WorldWideScience

Sample records for publication pagination cost

  1. Pagine di storia linguistica Istrianas VII

    Directory of Open Access Journals (Sweden)

    Franco Crevatin

    1979-12-01

    Full Text Available Nella prima di queste Pagine (= "Bollettino del Centro per lo Studio dei Dialetti Veneti dell'Istria" 2, 1973-74, pp.31-42 è stato toccata quello che a mio avviso è un argomento di grossa rilevanza storica, ossia la presenza in Istria. dei Lon­ gobardi e la loro incidenza linguistico-culturale: ivi discu­ tevo uno di tali riflessi linguistici (plovīna "aratro asim­ metrico "; ora credo di poter riaprire il discorso più gene­ rale introducendo un nuovo elemento di giudizio.

  2. 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

  3. 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…

  4. 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…

  5. 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…

  6. 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...

  7. 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

  8. Frammenti di un rito mutilato. Analisi di "Pagine di gloria" di Valentino Zeichen

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    Mattia Jacopo Majerna

    2016-07-01

    Full Text Available Il presente articolo intende analizzare una delle raccolte centrali della produzione di Valentino Zeichen, Pagine di gloria (1983, nel tentativo di offrire spunti critici per un suo inquadramento nella scena poetica più recente. Si concentra, dapprima, sulla fisionomia eteroclita dell’io poetante, che, in controtendenza rispetto alle esperienze poetiche coeve, riveste un ruolo d’indiscussa centralità, cui corrisponde, nella prassi versificatoria, un impianto saldamente monologico. Si procede, quindi, alla ricerca delle costanti figurative che paiono fondare la poesia di Zeichen e che permettono l’accesso al cuore del suo immaginario. In tal senso ci si soffermerà su alcuni aspetti linguistici salienti di Pagine di gloria, con particolare attenzione all’impiego dei tecnoletti in sede di metafora, per passare, poi, alle ricorrenze più propriamente figurative, come l’iconografia classicheggiante o metafisica e le immagini di derivazione economica.

  9. 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

  10. 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....

  11. 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....

  12. 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...

  13. 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...

  14. 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

  15. 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.

  16. 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…

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. 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...

  5. 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…

  6. 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.

  7. 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)

  8. 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...

  9. 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.

  10. 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...

  11. 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.

  12. 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…

  13. 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

  14. 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...

  15. 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...

  16. 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 ...

  17. 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.

  18. 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.

  19. 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...

  20. 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…

  1. 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.

  2. 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.

  3. 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.

  4. 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...

  5. 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....

  6. 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

  7. 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...

  8. 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.

  9. 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.

  10. 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

  11. 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

  12. 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

  13. 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.

  14. 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...

  15. 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

  16. 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.

  17. 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...

  18. 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.

  19. [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.

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. [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.

  5. 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.

  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. 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.

  9. 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.

  10. 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…

  11. 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.

  12. 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

  13. 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.

  14. 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...

  15. 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…

  16. 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.

  17. 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...

  18. 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...

  19. 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.

  20. 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.

  1. 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

  2. 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.

  3. 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

  4. 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

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. 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,...

  11. 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...

  12. 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

  13. 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.

  14. [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.

  15. 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.

  16. 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.

  17. 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.

  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. 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.

  1. 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.

  2. Kirsten Fudeman, Aaron Lawson, Carol Rosen and Devon Strolovitch (Editors, Cornell Working Papers in Linguistics, Romance Philology 17, Cornell University, Ithaca, NY 1999, 196 pagine

    Directory of Open Access Journals (Sweden)

    Pavao Tekavčić

    2000-12-01

    Full Text Available Sotto questo titolo è apparsa nell'autunno del 1999 un'antologia curata dai quattro editori,. contenente 29 brani ( ad opera dei curatori e altri collaboratori. Le linee direttrici sono esposte nella prefazione (Preface, 2 pagine introduttive fuori paginazione. La base è l'antologia Early Romance Texts: An Anthology (1980 di Rodney Sampson, definita invaluable, ma ormai di difficile accesso. Perciò, con la presente scelta di testi si cerca di ovviare a questa situazione. Ci sono però determinati limiti: infatti, sono stati tralasciati i testi più noti, canonici, già bene studiati, ma nel contempo si è desistito anche dall'includere soltanto testi finora non pubblicati. In tal modo si è scelta una via di mezzo, includendo i testi meno noti e meno discussi, tutti pubblicati, è vero, già prima ma in places now considered relatively obscure e parecchio tempo (perfino tutto un secolo fa. La struttura di tutti i contributi è identica: ad una succinta introduzione (dati essenziali sul relativo testo seguono il brano, i commenti, la bibliografia e la traduzione inglese. In tal modo l'antologia è coerente, di facile orientamento ed altrettanto facili confronti tra i singoli testi, il che è di notevole importanza scientifica e pedagogica. Infine, i curatori fanno risaltare il ruolo delle ricerche filologiche negli studi più propriamente linguistici.

  3. 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.

  4. 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.

  5. 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.

  6. 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...

  7. 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...

  8. 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.

  9. 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.

  10. 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…

  11. 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…

  12. 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...

  13. 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…

  14. 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

  15. 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.

  16. 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...

  17. 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

  18. 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.

  19. 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

  20. 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.

  1. 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.

  2. 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

  3. 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.

  4. 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

  5. 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

  6. 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

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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

  12. 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

  13. 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 ...

  14. 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.

  15. 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.

  16. 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.

  17. 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;

  18. 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.

  19. 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.

  20. 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.

  1. [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.

  2. 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.

  3. 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.

  4. 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

  5. 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,

  6. 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

  7. 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…

  8. 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 ...

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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...

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. 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™.

  20. 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.

  1. 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.

  2. 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.

  3. 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

  4. 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

  5. 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

  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. 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...

  8. 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.

  9. 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.

  10. 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

  11. 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…

  12. [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...

  13. 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.

  14. 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...

  15. 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,.

  16. 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.

  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. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. 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

  5. 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

  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. 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.

  11. 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

  12. 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...

  13. 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.

  14. 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

  15. 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.

  16. 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.

  17. 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...

  18. 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

  19. 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...

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. 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

  5. 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).

  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. 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.

  10. 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.

  11. 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.

  12. 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...

  13. 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.)

  14. 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.)

  15. 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...

  16. 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

  17. 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,

  18. 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.

  19. 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

  20. 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

  1. 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.

  2. 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

  3. 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

  4. 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.

  5. 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.

  6. 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.

  7. 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

  8. 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…

  9. 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.)

  10. 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.

  11. 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...

  12. 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.

  13. 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.

  14. 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

  15. 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...

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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

  2. 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.

  3. 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...

  4. 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.

  5. 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

  6. 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

  7. 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.

  8. 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.

  9. 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

  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. 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

  13. [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.

  14. 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

    high. Caregivers' psychological burden decreased substantially. On a 3 months period, length of hospital stays dropped from 13 to 4 days, and home care services decreased from 18 to 10 visits/client. Total cost of health and social public services used per client dropped by 17% after the first 3 months and by 39% in the second 3 months. Conclusion The ratio of 0.50 calls per client to the call center for health events is three times higher than that reported in the literature. This difference is probably attributable to the fact that nurses rather than non-health professional personnel were available to answer the clients' questions about their health and medications. Cost evolution showed that registering older adults at a telesurveillance center staffed by nurses, upon a health professional recommendation, costs the health care system less and does not have any negative effects on the well-being of the individuals and their families. Telesurveillance for the elderly is effective and efficient.

  15. [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.

  16. 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

  17. “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。

  18. 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.

  19. 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.

  20. 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...

  1. 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...

  2. 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

  3. 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.

  4. 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.

  5. 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.)

  6. Study and practice of cost control methodology in public hospitals%公立医院成本控制方法研究与实践

    Institute of Scientific and Technical Information of China (English)

    陈亚光; 张英英; 唐胜辉; 张甄

    2010-01-01

    通过分析1998年~2008年医疗成本占医疗收入比例的变化,研究不断增高的成本内容和原因;通过采用预算管理、成本核算、比例控制、项目管理等方法降低成本;通过人事分配制度改革控制人力成本增长速度,最终达到医疗收支平衡的目标.%An analysis of the varying proportions of medical costs in medical revenue from 1998 to 2008,probes into the items and causes for escalating costs;such methods as budget control,cost keeping,proportional control and project management are called into play to control costs;human cost growth is under control by means of reforms in personnel & placement system,which are targeted at striking a balance between medical revenue and medical cost.

  7. EPA Strengthens Ozone Standards to Protect Public Health/Science-based standards to reduce sick days, asthma attacks, emergency room visits, greatly outweigh costs

    Science.gov (United States)

    WASHINGTON - Based on extensive scientific evidence on effects that ground-level ozone pollution, or smog, has on public health and welfare, the U.S. Environmental Protection Agency (EPA) has strengthened the National Ambient Air Quality Standards (

  8. A comparison of long-term cost and clinical outcomes between the two-stage sequence expander/prosthesis and autologous deep inferior epigastric flap methods for breast reconstruction in a public hospital.

    Science.gov (United States)

    Lagares-Borrego, A; Gacto-Sanchez, P; Infante-Cossio, P; Barrera-Pulido, F; Sicilia-Castro, D; Gomez-Cia, T

    2016-02-01

    Postmastectomy breast reconstruction involves the use of large amounts of hospital resources. This study provides comparative data on the clinical results and long-term economic costs of two methods of breast reconstruction in a public hospital. A prospective cohort study was performed to evaluate the costs incurred by delayed unilateral breast reconstruction performed using either the two-stage sequence expander/prosthesis (E-P) or autologous deep inferior epigastric flap (DIEP) method during 2005-2013 in 134 patients. The major evaluated variables included previous clinical records, history of radiotherapy, and number of surgical procedures. Total costs accounted for both direct intra- and extra-hospital costs derived from the initial reconstruction and those resulting from associated reoperations due to aesthetic retouches and/or complications. Patients undergoing E-P reconstruction required a higher number of surgery sessions to complete the reconstruction (3.07 vs. 2.32, p breast reconstruction using the DIEP method is more cost-effective and involves fewer serious complications that result in reconstruction failure or undesirable aesthetic results. E-P reconstruction presents a higher number of complications that may cause surgical failure or poor outcomes. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  9. 公立医院成本核算应用存在的问题和对策%Problems and countermeasures of cost accounting of public hospitals

    Institute of Scientific and Technical Information of China (English)

    马伊芳; 胡成雅

    2014-01-01

    Literature reviews,expert interviews and case studies were conducted for investigation of the current cost accounting system in a hospital in Shanghai. It was found that there were essential problems in aspects such as cost accumulation and cost allocation. Some countermeasures were put forward accordingly.%运用文献查阅、专家访谈、案例研究等方法,对上海市公立医院成本核算方案的实践情况进行案例分析,提出了成本归集、成本分摊等方面的问题,并研究解决策略。

  10. Diretrizes e modelo conceitual de custos para o setor público a partir da experiência no governo federal do Brasil Guidelines and conceptual model of costs for the public sector based on the Brazilian federal government's experience

    Directory of Open Access Journals (Sweden)

    Nelson Machado

    2010-08-01

    Full Text Available Este artigo apresenta o Sistema de Informação de Custos do Governo Federal, descrevendo o modelo e suas principais características, desde o conceito até a finalidade e os grupos de usuários, explorando a correspondência entre os conceitos de contabilidade governamental e de custos. O artigo demonstra o relacionamento entre as políticas públicas, recursos, atividades e objetos de custo. Para tanto, remete aos conceitos de sistema de acumulação e método de custeio de custos no setor público, correlacionando-os aos sistemas de informação governamentais. O artigo também apresenta o modelo téorico-conceitual, as diretrizes que sustentaram a sua concepção e a descrição do seu processo de implantação que ainda está em curso. O artigo finalmente olha para o futuro, depois de vencida a etapa de implantação do sistema, e exorta os leitores a se inserirem no debate sobre mensuração de custos. A importância do SIC é enfatizada como elemento de melhoria da qualidade do gasto no setor públicoThis article presents the Cost Information System (CIS of the Brazilian federal government. It describes the taxonomic model and its main features, from its concepts to its purposes and user groups, and explores the correlation between the concepts of governmental accounting and cost accounting. It demonstrates the relationship between public policies, fund management, activities and cost objects. To this end, it uses the concepts of accumulation system, costing method and costs in the public sector, as well as government information systems. The article also presents the theoretic conceptual model and the guidelines of the design, and describes the implementation process, which is still ongoing. It finally looks into the future after the development stage of the CIS, and urges its readers to dive into the debate about measuring costs. The importance of CIS to improve the quality of spending in the public sector is highlighted

  11. Delivering Cost-Efficient Public Services in Health Care, Education and Housing in Chile. OECD Economics Department Working Papers, No. 606

    Science.gov (United States)

    Moccero, D.

    2008-01-01

    The Chilean authorities plan to raise budgetary allocations over the medium term for a variety of social programmes, including education, health care and housing. This incremental spending will need to be carried out in a cost-efficient manner to make sure that it yields commensurate improvements in social outcomes. Chile's health indicators show…

  12. Cost Analysis of a Transition to Green Vehicle Technology for Light Duty Fleet Vehicles in Public Works Department Naval Support Activity Monterey (PWD Monterey)

    Science.gov (United States)

    2015-12-01

    replacing ICEs with green technologies on the federal fleet level. The current leader in this research is the AVTA, a subcomponent of the Idaho...the market that may provide additional benefits. C. FOLLOW-ON RESEARCH Possibilities for future research are as follows: 1. Determine the...NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA MBA PROFESSIONAL REPORT COST ANALYSIS OF A TRANSITION TO GREEN VEHICLE

  13. 环境公益诉讼的原告模式及司法成本分析%Analysis of plaintiff mode of environmental public interest litigation and judicial cost

    Institute of Scientific and Technical Information of China (English)

    魏娜

    2012-01-01

    To date, China has accumulated more than 10 cases of environmental public interest litigation cases. These cases are both a breakthrough of the concept of dynamic justice to the parties in civil litigation sys- tem and providing a number of plaintiff modes of public interest litigation. Com- pare with judicial costs of different modes, can easily find the joint plaintiff mode of procuratorial organs supplemented by gov- ernment departments and environmental or- ganizations is the easiest to reduce the legal costs and decentralize the litigation risk, and the best for the sustainable development of environmental public interest litigation.%迄今为止,我国已累计出现10余例环境公益诉讼案件。这些案例既是“能动司法”理念对民事诉讼当事人制度的突破,也提供了公益诉讼的若干原告模式。比较不同模式的司法成本。不难发现,以检察机关为主,以政府职能部门和环保组织为辅的联合原告模式,最易于降低司法成本和分散诉讼风险,对我国环境公益诉讼的可持续发展最为有利。

  14. Cost-Effectiveness of High, Moderate and Low-Dose Statins in the Prevention of Vascular Events in the Brazilian Public Health System

    Directory of Open Access Journals (Sweden)

    Rodrigo Antonini Ribeiro

    2015-01-01

    Full Text Available Background: Statins have proven efficacy in the reduction of cardiovascular events, but the financial impact of its widespread use can be substantial. Objective: To conduct a cost-effectiveness analysis of three statin dosing schemes in the Brazilian Unified National Health System (SUS perspective. Methods: We developed a Markov model to evaluate the incremental cost-effectiveness ratios (ICERs of low, intermediate and high intensity dose regimens in secondary and four primary scenarios (5%, 10%, 15% and 20% ten-year risk of prevention of cardiovascular events. Regimens with expected low-density lipoprotein cholesterol reduction below 30% (e.g. simvastatin 10mg were considered as low dose; between 30-40%, (atorvastatin 10mg, simvastatin 40mg, intermediate dose; and above 40% (atorvastatin 20-80mg, rosuvastatin 20mg, high-dose statins. Effectiveness data were obtained from a systematic review with 136,000 patients. National data were used to estimate utilities and costs (expressed as International Dollars - Int$. A willingness-to-pay (WTP threshold equal to the Brazilian gross domestic product per capita (circa Int$11,770 was applied. Results: Low dose was dominated by extension in the primary prevention scenarios. In the five scenarios, the ICER of intermediate dose was below Int$10,000 per QALY. The ICER of the high versus intermediate dose comparison was above Int$27,000 per QALY in all scenarios. In the cost-effectiveness acceptability curves, intermediate dose had a probability above 50% of being cost-effective with ICERs between Int$ 9,000-20,000 per QALY in all scenarios. Conclusions: Considering a reasonable WTP threshold, intermediate dose statin therapy is economically attractive, and should be a priority intervention in prevention of cardiovascular events in Brazil.

  15. Cost-Effectiveness of High, Moderate and Low-Dose Statins in the Prevention of Vascular Events in the Brazilian Public Health System

    Energy Technology Data Exchange (ETDEWEB)

    Ribeiro, Rodrigo Antonini, E-mail: rodrigo.ribeiro@htanalyze.com [Programa de Pós-Graduação em Epidemiologia da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Instituto de Avaliação de Tecnologia em Saúde, Porto Alegre, RS (Brazil); Duncan, Bruce Bartholow [Programa de Pós-Graduação em Epidemiologia da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Instituto de Avaliação de Tecnologia em Saúde, Porto Alegre, RS (Brazil); Programa de Pós-Graduação em Cardiologia da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Ziegelmann, Patricia Klarmann [Instituto de Avaliação de Tecnologia em Saúde, Porto Alegre, RS (Brazil); Departamento de Estatística da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Stella, Steffan Frosi [Instituto de Avaliação de Tecnologia em Saúde, Porto Alegre, RS (Brazil); Programa de Pós-Graduação em Cardiologia da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Vieira, Jose Luiz da Costa [Instituto de Cardiologia / Fundação Universitária de Cardiologia, Porto Alegre, RS (Brazil); Restelatto, Luciane Maria Fabian [Serviço de Medicina Interna do Hospital de Clínicas de Porto Alegre, Porto Alegre, RS (Brazil); Polanczyk, Carisi Anne [Programa de Pós-Graduação em Epidemiologia da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Instituto de Avaliação de Tecnologia em Saúde, Porto Alegre, RS (Brazil); Programa de Pós-Graduação em Cardiologia da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil)

    2015-01-15

    Statins have proven efficacy in the reduction of cardiovascular events, but the financial impact of its widespread use can be substantial. To conduct a cost-effectiveness analysis of three statin dosing schemes in the Brazilian Unified National Health System (SUS) perspective. We developed a Markov model to evaluate the incremental cost-effectiveness ratios (ICERs) of low, intermediate and high intensity dose regimens in secondary and four primary scenarios (5%, 10%, 15% and 20% ten-year risk) of prevention of cardiovascular events. Regimens with expected low-density lipoprotein cholesterol reduction below 30% (e.g. simvastatin 10mg) were considered as low dose; between 30-40%, (atorvastatin 10mg, simvastatin 40mg), intermediate dose; and above 40% (atorvastatin 20-80mg, rosuvastatin 20mg), high-dose statins. Effectiveness data were obtained from a systematic review with 136,000 patients. National data were used to estimate utilities and costs (expressed as International Dollars - Int$). A willingness-to-pay (WTP) threshold equal to the Brazilian gross domestic product per capita (circa Int$11,770) was applied. Low dose was dominated by extension in the primary prevention scenarios. In the five scenarios, the ICER of intermediate dose was below Int$10,000 per QALY. The ICER of the high versus intermediate dose comparison was above Int$27,000 per QALY in all scenarios. In the cost-effectiveness acceptability curves, intermediate dose had a probability above 50% of being cost-effective with ICERs between Int$ 9,000-20,000 per QALY in all scenarios. Considering a reasonable WTP threshold, intermediate dose statin therapy is economically attractive, and should be a priority intervention in prevention of cardiovascular events in Brazil.

  16. Successful and cost neutral strategies to increase organic food used in public kitchens: results from the Danish Organic Action Plan 2020

    DEFF Research Database (Denmark)

    Thorsen, Anne Vibeke; Brorson, B.; Lassen, Anne Dahl

    of practical strategies being effective in increasing the organic food used in the public kitchens.MethodsStudy design included baseline data collection, training sessions for all kitchens employees, goal setting, strategy development and implementation for each kitchen, and end point data collection...... baseline to end point were 29 percentage points (Ptrained in the principles of organic food production. The organic price premium was covered within...... existing budget by optimizing the budget and menu planning, minimizing food waste, increase production of homemade food, focusing on seasonal food, and optimizing meat and fish consumption.ConclusionsThis study demonstrates a large potential for public kitchens to increase the level of organic food...

  17. Disaggregating the Truth: A Re-Analysis of the Costs and Benefits of Michigan's Public Universities. Professional File. Number 125, Summer 2012

    Science.gov (United States)

    Daun-Barnett, Nathan J.

    2012-01-01

    For more than 50 years, human capital theory has been the cornerstone for understanding the value of investing in individuals' productive capacities in terms of both personal social and economic gain and the collective benefits that accrue to society. Vedder and Denhart (2007) challenge the hypothesis that public investment in higher education…

  18. Vaccines for tick-borne diseases and cost-effectiveness of vaccination : a public health challenge to reduce the diseases’ burden

    NARCIS (Netherlands)

    Smit, Renata; Postma, Maarten J

    Tick-borne encephalitis (TBE) and Lyme borreliosis (LB) are tick-borne diseases (TBDs), and both present an increasing burden worldwide. Vaccination as public health intervention could be the most effective way to reduce this burden. TBE vaccines are available, but vaccines against LB are still in

  19. Vaccines for tick-borne diseases and cost-effectiveness of vaccination : a public health challenge to reduce the diseases’ burden

    NARCIS (Netherlands)

    Smit, Renata; Postma, Maarten J

    2016-01-01

    Tick-borne encephalitis (TBE) and Lyme borreliosis (LB) are tick-borne diseases (TBDs), and both present an increasing burden worldwide. Vaccination as public health intervention could be the most effective way to reduce this burden. TBE vaccines are available, but vaccines against LB are still in t

  20. What should be given a priority - costly medications for relatively few people or inexpensive ones for many? The Health Parliament public consultation initiative in Israel.

