WorldWideScience

Sample records for system cost effectiveness

  1. Cost effectiveness of recycling: A systems model

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-11-15

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

  2. Cost effectiveness of recycling: A systems model

    International Nuclear Information System (INIS)

    Tonjes, David J.; Mallikarjun, Sreekanth

    2013-01-01

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

  3. Cost effectiveness of recycling: a systems model.

    Science.gov (United States)

    Tonjes, David J; Mallikarjun, Sreekanth

    2013-11-01

    Financial analytical models of waste management systems have often found that recycling costs exceed direct benefits, and in order to economically justify recycling activities, externalities such as household expenses or environmental impacts must be invoked. Certain more empirically based studies have also found that recycling is more expensive than disposal. Other work, both through models and surveys, have found differently. Here we present an empirical systems model, largely drawn from a suburban Long Island municipality. The model accounts for changes in distribution of effort as recycling tonnages displace disposal tonnages, and the seven different cases examined all show that curbside collection programs that manage up to between 31% and 37% of the waste stream should result in overall system savings. These savings accrue partially because of assumed cost differences in tip fees for recyclables and disposed wastes, and also because recycling can result in a more efficient, cost-effective collection program. These results imply that increases in recycling are justifiable due to cost-savings alone, not on more difficult to measure factors that may not impact program budgets. Copyright © 2013 Elsevier Ltd. All rights reserved.

  4. Cost effective robust rule calibration system

    Directory of Open Access Journals (Sweden)

    Greeff P.

    2014-01-01

    Full Text Available One of the main calibration services of African NMIs (National Metrology Institutes is the measurement of tapes and rules. This is mainly regulated by legal metrology and OIML (International Organisation of Legal Metrology specifications are therefore referenced. Specifically, OIML R-35 is the standard to which rules or line scales must conform. The accuracy of most African NMIs systems however, cannot prove conformance to this specification. This article will detail the development of a new, cost effective, line scale calibration system, which will have accuracy better than the specification prescribed. The system was locally developed and its design is based on off-the-shelf components and open source software. It is also ready-for-upgrade to an absolute system. The system and details of the line detection algorithm will be presented.

  5. The relationship between cost system complexity, purposes of use, and cost system effectiveness

    NARCIS (Netherlands)

    Schoute, M.

    2009-01-01

    This paper uses survey data from 133 Dutch, medium-sized manufacturing firms to examine the associations between cost system complexity (in terms of the applied overhead absorption procedures), purposes of use, and cost system effectiveness. First, factor analysis identifies two underlying

  6. Cost Effectiveness Analysis of System Safety

    Science.gov (United States)

    1987-03-01

    determine the most desirable smog control device for automobiles. Similarly, the agency might also want to evaluate the comparative merits of expending funds...best allocation of available resoruces among the alternative opportunities. Conducting a cost-effectiveness evaluation to determine the best smog ...evaluation. Admittedly, not all complex problems can be solved by simple techni- ques , but disallusion to the mathematical sophistica- tion of the analytical

  7. Lens refracting cost effective photovoltaic solar energy concentrating systems

    International Nuclear Information System (INIS)

    Pilawjian, G.A.

    2014-01-01

    The overall cost reduction task is studied for photovoltaic (PV) solar energy systems. For that purpose, a new, cost effective lens refracting system is developed. The concentrating system consists of Fresnel lenses placed under different facet angles refracting the sun light onto the solar cells placed along a line. The developed photovoltaic concentrating system uses the mathematical model of Fresnel lens concentrating optics for photovoltaic systems used to optimize the system by cost. A computer program FLCPVSys2.1 for the new concentrating system is developed allowing to design a photovoltaic system of the required power with the minimum cost. The program can be used for designing a cost effective photovoltaic solar concentrating system

  8. A Cost Effective System Design Approach for Critical Space Systems

    Science.gov (United States)

    Abbott, Larry Wayne; Cox, Gary; Nguyen, Hai

    2000-01-01

    NASA-JSC required an avionics platform capable of serving a wide range of applications in a cost-effective manner. In part, making the avionics platform cost effective means adhering to open standards and supporting the integration of COTS products with custom products. Inherently, operation in space requires low power, mass, and volume while retaining high performance, reconfigurability, scalability, and upgradability. The Universal Mini-Controller project is based on a modified PC/104-Plus architecture while maintaining full compatibility with standard COTS PC/104 products. The architecture consists of a library of building block modules, which can be mixed and matched to meet a specific application. A set of NASA developed core building blocks, processor card, analog input/output card, and a Mil-Std-1553 card, have been constructed to meet critical functions and unique interfaces. The design for the processor card is based on the PowerPC architecture. This architecture provides an excellent balance between power consumption and performance, and has an upgrade path to the forthcoming radiation hardened PowerPC processor. The processor card, which makes extensive use of surface mount technology, has a 166 MHz PowerPC 603e processor, 32 Mbytes of error detected and corrected RAM, 8 Mbytes of Flash, and I Mbytes of EPROM, on a single PC/104-Plus card. Similar densities have been achieved with the quad channel Mil-Std-1553 card and the analog input/output cards. The power management built into the processor and its peripheral chip allows the power and performance of the system to be adjusted to meet the requirements of the application, allowing another dimension to the flexibility of the Universal Mini-Controller. Unique mechanical packaging allows the Universal Mini-Controller to accommodate standard COTS and custom oversized PC/104-Plus cards. This mechanical packaging also provides thermal management via conductive cooling of COTS boards, which are typically

  9. Attributes of system testing which promote cost-effectiveness

    International Nuclear Information System (INIS)

    Martin, L.C.

    1975-01-01

    A brief overview of conventional EMP testing activity examines attributes of overall systems tests which promote cost-effectiveness. The general framework represents an EMP-oriented systems test as a portion of a planned program to design, produce, and field system elements. As such, all so-called system tests should play appropriate cost-effective roles in this program, and the objective here is to disclose such roles. The intrinsic worth of such tests depends not only upon placing proper values on the outcomes, but also upon the possible eventual consequences of not doing tests. A relative worth measure is required. Attributes of EMP system testing over the range of potential activity which encompasses research and development, production, field handling, verification, evaluation, and others are reviewed and examined. Thus, the relative worth, in a cost-effective sense, is provided by relating such attributes to the overall program objectives so that values can be placed on the outcomes for tradeoff purposes

  10. Systems Analysis for Program Planning and Cost Effectiveness. (An Application).

    Science.gov (United States)

    van Gigch, John P.; Hill, Richard E.

    This paper describes an effort to implement a cost-effectiveness program using systems analysis in an elementary school district, the Rio Linda Union School District in California. The systems design cycle employed has three phases, policy-making evaluation, and action-implementation. During the first phase, the general philosophy or mission of…

  11. Cost-effective treatment of existing guardrail systems.

    Science.gov (United States)

    2013-05-01

    A cost-effective means for upgrading existing guardrail systems with deviations from current practice (i.e., low-rail heights, antiquated end : treatments, and improper installation) does not exist. As a result these systems remain on U.S. highways. ...

  12. A Layered Decision Model for Cost-Effective System Security

    Energy Technology Data Exchange (ETDEWEB)

    Wei, Huaqiang; Alves-Foss, James; Soule, Terry; Pforsich, Hugh; Zhang, Du; Frincke, Deborah A.

    2008-10-01

    System security involves decisions in at least three areas: identification of well-defined security policies, selection of cost-effective defence strategies, and implementation of real-time defence tactics. Although choices made in each of these areas affect the others, existing decision models typically handle these three decision areas in isolation. There is no comprehensive tool that can integrate them to provide a single efficient model for safeguarding a network. In addition, there is no clear way to determine which particular combinations of defence decisions result in cost-effective solutions. To address these problems, this paper introduces a Layered Decision Model (LDM) for use in deciding how to address defence decisions based on their cost-effectiveness. To validate the LDM and illustrate how it is used, we used simulation to test model rationality and applied the LDM to the design of system security for an e-commercial business case.

  13. A cost-effective Geographic Information Systems for Transportation ...

    African Journals Online (AJOL)

    A cost-effective Geographic Information Systems for Transportation (GIS-T) application for traffic congestion analyses in the Developing World. ... The PDF file you selected should load here if your Web browser has a PDF reader plug-in installed (for example, a recent version of Adobe Acrobat Reader). If you would like ...

  14. Relevant Costs for Decision in an Effective Controlling System

    Directory of Open Access Journals (Sweden)

    Mihaela TULVINSCHI

    2010-05-01

    Full Text Available Controlling is considered a leading concept in the sense of coordination, planning, control and automation, in order to produce the synthesis necessary in decision making. The purpose of article is to highlight the link between a dynamic accounting system and an effective controlling system. The research method used is based on the idea that the cost analysis in an efficient controlling system involves obtaining accounting information from within the entity which management then uses in decision making. In conclusion, we emphasize that an effective controlling system must provide managers the tools to meet their informational needs.

  15. Cost effectiveness methodology for evaluating Korean international communication system alternatives.

    OpenAIRE

    Hwang, Tae Kyun.

    1987-01-01

    Approved for public release; distribution in unlimited. Cost and Effectiveness models are developed by using of cost-effectiveness technique for fiber optic cable and satellite communication media. The models are applied to the Korean international communication problem. Alternative selection is required since the two medias different in cost and effectiveness. The major difficulties encountered were data gathering and measuring the effectiveness of the Korean international ...

  16. Development of a Cost Effective Power Generation System: An Overview

    Directory of Open Access Journals (Sweden)

    Shiv Prakash Bihari

    2016-03-01

    Full Text Available This paper presents an overview on development of cost effective power generation system and motivates for development of a model for hybrid system with wind to investigate the combined operation of wind with different sources to cater to wind’s stochastic nature for imbalance minimization and optimal operation. Development of model for trading power in competitive electricity market and development of strategies for trading in electricity markets (wind energy and reserves markets to investigate the effects of real time pricing tariffs on electricity market operation has been illustrated in this paper. Dynamic modelling related studies to investigate the wind generator’s kinetic energy for primary frequency support using simulink and simulation studies on doubly fed induction generator to study its capability during small disturbances / fluctuations on power system have been described.

  17. Mobile liquid VR system: a cost effective alternative

    International Nuclear Information System (INIS)

    Soto, R.; Harkins, R.; HPD, Inc., Naperville, IL)

    1985-01-01

    The need for cost effective alternatives to treat large volumes of liquid radwaste has never been more evident. As part of a continuing effort to introduce such alternatives, HPD, Inc., and Chem-Nuclear Systems, Inc., have integrated two proven state-of-the-art technologies to offer a mobile liquid volume reduction system that satisfies nuclear industry requirements, with respect to liquid radwaste handling. This system optimizes proven technology by employing a crystallizer unit to concentrate the waste liquids to 50 weight percent solids, thereby reducing the volume to be solidified by factors of 40, while using only 20 percent of the energy required by conventional evaporative systems. In addition, the system employs a field proven cement solidification process which has been accepted in a Topical Report by the US NRC and which offers the highest waste to container volume ratios for stable waste forms in the industry. This volume reduction-solidification system is able to reduce over 7000 gallons of liquid waste per day to less than 30 cubic feet of 10CFR61 certified stable solidified waste for ultimate disposal or on-site storage. This document describes the GEODE System; its applicability; economics; volume reduction; scope of responsibility and experience. Major benefits include higher VR factors; assurance of continual regulatory compliance; and no capital investment

  18. Cost Effective and Affordable Guidance and Control Systems.

    Science.gov (United States)

    1985-02-01

    FACTORY SUPORIT COST, . PODUCTION TEST & TEST EQUIPMENT COSTS SYSTEM DTPSESIG APROC BLOCK DIAGRAM r A CONFIGU RAEI1 TARGET~~~~~ADI COMMITTEES M...peut Atre rdduit en utilisant des circuits dlectroniques adaptds pour treiter les franges d’interfdrence. Bens ce cas, mmse avec: des gyrolasers de 6...warehouse of parts, and an editing and testing facility. The Japanese have reportedly achieved up to an 85% reuse rate in their software factories by using

  19. Systemic cost-effectiveness analysis of food hazard reduction

    DEFF Research Database (Denmark)

    Jensen, Jørgen Dejgård; Lawson, Lartey Godwin; Lund, Mogens

    2015-01-01

    An integrated microbiological-economic framework for policy support is developed to determine the cost-effectiveness of alternative intervention methods and strategies to reduce the risk of Campylobacter in broilers. Four interventions at the farm level and four interventions at the processing st...

  20. Can delivery systems use cost-effectiveness analysis to reduce healthcare costs and improve value?

    Science.gov (United States)

    Savitz, Lucy A; Savitz, Samuel T

    2016-01-01

    Understanding costs and ensuring that we demonstrate value in healthcare is a foundational presumption as we transform the way we deliver and pay for healthcare in the U.S. With a focus on population health and payment reforms underway, there is increased pressure to examine cost-effectiveness in healthcare delivery. Cost-effectiveness analysis (CEA) is a type of economic analysis comparing the costs and effects (i.e. health outcomes) of two or more treatment options. The result is expressed as a ratio where the denominator is the gain in health from a measure (e.g. years of life or quality-adjusted years of life) and the numerator is the incremental cost associated with that health gain. For higher cost interventions, the lower the ratio of costs to effects, the higher the value. While CEA is not new, the approach continues to be refined with enhanced statistical techniques and standardized methods. This article describes the CEA approach and also contrasts it to optional approaches, in order for readers to fully appreciate caveats and concerns. CEA as an economic evaluation tool can be easily misused owing to inappropriate assumptions, over reliance, and misapplication. Twelve issues to be considered in using CEA results to drive healthcare delivery decision-making are summarized. Appropriately recognizing both the strengths and the limitations of CEA is necessary for informed resource allocation in achieving the maximum value for healthcare services provided.

  1. Microhydro: Cost-effective, modular systems for low heads

    Energy Technology Data Exchange (ETDEWEB)

    Alexander, K.V. [Department of Mechanical Engineering, University of Canterbury, P.B. 4800, Christchurch (New Zealand); Giddens, E.P. [Department of Civil Engineering, University of Canterbury, 81 Grange Street, Opawa, Christchurch (New Zealand)

    2008-06-15

    This paper is an overview of a program that is in the final stages of developing a modular set of cost-effective microhydro schemes for site heads below those currently serviced by Pelton Wheels. The rationale has been that there is a multitude of viable low-head sites in isolated areas where microhydro is a realistic energy option, and where conventional economics are not appropriate, especially in Third World countries. The goals of this project have been to provide low-cost, soundly based turbine design solutions that systematically cover the 0.2-20 kW supply, that are uniquely resistant to debris blockage and are easily built by tradesmen of medium skills in regional workshops. The paper presents the results as a matrix of the most cost-effective penstocks matched to modular turbines using established electronic controls. It discusses practical issues of site selection and options for sites where exact matches are not achieved. It has been an object of the program to establish a benchmark for cost-effectiveness in the microhydro field. (author)

  2. Cost-effectiveness optimization of a solar hot water heater with integrated storage system

    International Nuclear Information System (INIS)

    Kamaruzzaman Sopian; Syahri, M.; Shahrir, A.; Mohd Yusof Othman; Baharuddin Yatim

    2006-01-01

    Solar processes are generally characterized by high first cost and low operating costs. Therefore, the basic economic problem is one of comparing an initial known investment with estimated future operating cost. This paper present the cost-benefit ratio of solar collector with integrated storage system. Evaluation of the annual cost (AC) and the annual energy gain (AEG) of the collector are performed and the ratio of AC/AEG or the cost benefit ratio is presented for difference combination of mass flow rate, solar collector length and channel depth. Using these cost-effectiveness curves, the user can select optimum design features, which correspond to minimum AC/AEG

  3. Cost-effective geophysical survey systems for uranium exploration

    International Nuclear Information System (INIS)

    Hasbrouck, J.C.

    1981-01-01

    When planning a uranium exploration survey the question always arises as to how to take advantage of the different exploration methods and equipment for maximum probability of success. Discussed here are the choice of radiometric geophysical equipment, its effectiveness in identifying targets, its limitations, and the criteria for selection. Particular attention is given to systems that are suitable for the exploration programmes of small size and on a small budget, that are common in Latin America. (author)

  4. Engineering approach for cost effective operation of industrial pump systems

    Science.gov (United States)

    Krickis, O.; Oleksijs, R.

    2017-10-01

    Power plants operators are persuaded to operate the main equipment such as centrifugal pumps in economically effective way. The operation of pump sets of district heating network at power plants should be done according to prescriptions of the original equipment manufacturer with further implementation of these requirements to distributed control system of the plant. In order to operate industrial pump sets with a small number of malfunctions is necessary to control the duty point of pump sets in H-Q coordinates, which could be complex task in some installations. Alternatively, pump operation control could be organized in H-n (head vs rpm) coordinates, utilizing pressure transmitters in pressure pipeline and value of rpm from variable speed driver. Safe operation range of the pump has to be limited with system parabolas, which prevents the duty point location outside of the predefined operation area. The particular study demonstrates the engineering approach for pump’s safe operation control development in MATLAB/Simulink environment, which allows to simulate the operation of the pump at different capacities in hydraulic system with variable characteristic and to predefine the conditions for efficient simultaneous pump operation in parallel connection.

  5. The integrated business information system: using automation to monitor cost-effectiveness of park operations

    Science.gov (United States)

    Dick Stanley; Bruce Jackson

    1995-01-01

    The cost-effectiveness of park operations is often neglected because information is laborious to compile. The information, however, is critical if we are to derive maximum benefit from scarce resources. This paper describes an automated system for calculating cost-effectiveness ratios with minimum effort using data from existing data bases.

  6. Cost effectiveness analysis of the SEAMIST trademark membrane system technology

    International Nuclear Information System (INIS)

    Henriksen, A.D.; Booth, S.R.

    1993-01-01

    This report describes the cost and performance characteristics of SEAMIST trademark, an innovative technology that facilitates measurements of contaminants in both vertical and horizontal vadose zone boreholes. This new technology consists of an airtight membrane linear that is pneumatically emplaced inside the borehole structure. Sampling ports with attached tubing, absorbent collectors, or various in situ measuring devices can be fabricated into the linear and used for monitoring volatile organic compounds (VOCs), semivolatile organic compounds (SVOCs), pesticides, herbicides, polynuclear aromatic hydrocarbons, polychlorinated biphenyls, or radioactive substances. In addition, small instruments can be guided through the lined borehole and measurements taken inside at specified intervals

  7. Cost-Effectiveness Analysis of an Automated Medication System Implemented in a Danish Hospital Setting.

    Science.gov (United States)

    Risør, Bettina Wulff; Lisby, Marianne; Sørensen, Jan

    To evaluate the cost-effectiveness of an automated medication system (AMS) implemented in a Danish hospital setting. An economic evaluation was performed alongside a controlled before-and-after effectiveness study with one control ward and one intervention ward. The primary outcome measure was the number of errors in the medication administration process observed prospectively before and after implementation. To determine the difference in proportion of errors after implementation of the AMS, logistic regression was applied with the presence of error(s) as the dependent variable. Time, group, and interaction between time and group were the independent variables. The cost analysis used the hospital perspective with a short-term incremental costing approach. The total 6-month costs with and without the AMS were calculated as well as the incremental costs. The number of avoided administration errors was related to the incremental costs to obtain the cost-effectiveness ratio expressed as the cost per avoided administration error. The AMS resulted in a statistically significant reduction in the proportion of errors in the intervention ward compared with the control ward. The cost analysis showed that the AMS increased the ward's 6-month cost by €16,843. The cost-effectiveness ratio was estimated at €2.01 per avoided administration error, €2.91 per avoided procedural error, and €19.38 per avoided clinical error. The AMS was effective in reducing errors in the medication administration process at a higher overall cost. The cost-effectiveness analysis showed that the AMS was associated with affordable cost-effectiveness rates. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  8. Modeling the cost-effectiveness of health care systems for alcohol use disorders: how implementation of eHealth interventions improves cost-effectiveness

    NARCIS (Netherlands)

    Smit, Filip; Lokkerbol, Joran; Riper, Heleen; Majo, Maria Cristina; Boon, Brigitte; Blankers, Matthijs

    2011-01-01

    Informing policy decisions about the cost-effectiveness of health care systems (ie, packages of clinical interventions) is probably best done using a modeling approach. To this end, an alcohol model (ALCMOD) was developed. The aim of ALCMOD is to estimate the cost-effectiveness of competing health

  9. Cost-effectiveness of posterior lumbar interbody fusion in the Japanese universal health insurance system.

    Science.gov (United States)

    Fujimori, Takahito; Miwa, Toshitada; Iwasaki, Motoki; Oda, Takenori

    2018-03-01

    Globally, the cost-effectiveness of spinal surgery is becoming increasingly important. However, these data are limited to a few countries. The purpose of our study was to examine the cost/quality adjusted life year (cost/QALY) gained for posterior lumbar interbody fusion (PLIF) in the Japanese universal health insurance system. Fifty five patients underwent PLIF for lumbar degenerative spinal canal stenosis between July 2013 and September 2015 was included. Effectiveness was measured using Euro QOL 5-dimension (EQ-5D), Short-Form 8 physical component summary (PCS), and visual analog scale (VAS). The cost was calculated from the perspective of the public healthcare payer. Effectiveness and cost were measured one year after surgery. QALYs were calculated by multiplying the utility value (EQ-5D) and life years. Only direct costs were included on the basis of actual reimbursements. Cost/QALY at a 5-year time horizon with a 2% discount rate was estimated. Sensitivity analysis was performed by varying the time horizon (2 years or 10 years). The exchange rate was defined as US $1 to Japanese 100 yen. Mean total cost one year after surgery was ¥2,802,900 ($28029). Operative cost was ¥1,779,700 ($17797). Mean gained score was 0.22 in EQ-5D, 10.3 in PCS, and -44 in VAS. Cost/QALY was ¥2,697,500 ($26975). Sensitivity analysis demonstrated that cost/QALY at a 10-year time horizon was ¥1,428,300 ($14283) and that cost/QALY at a 2-year time horizon was ¥6,435,400 ($64354). Clinical outcomes after PLIF improved beyond minimum clinical improvement difference. Cost/QALY was below the widely-accepted benchmark (cost/QALY < $50000). PLIF could be regarded as cost-effective interventions. Copyright © 2017 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

  10. A cost-effective Geographic Information Systems for Transportation ...

    African Journals Online (AJOL)

    In recent times, the Geographic Information Systems for Transportation (GIS-T) has gained prominence in the research and management of real-world transportation problems such as urban traffic congestion, especially in the developed countries. In developing countries, however, constraining factors such as initial ...

  11. Effects of different broiler production systems on health care costs in the Netherlands

    NARCIS (Netherlands)

    Gocsik, E.; Kortes, H.E.; Oude Lansink, A.G.J.M.; Saatkamp, H.W.

    2014-01-01

    This study analyzed the effects of different broiler production systems on health care costs in the Netherlands. In addition to the conventional production system, the analysis also included 5 alternative animal welfare systems representative of the Netherlands. The study was limited to the most

  12. Cost-Effectiveness of Surgery, Stereotactic Body Radiation Therapy, and Systemic Therapy for Pulmonary Oligometastases

    Energy Technology Data Exchange (ETDEWEB)

    Lester-Coll, Nataniel H., E-mail: nataniel.lester-coll@yale.edu [Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut (United States); Rutter, Charles E.; Bledsoe, Trevor J. [Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut (United States); Goldberg, Sarah B. [Department of Medicine (Medical Oncology), Yale University School of Medicine, New Haven, Connecticut (United States); Decker, Roy H.; Yu, James B. [Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut (United States)

    2016-06-01

    Introduction: Pulmonary oligometastases have conventionally been managed with surgery and/or systemic therapy. However, given concerns about the high cost of systemic therapy and improvements in local treatment of metastatic cancer, the optimal cost-effective management of these patients is unclear. Therefore, we sought to assess the cost-effectiveness of initial management strategies for pulmonary oligometastases. Methods and Materials: A cost-effectiveness analysis using a Markov modeling approach was used to compare average cumulative costs, quality adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs) among 3 initial disease management strategies: video-assisted thoracic surgery (VATS) wedge resection, stereotactic body radiation therapy (SBRT), and systemic therapy among 5 different cohorts of patient disease: (1) melanoma; (2) non-small cell lung cancer adenocarcinoma without an EGFR mutation (NSCLC AC); (3) NSCLC with an EGFR mutation (NSCLC EGFRm AC); (4) NSCLC squamous cell carcinoma (NSCLC SCC); and (5) colon cancer. One-way sensitivity analyses and probabilistic sensitivity analyses were performed to analyze uncertainty with regard to model parameters. Results: In the base case, SBRT was cost effective for melanoma, with costs/net QALYs of $467,787/0.85. In patients with NSCLC, the most cost-effective strategies were SBRT for AC ($156,725/0.80), paclitaxel/carboplatin for SCC ($123,799/0.48), and erlotinib for EGFRm AC ($147,091/1.90). Stereotactic body radiation therapy was marginally cost-effective for EGFRm AC compared to erlotinib with an incremental cost-effectiveness ratio of $126,303/QALY. For colon cancer, VATS wedge resection ($147,730/2.14) was the most cost-effective strategy. Variables with the greatest influence in the model were erlotinib-associated progression-free survival (EGFRm AC), toxicity (EGFRm AC), cost of SBRT (NSCLC SCC), and patient utilities (all histologies). Conclusions: Video-assisted thoracic

  13. Cost-Effectiveness of Surgery, Stereotactic Body Radiation Therapy, and Systemic Therapy for Pulmonary Oligometastases.

    Science.gov (United States)

    Lester-Coll, Nataniel H; Rutter, Charles E; Bledsoe, Trevor J; Goldberg, Sarah B; Decker, Roy H; Yu, James B

    2016-06-01

    Pulmonary oligometastases have conventionally been managed with surgery and/or systemic therapy. However, given concerns about the high cost of systemic therapy and improvements in local treatment of metastatic cancer, the optimal cost-effective management of these patients is unclear. Therefore, we sought to assess the cost-effectiveness of initial management strategies for pulmonary oligometastases. A cost-effectiveness analysis using a Markov modeling approach was used to compare average cumulative costs, quality adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs) among 3 initial disease management strategies: video-assisted thoracic surgery (VATS) wedge resection, stereotactic body radiation therapy (SBRT), and systemic therapy among 5 different cohorts of patient disease: (1) melanoma; (2) non-small cell lung cancer adenocarcinoma without an EGFR mutation (NSCLC AC); (3) NSCLC with an EGFR mutation (NSCLC EGFRm AC); (4) NSCLC squamous cell carcinoma (NSCLC SCC); and (5) colon cancer. One-way sensitivity analyses and probabilistic sensitivity analyses were performed to analyze uncertainty with regard to model parameters. In the base case, SBRT was cost effective for melanoma, with costs/net QALYs of $467,787/0.85. In patients with NSCLC, the most cost-effective strategies were SBRT for AC ($156,725/0.80), paclitaxel/carboplatin for SCC ($123,799/0.48), and erlotinib for EGFRm AC ($147,091/1.90). Stereotactic body radiation therapy was marginally cost-effective for EGFRm AC compared to erlotinib with an incremental cost-effectiveness ratio of $126,303/QALY. For colon cancer, VATS wedge resection ($147,730/2.14) was the most cost-effective strategy. Variables with the greatest influence in the model were erlotinib-associated progression-free survival (EGFRm AC), toxicity (EGFRm AC), cost of SBRT (NSCLC SCC), and patient utilities (all histologies). Video-assisted thoracic surgery wedge resection or SBRT can be cost-effective in select

  14. Cost-effectiveness of insulin analogs from the perspective of the Brazilian public health system

    Directory of Open Access Journals (Sweden)

    Maurílio de Souza Cazarim

    2017-11-01

    Full Text Available ABSTRACT Human insulin is provided by the Brazilian Public Health System (BPHS for the treatment of diabetes, however, legal proceedings to acquire insulin analogs have burdened the BPHS health system. The aim of this study was to perform a cost-effectiveness analysis to compare insulin analogs and human insulins. This is a pharmacoeconomic study of cost-effectiveness. The direct medical cost related to insulin extracted from the Ministry of Health drug price list was considered. The clinical results, i.e. reduction in glycated hemoglobin (HbA1c, were extracted by meta-analysis. Different scenarios were structured to measure the uncertainties regarding the costs and reduction in HbA1c. Decision tree was developed for sensitivity of Incremental Cost Effectiveness Ratio (ICER. A total of fifteen scenarios were structured. Given the best-case scenario for the insulin analogs, the insulins aspart, lispro, glargine and detemir showed an ICER of R$ 1,768.59; R$ 3,308.54; R$ 11,718.75 and R$ 2,685.22, respectively. In all scenarios in which the minimum effectiveness was proposed, lispro, glargine and detemir were dominant strategies. Sensitivity analysis showed that the aspart had R$ 3,066.98 [95 % CI: 2339.22; 4418.53] and detemir had R$ 6,163.97 [95% CI: 3919.29; 11401.57] for incremental costs. We concluded there was evidence that the insulin aspart is the most cost-effective.

  15. Assessment of the cost-effectiveness of photovoltaic systems for telecommunications in Nigeria

    Science.gov (United States)

    Oparaku, O. U.

    2002-03-01

    Developing countries seeking relevance in the international community have to adopt programmes in order to achieve cost-effective economic growth. Telecommunications is one area where emphasis must be laid because of its impact on development. Since the power supply forms an essential part of any communication system it is important to chose the power supply option that has the lowest life-cycle cost. The life-cycle costs of several power supply alternatives to some telecommunication systems in Nigeria have been evaluated. A hybrid (Solar/Gen. Set) power supply option is shown to be cost-effective when compared with diesel generating systems powering telecommunication equipment and airconditioning loads. The cost of PV power supply option used for a celluphone system is about 10% of the cost of the alternative of daily battery replacement and haulage. The low teledensity in the country creates a need for bold initiatives to incorporate solar power in telecommunications network, particularly in the remote rural communities where conventional electricity is not only unavailable, but is unreliable and very costly to maintain.

  16. Monitoring systems and their effectiveness for project cost control in construction

    NARCIS (Netherlands)

    Al-Jibouri, Saad H.S.

    2003-01-01

    This paper reports on a research to investigate the effectiveness of some commonly used monitoring systems, in detecting deviations from the planned cost and performance. The monitoring systems used in this work are: Leading parameter technique Variances method Activity based ratios technique The

  17. Estimating the Effects of Module Area on Thin-Film Photovoltaic System Costs: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Horowitz, Kelsey A [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Fu, Ran [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Silverman, Timothy J [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Woodhouse, Michael A [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Sun, Xingshu [Purdue University; Alam, Muhammad A [Purdue University

    2018-03-29

    We investigate the potential effects of module area on the cost and performance of photovoltaic systems. Applying a bottom-up methodology, we analyzed the costs associated with thin-film modules and systems as a function of module area. We calculate a potential for savings of up to 0.10 dollars/W and 0.13 dollars/W in module manufacturing costs for CdTe and CIGS respectively, with large area modules. We also find that an additional 0.04 dollars/W savings in balance-of-systems costs may be achieved. Sensitivity of the dollar/W cost savings to module efficiency, manufacturing yield, and other parameters is presented. Lifetime energy yield must also be maintained to realize reductions in the levelized cost of energy; the effects of module size on energy yield for monolithic thin-film modules are not yet well understood. Finally, we discuss possible non-cost barriers to adoption of large area modules.

  18. A Cost-Effectiveness Analysis of Seminatural Wetlands and Activated Sludge Wastewater-Treatment Systems

    Science.gov (United States)

    Mannino, Ilda; Franco, Daniel; Piccioni, Enrico; Favero, Laura; Mattiuzzo, Erika; Zanetto, Gabriele

    2008-01-01

    A cost-effectiveness analysis was performed to evaluate the competitiveness of seminatural Free Water Surface (FWS) wetlands compared to traditional wastewater-treatment plants. Six scenarios of the service costs of three FWS wetlands and three different wastewater-treatment plants based on active sludge processes were compared. The six scenarios were all equally effective in their wastewater-treatment capacity. The service costs were estimated using real accounting data from an experimental wetland and by means of a market survey. Some assumptions had to be made to perform the analysis. A reference wastewater situation was established to solve the problem of the different levels of dilution that characterize the inflow water of the different systems; the land purchase cost was excluded from the analysis, considering the use of public land as shared social services, and an equal life span for both seminatural and traditional wastewater-treatment plants was set. The results suggest that seminatural systems are competitive with traditional biotechnological systems, with an average service cost improvement of 2.1-fold to 8-fold, according to the specific solution and discount rate. The main improvement factor was the lower maintenance cost of the seminatural systems, due to the self-regulating, low artificial energy inputs and the absence of waste to be disposed. In this work, only the waste-treatment capacity of wetlands was considered as a parameter for the economic competitiveness analysis. Other goods/services and environmental benefits provided by FWS wetlands were not considered.

  19. Cost-Effectiveness Analysis of an Automated Medication System Implemented in a Danish Hospital Setting

    DEFF Research Database (Denmark)

    Risoer, Bettina Wulff; Lisby, Marianne; Soerensen, Jan

    2017-01-01

    outcome measure was the number of errors in the medication administration process observed prospectively before and after implementation. To determine the difference in proportion of errors after implementation of the AMS, logistic regression was applied with the presence of error(s) as the dependent......Objectives To evaluate the cost-effectiveness of an automated medication system (AMS) implemented in a Danish hospital setting. Methods An economic evaluation was performed alongside a controlled before-and-after effectiveness study with one control ward and one intervention ward. The primary...... of avoided administration errors was related to the incremental costs to obtain the cost-effectiveness ratio expressed as the cost per avoided administration error. Results The AMS resulted in a statistically significant reduction in the proportion of errors in the intervention ward compared with the control...

  20. Link Design Rules for Cost-Effective Short-Range Radio Over Multimode Fiber Systems

    DEFF Research Database (Denmark)

    Visani, Davide; Tartarini, Giovanni; Petersen, Martin Nordal

    2010-01-01

    Referring to short-range radio over multimode fiber links, we find out important guidelines for the realization of cost-effective intensity modulated directly detected systems. Since the quality of today's connectors is considerably higher than in the past, we demonstrate that two important...... for short-range applications, where the transmittable bandwidth does not constitute the main limitation....

  1. Cost-Effective Kernel Ridge Regression Implementation for Keystroke-Based Active Authentication System.

    Science.gov (United States)

    Wu, Pei-Yuan; Fang, Chi-Chen; Chang, Jien Morris; Kung, Sun-Yuan

    2017-11-01

    In this paper, a fast kernel ridge regression (KRR) learning algorithm is adopted with ( ) training cost for large-scale active authentication system. A truncated Gaussian radial basis function (TRBF) kernel is also implemented to provide better cost-performance tradeoff. The fast-KRR algorithm along with the TRBF kernel offers computational advantages over the traditional support vector machine (SVM) with Gaussian-RBF kernel while preserving the error rate performance. Experimental results validate the cost-effectiveness of the developed authentication system. In numbers, the fast-KRR learning model achieves an equal error rate (EER) of 1.39% with ( ) training time, while SVM with the RBF kernel shows an EER of 1.41% with ( ) training time.

  2. Cost and cost-effectiveness of computerized vs. in-person motivational interventions in the criminal justice system.

    Science.gov (United States)

    Cowell, Alexander J; Zarkin, Gary A; Wedehase, Brendan J; Lerch, Jennifer; Walters, Scott T; Taxman, Faye S

    2018-04-01

    Although substance use is common among probationers in the United States, treatment initiation remains an ongoing problem. Among the explanations for low treatment initiation are that probationers are insufficiently motivated to seek treatment, and that probation staff have insufficient training and resources to use evidence-based strategies such as motivational interviewing. A web-based intervention based on motivational enhancement principles may address some of the challenges of initiating treatment but has not been tested to date in probation settings. The current study evaluated the cost-effectiveness of a computerized intervention, Motivational Assessment Program to Initiate Treatment (MAPIT), relative to face-to-face Motivational Interviewing (MI) and supervision as usual (SAU), delivered at the outset of probation. The intervention took place in probation departments in two U.S. cities. The baseline sample comprised 316 participants (MAPIT = 104, MI = 103, and SAU = 109), 90% (n = 285) of whom completed the 6-month follow-up. Costs were estimated from study records and time logs kept by interventionists. The effectiveness outcome was self-reported initiation into any treatment (formal or informal) within 2 and 6 months of the baseline interview. The cost-effectiveness analysis involved assessing dominance and computing incremental cost-effectiveness ratios and cost-effectiveness acceptability curves. Implementation costs were used in the base case of the cost-effectiveness analysis, which excludes both a hypothetical license fee to recoup development costs and startup costs. An intent-to-treat approach was taken. MAPIT cost $79.37 per participant, which was ~$55 lower than the MI cost of $134.27 per participant. Appointment reminders comprised a large proportion of the cost of the MAPIT and MI intervention arms. In the base case, relative to SAU, MAPIT cost $6.70 per percentage point increase in the probability of initiating treatment. If

  3. Figure-of-merit analysis and cost effectiveness of low-level radioactive waste treatment systems

    International Nuclear Information System (INIS)

    Cox, N.D.; Falconer, K.L.; McCormack, M.D.; Hootman, H.D.; Thompson, T.K.

    1982-01-01

    Two studies were performed to assess low-level waste treatment systems that are available commercially for volume reduction and/or solidification. In the first, a Figure-of-Merit (FOM) decision analysis technique was used to evaluate fourteen low-level radioactive waste processing systems on their ability to treat power reactor wastes. The assessment of the various processing systems was accomplished using a five member task force. The systems were judged on eleven major criteria and twenty subcriteria. The system judged superior to all the others was compaction of dry wastes with liquid wastes and sludges being directly incorporated into concrete. This was also the lowest cost system. The controlled air incinerator was judged the preferred incineration process. The Werner-Pfleider bitumen extruder was the preferred liquid waste treatment system. In the second study, the cost economy of volume reduction measured in land disposal dollars was investigated. The greatest cost savings with volume reduction were realized with a BWR using a deep bed condensate polishing system; the least with a PWR with condensate polishing. For both BWR systems and PWRs without condensate cleanup, over 80% of the savings in land disposal dollars resulted from volume reduction of liquid waste streams (concentrated liquids and filter sludge). For a PWR with a condensate polishing system, which had the least cost effective system for volume reduction, about one-third of the savings resulting from incineration of spent resin and compactible trash was offset by the increased expense of casks required for transporting concentrated liquids which have undergone additional volume reduction

  4. Developing a cost effective rock bed thermal energy storage system: Design and modelling

    Science.gov (United States)

    Laubscher, Hendrik Frederik; von Backström, Theodor Willem; Dinter, Frank

    2017-06-01

    Thermal energy storage is an integral part of the drive for low cost of concentrated solar power (CSP). Storage of thermal energy enables CSP plants to provide base load power. Alternative, cheaper concepts for storing thermal energy have been conceptually proposed in previous studies. Using rocks as a storage medium and air as a heat transfer fluid, the proposed concept offers the potential of lower cost storage because of the abundance and affordability of rocks. A packed rock bed thermal energy storage (TES) concept is investigated and a design for an experimental rig is done. This paper describes the design and modelling of an experimental test facility for a cost effective packed rock bed thermal energy storage system. Cost effective, simplified designs for the different subsystems of an experimental setup are developed based on the availability of materials and equipment. Modelling of this design to predict the thermal performance of the TES system is covered in this study. If the concept under consideration proves to be successful, a design that is scalable and commercially viable can be proposed for further development of an industrial thermal energy storage system.

  5. Systems/cost summary

    International Nuclear Information System (INIS)

    Grand, P.; Danby, G.; Keane, J.; Spiro, J.; Sutter, D.; Cole, F.; Hoyer, E.; Freytag, K.; Burke, R.

    1977-01-01

    The purpose of the meeting was to discuss and develop cost-estimating methods for heavy-ion fusion accelerator systems. The group did not consider that its purpose was to make technical judgements on proposed systems, but to develop methods for making reasonable cost estimates of these systems. Such estimates will, it is hoped, provide material for systems studies, will help in guiding research and development efforts by identifying ''high-leverage'' subsystems (areas that account for a significant part of total system cost and that might be reduced in cost by further technical development) and to begin to provide data to aid in an eventual decision on the optimum type of accelerator for heavy-ion fusion

  6. Effect of the Enabling Perception of Costing Systems by Managers in the Performance of their Tasks

    Directory of Open Access Journals (Sweden)

    Guilherme Eduardo de Souza

    2017-12-01

    Full Text Available The goal of this study is to analyze the effect of the enabling perception of costing systems by managers in the performance of their tasks, mediated by the intensity in of use of these costing systems and the level of psychological empowerment. The research was carried out through a survey of 62 companies listed in the Perfil das Empresas com Projetos Aprovados ou em Implantação na Zona Franca de Manaus Profile of Companies, in 2014. With a view to analyzing the hypotheses replicated from Mahama’s and Cheng’s (2013 study, the Structural Equations Modeling technique wasused. The research results show that the managers’ enabling perception of costing systems does not affect their  intensity of use, but it impacts on psychological empowerment, and this is directly reflected in the performance of tasks, indicating that the greater the empowerment, the better manager performance will be. It isconcluded that the model partially supports the relationships delineated and that the antecedents related to the costing systems require further study.

  7. The Air Force Needs to Improve Cost-Effectiveness and Availability of the Joint Surveillance Target Attack Radar System (Redacted)

    Science.gov (United States)

    2016-11-01

    the Freedom of Information Act. The Air Force Needs to Improve Cost -Effectiveness and Availability of the Joint Surveillance Target Attack Radar... Target Attack Radar System Objective We determined whether the Air Force made cost -effective purchases on the performance-based logistics contract to...0263.000) Results in Brief The Air Force Needs to Improve Cost -Effectiveness and Availability of the Joint Surveillance Target Attack Radar System

  8. A cost-effective measurement-device-independent quantum key distribution system for quantum networks

    Science.gov (United States)

    Valivarthi, Raju; Zhou, Qiang; John, Caleb; Marsili, Francesco; Verma, Varun B.; Shaw, Matthew D.; Nam, Sae Woo; Oblak, Daniel; Tittel, Wolfgang

    2017-12-01

    We experimentally realize a measurement-device-independent quantum key distribution (MDI-QKD) system. It is based on cost-effective and commercially available hardware such as distributed feedback lasers and field-programmable gate arrays that enable time-bin qubit preparation and time-tagging, and active feedback systems that allow for compensation of time-varying properties of photons after transmission through deployed fiber. We examine the performance of our system, and conclude that its design does not compromise performance. Our demonstration paves the way for MDI-QKD-based quantum networks in star-type topology that extend over more than 100 km distance.

  9. The effect of short recovery period investment on least-cost generation system expansion

    International Nuclear Information System (INIS)

    Yiqun He; David, A.K.; Fernando, P.N.

    1995-01-01

    The effect of the short recovery period of private investment on least-cost generation system expansion is analysed, and a trade-off method for generation system expansion, which gives consideration to both the least-cost strategy and the short recovery period of private investment, is presented. First, the optimal mix of generation units under a standard recovery period for all units is established, and then the surcharge, due to the difference between the short recovery period and the standard recovery period, is calculated and shared between all units. The former is an optimization to make best use of natural resources, and the latter is a trade-off method to spread the surcharge throughout the system. (Author)

  10. Total cost of ownership of CHP SOFC systems: Effect of installation context

    International Nuclear Information System (INIS)

    Arduino, Francesco; Santarelli, Massimo

    2016-01-01

    Solid oxide fuel cells (SOFC) are one of the most interesting between the emerging technologies for energy production. Although some information about the production cost of these devices are already known, their operational cost has not been studied yet with sufficient accuracy. This paper presents a life cycle cost (LCC) analysis of CHP (combined heat and power) SOFC systems performed in hospitals located in various cities of the US and one in Italy. In this study the strong effects of the installation context will be analyzed using a customized use phase model for each location. The cost effectiveness of these devices has been proved without credits in Mondovi (IT), New York (NY) and Minneapolis (MN) where the payback time goes from 10 to 7 years. Considering the credits, it is possible to obtain economic feasibility also in Chicago (IL) and reduce the payback for other cities to values from 4 to 6 years. In other cities like Phoenix (AZ) and Houston (TX) the payback can’t be reached in any case. The life cycle impact assessment analysis has shown how, even in the cities with cleaner electricity grid, there is a reduction in the emissions of both greenhouse gases and pollutants. - Highlights: •Life cycle cost analysis has been performed for CHP SOFC systems. •The strong effects of the installation context have been analyzed. •Economic feasibility has been proven in new york, Minneapolis and Mondovi. •Economic feasibility can’t be reached in phoenix and Houston. •SOFC always provide a reduction in the emissions of greenhouse gases and pollutant.

  11. Effects of tunnel and station size on the costs and service of subway transit systems

    Science.gov (United States)

    Dayman, B., Jr.

    1979-01-01

    The feasibility of less spacious, less costly underground rail mass transit system designs is studied. The major cost saving expected from alternative tunnel designs results from using precast concrete segment liners in place of steel. The saying expected for a two-foot decrease in the diameter of twin, single track tunnels is about two million dollars per route mile from 13 million dollars for precast concrete segment liners (a saving of about 16%). The cost per route-mile of a double track tunnel appears to be 15 to 25% higher than for the twin, single track tunnels. The effective cost saving expected from stations with four-car train capability instead of the usual eight-car trains is nearly 25% or seven million dollars per route mile. The saving in station costs can be obtained while improving service to the user (lower transit time and less waiting for trains) up to a capacity of 36,000 riders per hour in each direction.

  12. Examining the effectiveness of municipal solid waste management systems: an integrated cost-benefit analysis perspective with a financial cost modeling in Taiwan.

    Science.gov (United States)

    Weng, Yu-Chi; Fujiwara, Takeshi

    2011-06-01

    In order to develop a sound material-cycle society, cost-effective municipal solid waste (MSW) management systems are required for the municipalities in the context of the integrated accounting system for MSW management. Firstly, this paper attempts to establish an integrated cost-benefit analysis (CBA) framework for evaluating the effectiveness of MSW management systems. In this paper, detailed cost/benefit items due to waste problems are particularly clarified. The stakeholders of MSW management systems, including the decision-makers of the municipalities and the citizens, are expected to reconsider the waste problems in depth and thus take wise actions with the aid of the proposed CBA framework. Secondly, focusing on the financial cost, this study develops a generalized methodology to evaluate the financial cost-effectiveness of MSW management systems, simultaneously considering the treatment technological levels and policy effects. The impacts of the influencing factors on the annual total and average financial MSW operation and maintenance (O&M) costs are analyzed in the Taiwanese case study with a demonstrative short-term future projection of the financial costs under scenario analysis. The established methodology would contribute to the evaluation of the current policy measures and to the modification of the policy design for the municipalities. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

  13. Examining the effectiveness of municipal solid waste management systems: An integrated cost-benefit analysis perspective with a financial cost modeling in Taiwan

    International Nuclear Information System (INIS)

    Weng, Yu-Chi; Fujiwara, Takeshi

    2011-01-01

    In order to develop a sound material-cycle society, cost-effective municipal solid waste (MSW) management systems are required for the municipalities in the context of the integrated accounting system for MSW management. Firstly, this paper attempts to establish an integrated cost-benefit analysis (CBA) framework for evaluating the effectiveness of MSW management systems. In this paper, detailed cost/benefit items due to waste problems are particularly clarified. The stakeholders of MSW management systems, including the decision-makers of the municipalities and the citizens, are expected to reconsider the waste problems in depth and thus take wise actions with the aid of the proposed CBA framework. Secondly, focusing on the financial cost, this study develops a generalized methodology to evaluate the financial cost-effectiveness of MSW management systems, simultaneously considering the treatment technological levels and policy effects. The impacts of the influencing factors on the annual total and average financial MSW operation and maintenance (O and M) costs are analyzed in the Taiwanese case study with a demonstrative short-term future projection of the financial costs under scenario analysis. The established methodology would contribute to the evaluation of the current policy measures and to the modification of the policy design for the municipalities.

  14. A Transparent Framework for Evaluating the Effects of DGPV on Distribution System Costs

    Energy Technology Data Exchange (ETDEWEB)

    Horowitz, Kelsey A [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Mather, Barry A [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Ding, Fei [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Denholm, Paul L [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Palmintier, Bryan S [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2018-04-02

    Assessing the costs and benefits of distributed photovoltaic generators (DGPV) to the power system and electricity consumers is key to determining appropriate policies, tariff designs, and power system upgrades for the modern grid. We advance understanding of this topic by providing a transparent framework, terminology, and data set for evaluating distribution system upgrade costs, line losses, and interconnection costs as a function of DGPV penetration level.

  15. Comparative Cost-Effectiveness Analysis of Three Different Automated Medication Systems Implemented in a Danish Hospital Setting.

    Science.gov (United States)

    Risør, Bettina Wulff; Lisby, Marianne; Sørensen, Jan

    2018-02-01

    Automated medication systems have been found to reduce errors in the medication process, but little is known about the cost-effectiveness of such systems. The objective of this study was to perform a model-based indirect cost-effectiveness comparison of three different, real-world automated medication systems compared with current standard practice. The considered automated medication systems were a patient-specific automated medication system (psAMS), a non-patient-specific automated medication system (npsAMS), and a complex automated medication system (cAMS). The economic evaluation used original effect and cost data from prospective, controlled, before-and-after studies of medication systems implemented at a Danish hematological ward and an acute medical unit. Effectiveness was described as the proportion of clinical and procedural error opportunities that were associated with one or more errors. An error was defined as a deviation from the electronic prescription, from standard hospital policy, or from written procedures. The cost assessment was based on 6-month standardization of observed cost data. The model-based comparative cost-effectiveness analyses were conducted with system-specific assumptions of the effect size and costs in scenarios with consumptions of 15,000, 30,000, and 45,000 doses per 6-month period. With 30,000 doses the cost-effectiveness model showed that the cost-effectiveness ratio expressed as the cost per avoided clinical error was €24 for the psAMS, €26 for the npsAMS, and €386 for the cAMS. Comparison of the cost-effectiveness of the three systems in relation to different valuations of an avoided error showed that the psAMS was the most cost-effective system regardless of error type or valuation. The model-based indirect comparison against the conventional practice showed that psAMS and npsAMS were more cost-effective than the cAMS alternative, and that psAMS was more cost-effective than npsAMS.

  16. A cost-effective traffic data collection system based on the iDEN mobile telecommunication network.

    Science.gov (United States)

    2008-10-01

    This report describes a cost-effective data collection system for Caltrans 170 traffic signal : controller. The data collection system is based on TCP/IP communication over existing : low-cost mobile communication networks and Motorola iDEN1 mobile...

  17. Reliability, energy, and cost effects of wind-powered generation integrated with a conventional generating system

    Energy Technology Data Exchange (ETDEWEB)

    VanKuiken, J.C.; Buehring, W.A.; Huber, C.C.; Hub, K.A.

    1980-01-01

    The purpose of this investigation is to examine the potential impacts of incorporating wind turbines, without the aid of energy-storage devices, into a conventional electrical generating system. This study focuses on the contribution to generating-system reliability of wind turbines, and the methods used to calculate these benefits. In addition, a simple cost model was developed to estimate ranges of breakeven costs for wind turbines based on the sum of fuel cost savings, variable operation and maintenance (0 and M) cost savings, and reliability benefits of the wind turbines.

  18. A cost-effective and flexible metaphase finder system for chromosomal biodosimetry

    International Nuclear Information System (INIS)

    Furukawa, A.; Hayata, I.

    2003-01-01

    For biological dosimetry by counting chromosomes aberrations, automation technique has been required to process large number of sample preparations at low dose radiation exposure. Metaphase Finder is an automated optical microscope system, which automatically scans and finds metaphase cells on the slide glass, and relocates metaphase cells to the center of the field of view of the microscope to observe chromosomes in high magnification. There are several commercial products of metaphase finders, but these dedicated-system products are usually expensive and inconvenient for fitting to the variety of sample preparations. Now, we have constructed an improved system by assembling each components of the system, such as microscope, automated stage and computer, from the selection of the commercially available products, instead of purchasing one dedicated system. The new system has high cost-effectiveness and high flexibility in adapting to the new staining methods. This Metaphase Finder system consists of following components: an optical microscope, a motorized sample stage, an auto-focusing unit and two CCD cameras for focusing and for image acquisition. These components are controlled by a personal computer. The image recognition software for detecting metaphase cells from the microscope image was developed on the programming environment provided by the general-purpose image analysis software. The processing speed of this Metaphase Finder system is 20 to 30 minutes per one slide glass (typical scan area is 20 mm x 50 mm), which is enough acceptable for practical use and remarkably improved from the speed of our previous model of 1993. The algorithm for detecting metaphase cells has also improved to adapt to the variety of the condition of the sample preparation. This new system is scheduled to be distributed to several laboratories in Japan, and will be tested for the practical use

  19. Comparison of cost accounting methods from different DRG systems and their effect on health care quality.

    Science.gov (United States)

    Leister, Jan Eric; Stausberg, Jürgen

    2005-09-28

    Diagnosis related groups (DRGs) are a well-established provider payment system. Because of their imminent potential of cost reduction, they have been widely introduced. In addition to cost cutting, several social objectives - e.g., improving overall health care quality - feed into the DRG system. The WHO compared different provider payment systems with regard to the following objectives: prevention of further health problems, providing services and solving health problems, and responsiveness to people's legitimate expectations. However, no study has been published which takes the impact of different cost accounting systems across the DRG systems into account. We compared the impact of different cost accounting methods within DRG-like systems by developing six criteria: integration of patients' health risk into pricing practice, incentives for quality improvement and innovation, availability of high class evidence based therapy, prohibition of economically founded exclusions, reduction of fragmentation incentives, and improvement of patient oriented treatment. We set up a first overview of potential and actual impacts of the pricing practices within Yale-DRGs, AR-DRGs, G-DRGs, Swiss AP-DRGs adoption and Swiss MIPP. It could be demonstrated that DRGs are not only a 'homogenous' group of similar provider payment systems but quite different by fulfilling major health care objectives connected with the used cost accounting methods. If not only the possible cost reduction is used to put in a good word for DRG-based provider payment systems, maximum accurateness concerning the method of cost accounting should prevail when implementing a new DRG-based provider payment system.

