    Rodríguez-Porrero, Cristina

    2009-01-01

    Introduction Accessibility and assistive products and technologies are needed to ensure the rights of persons with disabilities and older persons. Many developments have been implemented in laws, standards, markets and from the consumers perspective, at international, European and national levels. The real issue is that not all the potential users benefit from the use of assistive products or accessible measures. Discussion Innovative methods are needed to allow all potential users to have real advantage of assistive technologies and accessible and design for all facilities. Best practices will be presented and existing gaps and recommendations will be discussed. Cost-benefits aspects will also be presented. Conclusion In order to get advantages from opportunities of globalization, hard work and responsibilities of all stakeholders are needed, so that assistive products and accessibility reach a whole range of situations and environments and contribute to ensure quality of life in a society for all.

  16. Cost-outcome analysis of joint replacement: evidence from a Spanish public hospital Análisis coste-resultado del remplazo de articulaciones: Evidencia de un hospital público español

    Directory of Open Access Journals (Sweden)

    José Luis Navarro Espigares

    2008-08-01

    Full Text Available Background and objectives: Efficiency-based healthcare decision-making has been widely accepted for some time, with cost per quality-adjusted life year (QALY as the main outcome measure. Nevertheless, for numerous medical procedures, little data are available on the cost per QALY gained. The aim of the present study was to calculate the cost per QALY gained with primary hip and knee replacement and to compare the result with the cost per QALY for other medical procedures, as well as with the maximum threshold cost considered acceptable in Spain. Methods: We performed a prospective cohort pre-test/post-test study of patients undergoing primary hip or knee arthroplasty. Age, sex, and clinical variables were recorded. Functional status and quality of life were measured by means of the WOMAC and EuroQol instruments, respectively, before the intervention and 6 months later. The direct costs of the intervention were calculated, with length of hospital stay and the prosthesis as the main cost drivers. Results: A total of 80 patients, 40 from each intervention, were included in this study. Both functional and perceived health status improved after the intervention. The number of QALYs gained in the knee cohort was 4.64, while that in the hip cohort was 0.86. The total cost of knee replacement was lower (6,865.52 € than that of hip replacement (7,891.21 €. The cost per QALY gained was 1,275.84 € and 7,936.12 € for knee and hip interventions, respectively. The calculations performed included a 6% discount rate for health outcomes, a 3% inflation rate for costs, and a success rate of 95% at 15 years. Conclusions: The costs of both knee and hip replacement were lower than the threshold of 30,000 € per QALY considered acceptable in Spain, and compared favorably with other medical and surgical procedures.Fundamento y objetivos: Está ampliamente aceptada la toma de decisiones sanitarias basada en la eficiencia, con el coste por año de vida ajustado

  17. 公立医院成本核算制度问题思考及改进建议%Recommendations on a better cost accounting system for public hospitals

    Institute of Scientific and Technical Information of China (English)

    李卫平; 高一红; 陈宇峰; 马伊芳; 陈希; 戎莉; 周皎; 周海平

    2016-01-01

    系统梳理公立医院成本核算内容及相关概念,深入研究公立医院成本核算制度存在的问题,提出对公立医院成本核算制度的改进建议。一方面为政府会计准则中相关成本费用准则的制定提供参考,另一方面也为公立医院改善成本核算方法、提高成本核算效率、准确性和及时性提供制度基础。同时提出公立医院成本核算结果更好地在医院管理、政府定价和社保支付方面应用的政策建议。%This paper made an intensive study on existing problems of the current public hospital cost accounting system and proposed amendments by sorting out cost accounting′s content and related concepts.The application value of this paper is,on one hand,to provide a reference for the formulation of cost and expense standards in government accounting standards,and on the other hand,to better its cost accounting method,and to lay system foundation for increasing accuracy efficiency and timeliness of cost accounting.And corresponding proposals were offered to make public hospitals′cost accounting results better applied in hospital management,government pricing and social insurance payment.

  18. Assistive Technologies

    Science.gov (United States)

    Auat Cheein, Fernando A., Ed.

    2012-01-01

    This book offers the reader new achievements within the Assistive Technology field made by worldwide experts, covering aspects such as assistive technology focused on teaching and education, mobility, communication and social interactivity, among others. Each chapter included in this book covers one particular aspect of Assistive Technology that…

  19. How much does curation cost?

    Science.gov (United States)

    Karp, Peter D

    2016-01-01

    NIH administrators have recently expressed concerns about the cost of curation for biological databases. However, they did not articulate the exact costs of curation. Here we calculate the cost of biocuration of articles for the EcoCyc database as $219 per article over a 5-year period. That cost is 6-15% of the cost of open-access publication fees for publishing biomedical articles, and we estimate that cost is 0.088% of the cost of the overall research project that generated the experimental results. Thus, curation costs are small in an absolute sense, and represent a miniscule fraction of the cost of the research.

  20. Public synthesis of the reference costs study of the electric power production; Synthese publique de l'etude des couts de reference de la production electrique

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2008-07-01

    Every 3 or 5 years, the DGEC published the reference costs study of the electric power production which evaluates, in a theoretical framework, the total cost of an electrical MWh, from different production ways. These studies bring information for the definition of the energy policy and the elaboration of the investments program. because of the great competition of the market, it was decided not to publish the absolute value of the hypothesis and the results but under indexed form. (A.L.B.)