    Science.gov (United States)

    Guttman, Nurit; Shalev, Carmel; Kaplan, Giora; Abulafia, Ahuva; Bin-Nun, Gabi; Goffer, Ronen; Ben-Moshe, Roei; Tal, Orna; Shani, Mordechai; Lev, Boaz

    2008-06-01

    In the past two decades, government and civic organizations have been implementing a wide range of deliberative public consultations on health care-related policy. Drawing on these experiences, a public consultation initiative in Israel called the Health Parliament was established. To implement a public consultation initiative that will engage members of the public in the discussion of four healthcare policy questions associated with equity in health services and on priorities for determining which medications and treatments should be included in the basket of national health services. One hundred thirty-two participants from the general population recruited through a random sample were provided with background materials and met over several months in six regional sites. Dilemma activities were used and consultants were available for questions and clarifications. Participants presented their recommendations in a national assembly to the Minister of Health. Across the regional groups the recommendations were mostly compatible, in particular regarding considering the healthcare system's monetary state, even at the expense of equity, but for each policy question minority views were also expressed. A strong emphasis in the recommendations was pragmatism. Participants felt the experience was worthwhile; though the actual impact of their recommendations on policy making was indirect, they were willing to participate in future consultations. However, despite enthusiasm the initiative was not continued. Issues raised are whether consultation initiatives must have a direct impact on healthcare policy decisions or can be mainly a venue to involve citizens in the deliberation of healthcare policy issues.

  1. 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...

  2. 45 CFR 98.55 - Cost allocation.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Cost allocation. 98.55 Section 98.55 Public... of Child Care and Development Funds § 98.55 Cost allocation. (a) The Lead Agency and subgrantees shall keep on file cost allocation plans or indirect cost agreements, as appropriate, that have...

  3. 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

    sector.A new health status indicator entitled Disability Adjusted Life Years (DALYs) was used to describe the level of ill health from the most common health problems in the Zimbabwean population in 1997. Epidemiological information was derived from multiple sources. The cause of death pattern...... by estimates from epidemiological studies from other settings if no Zimbabwean sources were available. Disease and public health experts were consulted about the identification of the best possible sources of information, the quality of these sources and the data adjustments made. Epidemiological information...... 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...

  4. What should be given a priority – costly medications for relatively few people or inexpensive ones for many? The Health Parliament public consultation initiative in Israel

    Science.gov (United States)

    Guttman, Nurit; Shalev, Carmel; Kaplan, Giora; Abulafia, Ahuva; Bin‐Nun, Gabi; Goffer, Ronen; Ben‐Moshe, Roei; Tal, Orna; Shani, Mordechai; Lev, Boaz

    2008-01-01

    Abstract Background  In the past two decades, government and civic organizations have been implementing a wide range of deliberative public consultations on health care‐related policy. Drawing on these experiences, a public consultation initiative in Israel called the Health Parliament was established. Goals  To implement a public consultation initiative that will engage members of the public in the discussion of four healthcare policy questions associated with equity in health services and on priorities for determining which medications and treatments should be included in the basket of national health services. Method  One hundred thirty‐two participants from the general population recruited through a random sample were provided with background materials and met over several months in six regional sites. Dilemma activities were used and consultants were available for questions and clarifications. Participants presented their recommendations in a national assembly to the Minister of Health. Outcomes  Across the regional groups the recommendations were mostly compatible, in particular regarding considering the healthcare system’s monetary state, even at the expense of equity, but for each policy question minority views were also expressed. A strong emphasis in the recommendations was pragmatism. Conclusion  Participants felt the experience was worthwhile; though the actual impact of their recommendations on policy making was indirect, they were willing to participate in future consultations. However, despite enthusiasm the initiative was not continued. Issues raised are whether consultation initiatives must have a direct impact on healthcare policy decisions or can be mainly a venue to involve citizens in the deliberation of healthcare policy issues. PMID:18429997

  5. Normative price for a manufactured product: the SAMICS methodology. Volume II. Analysis. JPL publication 78-98. [Solar Array Manufacturing Industry Costing Standards

    Energy Technology Data Exchange (ETDEWEB)

    Chamberlain, R.G.

    1979-01-15

    The Solar Array Manufacturing Industry Costing Standards (SAMICS) provide standard formats, data, assumptions, and procedures for determining the price a hypothetical solar array manufacturer would have to be able to obtain in the market to realize a specified after-tax rate of return on equity for a specified level of production. This document presents the methodology and its theoretical background. It is contended that the model is sufficiently general to be used in any production-line manufacturing environment. Implementation of this methodology by the Solar Array Manufacturing Industry Simulation computer program (SAMIS III, Release 1) is discussed.

  6. Task-sharing or public finance for the expansion of surgical access in rural Ethiopia: an extended cost-effectiveness analysis.

    Science.gov (United States)

    Shrime, Mark G; Verguet, Stéphane; Johansson, Kjell Arne; Desalegn, Dawit; Jamison, Dean T; Kruk, Margaret E

    2016-07-01

    Despite a high burden of surgical disease, access to surgical services in low- and middle-income countries is often limited. In line with the World Health Organization's current focus on universal health coverage and equitable access to care, we examined how policies to expand access to surgery in rural Ethiopia would impact health, impoverishment and equity. An extended cost-effectiveness analysis was performed. Deterministic and stochastic models of surgery in rural Ethiopia were constructed, utilizing pooled estimates of costs and probabilities from national surveys and published literature. Model calibration and validation were performed against published estimates, with sensitivity analyses on model assumptions to check for robustness. Outcomes of interest were the number of deaths averted, the number of cases of poverty averted and the number of cases of catastrophic expenditure averted for each policy, divided across wealth quintiles. Health benefits, financial risk protection and equity appear to be in tension in the expansion of access to surgical care in rural Ethiopia. Health benefits from each of the examined policies accrued primarily to the poor. However, without travel vouchers, many policies also induced impoverishment in the poor while providing financial risk protection to the rich, calling into question the equitable distribution of benefits by these policies. Adding travel vouchers removed the impoverishing effects of a policy but decreased the health benefit that could be bought per dollar spent. These results were robust to sensitivity analyses.

  7. Publicity and public relations

    Science.gov (United States)

    Fosha, Charles E.

    1990-01-01

    This paper addresses approaches to using publicity and public relations to meet the goals of the NASA Space Grant College. Methods universities and colleges can use to publicize space activities are presented.

  8. An estimate of the public health impact and cost-effectiveness of universal vaccination with a 9-valent HPV vaccine in Germany.

    Science.gov (United States)

    Largeron, Nathalie; Petry, Karl Ulrich; Jacob, Jorge; Bianic, Florence; Anger, Delphine; Uhart, Mathieu

    2017-02-01

    Since 2007, the German Standing Vaccination Committee recommends HPV vaccination for girls aged 12-17 with a 2- (Cervarix®) or 4-valent (Gardasil®) vaccine. A 9-valent vaccine (Gardasil 9®) recently received a European market authorization in 2015. A dynamic transmission model was calibrated to the German setting and used to estimate costs and QALYs associated with vaccination strategies. Compared to the current vaccination program, the 9-valent vaccine extended to boys shows further reductions of 24% in the incidence of cervical cancer, 30% and 14% in anal cancer for males and females, as well as over a million cases of genital warts avoided after 100 years. The new strategy is associated with an ICER of 22,987€ per QALY gained, decreasing to 329€ when considering the vaccine switch for girls-only. Universal vaccination with the 9-valent vaccine can yield significant health benefits when compared to the current program.

  9. Satisfaction and public health cost of a statewide influenza nurse triage line in response to pandemic H1N1 influenza.

    Directory of Open Access Journals (Sweden)

    Alicen B Spaulding

    Full Text Available BACKGROUND: The 2009 H1N1 pandemic strained healthcare systems. There was a need for supportive services, rapid antiviral access, and minimization of unnecessary healthcare contacts particularly face-to-face interactions. In response, the Minnesota Department of Health (MDH launched a telephone-based nurse triage line (NTL called the Minnesota FluLine coordinating all major MN healthcare systems with NTLs to form a single toll-free number triage service. Callers were evaluated for symptoms of influenza-like illness (ILI and were prescribed an antiviral if indicated, using nurse administered protocols. METHODS: To determine caller outcomes, associated healthcare seeking, and satisfaction a telephone survey of Minnesota FluLine callers was conducted using a 5% random sample of those who completed the protocol and those who did not. RESULTS: Of 6,122 callers with ILI who began the nurse protocol administered by the contract NTL, 1,221 people were contacted for the survey and 325 agreed to participate; response rate was 26%. Of those who completed the nurse protocol 73% said they would have sought healthcare without the Minnesota FluLine, 89% reported the service was moderately or very helpful, and 91% reported being satisfied or very satisfied. Of those not completing the protocol, 50% reported the service was moderately or very helpful and 50% reported being satisfied or very satisfied. 72% of qualitative responses to open-ended questions were positive regarding the MN FluLine. Cost to MDH for operating the Minnesota FluLine service was $331,226 to service 27,391 callers ($12.09/call. DISCUSSION: The Minnesota FluLine diverted patients with mild ILI symptoms away from acute care visits at low cost and had a high rate of satisfaction among callers. Early intervention likely prevented morbidity and possibly additional cases. NTLs are powerful and flexible tools for pandemic response and should be considered as an important tool for future emergency

  10. Analysis on Incremental Cost of Public Building Enforced with Green Building Standard in Chongqing%重庆市公共建筑强制执行绿色建筑标准增量成本分析

    Institute of Scientific and Technical Information of China (English)

    邓瑛鹏; 何丹

    2014-01-01

    The changing situation of the incremental cost of the public buildings enforced with the technical content of"integrated utilization of building environment design and resources"in Chapter 7 of Design Standard for Energy-saving Public Buildings (Green Building) is analyzed. Six analysis sam-ples are made in accordance with the reality of public buildings in Chongqing and the technical scheme of green building are analyzed with the document issued by Municipal and Rural Construction Committee of Chongqing. Also, the incremental cost situations of the technical measures for green buildings are fully analyzed.%该文分析了重庆市公共建筑项目在执行《公共建筑节能(绿色建筑)设计标准》第7章“建筑环境设计与资源综合利用”技术内容后的增量成本变化情况。文章根据重庆市公共建筑实际情况分别设定了6个分析样本,并根据重庆市城乡建设委员会发布的《重庆市建设工程设计文件编制技术规定建筑节能与绿色建筑专篇(公共建筑部分)》设定分析样本的绿色建筑技术方案,全面分析了其绿色建筑技术措施的增量成本情况。

  11. Cost Behavior

    DEFF Research Database (Denmark)

    Hoffmann, Kira

    The objective of this dissertation is to investigate determinants and consequences of asymmetric cost behavior. Asymmetric cost behavior arises if the change in costs is different for increases in activity compared to equivalent decreases in activity. In this case, costs are termed “sticky......” if the change is less when activity falls than when activity rises, whereas costs are termed “anti-sticky” if the change is more when activity falls than when activity rises. Understanding such cost behavior is especially relevant for decision-makers and financial analysts that rely on accurate cost information...

  12. Cost Behavior

    DEFF Research Database (Denmark)

    Hoffmann, Kira

    The objective of this dissertation is to investigate determinants and consequences of asymmetric cost behavior. Asymmetric cost behavior arises if the change in costs is different for increases in activity compared to equivalent decreases in activity. In this case, costs are termed “sticky......” if the change is less when activity falls than when activity rises, whereas costs are termed “anti-sticky” if the change is more when activity falls than when activity rises. Understanding such cost behavior is especially relevant for decision-makers and financial analysts that rely on accurate cost information...

  13. Aquisição de medicamentos no setor público: o binômio qualidade - custo Pharmaceutical procurement by the public sector: the quality/cost relationship

    Directory of Open Access Journals (Sweden)

    Vera Lúcia Luiza

    1999-10-01

    Full Text Available No presente trabalho, os autores abordam, dentro do âmbito da administração de materiais, a aquisição e o aprovisionamento de medicamentos no setor público de saúde, discutindo as duas principais vertentes da questão: qualidade e custo. São relatados os fatores que devem ser considerados pelo comprador quando se avalia o quesito qualidade de medicamentos, em especial a questão dos genéricos, a bioequivalência e a estabilidade das formulações. Por outro lado, o item custo é examinado, assim como as implicações que uma demanda diferenciada e voltada para as inovações tecnológicas tem sobre ele. Por fim, discutem-se alternativas, já empregadas em algumas instituições, apresentando-se sugestões cuja finalidade implica na possibilidade de compra de produtos de qualidade aliada à contenção de custos.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.

  14. Contractors and the Cost of War: Research into Economic and Cost-Effectiveness Arguments

    Science.gov (United States)

    2006-12-01

    32 Figure 4. Transaction Cost Economics Framework ........................................................50 x...the cost-effectiveness debate, there are a myriad of other issues that exist. For example, Transaction Cost Economics (TCE) yields key insights on...Perspectives on Public Choice. New York: Cambridge University Press, 455 – 480; qtd in Williamson, “Public and Private Bureaucracies: A Transaction Cost Economics

  15. The cost of children

    DEFF Research Database (Denmark)

    Nordström, Leif Jonas

    In this paper we estimate the opportunity cost of children. The underlying theoretical model is represented by a household production model. In the empirical analysis, we consider three different cohorts for men and women born between 1955 and 1970. For the women in the two oldest cohorts......, the opportunity cost of two children is estimated to 28-29 per cent of full income, which in monetary units is close to estimated income difference between women employed in the public and private sector. The opportunity cost of fatherhood is generally positive, but only significantly positive for men born...

  16. HPV vaccination and allocative efficiency: regional analysis of the costs and benefits with the bivalent AS04-adjuvanted vaccine, from the perspective of public health, for the prevention of cervical cancer and its pre-cancerous lesions

    Directory of Open Access Journals (Sweden)

    Paolo Bonanni

    2012-11-01

    Full Text Available Introduction: by means of the decisions on whether to introduce the HPV vaccination, Public Health has already established the importance of associating the vaccination strategy to the policy of secondary prevention. The screening + vaccination strategy is more effective than the two methods taken individually. In support of this combined strategy and in order to make available per each region concrete elements for their regional planning, an assessment has been made, which also takes into account the effect of cross-protection regarding high-risk strains not contained in both vaccines, bivalent and quadrivalent, and more frequently responsible for pre-cancerous lesions and cervical cancer (CCU. This analysis evaluates the costs and benefits of screening + vaccination strategy in a 12-year-old female cohort. Furthermore, the paper provides results that may be useful to assess the opportunity to extend the vaccination to a second cohort of 24-25-year-old women. The analysis is preceded by a brief summary of CCU epidemiology available data, public health policies that give precise guidelines for vaccination strategies and analytical tools suitable to support public policy makers to efficiently allocate resources. Methods: two different models were used for two regional analyses.The vaccines may have different sustained- and cross-protection levels against non-vaccine oncogenic HPV-types. In the first analysis, a prevalence-based model estimated the potential net difference in HPV-related lesions (abnormal pap smear, cervical intraepithelial neoplasia (CIN, cervical cancer (CC and genital warts (GW and associated costs generated by the two vaccines. Vaccine efficacy rates were based on published data for each vaccine. Lifetime vaccine efficacy was assumed. Results are reported over one year after reaching a steady state. Incidence and treatment costs were obtained from Italian and European sources. We also performed a cost-effectiveness analysis

  17. 45 CFR 304.15 - Cost allocation.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 2 2010-10-01 2010-10-01 false Cost allocation. 304.15 Section 304.15 Public... FEDERAL FINANCIAL PARTICIPATION § 304.15 Cost allocation. A State agency in support of its claims under title IV-D of the Social Security Act must have an approved cost allocation plan on file with...

  18. 42 CFR 433.34 - Cost allocation.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Cost allocation. 433.34 Section 433.34 Public... Provisions § 433.34 Cost allocation. A State plan under Title XIX of the Social Security Act must provide that the single or appropriate Agency will have an approved cost allocation plan on file with...

  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 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...

  1. 42 CFR 457.228 - Cost allocation.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Cost allocation. 457.228 Section 457.228 Public...; Reduction of Federal Medical Payments § 457.228 Cost allocation. A State plan must provide that the single or appropriate CHIP Agency will have an approved cost allocation plan on file with the Department...

  2. Costo-efectividad de prácticas en salud pública: revisión bibliográfica de las intervenciones de la Iniciativa Mesoamericana de Salud Cost-effectiveness of public health practices: A literature review of public health interventions from the Mesoamerican Health Initiative

    Directory of Open Access Journals (Sweden)

    Atanacio Valencia-Mendoza

    2011-01-01

    Full Text Available OBJETIVO: Presentar y analizar información de costo-efectividad de intervenciones propuestas por la Iniciativa Mesoamericana de Salud (IMS en las áreas de nutrición infantil, inmunizaciones, paludismo, dengue y salud materno-infantil y reproductiva. MATERIAL Y MÉTODOS: Se llevó a cabo una revisión sistemática de la literatura de evaluaciones económicas publicadas entre el año 2000 y agosto 2009 sobre intervenciones en las áreas de la salud mencionadas, en los idiomas inglés y español. RESULTADOS: Las intervenciones en nutrición y de salud materno-infantil mostraron ser altamente costo-efectivas (con rangos menores a US$200 por año de vida ajustado por discapacidad [AVAD] evitado para nutrición y US$100 para materno-infantil. En dengue sólo se encontró información sobre la aplicación de larvicidas, cuya razón de costo efectividad estimada fue de US$40.79 a US$345.06 por AVAD evitado. Respecto al paludismo, las intervenciones estudiadas resultaron costo-efectivas (OBJECTIVE: Present and analyze cost-effectiveness information of public health interventions proposed by the Mesoamerican Health Initiative in child nutrition, vaccination, malaria, dengue, and maternal, neonatal, and reproductive health. MATERIAL AND METHODS: A systematic literature review was conducted on cost-effectiveness studies published between January 2000 and August 2009 on interventions related to the health areas previously mentioned. Studies were included if they measured effectiveness in terms of Disability-Adjusted Life Year (DALY or death averted. RESULTS: Child nutrition and maternal and neonatal health interventions were found to be highly cost-effective (most of them below US$200 per DALY averted for nutritional interventions and US$100 for maternal and neonatal health. For dengue, information on cost-effectiveness was found just for application of larvicides, which resulted in a cost per DALY averted ranking from US$40.79 to US$345.06. Malarial

  3. Cost model for biobanks.

    Science.gov (United States)

    Gonzalez-Sanchez, M Beatriz; Lopez-Valeiras, Ernesto; Morente, Manuel M; Fernández Lago, Orlando

    2013-10-01

    Current economic conditions and budget constraints in publicly funded biomedical research have brought about a renewed interest in analyzing the cost and economic viability of research infrastructures. However, there are no proposals for specific cost accounting models for these types of organizations in the international scientific literature. The aim of this paper is to present the basis of a cost analysis model useful for any biobank regardless of the human biological samples that it stores for biomedical research. The development of a unique cost model for biobanks can be a complicated task due to the diversity of the biological samples they store. Different types of samples (DNA, tumor tissues, blood, serum, etc.) require different production processes. Nonetheless, the common basic steps of the production process can be identified. Thus, the costs incurred in each step can be analyzed in detail to provide cost information. Six stages and four cost objects were obtained by taking the production processes of biobanks belonging to the Spanish National Biobank Network as a starting point. Templates and examples are provided to help managers to identify and classify the costs involved in their own biobanks to implement the model. The application of this methodology will provide accurate information on cost objects, along with useful information to give an economic value to the stored samples, to analyze the efficiency of the production process and to evaluate the viability of some sample collections.

  4. 我国公立医院成本核算影响因素分析及制度建设%Analysis of cost accounting influencing factors for public hospitals in China and the institutional building

    Institute of Scientific and Technical Information of China (English)

    王珊; 王涤非; 陶琳; 刘丽华

    2016-01-01

    医院成本核算系统的影响因素可归为3类:驱动与激励因素、影响真实性与准确性的因素以及影响医院选择与应用的因素。随着DRG支付的广泛使用,成本核算得到前所未有的发展。在我国支付制度改革和公立医院补偿机制转换趋势下,精确支付、合理补偿以及公立医院内部成本绩效管理对成本核算提出新需求,公立医院成本核算制度亟待建立。需从宏观、微观目标同时出发,满足不同层级的需求,配合联动,才能最大化实现成本核算制度的作用。%The factors influencing cost accounting fall into such three categories as drivers and incentives,factors affecting authenticity and accuracy,and factors affecting application and selection.DRG payment,as it is getting more popular than before,is pushing forward cost accounting at an unprecedented pace.Thanks to the current payment system reform and the transition of public hospital reimbursement regime,such needs as exact payment,j ust compensation and cost/performance management of such hospitals are challenging the present cost accounting system,calling for the birth of a cost accounting system for these hospitals.To build such a system,micro-and macro-level goals need to be considered simultaneously,while needs of different levels should be designed,integrated and interacted with each other.Only in this way,goals can be reached for such a system.