  20. Impacts of rainfall variability and expected rainfall changes on cost-effective adaptation of water systems to climate change.

    Science.gov (United States)

    van der Pol, T D; van Ierland, E C; Gabbert, S; Weikard, H-P; Hendrix, E M T

    2015-05-01

    Stormwater drainage and other water systems are vulnerable to changes in rainfall and runoff and need to be adapted to climate change. This paper studies impacts of rainfall variability and changing return periods of rainfall extremes on cost-effective adaptation of water systems to climate change given a predefined system performance target, for example a flood risk standard. Rainfall variability causes system performance estimates to be volatile. These estimates may be used to recurrently evaluate system performance. This paper presents a model for this setting, and develops a solution method to identify cost-effective investments in stormwater drainage adaptations. Runoff and water levels are simulated with rainfall from stationary rainfall distributions, and time series of annual rainfall maxima are simulated for a climate scenario. Cost-effective investment strategies are determined by dynamic programming. The method is applied to study the choice of volume for a storage basin in a Dutch polder. We find that 'white noise', i.e. trend-free variability of rainfall, might cause earlier re-investment than expected under projected changes in rainfall. The risk of early re-investment may be reduced by increasing initial investment. This can be cost-effective if the investment involves fixed costs. Increasing initial investments, therefore, not only increases water system robustness to structural changes in rainfall, but could also offer insurance against additional costs that would occur if system performance is underestimated and re-investment becomes inevitable. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Value engineering and cost effectiveness of various fiber reinforced polymer (FRP) repair systems.

    Science.gov (United States)

    2006-06-01

    Seventeen 40 year old C-Channel type prestressed concrete bridge girders and one impact damaged AASHTO : Type II prestressed concrete girder were tested under static and fatigue loading to determine the cost-effectiveness : and value engineering aspe...

  2. Advanced Insulation for High Performance Cost-Effective Wall, Roof, and Foundation Systems Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Costeux, Stephane [Dow Chemical Company, Midland, MI (United States); Bunker, Shanon [Dow Chemical Company, Midland, MI (United States)

    2013-12-20

    The objective of this project was to explore and potentially develop high performing insulation with increased R/inch and low impact on climate change that would help design highly insulating building envelope systems with more durable performance and lower overall system cost than envelopes with equivalent performance made with materials available today. The proposed technical approach relied on insulation foams with nanoscale pores (about 100 nm in size) in which heat transfer will be decreased. Through the development of new foaming methods, of new polymer formulations and new analytical techniques, and by advancing the understanding of how cells nucleate, expand and stabilize at the nanoscale, Dow successfully invented and developed methods to produce foams with 100 nm cells and 80% porosity by batch foaming at the laboratory scale. Measurements of the gas conductivity on small nanofoam specimen confirmed quantitatively the benefit of nanoscale cells (Knudsen effect) to increase insulation value, which was the key technical hypotheses of the program. In order to bring this technology closer to a viable semi-continuous/continuous process, the project team modified an existing continuous extrusion foaming process as well as designed and built a custom system to produce 6" x 6" foam panels. Dow demonstrated for the first time that nanofoams can be produced in a both processes. However, due to technical delays, foam characteristics achieved so far fall short of the 100 nm target set for optimal insulation foams. In parallel with the technology development, effort was directed to the determination of most promising applications for nanocellular insulation foam. Voice of Customer (VOC) exercise confirmed that demand for high-R value product will rise due to building code increased requirements in the near future, but that acceptance for novel products by building industry may be slow. Partnerships with green builders, initial launches in smaller markets (e.g. EIFS

  3. Figure-of-merit analysis and cost effectiveness of low-level radioactive waste treatment systems

    Science.gov (United States)

    Cox, N. D.; Falconer, K. L.; McCormack, M. D.; Hootman, H. D.; Thompson, T. K.

    Two studies were performed to assess low level waste treatment systems that are available commercially for volume reduction and/or solidification. In the first, a Figure-of-Merit (FOM) decision analysis technique was used to evaluate fourteen low level radioactive waste processing systems on their ability to treat power reactor wastes. The assessment of the various processing systems was accomplished using a five member task force. The systems were judged on eleven major criteria and twenty subcriteria. The system judged superior to all the others was compaction of dry wastes with liquid wastes and sludges being directly incorporated into concrete. This was also the lowest cost system. The controlled air incinerator was judged the preferred incineration process. The Werner-Pfleider bitumen extruduer was the preferred liquid waste treatment system. In the second study, the cost economy of volume reduction measured in land disposal dollars was investigated.

  4. Cost-effectiveness of a shared computerized decision support system for diabetes linked to electronic medical records.

    Science.gov (United States)

    O'Reilly, Daria; Holbrook, Anne; Blackhouse, Gordon; Troyan, Sue; Goeree, Ron

    2012-01-01

    Computerized decision support systems (CDSSs) are believed to enhance patient care and reduce healthcare costs; however the current evidence is limited and the cost-effectiveness remains unknown. To estimate the long-term cost-effectiveness of a CDSS linked to evidence-based treatment recommendations for type 2 diabetes. Using the Ontario Diabetes Economic Model, changes in factors (eg, HbA1c) from a randomized controlled trial were used to estimate cost-effectiveness. The cost of implementation, development, and maintenance of the core dataset, and projected diabetes-related complications were included. The base case assumed a 1-year treatment effect, 5% discount rate, and 40-year time horizon. Univariate, one-way sensitivity analyses were carried out by altering different parameter values. The perspective was the Ontario Ministry of Health and costs were in 2010 Canadian dollars. The cost of implementing the intervention was $483,699. The one-year intervention reduced HbA1c by 0.2 and systolic blood pressure by 3.95 mm Hg, but increased body mass index by 0.02 kg/m², resulting in a relative risk reduction of 14% in the occurrence of amputation. The model estimated that the intervention resulted in an additional 0.0117 quality-adjusted life year; the incremental cost-effectiveness ratio was $160,845 per quality-adjusted life-year. The web-based prototype decision support system slightly improved short-term risk factors. The model predicted moderate improvements in long-term health outcomes. This disease management program will need to develop considerable efficiencies in terms of costs and processes or improved effectiveness to be considered a cost-effective intervention for treating patients with type 2 diabetes.

  5. The Brazilian Unified National Health System: Proposal of a Cost-effectiveness Evaluation Model

    Directory of Open Access Journals (Sweden)

    Lilian Ribeiro de Oliveira

    2016-04-01

    Full Text Available The Brazilian Unified National Health System (Sistema Único de Saúde [SUS] is in a prominent position compared to the existing social policies. One of the new tools used by SUS is known as Performance Index of the Unified Health System (Índice de Desempenho do Sistema Único de Saúde [IDSUS], which is intended to measure the performance of each municipality. Therefore, the aim of this study was to propose a model of cost-effectiveness to compare IDSUS performance against total revenues achieved in Homogeneous Group 2, consisting of 94 municipalities and analysed using data from IDSUS and the System Information of the Public Budget for Health Care (Sistema de Informação do Orçamento Público em Saúde [SIOPS] for the year 2011. After structuring this data, we carried out descriptive statistical and cluster analysis in order to group similar municipalities in accordance with established variables: IDSUS performance, population and total revenue in health per capita. Even with the division of municipalities into homogeneous groups and after using variables such as population and revenue to regroup them, the results showed there are municipalities with heterogeneous characteristics. Another finding is in the use and intersection of two distinct databases (IDSUS and SIOPS, which allowed for visualizing the impact of health care revenue on the municipalities performance.

  6. 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.

  7. Future costs in cost effectiveness analysis.

    Science.gov (United States)

    Lee, Robert H

    2008-07-01

    This paper resolves several controversies in CEA. Generalizing [Garber, A.M., Phelps, C.E., 1997. Economic foundations of cost-effectiveness analysis. Journal of Health Economics 16 (1), 1-31], the paper shows accounting for unrelated future costs distorts decision making. After replicating [Meltzer, D., 1997. Accounting for future costs in medical cost-effectiveness analysis. Journal of Health Economics 16 (1), 33-64] quite different conclusion that unrelated future costs should be included in CEA, the paper shows that Meltzer's findings result from modeling the budget constraint as an annuity, which is problematic. The paper also shows that related costs should be included in CEA. This holds for a variety of models, including a health maximization model. CEA should treat costs in the manner recommended by Garber and Phelps.

  8. Impacts of Rainfall Variability and Expected Rainfall Changes on Cost-Effective Adaptation of Water Systems to Climate Change

    NARCIS (Netherlands)

    Pol, van der T.D.; Ierland, van E.C.; Gabbert, S.G.M.; Weikard, H.P.; Hendrix, E.M.T.

    2015-01-01

    Stormwater drainage and other water systems are vulnerable to changes in rainfall and runoff and need to be adapted to climate change. This paper studies impacts of rainfall variability and changing return periods of rainfall extremes on cost-effective adaptation of water systems to climate change

  9. The effect of inflation rate on the cost of medical waste management system

    Directory of Open Access Journals (Sweden)

    Walery Maria Jolanta

    2017-01-01

    Full Text Available This paper describes the optimization study aimed to analyse the impact of the parameter describing the inflation rate on the cost of the system and its structure. The study was conducted on the example of the analysis of medical waste management system in north-eastern Poland, in the Podlaskie Province. The scope of operational research carried out under the optimization study was divided into two stages of optimization calculations with assumed technical and economic parameters of the system. In the first stage, the lowest cost of functioning of the analysed system was generated, whereas in the second one the influence of the input parameter of the system, i.e. the inflation rate on the economic efficiency index (E and the spatial structure of the system was determined. With the assumed inflation rate in the range of 1.00 to 1.12, the highest cost of the system was achieved at the level of PLN 2022.20/t (increase of economic efficiency index E by ca. 27% in comparison with run 1, with inflation rate = 1.12.

  10. The effect of inflation rate on the cost of medical waste management system

    Science.gov (United States)

    Jolanta Walery, Maria

    2017-11-01

    This paper describes the optimization study aimed to analyse the impact of the parameter describing the inflation rate on the cost of the system and its structure. The study was conducted on the example of the analysis of medical waste management system in north-eastern Poland, in the Podlaskie Province. The scope of operational research carried out under the optimization study was divided into two stages of optimization calculations with assumed technical and economic parameters of the system. In the first stage, the lowest cost of functioning of the analysed system was generated, whereas in the second one the influence of the input parameter of the system, i.e. the inflation rate on the economic efficiency index (E) and the spatial structure of the system was determined. With the assumed inflation rate in the range of 1.00 to 1.12, the highest cost of the system was achieved at the level of PLN 2022.20/t (increase of economic efficiency index E by ca. 27% in comparison with run 1, with inflation rate = 1.12).

  11. Development of a cost-effective heat pump system for family dwellings

    NARCIS (Netherlands)

    Stoel, J.P. van der; Traversari, A.A.L.; Veldhoven, L.A.A.

    1999-01-01

    Since the 1970s TNO MEP has played an important role in heat pump research, focused on perfonnance improvement, implementation, testing and development. In 1996/1997 a heat pump competition was organised. The main conclusion was, that the capital cost was too high and system performance was not

  12. FlexSAR, a high quality, flexible, cost effective, prototype SAR system

    Science.gov (United States)

    Jensen, Mark; Knight, Chad; Haslem, Brent

    2016-05-01

    The FlexSAR radar system was designed to be a high quality, low-cost, flexible research prototype instrument. Radar researchers and practitioners often desire the ability to prototype new or advanced configurations, yet the ability to enhance or upgrade existing radar systems can be cost prohibitive. FlexSAR answers the need for a flexible radar system that can be extended easily, with minimal cost and time expenditures. The design approach focuses on reducing the resources required for developing and validating new advanced radar modalities. Such an approach fosters innovation and provides risk reduction since actual radar data can be collected in the appropriate mode, processed, and analyzed early in the development process. This allows for an accurate, detailed understanding of the corresponding trade space. This paper is a follow-on to last years paper and discusses the advancements that have been made to the FlexSAR system. The overall system architecture is discussed and presented along with several examples illustrating the system utility.

  13. Cost-effective hybrid RF/FSO backhaul solution for next generation wireless systems

    KAUST Repository

    Dahrouj, Hayssam

    2015-10-28

    The rapid pace of demand for mobile data services and the limited supply of capacity in the current wireless access networks infrastructure are leading network operators to increase the density of base station deployments to improve network performance. This densification, made possible by small-cell deployment, also brings a novel set of challenges, specifically related to the cost of ownership, in which backhaul is of primary concern. This article proposes a cost-effective hybrid RF/free-space optical (FSO) solution to combine the advantages of RF backhauls (low cost, NLOS applications) and FSO backhauls (high-rate, low latency). To first illustrate the cost advantages of the RF backhaul solution, the first part of this article presents a business case of NLOS wireless RF backhaul, which has a low cost of ownership as compared to other backhaul candidates. RF backhaul, however, is limited by latency problems. On the other side, an FSO solution, which offers better latency and higher data rate than RF backhauls, remains sensitive to weather and nature conditions (e.g., rain, fog). To combine RF and FSO advantages, the second part of this article proposes a lowcost hybrid RF/FSO solution, wherein base stations are connected to each other using either optical fiber or hybrid RF/FSO links. This part addresses the problem of minimizing the cost of backhaul planning under reliability, connectivity, and data rate constraints, and proposes choosing the appropriate cost-effective backhaul connection between BSs (i.e., either OF or hybrid RF/FSO) using graph theory techniques.

  14. Cost-Effective Control Systems for Colleges and Universities: A New Paradigm.

    Science.gov (United States)

    Hubbell, Loren Loomis; Dougherty, Jennifer Dowling

    This report addresses the issue of maintaining adequate controls within a streamlined or restructured financial affairs environment at an institution of higher education. It presents a new paradigm for control structures designed to more effectively meet administrators' needs--both in terms of cost and risk management. The first section: (1)…

  15. Cost-effectiveness of an electronic medication ordering system (CPOE/CDSS) in hospitalized patients

    NARCIS (Netherlands)

    Vermeulen, K. M.; van Doormaal, J. E.; Zaal, R. J.; Mol, P. G. M.; Lenderink, A. W.; Haaijer-Ruskamp, F. M.; Kosterink, J. G. W.; van den Bemt, P. M. L. A.

    Introduction: Prescribing medication is an important aspect of almost all in-hospital treatment regimes. Besides their obviously beneficial effects, medicines can also cause adverse drug events (ADE), which increase morbidity, mortality and health care costs. Partially, these ADEs arise from

  16. A Guide to the Selection of Cost-Effective Wastewater Treatment Systems. Technical Report.

    Science.gov (United States)

    Van Note, Robert H.; And Others

    The data within this publication provide guidelines for planners, engineers and decision-makers at all governmental levels to evaluate cost-effectiveness of alternative wastewater treatment proposals. The processes described include conventional and advanced treatment units as well as most sludge handling and processing units. Flow sheets, cost…

  17. The effects of the global budget system on cost containment and the quality of care: experience in Taiwan.

    Science.gov (United States)

    Chang, Li; Hung, Jung-Hua

    2008-05-01

    This study is an attempt to determine whether the implementation of the Global Budget (GB) as a method of health reform has improved cost containment and quality of care in Taiwan. Panel-data analysis is used to investigate cost containment and quality of care in Taipei municipal hospitals before and after the introduction of the GB. The results suggest that there is a trade-off effect. The post-GB data indicate that cost containment comes at the expense of health-care quality. It may, therefore, be the case that policy-makers can more effectively balance cost containment and quality by refining the GB so that reimbursements would be linked to standards of quality. Another way to enhance the reforms would be a more effective monitoring and review system.

  18. Cost-effectiveness analysis of the SEAMIST trademark membrane system technology

    International Nuclear Information System (INIS)

    Henriksen, A.D.; Booth, S.R.

    1995-01-01

    SEAMIST trademark is a new technology that consists of an airtight membrane liner that is pneumatically emplaced inside the borehole. The positive air pressure inside the liner maintains the integrity of the borehole structure. Sampling ports with attached tubing, absorbent collectors, or various in situ measuring devices can be fabricated into the liner and used for monitoring volatile organic compounds (VOCs), semivolatile organic compounds (SVOCs), pesticides, herbicides, polynuclear aromatic hydrocarbons, polychlorinated biphenyls, or radioactive substances. In addition, small instruments can be guided through the lined borehole and measurements taken inside at specified intervals. The purpose of this study is to analyze the cost and performance effectiveness of this new technology. To do so, the authors constructed five hypothetical scenarios in which utilization of the SEAMIST trademark system can address various needs of the Department of Energy's environmental remediation program. Two of the scenarios involve vertical boreholes (or vertical instrument configurations) and two involve horizontal boreholes (or horizontal instrument configurations). The four scenarios jointly address contamination by VOCS, SVOCS, various water-soluble toxic substances, and low-level radioactive waste. One of the scenarios involves towing an instrument through a borehole and taking measurements of moisture levels in the surrounding soil

  19. RodPilotR - The Innovative and Cost-Effective Digital Control Rod Drive Control System for PWRs

    International Nuclear Information System (INIS)

    Baron, Clemens

    2008-01-01

    With RodPilot, AREVA NP offers an innovative and cost-effective system for controlling control rods in Pressurized Water Reactors. RodPilot controls the three operating coils of the control rod drive mechanism (lift, moveable gripper and stationary gripper coil). The rods are inserted into or withdrawn from the core as required by the Reactor Control System. The system combines modern components, state-of-the-art logic and a proven electronic control rod drive control principle to provide enhanced reliability and lower maintenance costs. (author)

  20. Introduction to cost-effectiveness analysis of risk reduction measures in energy systems

    International Nuclear Information System (INIS)

    1986-07-01

    The aim of this report is to introduce readers to methods of cost-effectiveness analysis and their application in risk reduction, especially in connection with the energy-producing industries. The background to the assessment of risk and the problems in estimating it quantitatively are outlined. The methodology of cost-effectiveness analysis is then described, particular attention being given to the way in which results are derived and the overall use that can be made of them. This is followed by a discussion of quantitative applications and an outline of the methods that may be used to derive estimates both of risk and the cost of reducing it. The use of cost-effectiveness analysis is illustrated in an appendix, which gives as a worked example a case study on the reduction of public risk associated with radioactive releases during normal operation of a PWR. After drawing some general conclusions the report recommends that such analyses should normally be used as an aid to risk management whenever several alternative risk reduction measures are under consideration

  1. Cost-effectiveness Assessment of 5G Systems with Cooperative Radio Resource Sharing

    Directory of Open Access Journals (Sweden)

    V. Nikolikj

    2015-11-01

    Full Text Available By use of techno-economic analysis of heterogeneous hierarchical cell structures and spectral efficiencies of the forthcoming advanced radio access technologies, this paper proposes various cost-efficient capacity enlargement strategies evaluated through the level of the production cost per transferred data unit and achievable profit margins. For the purpose of maximizing the aggregate performance (capacity or profit, we also assess the cooperative manners of radio resource sharing between mobile network operators, especially in the cases of capacity over-provisioning, when we also determine the principles to provide guaranteed data rates to a particular number of users. The results show that, for heavily loaded office environments, the future 5G pico base stations could be a preferable deployment solution. Also, we confirm that the radio resource management method with dynamic resource allocation can significantly improve the capacity of two comparably loaded operators which share the resources and aim to increase their cost effectiveness.

  2. Cost effective system for monitoring of fish migration with a camera

    Science.gov (United States)

    Sečnik, Matej; Brilly, Mitja; Vidmar, Andrej

    2016-04-01

    Within the European LIFE project Ljubljanica connects (LIFE10 NAT/SI/000142) we have developed a cost-effective solution for the monitoring of fish migration through the fish passes with the underwater camera. In the fish pass at Ambrožev trg and in the fish pass near the Fužine castle we installed a video camera called "Fishcam" to be able to monitor the migration of fish through the fish passes and success of its reconstruction. Live stream from fishcams installed in the fishpassesis available on our project website (http://ksh.fgg.uni-lj.si/ljubljanicaconnects/ang/12_camera). The system for the fish monitoring is made from two parts. First is the waterproof box for the computer with charger and the second part is the camera itself. We used a high sensitive Sony analogue camera. The advantage of this camera is that it has very good sensitivity in low light conditions, so it can take good quality pictures even at night with a minimum additional lighting. For the night recording we use additional IR reflector to illuminate passing fishes. The camera is connected to an 8-inch tablet PC. We decided to use a tablet PC because it is quite small, cheap, it is relatively fast and has a low power consumption. On the computer we use software which has advanced motion detection capabilities, so we can also detect the small fishes. When the fish is detected by a software, its photograph is automatically saved to local hard drive and for backup also on Google drive. The system for monitoring of fish migration has turned out to work very well. From the beginning of monitoring in June 2015 to end of the year there were more than 100.000 photographs produced. The first analysis of them was already prepared estimating fish species and their frequency in passing the fish pass.

  3. Cost Effective Prototyping

    Science.gov (United States)

    Wickman, Jerry L.; Kundu, Nikhil K.

    1996-01-01

    This laboratory exercise seeks to develop a cost effective prototype development. The exercise has the potential of linking part design, CAD, mold development, quality control, metrology, mold flow, materials testing, fixture design, automation, limited parts production and other issues as related to plastics manufacturing.

  4. The next generation of urban MACCs. Reassessing the cost-effectiveness of urban mitigation options by integrating a systemic approach and social costs

    International Nuclear Information System (INIS)

    Saujot, Mathieu; Lefèvre, Benoit

    2016-01-01

    Many cities are implementing policies and climate action plans. Yet local climate policies suffer from a lack of scientific understanding and evaluation methods able to support the definition of efficient mitigation strategies. The purpose of this paper is to build on classical approaches in the energy policy field that exist at the national and international level to propose an urban MACCs methodology able to fulfill this lack and inform local debates. The methodology is an extension of static “expert-based” MACCs; it combines a land use transport integrated model and an abatement cost methodology that integrates co-benefits, and takes into account the spatial and systemic dimensions of cities. The methodology is implemented for the transportation sector of a mid-sized European city (Grenoble, France). Our results present the cost-effectiveness and political feasibility of several proposed measures. We find that the inclusion of co-benefits can profoundly change the cost-benefit assessment of transport mitigation options. Moreover we underline the key parameters determining the cost-effectiveness ranking of mitigation options. These urban MACCs aim to serve as a bridge between urban planning and mitigation policies and can thus contribute to strengthen and align sustainable and climate change agendas at the local level. - Highlights: •Local climate policies lack scientific understanding for prioritizing mitigation actions. •We develop a method to evaluate cost-effectiveness of urban transportation actions. •This method combines urban modeling and MACCs to inform urban planning. •Abatement costs from its application to a mid-sized city are presented. •The impact of the inclusion of co-benefits is analyzed.

  5. Grid-connected photovoltaic systems for Malaysian residential sector: Effects of component costs, feed-in tariffs, and carbon taxes

    International Nuclear Information System (INIS)

    Lau, K.Y.; Muhamad, N.A.; Arief, Y.Z.; Tan, C.W.; Yatim, A.H.M.

    2016-01-01

    Blessed with abundant solar radiation, Malaysia has a huge potential for grid-connected PV (photovoltaic) installations, particularly for its fast-growing residential sector. Nevertheless, Malaysia's PV installation capacity is relatively small compared with the global PV capacity. Significantly, the pricing mechanisms for grid-connected PV projects need to be appropriately assessed to build up the public's confidence to invest in PV projects. In this paper, we analyze the effects of component costs, FiTs (feed-in tariffs), and carbon taxes on grid-connected PV systems in Malaysian residential sector using the HOMER (Hybrid Optimization of Multiple Energy Resources) software. Results demonstrate that the implementation of grid-connected PV systems is highly feasible with PV array costs of $ 1120/kW or lower. For higher PV array costs up to $ 2320/kW, introducing an FiT rate three times higher ($ 0.30/kWh) than the grid tariff for a 100 kW grid sale capacity will, NPC-wise, prioritize grid-connected PV systems over the utility grid. By implementing the FiT ($ 0.50/kWh) and the carbon tax ($ 36/metric ton) schemes simultaneously, grid-connected PV systems will remain as the optimal systems even for costly PV arrays (up to $ 4000/kW). The findings are of paramount importance as far as PV pricing variability is concerned. - Highlights: • Grid-connected PV for Malaysian residential sector has been analyzed using HOMER. • Component costs, feed-in tariffs, and carbon taxes affect optimal system types. • Grid-connected PV projects are feasible for low PV array costs ($ 1120/kW or lower). • For higher PV array and inverter costs, feed-in tariffs should be implemented. • Combining feed-in tariffs with carbon taxes are effective for further lowering NPCs.

  6. A critical evaluation of deterministic methods in size optimisation of reliable and cost effective standalone hybrid renewable energy systems

    International Nuclear Information System (INIS)

    Maheri, Alireza

    2014-01-01

    Reliability of a hybrid renewable energy system (HRES) strongly depends on various uncertainties affecting the amount of power produced by the system. In the design of systems subject to uncertainties, both deterministic and nondeterministic design approaches can be adopted. In a deterministic design approach, the designer considers the presence of uncertainties and incorporates them indirectly into the design by applying safety factors. It is assumed that, by employing suitable safety factors and considering worst-case-scenarios, reliable systems can be designed. In fact, the multi-objective optimisation problem with two objectives of reliability and cost is reduced to a single-objective optimisation problem with the objective of cost only. In this paper the competence of deterministic design methods in size optimisation of reliable standalone wind–PV–battery, wind–PV–diesel and wind–PV–battery–diesel configurations is examined. For each configuration, first, using different values of safety factors, the optimal size of the system components which minimises the system cost is found deterministically. Then, for each case, using a Monte Carlo simulation, the effect of safety factors on the reliability and the cost are investigated. In performing reliability analysis, several reliability measures, namely, unmet load, blackout durations (total, maximum and average) and mean time between failures are considered. It is shown that the traditional methods of considering the effect of uncertainties in deterministic designs such as design for an autonomy period and employing safety factors have either little or unpredictable impact on the actual reliability of the designed wind–PV–battery configuration. In the case of wind–PV–diesel and wind–PV–battery–diesel configurations it is shown that, while using a high-enough margin of safety in sizing diesel generator leads to reliable systems, the optimum value for this margin of safety leading to a

  7. Cost effective solutions for field development. System supplier approach to projects and operations

    International Nuclear Information System (INIS)

    Moe, P.O.

    1994-01-01

    The conference paper outlines the most important elements for a new approach to project realisation that enable a cost reduction of 30-50% compared to conventional methods. The achievements are based on studies and evaluations to the Norwegian Vigdis development project. The system elements covered are the electrical and automation systems including safety and process control and all traditional phases of a project from concept design to the operational phase. The concept involves new principles for project execution where traditional borderlines and interfaces between the various participants have been redefined. Management attention has been verified as an important prerequisite for a successful implementation of this strategy. 2 figs

  8. Japanese Cost Accounting Systems - analysis of the cost accounting systems of the Japanese cost accounting standard

    OpenAIRE

    Peter, Winter

    2005-01-01

    This paper aims at providing an insight into Japanese cost accounting. Firstly, the development of cost accounting in Japan is delineated. Subsequently, the cost accounting systems codified in the Japanese cost accounting standard are analysed based on the classification according to Hoitsch/Schmitz. Lastly, a critical appraisal of the cost accounting systems of the Japanese cost accounting standard as well as a comparison to German and American cost accounting systems are conducted.

  9. A microbial fuel cell–membrane bioreactor integrated system for cost-effective wastewater treatment

    International Nuclear Information System (INIS)

    Wang, Yong-Peng; Liu, Xian-Wei; Li, Wen-Wei; Li, Feng; Wang, Yun-Kun; Sheng, Guo-Ping; Zeng, Raymond J.; Yu, Han-Qing

    2012-01-01

    Highlights: ► An MFC–MBR integrated system for wastewater treatment and electricity generation. ► Stable electricity generation during 1000-h continuous operation. ► Low-cost electrode, separator and filter materials were adopted. -- Abstract: Microbial fuel cell (MFC) and membrane bioreactor (MBR) are both promising technologies for wastewater treatment, but both with limitations. In this study, a novel MFC–MBR integrated system, which combines the advantages of the individual systems, was proposed for simultaneous wastewater treatment and energy recovery. The system favored a better utilization of the oxygen in the aeration tank of MBR by the MFC biocathode, and enabled a high effluent quality. Continuous and stable electricity generation, with the average current of 1.9 ± 0.4 mA, was achieved over a long period of about 40 days. The maximum power density reached 6.0 W m −3 . Moreover, low-cost materials were used for the reactor construction. This integrated system shows great promise for practical wastewater treatment application.

  10. A Cost-Effectiveness Evaluation Approach to Improving Resource Allocations for School Systems. Administering for Change Program. A Professional Paper.

    Science.gov (United States)

    Temkin, Sanford

    This dissertation begins with a description of some methods employed in making public-sector resource-allocation decisions, with conclusions on the appropriateness of each method for evaluating the ongoing programs of a school system. The second section has been rewritten and published as "A Comprehensive Theory of Cost-Effectiveness" (EA 002…

  11. Centralising and optimising decentralised stroke care systems : A simulation study on short-term costs and effects

    NARCIS (Netherlands)

    Lahr, Maarten M. H.; van der Zee, Durk-Jouke; Luijckx, Gert-Jan; Vroomen, Patrick C. A. J.; Buskens, Erik

    2017-01-01

    Background: Centralisation of thrombolysis may offer substantial benefits. The aim of this study was to assess short term costs and effects of centralisation of thrombolysis and optimised care in a decentralised system. Methods: Using simulation modelling, three scenarios to improve decentralised

  12. Value engineering and cost effectiveness of various fiber reinforced polymer (FRP) repair systems : final report, June 2007.

    Science.gov (United States)

    2007-06-01

    This report is an extension to the final report for NCDOT project 2004-15 Value Engineering and Cost-Effectiveness of : Various Fiber Reinforced Polymers (FRP) Repair Systems, submitted in June 2005. In that report, seventeen 30-ft long : prest...

  13. Integrating unmanned aerial systems and LSPIV for rapid, cost-effective stream gauging

    Science.gov (United States)

    Lewis, Quinn W.; Lindroth, Evan M.; Rhoads, Bruce L.

    2018-05-01

    Quantifying flow in rivers is fundamental to assessments of water supply, water quality, ecological conditions, hydrological responses to storm events, and geomorphological processes. Image-based surface velocity measurements have shown promise in extending the range of discharge conditions that can be measured in the field. The use of Unmanned Aerial Systems (UAS) in image-based measurements of surface velocities has the potential to expand applications of this method. Thus far, few investigations have assessed this potential by evaluating the accuracy and repeatability of discharge measurements using surface velocities obtained from UAS. This study uses large-scale particle image velocimetry (LSPIV) derived from videos captured by cameras on a UAS and a fixed tripod to obtain discharge measurements at ten different stream locations in Illinois, USA. Discharge values are compared to reference values measured by an acoustic Doppler current profiler, a propeller meter, and established stream gauges. The results demonstrate the effects of UAS flight height, camera steadiness and leveling accuracy, video sampling frequency, and LSPIV interrogation area size on surface velocities, and show that the mean difference between fixed and UAS cameras is less than 10%. Differences between LSPIV-derived and reference discharge values are generally less than 20%, not systematically low or high, and not related to site parameters like channel width or depth, indicating that results are relatively insensitive to camera setup and image processing parameters typically required of LSPIV. The results also show that standard velocity indices (between 0.85 and 0.9) recommended for converting surface velocities to depth-averaged velocities yield reasonable discharge estimates, but are best calibrated at specific sites. The study recommends a basic methodology for LSPIV discharge measurements using UAS that is rapid, cost-efficient, and does not require major preparatory work at a

  14. Quality upgrading and cost reducing effects of using an operation control system for performance of maintenance tasks

    International Nuclear Information System (INIS)

    Ramler, K.

    1996-01-01

    According to available results, the use of an operation control system has come up to expections with respect to a quality enhancement of maintenance work. The tasks are performed more safely and there is more insight into the processes. so that, as indirect results, cost savings and rationalisation effects are to be expected. However, the cost savings achieved through the operation control system for maintenance tasks will remain modest. The truly cost-effective optimisation potentials in the maintenance area primarily consist in a reduction of preventive measures to the required scope, i.e reduction of the envisaged quantity of processes for maintenance and recurrent inspection. In order to extend savings to the organisational level, with respect to personnel expenditure, by DP supported maintenance planning, a suitable optimisation of the organisational structure and personnel employment is inevitable, because otherwise the rationalisation potentials will remain utopia. (orig.) [de

  15. Estimating the Reference Incremental Cost-Effectiveness Ratio for the Australian Health System.

    Science.gov (United States)

    Edney, Laura Catherine; Haji Ali Afzali, Hossein; Cheng, Terence Chai; Karnon, Jonathan

    2018-02-01

    Spending on new healthcare technologies increases net population health when the benefits of a new technology are greater than their opportunity costs-the benefits of the best alternative use of the additional resources required to fund a new technology. The objective of this study was to estimate the expected incremental cost per quality-adjusted life-year (QALY) gained of increased government health expenditure as an empirical estimate of the average opportunity costs of decisions to fund new health technologies. The estimated incremental cost-effectiveness ratio (ICER) is proposed as a reference ICER to inform value-based decision making in Australia. Empirical top-down approaches were used to estimate the QALY effects of government health expenditure with respect to reduced mortality and morbidity. Instrumental variable two-stage least-squares regression was used to estimate the elasticity of mortality-related QALY losses to a marginal change in government health expenditure. Regression analysis of longitudinal survey data representative of the general population was used to isolate the effects of increased government health expenditure on morbidity-related, QALY gains. Clinical judgement informed the duration of health-related quality-of-life improvement from the annual increase in government health expenditure. The base-case reference ICER was estimated at AUD28,033 per QALY gained. Parametric uncertainty associated with the estimation of mortality- and morbidity-related QALYs generated a 95% confidence interval AUD20,758-37,667. Recent public summary documents suggest new technologies with ICERs above AUD40,000 per QALY gained are recommended for public funding. The empirical reference ICER reported in this article suggests more QALYs could be gained if resources were allocated to other forms of health spending.

  16. Cost benefit analysis cost effectiveness analysis

    International Nuclear Information System (INIS)

    Lombard, J.

    1986-09-01

    The comparison of various protection options in order to determine which is the best compromise between cost of protection and residual risk is the purpose of the ALARA procedure. The use of decision-aiding techniques is valuable as an aid to selection procedures. The purpose of this study is to introduce two rather simple and well known decision aiding techniques: the cost-effectiveness analysis and the cost-benefit analysis. These two techniques are relevant for the great part of ALARA decisions which need the use of a quantitative technique. The study is based on an hypothetical case of 10 protection options. Four methods are applied to the data

  17. Comparison of cost effectiveness of risk reduction among different energy systems: French case studies. Final report of the co-ordinated research programme

    International Nuclear Information System (INIS)

    Lochard, Jacques

    1989-08-01

    This report presents the three French case studies performed in the framework of the coordinated research program on 'Comparison of Cost-effectiveness of Risk Reduction among different Energy Systems': Cost effectiveness of robotics and remote tooling for occupational risk reduction at a nuclear fuel fabrication facility; Cost-effectiveness of protection actions to reduce occupational exposures in underground uranium mines; Cost-effectiveness of safety measures to reduce public risk associated with the transportation of UF 6 by truck and trains

  18. Development of a compact and cost effective multi-input digital signal processing system

    Science.gov (United States)

    Darvish-Molla, Sahar; Chin, Kenrick; Prestwich, William V.; Byun, Soo Hyun

    2018-01-01

    A prototype digital signal processing system (DSP) was developed using a microcontroller interfaced with a 12-bit sampling ADC, which offers a considerably inexpensive solution for processing multiple detectors with high throughput. After digitization of the incoming pulses, in order to maximize the output counting rate, a simple algorithm was employed for pulse height analysis. Moreover, an algorithm aiming at the real-time pulse pile-up deconvolution was implemented. The system was tested using a NaI(Tl) detector in comparison with a traditional analogue and commercial digital systems for a variety of count rates. The performance of the prototype system was consistently superior to the analogue and the commercial digital systems up to the input count rate of 61 kcps while was slightly inferior to the commercial digital system but still superior to the analogue system in the higher input rates. Considering overall cost, size and flexibility, this custom made multi-input digital signal processing system (MMI-DSP) was the best reliable choice for the purpose of the 2D microdosimetric data collection, or for any measurement in which simultaneous multi-data collection is required.

  19. Using Systems Analysis to Implement Cost-Effectiveness and Program Budgeting in Education.

    Science.gov (United States)

    Van Gigch, John P.; Hill, Richard E.

    Program budgeting is an effective tool in helping school administrators and faculty to draw up budgets which reflect their own needs and those of their clients. The "systems approach" can be used to draw up a program budget systematically. Part I outlines systems concepts and the systems approach as they can be applied to education. Also, the…

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

    Science.gov (United States)

    Dasios, Athanasios; Gavalas, Damianos; Pantziou, Grammati; Konstantopoulos, Charalampos

    2015-06-18

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

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

    Directory of Open Access Journals (Sweden)

    Athanasios Dasios

    2015-06-01

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

  2. Effects of high-involvement work systems on employee satisfaction and service costs in veterans healthcare.

    Science.gov (United States)

    Harmon, Joel; Scotti, Dennis J; Behson, Scott; Farias, Gerard; Petzel, Robert; Neuman, Joel H; Keashly, Loraleigh

    2003-01-01

    Two strong imperatives for healthcare managers are reducing costs of service and attracting and retaining highly dedicated and competent patient care and support employees. Is there a trade-off or are there organizational practices that can further both objectives at the same time? High-involvement work systems (HIWS) represent a holistic work design that includes interrelated core features such as involvement, empowerment, development, trust, openness, teamwork, and performance-based rewards. HIWS have been linked to higher productivity, quality, employee and customer satisfaction, and market and financial performance in Fortune 1000 firms. Apparently, few prior studies have looked at the impacts of this holistic design within the healthcare sector. This research found that HIWS were associated with both greater employee satisfaction and lower patient service costs in 146 Veterans Health Administration centers, indicating that such practices pay off in both humanistic and financial terms. This suggests that managers implementing HIWS will incur real expenses that are likely to be more than offset by more satisfied employees, less organizational turmoil, and lower service delivery costs, which, in this study, amounted to over $1.2 million in savings for an average VHA facility.

  3. A Cost Effective Security Technology Integrated with RFID Based Automated Toll Collection System

    Directory of Open Access Journals (Sweden)

    Rafiya Hossain

    2017-09-01

    Full Text Available Crime statistics and research on criminology show that under similar circumstances,crimes are more likely to occur in developing countries than in developed countries due to their lack ofsecurity measures. Transport crimes on highways and bridges are one of the most common crimes in the developing nations. Automation of various systems like the toll collection system is being introduced in the developing countries to avoid corruption in the collection of toll, decrease cost and increase operational efficiency. The goal of this research is to find an integrated solution that enhances security along with the advantage of automated toll collection. Inspired by the availability of many security systems, this research presents a system that can block a specific vehicle or a particular type of vehicles at the toll booths based on directives from the law enforcement agencies. The heart of the system is based on RFID (Radio Frequency Identification technology. In this system, by sending a text message the law enforcement agency or the authority that controls the toll booths can prevent the barrier from being liftedeven after deduction of the toll charge if the passing vehicle has a security issue. The designed system should help the effort of reducing transport crimes on highways and bridges of developing countries.

  4. District heating systems' control for cost effective and environmentally compatible operation

    International Nuclear Information System (INIS)

    Balati, J.

    1999-01-01

    District heating systems are being developed in accordance with the growing of large European cities. These systems are formed by enlarging networks of heat distribution from heat sources to heat consumers and, simultaneously, by gradually connecting newly built heat sources. District heating control consists in optimum control of the output of heat sources and in control of heat distribution and consumption. The aim of the paper is to inform about the works in the field of creating a mathematical-physical model of extensive hot water and steam supply circle network and heat sources for the purpose of creating unconventional control algorithms for the complex control of the technological sequence ''heat production distribution- consumption''. For the optimum control algorithms the artificial intelligence methods are also utilised. The aim of the complex access to the solution of new control algorithms will be to decrease the cost of the consumed heat unit and increase environmental protection. The function of the Extensive Heating System District Heating System (DHS) is to ensure permanently the economically justified requirements of heat supply for all consumers with minimum cost per heat supply unit and with enhanced level of environmental protection. The requirements of heat consumers have to be in harmony with the requirements of the maximum possible economy of the whole DHS when adhering to the required qualitative parameters of supplied energy. Therefore, it offers the application of optimised control methods as artificial intelligence methods for the control of the operational circle of DHS heat networks. It is obvious that a higher level of DHS control is required from the technological, economic and ecological point of view. (author)

  5. Solar Irradiance Measurements Using Smart Devices: A Cost-Effective Technique for Estimation of Solar Irradiance for Sustainable Energy Systems

    Directory of Open Access Journals (Sweden)

    Hussein Al-Taani

    2018-02-01

    Full Text Available Solar irradiance measurement is a key component in estimating solar irradiation, which is necessary and essential to design sustainable energy systems such as photovoltaic (PV systems. The measurement is typically done with sophisticated devices designed for this purpose. In this paper we propose a smartphone-aided setup to estimate the solar irradiance in a certain location. The setup is accessible, easy to use and cost-effective. The method we propose does not have the accuracy of an irradiance meter of high precision but has the advantage of being readily accessible on any smartphone. It could serve as a quick tool to estimate irradiance measurements in the preliminary stages of PV systems design. Furthermore, it could act as a cost-effective educational tool in sustainable energy courses where understanding solar radiation variations is an important aspect.

  6. EPA Tools and Resources Webinar: Cost-Effective Treatment Technologies for Small Drinking Water Systems

    Science.gov (United States)

    This webinar will highlight a pilot study conducted by EPA in the small town of Palo, IA. The pilot system demonstrated the ability to effectively remove ammonia and iron while keeping nitrite and nitrate levels low.

  7. Cost-effectiveness analysis of levonorgestrel-releasing intrauterine system (LNG-IUS) 13.5 mg in contraception.

    Science.gov (United States)

    Trussell, James; Hassan, Fareen; Henry, Nathaniel; Pocoski, Jennifer; Law, Amy; Filonenko, Anna

    2014-05-01

    Levonorgestrel-releasing intrauterine system (LNG-IUS) 13.5 mg (total content) is a low-dose levonorgestrel intrauterine system for up to 3 years of use. This analysis evaluated the cost-effectiveness of LNG-IUS 13.5 mg in comparison with short-acting reversible contraceptive (SARC) methods in a cohort of young women in the United States from a third-party payer's perspective. A state transition model consisting of three mutually exclusive health states -- initial method, unintended pregnancy (UP) and subsequent method -- was developed. Cost-effectiveness of LNG-IUS 13.5 mg was assessed vs. SARC methods in a cohort of 1000 women aged 20-29 years. SARC methods comprise oral contraceptives (OC), ring, patch and injections, which are the methods commonly used by this cohort. Failure and discontinuation probabilities were based on published literature, contraceptive uptake was determined by the most recent data from the National Survey of Family Growth, and costs were taken from standard US databases. One-way sensitivity analysis was conducted around key inputs, while scenario analysis assessed a comparison between LNG-IUS 13.5 mg and the existing IUS, LNG-IUS 20 mcg/24 h. The key model output was cost per UP avoided. Compared to SARC methods, initiating contraception with LNG-IUS 13.5 mg resulted in fewer UP (64 UP vs. 276 UP) and lower total costs ($1,283,479 USD vs. $1,862,633 USD, a 31% saving) over the 3-year time horizon. Results were most sensitive to the probability of failure on OC, the probability of LNG-IUS 13.5 mg discontinuation and the cost of live births. Scenario analysis suggests that further cost savings may be generated with the initiation of LNG-IUS 20 mcg/24 h in place of SARC methods. From a third-party payer perspective, LNG-IUS 13.5 mg is a more cost-effective contraceptive option than SARC. Therefore, women switching from current SARC use to LNG-IUS 13.5 mg are likely to generate cost savings to third-party health care payers, driven

  8. Cost reduction through system integration

    International Nuclear Information System (INIS)

    Helsing, P.

    1994-01-01

    In resent years cost reduction has been a key issue in the petroleum industry. Several findings are not economically attractive at the current cost level, and for this and other reasons some of the major oil companies require the suppliers to have implemented a cost reduction programme to prequalify for projects. The present paper addresses cost reduction through system design and integration in both product development and working methods. This is to be obtained by the combination of contracts by reducing unnecessary coordination and allow re-use of proven interface designs, improve subsystem integration by ''top down'' system design, and improve communication and exchange of experience. 3 figs

  9. An interchangeable Mapleson A-E breathing system is practical and cost effective.

    Science.gov (United States)

    Robinson, M; Lighthall, G K

    2006-01-01

    In locations where oxygen and anesthesia gas supplies are limited, and where circle systems are not practical, means to reduce fresh gas flow during maintenance of inhalational anesthesia are of potential value. We investigated whether a common transport breathing apparatus could be modified to allow interchange between Mapleson D (Map-D) and Mapleson A (Map A) configurations. A common Map-D transport system was converted to a Map-A system by switching positions of the exhaust valve and the elbow connector where fresh gas is delivered; these two breathing systems were compared in this study. The key question was whether rebreathing of CO2 could be eliminated at a lower fresh gas flow rate (FGF) with the Map-A design. A structured protocol was followed. A mean decrease in FGF of 2.8 l/min was seen with the Map-A apparatus when compared with the Map-D (P=0.003). With no significant differences in physiologic or anesthetic variables, FGF/V(E) was significantly lower with the Mapleson A configuration than with the Mapleson D system design (1.1 vs. 1.8; P=0.007). The extent to which FGF could be lowered when switching between Mapleson D and A systems correlated strongly with the patients' respiratory rate while under anesthesia (r=0.45, P<0.01). Cost and resource savings can be realized through the use of a breathing system modification that achieves appropriate ventilation at lower fresh gas flows.

  10. Cost of photovoltaic energy systems as determined by balance-of-system costs

    Science.gov (United States)

    Rosenblum, L.

    1978-01-01

    The effect of the balance-of-system (BOS), i.e., the total system less the modules, on photo-voltaic energy system costs is discussed for multikilowatt, flat-plate systems. Present BOS costs are in the range of 10 to 16 dollars per peak watt (1978 dollars). BOS costs represent approximately 50% of total system cost. The possibility of future BOS cost reduction is examined. It is concluded that, given the nature of BOS costs and the lack of comprehensive national effort focussed on cost reduction, it is unlikely that BOS costs will decline greatly in the next several years. This prognosis is contrasted with the expectations of the Department of Energy National Photovoltaic Program goals and pending legislation in the Congress which require a BOS cost reduction of an order of magnitude or more by the mid-1980s.

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

    Science.gov (United States)

    Bejmuk, Bohdan I.; Williams, Larry

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

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

    Science.gov (United States)

    Bejmuk, Bohdan I.; Williams, Larry

    1992-01-01

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

  13. Comparison Study of Electromagnet and Permanent Magnet Systems for an Accelerator Using Cost-Based Failure Modes and Effects Analysis

    International Nuclear Information System (INIS)

    Spencer, C

    2004-01-01

    The next generation of particle accelerators will be one-of-a-kind facilities, and to meet their luminosity goals they must have guaranteed availability over their several decade lifetimes. The Next Linear Collider (NLC) is one viable option for a 1 TeV electron-positron linear collider, it has an 85% overall availability goal. We previously showed how a traditional Failure Modes and Effects Analysis (FMEA) of a SLAC electromagnet leads to reliability-enhancing design changes. Traditional FMEA identifies failure modes with high risk but does not consider the consequences in terms of cost, which could lead to unnecessarily expensive components. We have used a new methodology, ''Life Cost-Based FMEA'', which measures risk of failure in terms of cost, in order to evaluate and compare two different technologies that might be used for the 8653 NLC magnets: electromagnets or permanent magnets. The availabilities for the two different types of magnet systems have been estimated using empirical data from SLAC's accelerator failure database plus expert opinion on permanent magnet failure modes and industry standard failure data. Labor and material costs to repair magnet failures are predicted using a Monte Carlo simulation of all possible magnet failures over a 30-year lifetime. Our goal is to maximize up-time of the NLC through magnet design improvements and the optimal combination of electromagnets and permanent magnets, while reducing magnet system lifecycle costs

  14. Improvement in cost-effectiveness and customer satisfaction by a quality management system according to EN ISO 9001:2000.

    Science.gov (United States)

    Beholz, Sven; Konertz, Wolfgang

    2005-12-01

    The implementation of a quality management system (QMS) according to EN ISO 9001:2000 has proven to be possible for cardiac surgery departments. However, it remains unclear if a QMS can help to improve quality as indicated by cost-effectiveness and customer satisfaction. To control costs for medical goods and laboratory investigations an internal control system for the allocation of resources was implemented. Laboratory costs and medical goods per open heart procedure were investigated in the years 2000 to 2003. In terms of customer satisfaction, repeated questionnaire-based evaluation of referring physicians was obtained from 2001 to 2003 and the influence of repeated interventions on various aspects of communications was investigated. Costs of medical goods could be reduced by 6.1%, and for laboratory investigations by 35% per operation. Additionally, customer satisfaction could be increased efficiently with respect to accessibility and postoperative communication. By the introduction of a process based QMS, efficient control of the costs of medical goods and laboratory investigations could be achieved. Once a year repeat evaluation of satisfaction of advising physicians has proven to be a valuable tool in the process of continuous improvement.

  15. Upgrading Supply Chain Management Systems to Improve Availability of Medicines in Tanzania: Evaluation of Performance and Cost Effects.

    Science.gov (United States)

    Mwencha, Marasi; Rosen, James E; Spisak, Cary; Watson, Noel; Kisoka, Noela; Mberesero, Happiness

    2017-09-27

    To address challenges in public health supply chain performance, Tanzania invested in a national logistics management unit (LMU) and a national electronic logistics management information system (eLMIS). This evaluation examined the impact of those 2 key management upgrades approximately 1 year after they were introduced. We used a nonexperimental pre-post study design to compare the previous system with the upgraded management system. We collected baseline data from August to November 2013. We conducted round 1 of post-implementation data collection during April and May 2015, about 1 year after implementation of the upgrades. We evaluated key indicators of data use and reporting; supply chain management practices such as storage and supervision; supply chain performance including stock-out and expiry rates; and supply chain cost and savings. We analyzed the data using a range of techniques including statistical testing of baseline and round-1 results, and cost, cost-effectiveness, and return on investment analysis. The upgrades were associated with improvements in data use, accessibility, visibility, and transparency; planning, control, and monitoring; support for quantification; stock-out rates; stock-out duration; commodity expiry; and forecast error. The upgraded system was more costly, but it was also more efficient, particularly when adjusting for the performance improvements. The upgrades also generated substantial savings that defrayed some, but not all, of the investment costs. Upgrades to Tanzania's supply chain management systems created multiple and complex pathways to impact. One year after implementation, the LMU and eLMIS brought about performance improvements through better data use and through improvements in some, but not all, management practices. Furthermore, the upgrades-while not inexpensive-contributed to greater system efficiency and modest savings. © Mwencha et al.

  16. Configuration optimization of series flow double-effect water-lithium bromide absorption refrigeration systems by cost minimization

    DEFF Research Database (Denmark)

    Mussati, Sergio F.; Cignitti, Stefano; Mansouri, Seyed Soheil

    2018-01-01

    An optimal process configuration for double-effect water-lithium bromide absorption refrigeration systems with series flow – where the solution is first passed through the high-temperature generator – is obtained by minimization of the total annual cost for a required cooling capacity. To this end......W) and the temperature of the cooling water (15–35 °C). The results of this work motivate to apply the simultaneous optimization approach to seek for new multi-effect absorption refrigeration system configurations with parallel and reverse flow as well as other series flow arrangements that minimize the total annual...

  17. Mobile-based system for cost-effective e-learning contents delivery in resource and bandwidth constrained learning environments

    Directory of Open Access Journals (Sweden)

    Michael P. J. Mahenge

    2014-12-01

    Full Text Available The advancement in Information and Communication Technologies (ICTs has brought opportunities for the development of Smart Cities. The Smart City uses ICT to enhance performance and wellbeing, to reduce costs and resource consumption, and to engage more effectively and actively with its citizens. In particular, the education sector is adopting new ways of learning in Higher Education Institutions (HEIs through e-learning systems. While these opportunities exist, e-learning content delivery and accessibility in third world countries like Tanzania is still a challenge due to resource and network constrained environments. The challenges include: high cost of bandwidth connection and usage; high dependency on the Internet; limited mobility and portability features; inaccessibility during the offline period and shortage of ICT facilities. In this paper, we investigate the use of mobile technology to sustainably support education and skills development particularly in developing countries. Specifically, we propose a Cost-effective Mobile Based Learning Content Delivery system for resource and network constrained environments. This system can be applied to cost-effectively broaden and support education in many cities around the world, which are approaching the 'Smart City' concept in their own way, even with less available technology infrastructure. Therefore, the proposed solution has the potential to reduce the cost of the bandwidth usage, and cut down the server workload and the Internet usage overhead by synchronizing learning contents from some remote server to a local database in the user’s device for offline use. It will also improve the quality of experience and participation of learners as well as facilitate mobility and portability in learning activities, which also supports the all-compassing learning experience in a Smart City.

  18. Assessing the interaction effect of cost control systems and information technology integration on manufacturing plant financial performance

    OpenAIRE

    Maiga, Adam S; Nilsson, Anders; Jacobs, Fred

    2014-01-01

    The interface between management control and information technology is an under-developed research area with a knowledge gap concerning its implications for financial performance. This study contributes to bridging this gap by investigates the interaction effect of cost control systems and information technology integration on manufacturing plant financial performance. We surveyed a sample of 518 managers of U.S. manufacturing plants, approximately evenly distributed between those using activ...

  19. ScreenCube: A 3D Printed System for Rapid and Cost-Effective Chemical Screening in Adult Zebrafish.

    Science.gov (United States)

    Monstad-Rios, Adrian T; Watson, Claire J; Kwon, Ronald Y

    2018-02-01

    Phenotype-based small molecule screens in zebrafish embryos and larvae have been successful in accelerating pathway and therapeutic discovery for diverse biological processes. Yet, the application of chemical screens to adult physiologies has been relatively limited due to additional demands on cost, space, and labor associated with screens in adult animals. In this study, we present a 3D printed system and methods for intermittent drug dosing that enable rapid and cost-effective chemical administration in adult zebrafish. Using prefilled screening plates, the system enables dosing of 96 fish in ∼3 min, with a 10-fold reduction in drug quantity compared to that used in previous chemical screens in adult zebrafish. We characterize water quality kinetics during immersion in the system and use these kinetics to rationally design intermittent dosing regimens that result in 100% fish survival. As a demonstration of system fidelity, we show the potential to identify two known chemical inhibitors of adult tail fin regeneration, cyclopamine and dorsomorphin. By developing methods for rapid and cost-effective chemical administration in adult zebrafish, this study expands the potential for small molecule discovery in postembryonic models of development, disease, and regeneration.

  20. Development of a cost-effective and flexible vibration DAQ system for long-term continuous structural health monitoring

    Science.gov (United States)

    Nguyen, Theanh; Chan, Tommy H. T.; Thambiratnam, David P.; King, Les

    2015-12-01

    In the structural health monitoring (SHM) field, long-term continuous vibration-based monitoring is becoming increasingly popular as this could keep track of the health status of structures during their service lives. However, implementing such a system is not always feasible due to on-going conflicts between budget constraints and the need of sophisticated systems to monitor real-world structures under their demanding in-service conditions. To address this problem, this paper presents a comprehensive development of a cost-effective and flexible vibration DAQ system for long-term continuous SHM of a newly constructed institutional complex with a special focus on the main building. First, selections of sensor type and sensor positions are scrutinized to overcome adversities such as low-frequency and low-level vibration measurements. In order to economically tackle the sparse measurement problem, a cost-optimized Ethernet-based peripheral DAQ model is first adopted to form the system skeleton. A combination of a high-resolution timing coordination method based on the TCP/IP command communication medium and a periodic system resynchronization strategy is then proposed to synchronize data from multiple distributed DAQ units. The results of both experimental evaluations and experimental-numerical verifications show that the proposed DAQ system in general and the data synchronization solution in particular work well and they can provide a promising cost-effective and flexible alternative for use in real-world SHM projects. Finally, the paper demonstrates simple but effective ways to make use of the developed monitoring system for long-term continuous structural health evaluation as well as to use the instrumented building herein as a multi-purpose benchmark structure for studying not only practical SHM problems but also synchronization related issues.

  1. Cost-effective system for facial imaging and three-dimensional reconstruction

    Science.gov (United States)

    Shokouhi, S. B.; Monro, D. M.; Sherlock, Barry G.

    1998-06-01

    Three dimensional (3-D) images have recently received wide attention in applications involving medical treatment. Most current 3-D imaging methods focus on the internal organs of the body. However, several medical image applications such as plastic surgery, body deformities, rehabilitation, dental surgery and orthodontics, make use of the surface contours of the body. Several techniques are currently available for producing 3-D images of the body surface and most of the systems which implement these techniques are expensive, requiring complex equipment with highly trained operators. The research involves the development of a simple, low cost and non-invasive contour capturing method for facial surfaces. This is achieved using the structured light technique, employing a standard commercial slide projector, CCD camera and a frame-grabber card linked to a PC. Structured light has already been used for many applications, but only to a limited extent in the clinical environment. All current implementations involve extensive manual intervention by highly skilled operators and this has proven to be a serious hindrance to clinical acceptance of 3-D imaging. A primary objective of this work is to minimize the amount of manual intervention required, so that the system can be used by clinicians who do not have specialist training in the use of this equipment. The eventual aim is to provide a software assisted surgical procedure, which by merging the facial data, allows the manipulation of soft tissue and gives the facility to predict and monitor post-surgical appearance. The research focuses on how the images are obtained using the structured light optic system and the subsequent image processing of data to give a realistic 3-D image.

  2. COST EFFECTIVE VOC EMISSION CONTROL STARTEGIES FOR MILITARY, AEROSPACE,AND INDUSTRIAL PAINT SPRAY BOOTH OPERATIONS: COMBINING IMPROVED VENTILATION SYSTEMS WITH INNOVATIVE, LOW COST EMISSION CONTROL TECHNOLOGIES

    Science.gov (United States)

    The paper describes a full-scale demonstration program in which several paint booths were modified for recirculation ventilation; the booth exhaust streams are vented to an innovative volatile organic compound (VOC) emission control system having extremely low operating costs. ...

  3. Intermittent preventive treatment of malaria in pregnancy: the incremental cost-effectiveness of a new delivery system in Uganda

    DEFF Research Database (Denmark)

    Mbonye, Anthony; Hansen, Kristian Schultz; Bygbjerg, Ib

    2008-01-01

    -effectiveness of the intervention. The study enrolled 2785 pregnant women. The majority, 1404/2081 (67.5%) receiving community-based care, received SP early and adhered to the two recommended doses compared with 281/704 (39.9%) at health centres (P... of the community delivery system was Uganda shillings 1869 (US$1.10) per lost disability-adjusted life-year (DALY) averted. In conclusion, community-based delivery increased access and adherence to IPTp and was cost-effective....

  4. Centralising and optimising decentralised stroke care systems: a simulation study on short-term costs and effects

    Directory of Open Access Journals (Sweden)

    Maarten M. H. Lahr

    2017-01-01

    Full Text Available Abstract Background Centralisation of thrombolysis may offer substantial benefits. The aim of this study was to assess short term costs and effects of centralisation of thrombolysis and optimised care in a decentralised system. Methods Using simulation modelling, three scenarios to improve decentralised settings in the North of Netherlands were compared from the perspective of the policy maker and compared to current decentralised care: (1 improving stroke care at nine separate hospitals, (2 centralising and improving thrombolysis treatment to four, and (3 two hospitals. Outcomes were annual mean and incremental costs per patient up to the treatment with thrombolysis, incremental cost-effectiveness ratio (iCER per 1% increase in thrombolysis rate, and the proportion treated with thrombolysis. Results Compared to current decentralised care, improving stroke care at individual community hospitals led to mean annual costs per patient of $US 1,834 (95% CI, 1,823–1,843 whereas centralising to four and two hospitals led to $US 1,462 (95% CI, 1,451–1,473 and $US 1,317 (95% CI, 1,306–1,328, respectively (P < 0.001. The iCER of improving community hospitals was $US 113 (95% CI, 91–150 and $US 71 (95% CI, 59–94, $US 56 (95% CI, 44–74 when centralising to four and two hospitals, respectively. Thrombolysis rates decreased from 22.4 to 21.8% and 21.2% (P = 0.120 and P = 0.001 in case of increasing centralisation. Conclusions Centralising thrombolysis substantially lowers mean annual costs per patient compared to raising stroke care at community hospitals simultaneously. Small, but negative effects on thrombolysis rates may be expected.

  5. A perspective on cost-effectiveness of greenhouse gas reduction solutions in water distribution systems

    Science.gov (United States)

    Hendrickson, Thomas P.; Horvath, Arpad

    2014-01-01

    Water distribution systems (WDSs) face great challenges as aging infrastructures require significant investments in rehabilitation, replacement, and expansion. Reducing environmental impacts as WDSs develop is essential for utility managers and policy makers. This study quantifies the existing greenhouse gas (GHG) footprint of common WDS elements using life-cycle assessment (LCA) while identifying the greatest opportunities for emission reduction. This study addresses oversights of the related literature, which fails to capture several WDS elements and to provide detailed life-cycle inventories. The life-cycle inventory results for a US case study utility reveal that 81% of GHGs are from pumping energy, where a large portion of these emissions are a result of distribution leaks, which account for 270 billion l of water losses daily in the United States. Pipe replacement scheduling is analyzed from an environmental perspective where, through incorporating leak impacts, a tool reveals that optimal replacement is no more than 20 years, which is in contrast to the US average of 200 years. Carbon abatement costs (CACs) are calculated for different leak reduction scenarios for the case utility that range from -130 to 35 t-1 CO2(eq). Including life-cycle modeling in evaluating pipe materials identified polyvinyl chloride (PVC) and cement-lined ductile iron (DICL) as the Pareto efficient options, however; utilizing PVC presents human health risks. The model developed for the case utility is applied to California and Texas to determine the CACs of reducing leaks to 5% of distributed water. For California, annual GHG savings from reducing leaks alone (3.4 million tons of CO2(eq)) are found to exceed California Air Resources Board’s estimate for energy efficiency improvements in the state’s water infrastructure.

  6. Costing systems design for sustainability

    Directory of Open Access Journals (Sweden)

    Mihaela TURTUREA

    2013-10-01

    Full Text Available The aim of this article is to present an overall image of the way Accounting responds to nowadays user’s needs in relation to the quantification of the impact companies have towards the environment. Regarding this, there have been analyzed concepts like sustainable development, environmental accounting, environmental costs and there have been presented the main progress towards environmental cost identification and measurement from the perspective of Activity Based Costing system. To provide an overall image of this concepts, there have been used as research methodology methods the documentation from literature review, analysis, synthesis and comparison.

  7. The Societal Costs and Benefits of Commuter Bicycling: Simulating the Effects of Specific Policies Using System Dynamics Modeling

    Science.gov (United States)

    Connor, Jennie; Witten, Karen; Kearns, Robin; Rees, David; Woodward, Alistair

    2014-01-01

    Background: Shifting to active modes of transport in the trip to work can achieve substantial co-benefits for health, social equity, and climate change mitigation. Previous integrated modeling of transport scenarios has assumed active transport mode share and has been unable to incorporate acknowledged system feedbacks. Objectives: We compared the effects of policies to increase bicycle commuting in a car-dominated city and explored the role of participatory modeling to support transport planning in the face of complexity. Methods: We used system dynamics modeling (SDM) to compare realistic policies, incorporating feedback effects, nonlinear relationships, and time delays between variables. We developed a system dynamics model of commuter bicycling through interviews and workshops with policy, community, and academic stakeholders. We incorporated best available evidence to simulate five policy scenarios over the next 40 years in Auckland, New Zealand. Injury, physical activity, fuel costs, air pollution, and carbon emissions outcomes were simulated. Results: Using the simulation model, we demonstrated the kinds of policies that would likely be needed to change a historical pattern of decline in cycling into a pattern of growth that would meet policy goals. Our model projections suggest that transforming urban roads over the next 40 years, using best practice physical separation on main roads and bicycle-friendly speed reduction on local streets, would yield benefits 10–25 times greater than costs. Conclusions: To our knowledge, this is the first integrated simulation model of future specific bicycling policies. Our projections provide practical evidence that may be used by health and transport policy makers to optimize the benefits of transport bicycling while minimizing negative consequences in a cost-effective manner. The modeling process enhanced understanding by a range of stakeholders of cycling as a complex system. Participatory SDM can be a helpful method

  8. Cost Based Failure Modes and Effects Analysis (FMEA) for Systems of Accelerator Magnets.

    Energy Technology Data Exchange (ETDEWEB)

    Spencer, Cherrill M

    2003-06-02

    The proposed Next Linear Collider (NLC) has a proposed 85% overall availability goal, the availability specifications for all its 7200 magnets and their 6167 power supplies are 97.5% each. Thus all of the electromagnets and their power supplies must be highly reliable or quickly repairable. Improved reliability or repairability comes at a higher cost. We have developed a set of analysis procedures for magnet designers to use as they decide how much effort to exert, i.e. how much money to spend, to improve the reliability of a particular style of magnet. We show these procedures being applied to a standard SLAC electromagnet design in order to make it reliable enough to meet the NLC availability specs. First, empirical data from SLAC's accelerator failure database plus design experience are used to calculate MTBF for failure modes identified through a FMEA. Availability for one particular magnet can be calculated. Next, labor and material costs to repair magnet failures are used in a Monte Carlo simulation to calculate the total cost of all failures over a 30-year lifetime. Opportunity costs are included. Engineers choose from amongst various designs by comparing lifecycle costs.

  9. Cost Based Failure Modes and Effects Analysis (FMEA) for Systems of Accelerator Magnets

    International Nuclear Information System (INIS)

    Spencer, Cherrill M

    2003-01-01

    The proposed Next Linear Collider (NLC) has a proposed 85% overall availability goal, the availability specifications for all its 7200 magnets and their 6167 power supplies are 97.5% each. Thus all of the electromagnets and their power supplies must be highly reliable or quickly repairable. Improved reliability or repairability comes at a higher cost. We have developed a set of analysis procedures for magnet designers to use as they decide how much effort to exert, i.e. how much money to spend, to improve the reliability of a particular style of magnet. We show these procedures being applied to a standard SLAC electromagnet design in order to make it reliable enough to meet the NLC availability specs. First, empirical data from SLAC's accelerator failure database plus design experience are used to calculate MTBF for failure modes identified through a FMEA. Availability for one particular magnet can be calculated. Next, labor and material costs to repair magnet failures are used in a Monte Carlo simulation to calculate the total cost of all failures over a 30-year lifetime. Opportunity costs are included. Engineers choose from amongst various designs by comparing lifecycle costs

  10. Lean systems approaches to health technology assessment: a patient-focused alternative to cost-effectiveness analysis.

    Science.gov (United States)

    Bridges, John F P

    2006-12-01

    Many countries now use health technology assessment (HTA) to review new and emerging technologies, especially with regard to reimbursement, pricing and/or clinical guidelines. One of the common, but not universal, features of these systems is the use of economic evaluation, normally cost-effectiveness analysis (CEA), to confirm that new technologies offer value for money. Many have criticised these systems as primarily being concerned with cost containment, rather than advancing the interests of patients or innovators. This paper calls into question the underlying principles of CEA by arguing that value in the healthcare system may in fact be unconstrained. It is suggested that 'lean management principles' can be used not only to trim waste from the health system, but as a method of creating real incentives for innovation and value creation. Following the lean paradigm, this value must be defined purely from the patients' perspective, and the entire health system needs to work towards the creation of such value. This paper offers as a practical example a lean approach to HTA, arguing that such an approach would lead to better incentives for innovation in health, as well as more patient-friendly outcomes in the long run.

  11. The effective cost of tritium for tokamak fusion power reactors with reduced tritium production systems

    International Nuclear Information System (INIS)

    Gilligan, J.G.; Evans, K.

    1983-01-01

    If sufficient tritium cannot be produced and processed in tokamak blankets then at least two alternatives are possible. Tritium can be purchased; or reactors with reduced tritium (RT) content in the plasma can be designed. The latter choice may require development of magnet technology etc., but the authors show that the impact on the cost-of-electricity may be mild. Cost tradeoffs are compared to the market value of tritium. Adequate tritium production in fusion blankets is preferred, but the authors show there is some flexibility in the deployment of fusion if this is not possible

  12. Comparison of cost effectiveness of risk reduction among different energy systems: French case studies. Final report for the period 1 May 1982 - 20 February 1988

    International Nuclear Information System (INIS)

    Lochard, J.

    1989-08-01

    The report presents the three French case studies performed in the framework of the co-ordinated research programme on ''Comparison of Cost-Effectiveness of Risk Reduction Among Different Energy Systems'': cost-effectiveness of robotics and remote tooling for occupational risk reduction at a nuclear fuel fabrication facility; cost-effectiveness of protection actions to reduce occupational exposure in underground uranium mines; cost effectiveness of safety measures to reduce public risk associated with the transportation of UF 6 by truck and trains. Figs and tabs

  13. Incorrect modeling of the failure process of minimally repaired systems under random conditions: The effect on the maintenance costs

    International Nuclear Information System (INIS)

    Pulcini, Gianpaolo

    2015-01-01

    This note investigates the effect of the incorrect modeling of the failure process of minimally repaired systems that operates under random environmental conditions on the costs of a periodic replacement maintenance. The motivation of this paper is given by a recently published paper, where a wrong formulation of the expected cost for unit time under a periodic replacement policy is obtained. This wrong formulation is due to the incorrect assumption that the intensity function of minimally repaired systems that operate under random conditions has the same functional form as the failure rate of the first failure time. This produced an incorrect optimization of the replacement maintenance. Thus, in this note the conceptual differences between the intensity function and the failure rate of the first failure time are first highlighted. Then, the correct expressions of the expected cost and of the optimal replacement period are provided. Finally, a real application is used to measure how severe can be the economical consequences caused by the incorrect modeling of the failure process.

  14. Effects of category-specific costs on neural systems for perceptual decision-making

    DEFF Research Database (Denmark)

    Fleming, Stephen M; Whiteley, Louise Emma; Hulme, Oliver James

    2010-01-01

    Perceptual judgments are often biased by prospective losses, leading to changes in decision criteria. Little is known about how and where sensory evidence and cost information interact in the brain to influence perceptual categorization. Here we show that prospective losses systematically bias...... toward accounting for how prospective losses are flexibly integrated with sensory evidence in the brain....

  15. Computerised decision support systems in order communication for diagnostic, screening or monitoring test ordering: systematic reviews of the effects and cost-effectiveness of systems.

    Science.gov (United States)

    Main, C; Moxham, T; Wyatt, J C; Kay, J; Anderson, R; Stein, K

    2010-10-01

    Order communication systems (OCS) are computer applications used to enter diagnostic and therapeutic patient care orders and to view test results. Many potential benefits of OCS have been identified including improvements in clinician ordering patterns, optimisation of clinical time, and aiding communication processes between clinicians and different departments. Many OCS now include computerised decision support systems (CDSS), which are information systems designed to improve clinical decision-making. CDSS match individual patient characteristics to a computerised knowledge base, and software algorithms generate patient-specific recommendations. To investigate which CDSS in OCS are in use within the UK and the impact of CDSS in OCS for diagnostic, screening or monitoring test ordering compared to OCS without CDSS. To determine what features of CDSS are associated with clinician or patient acceptance of CDSS in OCS and what is known about the cost-effectiveness of CDSS in diagnostic, screening or monitoring test OCS compared to OCS without CDSS. A generic search to identify potentially relevant studies for inclusion was conducted using MEDLINE, EMBASE, Cochrane Controlled Trials Register (CCTR), CINAHL (Cumulative Index to Nursing and Allied Health Literature), DARE (Database of Abstracts of Reviews of Effects), Health Technology Assessment (HTA) database, IEEE (Institute of Electrical and Electronic Engineers) Xplore digital library, NHS Economic Evaluation Database (NHS EED) and EconLit, searched between 1974 and 2009 with a total of 22,109 titles and abstracts screened for inclusion. CDSS for diagnostic, screening and monitoring test ordering OCS in use in the UK were identified through contact with the 24 manufacturers/suppliers currently contracted by the National Project for Information Technology (NpfIT) to provide either national or specialist decision support. A generic search to identify potentially relevant studies for inclusion in the review was

  16. Pursuing Photovoltaic Cost-Effectiveness

    DEFF Research Database (Denmark)

    Yang, Yongheng; Koutroulis, Eftichios; Sangwongwanich, Ariya

    2017-01-01

    Countries with considerable PhotoVoltaic (PV) installations are facing a challenge of overloading their power grid during peak-power production hours if the power infrastructure remains the same. To address this, regulations have been imposed on PV systems, where more active power control should...... be flexibly performed. As an advanced control strategy, the Absolute Active Power Control (AAPC) can effectively solve the overloading issues by limiting the maximum possible PV power to a certain level (i.e., the power limitation), and also benefit the inverter reliability due to the reduction in the thermal...... loading of the power devices. However, its feasibility is challenged by the associated energy losses. An increase of the inverter lifetime and a reduction of the energy yield can alter the cost of energy, demanding an optimization of the power limitation. Therefore, aiming at minimizing the Levelized Cost...

  17. Calibration of a portable cost-effective chemical residue detection system with adaptive neural net control

    Science.gov (United States)

    Tripp, Alan C.; Walker, James C.

    2003-07-01

    The Sensory Research Institute at the Florida State University has quantitatively characterized a chemical residue detection system with adaptive neural net data processing. Two separate configurations, "Stormy" and "Gaea", were trained by exposure to decreasing amounts of n-amyl acetate from chemical emitters randomly distributed among a collection of non-emitters. The concentration of chemical in the sampled air stream was controlled precisely. The detection threshold for "Stormy" was 1.14 ppt; that for "Gaea" was 1.9 ppt. Cycle time for sampling and chemical analysis of each sample port was on the order of seconds. Possible effects on the sensors of environmental factors such as ambient humidity, temperature, and air velocity were not considered. Besides processing individual air sample data, the neural nets can sense concentration gradients and track to chemical source. The adaptive neural nets are accessed by a voice recognition system and are capable of point testing or free-ranging search. The service life of the detectors, the neural net processors, and auxiliary packaging is approximately 8 years under normal field use. Maintenance requires a good quality kibble and an occasional romp in the park.

  18. Modifications to Replacement Costs System

    International Nuclear Information System (INIS)

    Godec, M.

    1989-01-01

    The purpose of this memorandum is to document the improvements and modifications made to the Replacement Costs of Crude Oil (REPCO) Supply Analysis System. While some of this work was performed under our previous support contract to DOE/ASFE, we are presenting all modifications and improvements are presented here for completeness. The memo primarily documents revisions made to the Lower-48 Onshore Model. Revisions and modifications made to other components and models in the REPCO system which are documented elsewhere are only highlighted in this memo. Generally, the modifications made to the Lower-48 Onshore Model reflect changes that have occurred in domestic drilling, oil field costs, and reserves since 1982, the date of the most recent available data used for the original Replacement Costs report, published in 1985

  19. The cost-effectiveness of household photovoltaic systems in reducing greenhouse gas emissions in Australia: Linking subsidies with emission reductions

    International Nuclear Information System (INIS)

    Burtt, D.; Dargusch, P.

    2015-01-01

    Highlights: • Payback period for Australian household PV fell to four years in 2011 and 2012. • PV became attractive due to high feed-in tariffs and declining PV costs. • Cost was AU$200/t CO 2 e in 2010, expected to be AU$65 to AU$100/t CO 2 e by 2020. • PV resulted in greenhouse gas emissions reducing by 3.7 million t CO 2 e in 2013. • PV expected to reduce greenhouse gas emissions by 8 million t CO 2 e in 2020. - Abstract: This paper examines the cost-effectiveness of subsidies (feed-in tariffs and renewable energy credits) paid for by electricity consumers to support the uptake of roof top photovoltaic (PV) systems by households in Australia. We estimate annual payback periods, and then regress these against the actual uptake of household PV and associated emission reductions, creating a relationship not apparent in other research. Sensitivity analysis reveals that the declining cost of PV panels had most impact on PV uptake followed by feed-in tariffs, renewable energy credits and the increasing cost of household electricity tariffs. Our modelling shows that feed-in tariffs were higher than necessary to achieve the resultant levels of PV uptake and that the low cost of PV panels and comparatively high electricity tariffs are likely to result in a continuing strong uptake of household PV in Australia. Our modelling shows that subsidies peaked in 2011 and 2012, with payback periods of three to four years, having since increased to five to six years. Emission reduction costs are expected to reduce from over AU$200 per t CO 2 e in 2013 to between AU$65 and AU$100 per t CO 2 e in 2020. Household PV reduced Australia’s emissions by 3.7 million t CO 2 e in 2013 (1.7% of Australia’s total emissions) and is expected to reach eight million tonnes (3.7% of Australia’s total emissions) by 2020

  20. A cost-effectiveness analysis of fistula treatment in the abdominal region using a new integrated fistula and wound management system

    DEFF Research Database (Denmark)

    Keiding, Hans; Skovgaard, Rasmus

    2008-01-01

    OBJECTIVE: To evaluate wear time and costs of a new fistula and wound management system (FWMS) compared to standard fistula treatments. METHODS: Data were collected from 22 patients with an abdominal fistula recruited from 5 sites in the United States. This economic evaluation was based on a cost......-effectiveness analysis with wear time, material costs, and labor costs taken into account. RESULTS: A longer wear time for each pouch as well as simpler handling by nurses amounted to an average lower cost of $83 per day of treatment with the FWMS. A large variation was observed in the collected data. However...

  1. A Cost-Effective, In-House, Positioning and Cutting Guide System for Orthognathic Surgery.

    Science.gov (United States)

    McAllister, Peter; Watson, Melanie; Burke, Ezra

    2018-03-01

    Technological advances in 3D printing can dramatically improve orthognathic surgical planning workflow. Custom positioning and cutting guides enable intraoperative reproduction of pre-planned osteotomy cuts and can result in greater surgical accuracy and patient safety. This short paper describes the use of freeware (some with open-source) combined with in-house 3D printing facilities to produce reliable, affordable osteotomy cutting guides. Open-source software (3D Slicer) is used to visualise and segment three-dimensional planning models from imported conventional computed tomography (CT) scans. Freeware (Autodesk Meshmixer ©) allows digital manipulation of maxillary and mandibular components to plan precise osteotomy cuts. Bespoke cutting guides allow exact intraoperative positioning. These are printed in polylactic acid (PLA) using a fused-filament fabrication 3D printer. Fixation of the osteotomised segments is achieved using plating templates and four pre-adapted plates with planned screw holes over the thickest bone. We print maxilla/ mandible models with desired movements incorporated to use as a plating template. A 3D printer capable of reproducing a complete skull can be procured for £1000, with material costs in the region of £10 per case. Our production of models and guides typically takes less than 24 hours of total print time. The entire production process is frequently less than three days. Externally sourced models and guides cost significantly more, frequently encountering costs totalling £1500-£2000 for models and guides for a bimaxillary osteotomy. Three-dimensional guided surgical planning utilising custom cutting guides enables the surgeon to determine optimal orientation of osteotomy cuts and better predict the skeletal maxilla/mandible relationship following surgery. The learning curve to develop proficiency using planning software and printer settings is offset by increased surgical predictability and reduced theatre time, making this

  2. Reviewing the potential and cost-effectiveness of off-grid PV systems in Indonesia on a provincial level

    NARCIS (Netherlands)

    Veldhuis, A.J.; Reinders, Angelina H.M.E.

    2015-01-01

    In this study the amount and costs of off-grid PV systems required to electrify Indonesian rural households lacking electricity access are estimated. Due to the Indonesian geography large differences exist among different provinces, therefore this study evaluates the potential and costs of off-grid

  3. A cost-effective eigensolution method for large systems with Rockwell NASTRAN

    International Nuclear Information System (INIS)

    Gupta, V.K.; Cole, J.G.; Mock, W.D.

    1984-01-01

    The Lanczos method with reorthogonalization based on Householder transformations has been implemented in Rockwell's version of the COSMIC-released NASTRAN program for partial solution of a large-scale symmetric eigenvalue problem. A special technique has been included for restarting Lanczositeration with a new random vector, partly to avoid premature termination associated with a null or linearly dependent Lanczos feed vector and partly to discover multiple eigenvalues. The developed Lanczos-Householder algorithm with built-in random restart capability shows appreciable cost-savings over the conventional subspace iteration technique as well as the COSMIC NASTRAN method, FEER, which utilizes the modified Gram-Schmidt process to reorthogonalize the Lanczos feed vector with respect to those previously converged. (orig.)

  4. Photonic Integrated Circuits for Cost-Effective, High Port Density, and Higher Capacity Optical Communications Systems

    Science.gov (United States)

    Chiappa, Pierangelo

    Bandwidth-hungry services, such as higher speed Internet, voice over IP (VoIP), and IPTV, allow people to exchange and store huge amounts of data among worldwide locations. In the age of global communications, domestic users, companies, and organizations around the world generate new contents making bandwidth needs grow exponentially, along with the need for new services. These bandwidth and connectivity demands represent a concern for operators who require innovative technologies to be ready for scaling. To respond efficiently to these demands, Alcatel-Lucent is fast moving toward photonic integration circuits technologies as the key to address best performances at the lowest "bit per second" cost. This article describes Alcatel-Lucent's contribution in strategic directions or achievements, as well as possible new developments.

  5. Development of a cost-effective machine vision system for in-field sorting and grading of apples: Fruit orientation and size estimation

    Science.gov (United States)

    The objective of this research was to develop an in-field apple presorting and grading system to separate undersized and defective fruit from fresh market-grade apples. To achieve this goal, a cost-effective machine vision inspection prototype was built, which consisted of a low-cost color camera, L...

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

    Directory of Open Access Journals (Sweden)

    Yie-Ru Chiu

    2015-11-01

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

  7. A novel cost-effective parallel narrowband ANC system with local secondary-path estimation

    Science.gov (United States)

    Delegà, Riccardo; Bernasconi, Giancarlo; Piroddi, Luigi

    2017-08-01

    Many noise reduction applications are targeted at multi-tonal disturbances. Active noise control (ANC) solutions for such problems are generally based on the combination of multiple adaptive notch filters. Both the performance and the computational cost are negatively affected by an increase in the number of controlled frequencies. In this work we study a different modeling approach for the secondary path, based on the estimation of various small local models in adjacent frequency subbands, that greatly reduces the impact of reference-filtering operations in the ANC algorithm. Furthermore, in combination with a frequency-specific step size tuning method it provides a balanced attenuation performance over the whole controlled frequency range (and particularly in the high end of the range). Finally, the use of small local models is greatly beneficial for the reactivity of the online secondary path modeling algorithm when the characteristics of the acoustic channels are time-varying. Several simulations are provided to illustrate the positive features of the proposed method compared to other well-known techniques.

  8. Linear collider systems and costs

    International Nuclear Information System (INIS)

    Loew, G.A.

    1993-05-01

    The purpose of this paper is to examine some of the systems and sub-systems involved in so-called ''conventional'' e + e - linear colliders and to study how their design affects the overall cost of these machines. There are presently a total of at least six 500 GeV c. of m. linear collider projects under study in the world. Aside from TESLA (superconducting linac at 1.3 GHz) and CLIC (two-beam accelerator with main linac at 30GHz), the other four proposed e + e - linear colliders can be considered ''conventional'' in that their main linacs use the proven technique of driving room temperature accelerator sections with pulsed klystrons and modulators. The centrally distinguishing feature between these projects is their main linac rf frequency: 3 GHz for the DESY machine, 11.424 GHz for the SLAC and JLC machines, and 14 GHz for the VLEPP machine. The other systems, namely the electron and positron sources, preaccelerators, compressors, damping rings and final foci, are fairly similar from project to project. Probably more than 80% of the cost of these linear colliders will be incurred in the two main linacs facing each other and it is therefore in their design and construction that major savings or extra costs may be found

  9. Towards Cost-Effective Robotic Systems for Small and Medium Enterprises

    DEFF Research Database (Denmark)

    Andersen, Rasmus Hasle

    Developers, Process Modellers and Operators. This dissertation presents a system-building platform—the Robot CoWorker Platform—which enables rapid creating of bespoke systems, targeted at SMEs, by enabling flexibility, usability and reusability and by separating the responsibilities of the identified key...... behaviour through process modelling and Operators focus only on selecting and configuring appropriate process models using the system in production. The Robot CoWorker Platform comprises three fundamental technical components: 1) A hardware-independent capability modelling framework, 2) Intuitive Human...... Robot Interaction (HRI) enabling instruction by non-technical users, and 3) an implementation of this in the Robot CoWorker Architecture. Each of these is described in detail. The platform is evaluated with respect flexibility, usability and reusability through a set of seven cases where the Robot CoWorker...

  10. A Systems Approach to Finding Cost-Effective Alternatives to European Ballistic Missile Defense

    Science.gov (United States)

    2013-09-01

    has holes in its ability to cover the entire region as required. What are the existing approaches to ballistic missile defense in Europe? 4. What Are...however, this report focuses on ballistic missiles which use stellar or inertial guidance systems which are not subject to electromagnetic...location as the Baseline system (35.6° N, 32.5° E) while the other was placed north of Turkey in the Black Sea (41.5° N, 38.1° E). Each Aegis ship was

  11. Assessment of the Economic Impact of Belimumab for the Treatment of Systemic Lupus Erythematosus in the Italian Setting: A Cost-Effectiveness Analysis.

    Science.gov (United States)

    Pierotti, Francesca; Palla, Ilaria; Treur, Maarten; Pippo, Lara; Turchetti, Giuseppe

    2015-01-01

    The purpose of this analysis is to evaluate the cost-effectiveness of belimumab, a new biological treatment specifically developed for the treatment of Systemic Lupus Erythematosus (SLE), in the Italian setting. SLE is a chronic non-organ specific autoimmune disease characterized by a disregulation of the immune system that involves many organs and systems. A cost-effectiveness micro-simulation model with a lifetime horizon originally developed for the UK was adapted to the Italian setting. The analysis compared Standard of Care (SoC) alone vs belimumab plus SoC from a National Healthcare Service (NHS) and societal perspective. Health-economic consequences of treatments and organ damage progression were calculated. When available, Italian data were used, otherwise UK costs were converted using Purchasing Power Parities (PPPs). Utility values were based on the EQ-5D™ assessments in the belimumab clinical trials (BLISS 52 and 76). Results were discounted with 3% for costs and effects. A maximum belimumab treatment duration of 6 years was assumed and wastage costs were considered. Cost per life year gained (Incremental Cost-Effectiveness Ratio, ICER) and cost per Quality Adjusted Life Year (QALY) (Incremental Cost-Utility Ratio, ICUR) were €22,990 and €32,859, respectively. These values reduced to €20,119 and €28,754, respectively, when indirect costs were included. It may be concluded that in the Italian setting and according to the guidelines of the Italian Association of Health Economics (IAHE), belimumab was shown to be cost-effective, in terms of both ICER and ICUR, (€25-40,000/QALY).

  12. Assessment of the Economic Impact of Belimumab for the Treatment of Systemic Lupus Erythematosus in the Italian Setting: A Cost-Effectiveness Analysis.

    Directory of Open Access Journals (Sweden)

    Francesca Pierotti

    Full Text Available The purpose of this analysis is to evaluate the cost-effectiveness of belimumab, a new biological treatment specifically developed for the treatment of Systemic Lupus Erythematosus (SLE, in the Italian setting. SLE is a chronic non-organ specific autoimmune disease characterized by a disregulation of the immune system that involves many organs and systems.A cost-effectiveness micro-simulation model with a lifetime horizon originally developed for the UK was adapted to the Italian setting. The analysis compared Standard of Care (SoC alone vs belimumab plus SoC from a National Healthcare Service (NHS and societal perspective. Health-economic consequences of treatments and organ damage progression were calculated. When available, Italian data were used, otherwise UK costs were converted using Purchasing Power Parities (PPPs. Utility values were based on the EQ-5D™ assessments in the belimumab clinical trials (BLISS 52 and 76. Results were discounted with 3% for costs and effects. A maximum belimumab treatment duration of 6 years was assumed and wastage costs were considered.Cost per life year gained (Incremental Cost-Effectiveness Ratio, ICER and cost per Quality Adjusted Life Year (QALY (Incremental Cost-Utility Ratio, ICUR were €22,990 and €32,859, respectively. These values reduced to €20,119 and €28,754, respectively, when indirect costs were included.It may be concluded that in the Italian setting and according to the guidelines of the Italian Association of Health Economics (IAHE, belimumab was shown to be cost-effective, in terms of both ICER and ICUR, (€25-40,000/QALY.

  13. Early warning systems for the management of chronic heart failure: a systematic literature review of cost-effectiveness models.

    Science.gov (United States)

    Albuquerque De Almeida, Fernando; Al, Maiwenn; Koymans, Ron; Caliskan, Kadir; Kerstens, Ankie; Severens, Johan L

    2018-04-01

    Describing the general and methodological characteristics of decision-analytical models used in the economic evaluation of early warning systems for the management of chronic heart failure patients and performing a quality assessment of their methodological characteristics is expected to provide concise and useful insight to inform the future development of decision-analytical models in the field of heart failure management. Areas covered: The literature on decision-analytical models for the economic evaluation of early warning systems for the management of chronic heart failure patients was systematically reviewed. Nine electronic databases were searched through the combination of synonyms for heart failure and sensitive filters for cost-effectiveness and early warning systems. Expert commentary: The retrieved models show some variability with regards to their general study characteristics. Overall, they display satisfactory methodological quality, even though some points could be improved, namely on the consideration and discussion of any competing theories regarding model structure and disease progression, identification of key parameters and the use of expert opinion, and uncertainty analyses. A comprehensive definition of early warning systems and further research under this label should be pursued. To improve the transparency of economic evaluation publications, authors should make available detailed technical information regarding the published models.

  14. Automatic Synthesis of Cost Effective FFT/IFFT Cores for VLSI OFDM Systems

    Science.gov (United States)

    L'Insalata, Nicola E.; Saponara, Sergio; Fanucci, Luca; Terreni, Pierangelo

    This work presents an FFT/IFFT core compiler particularly suited for the VLSI implementation of OFDM communication systems. The tool employs an architecture template based on the pipelined cascade principle. The generated cores support run-time programmable length and transform type selection, enabling seamless integration into multiple mode and multiple standard terminals. A distinctive feature of the tool is its accuracy-driven configuration engine which automatically profiles the internal arithmetic and generates a core with minimum operands bit-width and thus minimum circuit complexity. The engine performs a closed-loop optimization over three different internal arithmetic models (fixed-point, block floating-point and convergent block floating-point) using the numerical accuracy budget given by the user as a reference point. The flexibility and re-usability of the proposed macrocell are illustrated through several case studies which encompass all current state-of-the-art OFDM communications standards (WLAN, WMAN, xDSL, DVB-T/H, DAB and UWB). Implementations results of the generated macrocells are presented for two deep sub-micron standard-cells libraries (65 and 90nm) and commercially available FPGA devices. When compared with other tools for automatic FFT core generation, the proposed environment produces macrocells with lower circuit complexity expressed as gate count and RAM/ROM bits, while keeping the same system level performance in terms of throughput, transform size and numerical accuracy.

  15. Cost-Effective Video Filtering Solution for Real-Time Vision Systems

    Directory of Open Access Journals (Sweden)

    Karl Martin

    2005-08-01

    Full Text Available This paper presents an efficient video filtering scheme and its implementation in a field-programmable logic device (FPLD. Since the proposed nonlinear, spatiotemporal filtering scheme is based on order statistics, its efficient implementation benefits from a bit-serial realization. The utilization of both the spatial and temporal correlation characteristics of the processed video significantly increases the computational demands on this solution, and thus, implementation becomes a significant challenge. Simulation studies reported in this paper indicate that the proposed pipelined bit-serial FPLD filtering solution can achieve speeds of up to 97.6 Mpixels/s and consumes 1700 to 2700 logic cells for the speed-optimized and area-optimized versions, respectively. Thus, the filter area represents only 6.6 to 10.5% of the Altera STRATIX EP1S25 device available on the Altera Stratix DSP evaluation board, which has been used to implement a prototype of the entire real-time vision system. As such, the proposed adaptive video filtering scheme is both practical and attractive for real-time machine vision and surveillance systems as well as conventional video and multimedia applications.

  16. Techno-Economic Feasibility of Highly Efficient Cost-Effective Thermoelectric-SOFC Hybrid Power Generation Systems

    Energy Technology Data Exchange (ETDEWEB)

    Jifeng Zhang; Jean Yamanis

    2007-09-30

    Solid oxide fuel cell (SOFC) systems have the potential to generate exhaust gas streams of high temperature, ranging from 400 to 800 C. These high temperature gas streams can be used for additional power generation with bottoming cycle technologies to achieve higher system power efficiency. One of the potential candidate bottoming cycles is power generation by means of thermoelectric (TE) devices, which have the inherent advantages of low noise, low maintenance and long life. This study was to analyze the feasibility of combining coal gas based SOFC and TE through system performance and cost techno-economic modeling in the context of multi-MW power plants, with 200 kW SOFC-TE module as building blocks. System and component concepts were generated for combining SOFC and TE covering electro-thermo-chemical system integration, power conditioning system (PCS) and component designs. SOFC cost and performance models previously developed at United Technologies Research Center were modified and used in overall system analysis. The TE model was validated and provided by BSST. The optimum system in terms of energy conversion efficiency was found to be a pressurized SOFC-TE, with system efficiency of 65.3% and cost of $390/kW of manufacturing cost. The pressurization ratio was approximately 4 and the assumed ZT of the TE was 2.5. System and component specifications were generated based on the modeling study. The major technology and cost barriers for maturing the system include pressurized SOFC stack using coal gas, the high temperature recycle blowers, and system control design. Finally, a 4-step development roadmap is proposed for future technology development, the first step being a 1 kW proof-of-concept demonstration unit.

  17. Modeling the cost-effectiveness of the integrated disease surveillance and response (IDSR system: meningitis in Burkina Faso.

    Directory of Open Access Journals (Sweden)

    Zana C Somda

    Full Text Available BACKGROUND: Effective surveillance for infectious diseases is an essential component of public health. There are few studies estimating the cost-effectiveness of starting or improving disease surveillance. We present a cost-effectiveness analysis the Integrated Disease Surveillance and Response (IDSR strategy in Africa. METHODOLOGY/PRINCIPAL FINDINGS: To assess the impact of the IDSR in Africa, we used pre- and post- IDSR meningococcal meningitis surveillance data from Burkina Faso (1996-2002 and 2003-2007. IDSR implementation was correlated with a median reduction of 2 weeks to peak of outbreaks (25(th percentile 1 week; 75(th percentile 4 weeks. IDSR was also correlated with a reduction of 43 meningitis cases per 100,000 (25(th-40: 75(th-129. Assuming the correlations between reductions in time to peak of outbreaks and cases are related, the cost-effectiveness of IDSR was $23 per case averted (25(th-$30; 75(th--cost saving, and $98 per meningitis-related death averted (25(th-$140: 75(th--cost saving. CONCLUSIONS/SIGNIFICANCE: We cannot absolutely claim that the measured differences were due to IDSR. We believe, however, that it is reasonable to claim that IDSR can improve the cost-effectiveness of public health surveillance.

  18. Benchmarking management of sewer systems: more to learn than cost effectiveness.

    Science.gov (United States)

    Beenen, A S

    2005-01-01

    Thirty-nine municipalities in the Netherlands conducted a pilot study to develop and try out a methodology to compare the quality of their sewerage management. The participants chose a multidimensional benchmarking with an emphasis on the aim of improving the working processes within sewerage management. A second goal was accountability to the stakeholders. The benchmarking methodology was based as well on analysing data within a "balanced-score-card" system as on intensive exchange of knowledge and experiences. The pilot resulted in a state of the art overview of the quality of sewerage management in the Netherlands. However, above all, it resulted in the shocking fact that the work is carried out in many different ways which cannot be explained by technical reasons or local circumstances. To pinpoint best practices and actually implement these improvements the learning process must continue after the analysis and presentation of the data. A start has been made to form regional specialist networks for further discussion and exchange of experiences.

  19. Development & Optimization of Materials and Processes for a Cost Effective Photoelectrochemical Hydrogen Production System. Final report

    Energy Technology Data Exchange (ETDEWEB)

    McFarland, Eric W

    2011-01-17

    The overall project objective was to apply high throughput experimentation and combinatorial methods together with novel syntheses to discover and optimize efficient, practical, and economically sustainable materials for photoelectrochemical production of bulk hydrogen from water. Automated electrochemical synthesis and photoelectrochemical screening systems were designed and constructed and used to study a variety of new photoelectrocatalytic materials. We evaluated photocatalytic performance in the dark and under illumination with or without applied bias in a high-throughput manner and did detailed evaluation on many materials. Significant attention was given to -Fe2O3 based semiconductor materials and thin films with different dopants were synthesized by co-electrodeposition techniques. Approximately 30 dopants including Al, Zn, Cu, Ni, Co, Cr, Mo, Ti, Pt, etc. were investigated. Hematite thin films doped with Al, Ti, Pt, Cr, and Mo exhibited significant improvements in efficiency for photoelectrochemical water splitting compared with undoped hematite. In several cases we collaborated with theorists who used density functional theory to help explain performance trends and suggest new materials. The best materials were investigated in detail by X-ray diffraction (XRD), scanning electron microscopy (SEM), ultraviolet-visual spectroscopy (UV-Vis), X-ray photoelectron spectroscopy (XPS). The photoelectrocatalytic performance of the thin films was evaluated and their incident photon

  20. Filmless versus film-based systems in radiographic examination costs: an activity-based costing method.

    Science.gov (United States)

    Muto, Hiroshi; Tani, Yuji; Suzuki, Shigemasa; Yokooka, Yuki; Abe, Tamotsu; Sase, Yuji; Terashita, Takayoshi; Ogasawara, Katsuhiko

    2011-09-30

    Since the shift from a radiographic film-based system to that of a filmless system, the change in radiographic examination costs and costs structure have been undetermined. The activity-based costing (ABC) method measures the cost and performance of activities, resources, and cost objects. The purpose of this study is to identify the cost structure of a radiographic examination comparing a filmless system to that of a film-based system using the ABC method. We calculated the costs of radiographic examinations for both a filmless and a film-based system, and assessed the costs or cost components by simulating radiographic examinations in a health clinic. The cost objects of the radiographic examinations included lumbar (six views), knee (three views), wrist (two views), and other. Indirect costs were allocated to cost objects using the ABC method. The costs of a radiographic examination using a filmless system are as follows: lumbar 2,085 yen; knee 1,599 yen; wrist 1,165 yen; and other 1,641 yen. The costs for a film-based system are: lumbar 3,407 yen; knee 2,257 yen; wrist 1,602 yen; and other 2,521 yen. The primary activities were "calling patient," "explanation of scan," "take photographs," and "aftercare" for both filmless and film-based systems. The cost of these activities cost represented 36.0% of the total cost for a filmless system and 23.6% of a film-based system. The costs of radiographic examinations using a filmless system and a film-based system were calculated using the ABC method. Our results provide clear evidence that the filmless system is more effective than the film-based system in providing greater value services directly to patients.

  1. Cost-effectiveness of health systems strengthening interventions in improving maternal and child health in low- and middle-income countries: a systematic review.

    Science.gov (United States)

    Zeng, Wu; Li, Guohong; Ahn, Haksoon; Nguyen, Ha Thi Hong; Shepard, Donald S; Nair, Dinesh

    2018-03-01

    Health systems strengthening (HSS) interventions are increasingly being implemented to improve maternal and child health (MCH) services in low- and middle-income countries (LMICs). This study reviews global literature on cost-effectiveness of HSS interventions in improving MCH. A systematic review was conducted. Keywords, based on World Health Organization framework on health systems and prior studies, were applied to search in bibliographic databases and on the web. Articles that estimated cost-effectiveness of HSS interventions in LMICs were included in the analysis. Each of the 24 selected studies from 15 countries was assessed in terms of quality and biases using Cochrane's criteria. Review Manager and an Excel template were used to extract data and synthesize findings. HSS interventions concentrated on the components of service delivery, health financing, human resources and quality improvement. Within each component, there existed diverse strategies to strengthen health systems. Among the 24 studies, 15 were rated as high quality, 5 as medium and 4 as low quality. A majority of studies reported cost per disability-adjusted life year (DALY) averted or cost per quality-adjusted life year (QALY) gained; other studies reported cost per life saved or life year gained. However, studies used mixed perspectives of analyses. Compared with gross domestic product per capita, interventions in studies reporting cost per DALY averted or QALY gained were all cost-effective, including performance-based financing, health insurance and quality improvement. This review shows the diversity of HSS interventions in improving MCH, and their potential cost-effectiveness. However, the different perspectives employed in the studies, costing components included in the analyses, and heterogeneous measures of effectiveness and outputs, made it challenging to compare cost-effectiveness across all studies, calling for more and standardized cost-effectiveness studies. For policy making, it

  2. Cost-effectiveness and economic impact of the KineSpring ® Knee Implant System in the treatment for knee osteoarthritis.

    Science.gov (United States)

    Li, Chuan Silvia; Seeger, Thomas; Auhuber, Thomas C; Bhandari, Mohit

    2013-11-01

    To investigate the cost-effectiveness and economic impact of the KineSpring System in the treatment for knee osteoarthritis in Germany. Functional outcome scores of the general German population and knee osteoarthritis (OA) patients under surgical treatments (HTO, UKA and TKA), conservative treatments and treatment with the KineSpring System were used to derive the utility scores for each group. Quality-adjusted life years (QALYs) of each group were estimated using the utility scores. Finally, cost-utility analysis was performed using cost and QALYs data. The economic impact of knee OA in Germany was assessed in terms of annual total direct cost and indirect cost, total diseased population and potential QALYs saved with the KineSpring System. Assuming the durability of 10 years, the cost-utility ratio of the KineSpring System, surgical treatments and conservative treatments compared to no treatment in 2012 was euro>3,402/QALY, euro 4,899/QALY and euro 9,996/QALY, respectively. With even a lesser durability of 5 years, the cost-utility ratio of the KineSpring System maintained superiority over surgical treatments and conservative treatments (euro 7,327/QALY, euro 9,706/QALY and euro 10,467/QALY, respectively). The KineSpring System is a highly cost-effective alternative for knee osteoarthritis compared with the current accepted cost-effective threshold (willingness to pay) of $50,000 US/QALY gained. Our models suggest KineSpring System, if adapted widely could save up to 2.0 ± 0.07 million QALY assuming it has a 5-year durability and save up to 3.9 ± 0.1 million QALY assuming it has a 10-year durability. An economic advantage for using the KineSpring System over other surgical and conservative treatments in knee OA patients in Germany is suggested by our model. According to currently accepted cost-effectiveness guidelines, the KineSpring Knee Implant System for knee OA is a cost-effective strategy.

  3. Principles and methods of managerial cost-accounting systems.

    Science.gov (United States)

    Suver, J D; Cooper, J C

    1988-01-01

    An introduction to cost-accounting systems for pharmacy managers is provided; terms are defined and examples of specific applications are given. Cost-accounting systems determine, record, and report the resources consumed in providing services. An effective cost-accounting system must provide the information needed for both internal and external reports. In accounting terms, cost is the value given up to secure an asset. In determining how volumes of activity affect costs, fixed costs and variable costs are calculated; applications include pricing strategies, cost determinations, and break-even analysis. Also discussed are the concepts of direct and indirect costs, opportunity costs, and incremental and sunk costs. For most pharmacy department services, process costing, an accounting of intermediate outputs and homogeneous units, is used; in determining the full cost of providing a product or service (e.g., patient stay), job-order costing is used. Development of work-performance standards is necessary for monitoring productivity and determining product costs. In allocating pharmacy department costs, a ratio of costs to charges can be used; this method is convenient, but microcosting (specific identification of the costs of products) is more accurate. Pharmacy managers can use cost-accounting systems to evaluate the pharmacy's strategies, policies, and services and to improve budgets and reports.

  4. Insights from a Systematic Search for Information on Designs, Costs, and Effectiveness of Poliovirus Environmental Surveillance Systems.

    Science.gov (United States)

    Duintjer Tebbens, Radboud J; Zimmermann, Marita; Pallansch, Mark A; Thompson, Kimberly M

    2017-12-01

    Poliovirus surveillance plays a critical role in achieving and certifying eradication and will play a key role in the polio endgame. Environmental surveillance can provide an opportunity to detect circulating polioviruses prior to the observation of any acute flaccid paralysis cases. We completed a systematic review of peer-reviewed publications on environmental surveillance for polio including the search terms "environmental surveillance" or "sewage," and "polio," "poliovirus," or "poliomyelitis," and compared characteristics of the resulting studies. The review included 146 studies representing 101 environmental surveillance activities from 48 countries published between 1975 and 2016. Studies reported taking samples from sewage treatment facilities, surface waters, and various other environmental sources, although they generally did not present sufficient details to thoroughly evaluate the sewage systems and catchment areas. When reported, catchment areas varied from 50 to over 7.3 million people (median of 500,000 for the 25% of activities that reported catchment areas, notably with 60% of the studies not reporting this information and 16% reporting insufficient information to estimate the catchment area population size). While numerous studies reported the ability of environmental surveillance to detect polioviruses in the absence of clinical cases, the review revealed very limited information about the costs and limited information to support quantitative population effectiveness of conducting environmental surveillance. This review motivates future studies to better characterize poliovirus environmental surveillance systems and the potential value of information that they may provide in the polio endgame.

  5. Maintenance cost models in deregulated power systems under opportunity costs

    International Nuclear Information System (INIS)

    Al-Arfaj, K.; Dahal, K.; Azaiez, M.N.