  5. Cost Behavior

    DEFF Research Database (Denmark)

    Hoffmann, Kira

    The objective of this dissertation is to investigate determinants and consequences of asymmetric cost behavior. Asymmetric cost behavior arises if the change in costs is different for increases in activity compared to equivalent decreases in activity. In this case, costs are termed “sticky......” if the change is less when activity falls than when activity rises, whereas costs are termed “anti-sticky” if the change is more when activity falls than when activity rises. Understanding such cost behavior is especially relevant for decision-makers and financial analysts that rely on accurate cost information...... to facilitate resource planning and earnings forecasting. As such, this dissertation relates to the topic of firm profitability and the interpretation of cost variability. The dissertation consists of three parts that are written in the form of separate academic papers. The following section briefly summarizes...

  6. Custo-efetividade de cardiodesfibriladores implantáveis no Brasil nos setores público e privado Cost-effectiveness of implantable cardioverter defibrillators in Brazil in the public and private sectors

    Directory of Open Access Journals (Sweden)

    Rodrigo Antonini Ribeiro

    2010-10-01

    -effectiveness, but these data are not applicable to Brazil. OBJECTIVE: To evaluate the cost-effectiveness of ICD in CHF patients under two perspectives in Brazil: public and supplementary health systems. METHODS: A Markov model was developed to analyze the incremental cost-effectiveness ratio (ICER of ICD compared to conventional therapy in patients with CHF. Effectiveness was measured in quality-adjusted life years (QALYs. We searched the literature for data regarding effectiveness and complications. Costs were retrieved from public and health insurances reimbursement codebooks and from mean cost of admissions from a public and a private hospital. One-way sensitivity analysis was performed in all variables of the model. RESULTS: ICER was R$ 68,318/QALY in the public and R$ 90,942/QALY in the private perspective. These values are much higher than the one suggested by the World Health Organization of 3 times the gross domestic product per head (R$ 40,545 in Brazil. The results were sensitive to the cost of the device, battery replacement interval and ICD effectiveness. In a simulation resembling MADIT-I population survival and ICD benefit, ICER was R$ R$ 23,739/QALY in the public and R$ 33,592/QALY in the private perspective. CONCLUSION: The ICER aof ICD is elevated in the general ICC population, in either the public or private perspective. A more favorable result occurs in patients with a high sudden death risk.

  7. 45 CFR 400.13 - Cost allocation.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 2 2010-10-01 2010-10-01 false Cost allocation. 400.13 Section 400.13 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN... for Refugee Resettlement Award of Grants to States § 400.13 Cost allocation. (a) A State must...

  8. 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...

  9. Tracking Costs

    Science.gov (United States)

    Erickson, Paul W.

    2010-01-01

    Even though there's been a slight reprieve in energy costs, the reality is that the cost of non-renewable energy is increasing, and state education budgets are shrinking. One way to keep energy and operations costs from overshadowing education budgets is to develop a 10-year energy audit plan to eliminate waste. First, facility managers should…

  10. O financiamento da educação pública municipal de Teresina: o custo-aluno/ano Financiación de la educación pública municipal de Teresina: el coste alumno/año The public education financing in Teresina: the student per year cost

    Directory of Open Access Journals (Sweden)

    Luís Carlos Sales

    2009-12-01

    of Municipal Public School financing of Teresina city - Piauí", which aimed to define the municipal educational cost , specially those related to the direct operational cost of seventeen institutions. This dissertation intended to answer three questions: a what the student per year cost of public school in the basic education in Teresina city in 2006 is; b what is the category or what are the categories of items which present a higher participation in the composition of direct cost of the municipal schools and what factors intervene in this cost?, and finally, c what is the participation of Fundef in the composition of the student per year cost in the public education of Teresina city in 2006? In order to examine deeply the result of the last question, it was intended to disaggregate the expense per each student undertaken by the municipality of Teresina in 17 municipal public schools,intentionally chosen and giving special attention to some features, in order to identify Fundef's participation in relation to the school expenses in the different stages of the Basic education in each zone covered by it (rural and urban. It was searched in Schultz's (1973, Verhine's (1998, 2003, Castro's (1973, 1976 and Davies's (1999, 2004, 2005 studies and also in the current educational legislation, the necessary epistemology basis to dialogue with the collected data. It was concluded that the student per year cost of the schools remained pretty above of the student per year amount nationally defined for Fundef, which reinforces some criticism stood out in the literature about the lack of accomplishment by the Federal Government established by the 1st from the 6th article from the Law 9.424/96 which deals with the calculus methodology to define the national minimum amount.

  11. Public Education, Public Good.

    Science.gov (United States)

    Tomlinson, John

    1986-01-01

    Criticizes policies which would damage or destroy a public education system. Examines the relationship between government-provided education and democracy. Concludes that privatization of public education would emphasize self-interest and selfishness, further jeopardizing the altruism and civic mindedness necessary for the public good. (JDH)

  12. Efficiency Assessment of E-waste Management System in Lithuanian Public Sector

    Directory of Open Access Journals (Sweden)

    Laura Vasilenko

    2009-10-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} Rapid technology change, low initial costs have resulted in a fast-growing surplus of electrical and electronic equipment waste (e-waste around the globe. Management of e-waste in an environment friendly way according to all legal regulations carries great importance. E-waste management system incorporates different stakeholders through the whole life cycle of electrical and electronic equipment (EEE - producers/importers, distributors, consumers/users, collectors, recyclers. The system's efficiency depends on the environmental awareness and effective activity of each of the actors. The public sector is dealt with in this paper describing the differences and problems of a non-household (B2B sector in the e-waste chain. The aim of this paper is to evaluate efficiency of the e-waste management system in the public sector (PS, identifying the problems which have brought about reduced e-waste management efficiency. It is anticipated that the recommendations proposed should increase the efficiency of the PS and some of the recommendations could be applied to the e-waste management system in general.

  13. 38 CFR 17.259 - Direct costs.

    Science.gov (United States)

    2010-07-01

    ... personnel or for fringe benefits, rent, publications, educational programs, training, research... Exchange of Information § 17.259 Direct costs. Direct costs to which grant funds may be applied may...

  14. The health care costs of smoking

    NARCIS (Netherlands)

    J.J.M. Barendregt (Jan); L.G.A. Bonneux (Luc); P.J. van der Maas (Paul)

    1997-01-01

    textabstractBACKGROUND: Although smoking cessation is desirable from a public health perspective, its consequences with respect to health care costs are still debated. Smokers have more disease than nonsmokers, but nonsmokers live longer and can incur more health costs

  15. 重庆市基本公共卫生服务标准化流程及其成本测算研究%Standard operation procedure and cost of primary public healthcare services

    Institute of Scientific and Technical Information of China (English)

    梁小华; 张萍; 沈星亮; 何春玲; 李大兴; 肖伦

    2013-01-01

    Objective To explore cost of standard operation procedure of primary public healthcare services.Methods Standard operation procedure of primary public healthcare services was put forward according to national basic public healthcare service standards (2011 edition) in 2012.Random sampling method was used to choose participants from two community sanitary service centers,two township heahhcare centers and one maternity and child heahhcare hospital.Service standard operation procedure was used to measure human cost and supportive cost of public healthcare services.Results Management of 10 thousand patients who had different diseases needed various numbers of medical staff (MS),such as health profile needed 3.4 MS,hypertension management needed 10.8 MS,diabetes management needed 10.6 MS,elderly people care needed 9.2 MS,child care needed 4.6 MS,maternal care needed 24.3 MS,psychosis management needed 13.3 MS,and planned immunity for children needed 4.6 MS.Besides,the people whole covered service projects need 2.4 MS per 100 thousand people.The research showed that managing 1 sample of different kind people needed different human cost,such as health profile needed 22.67 yuan,hypertension management needed 72.69 yuan,planned immunity for children needed 30.68 yuan,diabetes management needed 71.34 yuan,old people management needed 61.50 yuan,child care needed 30.88 yuan,maternal care needed 157.15 yuan,psychosis management needed 74.25 yuan.Besides,the people whole covered service projects needed 124.9 thousand yuan per 100 thousand people.Conclusion For primary public healthcare service project,it should be critical to modify manning regulation and labor costs.%目的 研究重庆市基本公共卫生服务标准流程所需的人力时间成本.方法 本研究于2012年根据《国家基本公共卫生服务规范(2011年版)》,制定社区实施公共卫生服务的具体操作流程.采取随机抽样的方法在城市及农村分别选取重庆市2个社区卫生

  16. Public services, personal benefits

    NARCIS (Netherlands)

    Bob Kuhry; Evert Pommer; Jedid-Jah Jonker; John Stevens

    2006-01-01

    Original title: Publieke productie & persoonlijk profijt. This report looks in detail at the costs of public services (such as care, education, public administration and safety) and the benefits that citizens derive from the government expenditure involved in delivering those services. In

  17. Public services, personal benefits

    NARCIS (Netherlands)

    Bob Kuhry; Evert Pommer; Jedid-Jah Jonker; John Stevens

    2006-01-01

    Original title: Publieke productie & persoonlijk profijt. This report looks in detail at the costs of public services (such as care, education, public administration and safety) and the benefits that citizens derive from the government expenditure involved in delivering those services. In 2003,

  18. Implications of Transaction Costs for Acquisition Program Cost Breaches

    Science.gov (United States)

    2013-06-01

    Government. IRB Protocol number ____N/A____. 12a. DISTRIBUTION / AVAILABILITY STATEMENT Approved for public release; distribution is unlimited 12b...purchasing price for the home (bargaining and decision costs). Last, if the home was purchased using money that was borrowed from a mortgage lender , the...not significantly affect the ability of an MDAP to operate within its approved financial constraints as measured by cost breaches. B. DATA The cost

  19. Cost leadership and bank internationalization

    OpenAIRE

    Galema, Rients; Koetter, Michael; Liesegang, Caroline

    2013-01-01

    We adapt a theoretical model from the goods trade literature to test whether banks with a comparative cost advantage are more likely to enter foreign markets by means of foreign direct investment. We combine detailed proprietary bank-level data on the international activities of all German banks with publicly available bank micro data from possible destination markets to show that the decision to go abroad is driven by relative cost differences. Banks enter markets where they are cost leaders...

  20. Public Speech.

    Science.gov (United States)

    Green, Thomas F.

    1994-01-01

    Discusses the importance of public speech in society, noting the power of public speech to create a world and a public. The paper offers a theory of public speech, identifies types of public speech, and types of public speech fallacies. Two ways of speaking of the public and of public life are distinguished. (SM)

  1. Analysis of the Effects of Controlling Cost in Jiangxi Provinces' Public Hospitals under the Background of New Health System Reform%新医改背景下江西省公立医院控费效果分析

    Institute of Scientific and Technical Information of China (English)

    宁黎霞; 路玲; 王素珍

    2012-01-01

    Objective: To analyze the patients' cost change in Jiangxi Provinces' public hosptials under the background of new health system reform. Methods: Selecting outpatient and inpatient cost data from 2008 to 2011 from national health statistics information network,and do Excel analysis. Results: The effects of controlling cost are overall good. Conclusion: Basic drug system should be con tinued to be implemented, the medical seperation be explored, the reform of the Medicare payment methods be promoted, health service information be announced, and the appraisal system be improved.%目的:分析新医改背景下江西省公立医院病人费用变化情况.方法:从国家卫生统计信息网络直报系统选取2008年到2011年江西省各级公立医院门诊和住院病人费用的数据,并将其录入Excel进行统计分析.结果:江西省公立医院病人费用总体控制情况较好.2011年与2008年按可比价格比较,江西省公立医院次均门诊费用、药费、检查费分别上涨-9.7%、7.9%、39.8%,全国对应为20.1%、18.7%和22.1%;江西省公立医院人均住院费用、药费、检查费涨幅分别为15.9%、8.7%和72.7%,全国对应为19.2%、-1.1%和6.8%.其中,检查费用涨幅普遍高于全国平均水平,但绝对数远低于全国.结论:继续贯彻落实基本药物制度,探索医药分开,推进医保付费方式改革,公开医疗卫生服务信息,完善绩效考核制度.

  2. Cost comparisons

    CERN Multimedia

    CERN Bulletin

    2010-01-01

    How much does the LHC cost? And how much does this represent in other currencies? Below we present a table showing some comparisons with the cost of other projects. Looking at the figures, you will see that the cost of the LHC can be likened to that of three skyscrapers, or two seasons of Formula 1 racing! One year's budget of a single large F1 team is comparable to the entire materials cost of the ATLAS or CMS experiments.   Please note that all the figures are rounded for ease of reading.    CHF € $   LHC 4.6 billions 3 billions  4 billions   Space Shuttle Endeavour (NASA) 1.9 billion 1.3 billion 1.7 billion   Hubble Space Telescope (cost at launch – NASA/...

  3. School Security: Planning and Costs.

    Science.gov (United States)

    Hunter, Richard C.; Mazingo, Terri H.

    2003-01-01

    Describes efforts by two school districts to address the potential threats of shootings and other school disruptions: Baltimore City Public Schools in Maryland and Charlotte-Mecklenburg Public Schools in North Carolina. Also describes the growing costs of providing safety and security in elementary and secondary schools. (Contains 13 references.)…

  4. 重庆市基本公共卫生服务人力时间成本测算研究%Research on the Measurement of Public Health Service Manpower Costs of Chongqing

    Institute of Scientific and Technical Information of China (English)

    梁小华; 张萍; 沈星亮; 何春玲

    2014-01-01

    Objective To research on the costs of the time that public health service workers often spend in finishing a standard flow. Methods Random sampling was used to choose a certain amount of participants from two community sanitary serv-ice centers,two township health centers and one maternity and child health care hospital located at Jiulongpo district, Chongqing. Service standard operating procedures were used to measure the manpower cost of each public health service(health record of the urban and rural residents,health education,vaccination,health management of children under 6 years old,the pregnant women including neonatel visiting,the elderly,the disabled,the patients with high blood pressure,the patients with type Ⅱ diabetes mellitus and severely - stricken mental patients,report and processing about infectious diseases and public health emergency,cooperation with hygiene supervision,premarital examination,physical check - up of childbearing women above 35 and AIDS management and diagnosis). Results The research showed that residents per 10 thousand only needed 8. 4 general practitioners(GP)on average for 12 kinds of public health services directed at the important population in the Jiulongpo dis-trict. According to the performance evaluation indicators of basic public health service package of Jiulongpo,the number was 799 GP. According to the performance evaluation indicators of basic public health service package of Chongqing,the number was 459 GP. Completing the whole covered service project of Jiulongpo,83 GP were needed,that was 0. 76 GP per 10 thousand resi-dents. Completing 16 items of basic public health services needs 9 GP per 10 thousand residents. The research results showed that the number of GP needed:911 for the important population,83 for the whole population and 994 while offering the 16 kinds of public health services. According to the proportion of each type of population in the whole,the proportions of the number of GP needed in each

  5. 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...

  6. The Application of Time-driven Activity-based Costing to Basic Public Health Services%时间驱动作业成本法在基本公共卫生服务项目成本测算中的应用

    Institute of Scientific and Technical Information of China (English)

    方玉凤; 闫晓娜; 王健; 张丽; 黄飞; 吴树运

    2014-01-01

    Currently, time-driven activity-based costing is a new method estimating the cost in abroad, and is applied in the health field successfully.However, the present study on the use of time-driven activity-based costing measuring basic public health services cost is still in the exploratory stage.Therefore, we try to draw lessons from the basic principles of time-driven activity-based costing method, using the time as the primary cost driver, in order to estimate the cost of public health services items by managers estimating the capacity cost rate and unit time of each transaction, and expect to introduce a new cost estimating method to health field.%时间驱动作业成本法是国外新兴的成本测算方法,在国外卫生领域中的应用已较为成熟。目前国内利用时间驱动作业成本法测算基本公共卫生服务项目成本的研究仍处于探索阶段。为弥补国内相关研究的不足,本文借鉴时间驱动作业成本法的基本原理,分析其在基本公共卫生服务项目成本测算中的必要性和可行性,将时间作为主要的成本动因,通过管理人员估计产能成本率和作业单位时间,来测量基本公共卫生服务项目的成本,以期为卫生领域引入一种新的成本测算理念。

  7. 45 CFR 74.27 - Allowable costs.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Allowable costs. 74.27 Section 74.27 Public..., AND COMMERCIAL ORGANIZATIONS Post-Award Requirements Financial and Program Management § 74.27 Allowable costs. (a) For each kind of recipient, there is a particular set of Federal principles...

  8. The cost of publishing in Danish astronomy

    DEFF Research Database (Denmark)

    Dorch, Bertil F.

    I investigate the cost of publishing in Danish astronomy on a fine scale, including all direct publication costs: The figures show how the annual number of publications with authors from Denmark in astronomy journals increased by a factor approximately four during 15 years (Elsevier’s Scopus...

  9. Minimizing Costs Can Be Costly

    Directory of Open Access Journals (Sweden)

    Rasmus Rasmussen

    2010-01-01

    Full Text Available A quite common practice, even in academic literature, is to simplify a decision problem and model it as a cost-minimizing problem. In fact, some type of models has been standardized to minimization problems, like Quadratic Assignment Problems (QAPs, where a maximization formulation would be treated as a “generalized” QAP and not solvable by many of the specially designed softwares for QAP. Ignoring revenues when modeling a decision problem works only if costs can be separated from the decisions influencing revenues. More often than we think this is not the case, and minimizing costs will not lead to maximized profit. This will be demonstrated using spreadsheets to solve a small example. The example is also used to demonstrate other pitfalls in network models: the inability to generally balance the problem or allocate costs in advance, and the tendency to anticipate a specific type of solution and thereby make constraints too limiting when formulating the problem.

  10. Public Values

    DEFF Research Database (Denmark)

    Beck Jørgensen, Torben; Rutgers, Mark R.

    2015-01-01

    administration is approached in terms of processes guided or restricted by public values and as public value creating: public management and public policy-making are both concerned with establishing, following and realizing public values. To study public values a broad perspective is needed. The article suggest......This article provides the introduction to a symposium on contemporary public values research. It is argued that the contribution to this symposium represent a Public Values Perspective, distinct from other specific lines of research that also use public value as a core concept. Public...... a research agenda for this encompasing kind of public values research. Finally the contributions to the symposium are introduced....

  11. Assessing the Cost Efficiency of Italian Universities

    NARCIS (Netherlands)

    Agasisti, Tommaso; Salerno, Carlo

    2007-01-01

    This study uses Data Envelopment Analysis to evaluate the cost efficiency of 52 Italian public universities. In addition to being one of the first such cost studies of the Italian system, it explicitly takes into account the internal cost structure of institutions’ education programs; a task not pre

  12. 25 CFR 215.12 - Advertising costs.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Advertising costs. 215.12 Section 215.12 Indians BUREAU... LEASES, QUAPAW AGENCY § 215.12 Advertising costs. All advertising costs, publication fees, expenses incurred for abstracts of lease title, and other expenses incurred in connection with the advertising...

  13. 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...

  14. Estimation of immunization providers' activities cost, medication cost, and immunization dose errors cost in Iraq.

    Science.gov (United States)

    Al-lela, Omer Qutaiba B; Bahari, Mohd Baidi; Al-abbassi, Mustafa G; Salih, Muhannad R M; Basher, Amena Y

    2012-06-01

    The immunization status of children is improved by interventions that increase community demand for compulsory and non-compulsory vaccines, one of the most important interventions related to immunization providers. The aim of this study is to evaluate the activities of immunization providers in terms of activities time and cost, to calculate the immunization doses cost, and to determine the immunization dose errors cost. Time-motion and cost analysis study design was used. Five public health clinics in Mosul-Iraq participated in the study. Fifty (50) vaccine doses were required to estimate activities time and cost. Micro-costing method was used; time and cost data were collected for each immunization-related activity performed by the clinic staff. A stopwatch was used to measure the duration of activity interactions between the parents and clinic staff. The immunization service cost was calculated by multiplying the average salary/min by activity time per minute. 528 immunization cards of Iraqi children were scanned to determine the number and the cost of immunization doses errors (extraimmunization doses and invalid doses). The average time for child registration was 6.7 min per each immunization dose, and the physician spent more than 10 min per dose. Nurses needed more than 5 min to complete child vaccination. The total cost of immunization activities was 1.67 US$ per each immunization dose. Measles vaccine (fifth dose) has a lower price (0.42 US$) than all other immunization doses. The cost of a total of 288 invalid doses was 744.55 US$ and the cost of a total of 195 extra immunization doses was 503.85 US$. The time spent on physicians' activities was longer than that spent on registrars' and nurses' activities. Physician total cost was higher than registrar cost and nurse cost. The total immunization cost will increase by about 13.3% owing to dose errors.

  15. Transaction Costs and Cost Breaches in Major Defense Acquisition Programs

    Science.gov (United States)

    2014-02-04

    ADDRESS(ES) 10. SPONSOR/MONITOR’S ACRONYM(S) 11. SPONSOR/MONITOR’S REPORT NUMBER(S) 12. DISTRIBUTION/AVAILABILITY STATEMENT Approved for public release...price for the home (bargaining and decision costs). Last, if the home was purchased using money that was borrowed from a mortgage lender , the...operate within its approved financial constraints as measured by cost breaches. Data Sources This study used two major data sources to develop the

  16. Comments on “Simoens, S. Health Economic Assessment: A Methodological Primer. Int. J. Environ. Res. Public Health 2009, 6, 2950-2966”—New Zealand in Fact Has No Cost-Effectiveness Threshold

    Directory of Open Access Journals (Sweden)

    Scott Metcalfe

    2010-04-01

    Full Text Available The Journal recently incorrectly ascribed cost-effectiveness thresholds to New Zealand, alongside other countries. New Zealand has no such thresholds when deciding the funding of pharmaceuticals. As we fund pharmaceuticals within a fixed budget, and cost-effectiveness is only one of nine decision criteria used to inform decisions, thresholds cannot be inferred or calculated. Thresholds inadequately account for opportunity cost and affordability, and are incompatible with budgets and maximising health gains. In New Zealand, pharmaceutical investments can only be considered ‘cost-effective’ when prioritised against other proposals at the time, and threshold levels must inevitably vary with available funds and the other criteria.