    2007-01-01

    In a centralized power system, the operator is responsible for scheduling maintenance. There are different types of maintenance, including corrective maintenance; predictive maintenance; preventive maintenance; and reliability-centred maintenance. The main cause of power failures is poor maintenance. As such, maintenance costs play a significant role in deregulated power systems. They include direct costs associated with material and labor costs as well as indirect costs associated with spare parts inventory, shipment, test equipment, indirect labor, opportunity costs and cost of failure. In maintenance scheduling and planning, the cost function is the only component of the objective function. This paper presented the results of a study in which different components of maintenance costs were modeled. The maintenance models were formulated as an optimization problem with single and multiple objectives and a set of constraints. The maintenance costs models could be used to schedule the maintenance activities of power generators more accurately and to identify the best maintenance strategies over a period of time as they consider failure and opportunity costs in a deregulated environment. 32 refs., 4 tabs., 4 figs

  6. Analyzing grid extension and stand-alone photovoltaic systems for the cost-effective electrification of Kenya

    NARCIS (Netherlands)

    Zeyringer, Marianne; Pachauri, Shonali; Schmid, Erwin; Schmidt, Johannes; Worrell, Ernst; Morawetz, Ulrich B.

    2015-01-01

    The declaration of 2014-2024 as the Decade of Sustainable Energy for All has catalyzed actions towards achieving universal electricity access. The high costs of building electric infrastructure are a major impediment to improved access, making stand-alone photovoltaic (PV) systems an attractive

  7. Monitoring drug effectiveness in kala-azar in Bihar, India: cost and feasibility of periodic random surveys vs. a health service-based reporting system.

    Science.gov (United States)

    Malaviya, P; Singh, R P; Singh, S P; Hasker, E; Ostyn, B; Shankar, R; Boelaert, M; Sundar, S

    2011-09-01

    In 2009, a random survey was conducted in Muzaffarpur district to document the clinical outcomes of visceral leishmaniasis patients (VL) treated by the public health care system in 2008, to assess the effectiveness of miltefosine against VL. We analysed the operational feasibility and cost of such periodic random surveys as compared with health facility-based routine monitoring. A random sample of 150 patients was drawn from registers kept at Primary Health Care centres. Patient records were examined, and the patients were located at their residence. Patients and physicians were interviewed with the help of two specifically designed questionnaires by a team of one supervisor, one physician and one field worker. Costs incurred during this survey were properly documented, and vehicle log books maintained for analysis. Hundred and 39 (76.7%) of the patients could be located. Eleven patients were not traceable. Per patient, follow-up cost was US$ 15.51 and on average 2.27 patients could be visited per team-day. Human resource involvement constituted 75% of the total cost whereas involvement of physician costs 51% of the total cost. A random survey to document clinical outcomes is costly and labour intensive but gives probably the most accurate information on drug effectiveness. A health service-based retrospective cohort reporting system modelled on the monitoring system developed by tuberculosis programmes could be a better alternative. Involvement of community health workers in such monitoring would offer the additional advantage of treatment supervision and support. © 2011 Blackwell Publishing Ltd.

  8. A Cost-effective and Emission-aware Power Management System for Ships with Integrated Full Electric Propulsion

    DEFF Research Database (Denmark)

    Kanellos, Fotis D.; Anvari-Moghaddam, Amjad; Guerrero, Josep M.

    2017-01-01

    The extensive exploitation of electric power in ships enables the development of more efficient and environmentally friendlier ships, as it allows for a more flexible ship power system operation and configuration. In this paper, an optimal power management method for ship electric power systems c....... The proposed fuzzy-based particle swarm optimization (FPSO) algorithm aims at minimizing the operation cost, limiting the greenhouse gas (GHG) emissions and satisfying the technical and operational constraints of the ship....

  9. BLUECOM+ project: Connecting Humans and Systems at Ocean Remote Areas using Cost-effective Broadband Communications field

    Science.gov (United States)

    Brito, Pedro; Terrinha, Pedro; Magalhães, Vitor; Santos, Joana; Duarte, Débora; Campos, Rui

    2017-04-01

    The BLUECOM + project (Connecting Humans and Systems at Remote Ocean Areas using Cost-effective Broadband Communications) aims at developing an innovative communications solution that will enable broadband, cost-effective Internet access in remote ocean areas (ideally beyond 100 km from shore), using standard wireless access technologies - e.g., Wi-Fi and LTE. BLUECOM+ is an EEA Grants PT02 project developed by INESC TEC (Institute for Systems and Computer Engineering, Technology and Science), IPMA (Portuguese Institute for the Sea and the Atmosphere), and MARLO (Transport and Logistics Consultants). The BLUECOM+ key idea and innovation lies on deploying a long-term communications infrastructure, which will extend broadband communications from shore to remote ocean areas by leveraging (1) Helikites - a combination of a helium balloon and kite - that can be tethered to existing or new land and ocean platforms, (2) long range line of sight wireless communications using TV white spaces, and (3) multi-hop relaying techniques to further increase range. At this stage the communications protocols were defined and tested in lab conditions and two sea trials for demonstration of the system were carried out in July/2016 and September/2016 using research vessels. Results of the cruises: 1st cruise corresponded to the first sea-trials of the project. Single-hop communications were established between a land base station deployed at Cabo Espichel lighthouse and the Sea Station deployed in a Helikite launched from the vessel and flying at an altitude of 120m. Successful communications between the two stations were established at a maximum distance of 40km with a data rate in excess of 1Mbit/s. 2nd cruise corresponded to the second sea-trials. During this trial single-hop and two-hop land-sea communications were tested. For two-hop communications tests two Helikites were launched at 120m from two vessels. The first was launched from a vessel closer to shore; the other was

  10. Cost Effectiveness of Genotype-Guided Warfarin Dosing in Patients with Mechanical Heart Valve Replacement Under the Fee-for-Service System.

    Science.gov (United States)

    Kim, Dong-Jin; Kim, Ho-Sook; Oh, Minkyung; Kim, Eun-Young; Shin, Jae-Gook

    2017-10-01

    Although studies assessing the cost effectiveness of genotype-guided warfarin dosing for the management of atrial fibrillation, deep vein thrombosis, and pulmonary embolism have been reported, no publications have addressed genotype-guided warfarin therapy in mechanical heart valve replacement (MHVR) patients or genotype-guided warfarin therapy under the fee-for-service (FFS) insurance system. The aim of this study was to evaluate the cost effectiveness of genotype-guided warfarin dosing in patients with MHVR under the FFS system from the Korea healthcare sector perspective. A decision-analytic Markov model was developed to evaluate the cost effectiveness of genotype-guided warfarin dosing compared with standard dosing. Estimates of clinical adverse event rates and health state utilities were derived from the published literature. The outcome measure was the incremental cost-effectiveness ratio (ICER) per quality-adjusted life-year (QALY). One-way and probabilistic sensitivity analyses were performed to explore the range of plausible results. In a base-case analysis, genotype-guided warfarin dosing was associated with marginally higher QALYs than standard warfarin dosing (6.088 vs. 6.083, respectively), at a slightly higher cost (US$6.8) (year 2016 values). The ICER was US$1356.2 per QALY gained. In probabilistic sensitivity analysis, there was an 82.7% probability that genotype-guided dosing was dominant compared with standard dosing, and a 99.8% probability that it was cost effective at a willingness-to-pay threshold of US$50,000 per QALY gained. Compared with only standard warfarin therapy, genotype-guided warfarin dosing was cost effective in MHVR patients under the FFS insurance system.

  11. Greenhouse, energy efficiency and cost effectiveness

    International Nuclear Information System (INIS)

    Naughten, B.; Dickson, A.

    1995-01-01

    MENSA, a detailed model of Australia's energy system suggests that policies for overcoming information barriers to energy efficient investment may contribute to cost effectively reducing greenhouse gases by as much as 6 million tonnes in residential and transport sectors by 2000. The model also indicates that energy efficiency policies in these and other parts of the energy system would be insufficient to achieve a pro-rata of greenhouse gas reductions required to stabilize year 2000 emissions at 1990 levels. One cost effective policy involving the early scrapping of existing less fuel efficient motors is reviewed. 2 tabs., 1 fig., refs

  12. Cost?effectiveness thresholds: pros and cons

    OpenAIRE

    Bertram, Melanie Y; Lauer, Jeremy A; De Joncheere, Kees; Edejer, Tessa; Hutubessy, Raymond; Kieny, Marie-Paule; Hill, Suzanne R

    2016-01-01

    Abstract Cost?effectiveness analysis is used to compare the costs and outcomes of alternative policy options. Each resulting cost?effectiveness ratio represents the magnitude of additional health gained per additional unit of resources spent. Cost?effectiveness thresholds allow cost?effectiveness ratios that represent good or very good value for money to be identified. In 2001, the World Health Organization?s Commission on Macroeconomics in Health suggested cost?effectiveness thresholds based...

  13. [Analysis of cost-effectiveness of simvastatin versus atorvastatin in the secondary prevention of cardiovascular events within the Brazilian public healthcare system].

    Science.gov (United States)

    Araujo, Denizar Vianna; Ribeiro de Souza, Camila Pepe; Bahia, Luciana Ribeiro; Rey, Helena Cramer Veiga; Dos Santos Junior, Braulio; Tura, Bernardo Rangel; Berwanger, Otavio; Buehler, Anna Maria; Silva, Marcus Tolentino

    2011-01-01

    The objective of this study is to perform an economic evaluation analyzing the treatment with atorvastatin and simvastatin in comparison to placebo treatment, within the Brazilian Public Healthcare System (SUS) scenario, for patients with high risk of cardiovascular disease; analyzing if the additional cost related to statin treatment is justified by the clinical benefits expected, in terms of cardiovascular event and mortality reduction. Cardiovascular event risk and mortality risk were used as outcomes. Statin efficacy at LDL-c and cardiovascular events levels lowering data was obtained from a systematic review of literature. A decision analytic model was developed to perform a cost-effectiveness analysis comparing atorvastatin 10mg/day and simvastatin 40 mg/day to placebo treatment in patients with dyslipidemia in Brazil. The target population of this study was a hypothetic cohort of men and women with a mean age of 50 years old and high risk of cardiovascular disease. The model includes only direct costs obtained from Ambulatory and Hospital Information System and Price Database of Brazilian Ministry of Health. The comparative cost-effectiveness analysis itself was done through Excel spreadsheets covering a 5 -years time horizon. The result shows that atorvastatin 10mg/day in comparison to placebo has higher cost with higher effectiveness in the time horizon of 5 years (Incremental Cost Effectiveness Ratio of R$ 433.065,05 per life year gained). In this scenario atorvastatin is not cost effective in comparison to placebo. The simvastatin 40 mg/day appears to be a strategy with lower cost and higher effectiveness in comparison to placebo, in the time horizon analyzed (5 years). In the multivariate probabilistic sensitivity analysis, simvastatin showed 53% of the results in the quadrant with greater effectiveness and lower cost. This study is an important tool for public decision makers. The study can be used in the decision process of increasing cardiovascular

  14. Implementation of a Cost-Accounting System for Visibility of Weapon Systems Life-Cycle Costs

    National Research Council Canada - National Science Library

    Ugone, Mary

    2001-01-01

    ... costs through activity-based costing and management. The system must deliver timely, integrated data for management purposes to permit understanding of total weapon costs, provide a basis for estimating costs of future systems, and feed other tools for life-cycle cost management.

  15. Cost Accounting System for fusion studies

    Energy Technology Data Exchange (ETDEWEB)

    Hamilton, W.R.; Keeton, D.C.; Thomson, S.L.

    1985-12-01

    A Cost Accounting System that is applicable to all magnetic fusion reactor design studies has been developed. This system provides: (1) definitions of the elements of cost and methods for the combination of these elements to form a cost estimate; (2) a Code of Accounts that uses a functional arrangement for identification of the plant components; and (3) definitions and methods to analyze actual cost data so that the data can be directly reported into this Cost Accounting System. The purpose of the Cost Accounting System is to provide the structure for the development of a fusion cost data base and for the development of validated cost estimating procedures. This system has been developed through use at the Fusion Engineering Design Center (FEDC) and has been applied to different confinement concepts (tokamaks and tandem mirrors) and to different types of projects (experimental devices and commercial power plants). The use of this Cost Accounting System by all magnetic fusion projects will promote the development of a common cost data base, allow the direct comparison of cost estimates, and ultimately establish the cost credibility of the program.

  16. Cost Accounting System for fusion studies

    International Nuclear Information System (INIS)

    Hamilton, W.R.; Keeton, D.C.; Thomson, S.L.

    1985-12-01

    A Cost Accounting System that is applicable to all magnetic fusion reactor design studies has been developed. This system provides: (1) definitions of the elements of cost and methods for the combination of these elements to form a cost estimate; (2) a Code of Accounts that uses a functional arrangement for identification of the plant components; and (3) definitions and methods to analyze actual cost data so that the data can be directly reported into this Cost Accounting System. The purpose of the Cost Accounting System is to provide the structure for the development of a fusion cost data base and for the development of validated cost estimating procedures. This system has been developed through use at the Fusion Engineering Design Center (FEDC) and has been applied to different confinement concepts (tokamaks and tandem mirrors) and to different types of projects (experimental devices and commercial power plants). The use of this Cost Accounting System by all magnetic fusion projects will promote the development of a common cost data base, allow the direct comparison of cost estimates, and ultimately establish the cost credibility of the program

  17. Cost-Effective Pavement Performance Management of Indiana's Enhanced National Highway System through Strategic Modification of the Pavement Rehabilitation Treatment Trigger Values

    OpenAIRE

    Noureldin, Menna; Fricker, Jon D.; Sinha, Kumares C.

    2015-01-01

    Cost-Effective Pavement Performance Management of Indiana's Enhanced National Highway System through Strategic Modification of the Pavement Rehabilitation Treatment Trigger Values Presented during Session 3: Policy and Funding, moderated by Magdy Mikhail, at the 9th International Conference on Managing Pavement Assets (ICMPA9) in Alexandria, VA. Includes conference paper and PowerPoint slides.

  18. A new costing model in hospital management: time-driven activity-based costing system.

    Science.gov (United States)

    Öker, Figen; Özyapıcı, Hasan

    2013-01-01

    Traditional cost systems cause cost distortions because they cannot meet the requirements of today's businesses. Therefore, a new and more effective cost system is needed. Consequently, time-driven activity-based costing system has emerged. The unit cost of supplying capacity and the time needed to perform an activity are the only 2 factors considered by the system. Furthermore, this system determines unused capacity by considering practical capacity. The purpose of this article is to emphasize the efficiency of the time-driven activity-based costing system and to display how it can be applied in a health care institution. A case study was conducted in a private hospital in Cyprus. Interviews and direct observations were used to collect the data. The case study revealed that the cost of unused capacity is allocated to both open and laparoscopic (closed) surgeries. Thus, by using the time-driven activity-based costing system, managers should eliminate the cost of unused capacity so as to obtain better results. Based on the results of the study, hospital management is better able to understand the costs of different surgeries. In addition, managers can easily notice the cost of unused capacity and decide how many employees to be dismissed or directed to other productive areas.

  19. Cost-Effective Telemetry and Command Ground Systems Automation Strategy for the Soil Moisture Active Passive (SMAP) Mission

    Science.gov (United States)

    Choi, Joshua S.; Sanders, Antonio L.

    2012-01-01

    Soil Moisture Active Passive (SMAP) is an Earth-orbiting, remote-sensing NASA mission slated for launch in 2014.[double dagger] The ground data system (GDS) being developed for SMAP is composed of many heterogeneous subsystems, ranging from those that support planning and sequencing to those used for real-time operations, and even further to those that enable science data exchange. A full end-to-end automation of the GDS may result in cost savings during mission operations, but it would require a significant upfront investment to develop such comprehensive automation. As demonstrated by the Jason-1 and Wide-field Infrared Survey Explorer (WISE) missions, a measure of "lights-out" automation for routine, orbital pass ground operations can still reduce mission cost through smaller staffing of operators and limited work hours. The challenge, then, for the SMAP GDS engineering team is to formulate an automated operations strategy--and corresponding system architecture--to minimize operator intervention during operations, while balancing the development cost associated with the scope and complexity of automation. This paper discusses the automated operations approach being developed for the SMAP GDS. The focus is on automating the activities involved in routine passes, which limits the scope to real-time operations. A key subsystem of the SMAP GDS--NASA's AMMOS Mission Data Processing and Control System (AMPCS)--provides a set of capabilities that enable such automation. Also discussed are the lights-out pass automations of the Jason-1 and WISE missions and how they informed the automation strategy for SMAP. The paper aims to provide insights into what is necessary in automating the GDS operations for Earth satellite missions.

  20. FORMATION OF THE ENTERPRISE COSTS MANAGEMENT SYSTEM

    Directory of Open Access Journals (Sweden)

    Borysiuk Iryna

    2018-01-01

    Full Text Available Introduction. The paper deals with the actual issues of formation of the enterprise management system costs, because in the conditions of an unstable market environment the financial performance depends on the efficiency of the cost management system, competitiveness, financial sustainability and investment attractiveness of any subject of economic activity. Purpose of the article is consolidation of approaches to cost management, theoretical substantiation and development of recommendations regarding the formation of the enterprise cost management system. Results. Development of an enterprise cost management system based on research on the essence and cost management approaches. The goals, tasks, principles, methods, tools, functions and main elements of the cost management system were determined, factors of the external and internal environment of the enterprise, that affect the system of its costs management. Conclusions. Formation of integrated cost management system ensures the successful company operation on the market, production of competitive products based on costs and prices optimization and making a profit, increase of the reasonableness of making managerial decisions.

  1. [Pricing system for costly equipment. Cost allocation adapted to technical operating costs].

    Science.gov (United States)

    Alies-Patin, A

    1990-10-01

    1. Our study consists on analysing annual technical operating costs (excluding professional fees) of computed tomography and extracorporeal lithotripsy in order to define a pricing system able to provide proper reimbursements of technical costs for costly equipment. 2. Economic and utilization data have been collected from physicians responsible for facilities and from equipment current manufacturers. Annual charges are assessed in function of annual volume of procedures. 3. Definition of mean costs (total mean cost, mean cost of one more procedure) and mean cost distribution analysis according to annual volume of procedures lead to propose a method for financing costly technical medical activities based on a two-price rate: until a defined number of procedures is reached, a full-rate reimbursement is applied and then, it is replaced by a reduced-rate reimbursement. 4. Such a pricing system is easy to manage and allows to fit annual technical receipts to annual technical expenditure on a wide range of patient procedure volume.

  2. Effects of a mobility monitoring system on the cost of care in relation to reimbursement at Swiss nursing homes: learnings from a randomized controlled trial.

    Science.gov (United States)

    Stark, Mario; Tietz, Rigo; Gattinger, Heidrun; Hantikainen, Virpi; Ott, Stefan

    2017-12-01

    Nursing homes in Switzerland are under pressure to efficiently coordinate staff activities to cover their personnel costs under the care financing system. In this study, the use of a mobility monitoring system accompanied with case conferences was investigated in order to improve sleep quality and estimate the cost benefit of this intervention. In an open two-phase randomized controlled trial at three nursing homes, residents with cognitive impairment were randomly assigned to an intervention group and a control group. In the intervention group, a 10-week period of intensive use of the monitoring system and case conferences led by an advanced nurse practitioner (Phase I) was followed by 3 months of reduced use of the monitoring system and case conferences led by an internal registered nurse (Phase II). In the control group, the monitoring system was only used for data acquisition. Nurses reported the activities with a specifically developed tool. Based on the recorded activities, the cost of care was calculated. The correlating reimbursement per patient was calculated from the care levels in the Swiss reimbursement system. Data from 44 residents was included in the analysis with a linear mixed model. Although analysis revealed no statistically significant effects, results indicate that the use of a monitoring system can guide nurses in organizing their tasks to increase effectiveness. Information systems such as the mobility monitor can help to identify single outliers that do not correspond with the overall situation. In the health care system, problematic individual cases can account for a disproportionally high cost levels. It was shown that information systems can have a significant economic impact in the long run. The study is registered at the German Clinical Trials Register under the Nr. DRKS00006829 .

  3. A cost-effectiveness analysis of three components of a syndromic surveillance system for the early warning of epidemics in rural China.

    Science.gov (United States)

    Ding, Yan; Sauerborn, Rainer; Xu, Biao; Shaofa, Nie; Yan, Weirong; Diwan, Vinod K; Dong, Hengjin

    2015-11-14

    Syndromic surveillance systems (SSSs) collect non-specific syndromes in early stages of disease outbreaks. This makes an SSS a promising tool for the early detection of epidemics. An Integrated Surveillance System in rural China (ISSC project), which added an SSS to the existing Chinese surveillance system for the early warning of epidemics, was implemented from April 2012 to March 2014 in Jiangxi and Hubei Provinces. This study aims to measure the costs and effectiveness of the three components of the SSS in the ISSC project. The central measures of the cost-effectiveness analysis of the three components of the syndromic surveillance system were: 1) the costs per reported event, respectively, at the health facilities, the primary schools and the pharmacies; and 2) the operating costs per surveillance unit per year, respectively, at the health facilities, the primary schools and the pharmacies. Effectiveness was expressed by reporting outputs which were numbers of reported events, numbers of raw signals, and numbers of verified signals. The reported events were tracked through an internal data base. Signal verification forms and epidemiological investigation reports were collected from local country centers for disease control and prevention. We adopted project managers' perspective for the cost analysis. Total costs included set-up costs (system development and training) and operating costs (data collection, quality control and signal verification). We used self-designed questionnaires to collect cost data and received, respectively, 369 and 477 facility and staff questionnaires through a cross-sectional survey with a purposive sampling following the ISSC project. All data were entered into Epidata 3.02 and exported to Stata for descriptive analysis. The number of daily reported events per unit was the highest at pharmacies, followed by health facilities and finally primary schools. Variances existed within the three groups and also between Jiangxi and Hubei

  4. Building 834 -- Cost-effective and innovative design of remediation systems using surplus equipment from former weapons programs

    Energy Technology Data Exchange (ETDEWEB)

    Daley, P.F.; Landgraf, R.K.; Lima, M.R.; Lamarre, A.L.

    1995-07-01

    The Building 834 Complex at the Lawrence Livermore National Laboratory (LLNL) Site 300, has been used by the weapons development programs at LLNL as a testing facility for measuring component response to environmental stresses such as extreme temperature. The heat-exchange system at the facility used trichloroethene TCE, at times with adjuvants, as the primary heat-transfer media for over 20 years. Accidental spills, pipe failures, and seal blowouts over that period contributed to a substantial contaminant plume in a perched water-bearing zone underlying the Complex. Individual wells near the source area have produced ground water samples with TCE concentrations exceeding 800,000 ppb. In the last several years, the authors have developed a modular ground water and soil vapor extraction system for remediating the plume source area. The modular facility design permits the testing of new technologies to expedite remediation, and/or reduce the quantity of hazardous wastes generated as byproducts of the primary remedial activities. To contain costs, the authors have used equipment and components recycled from the original Building 834 Complex heat-exchange system, and surplus equipment from other LLNL divisions. The authors have executed two large-scale tests of energy injection systems for TCE destruction in air (a free-air electron beam and a pulsed, ultraviolet photolysis system), and a soil heating test for accelerating vapor extraction. New work plans for this unique site are being prepared, incorporating the lessons learned in developing new technology with recycled equipment.

  5. Comparing the cost-effectiveness of linezolid to trimethoprim/sulfamethoxazole plus rifampicin for the treatment of methicillin-resistant Staphylococcus aureus infection: a healthcare system perspective.

    Science.gov (United States)

    von Dach, E; Morel, C M; Murthy, A; Pagani, L; Macedo-Vinas, M; Olearo, F; Harbarth, S

    2017-09-01

    Few industry-independent studies have been conducted to compare the relative costs and benefits of drugs to treat methicillin-resistant Staphylococcus aureus (MRSA) infection. We performed a stochastic cost-effectiveness analysis comparing two treatment strategies-linezolid versus trimethoprim-sulfamethoxazole plus rifampicin-for the treatment of MRSA infection. We used cost and effectiveness data from a previously conducted clinical trial, complementing with other data from published literature, to compare the two regimens from a healthcare system perspective. Effectiveness was expressed in terms of quality-adjusted life-years (QALYs). Several sensitivity analyses were performed using Monte Carlo simulation, to measure the effect of potential parameter changes on the base-case model results, including potential differences related to type of infection and drug toxicity. Treatment of MRSA infection with trimethoprim-sulfamethoxazole plus rifampicin and linezolid were found to cost on average €146 and €2536, and lead to a gain of 0.916 and 0.881 QALYs, respectively. Treatment with trimethoprim-sulfamethoxazole plus rifampicin was found to be more cost-effective than linezolid in the base case and remained dominant over linezolid in most alternative scenarios, including different types of MRSA infection and potential disadvantages in terms of toxicity. With a willingness-to-pay threshold of €0, €50 000 and €200 000 per QALY gained, trimethoprim-sulfamethoxazole plus rifampicin was dominant in 100%, 96% and 85% of model iterations. A 95% discount on the current purchasing price of linezolid would be needed when it goes off-patent for it to represent better value for money compared with trimethoprim-sulfamethoxazole plus rifampicin. Combined treatment of trimethoprim-sulfamethoxazole plus rifampicin is more cost-effective than linezolid in the treatment of MRSA infection. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  6. A complete low cost radon detection system

    International Nuclear Information System (INIS)

    Bayrak, A.; Barlas, E.; Emirhan, E.; Kutlu, Ç.; Ozben, C.S.

    2013-01-01

    Monitoring the 222 Rn activity through the 1200 km long Northern Anatolian fault line, for the purpose of earthquake precursory, requires large number of cost effective radon detectors. We have designed, produced and successfully tested a low cost radon detection system (a radon monitor). In the detector circuit of this monitor, First Sensor PS100-7-CER-2 windowless PIN photodiode and a custom made transempedence/shaping amplifier were used. In order to collect the naturally ionized radon progeny to the surface of the PIN photodiode, a potential of 3500 V was applied between the conductive hemi-spherical shell and the PIN photodiode. In addition to the count rate of the radon progeny, absolute pressure, humidity and temperature were logged during the measurements. A GSM modem was integrated to the system for transferring the measurements from the remote locations to the data process center. - Author-Highlights: • Low cost radon detection. • Integrated GSM modem for early warning of radon anomalies. • Radon detection in environment

  7. Development of a secure and cost-effective infrastructure for the access of arbitrary web-based image distribution systems

    International Nuclear Information System (INIS)

    Hacklaender, T.; Demabre, N.; Cramer, B.M.; Kleber, K.; Schneider, H.

    2004-01-01

    Purpose: To build an infrastructure that enables radiologists on-call and external users a teleradiological access to the HTML-based image distribution system inside the hospital via internet. In addition, no investment costs should arise on the user side and the image data should be sent renamed using cryptographic techniques. Materials and Methods: A pure HTML-based system manages the image distribution inside the hospital, with an open source project extending this system through a secure gateway outside the firewall of the hospital. The gateway handles the communication between the external users and the HTML server within the network of the hospital. A second firewall is installed between the gateway and the external users and builds up a virtual private network (VPN). A connection between the gateway and the external user is only acknowledged if the computers involved authenticate each other via certificates and the external users authenticate via a multi-stage password system. All data are transferred encrypted. External users get only access to images that have been renamed to a pseudonym by means of automated processing before. Results: With an ADSL internet access, external users achieve an image load frequency of 0.4 CT images per second. More than 90% of the delay during image transfer results from security checks within the firewalls. Data passing the gateway induce no measurable delay. (orig.)

  8. Is FDG PET/CT cost-effective for pre-operation staging of potentially operative non-small cell lung cancer? – From Chinese healthcare system perspective

    International Nuclear Information System (INIS)

    Wang, Yu-ting; Huang, Gang

    2012-01-01

    Objectives: The remarkable morbidity and mortality of lung cancer in the large population address major economic challenges to Chinese healthcare system. This study aims to assess the cost-effectiveness of fluorodeoxyglucose positron emission tomography (FDG PET)/CT for staging patients with non-small cell lung cancer (NSCLC) in China. Methods: Management of potentially operative NSCLC was modeled on decision analysis employing data in China. The strategies compared were conventional CT staging (strategy A), additional PET/CT in all patients (strategy B) or only in patients with normal-sized lymph nodes on CT (strategy C). Published medical data for Chinese patients was extracted. The costs corresponded to reimbursement by Chinese public health provider in 2010. Uncertainly of employed parameters was calculated in sensitivity analysis. Results: Taking strategy A as baseline, the incremental cost-effectiveness ratio (ICER) of strategy B was 23,800 RMB ($3500) per life year saved, which was acceptable in views of a developing country as China; while strategy C exhibited some loss of life years. Sensitivity analysis suggested the ICER (B–A) was raised more remarkably by a deterioration of PET specificity than by that of its sensitivity. The ICER was turned negative by PET specificity lower than 0.79. Economically, PET cost was proportional to the ICER (B–A), and decrease of palliative therapy cost could reduce both the ICER and overall cost. Conclusions: The PET/CT strategy is potentially cost-effective for management of NSCLC in China. Patients with nodal-positive CT results are not suggested to be excluded from further PET/CT. Furthermore, maintaining high specificity of PET in clinical scenarios is crucial. Prospective trials are warranted to transfer these results into policy making.

  9. Cost-effectiveness analysis of human papillomavirus DNA testing and Pap smear for cervical cancer screening in a publicly financed health-care system.

    Science.gov (United States)

    Chow, I H-I; Tang, C-H; You, S-L; Liao, C-H; Chu, T-Y; Chen, C-J; Chen, C-A; Pwu, R-F

    2010-12-07

    to evaluate the long-term cost-effectiveness of different strategies for human papillomavirus (HPV) DNA testing combined with Pap smear for cervical cancer screening in Taiwan. this study adopts a perspective of Department of Health in cost-effectiveness analysis to compare a no-screening strategy with nine different screening strategies. These strategies comprise three screening tools (Pap smear alone, HPV DNA testing followed by Pap smear triage, and HPV DNA testing combined with Pap smear), and three screening intervals (annually, every 3 years, and every 5 years). Outcomes are life expectancy, quality-adjusted life years (QALYs), lifetime costs, and incremental cost-effectiveness ratios (ICERs). Probabilistic sensitivity analyses (PSAs) were conducted to assess parameter uncertainty. when three times gross domestic product per capita is used as the decision threshold, all nine screening strategies were cost-effective compared with the no-screening strategy. Compared with the current screening strategy (an annual Pap smear), HPV DNA testing followed by Pap smear triage every 5 years and every 3 years were cost-effective. Results of PSA also indicated that a HPV DNA testing followed by Pap smear triage every 5 or every 3 years achieved the highest expected net benefits. possible economic advantages are associated with extending the cervical cancer screening interval from one Pap smear annually to HPV DNA testing followed by Pap smear triage every 5 years with an ICER $1 247 000 per QALY gained, especially in a country with a publicly financed health-care system. 2010 Cancer Resaerch UK.

  10. The EOS 2D/3D X-ray imaging system: a cost-effectiveness analysis quantifying the health benefits from reduced radiation exposure.

    Science.gov (United States)

    Faria, Rita; McKenna, Claire; Wade, Ros; Yang, Huiqin; Woolacott, Nerys; Sculpher, Mark

    2013-08-01

    To evaluate the cost-effectiveness of the EOS(®) 2D/3D X-ray imaging system compared with standard X-ray for the diagnosis and monitoring of orthopaedic conditions. A decision analytic model was developed to quantify the long-term costs and health outcomes, expressed as quality-adjusted life years (QALYs) from the UK health service perspective. Input parameters were obtained from medical literature, previously developed cancer models and expert advice. Threshold analysis was used to quantify the additional health benefits required, over and above those associated with radiation-induced cancers, for EOS(®) to be considered cost-effective. Standard X-ray is associated with a maximum health loss of 0.001 QALYs, approximately 0.4 of a day in full health, while the loss with EOS(®) is a maximum of 0.00015 QALYs, or 0.05 of a day in full health. On a per patient basis, EOS(®) is more expensive than standard X-ray by between £10.66 and £224.74 depending on the assumptions employed. The results suggest that EOS(®) is not cost-effective for any indication. Health benefits over and above those obtained from lower radiation would need to double for EOS to be considered cost-effective. No evidence currently exists on whether there are health benefits associated with imaging improvements from the use of EOS(®). The health benefits from radiation dose reductions are very small. Unless EOS(®) can generate additional health benefits as a consequence of the nature and quality of the image, comparative patient throughput with X-ray will be the major determinant of cost-effectiveness. Crown Copyright © 2013. Published by Elsevier Ireland Ltd. All rights reserved.

  11. Cost and performance analysis of physical security systems

    Energy Technology Data Exchange (ETDEWEB)

    Hicks, M.J. [Sandia National Lab., Albuquerque, NM (United States); Yates, D.; Jago, W.H. [Tecolote Research, Inc., Santa Barbara, CA (United States)] [and others

    1997-06-01

    CPA - Cost and Performance Analysis - is a prototype integration of existing PC-based cost and performance analysis tools: ACEIT (Automated Cost Estimating Integrated Tools) and ASSESS (Analytic System and Software for Evaluating Safeguards and Security). ACE is an existing DOD PC-based tool that supports cost analysis over the full life cycle of a system; that is, the cost to procure, operate, maintain and retire the system and all of its components. ASSESS is an existing DOE PC-based tool for analysis of performance of physical protection systems. Through CPA, the cost and performance data are collected into Excel workbooks, making the data readily available to analysts and decision makers in both tabular and graphical formats and at both the system and subsystem levels. The structure of the cost spreadsheets incorporates an activity-based approach to cost estimation. Activity-based costing (ABC) is an accounting philosophy used by industry to trace direct and indirect costs to the products or services of a business unit. By tracing costs through security sensors and procedures and then mapping the contributions of the various sensors and procedures to system effectiveness, the CPA architecture can provide security managers with information critical for both operational and strategic decisions. The architecture, features and applications of the CPA prototype are presented. 5 refs., 3 figs.

  12. Cost and performance analysis of physical security systems

    International Nuclear Information System (INIS)

    Hicks, M.J.; Yates, D.; Jago, W.H.

    1997-01-01

    CPA - Cost and Performance Analysis - is a prototype integration of existing PC-based cost and performance analysis tools: ACEIT (Automated Cost Estimating Integrated Tools) and ASSESS (Analytic System and Software for Evaluating Safeguards and Security). ACE is an existing DOD PC-based tool that supports cost analysis over the full life cycle of a system; that is, the cost to procure, operate, maintain and retire the system and all of its components. ASSESS is an existing DOE PC-based tool for analysis of performance of physical protection systems. Through CPA, the cost and performance data are collected into Excel workbooks, making the data readily available to analysts and decision makers in both tabular and graphical formats and at both the system and subsystem levels. The structure of the cost spreadsheets incorporates an activity-based approach to cost estimation. Activity-based costing (ABC) is an accounting philosophy used by industry to trace direct and indirect costs to the products or services of a business unit. By tracing costs through security sensors and procedures and then mapping the contributions of the various sensors and procedures to system effectiveness, the CPA architecture can provide security managers with information critical for both operational and strategic decisions. The architecture, features and applications of the CPA prototype are presented. 5 refs., 3 figs

  13. Costing the OMNIUM-G system 7500

    Science.gov (United States)

    Fortgang, H. R.

    1980-05-01

    A complete OMNIUM-G System 7500 was cost analyzed for annual production quantities ranging from 25 to 10,000 units per year. Parts and components were subjected to in-depth scrutiny to determine optimum manufacturing processes, coupled with make or buy decisions on materials and small parts. When production quantities increase both labor and material costs reduce substantially. A redesign of the system that was analyzed could result in lower costs when annual production runs approach 100,000 units/year. Material and labor costs for producing 25, 100, 25,000 and 100,00 units are given for 17 subassembly units.

  14. Open-source electronic data capture system offered increased accuracy and cost-effectiveness compared with paper methods in Africa.

    Science.gov (United States)

    Dillon, David G; Pirie, Fraser; Rice, Stephen; Pomilla, Cristina; Sandhu, Manjinder S; Motala, Ayesha A; Young, Elizabeth H

    2014-12-01

    Existing electronic data capture options are often financially unfeasible in resource-poor settings or difficult to support technically in the field. To help facilitate large-scale multicenter studies in sub-Saharan Africa, the African Partnership for Chronic Disease Research (APCDR) has developed an open-source electronic questionnaire (EQ). To assess its relative validity, we compared the EQ against traditional pen-and-paper methods using 200 randomized interviews conducted in an ongoing type 2 diabetes case-control study in South Africa. During its 3-month validation, the EQ had a lower frequency of errors (EQ, 0.17 errors per 100 questions; paper, 0.73 errors per 100 questions; P-value ≤0.001), and a lower monetary cost per correctly entered question, compared with the pen-and-paper method. We found no marked difference in the average duration of the interview between methods (EQ, 5.4 minutes; paper, 5.6 minutes). This validation study suggests that the EQ may offer increased accuracy, similar interview duration, and increased cost-effectiveness compared with paper-based data collection methods. The APCDR EQ software is freely available (https://github.com/apcdr/questionnaire). Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

  15. Optimal expansion of a drinking water infrastructure system with respect to carbon footprint, cost-effectiveness and water demand.

    Science.gov (United States)

    Chang, Ni-Bin; Qi, Cheng; Yang, Y Jeffrey

    2012-11-15

    Urban water infrastructure expansion requires careful long-term planning to reduce the risk from climate change during periods of both economic boom and recession. As part of the adaptation management strategies, capacity expansion in concert with other management alternatives responding to the population dynamics, ecological conservation, and water management policies should be systematically examined to balance the water supply and demand temporally and spatially with different scales. To mitigate the climate change impact, this practical implementation often requires a multiobjective decision analysis that introduces economic efficiencies and carbon-footprint matrices simultaneously. The optimal expansion strategies for a typical water infrastructure system in South Florida demonstrate the essence of the new philosophy. Within our case study, the multiobjective modeling framework uniquely features an integrated evaluation of transboundary surface and groundwater resources and quantitatively assesses the interdependencies among drinking water supply, wastewater reuse, and irrigation water permit transfer as the management options expand throughout varying dimensions. With the aid of a multistage planning methodology over the partitioned time horizon, such a systems analysis has resulted in a full-scale screening and sequencing of multiple competing objectives across a suite of management strategies. These strategies that prioritize 20 options provide a possible expansion schedule over the next 20 years that improve water infrastructure resilience and at low life-cycle costs. The proposed method is transformative to other applications of similar water infrastructure systems elsewhere in the world. Copyright © 2012 Elsevier Ltd. All rights reserved.

  16. Costs, health effects and cost-effectiveness of alcohol and tobacco control strategies in Estonia.

    NARCIS (Netherlands)

    Lai, T.; Habicht, J.; Reinap, M.; Chisholm, D.; Baltussen, R.M.P.M.

    2007-01-01

    OBJECTIVE: To assess the population-level costs, effects and cost-effectiveness of different alcohol and tobacco control strategies in Estonia. DESIGN: A WHO cost-effectiveness modelling framework was used to estimate the total costs and effects of interventions. Costs were assessed in Estonian

  17. Results and assessment of participation of VUPEK in coordinated research project of the IAEA ''Comparison of cost-effectiveness of risk reduction among different energy systems''

    International Nuclear Information System (INIS)

    Kadlec, J.; Horacek, P.

    1989-01-01

    The results and conclusions are summarized of the research programme ''Comparison of cost-effectiveness of risk reduction among different energy systems'' co-ordinated in 1983 to 1988 by the International Atomic Energy Agency. Institutes in 18 member states were involved which performed 33 case studies in the field of risk reduction in various power systems or their parts. A comparison with cost-effectiveness of risk reduction in other fields was made as well. The health risks (occupational, those of population) and the environmental risks were evaluated. The case studies cover various stages of the decision-making process and various decision makers. The solution resulted in 5 methodological studies and 16 models. 11 case studies and 1 methodological study were conducted by the Research Institute of the Fuel and Energy Complex. The experiences obtained, the questions so far unanswered and recommendations for those who will perform similar studies are given. (author). 1 fig., 2 tabs., 3 refs

  18. The Launch Systems Operations Cost Model

    Science.gov (United States)

    Prince, Frank A.; Hamaker, Joseph W. (Technical Monitor)

    2001-01-01

    One of NASA's primary missions is to reduce the cost of access to space while simultaneously increasing safety. A key component, and one of the least understood, is the recurring operations and support cost for reusable launch systems. In order to predict these costs, NASA, under the leadership of the Independent Program Assessment Office (IPAO), has commissioned the development of a Launch Systems Operations Cost Model (LSOCM). LSOCM is a tool to predict the operations & support (O&S) cost of new and modified reusable (and partially reusable) launch systems. The requirements are to predict the non-recurring cost for the ground infrastructure and the recurring cost of maintaining that infrastructure, performing vehicle logistics, and performing the O&S actions to return the vehicle to flight. In addition, the model must estimate the time required to cycle the vehicle through all of the ground processing activities. The current version of LSOCM is an amalgamation of existing tools, leveraging our understanding of shuttle operations cost with a means of predicting how the maintenance burden will change as the vehicle becomes more aircraft like. The use of the Conceptual Operations Manpower Estimating Tool/Operations Cost Model (COMET/OCM) provides a solid point of departure based on shuttle and expendable launch vehicle (ELV) experience. The incorporation of the Reliability and Maintainability Analysis Tool (RMAT) as expressed by a set of response surface model equations gives a method for estimating how changing launch system characteristics affects cost and cycle time as compared to today's shuttle system. Plans are being made to improve the model. The development team will be spending the next few months devising a structured methodology that will enable verified and validated algorithms to give accurate cost estimates. To assist in this endeavor the LSOCM team is part of an Agency wide effort to combine resources with other cost and operations professionals to

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

    Science.gov (United States)

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

    2011-01-01

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

  20. Supporting the delivery of cost-effective interventions in primary health-care systems in low-income and middle-income countries: an overview of systematic reviews.

    Science.gov (United States)

    Lewin, Simon; Lavis, John N; Oxman, Andrew D; Bastías, Gabriel; Chopra, Mickey; Ciapponi, Agustín; Flottorp, Signe; Martí, Sebastian García; Pantoja, Tomas; Rada, Gabriel; Souza, Nathan; Treweek, Shaun; Wiysonge, Charles S; Haines, Andy

    2008-09-13

    Strengthening health systems is a key challenge to improving the delivery of cost-effective interventions in primary health care and achieving the vision of the Alma-Ata Declaration. Effective governance, financial and delivery arrangements within health systems, and effective implementation strategies are needed urgently in low-income and middle-income countries. This overview summarises the evidence from systematic reviews of health systems arrangements and implementation strategies, with a particular focus on evidence relevant to primary health care in such settings. Although evidence is sparse, there are several promising health systems arrangements and implementation strategies for strengthening primary health care. However, their introduction must be accompanied by rigorous evaluations. The evidence base needs urgently to be strengthened, synthesised, and taken into account in policy and practice, particularly for the benefit of those who have been excluded from the health care advances of recent decades.

  1. Remediation of uranium-contaminated soil using the Segmented Gate System and containerized vat leaching techniques: a cost effectiveness study

    International Nuclear Information System (INIS)

    Cummings, M.; Booth, S.R.

    1996-01-01

    Because it is difficult to characterize heterogeneously contaminated soils in detail and to excavate such soils precisely using heavy equipment, it is common for large quantities of uncontaminated soil to be removed during excavation of contaminated sites. Until now, volume reduction of radioactively contaminated soil depended upon manual screening and analysis of samples, a costly and impractical approach, particularly with large volumes of heterogeneously contaminated soil. The baseline approach for the remediation of soils containing radioactive waste is excavation, pretreatment, containerization, and disposal at a federally permitted landfill. However, disposal of low-level radioactive waste is expensive and storage capacity is limited. ThermoNuclean's Segmented Gate System (SGS) removes only the radioactively contaminated soil, in turn greatly reducing the volume of soils that requires disposal. After processing using the SGS, the fraction of contaminated soil is processed using the containerized vat leaching (CVL) system developed at LANL. Uranium is leached out of the soil in solution. The uranium is recovered with an ion exchange resin, leaving only a small volume of liquid low-level waste requiring disposal. The reclaimed soil can be returned to its original location after treatment with CVL

  2. Extreme Cost Reductions with Multi-Megawatt Centralized Inverter Systems

    Energy Technology Data Exchange (ETDEWEB)

    Schwabe, Ulrich [Alencon LLC; Fishman, Oleg [Alencon LLC

    2015-03-20

    The objective of this project was to fully develop, demonstrate, and commercialize a new type of utility scale PV system. Based on patented technology, this includes the development of a truly centralized inverter system with capacities up to 100MW, and a high voltage, distributed harvesting approach. This system promises to greatly impact both the energy yield from large scale PV systems by reducing losses and increasing yield from mismatched arrays, as well as reduce overall system costs through very cost effective conversion and BOS cost reductions enabled by higher voltage operation.

  3. Cost-effective personal workstation

    Science.gov (United States)

    Mun, In K.

    1990-07-01

    A cost-effective personal workstation has been designed and developed using PC based commercial products, to assist physicians and scientists who are interested in creating teaching programs based on CT and MR images, collecting interesting cases, carrying out research projects requiring original digital image information, or generating reports. The development hardware is based on an IBM PS/2 Model 80 with a 85 14 graphics adaptor, an optical disk, a trackball, a digitizing pad, a 9 track tape drive, a mouse, a T800 transputer card, an Ethernet card, a voice recognition card, and a fax machine. The software development has been done using Microsoft C under Windows/286, such that software can be used with any 80286/80386 PCs capably of supporting Windows/286.

  4. 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.

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

    International Nuclear Information System (INIS)

    Ribeiro, Rodrigo Antonini; Duncan, Bruce Bartholow; Ziegelmann, Patricia Klarmann; Stella, Steffan Frosi; Vieira, Jose Luiz da Costa; Restelatto, Luciane Maria Fabian; Polanczyk, Carisi Anne

    2015-01-01

    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

  6. 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.

  7. Assessing the effect of standardized cost systems on financial performance. A difference-in-differences approach for hospitals according to their technological level.

    Science.gov (United States)

    García-Cornejo, Beatriz; Pérez-Méndez, José A

    2018-02-01

    Promoting the improvement of standardized cost systems (CS) is one of the measures available to health policy makers for the purpose of improving efficiency in hospitals over the long-term. Nevertheless, very few studies evaluate the relationship between alternative CS and the costs really incurred. We use data from 242 hospitals of the Spanish National Health Service (NHS) between 2010 and 2013 in order to explore the determinants of the cost per adjusted patient day, using a difference-in-differences approach where the treatment is the implementation of an advanced CS. We also investigate if the association between advanced CS and unit cost is different depending upon the technological level of the hospital. Results show that hospitals with more advanced CS contained their costs better. However, the latter effect of advanced CS is lower in hospitals with a greater endowment of high technology. Results suggest that health authorities should support the development of CS, particularly in high-tech hospitals, which are usually larger and more complex hospitals that tend to accumulate a greater portion of NHS hospital sector expenditure. Copyright © 2018 Elsevier B.V. All rights reserved.

  8. Minimum Cost Nanosatellite Launch System, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — Delta Velocity Corporation proposes the development of a very low cost, highly responsive nanosat launch system. We propose to develop an integrated propulsion...

  9. Design of cost effective antennas for instrumentation radars

    CSIR Research Space (South Africa)

    Botha, L

    2012-09-01

    Full Text Available The cost of antennas for instrumentation radars are determined by the development cost. By re-use of the reflector system cost effective antennas can be designed. The factors governing the design of such antennas are described here....

  10. Evolutionary systems biology of amino acid biosynthetic cost in yeast.

    Directory of Open Access Journals (Sweden)

    Michael D Barton

    2010-08-01

    Full Text Available Every protein has a biosynthetic cost to the cell based on the synthesis of its constituent amino acids. In order to optimise growth and reproduction, natural selection is expected, where possible, to favour the use of proteins whose constituents are cheaper to produce, as reduced biosynthetic cost may confer a fitness advantage to the organism. Quantifying the cost of amino acid biosynthesis presents challenges, since energetic requirements may change across different cellular and environmental conditions. We developed a systems biology approach to estimate the cost of amino acid synthesis based on genome-scale metabolic models and investigated the effects of the cost of amino acid synthesis on Saccharomyces cerevisiae gene expression and protein evolution. First, we used our two new and six previously reported measures of amino acid cost in conjunction with codon usage bias, tRNA gene number and atomic composition to identify which of these factors best predict transcript and protein levels. Second, we compared amino acid cost with rates of amino acid substitution across four species in the genus Saccharomyces. Regardless of which cost measure is used, amino acid biosynthetic cost is weakly associated with transcript and protein levels. In contrast, we find that biosynthetic cost and amino acid substitution rates show a negative correlation, but for only a subset of cost measures. In the economy of the yeast cell, we find that the cost of amino acid synthesis plays a limited role in shaping transcript and protein expression levels compared to that of translational optimisation. Biosynthetic cost does, however, appear to affect rates of amino acid evolution in Saccharomyces, suggesting that expensive amino acids may only be used when they have specific structural or functional roles in protein sequences. However, as there appears to be no single currency to compute the cost of amino acid synthesis across all cellular and environmental

  11. Analysis of the performance and cost effectiveness of nine small wind energy conversion systems funded by the DOE small grants program

    Energy Technology Data Exchange (ETDEWEB)

    Kay, Joshua [Univ. of California, Berkeley, CA (United States)

    1982-04-01

    This report presents an analysis of the technical performance and cost effectiveness of nine small wind energy conversion systems (SWECS) funded during FY 1979 by the U.S. Department of Energy. Chapter 1 gives an analytic framework with which to evaluate the systems. Chapter 2 consists of a review of each of the nine projects, including project technical overviews, estimates of energy savings, and results of economic analysis. Chapter 3 summarizes technical, economic, and institutional barriers that are likely to inhibit widespread dissemination of SWECS technology.

  12. Local infiltration of rabies immunoglobulins without systemic intramuscular administration: An alternative cost effective approach for passive immunization against rabies.

    Science.gov (United States)

    Bharti, Omesh Kumar; Madhusudana, Shampur Narayan; Gaunta, Pyare Lal; Belludi, Ashwin Yajaman

    2016-03-03

    Presently the dose of rabies immunoglobulin (RIG) which is an integral part of rabies post exposure prophylaxis (PEP) is calculated based on body weight though the recommendation is to infiltrate the wound(s). This practice demands large quantities of RIG which may be unaffordable to many patients. In this background, we conducted this study to know if the quantity and cost of RIG can be reduced by restricting passive immunization to local infiltration alone and avoiding systemic intramuscular administration based on the available scientific evidence. Two hundred and sixty nine category III patients bitten by suspect or confirmed rabid dogs/animals were infiltrated with equine rabies immunoglobulin (ERIGs) in and around the wound. The quantity of ERIG used was proportionate to the size and number of wounds irrespective of their body weight. They were followed with a regular course of rabies vaccination by intra-dermal route. As against 363 vials of RIGs required for all these cases as per current recommendation based on body weight, they required only 42 vials of 5ml RIG. Minimum dose of RIGs given was 0.25 ml and maximum dose given was 8 ml. On an average 1.26 ml of RIGs was required per patient that costs Rs. 150 ($3). All the patients were followed for 9 months and they were healthy and normal at the end of observation period. With local infiltration, that required small quantities of RIG, the RIGs could be made available to all patients in times of short supply in the market. A total of 30 (11%) serum samples of patients were tested for rabies virus neutralizing antibodies by the rapid fluorescent focus inhibition test (RFFIT) and all showed antibody titers >0.5 IU/mL by day 14. In no case the dose was higher than that required based on body weight and no immunosuppression resulted. To conclude, this pilot study shows that local infiltration of RIG need to be considered in times of non-availability in the market or unaffordability by poor patients. This

  13. Cost of radon-barrier systems for uranium mill tailings

    International Nuclear Information System (INIS)

    Baker, E.G.; Hartley, J.N.

    1982-08-01

    This report deals specifically with the cost of three types of radon barrier systems, earthen covers, asphalt emulsion covers, and multilayer covers, which could meet standards proposed by the Environmental Protection Agency to stabilize uranium mill tailings located primarily in the western US. In addition, the report includes a sensitivity analysis of various factors which significantly effect the overall cost of the three systems. These analyses were based on a generic disposal site. Four different 3m thick earthen covers were tested and cost an average of $27/m 2 . The least expensive earthen cover cost was about $21/m 2 . The asphalt cover system (6 to 7 cm of asphalt topped with 0.6m of overburden) cost about $28/m 2 . The four multilayer covers averaged $57/m 2 , but materials handling problems encountered during the test inflated this cost above what was anticipated and significant cost reductions should be possible. The least expensive multilayer cover cost $43/m 2 . Based on the results of the Grand Junction field test we estimated the cost of covering the tailings from three high priority sites, Durango, Shiprock, and Salt Lake City (Vitro). The cost of a 3m earthen cover ranged from $18 to 33/m 2 for the seven disposal sites (two or three at each location) studied. The cost of asphalt cover systems were $23 to 28/m 2 and the multilayer cover costs were between $31 to 36/m 2 . The earthen cover costs are less than the Grand Junction field test cost primarily because cover material is available at or near most of the disposal sites selected. Earthen material was imported from 6 to 10 miles for the field test. Assuming more efficienct utilization of materials significantly reduced the cost of the multilayer covers

  14. Low-cost image analysis system

    Energy Technology Data Exchange (ETDEWEB)

    Lassahn, G.D.

    1995-01-01

    The author has developed an Automatic Target Recognition system based on parallel processing using transputers. This approach gives a powerful, fast image processing system at relatively low cost. This system scans multi-sensor (e.g., several infrared bands) image data to find any identifiable target, such as physical object or a type of vegetation.