  17. Development Phase Cost Drivers for Production Costs: The Case of Tracked Vehicles

    OpenAIRE

    Boger, Dan C.; Malcolm, David S.

    1993-01-01

    Approved for public release; distribution is unlimited. There are two different approaches, the disjoint and sequential models, which attempt to account for differences between development unit cost and production unit cost. The disjoint model uses a production cost improvement curve that is physically separate from the development cost improvement curve. For the sequential model, however, the first unit cost of production units directly follows the last development unit due to a carryover...

  18. Fitness cost

    DEFF Research Database (Denmark)

    Nielsen, Karen L.; Pedersen, Thomas M.; Udekwu, Klas I.

    2012-01-01

    of each isolate was determined in a growth competition assay with a reference isolate. Significant fitness costs of 215 were determined for the MRSA isolates studied. There was a significant negative correlation between number of antibiotic resistances and relative fitness. Multiple regression analysis...... to that seen in Denmark. We propose a significant fitness cost of resistance as the main bacteriological explanation for the disappearance of the multiresistant complex 83A MRSA in Denmark following a reduction in antibiotic usage.......Denmark and several other countries experienced the first epidemic of methicillin-resistant Staphylococcus aureus (MRSA) during the period 196575, which was caused by multiresistant isolates of phage complex 83A. In Denmark these MRSA isolates disappeared almost completely, being replaced by other...

  19. Enzo Croatto, Vocabolario ampezzano, Cortina d'Ampezzo, 1986; XXX + 426 pagine.Enzo Croatto, Vocabolario ampezzano, Cortina d'Ampezzo, 1986; XXX + 426 pagine

    Directory of Open Access Journals (Sweden)

    Mitja Skubic

    1997-12-01

    Full Text Available Il  prof. Enzo Croatto si dichiara solo coordinatore di questo vocabolario, ma i  suoi meriti non sono pochi. E' vero che ha raccolto oltre alle inchieste dirette anche fonti già pubblicate, soprattutto il vocabolario di Angelo Majoni, pubblicato nel lontano 1929, che ottenne delle lodi da parte del grande conoscitore del lessico e della vita nelle Dolomiti che fu Carlo Battisti; però ha arricchito il vocabolario aggiungendo le inchieste dirette e anche i materiali dell'AIS e del (mai pubblicato ALI, nonché il materiale che contiene il Vocabolario provvisorio della parlata ampezzana, pubblicato nei fascicoli tra il 1974 e il 1977. Il vocabolario fornisce anche informazioni grammaticali, ad es. sulla formazione del plurale dei nomi o sulle forme verbali le quali, per i così detti verbi irregolari, appaiono per intero

  20. 42 CFR 447.76 - Public schedule.

    Science.gov (United States)

    2010-10-01

    ...) Current premiums, enrollment fees, or similar fees. (2) Current cost sharing charges. (3) The aggregate limit on premiums and cost sharing or just cost sharing. (4) Mechanisms for making payments for required... Cost Sharing Under Section 1916a § 447.76 Public schedule. (a) The State must make available to...

  1. Multicentre study of haemodialysis costs.

    Science.gov (United States)

    Parra Moncasi, E; Arenas Jiménez, M D; Alonso, M; Martínez, M F; Gámen Pardo, A; Rebollo, P; Ortega Montoliú, T; Martínez Terrer, T; Alvarez-Ude, F

    2011-01-01

    Previous studies to determine the cost of haemodialysis (HD) in Spain have significant limitations: they are outdated or used indirect methods. There is also a lack of analysis performed simultaneously on Public centres (PC), with direct HD services, and partially state-subsidised centres (SC). This is an important issue since the two systems coexist in Spain. To estimate the cost of HD replacement therapy for chronic renal failure in several centres. This is a prospective and publicly-funded study, which estimates the costs for 2008 using a cost accounting system with specific allocation criteria. We collected demographic and comorbidity data for each centre. Six centres participated, two PC and four SC. There were no significant differences between centres in terms of patient demographics, time on haemodialysis and the Charlson comorbidity index. The total cost per patient per year ranged between € 46, 254 and € 33,130. The cost per patient per year (excluding vascular access and hospital admission) for PC was € 42, 547 and € 39, 289 and for SC € 32 872, € 29, 786, € 35, 461 and € 35, 294 (23% more in PC than SC). Costs related to staff/patient/year and consumables/patient/year were 67% and 83% respectively, higher for PC than SC. The highest percentage cost was for staff (average 30.9%), which showed significant variability between centres, both in absolute numbers (staff cost per patient per year between € 18,151 and € 8504) and as a percentage (between 42.6 % and 25.4%). Cost variability exists among different HD centres, and this can be attributed primarily to staff and consumables costs, which is higher for PC than SC.

  2. [Public policy analysis].

    Science.gov (United States)

    Subirats, J

    2001-01-01

    This article presents to public health professionals concepts and perspectives from political science relevant for creating a healthier public policy. Currently, there is no uniform vision of what constitutes public interest and the decisions of public administrations tend to be based on compromise. In public debate, what is paramount is the capacity to persuade. From the perspective of public policy analysis, the crucial issue is definition: the final decision depends on the definition of the problem that has emerged triumphant in the public debate among competing actors with different definitions of the problem. From a policy analysis perspective, the problems entering the agenda of public administration does not necessarily correspond to their severity, as competing actors try to impose their point of view. Because of its historical evolution, the Spanish political system has specific traits. The relatively weak democratic tradition tends to make the decision process less visibles, with strong technocratic elements and weaker social articulation. Both the juridical tradition and liberal rhetoric portray lobbying as contrary to public interest, when in fact it is constantly performed by powerful vested interest groups, through both personal contacts and economic connections. Regulatory policies, with concentrated costs and diffuse benefits, seem to be moving from Spain to the European Union. To promote healthier public policies, the development of civil society initiatives and the building of coalitions will play an increasingly greater role in the future.

  3. Public lighting.

    NARCIS (Netherlands)

    Schreuder, D.A.

    1986-01-01

    The function of public lighting and the relationship between public lighting and accidents are considered briefly as aspects of effective countermeasures. Research needs and recent developments in installation and operational described. Public lighting is an efficient accident countermeasure, but

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

    Science.gov (United States)

    Cutler, David M; Ericson, Keith M Marzilli

    2010-01-01

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

  5. Public health ethics: informing better public health practice.

    Science.gov (United States)

    Carter, Stacy M; Kerridge, Ian; Sainsbury, Peter; Letts, Julie K

    2012-01-01

    Public health ethics has emerged and grown as an independent discipline over the last decade. It involves using ethical theory and empirical analyses to determine and justify the right thing to do in public health. In this paper, we distinguish public health ethics from clinical ethics, research ethics, public health law and politics. We then discuss issues in public health ethics including: how to weigh up the benefits, harms and costs of intervening; how to ensure that public health interventions produce fair outcomes; the potential for public health to undermine or promote the rights of citizens; and the significance of being transparent and inclusive in public health interventions. We conclude that the explicit and systematic consideration of ethical issues will, and should, become central to every public health worker's daily practice.

  6. Evaluation of public transport

    DEFF Research Database (Denmark)

    Flyvbjerg, Bent; Kahr, Kjeld; Petersen, Peter Bo

    1986-01-01

    This paper discusses a method to evaluate sceduled, fixed-route public transport. One major evaluation criterion in the method is total travel time, subdivided into walking time, waiting time, time on vehicle, transfer time, and concealed waiting time. The other major criterion is cost incurred...... by a given supply of transport. In contrast with conventional methods, this method operates with real measures, i.e. real location (instead of traffic zones), real time (instead of average travel time), and real costs (instead of proxy-costs). The purpose is to produce relevant and easily understandable...... results suitable to open planning, for instance with citizen participation. Five examples of application of the method are given: (1) evaluation of changes in suburban bus services; (2) evaluation of geographical localities as regards public transport; (3) evaluation of circular bus routes; (4) evaluation...

  7. Public Broadcasting.

    Science.gov (United States)

    Shooshan, Harry M.; Arnheim, Louise

    This paper, the second in a series exploring future options for public policy in the communications and information arenas, examines some of the issues underlying public broadcasting, primarily public television. It advances two reasons why quality local public television programming is scarce: funds for the original production of programming have…

  8. The costs of providing antiretroviral therapy services to HIV-infected individuals presenting with advanced HIV disease at public health centres in Dar es Salaam, Tanzania: Findings from a randomised trial evaluating different health care strategies

    Science.gov (United States)

    Kimaro, Godfather Dickson; Mfinanga, Sayoki; Simms, Victoria; Kivuyo, Sokoine; Bottomley, Christian; Hawkins, Neil; Harrison, Thomas S.; Jaffar, Shabbar; Guinness, Lorna

    2017-01-01

    Background Understanding the costs associated with health care delivery strategies is essential for planning. There are few data on health service resources used by patients and their associated costs within antiretroviral (ART) programmes in Africa. Material and methods The study was nested within a large trial, which evaluated screening for cryptococcal meningitis and tuberculosis and a short initial period of home-based adherence support for patients initiating ART with advanced HIV disease in Tanzania and Zambia. The economic evaluation was done in Tanzania alone. We estimated costs of providing routine ART services from the health service provider's perspective using a micro-costing approach. Incremental costs for the different novel components of service delivery were also estimated. All costs were converted into US dollars (US$) and based on 2012 prices. Results Of 870 individuals enrolled in Tanzania, 434 were enrolled in the intervention arm and 436 in the standard care/control arm. Overall, the median (IQR) age and CD4 cell count at enrolment were 38 [31, 44] years and 52 [20, 89] cells/mm3, respectively. The mean per patient costs over the first three months and over a one year period of follow up following ART initiation in the standard care arm were US$ 107 (95%CI 101–112) and US$ 265 (95%CI 254–275) respectively. ART drugs, clinic visits and hospital admission constituted 50%, 19%, and 19% of the total cost per patient year, while diagnostic tests and non-ART drugs (co-trimoxazole) accounted for 10% and 2% of total per patient year costs. The incremental costs of the intervention to the health service over the first three months was US$ 59 (p<0.001; 95%CI 52–67) and over a one year period was US$ 67(p<0.001; 95%CI 50–83). This is equivalent to an increase of 55% (95%CI 51%–59%) in the mean cost of care over the first three months, and 25% (95%CI 20%–30%) increase over one year of follow up. PMID:28234969

  9. Patterns and Costs of Crime.

    Science.gov (United States)

    Lincoln, Alan Jay

    1984-01-01

    Presents results of the Library Crime Research Project, a three-year study of crime and disruption patterns in public libraries in all 50 states. Patterns of crime, costs of crime (direct, indirect), losses due to crime, patterns of security use, and effects of victimization are covered. Three references are listed. (EJS)

  10. The Basic Public Finance of Public-Private Partnerships

    OpenAIRE

    Engel, Eduardo M. R. A.; Fischer, Ronald D.; Galetovic, Alexander

    2007-01-01

    Public-private partnerships (PPPs) have been justified because they release public funds or save on distortionary taxes. However, the resources saved by a government that does not finance the upfront investment are offset by giving up future revenue flows to the concessionaire. If a PPP can be justified on efficiency grounds, the PPP contract that optimally balances demand risk, userfee distortions and the opportunity cost of public funds has a minimum revenue guarantee and a revenue cap. The...

  11. The Basic Public Finance of Public-Private Partnerships

    OpenAIRE

    Eduardo M.R.A. Engel; Ronald D. Fischer; Galetovic, Alexander

    2007-01-01

    Public-private partnerships (PPPs) have been justified because they release public funds or save on distortionary taxes. However, the resources saved by a government that does not finance the upfront investment are offset by giving up future revenue flows to the concessionaire. If a PPP can be justified on efficiency grounds, the PPP contract that optimally balances demand risk, userfee distortions and the opportunity cost of public funds has a minimum revenue guarantee and a revenue cap. The...

  12. Inefficiencies in public environmental services

    NARCIS (Netherlands)

    de Jong, R.; Nentjes, A.; Wiersma, D.

    The paper discusses efficiency issues in the public provision of environmental services, in particular waste water treatment. It is shown that in the face of increasing, respectively decreasing returns to scale the zero profit constraint of a cost minimizing public firm induces underinvestment,

  13. Inefficiencies in public environmental services

    NARCIS (Netherlands)

    de Jong, R.; Nentjes, A.; Wiersma, D.

    2000-01-01

    The paper discusses efficiency issues in the public provision of environmental services, in particular waste water treatment. It is shown that in the face of increasing, respectively decreasing returns to scale the zero profit constraint of a cost minimizing public firm induces underinvestment, resp

  14. Victorian Public Libraries and the Internet: Results and Issues.

    Science.gov (United States)

    Bertot, John Carlo; McClure, Charles R.

    This study collected Victorian (Australia) public library and public library user Internet connectivity data that: provides a baseline measure of public library Internet connectivity; describes public library type and level of Internet connectivity; details public library branch Internet connectivity; reviews the costs of public library Internet…

  15. A utilização das informações de custos na gestão da saúde pública: um estudo preliminar em secretarias municipais de saúde do estado de Santa Catarina The use of costs information in public health: a preliminary study in local health departments in the state of Santa Catarina

    Directory of Open Access Journals (Sweden)

    André Graf de Almeida

    2009-06-01

    Full Text Available Este artigo analisa o uso das informações de custos pelos gestores de 20 grandes secretarias municipais da saúde do estado de Santa Catarina. Para isso, foi avaliado o perfil dos gestores entrevistados; foi verificada a existência ou não de sistemas de custos implantados nessas secretarias; foi feita uma avaliação da percepção desses gestores sobre a utilização das informações de custos no processo de tomada de decisão e foram identificadas quais informações de custos são utilizadas atualmente na gestão desses órgãos. Os entrevistados foram os ocupantes de cargos administrativos nas secretarias municipais da saúde pesquisadas. Conseguiu-se avaliar o uso das informações de custos na gestão de 18 secretarias municipais da saúde do estado de Santa Catarina. Os resultados indicam que apenas duas secretarias municipais da saúde possuem esse processo um pouco mais avançado; nas demais, o que se verifica é que existem algumas tentativas de se obter informações mais detalhadas sobre custos. Entretanto, na opinião dos entrevistados, as informações de custos são bastante importantes na gestão das secretarias.This article analyzes the use of costs information in decision-making by managers of the 20 local health departments in the state of Santa Catarina, Brazil. Public managers profiles were assessed so as to verify whether they had the schooling and experience needed to produce ethical information on certain issues. The existence of costs systems in such departments was assessed through the managers' perceptions of the use of costs information in the decision-making process, and which information is actually used. The methodology used was guided interviews, and the subjects were public employees withholding managing positions in local health departments. The goals of the study were reached as 18 local health departments in the state of Santa Catarina were assessed on their use of costs information. Results show that in

  16. Adherence and health care costs

    Directory of Open Access Journals (Sweden)

    Iuga AO

    2014-02-01

    Full Text Available Aurel O Iuga,1,2 Maura J McGuire3,4 1Johns Hopkins Bloomberg School of Public Health, 2Johns Hopkins University, 3Johns Hopkins Community Physicians, 4Johns Hopkins University School of Medicine, Baltimore, MD, USA Abstract: Medication nonadherence is an important public health consideration, affecting health outcomes and overall health care costs. This review considers the most recent developments in adherence research with a focus on the impact of medication adherence on health care costs in the US health system. We describe the magnitude of the nonadherence problem and related costs, with an extensive discussion of the mechanisms underlying the impact of nonadherence on costs. Specifically, we summarize the impact of nonadherence on health care costs in several chronic diseases, such as diabetes and asthma. A brief analysis of existing research study designs, along with suggestions for future research focus, is provided. Finally, given the ongoing changes in the US health care system, we also address some of the most relevant and current trends in health care, including pharmacist-led medication therapy management and electronic (e-prescribing. Keywords: patient, medication, adherence, compliance, nonadherence, noncompliance, cost

  17. 76 FR 68040 - Federal Acquisition Regulation; Labor Relations Costs

    Science.gov (United States)

    2011-11-02

    ... careful review of public comments, discussed below, DoD, GSA, and NASA have concluded that the proposed... Federal Acquisition Regulation; Labor Relations Costs AGENCY: Department of Defense (DoD), General....205-21, the cost principle addressing labor relations costs. Currently, this cost principle states...

  18. 42 CFR 417.538 - Enrollment and marketing costs.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Enrollment and marketing costs. 417.538 Section 417... PREPAYMENT PLANS Medicare Payment: Cost Basis § 417.538 Enrollment and marketing costs. (a) Principle. Costs incurred by an HMO or CMP in performing the enrollment and marketing activities described in subpart k...

  19. 77 FR 67366 - Federal Acquisition Regulation; Information Collection; Travel Costs

    Science.gov (United States)

    2012-11-09

    ... Regulation; Information Collection; Travel Costs AGENCY: Department of Defense (DOD), General Services... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF DEFENSE... collection requirement concerning Travel Costs. Public comments are particularly invited on: Whether...

  20. Thinking on the High Undesirable Administrative Costs of Chinese Government---Reflection on the Junket ofPublic Servants in China%中国政府不良行政成本偏高的制度思考--对我国公务人员公费旅游的反思

    Institute of Scientific and Technical Information of China (English)

    王明杰

    2016-01-01

    The relationship between state and society,government and citizen reflected in the administrative costs determines its significance in public affairs.Whether the administrative costs is reasonable or not is directly related to the credibility of the government as well as the legitimacy of the regime.This study divides the administrative costs into “necessary administrative costs”and “undesirable administrative costs”,starts from the defects of the current system of public servants out learning in our country,has deep reflection on the cause of the high undesirable administrative costs and explore the solutions in terms of system to reduce the administrative costs and improve administrative efficiency .%行政成本所内含的国家与社会、政府与公民关系决定了其在公共事务中的重要意义,行政成本合理与否将直接关系到政府的公信力以及政权的合法性。文章将行政成本分为“必须行政成本”和“不良行政成本”,从我国现行公务人员外出学习考察体制的制度缺陷着手,对不良行政成本偏高的原因进行深层次的反思,探寻降低行政成本,提高行政效率的制度上的解法。

  1. Sharing the cost of redundant items

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Moulin, Hervé

    2014-01-01

    are network connectivity problems when an existing (possibly inefficient) network must be maintained. We axiomatize a family cost ratios based on simple liability indices, one for each agent and for each item, measuring the relative worth of this item across agents, and generating cost allocation rules......We ask how to share the cost of finitely many public goods (items) among users with different needs: some smaller subsets of items are enough to serve the needs of each user, yet the cost of all items must be covered, even if this entails inefficiently paying for redundant items. Typical examples...... additive in costs....

  2. On the weak project construction cost management

    Institute of Scientific and Technical Information of China (English)

    高守刚; 姜婧; 李玲

    2013-01-01

    the weak cost management is the most talked about topics in the weak industry, but also the basis of the weak construction business management and focus. With the increasingly fierce market competition, weak construction enterprises, the competition among enterprises wil gradual y transition from product quality competition to price competition. To strengthen the management of the weak construction enterprises cost, cut public spending ef iciency, improve market competitiveness, wil be the main way most weak construction corporate earnings and long-term business strategy. Based on the to weak project construction cost management based on analysis of the type of project construction costs, and further proposed the weak project construction cost management measures.

  3. Public Schools

    Data.gov (United States)

    Department of Homeland Security — This Public Schools feature dataset is composed of all Public elementary and secondary education in the United States as defined by the Common Core of Data, National...

  4. Public lighting.

    NARCIS (Netherlands)

    2011-01-01

    Visual perception is very important for road users and in the dark it can be facilitated by public lighting. Public lighting has a mostly positive road safety effect. Installing public lighting on roads that were previously unlit generally results in fewer and less serious crashes. This effect seems

  5. Program Costing in a Community College

    Science.gov (United States)

    Balinsky, Warren; Burns, John

    1975-01-01

    This paper discusses improving the budget control process for a community college by use of program cost accounting. The authors suggest that adoption of such a program will improve resource allocation and program evaluation, aid planning, and better inform the public about the purposes, costs, and results of school programs. (JG)

  6. 24 CFR 700.145 - Cost distribution.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Cost distribution. 700.145 Section 700.145 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued... PUBLIC AND INDIAN HOUSING PROGRAMS) CONGREGATE HOUSING SERVICES PROGRAM § 700.145 Cost distribution....

  7. 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...