  15. Changing HIV treatment eligibility under health system constraints in sub-Saharan Africa: investment needs, population health gains, and cost-effectiveness.

    Science.gov (United States)

    Hontelez, Jan A C; Chang, Angela Y; Ogbuoji, Osondu; de Vlas, Sake J; Bärnighausen, Till; Atun, Rifat

    2016-09-24

    We estimated the investment needs, population health gains, and cost-effectiveness of different policy options for scaling-up prevention and treatment of HIV in the 10 countries that currently comprise 80% of all people living with HIV in sub-Saharan Africa (Ethiopia, Kenya, Malawi, Mozambique, Nigeria, South Africa, Tanzania, Uganda, Zambia, and Zimbabwe). We adapted the established STDSIM model to capture the health system dynamics: demand-side and supply-side constraints in the delivery of antiretroviral treatment (ART). We compared different scenarios of supply-side (i.e. health system capacity) and demand-side (i.e. health seeking behavior) constraints, and determined the impact of changing guidelines to ART eligibility at any CD4 cell count within these constraints. Continuing current scale-up would require US$178 billion by 2050. Changing guidelines to ART at any CD4 cell count is cost-effective under all constraints tested in the model, especially in demand-side constrained health systems because earlier initiation prevents loss-to-follow-up of patients not yet eligible. Changing guidelines under current demand-side constraints would avert 1.8 million infections at US$208 per life-year saved. Treatment eligibility at any CD4 cell count would be cost-effective, even under health system constraints. Excessive loss-to-follow-up and mortality in patients not eligible for treatment can be avoided by changing guidelines in demand-side constrained systems. The financial obligation for sustaining the AIDS response in sub-Saharan Africa over the next 35 years is substantial and requires strong, long-term commitment of policy-makers and donors to continue to allocate substantial parts of their budgets.

  16. The relationship between effectiveness and costs measured by a risk-adjusted case-mix system: multicentre study of Catalonian population data bases

    Directory of Open Access Journals (Sweden)

    Flor-Serra Ferran

    2009-06-01

    Full Text Available Abstract Background The main objective of this study is to measure the relationship between morbidity, direct health care costs and the degree of clinical effectiveness (resolution of health centres and health professionals by the retrospective application of Adjusted Clinical Groups in a Spanish population setting. The secondary objectives are to determine the factors determining inadequate correlations and the opinion of health professionals on these instruments. Methods/Design We will carry out a multi-centre, retrospective study using patient records from 15 primary health care centres and population data bases. The main measurements will be: general variables (age and sex, centre, service [family medicine, paediatrics], and medical unit, dependent variables (mean number of visits, episodes and direct costs, co-morbidity (Johns Hopkins University Adjusted Clinical Groups Case-Mix System and effectiveness. The totality of centres/patients will be considered as the standard for comparison. The efficiency index for visits, tests (laboratory, radiology, others, referrals, pharmaceutical prescriptions and total will be calculated as the ratio: observed variables/variables expected by indirect standardization. The model of cost/patient/year will differentiate fixed/semi-fixed (visits costs of the variables for each patient attended/year (N = 350,000 inhabitants. The mean relative weights of the cost of care will be obtained. The effectiveness will be measured using a set of 50 indicators of process, efficiency and/or health results, and an adjusted synthetic index will be constructed (method: percentile 50. The correlation between the efficiency (relative-weights and synthetic (by centre and physician indices will be established using the coefficient of determination. The opinion/degree of acceptance of physicians (N = 1,000 will be measured using a structured questionnaire including various dimensions. Statistical analysis: multiple regression

  17. Development of cost-benefit analysis system

    International Nuclear Information System (INIS)

    Shiba, Tsuyoshi; Mishima, Tetsuya; Yuyama, Tomonori; Suzuki, Atsushi

    2001-01-01

    In order to promote the FDR development, it is necessary to see various benefits brought by introduction of FBR from multiple perspectives and have a good grasp of such benefits quantitatively and an adequate R and D investment scale which corresponds with them. In this study, the structured prototype in the previous study was improved to be able to perform cost-benefit analysis. An example of improvement made in the system is addition of subroutine used for comparison between new energy and benefits brought by introduction of FBR with special emphasis on addition of logic for analyzing externality about the new energy. Other improvement examples are modification of the Conventional Year Expense Ratio method of power generation cost to Average Durable Year Cost method, addition of database function and turning input data into database, and reviewing idea on cost by the type of waste material and price of uranium. The cost-benefit analysis system was also restructured utilizing Microsoft ACCESS so that it should have a data base function. As the result of the improvement mentioned above, we expect that the improved cost-benefit analysis system will have higher generality than the system before; therefore, great deal of benefits brought by application of the system in the future is expected. (author)

  18. An Evaluation of Cost-Effectiveness of Micro Computerized ...

    African Journals Online (AJOL)

    An Evaluation of Cost-Effectiveness of Micro Computerized Documentation System/Integrated Set of Information System (CDS/ISIS) Software of Raw Materials Research and Development Council (RMRDC), Abuja.

  19. Cost, cost-efficiency and cost-effectiveness of integrated family planning and HIV services.

    Science.gov (United States)

    Shade, Starley B; Kevany, Sebastian; Onono, Maricianah; Ochieng, George; Steinfeld, Rachel L; Grossman, Daniel; Newmann, Sara J; Blat, Cinthia; Bukusi, Elizabeth A; Cohen, Craig R

    2013-10-01

    To evaluate costs, cost-efficiency and cost-effectiveness of integration of family planning into HIV services. Integration of family planning services into HIV care and treatment clinics. A cluster-randomized trial. Twelve health facilities in Nyanza, Kenya were randomized to integrate family planning into HIV care and treatment; six health facilities were randomized to (nonintegrated) standard-of-care with separately delivered family planning and HIV services. We assessed costs, cost-efficiency (cost per additional use of more effective family planning), and cost-effectiveness (cost per pregnancy averted) associated with the first year of integration of family planning into HIV care. More effective family planning methods included oral and injectable contraceptives, subdermal implants, intrauterine device, and female and male sterilization. We collected cost data through interviews with study staff and review of financial records to determine costs of service integration. Integration of services was associated with an average marginal cost of $841 per site and $48 per female patient. Average overall and marginal costs of integration were associated with personnel costs [initial ($1003 vs. $872) and refresher ($498 vs. $330) training, mentoring ($1175 vs. $902) and supervision ($1694 vs. $1636)], with fewer resources required for other fixed ($18 vs. $0) and recurring expenses ($471 vs. $287). Integration was associated with a marginal cost of $65 for each additional use of more effective family planning and $1368 for each pregnancy averted. Integration of family planning and HIV services is feasible, inexpensive to implement, and cost-efficient in the Kenyan setting, and thus supports current Kenyan integration policy.

  20. The cost of systemic therapy for metastatic colorectal carcinoma in Slovenia: discrepancy analysis between cost and reimbursement.

    Science.gov (United States)

    Mesti, Tanja; Boshkoska, Biljana Mileva; Kos, Mitja; Tekavčič, Metka; Ocvirk, Janja

    2015-06-01

    The aim of the study was to estimate the direct medical costs of metastatic colorectal cancer (mCRC) treated at the Institute of Oncology Ljubljana and to question the healthcare payment system in Slovenia. Using an internal patient database, the costs of mCRC patients were estimated in 2009 by examining (1) mCRC direct medical related costs, and (2) the cost difference between payment received by Slovenian health insurance and actual mCRC costs. Costs were analysed in the treatment phase of the disease by assessing the direct medical costs of hospital treatment with systemic therapy together with hospital treatment of side effects, without assessing radiotherapy or surgical treatment. Follow-up costs, indirect medical costs, and nonmedical costs were not included. A total of 209 mCRC patients met all eligibility criteria. The direct medical costs of mCRC hospitalization with systemic therapy in Slovenia for 2009 were estimated as the cost of medications (cost of systemic therapy + cost of drugs for premedication) + labor cost (the cost of carrying out systemic treatment) + cost of lab tests + cost of imaging tests + KRAS testing cost + cost of hospital treatment due to side effects of mCRC treatment, and amounted to €3,914,697. The difference between the cost paid by health insurance and actual costs, estimated as direct medical costs of hospitalization of mCRC patients treated with systemic therapy at the Institute of Oncology Ljubljana in 2009, was €1,900,757.80. The costs paid to the Institute of Oncology Ljubljana by health insurance for treating mCRC with systemic therapy do not match the actual cost of treatment. In fact, the difference between the payment and the actual cost estimated as direct medical costs of hospitalization of mCRC patients treated with systemic therapy at the Institute of Oncology Ljubljana in 2009 was €1,900,757.80. The model Australian Refined Diagnosis Related Groups (AR-DRG) for cost assessment in oncology being currently used

  1. The Robustness and Effectiveness of the Triage System at Times of Overcrowding and the Extra Costs due to Inappropriate Use of Emergency Departments.

    Science.gov (United States)

    Cremonesi, Paolo; di Bella, Enrico; Montefiori, Marcello; Persico, Luca

    2015-10-01

    Overcrowding is one of the most harmful problems for Emergency Department (ED) management and the correct estimation of time resource absorption by each type of patient plays a strategic role in dealing with overcrowding and correctly programming ED activity. We aimed to investigate how overcrowding may affect urgent patients' waiting times (i.e., the robustness of the triage patient priority system) and to evaluate the extra costs due to inappropriate use of EDs. Data referring to 54,254 patients who accessed the ED of a major Italian hospital in 2011 were analyzed to study patient flows and overcrowding. To define an average per-patient cost, according to the severity of his or her health condition, the 2010 profit and loss account of the aforementioned hospital was studied and the time devoted by physicians to each type of patient was estimated by means of a self-reported survey. Empirical findings confirm a positive correlation between overcrowding and the time a patient has to wait before receiving treatment. This effect is relevant only for non-urgent patients who are responsible for the overcrowding itself. However, urgent patients' waiting times do not increase in the presence of overcrowding, confirming that the triage priority system is robust against the overcrowding situation. The analysis estimates, using 2010 data, that the actual per patient cost incurred by the hospital when treating white-coded patients is, on average, 36.54 euros; a green code costs 93.17, yellow 170.62, and red 227.62. It emerges that 4% of all the personnel costs are attributable to white color-code assistance, 67% to green codes, 23% to yellow codes, and the remaining 6% to red codes. The implementation of effective policies intended to improve both efficiency and quality in providing emergency health services has to deal with the systemic problem of inappropriate use of EDs. Policy-makers should be aware of the fact that there is a considerable portion of ED demand for

  2. Combined modality therapy versus chemotherapy alone as an induction regimen for primary central nervous system lymphoma: a cost-effectiveness analysis.

    Science.gov (United States)

    Prica, A; Chan, K; Cheung, M

    2014-10-01

    In immunocompetent patients with primary central nervous system lymphoma (PCNSL), combined modality therapy (CMT) using high-dose methotrexate and radiotherapy (WBRT) has improved response rates compared with chemotherapy alone. The trade-off is delayed and potentially devastating treatment-related neurotoxicity (NT). A cost-effectiveness analysis using a Markov model compared CMT with chemotherapy alone in age-stratified patients with PCNSL. Baseline probabilities were derived from a systematic literature review. Direct and lost productivity costs were collected from a Canadian perspective and presented in Can$ in 2011. Outcomes were life expectancy, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratio. The quality-adjusted life expectancy was 1.55 QALYs for CMT and 1.53 QALYs for chemotherapy alone. In younger patients (aged <60 years), CMT yielded 2.44 QALYs, compared with 1.89 QALYs for chemotherapy alone, yielding an expected benefit with CMT of 0.55 QALYs or 6.6 quality-adjusted months. The CMT strategy dominated in younger patients, as it was Can$11 951 less expensive than chemotherapy alone. The chemotherapy-alone strategy dominated in older patients, as it was Can$11 244 less expensive than CMT, and there was no difference in QALYs between the strategies. The model was robust in sensitivity analyses of key variables tested through the plausible ranges obtained from costing sources and published literature. The preferred induction strategy for younger patients with PCNSL appears to be CMT, which minimized cost while maximizing life expectancy and QALYs. This analysis confirms that the preferred strategy for older patients is chemotherapy alone. © The Author(s) 2014. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. The cost-effectiveness of NBPTS teacher certification.

    Science.gov (United States)

    Yeh, Stuart S

    2010-06-01

    A cost-effectiveness analysis of the National Board for Professional Teaching Standards (NBPTS) program suggests that Board certification is less cost-effective than a range of alternative approaches for raising student achievement, including comprehensive school reform, class size reduction, a 10% increase in per pupil expenditure, the use of value-added statistical methods to identify effective teachers, and the implementation of systems where student performance in math and reading is rapidly assessed 2-5 times per week. The most cost-effective approach, rapid assessment, is three magnitudes as cost-effective as Board certification.

  4. An Evaluation of Cost-Effectiveness of Micro Computerized ...

    African Journals Online (AJOL)

    /Integrated Set of Information System (CDS/ISIS) application software in the library and its effectiveness in performance operations was evaluated to determine the costeffectiveness. The study population was made up of all the staff involved ...

  5. High-throughput determination of vancomycin in human plasma by a cost-effective system of two-dimensional liquid chromatography.

    Science.gov (United States)

    Sheng, Yanghao; Zhou, Boting

    2017-05-26

    Therapeutic drug monitoring (TDM) is one of the most important services of clinical laboratories. Two main techniques are commonly used: the immunoassay and chromatography method. We have developed a cost-effective system of two-dimensional liquid chromatography with ultraviolet detection (2D-LC-UV) for high-throughput determination of vancomycin in human plasma that combines the automation and low start-up costs of the immunoassay with the high selectivity and sensitivity of the liquid chromatography coupled with mass spectrometric detection without incurring their disadvantages, achieving high cost-effectiveness. This 2D-LC system offers a large volume injection to provide sufficient sensitivity and uses simulated gradient peak compression technology to control peak broadening and to improve peak shape. A middle column was added to reduce the analysis cycle time and make it suitable for high-throughput routine clinical assays. The analysis cycle time was 4min and the peak width was 0.8min. Compared with other chromatographic methods that have been developed, the analysis cycle time and peak width for vancomycin was reduced significantly. The lower limit of quantification was 0.20μg/mL for vancomycin, which is the same as certain LC-MS/MS methods that have been recently developed and validated. The method is rapid, automated, and low-cost and has high selectivity and sensitivity for the quantification of vancomycin in human plasma, thus making it well-suited for use in hospital clinical laboratories. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Cost-effectiveness and performance of overlay systems in Illinois, volume 1 : effectiveness assessment of HMA overlay interlayer systems used to retard reflective cracking.

    Science.gov (United States)

    2009-05-01

    This project evaluated the ability of interlayer systems used in HMA overlays to retard reflective cracking. Field : crack surveys and forensic investigation, including video imaging and ground penetrating radar surveys as well : as laboratory testin...

  7. [Relationship between cost systems and hospital expenditure].

    Science.gov (United States)

    García-Cornejo, Beatriz; Pérez-Méndez, José A

    To analyze the relationship between the degree of development of hospital cost systems (CS) implemented by the regional health services (RHS) and the variation in unit cost of hospitals in Spanish National Health Service (NHS) between 2010 and 2013 and to identify other explanatory factors of this variation. A database of NHS hospitals was constructed from exclusively public sources. Using a multilevel regression model, explaining factors of the variation in unit cost (cost per weighted unit of activity [WAU]) of a sample of 170 hospitals were analyzed. The variables representative of the degree of development of CS are associated in a negative and significant way with the variation of the cost per WAU. It is observed that if a high-level development CS is used the cost variation per WAU would be reduced by close to 3.2%. There is also a negative and significant relationship between the variation in the cost per WAU and the variations in the percentage of high technology and the hospital occupancy rate. On the other hand, the variations in the average cost of personnel and in the number of workers per 100 beds are associated in a positive and significant way with the variation of the cost per WAU. In the period analysed, during which the main health expenditure adjustment was made, the control in hospital unit cost is associated not only with spending cuts but also with aspects related to their management, such as the implementation of more developed CS. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Final Report: Hydrogen Storage System Cost Analysis

    Energy Technology Data Exchange (ETDEWEB)

    James, Brian David [Strategic Analysis Inc., Arlington, VA (United States); Houchins, Cassidy [Strategic Analysis Inc., Arlington, VA (United States); Huya-Kouadio, Jennie Moton [Strategic Analysis Inc., Arlington, VA (United States); DeSantis, Daniel A. [Strategic Analysis Inc., Arlington, VA (United States)

    2016-09-30

    The Fuel Cell Technologies Office (FCTO) has identified hydrogen storage as a key enabling technology for advancing hydrogen and fuel cell power technologies in transportation, stationary, and portable applications. Consequently, FCTO has established targets to chart the progress of developing and demonstrating viable hydrogen storage technologies for transportation and stationary applications. This cost assessment project supports the overall FCTO goals by identifying the current technology system components, performance levels, and manufacturing/assembly techniques most likely to lead to the lowest system storage cost. Furthermore, the project forecasts the cost of these systems at a variety of annual manufacturing rates to allow comparison to the overall 2017 and “Ultimate” DOE cost targets. The cost breakdown of the system components and manufacturing steps can then be used to guide future research and development (R&D) decisions. The project was led by Strategic Analysis Inc. (SA) and aided by Rajesh Ahluwalia and Thanh Hua from Argonne National Laboratory (ANL) and Lin Simpson at the National Renewable Energy Laboratory (NREL). Since SA coordinated the project activities of all three organizations, this report includes a technical description of all project activity. This report represents a summary of contract activities and findings under SA’s five year contract to the US Department of Energy (Award No. DE-EE0005253) and constitutes the “Final Scientific Report” deliverable. Project publications and presentations are listed in the Appendix.

  9. Distribution system costs associated with the deployment of photovoltaic systems

    Energy Technology Data Exchange (ETDEWEB)

    Horowitz, Kelsey A. W.; Palmintier, Bryan; Mather, Barry; Denholm, Paul

    2018-07-01

    The broadening of our energy system to include increasing amounts of wind and solar has led to significant debate about the total costs and benefits associated with different types of generators - with potentially far-reaching policy implications. This has included debate about the cost associated with integrating these generators onto the electric grid. For photovoltaics (PV), this encompasses costs incurred on both the bulk power and distribution systems, as well as the value provided to them. These costs and benefits, in particular those associated with integrating PV onto the distribution system, are not well understood. We seek to advance the state of understanding of 'grid integration costs' for the distribution system by reviewing prior literature and outlining a transparent, bottom-up approach that can be used to calculate these costs. We provide a clear delineation of costs to integrate PV in to the distribution system within the larger context of total costs and benefits associated with PV generators. We emphasize that these costs are situationally dependent, and that a single 'cost of integration' cannot be obtained. We additionally emphasize that benefits must be considered when evaluating the competitiveness of the technology in a given situation.

  10. Integrated waste management system costs in a MPC system

    International Nuclear Information System (INIS)

    Supko, E.M.

    1995-01-01

    The impact on system costs of including a centralized interim storage facility as part of an integrated waste management system based on multi-purpose canister (MPC) technology was assessed in analyses by Energy Resources International, Inc. A system cost savings of $1 to $2 billion occurs if the Department of Energy begins spent fuel acceptance in 1998 at a centralized interim storage facility. That is, the savings associated with decreased utility spent fuel management costs will be greater than the cost of constructing and operating a centralized interim storage facility

  11. Cost Effectiveness Study of Wastewater Management Systems for Selected U.S. Coast Guard Vessels. Volume I. Results of Cost and Effectiveness Analyses and Selection of Optimum Candidate Systems

    Science.gov (United States)

    1977-04-01

    above is in sharp contrast to approaches for quantifying effective- ness which are based on a fixed and preformulated expression for effective- ness... preformulated expression in terms of some specific variables. Instead, the following definition of effectiveness is used: The effectiveness of a candidate

  12. Cost-effectiveness thresholds: pros and cons.

    Science.gov (United States)

    Bertram, Melanie Y; Lauer, Jeremy A; De Joncheere, Kees; Edejer, Tessa; Hutubessy, Raymond; Kieny, Marie-Paule; Hill, Suzanne R

    2016-12-01

    Cost-effectiveness analysis is used to compare the costs and outcomes of alternative policy options. Each resulting cost-effectiveness ratio represents the magnitude of additional health gained per additional unit of resources spent. Cost-effectiveness thresholds allow cost-effectiveness ratios that represent good or very good value for money to be identified. In 2001, the World Health Organization's Commission on Macroeconomics in Health suggested cost-effectiveness thresholds based on multiples of a country's per-capita gross domestic product (GDP). In some contexts, in choosing which health interventions to fund and which not to fund, these thresholds have been used as decision rules. However, experience with the use of such GDP-based thresholds in decision-making processes at country level shows them to lack country specificity and this - in addition to uncertainty in the modelled cost-effectiveness ratios - can lead to the wrong decision on how to spend health-care resources. Cost-effectiveness information should be used alongside other considerations - e.g. budget impact and feasibility considerations - in a transparent decision-making process, rather than in isolation based on a single threshold value. Although cost-effectiveness ratios are undoubtedly informative in assessing value for money, countries should be encouraged to develop a context-specific process for decision-making that is supported by legislation, has stakeholder buy-in, for example the involvement of civil society organizations and patient groups, and is transparent, consistent and fair.

  13. Filmless versus film-based systems in radiographic examination costs: an activity-based costing method

    OpenAIRE

    Muto, Hiroshi; Tani, Yuji; Suzuki, Shigemasa; Yokooka, Yuki; Abe, Tamotsu; Sase, Yuji; Terashita, Takayoshi; Ogasawara, Katsuhiko

    2011-01-01

    Abstract Background Since the shift from a radiographic film-based system to that of a filmless system, the change in radiographic examination costs and costs structure have been undetermined. The activity-based costing (ABC) method measures the cost and performance of activities, resources, and cost objects. The purpose of this study is to identify the cost structure of a radiographic examination comparing a filmless system to that of a film-based system using the ABC method. Methods We calc...

  14. Impact of Platon ETC system on intercity trucking cost

    Directory of Open Access Journals (Sweden)

    Pogotovkina Natalya

    2017-01-01

    Full Text Available In 2015 Platon ETC System, a system of charging trucks with gross vehicle weight exceeding 12 tons, was implemented in Russia. The payment is collected as a compensation fo0 the damage caused to the federal public roads. Platon system is an additional source of financing for the road sector. However, its implementation made the carriers face the increasing costs. This paper presents the first results of the system functioning and the problems, associated with it. We consider the foreign systems of truck charging. The results of calculations, which show the effect of the toll collection on the prime cost of road freight transportation, are also presented.

  15. Accelerating PV Cost Effectiveness Through Systems Design, Engineering, and Quality Assurance: Phase I Annual Technical Report, 4 November 2004 - 3 November 2005

    Energy Technology Data Exchange (ETDEWEB)

    Botkin, J.

    2006-07-01

    During Phase I of this PV Manufacturing R&D subcontract, PowerLight Corporation has made significant progress toward the reduction of installed costs for commercial-scale, rooftop PV systems. PowerLight has worked to reduce operating costs by improving long-term reliability and performance through the development of more sophisticated tools used in system design and monitoring. Additionally, PowerLight has implemented design improvements with the goal of reducing cost while maintaining and/or improving product quality. As part of this effort, PowerLight also modified manufacturing and shipping processes to accommodate these design changes, streamline material flow, reduce cost, and decrease waste streams. During Phase II of this project, PowerLight plans to continue this work with the goal of reducing system cost and improving system performance.

  16. Parametric cost model for solar space power and DIPS systems

    International Nuclear Information System (INIS)

    Meisl, C.J.

    1993-01-01

    A detailed cost model has been developed to parametrically determine the program development and production cost of (1) photovoltaic, (2) solar dynamic and (3) dynamic isotope (DIPS) space power systems. The model is applicable in the net electrical power range of 3 to 300 kWe for solar power, and 0.5 to 10 kWe for DIPS. Application of the cost model allows spacecraft or space-based power system architecture and design trade studies or budgetary forecasting and cost benefit analyses. The cost model considers all major power subsystems (i.e., power generation, power conversion, energy storage, thermal management, and power management/distribution/control). It also considers system cost effects such as integration, testing, management, etc. The cost breakdown structure, model assumptions, ground rules, bases, Cost Estimation Relationship (CER) format and rationale are presented, and the application of the cost model to 100-kWe solar space power plants and to a 1.0-kWe DIPS are demonstrated

  17. Analysis of costs-benefits tradeoffs of complex security systems

    Energy Technology Data Exchange (ETDEWEB)

    Hicks, M.J. [Sandia National Labs., Albuquerque, NM (United States). Security Systems Analysis and Development Dept.

    1996-12-31

    Essential to a systems approach to design of security systems is an analysis of the cost effectiveness of alternative designs. While the concept of analysis of costs and benefits is straightforward, implementation can be at the least tedious and, for complex designs and alternatives, can become nearly intractable without the help of structured analysis tools. PACAIT--Performance and Cost Analysis Integrated Tools--is a prototype tool. The performance side of the analysis collates and reduces data from ASSESS, and existing DOE PC-based security systems performance analysis tool. The costs side of the analysis uses ACE, an existing DOD PC-based costs analysis tool. Costs are reported over the full life-cycle of the system, that is, the costs to procure, operate, maintain and retire the system and all of its components. Results are collected in Microsoft{reg_sign} Excel workbooks and are readily available to analysts and decision makers in both tabular and graphical formats and at both the system and path-element levels.

  18. Analysis of costs-benefits tradeoffs of complex security systems

    International Nuclear Information System (INIS)

    Hicks, M.J.

    1996-01-01

    Essential to a systems approach to design of security systems is an analysis of the cost effectiveness of alternative designs. While the concept of analysis of costs and benefits is straightforward, implementation can be at the least tedious and, for complex designs and alternatives, can become nearly intractable without the help of structured analysis tools. PACAIT--Performance and Cost Analysis Integrated Tools--is a prototype tool. The performance side of the analysis collates and reduces data from ASSESS, and existing DOE PC-based security systems performance analysis tool. The costs side of the analysis uses ACE, an existing DOD PC-based costs analysis tool. Costs are reported over the full life-cycle of the system, that is, the costs to procure, operate, maintain and retire the system and all of its components. Results are collected in Microsoft reg-sign Excel workbooks and are readily available to analysts and decision makers in both tabular and graphical formats and at both the system and path-element levels

  19. Activity-Based Costing Systems for Higher Education.

    Science.gov (United States)

    Day, Dennis H.

    1993-01-01

    Examines traditional costing models utilized in higher education and pinpoints shortcomings related to proper identification of costs. Describes activity-based costing systems as a superior alternative for cost identification, measurement, and allocation. (MLF)

  20. Cost-effectiveness of IDH testing in diffuse gliomas according to the 2016 WHO classification of tumors of the central nervous system recommendations.

    Science.gov (United States)

    DeWitt, John C; Jordan, Justin T; Frosch, Matthew P; Samore, Wesley R; Iafrate, A John; Louis, David N; Lennerz, Jochen K

    2017-11-29

    Due to the decreasing prevalence of IDH1 mutations in older patients, the 2016 World Health Organization (WHO) classification of brain tumors proposed not to perform sequencing for isocitrate dehydrogenase (IDH) in glioblastoma patients ≥55 years old. We present a cost-effectiveness analysis to estimate the financial impact of these guidelines. From 2010 to 2015 we performed 1023 IDH tests in gliomas, amounting to ~$1.09 million in direct laboratory test costs. Samples were tested using R132H-specific immunohistochemistry, DNA sequencing validated for detection of noncanonical IDH1/2 mutations, or both methods. In cases tested by DNA sequencing, the fraction of non-R132H mutations was 5.4%, which included only 2 high-grade gliomas in patients ≥55 years (0.9%). When remodeling the optimal age cutoff in our patient population using 5-year age-binning, we found a 10-times higher pretest probability for the presence of a noncanonical IDH1 mutation in the setting of a negative IDH1-R132H immunohistochemistry result in patients IDH mutations in glioblastoma patients ≥55 years argues against universal IDH sequencing in this population. We predict that adoption of this age-based sequencing cutoff recommendation from the 2016 WHO guidelines will result in significant cost and time savings throughout the global health care system.

  1. Gedanken Experiments in Educational Cost Effectiveness

    Science.gov (United States)

    Brudner, Harvey J.

    1978-01-01

    Discusses the effectiveness of cost determining techniques in education. The areas discussed are: education and management; cost-effectiveness models; figures of merit determination; and the implications as they relate to the areas of audio-visual and computer educational technology. (Author/GA)

  2. A cost-effectiveness analysis of water security and water quality: impacts of climate and land-use change on the River Thames system.

    Science.gov (United States)

    Whitehead, P G; Crossman, J; Balana, B B; Futter, M N; Comber, S; Jin, L; Skuras, D; Wade, A J; Bowes, M J; Read, D S

    2013-11-13

    The catchment of the River Thames, the principal river system in southern England, provides the main water supply for London but is highly vulnerable to changes in climate, land use and population. The river is eutrophic with significant algal blooms with phosphorus assumed to be the primary chemical indicator of ecosystem health. In the Thames Basin, phosphorus is available from point sources such as wastewater treatment plants and from diffuse sources such as agriculture. In order to predict vulnerability to future change, the integrated catchments model for phosphorus (INCA-P) has been applied to the river basin and used to assess the cost-effectiveness of a range of mitigation and adaptation strategies. It is shown that scenarios of future climate and land-use change will exacerbate the water quality problems, but a range of mitigation measures can improve the situation. A cost-effectiveness study has been undertaken to compare the economic benefits of each mitigation measure and to assess the phosphorus reductions achieved. The most effective strategy is to reduce fertilizer use by 20% together with the treatment of effluent to a high standard. Such measures will reduce the instream phosphorus concentrations to close to the EU Water Framework Directive target for the Thames.

  3. 78 FR 7718 - Review of the General Purpose Costing System

    Science.gov (United States)

    2013-02-04

    .... EP 431 (Sub-No. 4)] Review of the General Purpose Costing System AGENCY: Surface Transportation Board... Transportation Board (Board) is proposing certain changes to its general purpose costing system, the Uniform... general purpose costing system. Adoption of the Unif. R.R. Costing Sys. as a Gen. Purpose Costing Sys. for...

  4. A cost-effectiveness analysis of fistula treatment in the abdominal region using a new integrated fistula and wound management system

    DEFF Research Database (Denmark)

    Keiding, Hans; Skovgaard, Rasmus

    2008-01-01

    OBJECTIVE: To evaluate wear time and costs of a new fistula and wound management system (FWMS) compared to standard fistula treatments. METHODS: Data were collected from 22 patients with an abdominal fistula recruited from 5 sites in the United States. This economic evaluation was based on a cost......, the sensitivity analysis showed that 77% of patients achieved a cost reduction when changing to the FWMS. CONCLUSION: The FWMS was less costly than traditional methods for managing abdominal fistula, probably due to longer wear time and less time spent on each pouching session....

  5. Axiomatic foundations for cost-effectiveness analysis.

    Science.gov (United States)

    Canning, David

    2013-12-01

    We show that individual utilities can be measured in units of healthy life years. Social preferences over these life metric utilities are assumed to satisfy the Pareto principle, anonymity, and invariance to a change in origin. These axioms generate a utilitarian social welfare function implying the use of cost-effectiveness analysis in ordering health projects, based on maximizing the healthy years equivalents gained from a fixed health budget. For projects outside the health sector, our cost-effectiveness axioms imply a form of cost-benefit analysis where both costs and benefits are measured in equivalent healthy life years. Copyright © 2013 John Wiley & Sons, Ltd.

  6. Potential and cost-effectiveness of off-grid PV systems in Indonesia - An evaluation on a provincial level

    NARCIS (Netherlands)

    Veldhuis, A.J.; Reinders, Angelina H.M.E.

    2014-01-01

    In this study we estimate the potential of off-grid PV systems in Indonesia at a provincial level as a follow-up of a study on the potential of grid-connected PV systems in Indonesia which we executed in 2012 [1]. For this study we use an adapted methodology leading to cumulative numbers for the

  7. A Novel System for Rapid and Cost-Effective Production of Detection and Diagnostic Reagents of West Nile Virus in Plants

    Directory of Open Access Journals (Sweden)

    Junyun He

    2012-01-01

    Full Text Available The threat of West Nile virus (WNV epidemics necessitates the development of a technology platform that can produce reagents to support detection and diagnosis rapidly and inexpensively. A plant expression system is attractive for protein production due to its low-cost and high-scalability nature and its ability to make appropriate posttranslational modifications. Here, we investigated the feasibility of using plants to produce two WNV detection and diagnostic reagents to address the current cost and scalability issues. We demonstrated that WNV DIII antigen and E16 monoclonal antibody are rapidly produced at high levels in two plant species and are easily purified. Furthermore, they are effective in identifying WNV and in detecting human IgM response to WNV infection. E16 mAb does not cross-react with other flaviviruses, therefore, is valuable for improving diagnostic accuracy. This study provides a proof of principle for using plants as a robust and economical system to produce diagnostic reagents for arboviruses.

  8. Working paper : the ITS cost data repository at Mitretek Systems

    Science.gov (United States)

    1998-11-30

    Mitretek Systems has been tasked by the Intelligent Transportation Systems (ITS) Joint Program Office (JPO) to collect available information on ITS costs and maintain the information in a cost database, which serves as the ITS Cost Data Repository. T...

  9. Costs and effects in lumbar spinal fusion

    DEFF Research Database (Denmark)

    Soegaard, Rikke; Christensen, Finn Bjarke; Christiansen, Terkel

    2007-01-01

    consecutive patients with chronic low back pain, who were surgically treated from January 2001 through January 2003, was followed until 2 years postoperatively. Operations took place at University Hospital of Aarhus and all patients had either (1) non-instrumented posterolateral lumbar spinal fusion, (2......) instrumented posterolateral lumbar spinal fusion, or (3) instrumented posterolateral lumbar spinal fusion + anterior intervertebral support. Analysis of costs was performed at the patient-level, from an administrator's perspective, by means of Activity-Based-Costing. Clinical effects were measured by means...... of the Dallas Pain Questionnaire and the Low Back Pain Rating Scale at baseline and 2 years postoperatively. Regression models were used to reveal determinants for costs and effects. Costs and effects were analyzed as a net-benefit measure to reveal determinants for cost-effectiveness, and finally, adjusted...

  10. PLACE OF PRODUCTION COSTS SYSTEM ANALYSIS IN SYSTEM ANALYSIS

    Directory of Open Access Journals (Sweden)

    Mariia CHEREDNYCHENKO

    2016-12-01

    Full Text Available Current economic conditions require the development and implementation of an adequate system of production costs, which would ensure a steady profit growth and production volumes in a highly competitive, constantly increasing input prices and tariffs. This management system must be based on an integrated production costs system analysis (PCSA, which would provide all operating costs management subsystems necessary information to design and make better management decisions. It provides a systematic analysis of more opportunities in knowledge, creating conditions of integrity mechanism knowledge object consisting of elements that show intersystem connections, each of which has its own defined and limited objectives, relationship with the environment.

  11. Systems effectiveness

    CERN Document Server

    Habayeb, A R

    1987-01-01

    Highlights three principal applications of system effectiveness: hardware system evaluation, organizational development and evaluation, and conflict analysis. The text emphasizes the commonality of the system effectiveness discipline. The first part of the work presents a framework for system effectiveness, partitioning and hierarchy of hardware systems. The second part covers the structure, hierarchy, states, functions and activities of organizations. Contains an extended Appendix on mathematical concepts and also several project suggestions.

  12. Cost effectiveness of detritiating water with resin columns

    International Nuclear Information System (INIS)

    Drake, R.H.; Williams, D.S.

    1997-10-01

    There are technologies in use for cleaning up concentrated tritiated process water. These are not cost effective for tritiated water with low concentrations of tritium. There are currently no cost-effective technologies for cleaning up low-tritium-concentration tritiated water, such as most tritiated groundwater, spent fuel storage basin water, or underground storage tank water. Resin removal of tritium from tritiated water at low concentrations (near the order of magnitude of drinking water standard maximums) is being tested on TA-SO (Los Alamos National Laboratory's Liquid Radioactive Waste Treatment Facility) waste streams. There are good theoretical and test indications that this may be a technologically effective means of removing tritium from tritiated water. Because of likely engineering design similarity, it is reasonable to anticipate that a resin column system's costs will be similar to some common commercial water treatment systems. Thus, the potential cost effectiveness of a resin treatment system offers hope for treating tritiated water at affordable costs. The TA-50 resin treatment cost projection of $18 per 1,000 gallons is within the same order of magnitude as cost data for typical commercial groundwater cleanup projects. The prospective Los Alamos National Laboratory (LANL) resin treatment system at $18 per 1,000 gallons appears to have a likely cost advantage of at least an order of magnitude over the competing, developmental, water detritiation technologies

  13. Evaluation of a Non-Traditional College: Costs and Effectiveness.

    Science.gov (United States)

    McIntyre, Catherine E.; Wales, Christy A.

    This document compares the operating effectiveness and costs associated with Whatcom Community College (WCC), a non-campus educational system, to estimated alternative costs of a traditional campus operation for WCC. Comparative data were obtained by using three other colleges as proxy institutions for a hypothetical campus-based WCC. Among the…

  14. Long Term Cost Efficiency through Green Management Control Systems

    OpenAIRE

    Vukania Adda, Nancy; Qin, Xiaochen

    2012-01-01

    Title: Long term cost efficiency through green management control systems.Authors: Nancy Vukania &Xiaochen QinSupervisor: Åsa Karin-EngstrandBackground: The worldwide financial crisis of 2008 has reconfigured the economic turf leading to a more uncertain and turbulent playing field – a greater challenge for business strategy and the quest for optimization- The oil price hike of 2008 (Furlong 2010)1 caused its rippling effect to affect various cost categories including energy, labor and lo...

  15. A cost-effective sensor system to train light weight juggling using an interactive virtual reality interface

    Directory of Open Access Journals (Sweden)

    Bergamasco Massimo

    2011-12-01

    Full Text Available This paper presents a novel approach to train how to juggle using a sensor system based on one of the most commercial, sophisticated and accessible input devices, the Wii Remote controller. This platform, particularly its infrared camera, is used to develop a real-time sensor system for hand motion tracking and fit it into a virtual reality interface. The quality of our algorithm was tested through this 3D virtual interface, which has the finality to give the user visual feedback of his/her hand positions, and created for the user the sensation of juggling.

  16. Cost-effectiveness analysis of sandhill crane habitat management

    Science.gov (United States)

    Kessler, Andrew C.; Merchant, James W.; Shultz, Steven D.; Allen, Craig R.

    2013-01-01

    Invasive species often threaten native wildlife populations and strain the budgets of agencies charged with wildlife management. We demonstrate the potential of cost-effectiveness analysis to improve the efficiency and value of efforts to enhance sandhill crane (Grus canadensis) roosting habitat. We focus on the central Platte River in Nebraska (USA), a region of international ecological importance for migrating avian species including sandhill cranes. Cost-effectiveness analysis is a valuation process designed to compare alternative actions based on the cost of achieving a pre-determined objective. We estimated costs for removal of invasive vegetation using geographic information system simulations and calculated benefits as the increase in area of sandhill crane roosting habitat. We generated cost effectiveness values for removing invasive vegetation on 7 land parcels and for the entire central Platte River to compare the cost-effectiveness of management at specific sites and for the central Platte River landscape. Median cost effectiveness values for the 7 land parcels evaluated suggest that costs for creating 1 additional hectare of sandhill crane roosting habitat totaled US $1,595. By contrast, we found that creating an additional hectare of sandhill crane roosting habitat could cost as much as US $12,010 for some areas in the central Platte River, indicating substantial cost savings can be achieved by using a cost effectiveness analysis to target specific land parcels for management. Cost-effectiveness analysis, used in conjunction with geographic information systems, can provide decision-makers with a new tool for identifying the most economically efficient allocation of resources to achieve habitat management goals.

  17. Development of an accumulation-based system for cost-effective chamber measurements of inert trace gas fluxes

    DEFF Research Database (Denmark)

    Ambus, Per; Skiba, U.; Drewer, J.

    2010-01-01

    sampling with low-frequency chemical analysis. The System for Inert Gas Monitoring by Accumulation (SIGMA) is suited particularly for stand-alone observations in remote locations. The SIGMA is connected to an automated chamber with headspace sampling several times per day. Air samples are aggregated...

  18. Cost-effectiveness comparison between non-penetrating deep sclerectomy and maximum-tolerated medical therapy for glaucoma within the Brazilian National Health System (SUS

    Directory of Open Access Journals (Sweden)

    Ricardo Augusto Paletta Guedes

    2012-02-01

    Full Text Available PURPOSE: Non-penetrating deep sclerectomy (NPDS has emerged as a viable option in the surgical management of open-angle glaucoma. Our aim is to assess the cost-effectiveness of NPDS and to compare it to maximum medical treatment in a 5-year follow-up. METHODS: A decision analysis model was built. Surgical (NPDS arm of the decision tree was observational (consecutive retrospective case series and maximum medical treatment arm was hypothetical. Maximum medical therapy was considered a three-drug regimen (association of a fixed combination of timolol/dorzolamide [FCTD] and a prostaglandin analogue [bimatoprost, latanoprost or travoprost]. Cost-effectiveness ratio was defined as direct cost (US dollars for each percentage of intraocular pressure (IOP reduction. Horizon was 5 years and perspective is from the public health care service in Brazil (SUS. Incremental cost-effectiveness ratio (ICER was calculated. RESULTS: Direct cost for each percentage of IOP reduction in 5 years (cost-effectiveness ratio was US$ 10.19 for NPDS; US$ 37.45 for the association of a FCTD and bimatoprost; US$ 39.33 for FCTD and travoprost; and US$ 41.42 for FCTD and latanoprost. NPDS demonstrated a better cost-effectiveness ratio, compared to maximum medical therapy. The ICER was negative for all medical treatment options; therefore NPDS was dominant. CONCLUSIONS: Despite some limitations, NPDS was both less costly and more effective than maximum medical therapy. From the Brazilian public health perspective, it was the most cost-effective treatment option when compared to maximum medical therapy (FCTD and prostaglandin.

  19. Effect of different feeding strategies in intensive dairy farming systems on milk fatty acid profiles, and implications on feeding costs in Italy.

    Science.gov (United States)

    Borreani, G; Coppa, M; Revello-Chion, A; Comino, L; Giaccone, D; Ferlay, A; Tabacco, E

    2013-01-01

    The aim of this work was to characterize the fatty acid (FA) profile of milk from intensive dairy farming systems in the Po Plain (Italy) to estimate the costs of the adopted feeding strategies and to simulate the effect of supplementary premiums on the basis of milk FA composition on milk income. Twenty dairy farms with 5 different feeding strategies were studied: 3 corn silage-based systems in which cows were supplemented with a great proportion (CCH), a medium proportion (CCM), or without commercial concentrate mix (CC0), and 2 systems in which part of corn silage was replaced with grass or legume silage (HF) or with fresh herbage (G), cut and fed indoors. Bulk milk was sampled and lactating cow performance, feeding strategies and forage characteristics were recorded through a survey, 3 times during a year. The milk FA supplementary premium was calculated considering C18:3n-3 and saturated FA (SFA) concentrations, and ratio of total cis C18:1 isomers to C16:0. The CCH, CCM, and CC0 systems bought most of their dairy cow feeds off farm, which allowed them to increase milk production to 35,000 L/yr per hectare. Their low dry matter and crude protein self-sufficiency led to higher feeding costs per liter of milk (from €0.158 to €0.184), and highest income over feed cost was achieved only for milk yield performance greater than 10,000 kg/cow per year. The use of homegrown forages in HF and G increased dry matter and crude protein self-sufficiency and reduced the feeding costs per liter of milk from 9 to 22%, compared with the other studied systems, making HF and G feeding economically competitive, even for a lower milk yield per cow. The studied systems highlighted a remarkable variation in FA profiles. The concentrations of C16:0 and SFA were the highest in CCH (31.53 and 67.84 g/100g of FA) and G (31.23 and 68.45 g/100g of FA), because of the larger proportion of commercial concentrate mix in the cow diet. The concentrations of C16:0 and SFA were the lowest in

  20. On farm evaluation of the effect of low cost drip irrigation on water and crop productivity compared to conventional surface irrigation system

    Science.gov (United States)

    Maisiri, N.; Senzanje, A.; Rockstrom, J.; Twomlow, S. J.

    This on-farm research study was carried out at Zholube irrigation scheme in a semi-arid agro tropical climate of Zimbabwe to determine how low cost drip irrigation technologies compare with conventional surface irrigation systems in terms of water and crop productivity. A total of nine farmers who were practicing surface irrigation were chosen to participate in the study. The vegetable English giant rape ( Brassica napus) was grown under the two irrigation systems with three fertilizer treatments in each system: ordinary granular fertilizer, liquid fertilizer (fertigation) and the last treatment with no fertilizer. These trials were replicated three times in a randomized block design. Biometric parameters of leaf area index (LAI) and fresh weight of the produce, water use efficiency (WUE) were used to compare the performance of the two irrigation systems. A water balance of the inflows and outflows was kept for analysis of WUE. The economic profitability and the operation, maintenance and management requirements of the different systems were also evaluated. There was no significant difference in vegetable yield between the irrigation systems at 8.5 ton/ha for drip compared to 7.8 ton/ha in surface irrigation. There were significant increases in yields due to use of fertilizers. Drip irrigation used about 35% of the water used by the surface irrigation systems thus giving much higher water use efficiencies. The leaf area indices were comparable in both systems with the same fertilizer treatment ranging between 0.05 for surface without fertilizer to 6.8 for low cost drip with fertigation. Low cost drip systems did not reflect any labour saving especially when manually lifting the water into the drum compared to the use of siphons in surface irrigation systems. The gross margin level for surface irrigation was lower than for low cost drip irrigation but the gross margin to total variable cost ratio was higher in surface irrigation systems, which meant that surface

  1. The effects of product photographs and reputation systems on consumer behavior and product cost on eBay

    NARCIS (Netherlands)

    Van Der Heide, B.; Johnson, B.K.; Vang, M.H.

    2013-01-01

    For years, computer-mediated communication (CMC) research has explored and theorized about the effects of technology on the process of interpersonal impression formation. However, as the Internet has evolved to allow users to accomplish more and more day-to-day tasks (e. g., the buying and selling

  2. Cost-effectiveness analysis of strategies introducing FDG-PET into the mediastinal staging of non-small-cell lung cancer from the French healthcare system perspective

    International Nuclear Information System (INIS)

    Alzahouri, K.; Lejeune, C.; Woronoff-Lemsi, M.-C.; Arveux, P.; Guillemin, F.

    2005-01-01

    AIM: To determine the most cost-effective strategy using PET for mediastinal staging of potentially operable non-small-cell lung cancer (NSCLC). METHODS: Four decision strategies based on French NSCLC work-up practices for the selection of potential surgical candidates were compared, comprising CT only, PET for negative CT, PET for all with anatomical CT, and CT and PET for all cases. The medical literature was surveyed to obtain values for all variables of interest. Costs were assessed with reimbursements from the French healthcare insurance for the year 1999. Expected cost and life expectancy were calculated for all possible outcomes of each strategy. Sensitivity analysis was performed to determine the effects of changing variables on the expected cost and life expectancy. RESULTS: Compared with the CT only strategy, CT and PET for all resulted in a relative reduction of 70% of surgery for persons with mediastinal lymph node metastasis. PET for all with anatomical CT was shown to be a cost-effective alternative to the CT only, with life expectancy increased by 0.10 years and expected cost savings of 61 euros. This strategy was more favourable than PET for negative CT. Overall, sensitivity analyses showed the robustness of the results. CONCLUSION: The introduction of thoracic PET for NSCLC staging is potentially cost-effective in France. Further clinical investigation might help to validate this result

  3. Cost-effectiveness analysis of strategies introducing FDG-PET into the mediastinal staging of non-small-cell lung cancer from the French healthcare system perspective

    Energy Technology Data Exchange (ETDEWEB)

    Alzahouri, K. [CEC-Inserm, Service d' Epidemiologie et Evaluation Cliniques, C.H.U. de Nancy, Nancy (France); Lejeune, C. [Inserm EMI 01 06, Faculte de Medecine, BP 87900, Dijon (France); Woronoff-Lemsi, M.-C. [Service Pharmacie, Unite Evaluation Medico-economique, Besancon (France); Arveux, P. [Departement d' Information Medicale, Centre Georges-Francois Leclerc, Dijon (France); Guillemin, F. [CEC-Inserm, Service d' Epidemiologie et Evaluation Cliniques, C.H.U. de Nancy, Nancy (France)]. E-mail: f.guillemin@chu-nancy.fr

    2005-04-01

    AIM: To determine the most cost-effective strategy using PET for mediastinal staging of potentially operable non-small-cell lung cancer (NSCLC). METHODS: Four decision strategies based on French NSCLC work-up practices for the selection of potential surgical candidates were compared, comprising CT only, PET for negative CT, PET for all with anatomical CT, and CT and PET for all cases. The medical literature was surveyed to obtain values for all variables of interest. Costs were assessed with reimbursements from the French healthcare insurance for the year 1999. Expected cost and life expectancy were calculated for all possible outcomes of each strategy. Sensitivity analysis was performed to determine the effects of changing variables on the expected cost and life expectancy. RESULTS: Compared with the CT only strategy, CT and PET for all resulted in a relative reduction of 70% of surgery for persons with mediastinal lymph node metastasis. PET for all with anatomical CT was shown to be a cost-effective alternative to the CT only, with life expectancy increased by 0.10 years and expected cost savings of 61 euros. This strategy was more favourable than PET for negative CT. Overall, sensitivity analyses showed the robustness of the results. CONCLUSION: The introduction of thoracic PET for NSCLC staging is potentially cost-effective in France. Further clinical investigation might help to validate this result.

  4. US-China Clean Energy Research Center on Building Energy Efficiency: Materials that Improve the Cost-Effectiveness of Air Barrier Systems

    Energy Technology Data Exchange (ETDEWEB)

    Hun, Diana E. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2016-12-01

    The US–China Clean Energy Research Center (CERC) was launched in 2009 by US Energy Secretary Steven Chu, Chinese Minister of Science and Technology Wan Gang, and Chinese National Energy Agency Administrator Zhang Guobao. This 5-year collaboration emerged from the fact that the United States and China are the world’s largest energy producers, energy consumers, and greenhouse gas emitters, and that their joint effort could have significant positive repercussions worldwide. CERC’s main goal is to develop and deploy clean energy technologies that will help both countries meet energy and climate challenges. Three consortia were established to address the most pressing energy-related research areas: Advanced Coal Technology, Clean Vehicles, and Building Energy Efficiency (BEE). The project discussed in this report was part of the CERC-BEE consortia; its objective was to lower energy use in buildings by developing and evaluating technologies that improve the cost-effectiveness of air barrier systems for building envelopes.

  5. The effectiveness of small scale Photovoltaic (PV) systems design and cost analysis simulation on Saudi Arabian Economy

    Science.gov (United States)

    Almansour, Faris Abdullah

    The advantages of Renewable Energy Sources (RES) are much more than the disadvantages, RES such as solar, wind energy, biomass, and geothermal, which can be used for generating distributed power but cannot directly replace the existing electric energy grid technologies. The latter are far too well established to abandon, while the new RES technologies are not sufficiently developed to meet the total energy demand. Therefore, it is sensible to gradually infuse RES into existing grids and transform the system over time Saudi Arabia (SA) is a semi-developed nation with a population of over twenty nine million people. It is the largest country in western Asia with an area of 2.225MKm2. SA's largest export is oil, owning 1/5 of the world's supply, and producing twelve million barrels a day. However, SA is far behind in developing a smart grid and RES. A lot of this is to do with lack of participation by both the government and the private business sector. Currently SA spends over $13B a year on generating electricity from oil. SA is the largest consumer of petroleum in the Middle East, due to the high demand for transportation and electricity generation. According to the Saudi electrical company, the total amount of generated power in 2011 was 190.280GW. In addition, SA's electricity consumption is currently growing 8% a year. SA aims to generate 55GW of renewable energy by 2020, in order to free up fossil fuels for export. 41GW of the 55GW will be generated from solar energy. Smart grid technologies are also under consideration in SA; this will allow an efficient and reliable way to control the energy in the future. In addition, the potential for wind and geothermal energy is very high. In this thesis, there is a full exploration of RES components which are critical to manage carbon emission and the limitations of the current grid to the new RES technologies, which face barriers to full-scale deployment. A study in Dhahran, SA has been simulated on a installing a Dual

  6. Increased accuracy of cost-estimation using product configuration systems

    DEFF Research Database (Denmark)

    Rasmussen, Jeppe Bredahl; Hvam, Lars; Mortensen, Niels Henrik

    This article describes an approach for utilizing Product Configuration Systems (PCS) for quantifying project costs in project-based companies. It presents a case study demonstrating a method of quantifying costs in a way that makes it possible to configure cost- and time estimates. Piecework costs......, material costs and sub-supplier costs are used as principle cost elements and linked to structural and process elements to facilitate configuration. The cost data are used by the PCS to generate fast and accurate cost-estimates, quotations, time estimates and cost summaries. The described cost...

  7. Development of a chamber system for rapid, high yield and cost-effective purification of deoxyribonucleic acid fragments from agarose gel.