  8. Cost Overrun Optimism: Fact or Fiction

    Science.gov (United States)

    2016-02-29

    Image designed by Diane Fleischer Cost Overrun Optimism : FACT or FICTION? Maj David D. Christensen, USAF Program managers are advocates by...3 : 254–271 A Publication of the Defense Acquisition University http://www.dau.mil Cost Overrun Optimism : Fact or Fiction? According to Gansler...generally confirmed. From as early as the 10 percent completion point, the optimism of the pro- jected cost overrun at completion is apparent. Throughout

  9. A Research on Operation Cost-Sharing of Boarding Junior Middle School and Primary School in Rural Areas in China: Based on the Theory of Public Goods%我国农村寄宿制中小学运行成本分担问题研究——基于公共产品理论的视角

    Institute of Scientific and Technical Information of China (English)

    董世华

    2011-01-01

    教育成本包括固定成本和变动成本两个方面,农村寄宿制学校运行成本的主体是变动成本。近年来,各地都在大力新建、改造农村寄宿制学校,而各级政府则成为固定成本的承担主体。但是,政策制定者对寄宿制学校运行成本的变化却关注甚少。在实际操作中,大量的运行成本却隐形地转嫁到学校、教师及学生家庭,危及了义务教育的公平。寄宿制学校教育作为完成农村义务教育的一种特殊形式,也应该属于公共产品。由此,政府需承担寄宿制学校的新增运行成本,以确保义务教育的均衡发展和教育公平的实现。%Education cost consists of fixed cost and carrying cost. The carrying cost is the main body of operation cost in rural boarding school. In recent years, governments at all levels have been the main body of fixed cost. They newly build and rebuild boarding schools. However, policy-makers have pay less attention to the changing operation cost. In practice, much of the carrying cost have been distributed to school, teachers and students" family secretly by a special form, so as to influence equity of compulsory education. As we know, compulsory education is a kind of public goods, so does the boarding school education, as a special form for completing rural compulsory education, thus deciding that government must bear the additional operating costs of boarding schools, ensure balanced development of compulsory education, and ultimately achieve educational eqmty

  10. Total educational costs of an integrated nursing curriculum.

    Science.gov (United States)

    Bobroff, Maria Cristina Cescatto; Gordan, Pedro A; Garanhani, Mara Lúcia

    2009-01-01

    Innovative changes in undergraduate Nursing programs have brought about new methodologies and the need for cost evaluation. This study aims to develop a model for cost estimation, and to estimate educational costs of an integrated Nursing curriculum at a public university. This is a case study conducted in stages: model development, data collection, analysis and interpretation. The cost-construction model consisted of six steps: data collection; educational and support activity costs; four-year course educational costs; educational support costs; joint product costs and total educational costs. Findings showed a total educational cost per student/year US$ 3,788.82. Course team faculty included 97 members. The cost analysis in faculty contact hours is the most appropriate cost unit as it most consistently reflects faculty time devoted to teaching. The knowledge about educational costs provided information that may be useful for a different approach to the integrated curriculum management, with a view to putting its educational objectives in practice.

  11. Unraveling Higher Education's Costs.

    Science.gov (United States)

    Gordon, Gus; Charles, Maria

    1998-01-01

    The activity-based costing (ABC) method of analyzing institutional costs in higher education involves four procedures: determining the various discrete activities of the organization; calculating the cost of each; determining the cost drivers; tracing cost to the cost objective or consumer of each activity. Few American institutions have used the…

  12. Road crash costs.

    NARCIS (Netherlands)

    2010-01-01

    Road crashes result in all kinds of social costs, such as medical costs, production loss, human losses, property damage, settlement costs and costs due to congestion. Studies into road crash costs and their trends are carried out quite regularly. In 2009, the costs amounted to € 12.5 billion, or 2.2

  13. COST MEASUREMENT AND COST MANAGEMENT IN TARGET COSTING

    Directory of Open Access Journals (Sweden)

    Moisello Anna Maria

    2012-07-01

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

  14. Hydropower Baseline Cost Modeling

    Energy Technology Data Exchange (ETDEWEB)

    O' Connor, Patrick W. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Zhang, Qin Fen [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); DeNeale, Scott T. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Chalise, Dol Raj [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Centurion, Emma E. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2015-01-01

    Recent resource assessments conducted by the United States Department of Energy have identified significant opportunities for expanding hydropower generation through the addition of power to non-powered dams and on undeveloped stream-reaches. Additional interest exists in the powering of existing water resource infrastructure such as conduits and canals, upgrading and expanding existing hydropower facilities, and the construction new pumped storage hydropower. Understanding the potential future role of these hydropower resources in the nation’s energy system requires an assessment of the environmental and techno-economic issues associated with expanding hydropower generation. To facilitate these assessments, this report seeks to fill the current gaps in publically available hydropower cost-estimating tools that can support the national-scale evaluation of hydropower resources.

  15. The ELENA Programme in the Province of Chieti - A Public Private Partnership Best Practice Improving Energy Efficiency of Buildings and Public Lighting Systems

    National Research Council Canada - National Science Library

    Fecondo, Pierluigi; Moca, Giancarlo

    2015-01-01

    Public Private Partnership initiatives and models are proven, scalable and internationally-recognized procurement methods for reducing the operating costs and improve environmental quality of public bodies...

  16. New pharmaceuticals reduce cost of illness.

    Science.gov (United States)

    Hansen, R W

    1986-06-01

    The cost of illness includes not only the funds required to treat illness, but also the effect on the patient's quality of life. Recent concern about rising health costs have focused on the direct expenditures without noting that the cost of illness in terms of mortality and morbidity has declined significantly. Pharmaceuticals have played a major role in reducing the total cost of illness. Several studies of the cost-effectiveness of past introductions of vaccines and pharmaceuticals reveal large cost savings. Although the focus of most studies has been on major advances, the continuing process of less dramatic therapeutic improvements has significantly trimmed the cost of illness. Cost-benefit studies of new drugs or changes in drug use, while more difficult to perform, make it possible to influence the selection of therapy. Since pharmaceuticals represent less than 10% of total treatment costs, reduction in the cost of pharmaceutical products can only have a minor impact on the total cost of illness. Pharmaceuticals can reduce the cost of illness by providing alternative therapies that reduce direct treatment cost or improve the public health.

  17. 77 FR 69441 - Federal Acquisition Regulation; Information Collection; Cost Accounting Standards Administration

    Science.gov (United States)

    2012-11-19

    ... Regulation; Information Collection; Cost Accounting Standards Administration AGENCY: Department of Defense... approved information collection requirement concerning cost accounting standards administration. Public... comments identified by Information Collection 9000- 0129, Cost Accounting Standards Administration by...

  18. 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.

  19. Dolci pagine: la pasticceria napoletana nell´opera di Matilde Serao

    Directory of Open Access Journals (Sweden)

    Fabiano Dalla Bona

    2004-12-01

    Full Text Available A identidade de um povo pode ser verificada também por meio de suas práticas culinárias e a literatura serve como um grande documento. Na obra de Matilde Serao, escritora e jornalista napolitana, a cidade de Nápoles é descrita de maneira completa e a cozinha é um elemento que serve para distinguir sua população das outras coletividades italianas, especialmente no tocante à confeitaria.

  20. 17 CFR 230.403 - Requirements as to paper, printing, language and pagination.

    Science.gov (United States)

    2010-04-01

    ... submit instead a fair and accurate English translation of the entire foreign language document, except as... translation of a foreign language document as an exhibit or attachment to a filing subject to review by the...) When submitting an English summary or English translation of a foreign language document under...

  1. Alternative Funding For Public Goods Provision

    OpenAIRE

    Kodrat Wibowo

    2002-01-01

    Finding alternatives in public good financing is one of the most recent issues in the government sector. Tax-financed for pure public good is well known results further problems like externalities and economic inequity. This paper only addresses the qualitative analysis in discussing benefits and costs of the society in applying some alternatives in funding public good provisions, pure and impure one.

  2. Custo da fluoretação das águas de abastecimento público, estudo de caso ­ Município de São Paulo, Brasil, período de 1985-2003 Cost of fluoridating the public water supply: a study case in the city of São Paulo, Brazil, 1985-2003

    Directory of Open Access Journals (Sweden)

    Antonio Carlos Frias

    2006-06-01

    Full Text Available O objetivo do artigo é estimar o custo da fluoretação das águas de abastecimento público no Município de São Paulo no período de 1985-2003. Para o cálculo da composição de custos da fluoretação das águas levou-se em conta os seguintes custos: (a capital inicial de instalação; (b produto químico (ácido fluorsilícico; (c operacionalização do sistema (manutenção do sistema, energia elétrica e recursos humanos; e (d controle dos teores de flúor. A ação do flúor mostrou-se efetiva, pois para a idade de 12 anos observou-se redução de 73% na experiência de cárie dentária, sendo que em 1986 a média do índice CPO-D era de 6,47 (6,12-6,82 e em 2002 foi de 1,75 (1,48-2,92. Nesta idade-índice 40% das crianças apresentaram CPO-D = 0 em 2002. O custo médio per capita/ano na Cidade de São Paulo foi de R$ 0,08 (US$ 0,03 em 2003. O custo acumulado em 18 anos de implantação do sistema de fluoretação foi de R$ 1,44 (US$ 0,97 per capita.The aim of this study was to estimate the cost of fluoridating the public water supply in the city of São Paulo, Brazil, from 1985 to 2003. Cost calculation for fluoridation of the public water supply used the following: capital cost of initial installation, chemical product (hydrofluosilicic acid, system's operational cost (maintenance, electricity, and human resources, and monitoring fluoride levels. Fluoridation was effective, since there was a decrease of 73% in dental caries in 12-year-olds ­ mean DMF was 6.47 (6.12-6.82 in 1986, having decreased to 1.75 (1.48-2.92 in 2002. In this age group, 40% of children presented DMF = 0 in 2002. Average cost per inhabitant/year for 2003 was R$ 0.08 (US$ 0.03. The accumulated cost for 18 years of implementation and maintenance of the fluoridation system was R$ 1.44 (US$ 0.97 per capita.

  3. The Quality Costs

    Directory of Open Access Journals (Sweden)

    Arsenie Constantin PAULICĂ

    2005-10-01

    Full Text Available Quality has a cost and this fact cannot be denied. In the same time, it is true that non-quality is more expensive. Quality is considered asbeing expensive because no one tries to calculate non-quality costs. Out of the final cost of a product, non-quality stands for 20% up to 35%.According to this idea all the economic sectors contain error costs caused by the mistakes made during the production process. To have a realconsummation situation, it is necessary to know the cost quantum. The final quality cost is the result of the following costs: prevention costs,necessary to preclude errors; evaluation costs, as results of a final product evaluation, and failure costs, generated by the non – attainment ofproduct’s purpose. The gross of these costs stand for the total quality costs. Nowadays, the problem inheres in how much this quality cost representsout of the final cost.

  4. 32 CFR Appendix B to Part 247 - CE Publications

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 2 2010-07-01 2010-07-01 false CE Publications B Appendix B to Part 247... Appendix B to Part 247—CE Publications A. Purpose. CE publications consist of DoD newspapers, magazines... publication. CE publishers sell advertising to cover costs and secure earnings, print the publications, and...

  5. Public traditional Chinese medicine hospitals cost accounting informatization cross-sectional study%中医医院成本核算信息化基本情况调查

    Institute of Scientific and Technical Information of China (English)

    徐静晗; 陈越; 蒋艳; 张舜瑞; 程薇

    2014-01-01

    目的:了解中医医院成本核算信息化的基本情况。方法对全国各省、自治区、直辖市所有公立中医医院进行成本核算信息化现状网络在线调查,并对调查结果进行数据分析。结果参与调查的1588家中医医院中,78.65%的医院存在软件配备不全面问题;57.43%的医院存在软件接口之间无法实现信息共享问题;43.20%的医院存在软件功能落后问题。医院信息系统(Hospital Information System, HIS)的配备率为81.86%,会计核算软件的配备率为87.09%,成本核算软件配备率为39.11%,尚未配备任何软件的占5.42%。收入数据统计到科室的医院占95%;支出数据统计到科室占80%;固定资产折旧费统计到科室占73.05%;无形资产摊销、医疗风险基金统计到科室的比例分别为51.39%和52.77%。内部服务量数据可统计到医疗辅助科室的医院占比要高于后勤服务科室,前者为81.49%,后者为63.85%。结论中医医院成本核算系统软件配备率不高。医院信息化建设存在系统软件配备不全面,软件系统之间无法实现信息共享等问题。%Objective To understand the basic situation and existing problems of cost accounting information construction in the traditional Chinese medicine hospital. Methods We made a cross-sectional study of all traditional Chinese medicine hospitals cost accounting informatization, and then analyzed the results. Results In the survey of 1588 traditional Chinese medicine hospitals, there exists the problem with 78.65%for limited software;57.43%for not sharing between the systems;43.20%for outdated software. The occupancy rate was 81.86%for HIS system, 87.09%for the accounting software, 39.11%for cost accounting software, 5.42%for none. The proportion of hospitals was over 95% whose income data statistics to department;80% for spending data;73.05%for fixed assets depreciation cost;51.39%for amortization of intangible assets and

  6. Guideline to Estimate Decommissioning Costs

    Energy Technology Data Exchange (ETDEWEB)

    Yun, Taesik; Kim, Younggook; Oh, Jaeyoung [KHNP CRI, Daejeon (Korea, Republic of)

    2016-10-15

    The primary objective of this work is to provide guidelines to estimate the decommissioning cost as well as the stakeholders with plausible information to understand the decommissioning activities in a reasonable manner, which eventually contribute to acquiring the public acceptance for the nuclear power industry. Although several cases of the decommissioning cost estimate have been made for a few commercial nuclear power plants, the different technical, site-specific and economic assumptions used make it difficult to interpret those cost estimates and compare them with that of a relevant plant. Trustworthy cost estimates are crucial to plan a safe and economic decommissioning project. The typical approach is to break down the decommissioning project into a series of discrete and measurable work activities. Although plant specific differences derived from the economic and technical assumptions make a licensee difficult to estimate reliable decommissioning costs, estimating decommissioning costs is the most crucial processes since it encompasses all the spectrum of activities from the planning to the final evaluation on whether a decommissioning project has successfully been preceded from the perspective of safety and economic points. Hence, it is clear that tenacious efforts should be needed to successfully perform the decommissioning project.

  7. The role of cost accounting in the university performance measurement in Portugal

    OpenAIRE

    Marques,Maria da Conceição da Costa

    2010-01-01

    Cost accounting is aimed at emphasising those elements of costs and profits of original importance to the management board of an organizational unit. Therefore, cost accounting was initially understood as mere collector of costs and profits, using the traditional system of costing everything, a budget with a limited base. Originally, it was designed to calculate real costs with the aim to determine the results. In public organizations, the aim of cost accounting, costs or management, c...

  8. COSTS CALCULATION OF TARGET COSTING METHOD

    Directory of Open Access Journals (Sweden)

    Sebastian UNGUREANU

    2014-06-01

    Full Text Available Cost information system plays an important role in every organization in the decision making process. An important task of management is ensuring control of the operations, processes, sectors, and not ultimately on costs. Although in achieving the objectives of an organization compete more control systems (production control, quality control, etc., the cost information system is important because monitors results of the other. Detailed analysis of costs, production cost calculation, quantification of losses, estimate the work efficiency provides a solid basis for financial control. Knowledge of the costs is a decisive factor in taking decisions and planning future activities. Managers are concerned about the costs that will appear in the future, their level underpinning the supply and production decisions as well as price policy. An important factor is the efficiency of cost information system in such a way that the information provided by it may be useful for decisions and planning of the work.

  9. COSTS CALCULATION OF TARGET COSTING METHOD

    Directory of Open Access Journals (Sweden)

    Sebastian UNGUREANU

    2014-06-01

    Full Text Available Cost information system plays an important role in every organization in the decision making process. An important task of management is ensuring control of the operations, processes, sectors, and not ultimately on costs. Although in achieving the objectives of an organization compete more control systems (production control, quality control, etc., the cost information system is important because monitors results of the other. Detailed analysis of costs, production cost calculation, quantification of losses, estimate the work efficiency provides a solid basis for financial control. Knowledge of the costs is a decisive factor in taking decisions and planning future activities. Managers are concerned about the costs that will appear in the future, their level underpinning the supply and production decisions as well as price policy. An important factor is the efficiency of cost information system in such a way that the information provided by it may be useful for decisions and planning of the work.

  10. Optimal public rationing and price response.

    Science.gov (United States)

    Grassi, Simona; Ma, Ching-To Albert

    2011-12-01

    We study optimal public health care rationing and private sector price responses. Consumers differ in their wealth and illness severity (defined as treatment cost). Due to a limited budget, some consumers must be rationed. Rationed consumers may purchase from a monopolistic private market. We consider two information regimes. In the first, the public supplier rations consumers according to their wealth information (means testing). In equilibrium, the public supplier must ration both rich and poor consumers. Rationing some poor consumers implements price reduction in the private market. In the second information regime, the public supplier rations consumers according to consumers' wealth and cost information. In equilibrium, consumers are allocated the good if and only if their costs are below a threshold (cost effectiveness). Rationing based on cost results in higher equilibrium consumer surplus than rationing based on wealth.

  11. Process-based costing.

    Science.gov (United States)

    Lee, Robert H; Bott, Marjorie J; Forbes, Sarah; Redford, Linda; Swagerty, Daniel L; Taunton, Roma Lee

    2003-01-01

    Understanding how quality improvement affects costs is important. Unfortunately, low-cost, reliable ways of measuring direct costs are scarce. This article builds on the principles of process improvement to develop a costing strategy that meets both criteria. Process-based costing has 4 steps: developing a flowchart, estimating resource use, valuing resources, and calculating direct costs. To illustrate the technique, this article uses it to cost the care planning process in 3 long-term care facilities. We conclude that process-based costing is easy to implement; generates reliable, valid data; and allows nursing managers to assess the costs of new or modified processes.

  12. Strategic Thinking about How Costs and Goals Interact

    Science.gov (United States)

    Cavanaugh, John C.; Graves, William H.

    2010-01-01

    In the grand economic scheme, the intense public pressure to lower costs came late to higher education. No institution--public or private, non-profit or for-profit--has escaped the always difficult, sometimes protracted discussions of how to increase efficiency and lower costs. Although this intense pressure predates the recent great recession,…

  13. 41 CFR 105-54.304 - Cost guidelines.

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Cost guidelines. 105-54.304 Section 105-54.304 Public Contracts and Property Management Federal Property Management... Administration 54-ADVISORY COMMITTEE MANAGEMENT 54.3-Advisory Committee Procedures § 105-54.304 Cost...

  14. Public knowledge and public trust.

    Science.gov (United States)

    Cunningham-Burley, Sarah

    2006-01-01

    As health care applications derived from human genetics research are likely to move increasingly from 'clinic to community', there is growing interest not just in how patients understand and take up health-related genetic information but also in the views of the wider population, as well as a range of professional groups. In this paper, issues relating public knowledge and public trust are raised and discussed in an attempt to move forward debates about public involvement in genomic research and the role of sociologists within interdisciplinary teams. As the field of public understanding of science has developed, we have seen a shift from a focus on the lack of scientific literacy as problem to a recognition of the range of different knowledges that people have and use as they confront science and technology in their everyday lives. As a mood for dialogue pervades many institutions in their relations with 'publics', attention must now be paid to the way in which knowledge and expertise is expressed, heard and acted upon in dialogic encounters. There is increasing concern about public trust in science and calls to increase public confidence, particularly through more open engagement with a range of publics. However, lack of trust or loss of confidence may be constructed as problems rather than reflecting empirical reality, where more complex relationships and attitudes prevail. Lack of trust is often privatized, deeply rooted in lived experience and routinely managed. Trust relations are generally characterized by ambivalence, uncertainty and risk, and are always provisional. Drawing on selected literature and empirical research to review and illustrate this field, this paper argues that scepticism or ambivalence on the part of publics are not necessarily problems to be overcome in the interest of scientific progress, but rather should be mobilized to enhance open and public debates about the nature and direction of genomics research, medicine, and the related

  15. Public opinion on public services

    NARCIS (Netherlands)

    Evelien Eggink; Debbie Verbeek-Oudijk; Evert Pommer

    2013-01-01

    Original titel: Burgers over de kwaliteit van publieke diensten Most citizens come into contact with public services, for example as a patient, as a student or pupil, as a passenger on public transport or as a museum visitor. More and more importance is being attached to the quality of those service

  16. Minimum cost connection networks

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Tvede, Mich

    . We use three axioms to characterize allocation rules that truthfully implement cost minimizing networks satisfying all connection demands in a game where: (1) a central planner announces an allocation rule and a cost estimation rule; (2) every agent reports her own connection demand as well as all...... connection costs; and, (3) the central planner selects a cost minimizing network satisfying reported connection demands based on estimated connection costs and allocates true connection costs of the selected network....

  17. Road crash costs.

    OpenAIRE

    2010-01-01

    Road crashes result in all kinds of social costs, such as medical costs, production loss, human losses, property damage, settlement costs and costs due to congestion. Studies into road crash costs and their trends are carried out quite regularly. In 2009, the costs amounted to € 12.5 billion, or 2.2% of the Gross Domestic Product (GDP). Insight into these costs is used for policy preparation and evaluation, and makes it possible to compare them with costs in other areas. Another important app...

  18. Public Sociology

    DEFF Research Database (Denmark)

    What is the role of sociology in society? How can - and should - sociology contribute with insights relevant and useful to the outside world? Is sociology attuned to accommodate the demands of the wider public and of surrounding society? Who benefits from the knowledge produced and provided...... by sociology? What are the social implications and cultural effects of the knowledge sociology provides and creates? All of these questions, and many others, concern and centre on sociology's relationship to the surrounding society, in short to the ‘public'. All of these questions - and many others...... irrelevance and introversion and the Charybdis of public relevancy and extroversion. But what does it mean to be a ‘public sociologist' in contemporary society and are there really any other ways of doing sociology? What are the requirements of sociologists in a social world increasingly informed and shaped...