    Science.gov (United States)

    Eslami, Gilda; Salehi, Rasoul

    2014-01-01

    There are several methods commonly practicing for deoxyribonucleic acid (DNA) purification from agarose gel. In most laboratories, especially in developing countries, present methods for recovering of DNA fragments from the gel are mostly involved organic solvents. However, manual purification using organic solvents are toxic, labor intensive, time consuming and prone to contamination owing to several handling steps. The above mentioned burdens as well as cost and long time to import them, especially in developing countries, prompted us to design and develop a chamber system for rapid, non-toxic, cost-effective and user friendly device for polymerase chain reaction (PCR) products purification from agarose gel. The device was made from plexiglass plates. After amplification of two fragments of 250 and 850 bp, PCR products were electrophoresed. Subsequently, the desired bands were excised and purified with three method: HiPer Mini chamber, phenol extraction method and spin column procedure. To assess the suitability of the purified DNAs, restriction digestion was applied. Results showed that the yield of recovered DNA in our method was above 95%, whereas the yields obtained with conventional phenol extraction and spin column methods were around 60%. In conclusion, the current method for DNA elution is quick, inexpensive and robust and it does not require the use of toxic organic solvents. In addition, the purified DNA was well has suited for further manipulations such as restriction digestion, ligation, cloning, sequencing and hybridization.

  8. A low-cost EDXRF analysis system

    International Nuclear Information System (INIS)

    Kahdeman, J.E.; Watson, W.

    1984-01-01

    The article deals with an EDXRF (Energy Dispersive X-ray Fluorescence) system, the Spectrace (sup TM) 4020 (Tractor X-ray). The Spectra analysis software is both powerful and flexible enough to handle a wide variety of applications. The instrument was designed to be economical by integrating the major system components into a single unit. This practical approach to hardware has cut the cost per unit. The software structure of the Spectra 4020 is presented in a flow chart. The article also contains a diagram of the hardware configuration of the instrument

  9. Green Infrastructure Siting and Cost Effectiveness Analysis

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — Parcel scale green infrastructure siting and cost effectiveness analysis. You can find more details at the project's website.

  10. Internal Logistics System Selection with Total Cost of Ownership Analysis

    Science.gov (United States)

    Araújo, Inês; Pimentel, Carina; Godina, Radu; Matias, João C. O.

    2017-06-01

    In this paper a methodology was followed in order to support the decision-making of one industrial unit regarding its internal logistics system. The addressed factory was facing issues with their internal logistics approach. Some alternatives were pointed out and a proper total cost of ownership (TCO) analysis was developed. This analysis was taken in order to demonstrate the more cost-effective solution for the internal logistics system. This tool is more and more valued by the companies, due to their willing to reduce the costs that are associated with the way of doing business. Despite the proposal of the best choice for the internal logistics system of the enterprise, this study also intends to present some conclusions about the match between the nature of the industrial unit and the logistics systems that best fit the requirements of those.

  11. Design And Implementation Of Cost Effective Inverter

    Directory of Open Access Journals (Sweden)

    Niaz Morshedul Haque

    2017-10-01

    Full Text Available This paper deals with the design and construct of a 100 Watt 220 Volt and 50 Hz Inverter. The system is designed without any microcontroller and it has a cost-effective design architecture. The elementary purpose of this device is to transmute 12 V DC to 220 V AC. Snubber technology is used to diminish the reverse potential transients and excessive heat of transformer winding and transistor switches. Switching pulse generated by NE 555 timer circuit and comparator circuit was used to take signal strength input from its rear as well as from both sides for triggering the MOSFET switches. Another switch is used to invert pulse between two switching circuitries. A 5 volts regulator IC 7805 was used to supply fixed 5V for biasing the switching and amplifying circuitry.

  12. [Incremental cost effectiveness of multifocal cataract surgery].

    Science.gov (United States)

    Pagel, N; Dick, H B; Krummenauer, F

    2007-02-01

    Supplementation of cataract patients with multifocal intraocular lenses involves an additional financial investment when compared to the corresponding monofocal supplementation, which usually is not funded by German health care insurers. In the context of recent resource allocation discussions, however, the cost effectiveness of multifocal cataract surgery could become an important rationale. Therefore an evidence-based estimation of its cost effectiveness was carried out. Three independent meta-analyses were implemented to estimate the gain in uncorrected near visual acuity and best corrected visual acuity (vision lines) as well as the predictability (fraction of patients without need for reading aids) of multifocal supplementation. Study reports published between 1995 and 2004 (English or German language) were screened for appropriate key words. Meta effects in visual gain and predictability were estimated by means and standard deviations of the reported effect measures. Cost data were estimated by German DRG rates and individual lens costs; the cost effectiveness of multifocal cataract surgery was then computed in terms of its marginal cost effectiveness ratio (MCER) for each clinical benefit endpoint; the incremental costs of multifocal versus monofocal cataract surgery were further estimated by means of their respective incremental cost effectiveness ratio (ICER). An independent meta-analysis estimated the complication profiles to be expected after monofocal and multifocal cataract surgery in order to evaluate expectable complication-associated additional costs of both procedures; the marginal and incremental cost effectiveness estimates were adjusted accordingly. A sensitivity analysis comprised cost variations of +/- 10 % and utility variations alongside the meta effect estimate's 95 % confidence intervals. Total direct costs from the health care insurer's perspective were estimated 3363 euro, associated with a visual meta benefit in best corrected visual

  13. Cost-Effectiveness of Nitrogen Mitigation by Alternative ...

    Science.gov (United States)

    Household wastewater, especially from conventional septic systems, is a major contributor to nitrogen pollution. Alternative household wastewater management technologies provide similar sewerage management services but their life cycle costs and nitrogen flow implications remain uncertain. We seek to address two key questions: (1) what are the total costs, nitrogen mitigation potential, and cost-effectiveness of a range of conventional and alternative municipal wastewater treatment technologies, and (2) what uncertainties influence these outcomes, and how can we improve our understanding of these technologies? We estimate a household nitrogen mass balance for various household wastewater treatment systems and combine this mass balance with life cycle cost assessment to calculate the cost-effectiveness of nitrogen mitigation, which we define as nitrogen removed from the local watershed. We apply our methods to Falmouth, MA, where failing septic systems have caused heightened eutrophication in local receiving water bodies. We find that flushing and dry (composting) urine-diversion toilets paired with conventional septic systems for greywater management demonstrate the lowest life cycle cost and highest cost-effectiveness (dollars per kilogram of nitrogen removed from the watershed). Composting toilets and neighborhood-scale blackwater digesters are also attractive options in some cases, particularly best-case nitrogen mitigation; innovative/advanced septic system

  14. Cost effectiveness studies of environmental technologies: Volume 1

    International Nuclear Information System (INIS)

    Silva, E.M.; Booth, S.R.

    1994-02-01

    This paper examines cost effectiveness studies of environmental technologies including the following: (1) In Situ Air Stripping, (2) Surface Towed Ordinance Locator System, (3) Ditch Witch Horizontal Boring Technology, (4) Direct Sampling Ion Trap Mass Spectrometer, (5) In Situ Vitrification, (6) Site Characterization and Analysis Penetrometer System, (7) In Situ Bioremediation, and (8) SEAMIST Membrane System Technology

  15. 48 CFR 252.215-7002 - Cost estimating system requirements.

    Science.gov (United States)

    2010-10-01

    ... historical costs, and other analyses used to generate cost estimates. (b) General. The Contractor shall... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Cost estimating system... of Provisions And Clauses 252.215-7002 Cost estimating system requirements. As prescribed in 215.408...

  16. AES, Automated Construction Cost Estimation System

    International Nuclear Information System (INIS)

    Holder, D.A.

    1995-01-01

    A - Description of program or function: AES (Automated Estimating System) enters and updates the detailed cost, schedule, contingency, and escalation information contained in a typical construction or other project cost estimates. It combines this information to calculate both un-escalated and escalated and cash flow values for the project. These costs can be reported at varying levels of detail. AES differs from previous versions in at least the following ways: The schedule is entered at the WBS-Participant, Activity level - multiple activities can be assigned to each WBS-Participant combination; the spending curve is defined at the schedule activity level and a weighing factor is defined which determines percentage of cost for the WBS-Participant applied to the schedule activity; Schedule by days instead of Fiscal Year/Quarter; Sales Tax is applied at the Line Item Level- a sales tax codes is selected to indicate Material, Large Single Item, or Professional Services; a 'data filter' has been added to allow user to define data the report is to be generated for. B - Method of solution: Average Escalation Rate: The average escalation for a Bill of is calculated in three steps. 1. A table of quarterly escalation factors is calculated based on the base fiscal year and quarter of the project entered in the estimate record and the annual escalation rates entered in the Standard Value File. 2. The percentage distribution of costs by quarter for the Bill of Material is calculated based on the schedule entered and the curve type. 3. The percent in each fiscal year and quarter in the distribution is multiplied by the escalation factor for the fiscal year and quarter. The sum of these results is the average escalation rate for that Bill of Material. Schedule by curve: The allocation of costs to specific time periods is dependent on three inputs, starting schedule date, ending schedule date, and the percentage of costs allocated to each quarter. Contingency Analysis: The

  17. Oxytocin in Uniject Disposable Auto-Disable Injection System versus Standard Use for the Prevention of Postpartum Hemorrhage in Latin America and the Caribbean: A Cost-Effectiveness Analysis.

    Science.gov (United States)

    Pichon-Riviere, Andrés; Glujovsky, Demián; Garay, Osvaldo Ulises; Augustovski, Federico; Ciapponi, Agustin; Serpa, Magdalena; Althabe, Fernando

    2015-01-01

    Postpartum hemorrhage (PPH) is a leading cause of maternal death. Despite strong evidence showing the efficacy of routine oxytocin in preventing PPH, the proportion of women receiving it after delivery is still below 100%. The Uniject injection system prefilled with oxytocin (Uniject) has the potential advantage, due to its ease of use, to increase oxytocin utilization rates. We aimed to assess its cost-effectiveness in Latin America and the Caribbean (LAC). We used an epidemiological model to estimate: a) the impact of replacing oxytocin in ampoules with Uniject on the incidence of PPH, quality-adjusted life years (QALYs) and costs from a health care system perspective, and b) the minimum increment in oxytocin utilization rates required to make Uniject a cost-effective strategy. A consensus panel of LAC experts was convened to quantify the expected increase in oxytocin rates as a consequence of making Uniject available. Deterministic and probabilistic sensitivity analyses were performed. In the base case, the incremental cost of Uniject with respect to oxytocin in ampoules was estimated to be USD 1.00 (2013 US dollars). In the cost-effectiveness analysis, Uniject ranged from being cost-saving (in 8 out of 30 countries) to having an incremental cost-effectiveness ratio (ICER) of USD 8,990 per QALY gained. In most countries these ICERs were below one GDP per capita. The minimum required increment in oxytocin rates to make Uniject a cost-effective strategy ranged from 1.3% in Suriname to 16.2% in Haiti. Switching to Uniject could prevent more than 40,000 PPH events annually in LAC. Uniject was cost-saving or very cost-effective in almost all countries. Even if countries can achieve only small increases in oxytocin rates by incorporating Uniject, this strategy could be considered a highly efficient use of resources. These results were robust in the sensitivity analysis under a wide range of assumptions.

  18. Oxytocin in Uniject Disposable Auto-Disable Injection System versus Standard Use for the Prevention of Postpartum Hemorrhage in Latin America and the Caribbean: A Cost-Effectiveness Analysis

    Science.gov (United States)

    Pichon-Riviere, Andrés; Glujovsky, Demián; Garay, Osvaldo Ulises; Augustovski, Federico; Ciapponi, Agustin; Serpa, Magdalena; Althabe, Fernando

    2015-01-01

    Postpartum hemorrhage (PPH) is a leading cause of maternal death. Despite strong evidence showing the efficacy of routine oxytocin in preventing PPH, the proportion of women receiving it after delivery is still below 100%. The Uniject injection system prefilled with oxytocin (Uniject) has the potential advantage, due to its ease of use, to increase oxytocin utilization rates. We aimed to assess its cost-effectiveness in Latin America and the Caribbean (LAC). We used an epidemiological model to estimate: a) the impact of replacing oxytocin in ampoules with Uniject on the incidence of PPH, quality-adjusted life years (QALYs) and costs from a health care system perspective, and b) the minimum increment in oxytocin utilization rates required to make Uniject a cost-effective strategy. A consensus panel of LAC experts was convened to quantify the expected increase in oxytocin rates as a consequence of making Uniject available. Deterministic and probabilistic sensitivity analyses were performed. In the base case, the incremental cost of Uniject with respect to oxytocin in ampoules was estimated to be USD 1.00 (2013 US dollars). In the cost-effectiveness analysis, Uniject ranged from being cost-saving (in 8 out of 30 countries) to having an incremental cost-effectiveness ratio (ICER) of USD 8,990 per QALY gained. In most countries these ICERs were below one GDP per capita. The minimum required increment in oxytocin rates to make Uniject a cost-effective strategy ranged from 1.3% in Suriname to 16.2% in Haiti. Switching to Uniject could prevent more than 40,000 PPH events annually in LAC. Uniject was cost-saving or very cost-effective in almost all countries. Even if countries can achieve only small increases in oxytocin rates by incorporating Uniject, this strategy could be considered a highly efficient use of resources. These results were robust in the sensitivity analysis under a wide range of assumptions. PMID:26057930

  19. Oxytocin in Uniject Disposable Auto-Disable Injection System versus Standard Use for the Prevention of Postpartum Hemorrhage in Latin America and the Caribbean: A Cost-Effectiveness Analysis.

    Directory of Open Access Journals (Sweden)

    Andrés Pichon-Riviere

    Full Text Available Postpartum hemorrhage (PPH is a leading cause of maternal death. Despite strong evidence showing the efficacy of routine oxytocin in preventing PPH, the proportion of women receiving it after delivery is still below 100%. The Uniject injection system prefilled with oxytocin (Uniject has the potential advantage, due to its ease of use, to increase oxytocin utilization rates. We aimed to assess its cost-effectiveness in Latin America and the Caribbean (LAC. We used an epidemiological model to estimate: a the impact of replacing oxytocin in ampoules with Uniject on the incidence of PPH, quality-adjusted life years (QALYs and costs from a health care system perspective, and b the minimum increment in oxytocin utilization rates required to make Uniject a cost-effective strategy. A consensus panel of LAC experts was convened to quantify the expected increase in oxytocin rates as a consequence of making Uniject available. Deterministic and probabilistic sensitivity analyses were performed. In the base case, the incremental cost of Uniject with respect to oxytocin in ampoules was estimated to be USD 1.00 (2013 US dollars. In the cost-effectiveness analysis, Uniject ranged from being cost-saving (in 8 out of 30 countries to having an incremental cost-effectiveness ratio (ICER of USD 8,990 per QALY gained. In most countries these ICERs were below one GDP per capita. The minimum required increment in oxytocin rates to make Uniject a cost-effective strategy ranged from 1.3% in Suriname to 16.2% in Haiti. Switching to Uniject could prevent more than 40,000 PPH events annually in LAC. Uniject was cost-saving or very cost-effective in almost all countries. Even if countries can achieve only small increases in oxytocin rates by incorporating Uniject, this strategy could be considered a highly efficient use of resources. These results were robust in the sensitivity analysis under a wide range of assumptions.

  20. Cost Optimal System Identification Experiment Design

    DEFF Research Database (Denmark)

    Kirkegaard, Poul Henning

    A structural system identification experiment design method is formulated in the light of decision theory, structural reliability theory and optimization theory. The experiment design is based on a preposterior analysis, well-known from the classical decision theory. I.e. the decisions concerning...... the experiment design are not based on obtained experimental data. Instead the decisions are based on the expected experimental data assumed to be obtained from the measurements, estimated based on prior information and engineering judgement. The design method provides a system identification experiment design...... reflecting the cost of the experiment and the value of obtained additional information. An example concerning design of an experiment for parametric identification of a single degree of freedom structural system shows the applicability of the experiment design method....

  1. Dramatic Reduction in Diarrhoeal Diseases through Implementation of Cost-Effective Household Drinking Water Treatment Systems in Makwane Village, Limpopo Province, South Africa.

    Science.gov (United States)

    Moropeng, Resoketswe Charlotte; Budeli, Phumudzo; Mpenyana-Monyatsi, Lizzy; Momba, Maggy Ndombo Benteke

    2018-02-27

    The main purpose of this study was to implement cost-effective household water treatment systems in every household of Makwane Village for the reduction of diarrhoeal diseases. These household water treatment systems were constructed with locally available materials and consisted of the biosand zeolite-silver impregnated granular clay filters and the silver-impregnated porous pot filters. During the study period (April 2015 to September 2015), the entire village had 88 households with a population size of 480. Prior to the implementation, a survey was conducted and results revealed that 75% (360/480) of the Makwane residents suffered from diarrhoeal disease and the majority of the cases were reported in children that were less than five years of age. Out of the 480 participants, 372 (77.5%) from 70 households accepted the installation of the systems (intervention group) and 108 (25.5%) from 18 households were reluctant to use the systems (the control group). To date, in the intervention group, only 3.8% (14/372) of participants reported cases of diarrhoea. In the control group, 57.4% (62/108) participants reported cases of diarrhoea and most of the episodes of diarrhoea were reported in children of less than five years old (85%), followed by the group aged ≥56 years (75%). The findings of the current study unequivocally demonstrated that the BSZ-SICG and SIPP filters were able to reduce the incidence of diarrhoea by 96.2%. These findings further demonstrate the importance of household water treatment systems (HWTS) interventions in rural areas to bring about meaningful reductions in diarrhoeal diseases by providing safe potable water.

  2. Least-cost failure diagnosis in uncertain reliability systems

    International Nuclear Information System (INIS)

    Cox, Louis Anthony; Chiu, Steve Y.; Sun Xiaorong

    1996-01-01

    In many textbook solutions, for systems failure diagnosis problems studied using reliability theory and artificial intelligence, the prior probabilities of different failure states can be estimated and used to guide the sequential search for failed components after the whole system fails. In practice, however, both the component failure probabilities and the structure function of the system being examined--i.e., the mapping between the states of its components and the state of the system--may not be known with certainty. At best:, the probabilities of different hypothesized system descriptions, each specifying the component failure probabilities and the system's structure function, may be known to a useful approximation, perhaps based on sample data and previous experience. Cost-effective diagnosis of the system's failure state is then a challenging problem. Although the probabilities of component failures are aleatory, uncertainties about these probabilities and about the system structure function are epistemic. This paper examines how to make best use of both epistemic prior probabilities for system descriptions and the information gleaned from costly inspections of component states after the system fails, to minimize the average cost of identifying the failure state. Two approaches are introduced for systems dominated by aleatory uncertainties, one motivated by information theory and the other based on the idea of trying to prove a hypothesis about the identity of the failure state as efficiently as possible. While the general problem of cost-effective failure diagnosis is computationally intractable (NP-hard), both heuristics provide useful approximations on small to moderate sized problems and optimal results for certain common types of reliability systems, including series, parallel, parallel-series, and k-out-of-n systems. A hybrid heuristic that adaptively chooses which heuristic to apply next after any sequence of observations (component test results

  3. Deregulation and Nuclear Training: Cost Effective Alternatives

    International Nuclear Information System (INIS)

    Richard P. Coe; Patricia A. Lake

    2000-01-01

    Training is crucial to the success of any organization. It is also expensive, with some estimates exceeding $50 billion annually spent on training by U.S. corporations. Nuclear training, like that of many other highly technical organizations, is both crucial and costly. It is unlikely that the amount of training can be significantly reduced. If anything, current trends indicate that training needs will probably increase as the industry and workforce ages and changes. With the advent of energy deregulation in the United States, greater pressures will surface to make the costs of energy more cost-competitive. This in turn will drive businesses to more closely examine existing costs and find ways to do things in a more cost-effective way. The commercial nuclear industry will be no exception, and nuclear training will be equally affected. It is time for nuclear training and indeed the entire nuclear industry to begin using more aggressive techniques to reduce costs. This includes the need for nuclear training to find alternatives to traditional methods for the delivery of cost-effective high-quality training that meets regulatory requirements and produces well-qualified personnel capable of working in an efficient and safe manner. Computer-based and/or Web-based training are leading emerging technologies

  4. The effects of patient cost sharing on inpatient utilization, cost, and outcome.

    Directory of Open Access Journals (Sweden)

    Yuan Xu

    Full Text Available Health insurance and provider payment reforms all over the world beg a key empirical question: what are the potential impacts of patient cost-sharing on health care utilization, cost and outcomes? The unique health insurance system and rich electronic medical record (EMR data in China provides us a unique opportunity to study this topic.Four years (2010 to 2014 of EMR data from one medical center in China were utilized, including 10,858 adult patients with liver diseases. We measured patient cost-sharing using actual reimbursement ratio (RR which is allowed us to better capture financial incentive than using type of health insurance. A rigorous risk adjustment method was employed with both comorbidities and disease severity measures acting as risk adjustors. Associations between RR and health use, costs and outcome were analyzed by multivariate analyses.After risk adjustment, patients with more generous health insurance coverage (higher RR were found to have longer hospital stay, higher total cost, higher medication cost, and higher ratio of medication to total cost, as well as higher number and likelihood that specific procedures were performed.Our study implied that patient cost-sharing affects health care services use and cost. This reflects how patients and physicians respond to financial incentives in the current healthcare system in China, and the responses could be a joint effect of both demand and supply side moral hazard. In order to contain cost and improve efficiency in the system, reforming provide payment and insurance scheme is urgently needed.

  5. Cost analysis of Navy acquisition alternatives for the NAVSTAR Global Positioning System

    Science.gov (United States)

    Darcy, T. F.; Smith, G. P.

    1982-12-01

    This research analyzes the life cycle cost (LCC) of the Navy's current and two hypothetical procurement alternatives for NAVSTAR Global Positioning System (GPS) user equipment. Costs are derived by the ARINC Research Corporation ACBEN cost estimating system. Data presentation is in a comparative format describing individual alternative LCC and differential costs between alternatives. Sensitivity analysis explores the impact receiver-processor unit (RPU) first unit production cost has on individual alternative LCC, as well as cost differentials between each alternative. Several benefits are discussed that might provide sufficient cost savings and/or system effectiveness improvements to warrant a procurement strategy other than the existing proposal.

  6. Implementing powered stretcher and load systems was a cost effective intervention to reduce the incidence rates of stretcher related injuries in a paramedic service.

    Science.gov (United States)

    Armstrong, Daniel P; Ferron, Richard; Taylor, Cindi; McLeod, Brent; Fletcher, Steve; MacPhee, Renée S; Fischer, Steven L

    2017-07-01

    Paramedic services are considering moving towards the use of powered stretcher and load systems to reduce stretcher related injuries, but cost is perceived as a barrier. This study compared injury incidence rates, days lost, and compensation costs between Niagara Emergency Medical Service (NEMS) and Hamilton Paramedic Service (HPS) pre- (four years) and post- (one year) implementation of powered stretcher and load systems in NEMS. Prior to the intervention stretcher related musculoskeletal disorder (MSD) incidence rates averaged 20.0 (±6.8) and 17.9 (±6.4) per 100 full time equivalent (FTE), in NEMS and HPS respectively. One-year post intervention rates decreased to 4.3 per 100 FTE in NEMS, a 78% reduction. Rates modestly increased to 24.6 per 100 FTE in HPS in same period. Cost-benefit analysis estimated that the added cost to purchase powered stretcher and load systems would be recovered within their expected 7-year service life due to the reduction in compensation costs. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Making Sense of Cost-Effectiveness and Benefit-Cost Analyses.

    Science.gov (United States)

    Temkin, Sanford

    Although two economic methods, cost effectiveness and benefit-cost analysis, are frequently mentioned as useful tools for educational decision making, only one, cost effectiveness, has potential for making a contribution to this field. A benefit-cost analysis tries for each alternative to measure benefits and costs, which are then discounted to…

  8. The system of account and control of logistics costs

    Directory of Open Access Journals (Sweden)

    Khayrullin Rustam Zinnatullovich

    Full Text Available The process of organization of civil engineering provides the delivery of construction materials, equipment to the civil engineering objects in the required quantities at the specified time. Effective tool for solving this problem is logistics. The basic components of logistics costs, which occupy the largest share in the sum of all logistics costs, are transportation costs and storage costs. The civil engineering industry is very promising for the use of outsourcing. The main part of works on providing material and technical resources in most cases is transferred to the outsourcing of other companies, including the group of companies forming the holding. In large holding companies the chain of movement of materials, goods and productions: purchase of materials and goods, completion materials, production structures, storage, movement, transportation, etc. may include several companies belonging in holding. The goods can be moved from one warehouse to another, with or without change of the owner of goods. Each company is obliged to show each movement of goods in their financial accounting. During the goods’ movement within a group of companies from one storage to another, from one owner to another, the total costs of the goods rise. Sales within a group of companies lead, as a rule, to a gain by one of the companies and the logistic expenses of another company. Selling to a consumer provides a profit to the seller company. Therefore, the problem of adequate allocation of logistics expenses and profits between separate legal entity and the task of continuous accounting and control of logistics costs and earnings in large companies, is vital. The automated system for accounting and controlling of logistics costs is suggested. The developed system allows controlling logistics costs of refining, storage and transportation for each ton, pieces, linear or square meters of the shipped cargoes. The System is based on complex algorithms of distribution

  9. Cost-effectiveness of pharmacological and psychosocial interventions for schizophrenia

    Science.gov (United States)

    2011-01-01

    Background Information on cost-effectiveness of interventions to treat schizophrenia can assist health policy decision making, particularly given the lack of health resources in developing countries like Thailand. This study aims to determine the optimal treatment package, including drug and non-drug interventions, for schizophrenia in Thailand. Methods A Markov model was used to evaluate the cost-effectiveness of typical antipsychotics, generic risperidone, olanzapine, clozapine and family interventions. Health outcomes were measured in disability adjusted life years. We evaluated intervention benefit by estimating a change in disease severity, taking into account potential side effects. Intervention costs included outpatient treatment costs, hospitalization costs as well as time and travel costs of patients and families. Uncertainty was evaluated using Monte Carlo simulation. A sensitivity analysis of the expected range cost of generic risperidone was undertaken. Results Generic risperidone is more cost-effective than typicals if it can be produced for less than 10 baht per 2 mg tablet. Risperidone was the cheapest treatment with higher drug costs offset by lower hospital costs in comparison to typicals. The most cost-effective combination of treatments was a combination of risperidone (dominant intervention). Adding family intervention has an incremental cost-effectiveness ratio of 1,900 baht/DALY with a 100% probability of a result less than a threshold for very cost-effective interventions of one times GDP or 110,000 baht per DALY. Treating the most severe one third of patients with clozapine instead of risperidone had an incremental cost-effectiveness ratio of 320,000 baht/DALY with just over 50% probability of a result below three times GDP per capita. Conclusions There are good economic arguments to recommend generic risperidone as first line treatment in combination with family intervention. As the uncertainty interval indicates the addition of clozapine

  10. Cost-effectiveness of pharmacological and psychosocial interventions for schizophrenia

    Directory of Open Access Journals (Sweden)

    Vos Theo

    2011-05-01

    Full Text Available Abstract Background Information on cost-effectiveness of interventions to treat schizophrenia can assist health policy decision making, particularly given the lack of health resources in developing countries like Thailand. This study aims to determine the optimal treatment package, including drug and non-drug interventions, for schizophrenia in Thailand. Methods A Markov model was used to evaluate the cost-effectiveness of typical antipsychotics, generic risperidone, olanzapine, clozapine and family interventions. Health outcomes were measured in disability adjusted life years. We evaluated intervention benefit by estimating a change in disease severity, taking into account potential side effects. Intervention costs included outpatient treatment costs, hospitalization costs as well as time and travel costs of patients and families. Uncertainty was evaluated using Monte Carlo simulation. A sensitivity analysis of the expected range cost of generic risperidone was undertaken. Results Generic risperidone is more cost-effective than typicals if it can be produced for less than 10 baht per 2 mg tablet. Risperidone was the cheapest treatment with higher drug costs offset by lower hospital costs in comparison to typicals. The most cost-effective combination of treatments was a combination of risperidone (dominant intervention. Adding family intervention has an incremental cost-effectiveness ratio of 1,900 baht/DALY with a 100% probability of a result less than a threshold for very cost-effective interventions of one times GDP or 110,000 baht per DALY. Treating the most severe one third of patients with clozapine instead of risperidone had an incremental cost-effectiveness ratio of 320,000 baht/DALY with just over 50% probability of a result below three times GDP per capita. Conclusions There are good economic arguments to recommend generic risperidone as first line treatment in combination with family intervention. As the uncertainty interval indicates

  11. Supported employment: cost-effectiveness across six European sites.

    Science.gov (United States)

    Knapp, Martin; Patel, Anita; Curran, Claire; Latimer, Eric; Catty, Jocelyn; Becker, Thomas; Drake, Robert E; Fioritti, Angelo; Kilian, Reinhold; Lauber, Christoph; Rössler, Wulf; Tomov, Toma; van Busschbach, Jooske; Comas-Herrera, Adelina; White, Sarah; Wiersma, Durk; Burns, Tom

    2013-02-01

    A high proportion of people with severe mental health problems are unemployed but would like to work. Individual Placement and Support (IPS) offers a promising approach to establishing people in paid employment. In a randomized controlled trial across six European countries, we investigated the economic case for IPS for people with severe mental health problems compared to standard vocational rehabilitation. Individuals (n=312) were randomized to receive either IPS or standard vocational services and followed for 18 months. Service use and outcome data were collected. Cost-effectiveness analysis was conducted with two primary outcomes: additional days worked in competitive settings and additional percentage of individuals who worked at least 1 day. Analyses distinguished country effects. A partial cost-benefit analysis was also conducted. IPS produced better outcomes than alternative vocational services at lower cost overall to the health and social care systems. This pattern also held in disaggregated analyses for five of the six European sites. The inclusion of imputed values for missing cost data supported these findings. IPS would be viewed as more cost-effective than standard vocational services. Further analysis demonstrated cost-benefit arguments for IPS. Compared to standard vocational rehabilitation services, IPS is, therefore, probably cost-saving and almost certainly more cost-effective as a way to help people with severe mental health problems into competitive employment. Copyright © 2013 World Psychiatric Association.

  12. Costs of task allocation with local feedback: Effects of colony size and extra workers in social insects and other multi-agent systems.

    Directory of Open Access Journals (Sweden)

    Tsvetomira Radeva

    2017-12-01

    Full Text Available Adaptive collective systems are common in biology and beyond. Typically, such systems require a task allocation algorithm: a mechanism or rule-set by which individuals select particular roles. Here we study the performance of such task allocation mechanisms measured in terms of the time for individuals to allocate to tasks. We ask: (1 Is task allocation fundamentally difficult, and thus costly? (2 Does the performance of task allocation mechanisms depend on the number of individuals? And (3 what other parameters may affect their efficiency? We use techniques from distributed computing theory to develop a model of a social insect colony, where workers have to be allocated to a set of tasks; however, our model is generalizable to other systems. We show, first, that the ability of workers to quickly assess demand for work in tasks they are not currently engaged in crucially affects whether task allocation is quickly achieved or not. This indicates that in social insect tasks such as thermoregulation, where temperature may provide a global and near instantaneous stimulus to measure the need for cooling, for example, it should be easy to match the number of workers to the need for work. In other tasks, such as nest repair, it may be impossible for workers not directly at the work site to know that this task needs more workers. We argue that this affects whether task allocation mechanisms are under strong selection. Second, we show that colony size does not affect task allocation performance under our assumptions. This implies that when effects of colony size are found, they are not inherent in the process of task allocation itself, but due to processes not modeled here, such as higher variation in task demand for smaller colonies, benefits of specialized workers, or constant overhead costs. Third, we show that the ratio of the number of available workers to the workload crucially affects performance. Thus, workers in excess of those needed to

  13. Waste Management facilities cost information: System Cost Model Software Quality Assurance Plan. Revision 2

    Energy Technology Data Exchange (ETDEWEB)

    Peterson, B.L.; Lundeen, A.S.

    1996-02-01

    In May of 1994, Lockheed Idaho Technologies Company (LITCO) in Idaho Falls, Idaho and subcontractors developed the System Cost Model (SCM) application. The SCM estimates life-cycle costs of the entire US Department of Energy (DOE) complex for designing; constructing; operating; and decommissioning treatment, storage, and disposal (TSD) facilities for mixed low-level, low-level, transuranic, and mixed transuranic waste. The SCM uses parametric cost functions to estimate life-cycle costs for various treatment, storage, and disposal modules which reflect planned and existing facilities at DOE installations. In addition, SCM can model new facilities based on capacity needs over the program life cycle. The SCM also provides transportation costs for truck and rail, which include transport of contact-handled, remote-handled, and alpha (transuranic) wastes. The user can provide input data (default data is included in the SCM) including the volume and nature of waste to be managed, the time period over which the waste is to be managed, and the configuration of the waste management complex (i.e., where each installation`s generated waste will be treated, stored, and disposed). Then the SCM uses parametric cost equations to estimate the costs of pre-operations (designing), construction costs, operation management, and decommissioning these waste management facilities. For the product to be effective and useful the SCM users must have a high level of confidence in the data generated by the software model. The SCM Software Quality Assurance Plan is part of the overall SCM project management effort to ensure that the SCM is maintained as a quality product and can be relied on to produce viable planning data. This document defines tasks and deliverables to ensure continued product integrity, provide increased confidence in the accuracy of the data generated, and meet the LITCO`s quality standards during the software maintenance phase. 8 refs., 1 tab.

  14. Waste Management facilities cost information: System Cost Model Software Quality Assurance Plan. Revision 2

    International Nuclear Information System (INIS)

    Peterson, B.L.; Lundeen, A.S.

    1996-02-01

    In May of 1994, Lockheed Idaho Technologies Company (LITCO) in Idaho Falls, Idaho and subcontractors developed the System Cost Model (SCM) application. The SCM estimates life-cycle costs of the entire US Department of Energy (DOE) complex for designing; constructing; operating; and decommissioning treatment, storage, and disposal (TSD) facilities for mixed low-level, low-level, transuranic, and mixed transuranic waste. The SCM uses parametric cost functions to estimate life-cycle costs for various treatment, storage, and disposal modules which reflect planned and existing facilities at DOE installations. In addition, SCM can model new facilities based on capacity needs over the program life cycle. The SCM also provides transportation costs for truck and rail, which include transport of contact-handled, remote-handled, and alpha (transuranic) wastes. The user can provide input data (default data is included in the SCM) including the volume and nature of waste to be managed, the time period over which the waste is to be managed, and the configuration of the waste management complex (i.e., where each installation's generated waste will be treated, stored, and disposed). Then the SCM uses parametric cost equations to estimate the costs of pre-operations (designing), construction costs, operation management, and decommissioning these waste management facilities. For the product to be effective and useful the SCM users must have a high level of confidence in the data generated by the software model. The SCM Software Quality Assurance Plan is part of the overall SCM project management effort to ensure that the SCM is maintained as a quality product and can be relied on to produce viable planning data. This document defines tasks and deliverables to ensure continued product integrity, provide increased confidence in the accuracy of the data generated, and meet the LITCO's quality standards during the software maintenance phase. 8 refs., 1 tab

  15. Economic Competitiveness of U.S. Utility-Scale Photovoltaics Systems in 2015: Regional Cost Modeling of Installed Cost ($/W) and LCOE ($/kWh)

    Energy Technology Data Exchange (ETDEWEB)

    Fu, Ran; James, Ted L.; Chung, Donald; Gagne, Douglas; Lopez, Anthony; Dobos, Aron

    2015-06-14

    Utility-scale photovoltaics (PV) system growth is largely driven by the economic metrics of total installed costs and levelized cost of electricity (LCOE), which differ by region. This study details regional cost factors, including environment (wind speed and snow loads), labor costs, material costs, sales taxes, and permitting costs using a new system-level bottom-up cost modeling approach. We use this model to identify regional all-in PV installed costs for fixed-tilt and one-axis tracker systems in the United States with consideration of union and non-union labor costs in 2015. LCOEs using those regional installed costs are then modeled and spatially presented. Finally, we assess the cost reduction opportunities of increasing module conversion efficiencies on PV system costs in order to indicate the possible economic impacts of module technology advancements and help future research and development (R&D) effects in the context of U.S. SunShot targets.

  16. Costing for the Future: Exploring Cost Estimation With Unmanned Autonomous Systems

    Science.gov (United States)

    2016-04-30

    ownership of this new breed of systems. Singularly applying traditional software and hardware cost models do not provide this capability because the...various types of costs into their respective phases to demonstrate Total Cost of Ownership . Cost Estimation Methods The exploration of new cost...vehicle; or if it is an attack/reconnaissance system—it needs to support munitions, missiles, or gun platforms. Although many more areas can be

  17. Effectiveness of a low-cost virtual reality system for children with developmental delay: a preliminary randomised single-blind controlled trial.

    Science.gov (United States)

    Salem, Yasser; Gropack, Stacy Jaffee; Coffin, Dale; Godwin, Ellen M

    2012-09-01

    Physical and occupational therapists have started to use the Nintendo Wii™ gaming system with adults and children as part of their regular treatment. Despite the growing use of the Wii and trend towards evidence-based practice, limited evidence is available on the effectiveness of virtual reality using the Wii for children with developmental delay. The purpose of this study was to determine the feasibility and preliminary effectiveness of a low-cost gaming system for young children with developmental delay. Single-blind, randomised controlled trial. Forty children with developmental delay (age 39 to 58 months) who attended a segregated or integrated preschool participated in this study. All children's parents read and signed an informed consent form approved by the institutional review board. Children were assigned at random to an experimental (Wii) group (n=20) or a control group (n=20). Two weekly sessions for 10 weeks using Nintendo Wii Sports™ and Nintendo Wii Fit™, including balance, strength training and aerobics games. Participants were evaluated 1 week before and 1 week after the programme by a blinded investigator. Primary outcomes were gait speed, timed up and go test, single leg stance test, five-times-sit-to-stand test, timed up and down stairs test, 2-minute walk test and grip strength. The Gross Motor Function Measure (GMFM) was used to assess gross motor skills. The two groups were homogenous regarding all parameters at baseline. The Wii training was feasible and enjoyable for those in the experimental group. There were no adverse effects or injuries reported over 267 training sessions. Comparison of groups following the intervention indicated that the experimental group showed significant improvements compared with the control group in single leg stance test {mean difference 1.03 [standard deviation (SD) 1.7], 95% confidence interval (CI) 0.2 to 1.9; P=0.017}, right grip strength [mean difference 1.11 (SD 1.84), 95% CI 0.15 to 2.06; P=0

  18. Cost optimization for buildings with hybrid ventilation systems

    Energy Technology Data Exchange (ETDEWEB)

    Ji, Kun; Lu, Yan

    2018-02-13

    A method including: computing a total cost for a first zone in a building, wherein the total cost is equal to an actual energy cost of the first zone plus a thermal discomfort cost of the first zone; and heuristically optimizing the total cost to identify temperature setpoints for a mechanical heating/cooling system and a start time and an end time of the mechanical heating/cooling system, based on external weather data and occupancy data of the first zone.

  19. Cost-effectiveness analysis and innovation.

    Science.gov (United States)

    Jena, Anupam B; Philipson, Tomas J

    2008-09-01

    While cost-effectiveness (CE) analysis has provided a guide to allocating often scarce resources spent on medical technologies, less emphasis has been placed on the effect of such criteria on the behavior of innovators who make health care technologies available in the first place. A better understanding of the link between innovation and cost-effectiveness analysis is particularly important given the large role of technological change in the growth in health care spending and the growing interest of explicit use of CE thresholds in leading technology adoption in several Westernized countries. We analyze CE analysis in a standard market context, and stress that a technology's cost-effectiveness is closely related to the consumer surplus it generates. Improved CE therefore often clashes with interventions to stimulate producer surplus, such as patents. We derive the inconsistency between technology adoption based on CE analysis and economic efficiency. Indeed, static efficiency, dynamic efficiency, and improved patient health may all be induced by the cost-effectiveness of the technology being at its worst level. As producer appropriation of the social surplus of an innovation is central to the dynamic efficiency that should guide CE adoption criteria, we exemplify how appropriation can be inferred from existing CE estimates. For an illustrative sample of technologies considered, we find that the median technology has an appropriation of about 15%. To the extent that such incentives are deemed either too low or too high compared to dynamically efficient levels, CE thresholds may be appropriately raised or lowered to improve dynamic efficiency.

  20. 18 CFR 301.7 - Average System Cost methodology functionalization.

    Science.gov (United States)

    2010-04-01

    ... SYSTEM COST METHODOLOGY FOR SALES FROM UTILITIES TO BONNEVILLE POWER ADMINISTRATION UNDER NORTHWEST POWER ACT § 301.7 Average System Cost methodology functionalization. (a) Functionalization of each Account... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Average System Cost...

  1. Solar Water Heating with Low-Cost Plastic Systems

    Energy Technology Data Exchange (ETDEWEB)

    None

    2012-01-01

    Federal buildings consumed over 392,000 billion Btu of site delivered energy for buildings during FY 2007 at a total cost of $6.5 billion. Earlier data indicate that about 10% of this is used to heat water.[2] Targeting energy consumption in Federal buildings, the Energy Independence and Security Act of 2007 (EISA) requires new Federal buildings and major renovations to meet 30% of their hot water demand with solar energy, provided it is cost-effective over the life of the system. In October 2009, President Obama expanded the energy reduction and performance requirements of EISA and its subsequent regulations with his Executive Order 13514.

  2. Making choices in health: WHO guide to cost effectiveness analysis

    National Research Council Canada - National Science Library

    Tan Torres Edejer, Tessa

    2003-01-01

    ... . . . . . . . . . . . . . . . . . . . . . . . XXI PART ONE: METHODS COST-EFFECTIVENESS FOR GENERALIZED ANALYSIS 1. 2. What is Generalized Cost-Effectiveness Analysis? . . . . . . . . . . . . 3 Undertaking...

  3. A cost effectiveness analysis of midwife psycho-education for fearful pregnant women - a health system perspective for the antenatal period.

    Science.gov (United States)

    Toohill, J; Callander, E; Gamble, J; Creedy, D K; Fenwick, J

    2017-07-11

    Psycho-education can reduce childbirth fear and caesarean section numbers. This study determines the cost-effectiveness of a midwife-led psycho-education intervention for women fearful of birth. One thousand four hundred ten pregnant women in south-east Queensland, Australia were screened for childbirth fear (W-DEQ A ≥ 66). Women with high scores (n = 339) were randomised to the BELIEF Study (Birth Emotions and Looking to Improve Expectant Fear) to receive psycho-education (n = 170) at 24 and 34 weeks of pregnancy or to the control group (n = 169). Women in both groups were surveyed 6 weeks postpartum with total cost for health service use during pregnancy calculated. Logistic regression models assessed the odds ratio of having vaginal birth or caesarean section in the study groups. Of 339 women randomised, 184 (54%) women returned data at 6 weeks postpartum (Intervention Group n = 91; Control Group n = 93). Women receiving psycho-education had a higher likelihood of vaginal birth compared to controls (n = 60, 66% vs. n = 54, 58%; OR 2.34). Mean 'treatment' cost for women receiving psycho-education was AUS$72. Mean cost for health services excluding the cost of psycho-education, was less in the intervention group (AUS$1193 vs. AUS$1236), but not significant (p = 0.78). For every five women who received midwife counselling, one caesarean section was averted. The incremental healthcare cost to prevent one caesarean section using this intervention was AUS$145. Costs of delivering midwife psycho-education to women with childbirth fear during pregnancy are offset by improved vaginal birth rates and reduction in caesarean section numbers. Australian New Zealand Controlled Trials Registry ACTRN12612000526875 , 17th May 2012 (retrospectively registered one week after enrolment of first participant).

  4. A framework for assessing cost management system changes: the case of activity-based costing implementation at food industry

    Directory of Open Access Journals (Sweden)

    Tayebeh Faraji

    2015-04-01

    Full Text Available An opportunity to investigate the technical and organizational effect of management accounting system changes has appeared with companies' adoption of activity-based costing (ABC. This paper presents an empirical investigation to study the effects of ABC system for case study from food industry in Iran. From this case, the paper develops a framework for assessing ABC implementation and hypotheses about factors that influence implementation. The study detects five cost centers and for each cost center, it determines different cost drivers. The results of our survey has detected that implementation of ABC system not only helps precise allocation of overhead costs but also helps internal management companies for better planning and control of production, making better decisions for company's profits.

  5. Incremental cost analysis of advanced concept CAES systems

    Energy Technology Data Exchange (ETDEWEB)

    Knutsen, C.A.

    1979-09-01

    The costs of compressed air energy storage (CAES) systems using thermal energy storage (TES) are compared to the costs of CAES systems without TES and simple cycle gas turbine systems. Comparisons are made in terms of the system energy costs levelized over the operating life of the systems. These are in 1985 price levels which is the assumed first year of operation for the systems.

  6. Cost-effectiveness in reproductive medicine

    NARCIS (Netherlands)

    Moolenaar, L.M.

    2013-01-01

    This thesis reports on cost-effectiveness in reproductive medicine. Firstly, we evaluated the methodologic quality of studies in reproductive medicine. Insight into the quality of economical analysis in reproductive medicine is important for valuing the performed studies and to assess whether these

  7. Cost-Effectiveness of Online Teacher Training

    Science.gov (United States)

    Jung, Insung

    2005-01-01

    This study aims to compare the cost-effectiveness of an online teacher training method with a face-to-face training method in teaching "ICT integration in the school curriculum". In addition, the study explores the possibilities of a school-based voluntary training method in supporting other approaches to ICT teacher training. The analyses of…

  8. Evaluation of effectiveness and cost-effectiveness of a clinical decision support system in managing hypertension in resource constrained primary health care settings: results from a cluster randomized trial.

    Science.gov (United States)

    Anchala, Raghupathy; Kaptoge, Stephen; Pant, Hira; Di Angelantonio, Emanuele; Franco, Oscar H; Prabhakaran, D

    2015-01-05

    Randomized control trials from the developed world report that clinical decision support systems (DSS) could provide an effective means to improve the management of hypertension (HTN). However, evidence from developing countries in this regard is rather limited, and there is a need to assess the impact of a clinical DSS on managing HTN in primary health care center (PHC) settings. We performed a cluster randomized trial to test the effectiveness and cost-effectiveness of a clinical DSS among Indian adult hypertensive patients (between 35 and 64 years of age), wherein 16 PHC clusters from a district of Telangana state, India, were randomized to receive either a DSS or a chart-based support (CBS) system. Each intervention arm had 8 PHC clusters, with a mean of 102 hypertensive patients per cluster (n=845 in DSS and 783 in CBS groups). Mean change in systolic blood pressure (SBP) from baseline to 12 months was the primary endpoint. The mean difference in SBP change from baseline between the DSS and CBS at the 12th month of follow-up, adjusted for age, sex, height, waist, body mass index, alcohol consumption, vegetable intake, pickle intake, and baseline differences in blood pressure, was -6.59 mm Hg (95% confidence interval: -12.18 to -1.42; P=0.021). The cost-effective ratio for CBS and DSS groups was $96.01 and $36.57 per mm of SBP reduction, respectively. Clinical DSS are effective and cost-effective in the management of HTN in resource-constrained PHC settings. http://www.ctri.nic.in. Unique identifier: CTRI/2012/03/002476. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  9. National Energy with Weather System Simultator (NEWS) Sets Bounds on Cost Effective Wind and Solar PV Deployment in the USA without the Use of Storage.

    Science.gov (United States)

    Clack, C.; MacDonald, A. E.; Alexander, A.; Dunbar, A. D.; Xie, Y.; Wilczak, J. M.

    2014-12-01

    The importance of weather-driven renewable energies for the United States energy portfolio is growing. The main perceived problems with weather-driven renewable energies are their intermittent nature, low power density, and high costs. In 2009, we began a large-scale investigation into the characteristics of weather-driven renewables. The project utilized the best available weather data assimilation model to compute high spatial and temporal resolution power datasets for the renewable resources of wind and solar PV. The weather model used is the Rapid Update Cycle for the years of 2006-2008. The team also collated a detailed electrical load dataset for the contiguous USA from the Federal Energy Regulatory Commission for the same three-year period. The coincident time series of electrical load and weather data allows the possibility of temporally correlated computations for optimal design over large geographic areas. The past two years have seen the development of a cost optimization mathematic model that designs electric power systems. The model plans the system and dispatches it on an hourly timescale. The system is designed to be reliable, reduce carbon, reduce variability of renewable resources and move the electricity about the whole domain. The system built would create the infrastructure needed to reduce carbon emissions to 0 by 2050. The advantages of the system is reduced water demain, dual incomes for farmers, jobs for construction of the infrastructure, and price stability for energy. One important simplified test that was run included existing US carbon free power sources, natural gas power when needed, and a High Voltage Direct Current power transmission network. This study shows that the costs and carbon emissions from an optimally designed national system decrease with geographic size. It shows that with achievable estimates of wind and solar generation costs, that the US could decrease its carbon emissions by up to 80% by the early 2030s, without an

  10. Cost-effectiveness assessment in outpatient sinonasal surgery.

    Science.gov (United States)

    Mortuaire, G; Theis, D; Fackeure, R; Chevalier, D; Gengler, I

    2018-02-01

    To assess the cost-effectiveness of outpatient sinonasal surgery in terms of clinical efficacy and control of expenses. A retrospective study was conducted from January 2014 to January 2016. Patients scheduled for outpatient sinonasal surgery were systematically included. Clinical data were extracted from surgical and anesthesiology computer files. The cost accounting methods applied in our institution were used to evaluate logistic and technical costs. The standardized hospital fees rating system based on hospital stay and severity in diagnosis-related groups (Groupes homogènes de séjours: GHS) was used to estimate institutional revenue. Over 2years, 927 outpatient surgical procedures were performed. The crossover rate to conventional hospital admission was 2.9%. In a day-1 telephone interview, 85% of patients were very satisfied with the procedure. All outpatient cases showed significantly lower costs than estimated for conventional management with overnight admission, while hospital revenue did not differ between the two. This study confirmed the efficacy of outpatient surgery in this indication. Lower costs could allow savings for the health system by readjusting the rating for the procedure. More precise assessment of cost-effectiveness will require more fine-grained studies based on micro costing at hospital level and assessment of impact on conventional surgical activity and post-discharge community care. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  11. A COST ORIENTED SYSTEM FOR HOLE MAKING PROCESSES

    OpenAIRE

    Uğur PAMUKOĞLU; Cevdet GÖLOĞLU

    2004-01-01

    A knowledge based system for manufacturing of various hole making processes has been developed. In the system, selection of machining methods, determination of sequences based on cutting tools for each process, determination of process time and cost analysis have been conducted. In the procedure, all available processes have been taken in to account regarding their costs and the most suitable in cost was chosen. The system generated helps facilitate determination of process time and the cost...

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

    Directory of Open Access Journals (Sweden)

    Okumura LM

    2016-09-01

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

  13. Cost effectiveness of transportation fuels from biomass

    International Nuclear Information System (INIS)

    De Jager, D.; Faaij, A.P.C.; Troelstra, W.P.

    1998-06-01

    The aim of the study on the title subject was to investigate whether stimulation of the production and use of biofuels for transportation is worthwhile compared to the production of electricity from biomass. Several options are compared to each other and with reference technologies on the basis of the consumption or the avoided input of fossil fuels, emissions of greenhouse gases, specific costs and cost effectiveness. For each phase in the biomass conversion process (cultivation, pretreatment, transportation, conversion, distribution and final consumption) indicators were collected from the literature. Next to costs of the bioconversion routes attention is paid to other relevant aspects that are important for the introduction of the technological options in the Netherlands. 41 refs

  14. Cost-effectiveness of continuous erythropoietin receptor activator in anemia

    Directory of Open Access Journals (Sweden)

    Schmid H

    2014-07-01

    Full Text Available Holger Schmid1,21Clinic and Policlinic IV, Section of Nephrology, Munich University Hospital, Campus Innenstadt, Munich, Germany; 2KfH Nierenzentrum Muenchen Laim, Munich, GermanyBackground: Erythropoiesis-stimulating agents (ESAs are the mainstay of anemia therapy. Continuous erythropoietin receptor activator (CERA is a highly effective, long-acting ESA developed for once-monthly dosing. A multitude of clinical studies has evaluated the safety and efficiency of this treatment option for patients with renal anemia. In times of permanent financial pressure on health care systems, the cost-effectiveness of CERA should be of particular importance for payers and clinicians.Objective: To critically analyze, from the nephrologists' point of view, the published literature focusing on the cost-effectiveness of CERA for anemia treatment.Methods: The detailed literature search covered electronic databases including MEDLINE, PubMed, and Embase, as well as international conference abstract databases.Results: Peer-reviewed literature analyzing the definite cost-effectiveness of CERA is scarce, and most of the available data originate from conference abstracts. Identified data are restricted to the treatment of anemia due to chronic kidney disease. Although the majority of studies suggest a considerable cost advantage for CERA, the published literature cannot easily be compared. While time and motion studies clearly indicate that a switch to CERA could minimize health care staff time in dialysis units, the results of studies comparing direct costs are more ambivalent, potentially reflecting the differences between health care systems and variability between centers.Conclusion: Analyzed data are predominantly insufficient; they miss clear evidence and have to thus be interpreted with great caution. In this day and age of financial restraints, results from well-designed, head-to-head studies with clearly defined endpoints have to prove whether CERA therapy can

  15. Subsystem cost data for the tritium systems test assembly

    International Nuclear Information System (INIS)

    Bartlit, J.R.; Anderson, J.L.; Rexroth, V.G.