  19. Miscellaneous Publications

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Late 19th century Weather Bureau publications and Congressional reports pertaining to weather. Set of Weather Bureau Snowfall Bulletins for Rocky Mountain states...

  20. Public Airports

    Data.gov (United States)

    Earth Data Analysis Center, University of New Mexico — This data set is a vector point digital data structure that contains the locations of General Public Use Airports in the State of New Mexico. It only contains those...

  1. Modelling the full trip costs of urban intermodal passenger transport

    OpenAIRE

    Yeh, Chao-Fu; Papon, Francis

    2011-01-01

    To face the competition of private motorized vehicles, intermodal transport becomes a successful condition to encourage public transport and non-motorized modes and to reasonably control the continual growth of individual motorized vehicles in the city area. Therefore, the objective of this research intends to develop a comparable calculating model combining the private, public and external costs of passenger urban transport networks. Private costs consist in the operational-private costs bor...

  2. Public meetings

    CERN Multimedia

    Staff Association

    2017-01-01

    Do you have questions about the elections to the Staff Council, 2017 MERIT exercise, EVE and School, LD to IC exercise, CHIS, the Pension Fund… Come get informed and ask your questions at our public meetings. These public meetings are also an opportunity to get the more information on current issues. Benefit from this occasion to get the latest news and to discuss with the representatives of the statutory body that is the Staff Association!

  3. 42 CFR 412.302 - Introduction to capital costs.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Introduction to capital costs. 412.302 Section 412... Inpatient Hospital Capital Costs General Provisions § 412.302 Introduction to capital costs. (a) New capital... hospital is required under State law to obtain preapproval of the capital project or acquisition by a...

  4. 48 CFR 9903.101 - Cost Accounting Standards.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Cost Accounting Standards. 9903.101 Section 9903.101 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD... ACCOUNTING STANDARDS CONTRACT COVERAGE General 9903.101 Cost Accounting Standards. Public Law 100-679 (41...

  5. 42 CFR 417.536 - Cost payment principles.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Cost payment principles. 417.536 Section 417.536... PREPAYMENT PLANS Medicare Payment: Cost Basis § 417.536 Cost payment principles. (a) Applicability. Unless otherwise specified in this subpart, the principles set forth in parts 412 and 413 of this chapter...

  6. How Much Does Instruction and Research Really Cost?

    Science.gov (United States)

    Rooney, Patrick M.; Borden, Victor M. H.; Thomas, Timothy J.

    1999-01-01

    Describes an institution-wide activity-based costing study conducted at a large, urban, public university. The program cost study provides campus-, school-, and department-level cost information for the full range of mission-critical activities in teaching, research, and service. It also includes allocation of all levels of overhead to…

  7. 42 CFR 50.504 - Allowable cost of drugs.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Allowable cost of drugs. 50.504 Section 50.504... APPLICABILITY Maximum Allowable Cost for Drugs § 50.504 Allowable cost of drugs. (a) The maximum amount which may be expended from program funds for the acquisition of any drug shall be the lowest of (1)...

  8. 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...

  9. The economics of infrastructure finance: Public-private partnerships versus public provision

    OpenAIRE

    Engel, Eduardo M. R. A.; Fischer, Ronald D.; Galetovic, Alexander

    2010-01-01

    We examine the economics of infrastructure finance, focusing on public provision and Public-Private Partnerships (PPPs). We show that project finance is appropriate for PPP projects, because there are few economies of scope and because assets are project specific. Furthermore, we suggest that the higher cost of finance of PPPs is not an argument in favour of public provision, since it appears to reflect the combination of deficient contract design and the cost-cutting incentives embedded in P...

  10. The economics of infrastructure finance: Public-private partnerships versus public provision

    OpenAIRE

    Eduardo M.R.A. Engel; Ronald D. Fischer; Galetovic, Alexander

    2010-01-01

    We examine the economics of infrastructure finance, focusing on public provision and Public-Private Partnerships (PPPs). We show that project finance is appropriate for PPP projects, because there are few economies of scope and because assets are project specific. Furthermore, we suggest that the higher cost of finance of PPPs is not an argument in favour of public provision, since it appears to reflect the combination of deficient contract design and the cost-cutting incentives embedded in P...

  11. Public Access Technologies in Public Libraries: Effects and Implications

    Directory of Open Access Journals (Sweden)

    John Carlo Bertot

    2009-06-01

    Full Text Available Public libraries were early adopters of Internet-based technologies and have provided public access to the Internet and computers since the early 1990s. The landscape of public-access Internet and computing was substantially different in the 1990s as the World Wide Web was only in its initial development. At that time, public libraries essentially experimented with publicaccess Internet and computer services, largely absorbing this service into existing service and resource provision without substantial consideration of the management, facilities, staffing, and other implications of public-access technology (PAT services and resources. This article explores the implications for public libraries of the provision of PAT and seeks to look further to review issues and practices associated with PAT provision resources. While much research focuses on the amount of public access that public libraries provide, little offers a view of the effect of public access on libraries. This article provides insights into some of the costs, issues, and challenges associated with public access and concludes with recommendations that require continued exploration.

  12. 78 FR 21708 - Proposed Collection; Comment Request for Publication 1345

    Science.gov (United States)

    2013-04-11

    ...) estimates of capital or start-up costs and costs of operation, maintenance, and purchase of services to.... Current Actions: There are no changes being made to the publication at this time. Type of Review...

  13. On the Construction of Management Cost of Public Crisis and Performance Evaluation System of Guizhou Province%贵州省公共危机管理成本与绩效评估体系构建

    Institute of Scientific and Technical Information of China (English)

    刘斌; 廖小东

    2015-01-01

    It not only helps improve the crisis management efficiency,maintain a stable society and promote economic development,but also guarantees the smooth implementation of the strategy for the development of the western region in China to explore management cost situation of governments at all levels in Guizhou,improve the performance evaluation system and enhance the crisis management capaci-ty of the government.%探求贵州各级地方政府公共危机的管理成本现状,完善危机绩效评估体系,提升政府危机治理水平,不仅有助于提高贵州各级政府的危机管理效率,维护社会秩序稳定和促进经济有序发展,还有利于保障国家西部大开发战略的顺利实施。

  14. Child Support Enforcement: A Framework for Evaluating Costs, Benefits, and Effects.

    Science.gov (United States)

    1991-03-01

    Locator Services Domain Indicator Measure Program and Operating costs of providing SPLS service per case Operating and other overhead costs publicO ...cost of pretrial hearings and court hearings (may include a trial by jury) and expert testimony costs, and (4) transportation costs for witnesses

  15. Sources of Operating Costs

    OpenAIRE

    Mackie, Peter; Nellthorp, John; Laird, James

    2005-01-01

    Historically, road vehicle operating costs have tended to dominate highway economic appraisals in developing countries, due to the poor road surfaces that can occur there. The operating costs of railways and ports are also substantial, and form key components of cost benefit analyses of their associated infrastructure. The definition of operating costs for Bank projects is therefore important ...

  16. Energy contracting, a contribution to air pollution abatement and cost reduction. A guide to energy contracting in public buildings; Energiespar-Contracting als Beitrag zu Klimaschutz und Kostensenkung. Ratgeber fuer Energiespar-Contracting in oeffentlichen Liegenschaften

    Energy Technology Data Exchange (ETDEWEB)

    Acricola, A.C. [Berliner Energieagentur GmbH, Berlin (Germany); Seifried, D. [Buero-OE-quadrat, Freiburg (Germany)

    2000-07-01

    Energy contracting is a contractual partnership between a contractor and a building owner. The contractor carries out investments and energy conservation measures in a building. He is refunded by the success of the energy conservation measures, i.e. on the basis of the reduced energy cost of the building. The building owner makes no investments, takes no risks and still gets part of the savings. Energy contracting refers to measures 'behind the meter', i.e. all measures that reduce the consumption of heat, electricity and, in some cases, also water. In contrast, plant contracting means that the contractor projects, constructs, finances, operates and maintains a supply system (e.g. heating boiler, cogeneration plant, wood chip fuelled heating system etc.) and is reimbursed on a contractual basis for the amount of electricity, heat, and cold supplied. [German] Energiespar-Contracting ist eine vertraglich vereinbarte Dienstleistung zwischen einem Unternehmen (Contractor oder auch Energiesparpartner) und einem Gebaeudeeigner (Auftraggeber). Der Contractor fuehrt in dem Gebaeude Investitionen und Massnahmen zur Energieeinsparung durch. Seine Aufwendungen laesst er sich durch den Erfolg der Einsparmassnahmen, also ueber die reduzierten Energiekosten des Gebaeudes, vergueten. Der Gebaeudeeigner muss nicht investieren, traegt kein Risiko und ist trotzdem an dem Erfolg der Einsparmassnahme beteiligt. Im Unterschied zum Anlagen-Contracting umfasst das Energiespar-Contracting Massnahmen, die hinter dem Zaehler ansetzen, also alle Massnahmen, die den Verbrauch von Waerme oder Strom reduzieren. Haeufig werden auch Massnahmen zur Wassereinsparung in die Konzepte einbezogen. Beim Anlagen-Contracting bietet ein Dienstleister in der Regel die Planung, Errichtung, Finanzierung, den Betrieb und die Wartung einer Versorgungsanlage (z.B. Heizkessel, Blockheizkraftwerk, Holzhackschnitzelanlage) an. Diese Dienstleistung laesst er sich ueber eine vertraglich festgelegte

  17. 45 CFR 2543.45 - Cost and price analysis.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Cost and price analysis. 2543.45 Section 2543.45 Public Welfare Regulations Relating to Public Welfare (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, AND OTHER NON-PROFIT...

  18. Rethinking Acquisition Reform: Cost-Growth Solutions May Aggravate More Important Problems

    Science.gov (United States)

    2008-04-23

    specifically at cost- estimating accuracy, Melese and his colleagues employ transaction cost economics (TCE) theory to the problem of cost growth. While...Dillard, J. (2007). Apply insights from transaction cost economics to improve cost estimates for public sector purchases: The case of U.S. Military...Fenced Capital Accounts (DAPA 2006) Rational Cost Model Reforms Budget to Higher Probability (DAPA 2006) Transaction Cost Economics (Melese, et

  19. Going public

    DEFF Research Database (Denmark)

    Meyer, Gitte; Sandøe, Peter

    2012-01-01

    The paper addresses issues of scientific conduct regarding relations between science and the media, relations between scientists and journalists, and attitudes towards the public at large. In the large and increasing body of literature on scientific conduct and misconduct, these issues seem...... deal with ethical public relations issues, guided by a norm or maxim of openness. Drawing on and rethinking the CUDOS codification of the scientific ethos, as it was worked out by Robert K. Merton in 1942, we propose that this, which is echoed in current codifications of norms for good scientific...... conduct, contains a tacit maxim of openness which may naturally be extended to cover the public relations of science. Discussing openness as access, accountability, transparency and receptiveness, the argumentation concentrates on the possible prevention of misconduct with respect to, on the one hand...

  20. Going public

    DEFF Research Database (Denmark)

    Meyer, Gitte; Sandøe, Peter

    2012-01-01

    The paper addresses issues of scientific conduct regarding relations between science and the media, relations between scientists and journalists, and attitudes towards the public at large. In the large and increasing body of literature on scientific conduct and misconduct, these issues seem...... deal with ethical public relations issues, guided by a norm or maxim of openness. Drawing on and rethinking the CUDOS codification of the scientific ethos, as it was worked out by Robert K. Merton in 1942, we propose that this, which is echoed in current codifications of norms for good scientific...... conduct, contains a tacit maxim of openness which may naturally be extended to cover the public relations of science. Discussing openness as access, accountability, transparency and receptiveness, the argumentation concentrates on the possible prevention of misconduct with respect to, on the one hand...

  1. Public Sphere

    DEFF Research Database (Denmark)

    Trenz, Hans-Jörg

    2015-01-01

    of the collective will of the people in the act of democratic self-government. The concept of the public sphere is used across the fields of media and communication research, cultural studies and the humanities, the history of ideas, legal and constitutional studies as well as democracy studies. Historically......In modern societies, the public sphere represents the intermediary realm that supports the communication of opinions, the discovery of problems that need to be dealt with collectively, the channeling of these problems through the filter of the media and political institutions, and the realization......, public spheres have undergone structural transformations that were closely connected to the emergence of different mass media. More recently, they are subject to trends of transnationalization and digitalization in politics and society....

  2. Public Sphere

    DEFF Research Database (Denmark)

    Trenz, Hans-Jörg

    2015-01-01

    In modern societies, the public sphere represents the intermediary realm that supports the communication of opinions, the discovery of problems that need to be dealt with collectively, the channeling of these problems through the filter of the media and political institutions, and the realization......, public spheres have undergone structural transformations that were closely connected to the emergence of different mass media. More recently, they are subject to trends of transnationalization and digitalization in politics and society....... of the collective will of the people in the act of democratic self-government. The concept of the public sphere is used across the fields of media and communication research, cultural studies and the humanities, the history of ideas, legal and constitutional studies as well as democracy studies. Historically...

  3. Software Cost Estimation Review

    OpenAIRE

    Ongere, Alphonce

    2013-01-01

    Software cost estimation is the process of predicting the effort, the time and the cost re-quired to complete software project successfully. It involves size measurement of the soft-ware project to be produced, estimating and allocating the effort, drawing the project schedules, and finally, estimating overall cost of the project. Accurate estimation of software project cost is an important factor for business and the welfare of software organization in general. If cost and effort estimat...

  4. OOTW COST TOOLS

    Energy Technology Data Exchange (ETDEWEB)

    HARTLEY, D.S.III; PACKARD, S.L.

    1998-09-01

    This document reports the results of a study of cost tools to support the analysis of Operations Other Than War (OOTW). It recommends the continued development of the Department of Defense (DoD) Contingency Operational Support Tool (COST) as the basic cost analysis tool for 00TWS. It also recommends modifications to be included in future versions of COST and the development of an 00TW mission planning tool to supply valid input for costing.

  5. public spaces

    Directory of Open Access Journals (Sweden)

    Elena Grigoryeva

    2013-01-01

    Full Text Available The topic of this issue is PUBLIC SPACES. It is familiar and clear to every citizen. The streets and courtyards as childhood experiences remain with us forever. And these are the places where we come with our parents at weekends, where we meet friends, where we have dates and where we already come for a walk with our children.The history of public spaces is long and captivating. It was the main city squares where the most important events took place in history. The Agoras of Ancient Greece and the Roman Forums, the squares of Vatican, Paris and London, Moscow and Saint Petersburg… Greve, Trafalgar, Senate, Palace, Red, Bolotnaya – behind every name there is life of capitals, countries and nations.Public spaces, their shapes, image and development greatly influence the perception of the city as a whole. Both visitors and inhabitants can see in public spaces not only the visage but the heart, the soul and the mind of the city.Unfortunately, sometimes we have to prove the value of public spaces and defend them from those who consider them nothing but a blank space, nobody’s land destined for barbarous development.What should happen to make citizens perceive public spaces as their own and to make authorities consider development and maintenance of squares and parks their priority task against the  background of increasing competition between cities and the fight for human capital? Lately they more often say about “a high-quality human capital”. And now, when they say “the city should be liveable” they add “for all groups of citizens, including the creative class”.

  6. The organizational costs of ethical conflicts.

    Science.gov (United States)

    Nelson, William A; Weeks, William B; Campfield, Justin M

    2008-01-01

    Ethical conflicts are a common phenomenon in today's healthcare settings. As healthcare executives focus on balancing quality care and cost containment, recognizing the costs associated with ethical conflicts is only logical. In this article, we present five case vignettes to identify several general cost categories related to ethical conflicts, including operational costs, legal costs, and marketing and public relations costs. In each of these cost categories, the associated direct, indirect, and long-term costs of the ethical conflict are explored as well. Our analysis suggests that organizations have, in addition to philosophical reasons, financial incentives to focus on decreasing the occurrence of ethical conflicts. The cost categories affected by ethical conflicts are not insignificant. Such conflicts can affect staff morale and lower the organization's overall culture and profit margin. Therefore, organizations should develop mechanisms and strategies for decreasing and possibly preventing ethical conflicts. The strategies suggested in this article seek to shift the organization's focus when dealing with conflicts, from just reacting to moving upstream-that is, understanding the root causes of ethical conflicts and employing approaches designed to reduce their occurrence and associated costs. Such an effort has the potential to enhance the organization's overall culture and ultimately lead to organizational success.

  7. Cost effectiveness and cost utility of the noncoding blood glucose meter CONTOUR® TS

    Directory of Open Access Journals (Sweden)

    Przemyslaw Holko

    2011-02-01

    Full Text Available Przemyslaw Holko, Pawal KawalecHTA Centre, Kraków, PolandAims: This study assessed the cost efficacy and cost utility of the automatic blood glucose meter CONTOUR® TS from the public payer (National Health Fund [NHF] and payer (patient and NHF perspectives over a 26-year analysis horizon.Methods: Clinical effectiveness data were obtained from prior clinical studies of automatic versus manually coded blood glucose meters. Cost data were obtained from the NHF. The probability of procedure use related to diabetic complications was obtained from four medical centers in Poland. The incremental cost-effectiveness ratio related to 1 life year gained and the incremental cost-utility ratio related to 1 quality-adjusted life year gained were calculated.Results: Assuming co-funding from public funds, introduction of the CONTOUR® TS is associated with savings of Polish złoty (PLN 31,846.19 (€8916.93 and PLN 113,018.19 (€31,645.09 per life year gained from the payer and public payer perspectives, respectively. Cost utility analyses showed that the CONTOUR® TS is associated with savings of PLN 40,465.59 (€11,330.37 and PLN 11,434.82 (€3201.75 per quality-adjusted life year gained from the payer and the public payer perspectives, respectively.Conclusion: The CONTOUR® TS appears superior to manually coded meters available in Poland both from the payer and the public payer perspectives and may represent an improved strategy for glycemic control.Keywords: blood glucose self monitoring, costs and cost analysis, health care costs, diabetes mellitus, diabetes complications 

  8. The Costs and Benefits of Home-Based Telecommuting

    OpenAIRE

    Shafizadeh, Kevan R.; Mokhtarian, Patricia L; Niemeier, Debbie A.; Salomon, Ilan

    2000-01-01

    This report evaluates the costs and benefits of home-based telecommuting. Combining empirical data from the literature with a Monte Carlo simulation technique, a distribution of cost-benefit ratios is produced from three perspectives: the employer, the telecommuter, and the public sector.... Depending on the underlying assumptions, the results indicate that telecommuter benefit-cost ratios are generally above one if the employer bears the majority of the equipment cost burden. ...Even when pa...

  9. 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

    in healthcare costs, considering that the country's democratic agenda has demanded transparency, accountability and, above all, efficiency in public funds management

  10. Economic costs of drug abuse: financial, cost of illness, and services.

    Science.gov (United States)

    Cartwright, William S

    2008-03-01

    This article examines costs as they relate to the financial costs of providing drug abuse treatment in private and public health plans, costs to society relating to drug abuse, and many smaller costing studies of various stakeholders in the health care system. A bibliography is developed from searches across PubMed, Web of Science, and other bibliographic sources. The review indicates that a wide collection of cost findings is available to policy makers. For example, the financial aspects of health plans have been dominated by considerations of actuarial costs of parity for drug abuse treatment. Cost-of-illness methods have been developed and extended to drug abuse costing to measure the national level of burden and are important to the economic evaluation of interventions at the program level. Costing is done in many small and focused studies, reflecting the interests of different stakeholders in the health care system. For costs in programs and health plans, as well as cost offsets of the impact of substance abuse treatment on medical expenditures, findings are surprisingly important to policy makers. Maintaining ongoing research that is highly policy relevant from the point of view of health services, more is needed on costing concepts and measurement applications.

  11. Public health

    NARCIS (Netherlands)

    Berg, van den A.E.

    2007-01-01

    Agnes van den Berg wrote an essay about human health and nature, establishing that subject as an important policy argument in developing (urban) nature in the Netherlands. She studied the public balance of fear and fascination for nature, summarising benefits on human health. In this chapter, she ad

  12. Public Affairs.

    Science.gov (United States)

    Snow, C. P.

    In this book effects of technological developments on world conditions are discussed on the basis of the author's public statements made between 1959-70. A total of seven pieces is presented under the headings: The Two Cultures and the Scientific Revolution, The Two Cultures: A Second Look, The Case of Leavis and the Serious Case, Science and…

  13. Public health

    NARCIS (Netherlands)

    Berg, van den A.E.