    1983-01-01

    Details of subsystem costs are among the questions most frequently asked about the $14.4 million Tritium Systems Test Assembly (TSTA) at Los Alamos National Laboratory. This paper presents a breakdown of cost components for each of the 20 major subsystems of TSTA. Also included are details to aid in adjusting the costs to other years, contracting conditions, or system sizes

  16. Subsystem cost data for the tritium systems test assembly

    Energy Technology Data Exchange (ETDEWEB)

    Bartlit, J.R.; Anderson, J.L.; Rexroth, V.G.

    1983-01-01

    Details of subsystem costs are among the questions most frequently asked about the $14.4 million Tritium Systems Test Assembly (TSTA) at Los Alamos National Laboratory. This paper presents a breakdown of cost components for each of the 20 major subsystems of TSTA. Also included are details to aid in adjusting the costs to other years, contracting conditions, or system sizes.

  17. Clinical evaluation based on cost-effectiveness

    International Nuclear Information System (INIS)

    Inoue, Takehiro; Inoue, Toshihiko

    1998-01-01

    We carried out two Phase III clinical trials using high dose rate (HDR) remote afterloading brachytherapy unit. We evaluated the clinical results based not only on the medical but also the economical standpoint. The first trial is the Phase III trial for cervical cancer treated with HDR or medium dose rate (MDR) intracavitary radiotherapy. The second one is the Phase III trial for tongue cancer treated with HDR or low dose rate (LDR) interstitial radiation. For cervical cancer, the survival rate of patients treated with HDR brachytherapy is the some as for LDR brachytherapy. The average total cost of treatment for the HDR group was 1.47 million yen, while that for the MDR group was 1.58 million yen. The average total admission days was 63. For tongue cancer, the local control rate of the HDR group is almost the same as that of the LDR groups. The average total cost for the HDR group was 780 thousand yen, and that for the LDR group was 830 thousand yen. The average total admission days was 34. According to the cost-effectiveness, HDR brachytherapy for cervical cancer has the same result as MDR, and HDR brachytherapy for tongue cancer has the same result as LDR. However, HDR can be treated without admission for patients who live near the hospital. HDR can be applied for these patients with less expense. We must be aware of not only the medical results but also the cost-effectiveness. (author)

  18. Impact of cost valuation on cost-effectiveness in adult spine deformity surgery.

    Science.gov (United States)

    Gum, Jeffrey L; Hostin, Richard; Robinson, Chessie; Kelly, Michael P; Carreon, Leah Yacat; Polly, David W; Bess, R Shay; Burton, Douglas C; Shaffrey, Christopher I; Smith, Justin S; LaFage, Virginie; Schwab, Frank J; Ames, Christopher P; Glassman, Steven D

    2017-01-01

    Over the past decade, the number of adult spinal deformity (ASD) surgeries has more than doubled in the United States. The complex surgeries needed to manage ASD are associated with significant resource utilization and high cost, making them a primary target for increased scrutiny. Accordingly, it is important to not only demonstrate value in ASD surgery as clinical effectiveness but also to translate outcome assessment to cost-effectiveness. To compare the difference between Medicare allowable rates and the actual, direct hospital costs for ASD surgeries. Longitudinal cohort. Consecutive patients enrolled in an ASD database from a single institution. Short Form (SF)-6D. Consecutive patients enrolled in an ASD database from a single institution from 2008 to 2013 were identified. Direct hospital costs were collected from hospital administrative records for the entire inpatient episode of surgical care. Medicare allowable rates were calculated for the same inpatient stays using the year-appropriate Center for Medicare-Medicaid Services Inpatient Pricer Payment System Tool. The SF-6D, a utility index derived from the SF-36v1, was used to determine quality-adjusted life years (QALY). Costs and QALYs were discounted at 3.5% annually. Of 580 surgical ASD patients eligible for 2-year follow up, 346 (60%) had complete baseline and 2-year data, and 60 were Medicare beneficiaries comprising the cohort for the present study. Mean SF-6D gained is 0.10 during year 1 after surgery and 0.02 at year 2, resulting in a cumulative SF-6D gain of 0.12 over 2 years. Mean Medicare allowable rate over the 2 years is $82,050 (range $42,383 to $220,749) and mean direct cost is $99,114 (range $28,447 to $217,717). Mean cost per QALY over 2 years is $683,750 using Medicare allowable rates and $825,950 using direct costs. This difference of $17,181 between the 2 cost calculation represents a 17% difference, which was statistically significant (p<.001). There is a significant difference in

  19. Cost Analysis Of Broadband Service Delivery Systems

    Science.gov (United States)

    Dunn, Donald A.; Johnson, M. Gens

    1990-01-01

    Costs for active double-star fiber networks for local exchange service are compared with the costs of copper twisted-pair single-star networks and copper coaxial-line tree networks with switching at the customer's premises. For both existing and new neighborhoods, it appears that delivery of broadband services through tree networks (possibly using fiber) and delivery of narrow band services through copper twisted-pair star networks will be the minimum cost approach for low market penetrations of the broadband service market. For near 100 percent market penetrations there is relatively little difference in the costs of the two approaches.

  20. Effects on annual cost of solar/air-heat utilization system of carbon tax and interest rate for a residential house; Jutakuyo taiyo/taikinetsu riyo system no nenkan keihi ni oyobosu tansozei kinri no eikyo

    Energy Technology Data Exchange (ETDEWEB)

    Shen, Q.; Kenmoku, Y.; Sakakibara, T. [Toyohashi University of Technology, Aichi (Japan); Nakagawa, S. [Maizuru National College of Technology, Kyoto (Japan); Kawamoto, T. [Shizuoka University, Shizuoka (Japan). Faculty of Engineering

    1996-10-27

    In recent years, a system has been proposed that utilizes river heat, air-heat, exhaust heat from a cooler, etc., in addition to natural energy for the heat pump. With the introduction of such system, the amount of energy used and that of CO2 exhaust will be greatly reduced, but annual expenses will be increased as it stands. In order to improve the cost efficiency of the system, a proposal has been made for the introduction of an economic policy such as the carbon tax and a low interest financing system. With these matters in the background, the subject study predicts the production of solar cells in the future and, on the basis of this production, determines the price, conversion efficiency and equipment energy of solar cells in the future. Using these values and taking into consideration the introduction of the carbon tax and the low interest financing system, the optimum area was determined for solar cells and heat concentrators in a future residential solar/air-heat energy system. The carbon tax, being imposed on all CO2 discharges, had a large effect. Moreover, as the tax increased, annual expenses decreased for the solar/air-heat system. 3 refs., 6 figs.

  1. Making choices in health: WHO guide to cost effectiveness analysis

    National Research Council Canada - National Science Library

    Tan Torres Edejer, Tessa

    2003-01-01

    ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 6. Uncertainty in cost-effectiveness analysis . . . . . . . . . . . . . . . . . . 73 7. 8. Policy uses of Generalized CEA...

  2. Cost effects of hospital mergers in Portugal.

    Science.gov (United States)

    Azevedo, Helda; Mateus, Céu

    2014-12-01

    The Portuguese hospital sector has been restructured by wide-ranging hospital mergers, following a conviction among policy makers that bigger hospitals lead to lower average costs. Since the effects of mergers have not been systematically evaluated, the purpose of this article is to contribute to this area of knowledge by assessing potential economies of scale to explore and compare these results with realized cost savings after mergers. Considering the period 2003-2009, we estimate the translog cost function to examine economies of scale in the years preceding restructuring. Additionally, we use the difference-in-differences approach to evaluate hospital centres (HC) that occurred between 2004 and 2007, comparing the years after and before mergers. Our findings suggest that economies of scale are present in the pre-merger configuration with an optimum hospital size of around 230 beds. However, the mergers between two or more hospitals led to statistically significant post-merger cost increases, of about 8 %. This result indicates that some HC become too large to explore economies of scale and suggests the difficulty of achieving efficiencies through combining operations and service specialization.

  3. Cost Effectiveness of Gene Expression Profile Testing in Community Practice.

    Science.gov (United States)

    Chandler, Young; Schechter, Clyde B; Jayasekera, Jinani; Near, Aimee; O'Neill, Suzanne C; Isaacs, Claudine; Phelps, Charles E; Ray, G Thomas; Lieu, Tracy A; Ramsey, Scott; Mandelblatt, Jeanne S

    2018-02-20

    Purpose Gene expression profile (GEP) testing can support chemotherapy decision making for patients with early-stage, estrogen receptor-positive, human epidermal growth factor 2-negative breast cancers. This study evaluated the cost effectiveness of one GEP test, Onco type DX (Genomic Health, Redwood City, CA), in community practice with test-eligible patients age 40 to 79 years. Methods A simulation model compared 25-year societal incremental costs and quality-adjusted life-years (QALYs) of community Onco type DX use from 2005 to 2012 versus usual care in the pretesting era (2000 to 2004). Inputs included Onco type DX and chemotherapy data from an integrated health care system and national and published data on Onco type DX accuracy, chemotherapy effectiveness, utilities, survival and recurrence, and Medicare and patient costs. Sensitivity analyses varied individual parameters; results were also estimated for ideal conditions (ie, 100% testing and adherence to test-suggested treatment, perfect test accuracy, considering test effects on reassurance or worry, and lowest costs). Results Twenty-four percent of test-eligible patients had Onco type DX testing. Testing was higher in younger patients and patients with stage I disease ( v stage IIA), and 75.3% and 10.2% of patients with high and low recurrence risk scores received chemotherapy, respectively. The cost-effectiveness ratio for testing ( v usual care) was $188,125 per QALY. Considering test effects on worry versus reassurance decreased the cost-effectiveness ratio to $58,431 per QALY. With perfect test accuracy, the cost-effectiveness ratio was $28,947 per QALY, and under ideal conditions, it was $39,496 per QALY. Conclusion GEP testing is likely to have a high cost-effectiveness ratio on the basis of community practice patterns. However, realistic variations in assumptions about key variables could result in GEP testing having cost-effectiveness ratios in the range of other accepted interventions. The

  4. Privacy Enforcement in a Cost-Effective Smart Grid

    DEFF Research Database (Denmark)

    Mikkelsen, Søren Aagaard

    In this technical report we present the current state of the research conducted during the first part of the PhD period. The PhD thesis “Privacy Enforcement in a Cost-Effective Smart Grid” focuses on ensuring privacy when generating market for energy service providers that develop web services...... and privacy challenges that emerge when designing a system architecture and infrastructure. The resulting architecture is a consumer-centric and agent-based design and uses open Internet-based communication protocols for enabling interoperability while being cost-effective. Finally, the PhD report present...

  5. Comparison of a Cost-Effective Integrated Plankton Sampling and Imaging Instrument with Traditional Systems for Mesozooplankton Sampling in the Celtic Sea

    Directory of Open Access Journals (Sweden)

    Sophie G. Pitois

    2018-01-01

    Full Text Available Three plankton collection methods were used to gather plankton samples in the Celtic Sea in October 2016. The Plankton Image Analysis (PIA system is a high-speed color line scan-based imaging instrument, which continuously pumps water, takes images of the passing particles, and identifies the zooplankton organisms present. We compared and evaluated the performance of the PIA against the Continuous Automatic Litter and Plankton Sampler (CALPS and the traditional ring net vertical haul. The PIA underestimated species abundance compared to the CALPS and ring net and gave an image of the zooplankton community structure that was different from the other two devices. There was, however, good agreement in the spatial distribution of abundances across the three systems. Our study suggests that the image capture and analysis step rather than the sampling method was responsible for the discrepancies noted between the PIA and the other two datasets. The two most important issues appeared to be differences in sub-sampling between the PIA system and the other two devices, and blurring of specimen features due to limited PIA optical depth of field. A particular advantage of the CALPS over more traditional vertical sampling methods is that it can be integrated within existing multidisciplinary surveys at little extra cost without requiring additional survey time. Additionally, PIA performs automatic image acquisition and it does remove the need to collect physical preserved samples for subsequent analysis in the laboratory. With the help of an expert taxonomist the system in its current form can also integrate the sampling and analysis steps, thus increasing the speed, and reducing the costs for zooplankton sampling in near real-time. Although the system shows some limitation we believe that a revised PIA system will have the potential to become an important element of an integrated zooplankton monitoring program.

  6. The cost-effectiveness of quality improvement projects: a conceptual framework, checklist and online tool for considering the costs and consequences of implementation-based quality improvement.

    Science.gov (United States)

    Thompson, Carl; Pulleyblank, Ryan; Parrott, Steve; Essex, Holly

    2016-02-01

    In resource constrained systems, decision makers should be concerned with the efficiency of implementing improvement techniques and technologies. Accordingly, they should consider both the costs and effectiveness of implementation as well as the cost-effectiveness of the innovation to be implemented. An approach to doing this effectively is encapsulated in the 'policy cost-effectiveness' approach. This paper outlines some of the theoretical and practical challenges to assessing policy cost-effectiveness (the cost-effectiveness of implementation projects). A checklist and associated (freely available) online application are also presented to help services develop more cost-effective implementation strategies. © 2015 John Wiley & Sons, Ltd.

  7. Cost and cost-effectiveness of nationwide school-based helminth control in Uganda

    Science.gov (United States)

    BROOKER, SIMON; KABATEREINE, NARCIS B; FLEMING, FIONA; DEVLIN, NANCY

    2009-01-01

    Estimates of cost and cost-effectiveness are typically based on a limited number of small-scale studies with no investigation of the existence of economies to scale or intra-country variation in cost and cost-effectiveness. This information gap hinders the efficient allocation of health care resources and the ability to generalize estimates to other settings. The current study investigates the intra-country variation in the cost and cost-effectiveness of nationwide school-based treatment of helminth (worm) infection in Uganda. Programme cost data were collected through semi-structured interviews with districts officials and from accounting records in six of the 23 intervention districts. Both financial and economic costs were assessed. Costs were estimated on the basis of cost in US$ per schoolchild treated and an incremental cost effectiveness ratio (cost in US$ per case of anaemia averted) was used to evaluate programme cost-effectiveness. Sensitivity analysis was performed to assess the effect of discount rate and drug price. The overall economic cost per child treated in the six districts was US$ 0.54 and the cost-effectiveness was US$ 3.19 per case of anaemia averted. Analysis indicated that estimates of both cost and cost-effectiveness differ markedly with the total number of children which received treatment, indicating economies of scale. There was also substantial variation between districts in the cost per individual treated (US$ 0.41-0.91) and cost per anaemia case averted (US$ 1.70-9.51). Independent variables were shown to be statistically associated with both sets of estimates. This study highlights the potential bias in transferring data across settings without understanding the nature of observed variations. PMID:18024966

  8. On cost-effective communication network designing

    Science.gov (United States)

    Zhang, Guo-Qiang

    2010-02-01

    How to efficiently design a communication network is a paramount task for network designing and engineering. It is, however, not a single objective optimization process as perceived by most previous researches, i.e., to maximize its transmission capacity, but a multi-objective optimization process, with lowering its cost to be another important objective. These two objectives are often contradictive in that optimizing one objective may deteriorate the other. After a deep investigation of the impact that network topology, node capability scheme and routing algorithm as well as their interplays have on the two objectives, this letter presents a systematic approach to achieve a cost-effective design by carefully choosing the three designing aspects. Only when routing algorithm and node capability scheme are elegantly chosen can BA-like scale-free networks have the potential of achieving good tradeoff between the two objectives. Random networks, on the other hand, have the built-in character for a cost-effective design, especially when other aspects cannot be determined beforehand.

  9. [ARCSTERILE: A COST-EFFECTIVE LUXURY].

    Science.gov (United States)

    Fenoll, Maria Andreu

    2015-05-01

    The aim of this study is to evaluate the safety, economic profitability, and cost-effectiveness of the controlled ambient surgical cabin ArcSterile. Retrospective observational study comparing the profitability of surgical procedures using the ArcSterile* with those using the operating room throughout a 12-month period by analysing the following variables: total number of treated patients, delay in surgical assistance delay and the cost per procedure. Throughout a 12-month period, a total number of 2011 surgical procedures were performed with the ArcSterile, and 1736 surgical procedures were performed in the conventional operating room. Minor ocular surgeries including chalazia, pterigium, intravitreal injections and others were considered, whereas cataract and vitrectomy surgeries were disregarded. The use of the ArcSterile* was associated with an increase of 14% in the number of surgeries. The cost per hour of the use of the ArcSterile* was 30.75 euro, whereas it was 142.78 euro for the coriventional operating room. The ArcSterile* may allow to treat more patients and to treat them earlier compared with the conventional operating room, optimizing the use of the latest for patients who need a more complex surgery. We estimated an economic impact of 134 121.39 euro savings during the 12-month period of analysis. The use of the ArcSterile* surgical cabin for outpatient ocularsurgery may represent an effective and efficient alternative to the operating room with many clinical and economic benefits.

  10. Cost effects of Cu powder and bentonite on the disposal costs of an HLW repository in

    International Nuclear Information System (INIS)

    Kim, Sung Ki; Lee, Min Soo; Lee, Jong Youl; Choi, Heui Joo; Choi, Jong Won

    2008-01-01

    This paper provides the cost effect results of Cu powder and bentonite on the disposal cost for an HLW repository in Korea. In the cost analysis for both of these cost drivers, the price of Cu powder and the bentonite can affect the canister cost and the bentonite cost of the disposal holes as well as backfilling cost of the tunnels, respectively. Finally, we found that the unit cost of Cu and bentonite was the dominant cost drivers for the surface and underground facilities of an HLW repository. Therefore, an optimization of a canister and the layout of a disposal hole and disposal tunnels are essential to decrease the direct disposal cost of spent fuels. The disposal costs can be largely divided into two parts such as a surface facilities' cost and an underground facilities' cost. According to the KRS' cost analysis, the encapsulation material as well as the buffering and backfilling cost were the significant costs. Especially, a canister's cost was approximately estimated to be more than one fourth of the overall disposal costs. So it can be estimated that the unit cost of Cu powder is an important cost diver. Because the outer shell of the canister was made of Cu powder by a cold spray coating method. In addition, the unit cost of bentonite can also affect the buffering and the backfilling costs of the disposal holes and the disposal tunnels. But, these material costs will be highly expensive and unstable due to the modernization of the developing countries. So the studies for a material cost should be continued to identify the actual cost of an HLW repository

  11. A cost effective CO2 strategy

    DEFF Research Database (Denmark)

    are evaluated according to CO2 reduction potential and according to the ‘shadow price’ on a reduction of one ton CO2. The shadow price reflects the costs (and benefits) of the different measures. Comparing the measures it is possible to identify cost effective measures, but these measures are not necessarily......) between measures are also addressed. It has not been possible to analyse combinations and packages of measures consistently in a model like the on outlined above. However, the obvious connections are addressed and clearly show the limitations with respect to fulfilling the target set by the Kyoto protocol...... national strategies for climate and transport and associated implementation deficits will be discussed, reflecting the presently changing institutional conditions for policy formulation and implementation. The main differences compared to earlier CO2 strategies are the EU ETS and targets set for non...

  12. Superconductors Enable Lower Cost MRI Systems

    Science.gov (United States)

    2013-01-01

    The future looks bright, light, and green, especially where aircraft are concerned. The division of NASA s Fundamental Aeronautics Program called the Subsonic Fixed Wing Project is aiming to reach new heights by 2025-2035, improving the efficiency and environmental impact of air travel by developing new capabilities for cleaner, quieter, and more fuel efficient aircraft. One of the many ways NASA plans to reach its aviation goals is by combining new aircraft configurations with an advanced turboelectric distributed propulsion (TeDP) system. Jeff Trudell, an engineer at Glenn Research Center, says, "The TeDP system consists of gas turbines generating electricity to power a large number of distributed motor-driven fans embedded into the airframe." The combined effect increases the effective bypass ratio and reduces drag to meet future goals. "While room temperature components may help reduce emissions and noise in a TeDP system, cryogenic superconducting electric motors and generators are essential to reduce fuel burn," says Trudell. Superconductors provide significantly higher current densities and smaller and lighter designs than room temperature equivalents. Superconductors are also able to conduct direct current without resistance (loss of energy) below a critical temperature and applied field. Unfortunately, alternating current (AC) losses represent the major part of the heat load and depend on the frequency of the current and applied field. A refrigeration system is necessary to remove the losses and its weight increases with decreasing temperature. In 2001, a material called magnesium diboride (MgB2) was discovered to be superconducting. The challenge, however, has been learning to manufacture MgB2 inexpensively and in long lengths to wind into large coils while meeting the application requirements.

  13. Teaching medical students about cost-effectiveness.

    Science.gov (United States)

    Iscoe, Mark; Lord, Robert; Schulz, John; Lee, David; Cayea, Danelle; Pahwa, Amit

    2018-02-01

    Rising and burdensome health care costs have driven interest in the practice of high-value care (HVC) and have inspired calls for increased HVC training across all levels of medical education, including among undergraduate medical students. Classroom-based HVC curricula targeted to medical students have not been previously described in the medical literature. We developed and evaluated a workshop comprising a lecture, a small-group exercise and a group discussion to instruct medical students on interpreting cost-effectiveness analyses (CEA), applying CEA to patient care and discussing the cost of care with patients. From January 2014 to September 2015 the workshop was administered to five cohorts, 120 students in total, in the internal medicine clerkships at two US medical schools. Pre- and post-intervention confidence in various domains was assessed with a Likert-type scale ranging from 1 to 4. The overall response rate was 87.9 per cent. The proportion of students reporting high confidence scores (3 or 4) rose significantly (p rated the overall quality of the course as 3.82 out of 5. Rising and burdensome health care costs have driven interest in the practice of high-value care IMPLICATIONS: Our experience of developing, evaluating and refining an HVC course targeted at medical students taught us that such a course is needed, can be educational and can be well-received. Future research is needed to assess the effects of curricula on clinical practice. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  14. Cost analysis of energy storage systems for electric utility applications

    Energy Technology Data Exchange (ETDEWEB)

    Akhil, A. [Sandia National Lab., Albuquerque, NM (United States); Swaminathan, S.; Sen, R.K. [R.K. Sen & Associates, Inc., Bethesda, MD (United States)

    1997-02-01

    Under the sponsorship of the Department of Energy, Office of Utility Technologies, the Energy Storage System Analysis and Development Department at Sandia National Laboratories (SNL) conducted a cost analysis of energy storage systems for electric utility applications. The scope of the study included the analysis of costs for existing and planned battery, SMES, and flywheel energy storage systems. The analysis also identified the potential for cost reduction of key components.

  15. Factors Associated with Photovoltaic System Costs (Topical Issues Brief)

    Energy Technology Data Exchange (ETDEWEB)

    Mortensen, J.

    2001-06-12

    A variety of factors can affect the cost of photovoltaic systems. This report analyses the relationship among such factors by using information entered into a voluntary registry of PV systems and performing regression analyses. The results showed statistically significant relationships between photovoltaic system cost and (a) grid connection, (b) installation year, (c) areas where the utility had entered into volume purchasing agreements.

  16. The cost system of GSI - heavy ion facility in Darmstadt

    International Nuclear Information System (INIS)

    1979-01-01

    The paper gives an overview about the organization and the research program of the GSI (Heavy Ion Facility in Darmstadt). The cost accounting system is discussed in detail, financing, cost center accounting and cost unit accounting are described. (A.N.)

  17. Is the system really the solution? Operating costs in hospital systems.

    Science.gov (United States)

    Burns, Lawton Robert; McCullough, Jeffrey S; Wholey, Douglas R; Kruse, Gregory; Kralovec, Peter; Muller, Ralph

    2015-06-01

    Hospital system formation has recently accelerated. Executives emphasize scale economies that lower operating costs, a claim unsupported in academic research. Do systems achieve lower costs than freestanding facilities, and, if so, which system types? We test hypotheses about the relationship of cost with membership in systems, larger systems, and centralized and local hub-and-spoke systems. We also test whether these relationships have changed over time. Examining 4,000 U.S. hospitals during 1998 to 2010, we find no evidence that system members exhibit lower costs. However, members of smaller systems are lower cost than larger systems, and hospitals in centralized systems are lower cost than everyone else. There is no evidence that the system's spatial configuration is associated with cost, although national system hospitals exhibit higher costs. Finally, these results hold over time. We conclude that while systems in general may not be the solution to lower costs, some types of systems are. © The Author(s) 2015.

  18. Cost-effective method for laparoscopic choledochotomy.

    Science.gov (United States)

    Griniatsos, John; Karvounis, Evangelos; Arbuckle, James; Isla, Alberto-Martinez

    2005-01-01

    Recent reports have noted that postoperative complications following open or laparoscopic choledochotomy for common bile duct (CBD) exploration are mainly related to the T-tube presence, and that there has been no trend of decrease in the laparoscopic era. Laparoscopic endobiliary stent placement with primary closure of the CBD has been proposed as a safe and effective alternative to T-tube placement. Between January 1999 and January 2003, 53 consecutive patients suffering from proven choledocholithiasis underwent laparoscopic common bile exploration (LCBDE) via choledochotomy. In the early period, a T-tube was placed at the end of the procedure (group A, n = 32) while, from June 2001 onwards, laparoscopic biliary stent placement and primary CBD closure were chosen as the drainage method (group B, n = 21). Six patients developed T-tube-related complications postoperatively. Univariate analysis revealed statistically significant lower morbidity rate and shorter postoperative hospital stay for the stent group. Although not statistically significant, a median saving of 780 UK pounds per patient was observed in the stent group. Biliary endoprosthesis placement following laparoscopic choledochotomy avoids the well-known complications of a T-tube, leading to a shorter postoperative hospital stay. The method is safe and effective and it should also be considered as cost-effective compared to T-tube placement. Further studies are required in order to document cost-effectiveness of the method.

  19. The use of parametric cost estimating relationships for transport aircraft systems in establishing initial Design to Cost Targets

    Science.gov (United States)

    Beltramo, M. N.; Anderson, J. L.

    1977-01-01

    This paper provides a brief overview of Design to Cost (DTC). Problems inherent in attempting to estimate costs are discussed, along with techniques and types of models that have been developed to estimate aircraft costs. A set of cost estimating relationships that estimate the total production cost of commercial and military transport aircraft at the systems level is presented and the manner in which these equations might be used effectively in developing initial DTC targets is indicated. The principal point made in this paper is that, by using a disagregated set of equations to estimate transport aircraft costs at the systems level, reasonably accurate preliminary cost estimates may be achieved. These estimates may serve directly as initial DTC targets, or adjustments may be made to the estimates obtained for some of the systems to estimate the production cost impact of alternative designs or manufacturing technologies. The relative ease by which estimates may be made with this model, the flexibility it provides by being disaggregated, and the accuracy of the estimates it provides make it a unique and useful tool in establishing initial DTC targets.

  20. System Approach of Logistic Costs Optimization Solution in Supply Chain

    OpenAIRE

    Majerčák, Peter; Masárová, Gabriela; Buc, Daniel; Majerčáková, Eva

    2013-01-01

    This paper is focused on the possibility of using the costs simulation in supply chain, which are on relative high level. Our goal is to determine the costs using logistic costs optimization which must necessarily be used in business activities in the supply chain management. The paper emphasizes the need to perform not isolated optimization in the whole supply chain. Our goal is to compare classic approach, when every part tracks its costs isolated, a try to minimize them, with the system (l...

  1. Resilient guaranteed cost control of a power system

    Science.gov (United States)

    Soliman, Hisham M.; Soliman, Mostafa H.; Hassan, Mohammad. F.

    2013-01-01

    With the development of power system interconnection, the low-frequency oscillation is becoming more and more prominent which may cause system separation and loss of energy to consumers. This paper presents an innovative robust control for power systems in which the operating conditions are changing continuously due to load changes. However, practical implementation of robust control can be fragile due to controller inaccuracies (tolerance of resistors used with operational amplifiers). A new design of resilient (non-fragile) robust control is given that takes into consideration both model and controller uncertainties by an iterative solution of a set of linear matrix inequalities (LMI). Both uncertainties are cast into a norm-bounded structure. A sufficient condition is derived to achieve the desired settling time for damping power system oscillations in face of plant and controller uncertainties. Furthermore, an improved controller design, resilient guaranteed cost controller, is derived to achieve oscillations damping in a guaranteed cost manner. The effectiveness of the algorithm is shown for a single machine infinite bus system, and then, it is extended to multi-area power system. PMID:25685505

  2. Priority Setting, Cost-Effectiveness, and the Affordable Care Act.

    Science.gov (United States)

    Persad, Govind

    2015-01-01

    The Affordable Care Act (ACA) may be the most important health law statute in American history, yet much of the most prominent legal scholarship examining it has focused on the merits of the court challenges it has faced rather than delving into the details of its priority-setting provisions. In addition to providing an overview of the ACA's provisions concerning priority setting and their developing interpretations, this Article attempts to defend three substantive propositions. First, I argue that the ACA is neither uniformly hostile nor uniformly friendly to efforts to set priorities in ways that promote cost and quality. Second, I argue that the ACA does not take a single, unified approach to priority setting; rather, its guidance varies depending on the aspect of the healthcare system at issue (Patient Centered Outcomes Research Institute, Medicare, essential health benefits) and the factors being excluded from priority setting (age, disability, life expectancy). Third, I argue that cost-effectiveness can be achieved within the ACA's constraints, but that doing so will require adopting new approaches to cost-effectiveness and priority setting. By limiting the use of standard cost-effectiveness analysis, the ACA makes the need for workable rivals to cost-effectiveness analysis a pressing practical concern rather than a mere theoretical worry.

  3. Mental health services costs within the Alberta criminal justice system.

    Science.gov (United States)

    Jacobs, Philip; Moffatt, Jessica; Dewa, Carolyn S; Nguyen, Thanh; Zhang, Ting; Lesage, Alain

    2016-01-01

    Mental illness has been widely cited as a driver of costs in the criminal justice system. The objective of this paper is to estimate the additional mental health service costs incurred within the criminal justice system that are incurred because of people with mental illnesses who go through the system. Our focus is on costs in Alberta. We set up a model of the flow of all persons through the criminal justice system, including police, court, and corrections components, and for mental health diversion, review, and forensic services. We estimate the transitional probabilities and costs that accrue as persons who have been charged move through the system. Costs are estimated for the Alberta criminal justice system as a whole, and for the mental illness component. Public expenditures for each person diverted or charged in Alberta in the criminal justice system, including mental health costs, were $16,138. The 95% range of this estimate was from $14,530 to $19,580. Of these costs, 87% were for criminal justice services and 13% were for mental illness-related services. Hospitalization for people with mental illness who were reviewed represented the greatest additional cost associated with mental illnesses. Treatment costs stemming from mental illnesses directly add about 13% onto those in the criminal justice system. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Cost minimisation analysis of thermometry in two different hospital systems.

    Science.gov (United States)

    Hayes, Kenneth; Shepard, Amanda; Cesarec, August; Likić, Robert

    2017-10-01

    Temperature monitoring can be accomplished by various methods, including oral (OT), rectal (RT), axillary (AT), tympanic membrane (TMT) and temporal artery (TAT) thermometry, with varying amounts of cost incurred by healthcare systems. The potential thermometry cost savings in two hospital systems-University Hospital Centre Zagreb (UHCZ), which uses TMT (device Covidien Genius 2) and University of Michigan Hospitals (UMH), which relies on OT, RT and AT (device Welch Allyn suretemp plus 692)-were analysed to evaluate institution-wide TAT (device Exergen TAT-5000) implementation. Two scenarios were developed: scenario 1, comparing costs for a period of 1, 3 and 5 years; scenario 2, calculation of the number of measurements per device for TAT to be cost-effective. At UHCZ, use of TAT would bring budget savings regardless of the number of devices per bed and the number of years observed. Savings would range from US$0.08 million (one device per bed, impact for 1 year) to US$1.8 million (one device per 10 beds, impact for 5 years). At UMH, use of TAT would lead to budget savings if one device per 10 beds were acquired, but only over a period of 3 or 5 years. Other TAT scenarios were associated with budget costs at UMH even after a period of 5 years. Sensitivity analyses showed that the price of current consumables had the highest impact on the model in both hospital settings, with TAT up to 10 times cheaper in that regard over TMT at UHCZ, potentially leading to considerable budget savings within a year of hospital-wide implementation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  5. Cost effective material control and accountability training

    International Nuclear Information System (INIS)

    Robichaux, J.J.; Shull, L.M.; Salizzoni, L.M.

    1995-01-01

    DOE Order 5630.15, ''Safeguards and Security Training Program'' is being implemented at the Savannah River Site within the Westinghouse Savannah River Company's material control and accountability program. This paper reviews the development of a material control and accountability task analysis, the development of specific material control and accountability courses, and the cost effective and innovative strategies employed to implement the training program. The paper also discusses how the site material control and accountability policies and procedures are incorporated into the Westinghouse Savannah River Company training program to ensure that personnel receive the most current information

  6. The Cost-Effective Evaluation of Syncope.

    Science.gov (United States)

    Angus, Steven

    2016-09-01

    Syncope is a common clinical problem that carries a high socioeconomic burden. A structured approach in the evaluation of syncope with special emphasis on a detailed history, comprehensive physical examination that includes orthostatic vital signs, and an electrocardiogram, proves to be the most cost-effective approach. The need for additional testing and hospital admission should be based on the results of the initial evaluation and use of risk-stratification tools that help identify those syncope patients at highest risk for poor outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Training effectiveness vs. cost effectiveness: The next millennium challenge

    International Nuclear Information System (INIS)

    Coe, Richard P.

    2003-01-01

    With the advent of the new millennium and energy deregulation, organizations will be challenged to be cost competitive and profitable. Deregulation in the US energy industry will force utilities and, more specifically, commercial nuclear power production to unprecedented cost control measures. It will also renew the fires of debate about costs vs. safety. With personnel costs being the single largest expenditure for most organizations management will be faced with constant dilemmas of competition for scarce resources. Salaries, benefits and training costs will be under greater scrutiny. Training resources and programs will face increased pressure to be job related, based on conservative requirements and more cost effective than in the past. For nearly two decades the US National Academy for Nuclear Training (NANT) has developed and used industry-wide accreditation and evaluation standards based on the Systematic Approach to Training (SAT). This process assures that existing and emerging technical training is constantly reviewed and evaluated against standardized criteria to assure job relatedness and enhanced job performance. The process also requires management to approve, actively participate in and support the training of NPP personnel. Instructors must be highly skilled and well trained in the SAT process and various instructional strategies. The SAT process is grounded in five interlocking keystone steps; Analysis - Design - Development - Implementation - Evaluation (ADDIE). Evaluation of training is often said to be the most crucial and most difficult step. Here is where an organization determines if the training is effective and meeting the legitimate needs of all of the stakeholders. This QA/QC aspect of training must be an ongoing process involving management, instructors and the students. It is only through the discipline of an SAT based evaluation process that an organization can truly determine if the training is efficient, effective, cost effective and

  8. Review of storage battery system cost estimates

    Energy Technology Data Exchange (ETDEWEB)

    Brown, D.R.; Russell, J.A.

    1986-04-01

    Cost analyses for zinc bromine, sodium sulfur, and lead acid batteries were reviewed. Zinc bromine and sodium sulfur batteries were selected because of their advanced design nature and the high level of interest in these two technologies. Lead acid batteries were included to establish a baseline representative of a more mature technology.

  9. [Cost of therapy for neurodegenerative diseases. Applying an activity-based costing system].

    Science.gov (United States)

    Sánchez-Rebull, María-Victoria; Terceño Gómez, Antonio; Travé Bautista, Angeles

    2013-01-01

    To apply the activity based costing (ABC) model to calculate the cost of therapy for neurodegenerative disorders in order to improve hospital management and allocate resources more efficiently. We used the case study method in the Francolí long-term care day center. We applied all phases of an ABC system to quantify the cost of the activities developed in the center. We identified 60 activities; the information was collected in June 2009. The ABC system allowed us to calculate the average cost per patient with respect to the therapies received. The most costly and commonly applied technique was psycho-stimulation therapy. Focusing on this therapy and on others related to the admissions process could lead to significant cost savings. ABC costing is a viable method for costing activities and therapies in long-term day care centers because it can be adapted to their structure and standard practice. This type of costing allows the costs of each activity and therapy, or combination of therapies, to be determined and aids measures to improve management. Copyright © 2012 SESPAS. Published by Elsevier Espana. All rights reserved.

  10. Costs of diarrheal disease and the cost-effectiveness of a rotavirus vaccination program in kyrgyzstan.

    Science.gov (United States)

    Flem, Elmira T; Latipov, Renat; Nurmatov, Zuridin S; Xue, Yiting; Kasymbekova, Kaliya T; Rheingans, Richard D

    2009-11-01

    We examined the cost-effectiveness of a rotavirus immunization program in Kyrgyzstan, a country eligible for vaccine funding from the GAVI Alliance. We estimated the burden of rotavirus disease and its economic consequences by using national and international data. A cost-effectiveness analysis was conducted from government and societal perspectives, along with a range of 1-way sensitivity analyses. Rotavirus-related hospitalizations and outpatient visits cost US$580,864 annually, of which $421,658 (73%) is direct medical costs and $159,206 (27%) is nonmedical and indirect costs. With 95% coverage, vaccination could prevent 75% of rotavirus-related hospitalizations and deaths and 56% of outpatient visits and could avert $386,193 (66%) in total costs annually. The medical break-even price at which averted direct medical costs equal vaccination costs is $0.65/dose; the societal break-even price is $1.14/dose for a 2-dose regimen. At the current GAVI Alliance-subsidized vaccine price of $0.60/course, rotavirus vaccination is cost-saving for the government. Vaccination is cost-effective at a vaccine price $9.41/dose, according to the cost-effectiveness standard set by the 2002 World Health Report. Addition of rotavirus vaccines to childhood immunization in Kyrgyzstan could substantially reduce disease burden and associated costs. Vaccination would be cost-effective from the national perspective at a vaccine price $9.41 per dose.

  11. Cost-effective analysis of PET application in NSCLC

    International Nuclear Information System (INIS)

    Gu Aichun; Liu Jianjun; Sun Xiaoguang; Shi Yiping; Huang Gang

    2006-01-01

    Objective: To evaluate the cost-effectiveness of PET and CT application for diagnosis of non-small cell lung cancer (NSCLC) in China. Methods: Using decision analysis method the diagnostic efficiency of PET and CT for diagnosis of NSCLC in china was analysed. And also the value of cost for accurate diagnosis (CAD), cost for accurate staging (CAS) and cost for effective therapy (CAT) was calculated. Results: (1) For the accurate diagnosis, CT was much more cost-effective than PET. (2) For the accurate staging, CT was still more cost-effective than PET. (3) For the all over diagnostic and therapeutic cost, PET was more cost-effective than CT. (4) The priority of PET to CT was for the diagnosis of stage I NSCLC. Conclusion: For the management of NSCLC patient in China, CT is more cost-effective for screening, whereas PET for clinical staging and monitoring therapeutic effect. (authors)

  12. Space construction system analysis. Part 2: Cost and programmatics

    Science.gov (United States)

    Vonflue, F. W.; Cooper, W.

    1980-01-01

    Cost and programmatic elements of the space construction systems analysis study are discussed. The programmatic aspects of the ETVP program define a comprehensive plan for the development of a space platform, the construction system, and the space shuttle operations/logistics requirements. The cost analysis identified significant items of cost on ETVP development, ground, and flight segments, and detailed the items of space construction equipment and operations.

  13. Concentrated photovoltaics system costs and learning curve analysis

    Science.gov (United States)

    Haysom, Joan E.; Jafarieh, Omid; Anis, Hanan; Hinzer, Karin

    2013-09-01

    An extensive set of costs in /W for the installed costs of CPV systems has been amassed from a range of public sources, including both individual company prices and market reports. Cost reductions over time are very evident, with current prices for 2012 in the range of 3.0 ± 0.7 /W and a predicted cost of 1.5 /W for 2020. Cost data is combined with deployment volumes in a learning curve analysis, providing a fitted learning rate of either 18.5% or 22.3% depending on the methodology. This learning rate is compared to that of PV modules and PV installed systems, and the influence of soft costs is discussed. Finally, if an annual growth rate of 39% is assumed for deployed volumes, then, using the learning rate of 20%, this would predict the achievement of a cost point of 1.5 /W by 2016.

  14. Labor costing for HANDI 2000 business management system

    Energy Technology Data Exchange (ETDEWEB)

    Wilson, D.

    1998-08-24

    Costing labor in the Financial Data System has traditionally been done using standard rates based on type of employee by organization. This methodology will change with the implementation of the PeopleSoft financial system. Labor in the new environment will be cost against actual dollars and marked up with an employee adder, to cover absences and fringe benefits.

  15. Cost, affordability and cost-effectiveness of strategies to control tuberculosis in countries with high HIV prevalence

    Directory of Open Access Journals (Sweden)

    Williams Brian G

    2005-12-01

    Full Text Available Abstract Background The HIV epidemic has caused a dramatic increase in tuberculosis (TB in East and southern Africa. Several strategies have the potential to reduce the burden of TB in high HIV prevalence settings, and cost and cost-effectiveness analyses can help to prioritize them when budget constraints exist. However, published cost and cost-effectiveness studies are limited. Methods Our objective was to compare the cost, affordability and cost-effectiveness of seven strategies for reducing the burden of TB in countries with high HIV prevalence. A compartmental difference equation model of TB and HIV and recent cost data were used to assess the costs (year 2003 US$ prices and effects (TB cases averted, deaths averted, DALYs gained of these strategies in Kenya during the period 2004–2023. Results The three lowest cost and most cost-effective strategies were improving TB cure rates, improving TB case detection rates, and improving both together. The incremental cost of combined improvements to case detection and cure was below US$15 million per year (7.5% of year 2000 government health expenditure; the mean cost per DALY gained of these three strategies ranged from US$18 to US$34. Antiretroviral therapy (ART had the highest incremental costs, which by 2007 could be as large as total government health expenditures in year 2000. ART could also gain more DALYs than the other strategies, at a cost per DALY gained of around US$260 to US$530. Both the costs and effects of treatment for latent tuberculosis infection (TLTI for HIV+ individuals were low; the cost per DALY gained ranged from about US$85 to US$370. Averting one HIV infection for less than US$250 would be as cost-effective as improving TB case detection and cure rates to WHO target levels. Conclusion To reduce the burden of TB in high HIV prevalence settings, the immediate goal should be to increase TB case detection rates and, to the extent possible, improve TB cure rates, preferably

  16. Cost Engineering Techniques and Their Applicability for Cost Estimation of Organic Rankine Cycle Systems

    Directory of Open Access Journals (Sweden)

    Sanne Lemmens

    2016-06-01

    Full Text Available The potential of organic Rankine cycle (ORC systems is acknowledged by both considerable research and development efforts and an increasing number of applications. Most research aims at improving ORC systems through technical performance optimization of various cycle architectures and working fluids. The assessment and optimization of technical feasibility is at the core of ORC development. Nonetheless, economic feasibility is often decisive when it comes down to considering practical instalments, and therefore an increasing number of publications include an estimate of the costs of the designed ORC system. Various methods are used to estimate ORC costs but the resulting values are rarely discussed with respect to accuracy and validity. The aim of this paper is to provide insight into the methods used to estimate these costs and open the discussion about the interpretation of these results. A review of cost engineering practices shows there has been a long tradition of industrial cost estimation. Several techniques have been developed, but the expected accuracy range of the best techniques used in research varies between 10% and 30%. The quality of the estimates could be improved by establishing up-to-date correlations for the ORC industry in particular. Secondly, the rapidly growing ORC cost literature is briefly reviewed. A graph summarizing the estimated ORC investment costs displays a pattern of decreasing costs for increasing power output. Knowledge on the actual costs of real ORC modules and projects remains scarce. Finally, the investment costs of a known heat recovery ORC system are discussed and the methodologies and accuracies of several approaches are demonstrated using this case as benchmark. The best results are obtained with factorial estimation techniques such as the module costing technique, but the accuracies may diverge by up to +30%. Development of correlations and multiplication factors for ORC technology in particular is

  17. Pipeline cost reduction through effective project management and applied technology

    Energy Technology Data Exchange (ETDEWEB)

    Jenkins, A. [TransCanada Pipeline Ltd., Alberta (Canada); Babuk, T. [Empress International Inc., Westwood, NJ (United States); Mohitpour, M. [Tempsys Pipeline Solutions Inc., Vancouver, BC (Canada); Murray, M.A. [National Energy Board of Canada (Canada)

    2005-07-01

    Pipelines are regarded by many as passive structures with the technology involved in their construction and operation being viewed as relatively simple and stable. If such is the case how can there be much room for cost improvement? In reality, there have been many technological and regulatory innovations required within the pipeline industry to meet the challenges posed by ever increasing consumer demand for hydrocarbons, the effects of aging infrastructure and a need to control operating and maintenance expenditures. The importance of technology management, as a subset of overall project management, is a key element of life cycle cost control. Assurance of public safety and the integrity of the system are other key elements in ensuring a successful pipeline project. The essentials of best practise project management from an owner/ operator's perspective are set out in the paper. Particular attention is paid to the appropriate introduction of new technology, strategic procurement practice and material selection, indicating that capital cost savings of up to 15% are achievable without harming life cycle cost. The value of partnering leading to technical innovation, cost savings and improved profitability for all the participants is described. Partnering also helps avoid duplicated effort through the use of common tools for design, planning schedule tracking and reporting. Investing in appropriate technology development has been a major source of cost reduction in recent years and the impact of a number of these recently introduced technologies in the areas of materials, construction processes and operation and maintenance are discussed in the paper. (author)

  18. [Cost-Effectiveness and Cost-Utility Analyses of Antireflux Medicine].

    Science.gov (United States)

    Gockel, Ines; Lange, Undine Gabriele; Schürmann, Olaf; Jansen-Winkeln, Boris; Sibbel, Rainer; Lyros, Orestis; von Dercks, Nikolaus

    2018-04-12

    Laparoscopic antireflux surgery and medical therapy with proton pump inhibitors are gold standards of gastroesophageal reflux treatment. On account of limited resources and increasing healthcare needs and costs, in this analysis, not only optimal medical results, but also superiority in health economics of these 2 methods are evaluated. We performed an electronic literature survey in MEDLINE, PubMed, Cochrane Library, ISRCTN (International Standard Randomization Controlled Trial Number) as well as in the NHS Economic Evaluation Database, including studies published until 1/2017. Only studies considering the effect size of QALY (Quality-Adjusted Life Years) (with respect to different quality of life-scores) as primary outcome comparing laparoscopic fundoplication and medical therapy were included. Criteria of comparison were ICER (Incremental Cost-Effectiveness Ratio) and ICUR (Incremental Cost-Utility Ratio). Superiority of the respective treatment option for each publication was worked out. In total, 18 comparative studies were identified in the current literature with respect to above-mentioned search terms, qualifying for the defined inclusion criteria. Six studies were finally selected for analyses. Out of 6 publications, 3 showed superiority of laparoscopic fundoplication over long-term medical management based on current cost-effectiveness data. Limitations were related to different time intervals, levels of evidence of studies and underlying resources/costs of analyses, healthcare systems and applied quality of life instruments. Future prospective, randomized trials should examine this comparison in greater detail. Additionally, there is a large potential for further research in the health economics assessment of early diagnosis and prevention measures of reflux disease and Barrett's esophagus/carcinoma. © Georg Thieme Verlag KG Stuttgart · New York.

  19. Cost Implications of an Interim Storage Facility in the Waste Management System

    Energy Technology Data Exchange (ETDEWEB)

    Jarrell, Joshua J. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Joseph, III, Robert Anthony [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Howard, Rob L [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Petersen, Gordon M. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Nutt, Mark [Argonne National Lab. (ANL), Argonne, IL (United States); Carter, Joe [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Cotton, Thomas [Complex Systems Group, Bozeman, MT (United States)

    2016-09-01

    This report provides an evaluation of the cost implications of incorporating a consolidated interim storage facility (ISF) into the waste management system (WMS). Specifically, the impacts of the timing of opening an ISF relative to opening a repository were analyzed to understand the potential effects on total system costs.

  20. External costs and taxes in heat supply systems

    International Nuclear Information System (INIS)

    Karlsson, Aasa; Gustavsson, Leif

    2003-01-01

    A systems approach was used to compare different heating systems from a consumer perspective. The whole energy system was considered from natural resources to the required energy services. District heating, electric heat pumps, electric boilers, natural-gas-, oil- or pellet-fired local boilers were considered when supplying heat to a detached house. The district heat production included wood-chip-fired and natural-gas-fired cogeneration plants. Electricity other than cogenerated electricity was produced in wood-chip- and natural-gas-fired stand-alone power plants. The analysis includes four tax scenarios, as well as the external cost of environmental and health damage arising from energy conversion emission based on the ExternE study of the European Commission. The most cost-efficient systems were the natural-gas and oil boiler systems, followed by the heat pump and district heating systems, when the external cost and taxes were excluded. When including the external costs of CO 2 emission, the wood-fuel-based systems were much more cost efficient than the fossil-fuel-based systems, also when CO 2 capture and storage were applied. The external costs are, however, highly uncertain. Taxes steer towards lowering energy use and lowering CO 2 emission if they are levied solely on all the fossil-fuel-related emission and fuel use in the systems. If consumer electricity and heat taxes are used, the taxes have an impact on the total cost, regardless of the fuel used, thereby benefiting fuel-based local heating systems. The heat pump systems were the least affected by taxes, due to their high energy efficiency. The electric boiler systems were the least cost-efficient systems, also when the external cost and taxes were included

  1. COST EFFECTIVE AND HIGH RESOLUTION SUBSURFACE CHARACTERIZATION USING HYDRAULIC TOMOGRAPHY

    Science.gov (United States)

    2017-08-01

    see that Approaches 1 and 2 are comparable in terms of costs if the equipment costs for hydraulic tomography are not accounted for. Equipment costs ...FINAL REPORT Cost -Effective and High-Resolution Subsurface Characterization Using Hydraulic Tomography ESTCP Project ER-201212 AUGUST...TITLE AND SUBTITLE 5a. CONTRACT NUMBER W912HQ-12-C-0024 COST -EFFECTIVE AND HIGH-RESOLUTION SUBSURFACE CHARACTERIZATION USING HYDRAULIC TOMOGRAPHY

  2. EOS Operations Systems: EDOS Implemented Changes to Reduce Operations Costs

    Science.gov (United States)

    Cordier, Guy R.; Gomez-Rosa, Carlos; McLemore, Bruce D.

    2007-01-01

    The authors describe in this paper the progress achieved to-date with the reengineering of the Earth Observing System (EOS) Data and Operations System (EDOS), the experience gained in the process and the ensuing reduction of ground systems operations costs. The reengineering effort included a major methodology change, applying to an existing schedule driven system, a data-driven system approach.

  3. Cost effectiveness of endometrial ablation with the NovaSure® system versus other global ablation modalities and hysterectomy for treatment of abnormal uterine bleeding: US commercial and Medicaid payer perspectives

    Directory of Open Access Journals (Sweden)

    Miller JD

    2015-01-01

    Full Text Available Jeffrey D Miller,1 Gregory M Lenhart,1 Machaon M Bonafede,1 Cindy M Basinski,2 Andrea S Lukes,3 Kathleen A Troeger4 1Truven Health Analytics, Cambridge, MA, 2Basinski, LLC, Newburgh, IN, 3Carolina Women’s Research and Wellness Center, Durham, NC, 4Hologic, Inc, Marlborough, MA, USA Objectives: Abnormal uterine bleeding (AUB interferes with physical, emotional, and social well-being, impacting the quality of life of more than 10 million women in the USA. Hysterectomy, the most common surgical treatment of AUB, has significant morbidity, low mortality, long recovery, and high associated health care costs. Global endometrial ablation (GEA provides a surgical alternative with reduced morbidity, cost, and recovery time. The NovaSure® system utilizes unique radiofrequency impedance-based GEA technology. This study evaluated cost effectiveness of AUB treatment with NovaSure ablation versus other GEA modalities and versus hysterectomy from the US commercial and Medicaid payer perspectives. Methods: A health state transition (semi-Markov model was developed using epidemiologic, clinical, and economic data from commercial and Medicaid claims database analyses, supplemented by published literature. Three hypothetical cohorts of women receiving AUB interventions were simulated over 1-, 3-, and 5-year horizons to evaluate clinical and economic outcomes for NovaSure, other GEA modalities, and hysterectomy. Results: Model analyses show lower costs for NovaSure-treated patients than for those treated with other GEA modalities or hysterectomy over all time frames under commercial payer and Medicaid perspectives. By Year 3, cost savings versus other GEA were $930 (commercial and $3,000 (Medicaid; cost savings versus hysterectomy were $6,500 (commercial and $8,900 (Medicaid. Coinciding with a 43%–71% reduction in need for re-ablation, there were 69%–88% fewer intervention/reintervention complications for NovaSure-treated patients versus other GEA modalities

  4. Effect of water treatment on the comparative costs of evaporative and dry cooled power plants

    International Nuclear Information System (INIS)

    Gold, H.; Goldstein, D.J.; Yung, D.