    2007-01-01

    Agnes van den Berg wrote an essay about human health and nature, establishing that subject as an important policy argument in developing (urban) nature in the Netherlands. She studied the public balance of fear and fascination for nature, summarising benefits on human health. In this chapter, she

  14. Publication Design.

    Science.gov (United States)

    Nelson, Roy Paul

    This book is designed to solve the problem of coordinating art and typography with content in publications. Through text and illustrations, this book suggests ways to make pages and spreads in magazines, newspapers, and books attractive and readable. As a book of techniques, it is directed at potential and practicing art directors, designers, and…

  15. Publication Design.

    Science.gov (United States)

    Nelson, Roy Paul

    This book is designed to solve the problem of coordinating art and typography with content in publications. Through text and illustrations, this book suggests ways to make pages and spreads in magazines, newspapers, and books attractive and readable. As a book of techniques, it is directed at potential and practicing art directors, designers, and…

  16. Ocorrência de custos ocultos em operações de serviços: insights sobre observação em uma sociedade de economia mista no Brasil Occurrence of hidden costs in service operations: insights into a publicly held company

    Directory of Open Access Journals (Sweden)

    Paulo César Pereira da Silva

    2011-01-01

    related to identification, checking, and measurement of the costs generated during the production of the final product. The main objective of this article is to verify the occurrence of hidden costs of services rendered by a public company controlled by the Paraiba State government in Brazil. The occurrence of hidden costs incurred by this corporation was verified in terms of the most common organizational malfunctioning such as: waiting time, useless motion, overpay, overconsumption, rework, occupational accidents, absenteeism, idleness, and litigations. This study was based on semi-structured interviews conducted with workstation operators and in loco observation of workers' activities. It is important to highlight the occurrence of hidden costs that are not accounted by the traditional cost systems and their intangibility, which is not recognized by productivity measurement models, for example, the Soniano Model (SON, 1991. The approach to investigate hidden costs used in this study was based on the theoretical foundation developed by Savall and Zardet (1991. The research results indicated the occurrence of hidden costs, mainly derived from malfunctioning related to rework, waiting time, high staff turnover, and stress. In addition, it was verified that among the most common hidden costs observed, rework, and waiting time, identified in virtually all sectors, are the ones that affect the most the proper functioning of the organization.

  17. Cost function estimation

    DEFF Research Database (Denmark)

    Andersen, C K; Andersen, K; Kragh-Sørensen, P

    2000-01-01

    on these criteria, a two-part model was chosen. In this model, the probability of incurring any costs was estimated using a logistic regression, while the level of the costs was estimated in the second part of the model. The choice of model had a substantial impact on the predicted health care costs, e......Statistical analysis of cost data is often difficult because of highly skewed data resulting from a few patients who incur high costs relative to the majority of patients. When the objective is to predict the cost for an individual patient, the literature suggests that one should choose...... a regression model based on the quality of its predictions. In exploring the econometric issues, the objective of this study was to estimate a cost function in order to estimate the annual health care cost of dementia. Using different models, health care costs were regressed on the degree of dementia, sex, age...

  18. [Cost of dialysis in France].

    Science.gov (United States)

    Zambrowski, Jean-Jacques

    2016-04-01

    According to latest data published by the French health authority (HAS), nearly 74,000 French patients in end-stage chronic renal disease are following a replacement therapy. They were 61,000 in 2007, amounting to a cost of 4 billions euros for public health insurance. The cost varies depending on the age and comorbidities. Continuous ambulatory peritoneal dialysis is the cheapest mode of treatment, while the heavy haemodialysis centres costs are close to twice as expensive. But these two different treatments are - a priori - not applied for the same patients in terms of level of severity of disease. Moreover, associated costs, medical treatment, transportation, etc. are to be taken into account, as well as losses of income for patients facing major job difficulties. As recommended by HAS experts, it will be important to regularly conduct surveys allowing a regular economic assessment of the various modes of financial healthcare for end-stage chronic renal disease. Copyright © 2016 Association Société de néphrologie. Published by Elsevier SAS. All rights reserved.

  19. 2015 Cost of Wind Energy Review

    Energy Technology Data Exchange (ETDEWEB)

    Moné, Christopher [National Renewable Energy Lab. (NREL), Golden, CO (United States); Hand, Maureen [National Renewable Energy Lab. (NREL), Golden, CO (United States); Bolinger, Mark [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Rand, Joseph [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Heimiller, Donna [National Renewable Energy Lab. (NREL), Golden, CO (United States); Ho, Jonathan [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2017-06-27

    This report uses representative utility-scale projects to estimate the levelized cost of energy (LCOE) for land-based and offshore wind plants in the United States. Data and results detailed here are derived from 2015 commissioned plants. More specifically, analysis detailed here relies on recent market data and state-of-the-art modeling capabilities to maintain an up-to-date understanding of wind energy cost trends and drivers. It is intended to provide insight into current component-level costs as well as a basis for understanding variability in LCOE across the industry. This publication reflects the fifth installment of this annual report.

  20. Minimum cost connection networks

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Tvede, Mich

    2015-01-01

    demands. We use a few axioms to characterize allocation rules that truthfully implement cost minimizing networks satisfying all connection demands in a game where: (1) a central planner announces an allocation rule and a cost estimation rule; (2) every agent reports her own connection demand as well...... as all connection costs; (3) the central planner selects a cost minimizing network satisfying reported connection demands based on the estimated costs; and, (4) the planner allocates the true costs of the selected network. It turns out that an allocation rule satisfies the axioms if and only if relative...

  1. 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.

  2. Costs of Illness Due to Endemic Cholera

    Science.gov (United States)

    Poulos, C.; Riewpaiboon, A.; Stewart, J.F.; Clemens, J.; Guh, S.; Agtini, M.; Sur, D.; Islam, Z.; Lucas, M.; Whittington, D.

    2013-01-01

    Summary Economic analyses of cholera immunization programmes require estimates of the costs of cholera. The Diseases of the Most Impoverished programme measured the public, provider, and patient costs of culture-confirmed cholera in four study sites with endemic cholera using a combination of hospital- and community-based studies. Families with culture-proven cases were surveyed at home 7 and 14 days after confirmation of illness. Public costs were measured at local health facilities using a micro-costing methodology. Hospital-based studies found that the costs of severe cholera were USD 32 and 47 in Matlab and Beira. Community-based studies in North Jakarta and Kolkata found that cholera cases cost between USD 28 and USD 206, depending on hospitalization. Patient costs of illness as a percentage of average monthly income were 21% and 65% for hospitalized cases in Kolkata and North Jakarta, respectively. This burden on families is not captured by studies that adopt a provider perspective. PMID:21554781

  3. 41 CFR 102-37.580 - Who is responsible for costs associated with the donation?

    Science.gov (United States)

    2010-07-01

    ... costs associated with the donation? 102-37.580 Section 102-37.580 Public Contracts and Property.../Destruction § 102-37.580 Who is responsible for costs associated with the donation? The recipient public body is responsible for paying the disposal costs incident to the donation, such as packing, preparation...

  4. The economic costs of Alzheimer's disease.

    Science.gov (United States)

    Hay, J W; Ernst, R L

    1987-09-01

    This paper estimates the economic costs of Alzheimer's Disease to individuals and to society, based on review of published Alzheimer's Disease-related research. The analysis is derived from epidemiological projections and cost information for the United States population in 1983. Estimated costs include both direct medical care and social support costs, as well as indirect costs, such as support services provided by family or volunteers, and the value of lost economic productivity in Alzheimer's Disease patients. Mid-range estimates of net annual expected costs for an Alzheimer's Disease patient, excluding the value of lost productivity, are $18,517 in the first year and $17,643 in subsequent years, with direct medical and social services comprising about half of these costs. Under base case assumptions, the total cost of disease per patient in 1983, was $48,544 to $493,277, depending upon patient's age at disease onset. The estimated present value of total net costs to society for all persons first diagnosed with Alzheimer's Disease in 1983 was $27.9-31.2 billion. Development of a public or private insurance market for the economic burdens of Alzheimer's Disease would fill some of the gaps in the current US system of financing long-term chronic disease care.

  5. Public Sociology

    DEFF Research Database (Denmark)

    What is the role of sociology in society? How can - and should - sociology contribute with insights relevant and useful to the outside world? Is sociology attuned to accommodate the demands of the wider public and of surrounding society? Who benefits from the knowledge produced and provided...... by sociology? What are the social implications and cultural effects of the knowledge sociology provides and creates? All of these questions, and many others, concern and centre on sociology's relationship to the surrounding society, in short to the ‘public'. All of these questions - and many others...... - will be addressed in this book.   Sociology, as the self-proclaimed ‘the science of society', finds itself in an exceptional position within the scientific community in that it studies a universe it itself is part and parcel of. This means that sociology and sociologists are inextricably connected and linked...

  6. Scientific publication

    Directory of Open Access Journals (Sweden)

    Getulio Teixeira Batista

    2007-06-01

    Full Text Available The necessary work for developing a scientific publication is sometimes underestimated and requires the effective participation of many players to obtain a result in good standard. Initially it depends upon the determination of the authors that decide to write the scientific article. Scientific writing is a very challenging and time consuming task, but at the same time essential for any scientist. A published scientific article is unquestionably one of the main indicators of scientific production, especially if published in a qualified scientific journal with highly qualified editorial committee and strict peer review procedure. By looking at evaluation criteria for scientific production of the several Thematic Scientific Committees of the Brazilian Council for Scientific and Technological Development (CNPq it becomes clear publications in scientific journals that has certified quality is the most important item in the evaluation of a scientist production.

  7. Public opinion.

    Science.gov (United States)

    Holden, A

    2013-04-01

    This opinion-based article aims to highlight the worrying decline in support for dental public health as a specialty. Not only is this specialty important for its role in commissioning services, it is crucial for the identification of vulnerable groups in society and ensuring dental services are acceptable and assessable for these populations. Dental public health also addresses the social determinants of health in its approach, acknowledging the impact of these in perpetuating inequalities and looking for multisectoral approaches to their management. This article also looks at the lack of appreciation for these determinants in dental foundation training and how a change in the structure of the programme could both address this and the current shortage of places.

  8. Public meetings

    CERN Multimedia

    Staff Association

    2012-01-01

    MARS PENSIONS CONTRACT POLICY GENERAL INFORMATION   PUBLIC MEETINGS COME AND BE INFORMED! Public meetings Monday 15 Oct. 2 pm Amphi IT, 31-3-004 Meyrin Wednesday 17 Oct. 10 am Amphi BE, 864-1-D02 Prévessin Thursday 18 Oct. 10 am Salle du Conseil/ Council Chamber 503-1-001 Meyrin Thursday 18 Oct. 2 pm Filtration Plant, 222-R-001(in English) Meyrin   Overview of the topics to be discussed Recognition of Merit – MARS Outcome of last exercise 2007 to 2012 : lessons learned Pension Fund Capital preservation policy : what is it ? Contract policy LC2IC statistics SA proposal General information CVI 2013 Voluntary programmes (PRP, SLS)  

  9. Medicare Cost Reports

    Data.gov (United States)

    U.S. Department of Health & Human Services — Medicare certified institutional providers are required to submit an annual cost report to a Medicare Administrative Contractor. The cost report contains provider...

  10. Unit Cost Compendium Calculations

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Unit Cost Compendium (UCC) Calculations raw data set was designed to provide for greater accuracy and consistency in the use of unit costs across the USEPA...

  11. Managing Information On Costs

    Science.gov (United States)

    Taulbee, Zoe A.

    1990-01-01

    Cost Management Model, CMM, software tool for planning, tracking, and reporting costs and information related to costs. Capable of estimating costs, comparing estimated to actual costs, performing "what-if" analyses on estimates of costs, and providing mechanism to maintain data on costs in format oriented to management. Number of supportive cost methods built in: escalation rates, production-learning curves, activity/event schedules, unit production schedules, set of spread distributions, tables of rates and factors defined by user, and full arithmetic capability. Import/export capability possible with 20/20 Spreadsheet available on Data General equipment. Program requires AOS/VS operating system available on Data General MV series computers. Written mainly in FORTRAN 77 but uses SGU (Screen Generation Utility).

  12. Realized Cost Savings 2016

    Data.gov (United States)

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

  13. Public illumination manual; Manual de iluminacao publica

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1992-12-31

    This work aims to guide in the correct choice and usage of the adequate public illumination equipment. It also aims to help the public authorities in terms of the best economical and technical choice, as well as the adequate maintenance of the equipment in order to obtain the most efficiency and safety with minimum costs 22 figs., 11 tabs.

  14. What Causes Cost Overrun in Transport Infrastructure 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 causes of cost escalation in transport infrastructure projects. The study is based on a sample of 258 rail, bridge, tunnel and roads projects worth US$90 billion. The focus is on the dependence of cost escalation on (1...... cost escalation for three types of project ownership - private, state-owned enterprise and other public ownership - it is shown that the oft-seen claim that public ownership is problematic and private ownership effective in curbing cost escalation is an oversimplification. Type of accountability...

  15. How Public Is Public Administration? A Constitutional Approach of Publicness

    Science.gov (United States)

    Ringeling, Arthur

    2015-01-01

    Both in Public Administration and in practice, there is a loss of the concept of public. A view became dominant in which markets were superior to governments and public to private. Not only did the esteem of the public sphere diminish, but also its significance in our reasoning and teaching. It became less clear what the public sphere stood for.…

  16. How Public Is Public Administration? A Constitutional Approach of Publicness

    Science.gov (United States)

    Ringeling, Arthur

    2015-01-01

    Both in Public Administration and in practice, there is a loss of the concept of public. A view became dominant in which markets were superior to governments and public to private. Not only did the esteem of the public sphere diminish, but also its significance in our reasoning and teaching. It became less clear what the public sphere stood for.…

  17. 43 CFR 426.6 - Leasing and full-cost pricing.

    Science.gov (United States)

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Leasing and full-cost pricing. 426.6 Section 426.6 Public Lands: Interior Regulations Relating to Public Lands BUREAU OF RECLAMATION, DEPARTMENT OF THE INTERIOR ACREAGE LIMITATION RULES AND REGULATIONS § 426.6 Leasing and full-cost pricing....

  18. Minimum cost connection networks

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Tvede, Mich

    In the present paper we consider the allocation of cost in connection networks. Agents have connection demands in form of pairs of locations they want to be connected. Connections between locations are costly to build. The problem is to allocate costs of networks satisfying all connection demands...

  19. Opportunity Cost: A Reexamination

    Science.gov (United States)

    Parkin, Michael

    2016-01-01

    Is opportunity cost an ambiguous and arbitrary concept or a simple, straightforward, and fruitful one? This reexamination of opportunity cost addresses this question, and shows that opportunity cost is an ambiguous concept because "two" definitions are in widespread use. One of the definitions is indeed simple, fruitful, and one that…

  20. Power Plant Cycling Costs

    Energy Technology Data Exchange (ETDEWEB)

    Kumar, N.; Besuner, P.; Lefton, S.; Agan, D.; Hilleman, D.

    2012-07-01

    This report provides a detailed review of the most up to date data available on power plant cycling costs. The primary objective of this report is to increase awareness of power plant cycling cost, the use of these costs in renewable integration studies and to stimulate debate between policymakers, system dispatchers, plant personnel and power utilities.

  1. Educational Cost Analysis.

    Science.gov (United States)

    Flynn, Donald L.

    Traditional approaches to the cost analysis of educational programs involve examining annual budgets. Such approaches do not properly consider the cost of either new capital expenditures or the current value of previously purchased items. This paper presents the methodology for a new approach to educational cost analysis that identifies the actual…

  2. A workplace physical activity program at a public university in Mexico can reduce medical costs associated with type 2 diabetes and hypertension Un programa de actividad física en el lugar de trabajo en una universidad pública de México puede reducir los costos médicos asociados a la diabetes tipo 2 e hipertensión

    Directory of Open Access Journals (Sweden)

    Pablo Méndez-Hernández

    2012-02-01

    Full Text Available OBJECTIVE: To assess the impact of a workplace leisure physical activity program on healthcare expenditures for type 2 diabetes and hypertension treatment. MATERIAL AND METHODS: We assessed a workplace program's potential to reduce costs by multiplying the annual healthcare costs of patients with type 2 diabetes and hypertension by the population attributable risk fraction of non-recommended physical activity levels. Feasibility of a physical activity program was assessed among 425 employees of a public university in Mexico. RESULTS: If 400 sedentary employees engaged in a physical activity program to decrease their risk of diabetes and hypertension, the potential annual healthcare cost reduction would be 138 880 US dollars. Each dollar invested in physical activity could reduce treatment costs of both diseases by 5.3 dollars. CONCLUSIONS: This research meets the call to use health economics methods to re-appraise health priorities, and devise strategies for optimal allocation of financial resources in the health sector.OBJETIVO: Evaluar el impacto de un programa de actividad física en el lugar de trabajo sobre la reducción de costos médicos directos relacionados con la diabetes tipo 2 y la hipertensión. MATERIAL Y MÉTODOS: Calculamos el potencial de la actividad física para reducir costos médicos, multiplicando los gastos médicos anuales que realizan diabéticos e hipertensos, multiplicados por la fracción atribuible poblacional asociada a un nivel de actividad física insuficiente. La factibilidad de ejecutar el programa fue evaluada en 425 trabajadores de una universidad pública en México. RESULTADOS: Si 400 trabajadores sedentarios participaran en un programa de actividad física recreativa para reducir su riesgo de diabetes e hipertensión, los costos médicos anuales reducirían en 138880 dólares. Cada dólar invertido en actividad física podría reducir 5.3 dólares en el tratamiento de ambas enfermedades. CONCLUSIONES: Esta

  3. The business of radiology: cost accounting.

    Science.gov (United States)

    Camponovo, Ernest J

    2004-08-01

    Radiology practices confront questions of resource allocation every day. Unfortunately, practices frequently fail to adequately analyze revenues and expenses, which are at the heart of success or failure in any business endeavor. Cost allocation problems permeate nearly all aspects of cost analysis and accumulation and exist throughout all types of private-sector and public-sector organizations. "Managerial" or "cost" accounting is the discipline concerned with measuring and assigning the costs of delivering services or producing products. In contrast to financial accounting, management accounting produces relevant information for internal decision making and in general is designed to answer a firm's specific operational questions. Because costs play such a critical role in deriving and planning for revenues and profits, managerial accounting is in large part devoted to measuring and accumulating costs with the aims of control and continuous cost reduction. Because radiologists' salaries are at record highs, when accounting for a practice's clinical activities, such as the provision of mammography services, some allocation of radiologist costs themselves must be made, or the practice will not be able to achieve its goal of efficient allocation of resources. Whatever cost-accounting method is used should be specific enough to allow the differentiation of costs to as detailed a level as necessary for the strategic decision at hand. It is imperative that a practice use some rational method to gather and analyze costs and that management then use these data in decision making. Successful practices will be those most aware of their costs and the minimum acceptable reimbursements necessary for their success.

  4. 45 CFR 2543.27 - Allowable costs.

    Science.gov (United States)

    2010-10-01

    ... Welfare Regulations Relating to Public Welfare (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, AND OTHER NON-PROFIT... Organizations.” The allowability of costs incurred by institutions of higher education is determined in...

  5. Explaining Increases in Higher Education Costs

    Science.gov (United States)

    Archibald, Robert B.; Feldman, David H.

    2008-01-01

    The real cost of higher education per full-time equivalent student has grown substantially over the last 75 years, and the rapid rise since the early 1980s is a cause of considerable public concern. Opinion surveys consistently find that how much one has to pay for a college education is a serious national issue. In his July 1996 congressional…

  6. The Hidden Cost of School Security

    Science.gov (United States)

    DeAngelis, Karen J.; Brent, Brian O.; Ianni, Danielle

    2011-01-01

    A spate of school shootings in the U.S. has prompted policymakers to address the public's growing perception that our schools are unsafe. As education policymakers continue to press for additional security initiatives, it is important to understand the costs borne by school systems for these programs. Thus far, the scholarly literature is silent…

  7. Anger motivates costly punishment of unfair behavior

    NARCIS (Netherlands)

    Seip, E.C.; van Dijk, W.W.; Rotteveel, M.

    2014-01-01

    In this article we provide empirical support for anger as an underlying mechanism of costly punishment in three studies. A first study showed that participants punished other players more the less these players cooperated in a Public Goods Game and that this effect was mediated by experienced anger.

  8. Economic Costs of Bias-Based Bullying

    Science.gov (United States)

    Baams, Laura; Talmage, Craig A.; Russell, Stephen T.

    2017-01-01

    Because many school districts receive funding based on student attendance, absenteeism results in a high cost for the public education system. This study shows the direct links between bias-based bullying, school absenteeism because of feeling unsafe at school, and loss of funds for school districts in California. Data from the 2011-2013…

  9. Cost effectiveness in trauma care.

    Science.gov (United States)

    Elliott, D C; Rodriguez, A

    1996-02-01

    The above discussion brings together a vast body of data that together proclaim with fervent clarity: Traumatic injuries are expensive. The expense is paid in productive lives lost, in permanent disability, in pain and suffering, and in health care resources consumed. As local and regional trauma systems struggle for development and survival, competition for the health care dollar casts in the additional necessity of providing the service of trauma care with maximum efficiency. Despite the variety of cost-efficiency measures described above, a majority of trauma centers continue to operate "in the red." Such cannot continue indefinitely. Fiscal responsibility dictates that health care institutions must balance budgets in order to maintain operations. Four primary strategies for cost containment appear from the above discussion: 1. Improve reimbursement rates from trauma patients. 2. Increase outside funding from government sources. 3. Improve cost efficiency of diagnostic and therapeutic procedures used in trauma patient management. 4. Increase efforts aimed at primary prevention of intentional and unintentional injuries. In the final analysis, most authors agree that the last strategy offers the best hope. As stated in their article, "The Economic Impact of Injuries," Harlan and colleagues conclude that "the most effective medical and cost reduction strategy would be prevention." The same article goes on to detail how greater funding for research into optimal prevention modalities could reap societal and economic benefits far beyond the value of the initial outlay. Yet such research funding continues to be inadequate. For every dollar spent on medical care of cancer patients, nine cents is directed to research. For every dollar spent on trauma care, less than a penny is spent on research. Until the public recognizes the terrible toll trauma extracts in lives, livelihood, and money wasted and until it realizes the pre-eminent importance of prevention, care of the

  10. Managing Public Accountability : How Public Managers Manage Public Accountability

    NARCIS (Netherlands)

    Schillemans, Thomas

    2015-01-01

    Accountability is of growing importance in contemporary governance. The academic literature on public accountability is fraught with concerned analyses, suggesting that accountability is a problematic issue for public managers. This article investigates how public managers experience accountability

  11. Cost incentives for doctors

    DEFF Research Database (Denmark)

    Schottmüller, Christoph

    2013-01-01

    If doctors take the costs of treatment into account when prescribing medication, their objectives differ from their patients' objectives because the patients are insured. This misalignment of interests hampers communication between patient and doctor. Giving cost incentives to doctors increases...... welfare if (i) the doctor's examination technology is sufficiently good or (ii) (marginal) costs of treatment are high enough. If the planner can costlessly choose the extent to which doctors take costs into account, he will opt for less than 100%. Optimal health care systems should implement different...... degrees of cost incentives depending on type of disease and/or doctor....

  12. Costing Practices in Healthcare

    DEFF Research Database (Denmark)

    Chapman, Christopher; Kern, Anja; Laguecir, Aziza

    2014-01-01

    The rising cost of healthcare is a globally pressing concern. This makes detailed attention to the way in which costing is carried out of central importance. This article offers a framework for considering the interdependencies between a dominant element of the contemporary healthcare context, i.......e., Diagnosis Related Group (DRG) systems, and costing practices. DRG-based payment systems strongly influence costing practices in multiple ways. In particular, setting DRG tariffs requires highly standardized costing practices linked with specific skill sets from management accountants and brings other...

  13. Public Procurement of Innovation Policy

    DEFF Research Database (Denmark)

    Rolfstam, Max; Petersen, Ole Helby

    2014-01-01

    Until recently, Danish policy interest in public procurement has mainly been driven by efficiency and cost-effectiveness concerns. Public-procurement policies have in general focused on the utilisation of economies of scale as a Means of achieving lower prices on goods and services. Attempts...... to develop mandatory procurement systems have also been gradually developing, while the focus on innovation has been relatively modest in Danish procurement policies until recently. This picture is currently changing, as several initiatives emphasising public procurement as a means of stimulating innovation...... have been launched. Whether this gradual change of focus in Danish procurement policies will make a deep and lasting impact on the role of public procurement as a driver for innovationis, however, yet an open question....

  14. Public meetings

    CERN Multimedia

    Staff Association

    2014-01-01

      MARS 2015 FIVE YEARLY REVIEW CONTRACT POLICY PENSION FUND GENERAL INFORMATION   COME AND BE INFORMED! PUBLIC MEETINGS Friday 3rd October at 10 am Amphi BE, 864-1-D02 Prévessin Friday 3rd October at 2 pm Salle du Conseil / Council Chamber, 503-1-001 (in English) Meyrin Monday 6th October at 10 am Kjell Johnsen Auditorium, 30-7-018 Meyrin Monday 6th October at 2 pm Salle du Conseil / Council Chamber, 503-1-001 Meyrin  

  15. Public meetings

    CERN Multimedia

    Staff Association

    2014-01-01

      Public meetings : Come and talk about your future employment conditions !   The Staff Association will come and present the results of our survey on the 2015 five-yearly review. Following the survey, the topics discussed, will be contract policy, recognition of merit (MARS), working time arrangements and family policy. After each meeting and around a cup of coffee or tea you will be able to continue the discussions. Do not hesitate to join us, the five-yearly review, it is with YOU!

  16. Cost function estimation

    DEFF Research Database (Denmark)

    Andersen, C K; Andersen, K; Kragh-Sørensen, P

    2000-01-01

    Statistical analysis of cost data is often difficult because of highly skewed data resulting from a few patients who incur high costs relative to the majority of patients. When the objective is to predict the cost for an individual patient, the literature suggests that one should choose...... a regression model based on the quality of its predictions. In exploring the econometric issues, the objective of this study was to estimate a cost function in order to estimate the annual health care cost of dementia. Using different models, health care costs were regressed on the degree of dementia, sex, age......, marital status and presence of any co-morbidity other than dementia. Models with a log-transformed dependent variable, where predicted health care costs were re-transformed to the unlogged original scale by multiplying the exponential of the expected response on the log-scale with the average...

  17. Costs of traffic injuries

    DEFF Research Database (Denmark)

    Kruse, Marie

    2015-01-01

    assessed using Danish national healthcare registers. Productivity costs were computed using duration analysis (Cox regression models). In a subanalysis, cost per severe traffic injury was computed for the 12 995 individuals that experienced a severe injury. RESULTS: The socioeconomic cost of a traffic......OBJECTIVE: The aim of this study was to analyse the socioeconomic costs of traffic injuries in Denmark, notably the healthcare costs and the productivity costs related to traffic injuries, in a bottom-up, register-based perspective. METHOD: Traffic injury victims were identified using national...... emergency room data and police records. Victims were matched with five controls per case by means of propensity score, nearest-neighbour matching. In the cohort, consisting of the 52 526 individuals that experienced a traffic injury in 2000 and 262 630 matched controls, attributable healthcare costs were...

  18. A public world without public relations?

    OpenAIRE

    Nayden, Nikolay

    2015-01-01

    The term "public relations" (PR) has long gained currency as meaning the practice of producing a positive public image. This article argues that public relations should be released from the prison of "PR" and, instead, reconceptualised as relations which define the public realm much as economic relations define the economy. From this point of view, three main levels of public relations can be distinguished: (1) relations between public institutions, (2) relations between citizens and public i...

  19. A public world without public relations?:

    OpenAIRE

    Nayden, Nikolay

    2009-01-01

    The term "public relations" (PR) has long gained currency as meaning the practice of producing a positive public image. This article argues that public relations should be released from the prison of "PR" and, instead, reconceptualised as relations which define the public realm much as economic relations define the economy. From this point of view, three main levels of public relations can be distinguished: (1) relations between public institutions, (2) relations between citizens and public i...

  20. 20 CFR 404.276 - Publication of notice of increase.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Publication of notice of increase. 404.276... DISABILITY INSURANCE (1950- ) Computing Primary Insurance Amounts Cost-Of-Living Increases § 404.276 Publication of notice of increase. When we determine that an automatic cost-of-living increase is due, we...

  1. Cost Analysis of MRI Services in Iran: An Application of Activity Based Costing Technique

    Directory of Open Access Journals (Sweden)

    Bayati

    2015-09-01

    Full Text Available Background Considerable development of MRI technology in diagnostic imaging, high cost of MRI technology and controversial issues concerning official charges (tariffs have been the main motivations to define and implement this study. Objectives The present study aimed to calculate the unit-cost of MRI services using activity-based costing (ABC as a modern cost accounting system and to fairly compare calculated unit-costs with official charges (tariffs. Materials and Methods We included both direct and indirect costs of MRI services delivered in fiscal year 2011 in Shiraz Shahid Faghihi hospital. Direct allocation method was used for distribution of overhead costs. We used micro-costing approach to calculate unit-cost of all different MRI services. Clinical cost data were retrieved from the hospital registering system. Straight-line method was used for depreciation cost estimation. To cope with uncertainty and to increase the robustness of study results, unit costs of 33 MRI services was calculated in terms of two scenarios. Results Total annual cost of MRI activity center (AC was calculated at USD 400,746 and USD 532,104 based on first and second scenarios, respectively. Ten percent of the total cost was allocated from supportive departments. The annual variable costs of MRI center were calculated at USD 295,904. Capital costs measured at USD 104,842 and USD 236, 200 resulted from the first and second scenario, respectively. Existing tariffs for more than half of MRI services were above the calculated costs. Conclusion As a public hospital, there are considerable limitations in both financial and administrative databases of Shahid Faghihi hospital. Labor cost has the greatest share of total annual cost of Shahid Faghihi hospital. The gap between unit costs and tariffs implies that the claim for extra budget from health providers may not be relevant for all services delivered by the studied MRI center. With some adjustments, ABC could be

  2. Cost Analysis of MRI Services in Iran: An Application of Activity Based Costing Technique.

    Science.gov (United States)

    Bayati, Mohsen; Mahboub Ahari, Alireza; Badakhshan, Abbas; Gholipour, Mahin; Joulaei, Hassan

    2015-10-01

    Considerable development of MRI technology in diagnostic imaging, high cost of MRI technology and controversial issues concerning official charges (tariffs) have been the main motivations to define and implement this study. The present study aimed to calculate the unit-cost of MRI services using activity-based costing (ABC) as a modern cost accounting system and to fairly compare calculated unit-costs with official charges (tariffs). We included both direct and indirect costs of MRI services delivered in fiscal year 2011 in Shiraz Shahid Faghihi hospital. Direct allocation method was used for distribution of overhead costs. We used micro-costing approach to calculate unit-cost of all different MRI services. Clinical cost data were retrieved from the hospital registering system. Straight-line method was used for depreciation cost estimation. To cope with uncertainty and to increase the robustness of study results, unit costs of 33 MRI services was calculated in terms of two scenarios. Total annual cost of MRI activity center (AC) was calculated at USD 400,746 and USD 532,104 based on first and second scenarios, respectively. Ten percent of the total cost was allocated from supportive departments. The annual variable costs of MRI center were calculated at USD 295,904. Capital costs measured at USD 104,842 and USD 236, 200 resulted from the first and second scenario, respectively. Existing tariffs for more than half of MRI services were above the calculated costs. As a public hospital, there are considerable limitations in both financial and administrative databases of Shahid Faghihi hospital. Labor cost has the greatest share of total annual cost of Shahid Faghihi hospital. The gap between unit costs and tariffs implies that the claim for extra budget from health providers may not be relevant for all services delivered by the studied MRI center. With some adjustments, ABC could be implemented in MRI centers. With the settlement of a reliable cost accounting system

  3. Preemptive public policy for genomics.

    Science.gov (United States)

    Carlson, Rick J

    2008-02-01

    To many, genomics is merely exploitable technology for the leviathan of biotechnology. This is both shallow and short sighted. Genomics is applied knowledge based on profound and evolving science about how living things develop, how healthy or sick we are, and what our future will be like. In health care, genomics technologies are disruptive yet potentially cost-effective because they enable primary prevention, the antidote to runaway costs and declining productivity. The challenges to integration are great, however, and many bioethical and social-policy implications are alarming. Because it is poorly understood today, we must debate genomics vigorously if we are to act wisely. Public policy must lead.

  4. Opportunity cost for early treatment of Chagas disease in Mexico

    National Research Council Canada - National Science Library

    Ramsey, Janine M; Elizondo-Cano, Miguel; Sanchez-González, Gilberto; Peña-Nieves, Adriana; Figueroa-Lara, Alejandro

    2014-01-01

    Given current neglect for Chagas disease in public health programs in Mexico, future healthcare and economic development policies will need a more robust model to analyze costs and impacts of timely...

  5. Analysis of the cost-effectiveness and costs rationalization of antidepressants consumption in Lithuania

    OpenAIRE

    2013-01-01

    In recent years, there has been much debate regarding the rationality of consumption and cost effectiveness of antidepressants. The economic aspects of treating depression are becoming more frequently evaluated as newer antidepressants become available and as healthcare entities attempt to address increasing costs. The aim of the research. To investigate and assess the possibilities of a more rational use of the public and private funds of the Lithuanian population in the cases of medicam...

  6. 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.

  7. Systematic Approach to Better Understanding Integration Costs

    Energy Technology Data Exchange (ETDEWEB)

    Stark, Gregory B. [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2015-09-01

    This research presents a systematic approach to evaluating the costs of integrating new generation and operational procedures into an existing power system, and the methodology is independent of the type of change or nature of the generation. The work was commissioned by the U.S. Department of Energy and performed by the National Renewable Energy Laboratory to investigate three integration cost-related questions: (1) How does the addition of new generation affect a system's operational costs, (2) How do generation mix and operating parameters and procedures affect costs, and (3) How does the amount of variable generation (non-dispatchable wind and solar) impact the accuracy of natural gas orders? A detailed operational analysis was performed for seven sets of experiments: variable generation, large conventional generation, generation mix, gas prices, fast-start generation, self-scheduling, and gas supply constraints. For each experiment, four components of integration costs were examined: cycling costs, non-cycling VO&M costs, fuel costs, and reserves provisioning costs. The investigation was conducted with PLEXOS production cost modeling software utilizing an updated version of the Institute of Electrical and Electronics Engineers 118-bus test system overlaid with projected operating loads from the Western Electricity Coordinating Council for the Sacramento Municipal Utility District, Puget Sound Energy, and Public Service Colorado in the year 2020. The test system was selected in consultation with an industry-based technical review committee to be a reasonable approximation of an interconnection yet small enough to allow the research team to investigate a large number of scenarios and sensitivity combinations. The research should prove useful to market designers, regulators, utilities, and others who want to better understand how system changes can affect production costs.

  8. 40 CFR Appendix A to Subpart I of... - Determination of Allowable Costs

    Science.gov (United States)

    2010-07-01

    ... project costs based on the Clean Water Act, EPA policy, appropriate Federal cost principles under part 30... applicable law and regulations must of course be made on a project-by-project basis. Those cost items not... necessary for the building of treatment works. c. The cost of contracting with another public agency or...

  9. 36 CFR 1206.45 - What rules govern subgrant distribution, cost sharing, grant administration, and reporting?

    Science.gov (United States)

    2010-07-01

    ... distribution, cost sharing, grant administration, and reporting? 1206.45 Section 1206.45 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION GENERAL RULES NATIONAL HISTORICAL..., cost sharing, grant administration, and reporting? (a) The Commission will annually establish...

  10. Politics of public utility regulation

    Energy Technology Data Exchange (ETDEWEB)

    Gormley, W.T. Jr.

    1983-01-01

    Since the early 1970s, energy and telecommunications policies have emerged as increasingly complex and conflictual issues in state government and have, consequently, brought about change in the politics of public utilities regulation. In this analysis, Gormley shows that state public utilities commissions, in determining the rates that can be charged by private utility companies, must confront elected government officials, members of the state bureaucracy, citizens' groups, and the regulated industries themselves in a very visible, highly technical, costly, and controversial process that pits investors against consumers, business groups against residential consumers, consumer groups against environmentalists, and low-income consumers against consumers as a whole.

  11. Public meeting

    CERN Multimedia

    HR Department

    2010-01-01

    Dear Colleagues, I am pleased to invite you to a public meeting which will be held on Thursday 11 November 2010 at 2:30 p.m., in the Main Auditorium (welcome coffee from 2 p.m.) In this meeting Sigurd Lettow, Director for Administration and General Infrastructure will present the Management’s proposals towards restoring full funding of the Pension Fund. The meeting will follow discussions which took place with the Staff Association, at the Standing Concertation Committee (CCP) of 1 November 2010 and will be held with the Members States, at the Tripartite Employment Conditions Forum (TREF) of 4 November 2010. You will be able to attend this presentation in the Main Auditorium or via the webcast. The Management will also be available to reply to your questions on this subject. Best regards, Anne-Sylvie Catherin

  12. Public meetings

    CERN Multimedia

    Staff Association

    2013-01-01

    MARS SURVEY 5YR 2015 GENERAL INFORMATION ELECTIONS 2013   COME AND BE INFORMED! Public meetings Tuesday 1st Oct. 10 am Amphi IT, 31-3-004 Meyrin Tuesday 1st Oct. 2 pm Council Chamber, 503-1-001 Meyrin Friday 4 Oct. 10 am Amphi BE, 864-1-D02 Prévessin Monday 7 Oct. 2 pm Council Chamber, 503-1-001 (in English) Meyrin Tuesday 8 Oct. 10 am Amphi Kjell Johnsen, 30-7-018 Meyrin   Overview of the topics to be discussed Recognition of Merit – MARS Outcome of last exercise 2007 to 2013: lessons learned Survey: five-yearly review, give us your opinion General information CVI 2014 Voluntary programmes (PRP, SLS) Elections 2013 Renewal of the Staff Council 2014 - 2015  

  13. Public Entrepreneurship

    DEFF Research Database (Denmark)

    Hjorth, Daniel

    2013-01-01

    on the entrepreneurship–society relationship. SE, as all entrepreneurship practices, operates by social and economic forces (limiting ourselves to those here), and generates social and economic outcomes (amongst others). Its second half, however, dominates the concept of SE, and our analysis seek to remedy this imbalance......In this paper we want to affirm the desiring-social-change that we find in practices presently represented by theorists and policy-makers as examples of ‘social entrepreneurship’ (SE). We do this as an attempt to intensify the presence of the social and sociality in today's discourse...... by focusing on the social productivity of entrepreneurship, on entrepreneurship desiring social change. We suggest ‘public entrepreneurship’ might grasp this as a more balanced concept that will also support a more precise analysis of the entrepreneurship–society relationship....

  14. A comparison of NEAR actual spacecraft costs with three parametric cost models

    Science.gov (United States)

    Mosher, Todd J.; Lao, Norman Y.; Davalos, Evelyn T.; Bearden, David A.

    1999-11-01

    Costs for modern (post-1990) U.S.-built small planetary spacecraft have been shown to exhibit significantly different trends from those of larger spacecraft. These differences cannot be accounted for simply by the change in size alone. Some have attributed this departure to NASA's "faster, better, cheaper" design approach embodied by the efficiency of smaller teams, reduced government oversight, increased focus on cost, and short development periods. With the Discovery, Mars Surveyor and New Millennium programs representing the new approach to planetary exploration, it is important to understand these current cost trends and to be able to estimate costs of future proposed missions. To address this issue, The Aerospace Corporation (hereafter referred to as Aerospace) performed a study to compare the actual costs of the Near Earth Asteroid Rendezvous (NEAR) spacecraft bus (instruments were not estimated) using three different cost models; the U.S. Air Force Unmanned Spacecraft Cost Model, Version 7 (USCM-7), the Science Applications International Corporation (SAIC) NASA/Air Force Cost Model 1996 (NAFCOM96) and The Aerospace Corporation's Small Satellite Cost Model 1998 (SSCM98). The NEAR spacecraft was chosen for comparison because it was the first Discovery mission launched, and recently recognized with a Laurel award by Aviation Week and Space Technology as a benchmark for NASA's Discovery program [North, 1997]. It was also selected because the cost data has been released into the public domain [Hemmings, 1996]which makes it easy to discuss in a public forum. This paper summarizes the NEAR program, provides a short synopsis of each of the three cost models, and demonstrates how they were applied for this study.

  15. Monthly Program Cost Report (MPCR)

    Data.gov (United States)

    Department of Veterans Affairs — The Monthly Program Cost Report (MPCR) replaces the Cost Distribution Report (CDR). The MPCR provides summary information about Veterans Affairs operational costs,...

  16. Heliostat cost optimization study

    Science.gov (United States)

    von Reeken, Finn; Weinrebe, Gerhard; Keck, Thomas; Balz, Markus

    2016-05-01

    This paper presents a methodology for a heliostat cost optimization study. First different variants of small, medium sized and large heliostats are designed. Then the respective costs, tracking and optical quality are determined. For the calculation of optical quality a structural model of the heliostat is programmed and analyzed using finite element software. The costs are determined based on inquiries and from experience with similar structures. Eventually the levelised electricity costs for a reference power tower plant are calculated. Before each annual simulation run the heliostat field is optimized. Calculated LCOEs are then used to identify the most suitable option(s). Finally, the conclusions and findings of this extensive cost study are used to define the concept of a new cost-efficient heliostat called `Stellio'.

  17. Applied cost allocation

    DEFF Research Database (Denmark)

    Bogetoft, Peter; Hougaard, Jens Leth; Smilgins, Aleksandrs

    2016-01-01

    This paper deals with empirical computation of Aumann–Shapley cost shares for joint production. We show that if one uses a mathematical programing approach with its non-parametric estimation of the cost function there may be observations in the data set for which we have multiple Aumann......–Shapley prices. We suggest to overcome such problems by using lexicographic goal programing techniques. Moreover, cost allocation based on the cost function is unable to account for differences between efficient and actual cost. We suggest to employ the notion of rational inefficiency in order to supply a set...... of assumptions concerning firm behavior. These assumptions enable us to connect inefficient with efficient production and thereby provide consistent ways of allocating the costs arising from inefficiency....

  18. Design to Cost and Life Cycle Cost.

    Science.gov (United States)

    1980-07-01

    Structural Corrosion Reductiop Bird Reistant Windshiel ds Standard Elt -ct rnic ’lodulet; N)tI 1NDE Fue I -l’ste Reduct ion .i gh Adhesion Sealants 4-1...Hence, the success of a new weapon system will decisively denend por t. p r,- ict -d n- naal cost for operations and support. The need to meet weapon

  19. Big Cost to Families

    Institute of Scientific and Technical Information of China (English)

    MATT; YOUNG

    2006-01-01

    If tobacco multinationals had their way, China might more closely resemble a chimney. So what are the costs of a potentially smokier future in China? Aside from health costs, there could be economically (and educationally) severe ones, according to a new study published in Social Science & Medicine by a Yale professor. Dr. Hong Wang analyzed how the cost of smoking impacts China's critical economic strengths: human capital investment (defined by education and healthcare), risk-taking capacity (defined by...

  20. ACTIVITY - BASED COSTING DESIGNING

    OpenAIRE

    Wioletta Skibiñska; Marta Kad³ubek

    2010-01-01

    The traditional costing system sometimes does not give accurate information about the consumption of different resources and the activities of the organisation. The activity-based costing system is an information-rich costing system which is more and more necessary for the success of many European companies. Base of designing and implementation of an ABC system in the enterprises are presented in the article.