    1976-07-01

    The report presents the results of a study on the relative cost of energy from a nominal 1000 Mwe nuclear steam electric generating plant using either dry or evaporative cooling at four sites in the United States: Rochester, New York; Sheridan, Wyoming; Gallup, New Mexico and Dallas, Texas. Previous studies have shown that because of lower efficiencies the total annual evaluated costs for dry cooling systems exceeds the total annual evaluated costs of evaporative cooling systems, not including the cost of water. The cost of water comprises the cost of supplying the makeup water, the cost of treatment of the makeup and/or the circulating water in the tower, and the cost of treatment and disposal of the blowdown in an environmentally acceptable manner. The purpose of the study is to show the effect of water costs on the comparative costs of dry and evaporative cooled towers

  5. Economics of human performance and systems total ownership cost.

    Science.gov (United States)

    Onkham, Wilawan; Karwowski, Waldemar; Ahram, Tareq Z

    2012-01-01

    Financial costs of investing in people is associated with training, acquisition, recruiting, and resolving human errors have a significant impact on increased total ownership costs. These costs can also affect the exaggerate budgets and delayed schedules. The study of human performance economical assessment in the system acquisition process enhances the visibility of hidden cost drivers which support program management informed decisions. This paper presents the literature review of human total ownership cost (HTOC) and cost impacts on overall system performance. Economic value assessment models such as cost benefit analysis, risk-cost tradeoff analysis, expected value of utility function analysis (EV), growth readiness matrix, multi-attribute utility technique, and multi-regressions model were introduced to reflect the HTOC and human performance-technology tradeoffs in terms of the dollar value. The human total ownership regression model introduces to address the influencing human performance cost component measurement. Results from this study will increase understanding of relevant cost drivers in the system acquisition process over the long term.

  6. Cost evaluation of clinical laboratory in Taiwan's National Health System by using activity-based costing.

    Science.gov (United States)

    Su, Bin-Guang; Chen, Shao-Fen; Yeh, Shu-Hsing; Shih, Po-Wen; Lin, Ching-Chiang

    2016-11-01

    To cope with the government's policies to reduce medical costs, Taiwan's healthcare service providers are striving to survive by pursuing profit maximization through cost control. This article aimed to present the results of cost evaluation using activity-based costing performed in the laboratory in order to throw light on the differences between costs and the payment system of National Health Insurance (NHI). This study analyzed the data of costs and income of the clinical laboratory. Direct costs belong to their respective sections of the department. The department's shared costs, including public expenses and administrative assigned costs, were allocated to the department's respective sections. A simple regression equation was created to predict profit and loss, and evaluate the department's break-even point, fixed cost, and contribution margin ratio. In clinical chemistry and seroimmunology sections, the cost per test was lower than the NHI payment and their major laboratory tests had revenues with the profitability ratio of 8.7%, while the other sections had a higher cost per test than the NHI payment and their major tests were in deficit. The study found a simple linear regression model as follows: "Balance=-84,995+0.543×income (R2=0.544)". In order to avoid deficit, laboratories are suggested to increase test volumes, enhance laboratory test specialization, and become marginal scale. A hospital could integrate with regional medical institutions through alliances or OEM methods to increase volumes to reach marginal scale and reduce laboratory costs, enhancing the level and quality of laboratory medicine.

  7. Multi-robot system using low-cost infrared sensors

    Directory of Open Access Journals (Sweden)

    Anubhav Kakkar

    2013-03-01

    Full Text Available This paper presents a proposed set of the novel technique, methods, and algorithm for simultaneous path planning, area exploration, area retrieval, obstacle avoidance, object detection, and object retrieval   autonomously by a multi-robot system. The proposed methods and algorithms are built considering the use of low cost infrared sensors with the ultimate function of efficiently exploring the given unknown area and simultaneously identifying desired objects by analyzing the physical characteristics of several of the objects that come across during exploration. In this paper, we have explained the scenario by building a coordinative multi-robot system consisting of two autonomously operated robots equipped with low-cost and low-range infrared sensors to perform the assigned task by analyzing some of the sudden changes in their environment. Along with identifying and retrieving the desired object, the proposed methodology also provide an inclusive analysis of the area being explored. The novelties presented in the paper may significantly provide a cost-effective solution to the problem of area exploration and finding a known object in an unknown environment by demonstrating an innovative approach of using the infrared sensors instead of high cost long range sensors and cameras. Additionally, the methodology provides a speedy and uncomplicated method of traversing a complicated arena while performing all the necessary and inter-related tasks of avoiding the obstacles, analyzing the area as well as objects, and reconstructing the area using all these information collected and interpreted for an unknown environment. The methods and algorithms proposed are simulated over a complex arena to depict the operations and manually tested over a physical environment which provided 78% correct results with respect to various complex parameters set randomly.

  8. At what costs will screening with CT colonography be competitive? A cost-effectiveness approach

    NARCIS (Netherlands)

    I. Lansdorp-Vogelaar (Iris); M. van Ballegooijen (Marjolein); A. Zauber (Ann); R. Boer (Rob); J.A. Wilschut (Janneke); J.D.F. Habbema (Dik)

    2009-01-01

    textabstractThe costs of computed tomographic colonography (CTC) are not yet established for screening use. In our study, we estimated the threshold costs for which CTC screening would be a cost-effective alternative to colonoscopy for colorectal cancer (CRC) screening in the general population. We

  9. Cost Effectiveness of Premium Versus Regular Gasoline in MCPS Buses.

    Science.gov (United States)

    Baacke, Clifford M.; Frankel, Steven M.

    The primary question posed in this study is whether premium or regular gasoline is more cost effective for the Montgomery County Public School (MCPS) bus fleet, as a whole, when miles-per-gallon, cost-per-gallon, and repair costs associated with mileage are considered. On average, both miles-per-gallon, and repair costs-per-mile favor premium…

  10. SCATS: SRB Cost Accounting and Tracking System handbook

    Science.gov (United States)

    Zorv, R. B.; Stewart, R. D.; Coley, G.; Higginbotham, M.

    1978-01-01

    The Solid Rocket Booster Cost Accounting and Tracking System (SCATS) which is an automatic data processing system designed to keep a running account of the number, description, and estimated cost of Level 2, 3, and 4 changes is described. Although designed specifically for the Space Shuttle Solid Rocket Booster Program, the ADP system can be used for any other program that has a similar structure for recording, reporting, and summing numbers and costs of changes. The program stores the alpha-numeric designators for changes, government estimated costs, proposed costs, and negotiated value in a MIRADS (Marshall Information Retrieval and Display System) format which permits rapid access, manipulation, and reporting of current change status. Output reports listing all changes, totals of each level, and totals of all levels, can be derived for any calendar interval period.

  11. A COST ORIENTED SYSTEM FOR HOLE MAKING PROCESSES

    Directory of Open Access Journals (Sweden)

    Uğur PAMUKOĞLU

    2004-01-01

    Full Text Available A knowledge based system for manufacturing of various hole making processes has been developed. In the system, selection of machining methods, determination of sequences based on cutting tools for each process, determination of process time and cost analysis have been conducted. In the procedure, all available processes have been taken in to account regarding their costs and the most suitable in cost was chosen. The system generated helps facilitate determination of process time and the costs of features to be manufactured. It is especially useful for quick cost estimation. In addition to these, the system helps people who are naïve in manufacturing operations so that people could be used for the related manufacturing stages.

  12. Costs and cost-effectiveness of delivering intermittent preventive treatment through schools in western Kenya

    Directory of Open Access Journals (Sweden)

    Jukes Matthew CH

    2008-09-01

    Full Text Available Abstract Background Awareness of the potential impact of malaria among school-age children has stimulated investigation into malaria interventions that can be delivered through schools. However, little evidence is available on the costs and cost-effectiveness of intervention options. This paper evaluates the costs and cost-effectiveness of intermittent preventive treatment (IPT as delivered by teachers in schools in western Kenya. Methods Information on actual drug and non-drug associated costs were collected from expenditure and salary records, government budgets and interviews with key district and national officials. Effectiveness data were derived from a cluster-randomised-controlled trial of IPT where a single dose of sulphadoxine-pyrimethamine and three daily doses of amodiaquine were provided three times in year (once termly. Both financial and economic costs were estimated from a provider perspective, and effectiveness was estimated in terms of anaemia cases averted. A sensitivity analysis was conducted to assess the impact of key assumptions on estimated cost-effectiveness. Results The delivery of IPT by teachers was estimated to cost US$ 1.88 per child treated per year, with drug and teacher training costs constituting the largest cost components. Set-up costs accounted for 13.2% of overall costs (equivalent to US$ 0.25 per child whilst recurrent costs accounted for 86.8% (US$ 1.63 per child per year. The estimated cost per anaemia case averted was US$ 29.84 and the cost per case of Plasmodium falciparum parasitaemia averted was US$ 5.36, respectively. The cost per case of anaemia averted ranged between US$ 24.60 and 40.32 when the prices of antimalarial drugs and delivery costs were varied. Cost-effectiveness was most influenced by effectiveness of IPT and the background prevalence of anaemia. In settings where 30% and 50% of schoolchildren were anaemic, cost-effectiveness ratios were US$ 12.53 and 7.52, respectively. Conclusion This

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

    Science.gov (United States)

    Garrison, Louis P; Mansley, Edward C; Abbott, Thomas A; Bresnahan, Brian W; Hay, Joel W; Smeeding, James

    2010-01-01

    Major guidelines regarding the application of cost-effectiveness analysis (CEA) have recommended the common and widespread use of the "societal perspective" for purposes of consistency and comparability. The objective of this Task Force subgroup report (one of six reports from the International Society for Pharmacoeconomics and Outcomes Research [ISPOR] Task Force on Good Research Practices-Use of Drug Costs for Cost Effectiveness Analysis [Drug Cost Task Force (DCTF)]) was to review the definition of this perspective, assess its specific application in measuring drug costs, identify any limitations in theory or practice, and make recommendations regarding potential improvements. Key articles, books, and reports in the methodological literature were reviewed, summarized, and integrated into a draft review and report. This draft report was posted for review and comment by ISPOR membership. Numerous comments and suggestions were received, and the report was revised in response to them. The societal perspective can be defined by three conditions: 1) the inclusion of time costs, 2) the use of opportunity costs, and 3) the use of community preferences. In practice, very few, if any, published CEAs have met all of these conditions, though many claim to have taken a societal perspective. Branded drug costs have typically used actual acquisition cost rather than the much lower social opportunity costs that would reflect only short-run manufacturing and distribution costs. This practice is understandable, pragmatic, and useful to current decision-makers. Nevertheless, this use of CEA focuses on static rather than dynamic efficacy and overlooks the related incentives for innovation. Our key recommendation is that current CEA practice acknowledge and embrace this limitation by adopting a new standard for the reference case as one of a "limited societal" or "health systems" perspective, using acquisition drug prices while including indirect costs and community preferences. The

  14. Health promotion in nursing and cost-effectiveness.

    Science.gov (United States)

    Jadelhack, Raja

    2012-01-01

    Close examination of the different healthcare systems and the present economic crisis worldwide suggests that all health organizations should re-evaluate the concept of health promotion and its relationship to cost-effectiveness. When choosing the most efficient and cost-effective system, each nation's healthcare system must seriously start to implement strategies for the change. Health professions, including nursing, must change their vision of education both in academic and practice settings, to focus on health promotion and illness prevention. The key principle underlying this paper is to illustrate the importance of health promotion and cost-effectiveness being adopted by all health organizations worldwide, as well as to observe the experiences of selected counties in developing a health policy related to education in primary healthcare. The paper will include a plan adopted by the General Nursing Directorate (GND) in the Kingdom of Saudi Arabia (SA), which contains a health promotion policy for the nursing administrations in all governmental primary healthcare centers in Saudi Arabia.

  15. Study protocol: Cost effectiveness of two strategies to implement the NVOG guidelines on hypertension in pregnancy: An innovative strategy including a computerised decision support system compared to a common strategy of professional audit and feedback, a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Luitjes Susanne HE

    2010-09-01

    Full Text Available Abstract Background Hypertensive disease in pregnancy remains the leading cause of maternal mortality in the Netherlands. Seventeen percent of the clinical pregnancies are complicated by hypertension and 2% by preeclampsia. The Dutch Society of Obstetrics and Gynaecology (NVOG has developed evidence-based guidelines on the management of hypertension in pregnancy and chronic hypertension. Previous studies showed a low adherence rate to other NVOG guidelines and a large variation in usual care in the different hospitals. An explanation is that the NVOG has no general strategy of practical implementation and evaluation of its guidelines. The development of an effective and cost effective implementation strategy to improve adherence to the guidelines on hypertension in pregnancy is needed. Methods/Design The objective of this study is to assess the cost effectiveness of an innovative implementation strategy of the NVOG guidelines on hypertension including a computerised decision support system (BOS compared to a common strategy of professional audit and feedback. A cluster randomised controlled trial with an economic evaluation alongside will be performed. Both pregnant women who develop severe hypertension or pre-eclampsia and professionals involved in the care for these women will participate. The main outcome measures are a combined rate of major maternal complications and process indicators extracted from the guidelines. A total of 472 patients will be included in both groups. For analysis, descriptive as well as regression techniques will be used. A cost effectiveness and cost utility analysis will be performed according to the intention-to-treat principle and from a societal perspective. Cost effectiveness ratios will be calculated using bootstrapping techniques.

  16. Waste management facilities cost information: System cost model product description. Revision 2

    International Nuclear Information System (INIS)

    Lundeen, A.S.; Hsu, K.M.; Shropshire, D.E.

    1996-02-01

    In May of 1994, Lockheed Idaho Technologies Company (LITCO) in Idaho Falls, Idaho and subcontractors developed the System Cost Model (SCM) application. The SCM estimates life-cycle costs of the entire US Department of Energy (DOE) complex for designing; constructing; operating; and decommissioning treatment, storage, and disposal (TSD) facilities for mixed low-level, low-level, transuranic, and mixed transuranic waste. The SCM uses parametric cost functions to estimate life-cycle costs for various treatment, storage, and disposal modules which reflect planned and existing facilities at DOE installations. In addition, SCM can model new facilities based on capacity needs over the program life cycle. The SCM also provides transportation costs for DOE wastes. Transportation costs are provided for truck and rail and include transport of contact-handled, remote-handled, and alpha (transuranic) wastes. The user can provide input data (default data is included in the SCM) including the volume and nature of waste to be managed, the time period over which the waste is to be managed, and the configuration of the waste management complex (i.e., where each installation's generated waste will be treated, stored, and disposed). Then the SCM uses parametric cost equations to estimate the costs of pre-operations (designing), construction costs, operation management, and decommissioning these waste management facilities

  17. The System Cost Model: A tool for life cycle cost and risk analysis

    International Nuclear Information System (INIS)

    Hsu, K.; Lundeen, A.; Shropshire, D.; Sherick, M.

    1996-01-01

    In May of 1994, Lockheed Idaho Technologies Company (LITCO) in Idaho Falls, Idaho and subcontractors began development of the System Cost Model (SCM) application. The SCM estimates life cycle costs of the entire US Department of Energy (DOE) complex for designing; constructing; operating; and decommissioning treatment, storage, and disposal (TSD) facilities for mixed low-level, low-level, and transuranic waste. The SCM uses parametric cost functions to estimate life cycle costs for various treatment, storage, and disposal modules which reflect planned and existing waste management facilities at DOE installations. In addition, SCM can model new TSD facilities based on capacity needs over the program life cycle. The user can provide input data (default data is included in the SCM) including the volume and nature of waste to be managed, the time period over which the waste is to be managed, and the configuration of the waste management complex (i.e., where each installation's generated waste will be treated, stored, and disposed). Then the SCM uses parametric cost equations to estimate the costs of pre-operations (designing), construction, operations and maintenance, and decommissioning these waste management facilities. The SCM also provides transportation costs for DOE wastes. Transportation costs are provided for truck and rail and include transport of contact-handled, remote-handled, and alpha (transuranic) wastes. A complement to the SCM is the System Cost Model-Risk (SCM-R) model, which provides relative Environmental, Safety, and Health (ES and H) risk information. A relative ES and H risk basis has been developed and applied by LITCO at the INEL. The risk basis is now being automated in the SCM-R to facilitate rapid risk analysis of system alternatives. The added risk functionality will allow combined cost and risk evaluation of EM alternatives

  18. A cost-effectiveness threshold analysis of a multidisciplinary structured educational intervention in pediatric asthma.

    Science.gov (United States)

    Rodriguez-Martinez, Carlos E; Sossa-Briceño, Monica P; Castro-Rodriguez, Jose A

    2018-05-01

    Asthma educational interventions have been shown to improve several clinically and economically important outcomes. However, these interventions are costly in themselves and could lead to even higher disease costs. A cost-effectiveness threshold analysis would be helpful in determining the threshold value of the cost of educational interventions, leading to these interventions being cost-effective. The aim of the present study was to perform a cost-effectiveness threshold analysis to determine the level at which the cost of a pediatric asthma educational intervention would be cost-effective and cost-saving. A Markov-type model was developed in order to estimate costs and health outcomes of a simulated cohort of pediatric patients with persistent asthma treated over a 12-month period. Effectiveness parameters were obtained from a single uncontrolled before-and-after study performed with Colombian asthmatic children. Cost data were obtained from official databases provided by the Colombian Ministry of Health. The main outcome was the variable "quality-adjusted life-years" (QALYs). A deterministic threshold sensitivity analysis showed that the asthma educational intervention will be cost-saving to the health system if its cost is under US$513.20. Additionally, the analysis showed that the cost of the intervention would have to be below US$967.40 in order to be cost-effective. This study identified the level at which the cost of a pediatric asthma educational intervention will be cost-effective and cost-saving for the health system in Colombia. Our findings could be a useful aid for decision makers in efficiently allocating limited resources when planning asthma educational interventions for pediatric patients.

  19. A Family of Cost-Effective Magnetically-Coupled Impedance Source Inverters

    DEFF Research Database (Denmark)

    Li, Kerui; Yang, Yongheng; Qin, Zian

    2017-01-01

    This paper presents a family of cost-effective magnetically-coupled impedance source inverters for renewable energy systems. The inverters are derived from magnetically-coupled impedance source networks, featuring low cost and no ground leakage current when used in PV system. The numbers of requi......This paper presents a family of cost-effective magnetically-coupled impedance source inverters for renewable energy systems. The inverters are derived from magnetically-coupled impedance source networks, featuring low cost and no ground leakage current when used in PV system. The numbers...

  20. The importance of fixed costs in animal health systems.

    Science.gov (United States)

    Tisdell, C A; Adamson, D

    2017-04-01

    In this paper, the authors detail the structure and optimal management of health systems as influenced by the presence and level of fixed costs. Unlike variable costs, fixed costs cannot be altered, and are thus independent of the level of veterinary activity in the short run. Their importance is illustrated by using both single-period and multi-period models. It is shown that multi-stage veterinary decision-making can often be envisaged as a sequence of fixed-cost problems. In general, it becomes clear that, the higher the fixed costs, the greater the net benefit of veterinary activity must be, if such activity is to be economic. The authors also assess the extent to which it pays to reduce fixed costs and to try to compensate for this by increasing variable costs. Fixed costs have major implications for the industrial structure of the animal health products industry and for the structure of the private veterinary services industry. In the former, they favour market concentration and specialisation in the supply of products. In the latter, they foster increased specialisation. While cooperation by individual farmers may help to reduce their individual fixed costs, the organisational difficulties and costs involved in achieving this cooperation can be formidable. In such cases, the only solution is government provision of veterinary services. Moreover, international cooperation may be called for. Fixed costs also influence the nature of the provision of veterinary education.

  1. Future Costs, Fixed Healthcare Budgets, and the Decision Rules of Cost-Effectiveness Analysis.

    Science.gov (United States)

    van Baal, Pieter; Meltzer, David; Brouwer, Werner

    2016-02-01

    Life-saving medical technologies result in additional demand for health care due to increased life expectancy. However, most economic evaluations do not include all medical costs that may result from this additional demand in health care and include only future costs of related illnesses. Although there has been much debate regarding the question to which extent future costs should be included from a societal perspective, the appropriate role of future medical costs in the widely adopted but more narrow healthcare perspective has been neglected. Using a theoretical model, we demonstrate that optimal decision rules for cost-effectiveness analyses assuming fixed healthcare budgets dictate that future costs of both related and unrelated medical care should be included. Practical relevance of including the costs of future unrelated medical care is illustrated using the example of transcatheter aortic valve implantation. Our findings suggest that guidelines should prescribe inclusion of these costs. Copyright © 2014 John Wiley & Sons, Ltd.

  2. Cost analysis of hot-air solar-heating systems

    Science.gov (United States)

    Hawkins, B. J.; Stewart, R. D.

    1979-01-01

    Report describes results of study of two operational test sites (Huntsville, Alabama and Carlsbad, New Mexico) furnishing stimates of actual costs and potential cost savings of new and retrofit hot-air solar heating and hot-water system for single family dwellings.

  3. Mirror Fusion Test Facility: Superconducting magnet system cost analysis

    Energy Technology Data Exchange (ETDEWEB)

    1977-07-01

    At the request of Victor Karpenko, Project manager for LLL`s Mirror Fusion Test Facility, EG&G has prepared this independent cost analysis for the proposed MFTF Superconducting Magnet System. The analysis has attempted to show sufficient detail to provide adequate definition for a basis of estimating costs.

  4. Cost-benefit analysis of electronic medical record system at a tertiary care hospital.

    Science.gov (United States)

    Choi, Jong Soo; Lee, Woo Baik; Rhee, Poong-Lyul

    2013-09-01

    Although Electronic Medical Record (EMR) systems provide various benefits, there are both advantages and disadvantages regarding its cost-effectiveness. This study analyzed the economic effects of EMR systems using a cost-benefit analysis based on the differential costs of managerial accounting. Samsung Medical Center (SMC) is a general hospital in Korea that developed an EMR system for outpatients from 2006 to 2008. This study measured the total costs and benefits during an 8-year period after EMR adoption. The costs include the system costs of building the EMR and the costs incurred in smoothing its adoption. The benefits included cost reductions after its adoption and additional revenues from both remodeling of paper-chart storage areas and medical transcriptionists' contribution. The measured amounts were discounted by SMC's expected interest rate to calculate the net present value (NPV), benefit-cost ratio (BCR), and discounted payback period (DPP). During the analysis period, the cumulative NPV and the BCR were US$3,617 thousand and 1.23, respectively. The DPP was about 6.18 years. Although the adoption of an EMR resulted in overall growth in administrative costs, it is cost-effective since the cumulative NPV was positive. The positive NPV was attributed to both cost reductions and additional revenues. EMR adoption is not so attractive to management in that the DPP is longer than 5 years at 6.18 and the BCR is near 1 at 1.23. However, an EMR is a worthwhile investment, seeing that this study did not include any qualitative benefits and that the paper-chart system was cost-centric.

  5. Evaluating effectiveness and cost of community care for schizophrenic patients.

    Science.gov (United States)

    Häfner, H; an der Heiden, W

    1991-01-01

    The two main types of mental health services research are (1) the evaluation of the mental health sector within comprehensive systems of health care and (2) the evaluation of individual mental health facilities or types of care. Depending on the information systems available, the difficulties of evaluating complex systems of care can be partially obviated by using descriptive approaches. Structural quality can be assessed by structural indices, the functioning of a system by monitoring utilization, and the overall effectiveness of a national mental health care system roughly by health indicators. Causal analyses of effectiveness are practical when they are based on individual facilities or types of care, which can be studied as isolated systems on the basis of intervention and outcome variables. Reliable and reproducible results can be achieved only if a standardized intervention is used or if the intervention and its objectives are described clearly, the output indicators are defined in terms of identifiable and repeatable operations. The assets and liabilities of quasi-experimental designs and three types of naturalistic approaches will be discussed. When the cost of a new type of care is compared with the cost of traditional mental health care, the section of the population actually served out of the total of patients with comparable needs for care should be considered. Results from the authors' studies will show how the neglect of this epidemiological aspect can lead to false statements.

  6. Construction of VLCC marine oil storage cost index system

    Science.gov (United States)

    Li, Yuan; Li, Yule; Lu, Jinshu; Wu, Wenfeng; Zhu, Faxin; Chen, Tian; Qin, Beichen

    2018-04-01

    VLCC as the research object, the basic knowledge of VLCC is summarized. According to the phenomenon that VLCC is applied to offshore oil storage gradually, this paper applies the theoretical analysis method to analyze the excess capacity from VLCC, the drop of oil price, the aging VLCC is more suitable for offshore storage The paper analyzes the reason of VLCC offshore oil storage from three aspects, analyzes the cost of VLCC offshore storage from the aspects of manpower cost and shipping cost, and constructs the cost index system of VLCC offshore oil storage.

  7. Cost effective tools for soil organic carbon monitoring

    Science.gov (United States)

    Shepherd, Keith; Aynekulu, Ermias

    2013-04-01

    providing for cost-effective interpretation of soil carbon and other soil quality indicators. The measurement is has high reproducibility over time, across instruments, and across laboratories compared with conventional soil tests. We describe wide-scale application of soil infrared spectroscopy in Africa in studies designed to measure soil carbon stocks and soil quality in landscapes. Future efforts should be directed towards analyzing the decisions that soil carbon measurements are supposed to support, and quantifying uncertainties in all relevant variables affecting those decisions. Only then can truly cost-effective measurement systems be designed.

  8. Cost effectiveness of endometrial ablation with the NovaSure® system versus other global ablation modalities and hysterectomy for treatment of abnormal uterine bleeding: US commercial and Medicaid payer perspectives

    Science.gov (United States)

    Miller, Jeffrey D; Lenhart, Gregory M; Bonafede, Machaon M; Basinski, Cindy M; Lukes, Andrea S; Troeger, Kathleen A

    2015-01-01

    Objectives Abnormal uterine bleeding (AUB) interferes with physical, emotional, and social well-being, impacting the quality of life of more than 10 million women in the USA. Hysterectomy, the most common surgical treatment of AUB, has significant morbidity, low mortality, long recovery, and high associated health care costs. Global endometrial ablation (GEA) provides a surgical alternative with reduced morbidity, cost, and recovery time. The NovaSure® system utilizes unique radiofrequency impedance-based GEA technology. This study evaluated cost effectiveness of AUB treatment with NovaSure ablation versus other GEA modalities and versus hysterectomy from the US commercial and Medicaid payer perspectives. Methods A health state transition (semi-Markov) model was developed using epidemiologic, clinical, and economic data from commercial and Medicaid claims database analyses, supplemented by published literature. Three hypothetical cohorts of women receiving AUB interventions were simulated over 1-, 3-, and 5-year horizons to evaluate clinical and economic outcomes for NovaSure, other GEA modalities, and hysterectomy. Results Model analyses show lower costs for NovaSure-treated patients than for those treated with other GEA modalities or hysterectomy over all time frames under commercial payer and Medicaid perspectives. By Year 3, cost savings versus other GEA were $930 (commercial) and $3,000 (Medicaid); cost savings versus hysterectomy were $6,500 (commercial) and $8,900 (Medicaid). Coinciding with a 43%–71% reduction in need for re-ablation, there were 69%–88% fewer intervention/reintervention complications for NovaSure-treated patients versus other GEA modalities, and 82%–91% fewer versus hysterectomy. Furthermore, NovaSure-treated patients had fewer days of work absence and short-term disability. Cost-effectiveness metrics showed NovaSure treatment as economically dominant over other GEA modalities in all circumstances. With few exceptions, similar

  9. Novel surface measurement system reading cost savings

    Energy Technology Data Exchange (ETDEWEB)

    Sword, M.

    1996-05-01

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

  10. The health system cost of postabortion care in Ethiopia.

    Science.gov (United States)

    Vlassoff, Michael; Fetters, Tamara; Kumbi, Solomon; Singh, Susheela

    2012-09-01

    To address the knowledge gap that exists in costing unsafe abortion in Ethiopia, estimates were derived of the cost to the health system of providing postabortion care (PAC), based on research conducted in 2008. Fourteen public and private health facilities were selected, representing 3 levels of health care. Cost information on drugs, supplies, material, personnel time, and out-of-pocket expenses was collected using an ingredients approach. Sensitivity analysis was used to determine the most likely range of costs. The average direct cost per client, across 5 types of abortion complications, was US $36.21. The annual direct cost nationally ranged from US $6.5 to US $8.9 million. Including indirect costs and satisfying all demand increased the annual national cost to US $47 million. PAC consumes a large portion of the total expenditure in reproductive health in Ethiopia. Investing more resources in family planning programs to prevent unwanted pregnancies would be cost-beneficial to the health system. Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  11. Sunk costs equal sunk boats? The effect of entry costs in a transboundary sequential fishery

    DEFF Research Database (Denmark)

    Punt, M. J.

    2017-01-01

    that for other fisheries substantial sunk investments are needed. In this paper I investigate the effect of such sunk entry costs in a sequential fisheries. I model the uncertainty as a shock to the stock dependent fishing costs, in a two player game, where one of the players faces sunk entry costs. I find that......, depending on parameters, sunk costs can i) increase the competitive pressure on the fish stock compared to a game where entry is free ii) act as a deterrence mechanism and iii) act as a commitment device. I conclude that entry costs can play a crucial role because they can change the outcome of the game...

  12. Cost-Effective Icy Bodies Exploration using Small Satellite Missions

    Science.gov (United States)

    Jonsson, Jonas; Mauro, David; Stupl, Jan; Nayak, Michael; Aziz, Jonathan; Cohen, Aaron; Colaprete, Anthony; Dono-Perez, Andres; Frost, Chad; Klamm, Benjamin; hide

    2015-01-01

    It has long been known that Saturn's moon Enceladus is expelling water-rich plumes into space, providing passing spacecraft with a window into what is hidden underneath its frozen crust. Recent discoveries indicate that similar events could also occur on other bodies in the solar system, such as Jupiter's moon Europa and the dwarf planet Ceres in the asteroid belt. These plumes provide a possible giant leap forward in the search for organics and assessing habitability beyond Earth, stepping stones toward the long-term goal of finding extraterrestrial life. The United States Congress recently requested mission designs to Europa, to fit within a cost cap of $1B, much less than previous mission designs' estimates. Here, innovative cost-effective small spacecraft designs for the deep-space exploration of these icy worlds, using new and emerging enabling technologies, and how to explore the outer solar system on a budget below the cost horizon of a flagship mission, are investigated. Science requirements, instruments selection, rendezvous trajectories, and spacecraft designs are some topics detailed. The mission concepts revolve around a comparably small-sized and low-cost Plume Chaser spacecraft, instrumented to characterize the vapor constituents encountered on its trajectory. In the event that a plume is not encountered, an ejecta plume can be artificially created by a companion spacecraft, the Plume Maker, on the target body at a location timed with the passage of the Plume Chaser spacecraft. Especially in the case of Ceres, such a mission could be a great complimentary mission to Dawn, as well as a possible future Europa Clipper mission. The comparably small volume of the spacecraft enables a launch to GTO as a secondary payload, providing multiple launch opportunities per year. Plume Maker's design is nearly identical to the Plume Chaser, and fits within the constraints for a secondary payload launch. The cost-effectiveness of small spacecraft missions enables the

  13. Low Cost Vision Based Personal Mobile Mapping System

    Science.gov (United States)

    Amami, M. M.; Smith, M. J.; Kokkas, N.

    2014-03-01

    Mobile mapping systems (MMS) can be used for several purposes, such as transportation, highway infrastructure mapping and GIS data collecting. However, the acceptance of these systems is not wide spread and their use is still limited due the high cost and dependency on the Global Navigation Satellite System (GNSS). A low cost vision based personal MMS has been produced with an aim to overcome these limitations. The system has been designed to depend mainly on cameras and use of low cost GNSS and inertial sensors to provide a bundle adjustment solution with initial values. The system has the potential to be used indoor and outdoor. The system has been tested indoors and outdoors with different GPS coverage, surrounded features, and narrow and curvy paths. Tests show that the system is able to work in such environments providing 3D coordinates of better than 10 cm accuracy.

  14. Low Cost Vision Based Personal Mobile Mapping System

    Directory of Open Access Journals (Sweden)

    M. M. Amami

    2014-03-01

    Full Text Available Mobile mapping systems (MMS can be used for several purposes, such as transportation, highway infrastructure mapping and GIS data collecting. However, the acceptance of these systems is not wide spread and their use is still limited due the high cost and dependency on the Global Navigation Satellite System (GNSS. A low cost vision based personal MMS has been produced with an aim to overcome these limitations. The system has been designed to depend mainly on cameras and use of low cost GNSS and inertial sensors to provide a bundle adjustment solution with initial values. The system has the potential to be used indoor and outdoor. The system has been tested indoors and outdoors with different GPS coverage, surrounded features, and narrow and curvy paths. Tests show that the system is able to work in such environments providing 3D coordinates of better than 10 cm accuracy.

  15. Healthcare Utilization and Costs of Systemic Lupus Erythematosus in Medicaid

    Directory of Open Access Journals (Sweden)

    Hong J. Kan

    2013-01-01

    Full Text Available Objective. Healthcare utilization and costs associated with systemic lupus erythematosus (SLE in a US Medicaid population were examined. Methods. Patients ≥ 18 years old with SLE diagnosis (ICD-9-CM 710.0x were extracted from a large Medicaid database 2002–2009. Index date was date of the first SLE diagnosis. Patients with and without SLE were matched. All patients had a variable length of followup with a minimum of 12 months. Annualized healthcare utilization and costs associated with SLE and costs of SLE flares were assessed during the followup period. Multivariate regressions were conducted to estimate incremental healthcare utilization and costs associated with SLE. Results. A total of 14,777 SLE patients met the study criteria, and 14,262 were matched to non-SLE patients. SLE patients had significantly higher healthcare utilization per year than their matched controls. The estimated incremental annual cost associated with SLE was $10,984, with the highest increase in inpatient costs (P<0.001. Cost per flare was $11,716 for severe flares, $562 for moderate flares, and $129 for mild flares. Annual total costs for patients with severe flares were $49,754. Conclusions. SLE patients had significantly higher healthcare resource utilization and costs than non-SLE patients. Patients with severe flares had the highest costs.

  16. Bayesian models for cost-effectiveness analysis in the presence of structural zero costs.

    Science.gov (United States)

    Baio, Gianluca

    2014-05-20

    Bayesian modelling for cost-effectiveness data has received much attention in both the health economics and the statistical literature, in recent years. Cost-effectiveness data are characterised by a relatively complex structure of relationships linking a suitable measure of clinical benefit (e.g. quality-adjusted life years) and the associated costs. Simplifying assumptions, such as (bivariate) normality of the underlying distributions, are usually not granted, particularly for the cost variable, which is characterised by markedly skewed distributions. In addition, individual-level data sets are often characterised by the presence of structural zeros in the cost variable. Hurdle models can be used to account for the presence of excess zeros in a distribution and have been applied in the context of cost data. We extend their application to cost-effectiveness data, defining a full Bayesian specification, which consists of a model for the individual probability of null costs, a marginal model for the costs and a conditional model for the measure of effectiveness (given the observed costs). We presented the model using a working example to describe its main features. © 2013 The Authors. Statistics in Medicine published by John Wiley & Sons, Ltd.

  17. Low-cost panoramic infrared surveillance system

    Science.gov (United States)

    Kecskes, Ian; Engel, Ezra; Wolfe, Christopher M.; Thomson, George

    2017-05-01

    A nighttime surveillance concept consisting of a single surface omnidirectional mirror assembly and an uncooled Vanadium Oxide (VOx) longwave infrared (LWIR) camera has been developed. This configuration provides a continuous field of view spanning 360° in azimuth and more than 110° in elevation. Both the camera and the mirror are readily available, off-the-shelf, inexpensive products. The mirror assembly is marketed for use in the visible spectrum and requires only minor modifications to function in the LWIR spectrum. The compactness and portability of this optical package offers significant advantages over many existing infrared surveillance systems. The developed system was evaluated on its ability to detect moving, human-sized heat sources at ranges between 10 m and 70 m. Raw camera images captured by the system are converted from rectangular coordinates in the camera focal plane to polar coordinates and then unwrapped into the users azimuth and elevation system. Digital background subtraction and color mapping are applied to the images to increase the users ability to extract moving items from background clutter. A second optical system consisting of a commercially available 50 mm f/1.2 ATHERM lens and a second LWIR camera is used to examine the details of objects of interest identified using the panoramic imager. A description of the components of the proof of concept is given, followed by a presentation of raw images taken by the panoramic LWIR imager. A description of the method by which these images are analyzed is given, along with a presentation of these results side-by-side with the output of the 50 mm LWIR imager and a panoramic visible light imager. Finally, a discussion of the concept and its future development are given.

  18. The 2008 IDA Cost Research Workshop: Contractor Data Reporting Systems

    National Research Council Canada - National Science Library

    Balut, Stephen J; Cloos, John J; Roark, Lance M

    2008-01-01

    Several Department of Defense (DoD) offices are responsible for estimating and monitoring the costs of defense systems and forces in support of planning, programming, budgeting, and acquisition decisions...

  19. Costs and benefits of MDOT intelligent transportation system deployments.

    Science.gov (United States)

    2015-07-01

    This report analyses costs and benefits of Intelligent Transportation Systems (ITS) deployed by : the Michigan Department of Transportation (MDOT). MDOT ITS focuses on traffic incident : management and also provide Freeway Courtesy Patrol services. A...

  20. Airport Visibility Measuring Systems Elements of Deployment Cost Analysis

    Science.gov (United States)

    1976-09-01

    This report analyzes the deployment cost for different visibility measuring systems necessary to satisfy CAT I, II, and II operations. The analysis is based on airport operational requirements and data for commercially available visibility measuring ...

  1. Costs and cost-effectiveness of malaria control interventions - a systematic review

    Directory of Open Access Journals (Sweden)

    White Michael T

    2011-11-01

    Full Text Available Abstract Background The control and elimination of malaria requires expanded coverage of and access to effective malaria control interventions such as insecticide-treated nets (ITNs, indoor residual spraying (IRS, intermittent preventive treatment (IPT, diagnostic testing and appropriate treatment. Decisions on how to scale up the coverage of these interventions need to be based on evidence of programme effectiveness, equity and cost-effectiveness. Methods A systematic review of the published literature on the costs and cost-effectiveness of malaria interventions was undertaken. All costs and cost-effectiveness ratios were inflated to 2009 USD to allow comparison of the costs and benefits of several different interventions through various delivery channels, across different geographical regions and from varying costing perspectives. Results Fifty-five studies of the costs and forty three studies of the cost-effectiveness of malaria interventions were identified, 78% of which were undertaken in sub-Saharan Africa, 18% in Asia and 4% in South America. The median financial cost of protecting one person for one year was $2.20 (range $0.88-$9.54 for ITNs, $6.70 (range $2.22-$12.85 for IRS, $0.60 (range $0.48-$1.08 for IPT in infants, $4.03 (range $1.25-$11.80 for IPT in children, and $2.06 (range $0.47-$3.36 for IPT in pregnant women. The median financial cost of diagnosing a case of malaria was $4.32 (range $0.34-$9.34. The median financial cost of treating an episode of uncomplicated malaria was $5.84 (range $2.36-$23.65 and the median financial cost of treating an episode of severe malaria was $30.26 (range $15.64-$137.87. Economies of scale were observed in the implementation of ITNs, IRS and IPT, with lower unit costs reported in studies with larger numbers of beneficiaries. From a provider perspective, the median incremental cost effectiveness ratio per disability adjusted life year averted was $27 (range $8.15-$110 for ITNs, $143 (range $135

  2. A Cost Benefit Analysis of an Accelerator Driven Transmutation System

    International Nuclear Information System (INIS)

    Westlen, D.; Gudowski, W.; Wallenius, J.; Tucek, K.

    2002-01-01

    This paper estimates the economical costs and benefits associated with a nuclear waste transmutation strategy. An 800 MWth, fast neutron spectrum, subcritical core design has been used in the study (the so called Sing-Sing Core). Three different fuel cycle scenarios have been compared. The main purpose of the paper has been to identify the cost drivers of a partitioning and transmutation strategy, and to estimate the cost of electricity generated in a nuclear park with operating accelerator driven systems. It has been found that directing all transuranic discharges from spent light water reactor (LWR) uranium oxide (UOX) fuel to accelerator driven systems leads to a cost increase for nuclear power of 50±15%, while introduction of a mixed oxide (MOX) burning step in the LWRs diminishes the cost penalty to 35±10%. (authors)

  3. Cost and cost-effectiveness of conventional and liquid-based ...

    African Journals Online (AJOL)

    Methods. The unit of effectiveness was defined as the number of cervical intraepithelial neoplasm (CIN) II or higher lesions detected. Costs were assessed retrospectively for the financial year (2010/11) from a laboratory service provider perspective. A cost-effectiveness analysis was performed by combining secondary data ...

  4. DRG systems in Europe: variations in cost accounting systems among 12 countries.

    Science.gov (United States)

    Tan, Siok Swan; Geissler, Alexander; Serdén, Lisbeth; Heurgren, Mona; van Ineveld, B Martin; Redekop, W Ken; Hakkaart-van Roijen, Leona

    2014-12-01

    Diagnosis-related group (DRG)-based hospital payment systems have gradually become the principal means of reimbursing hospitals in many European countries. Owing to the absence or inaccuracy of costs related to DRGs, these countries have started to routinely collect cost accounting data. The aim of the present article was to compare the cost accounting systems of 12 European countries. A standardized questionnaire was developed to guide comprehensive cost accounting system descriptions for each of the 12 participating countries. The cost accounting systems of European countries vary widely by the share of hospital costs reimbursed through DRG payment, the presence of mandatory cost accounting and/or costing guidelines, the share of cost collecting hospitals, costing methods and data checks on reported cost data. Each of these aspects entails a trade-off between accuracy of the cost data and feasibility constraints. Although a 'best' cost accounting system does not exist, our cross-country comparison gives insight into international differences and may help regulatory authorities and hospital managers to identify and improve areas of weakness in their cost accounting systems. Moreover, it may help health policymakers to underpin the development of a cost accounting system. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  5. Probabilistic markov model estimating cost effectiveness of methylphenidate osmotic-release oral system versus immediate-release methylphenidate in children and adolescents: Which information is needed?

    NARCIS (Netherlands)

    S.J. Schawo (Saskia); A. van der Kolk (Annemarie); C.A.M. Bouwmans-Frijters (Clazien); L. Annemans (Lieven); M.J. Postma (Maarten); J.K. Buitelaar (Jan); M. van Agthoven (Michel); L. van Hakkaart-van Roijen (Leona)

    2015-01-01

    textabstractBackground: Incidence of attention deficit hyperactivity disorder (ADHD) in children and adolescents has been increasing. The disorder results in high societal costs. Policymakers increasingly use health economic evaluations to inform decisions on competing treatments of ADHD. Yet,

  6. Probabilistic Markov Model Estimating Cost Effectiveness of Methylphenidate Osmotic-Release Oral System Versus Immediate-Release Methylphenidate in Children and Adolescents: Which Information is Needed?

    NARCIS (Netherlands)

    S.J. Schawo (Saskia); A. van der Kolk (Annemarie); C.A.M. Bouwmans-Frijters (Clazien); L. Annemans (Lieven); M.J. Postma (Maarten); J.K. Buitelaar (Jan); M. van Agthoven (Michel); L. van Hakkaart-van Roijen (Leona)

    2015-01-01

    markdownabstract__Abstract__ Background: Incidence of attention deficit hyperactivity disorder (ADHD) in children and adolescents has been increasing. The disorder results in high societal costs. Policymakers increasingly use health economic evaluations to inform decisions on competing treatments

  7. Effect of EMF on minimum cost power transmission

    International Nuclear Information System (INIS)

    Abdul-Rahman, K.H.; Shahidehpour, S.M.; Deeb, N.I.

    1994-01-01

    The concern about electromagnetic field (EMF) effects on human health has heightened public awareness of overhead transmission lines planning and operation. The objective of this paper is to study the effect of EMF constraints on optimal power generation scheduling. This study considers reducing EMF levels associated with critical transmission lines by redistributing the scheduled power generation, while maintaining the minimum operation cost as an objective. The EMF constraints are given in terms of control variables and fuzzy sets are utilized to model the tradeoff between minimizing the objective function and satisfying EMF constraints. Numerical results for the application of the proposed approach to test systems are discussed

  8. Development of LLW and VLLW disposal business cost estimation system

    International Nuclear Information System (INIS)

    Koibuchi, Hiroko; Ishiguro, Hideharu; Matsuda, Kenji

    2004-01-01

    In order to undertake the LLW and VLLW disposal business, various examinations are carried out in RANDEC. Since it is important in undertaking this business to secure funds, a disposal cost must be calculated by way of trial. However, at present, there are many unknown factors such as the amount of wastes, a disposal schedule, the location of a disposal site, and so on, and the cost cannot be determined. Meanwhile, the cost depends on complicated relations among these factors. Then, a 'LLW and VLLW disposal business cost estimation system' has been developed to calculate the disposal cost easily. This system can calculate an annual balance of payments by using a construction and operation cost of disposal facilities, considering economic parameters of tax, inflation rate, interest rate and so on. And the system can calculate internal reserves to assign to next-stage upkeep of the disposal facilities after the disposal operation. A model of disposal site was designed based on assumption of some preconditions and a study was carried out to make a trial calculation by using the system. Moreover, it will be required to reduce construction cost by rationalizing the facility and to make flat an annual business spending by examining the business schedule. (author)

  9. Cost benefit risk - a concept for management of integrated urban wastewater systems?

    DEFF Research Database (Denmark)

    Hauger, Mikkel B.; Rauch, W.; Linde, Jens Jørgen

    2002-01-01

    NPC as a decision variable has the problematic effect, that two alternatives performing completely differently when focusing on environmental cost can have the same NPC. The extreme example is one alternative with high risk and low cost and another with low risk and high cost. In this example it is up...... in the evaluation and design of urban wastewater systems. In this paper we present and discuss a probabilistic approach for evaluation of the performance of urban wastewater systems. Risk analysis together with the traditional cost-benefit analysis is a special variant of multi-criteria analysis that seeks to find...... the most feasible improvement alternative for an urban wastewater system. The most feasible alternative in this context is the alternative that has the best performance, meaning that the alternative has the lowest sum of costs, benefits and risks. The sum is expressed as the Net Present Cost (NPC). To use...

  10. Closing the mental health treatment gap in South Africa: a review of costs and cost-effectiveness

    Science.gov (United States)

    Jack, Helen; Wagner, Ryan G.; Petersen, Inge; Thom, Rita; Newton, Charles R.; Stein, Alan; Kahn, Kathleen; Tollman, Stephen; Hofman, Karen J.

    2014-01-01

    Background Nearly one in three South Africans will suffer from a mental disorder in his or her lifetime, a higher prevalence than many low- and middle-income countries. Understanding the economic costs and consequences of prevention and packages of care is essential, particularly as South Africa considers scaling-up mental health services and works towards universal health coverage. Economic evaluations can inform how priorities are set in system or spending changes. Objective To identify and review research from South Africa and sub-Saharan Africa on the direct and indirect costs of mental, neurological, and substance use (MNS) disorders and the cost-effectiveness of treatment interventions. Design Narrative overview methodology. Results and conclusions Reviewed studies indicate that integrating mental health care into existing health systems may be the most effective and cost-efficient approach to increase access to mental health services in South Africa. Integration would also direct treatment, prevention, and screening to people with HIV and other chronic health conditions who are at high risk for mental disorders. We identify four major knowledge gaps: 1) accurate and thorough assessment of the health burdens of MNS disorders, 2) design and assessment of interventions that integrate mental health screening and treatment into existing health systems, 3) information on the use and costs of traditional medicines, and 4) cost-effectiveness evaluation of a range of specific interventions or packages of interventions that are tailored to the national context. PMID:24848654

  11. Closing the mental health treatment gap in South Africa: a review of costs and cost-effectiveness

    Directory of Open Access Journals (Sweden)

    Helen Jack

    2013-05-01

    Full Text Available Background: Nearly one in three South Africans will suffer from a mental disorder in his or her lifetime, a higher prevalence than many low- and middle-income countries. Understanding the economic costs and consequences of prevention and packages of care is essential, particularly as South Africa considers scaling-up mental health services and works towards universal health coverage. Economic evaluations can inform how priorities are set in system or spending changes. Objective: To identify and review research from South Africa and sub-Saharan Africa on the direct and indirect costs of mental, neurological, and substance use (MNS disorders and the cost-effectiveness of treatment interventions. Design: Narrative overview methodology. Results and conclusions: Reviewed studies indicate that integrating mental health care into existing health systems may be the most effective and cost-efficient approach to increase access to mental health services in South Africa. Integration would also direct treatment, prevention, and screening to people with HIV and other chronic health conditions who are at high risk for mental disorders. We identify four major knowledge gaps: 1 accurate and thorough assessment of the health burdens of MNS disorders, 2 design and assessment of interventions that integrate mental health screening and treatment into existing health systems, 3 information on the use and costs of traditional medicines, and 4 cost-effectiveness evaluation of a range of specific interventions or packages of interventions that are tailored to the national context.

  12. Closing the mental health treatment gap in South Africa: a review of costs and cost-effectiveness.

    Science.gov (United States)

    Jack, Helen; Wagner, Ryan G; Petersen, Inge; Thom, Rita; Newton, Charles R; Stein, Alan; Kahn, Kathleen; Tollman, Stephen; Hofman, Karen J

    2014-01-01

    Nearly one in three South Africans will suffer from a mental disorder in his or her lifetime, a higher prevalence than many low- and middle-income countries. Understanding the economic costs and consequences of prevention and packages of care is essential, particularly as South Africa considers scaling-up mental health services and works towards universal health coverage. Economic evaluations can inform how priorities are set in system or spending changes. To identify and review research from South Africa and sub-Saharan Africa on the direct and indirect costs of mental, neurological, and substance use (MNS) disorders and the cost-effectiveness of treatment interventions. Narrative overview methodology. Reviewed studies indicate that integrating mental health care into existing health systems may be the most effective and cost-efficient approach to increase access to mental health services in South Africa. Integration would also direct treatment, prevention, and screening to people with HIV and other chronic health conditions who are at high risk for mental disorders. We identify four major knowledge gaps: 1) accurate and thorough assessment of the health burdens of MNS disorders, 2) design and assessment of interventions that integrate mental health screening and treatment into existing health systems, 3) information on the use and costs of traditional medicines, and 4) cost-effectiveness evaluation of a range of specific interventions or packages of interventions that are tailored to the national context.

  13. Cost and Cost-effectiveness of Students for Nutrition and Exercise (SNaX)

    Science.gov (United States)

    Ladapo, Joseph A.; Bogart, Laura M.; Klein, David J.; Cowgill, Burton O.; Uyeda, Kimberly; Binkle, David G.; Stevens, Elizabeth R.; Schuster, Mark A.

    2015-01-01

    Objective To examine the cost and cost-effectiveness of implementing Students for Nutrition and eXercise (SNaX), a 5-week middle-school-based obesity-prevention intervention combining school-wide environmental changes, multimedia, encouragement to eat healthy school cafeteria foods, and peer-led education. Methods Five intervention and five control middle schools (mean enrollment = 1,520 students) from the Los Angeles Unified School District participated in a randomized controlled trial of SNaX. Acquisition costs for materials and time and wage data for employees involved in implementing the program were used to estimate fixed and variable costs. Cost-effectiveness was determined using the ratio of variable costs to program efficacy outcomes. Results The costs of implementing the program over 5 weeks were $5,433.26 per school in fixed costs and $2.11 per student in variable costs, equaling a total cost of $8,637.17 per school, or $0.23 per student per day. This investment yielded significant increases in the proportion of students served fruit and lunch and a significant decrease in the proportion of students buying snacks. The cost-effectiveness of the program, per student over 5 weeks, was $1.20 per additional fruit served during meals, $8.43 per additional full-priced lunch served, $2.11 per additional reduced-price/free lunch served, and $1.69 per reduction in snacks sold. Conclusions SNaX demonstrated the feasibility and cost-effectiveness of a middle-school-based obesity-prevention intervention combining school-wide environmental changes, multimedia, encouragement to eat healthy school cafeteria foods, and peer-led education. Its cost is modest and unlikely to be a significant barrier to adoption for many schools considering its implementation. PMID:26427719

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

    Science.gov (United States)

    Rosmait, Russell L.

    1991-01-01

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

  15. (Dysfunctionality of accounting cost systems in manufacturing companies of Tuzla canton

    Directory of Open Access Journals (Sweden)

    Sado Puškarević

    2014-12-01

    Full Text Available This paper shows the results of the conducted primary survey on functionality of cost systems in manufacturing companies of Tuzla Canton (hereinafter “TC”. This paper assesses their adequacy to the needs of these companies: the present needs, and the ones that will be brought by the changes in the environment. These systems have to be up-to-date, as they influence the process of cost management, which is the key factor of companies’ adaptation to the conditions of a modern market. Cost management, which is based on the information of a cost system, enables the company to take the adequate stand towards customers on markets and toward their competition. Also, the quality cost information is a precondition for effective and efficient allocation of limited resources in a transitional period of society development. Therefore, only quality designed cost system in transitional economy will enable recovery, and then, growth and development of a company. This emphasizes the importance of research of the stated issues for transitional countries. The research results should also help to persuade the management about the need to modernize the operation organization, primarily the accounting function, mainly in the part of cost system organization. The determined defects, as well as deviances in relation to current needs for information about costs, are guidelines for an adequate process of redesigning cost systems in companies of transitional economy.

  16. Acceptance and rejection: cost-effectiveness and the working nephrologist.

    Science.gov (United States)

    McFarlane, Philip A; Bayoumi, Ahmed M

    2004-11-01

    While many nephrologists have developed a sophisticated approach to appraising clinical trials, an equal comfort in critiquing cost-effectiveness literature is often lagging. Readers can wonder how new results compare to those from other cost-effectiveness trials, and whether they should accept a new intervention as cost-effective or reject it as too costly for the benefit it produces. Critical readers should first judge whether the authors have made the correct trade-off between complexity and generalizability when selecting a study perspective, and should examine the method of linkage between costs and effectiveness. The most popular method is the incremental cost-effectiveness ratio (ICER), which has limitations that have led some authors to prefer the net monetary benefit (NMB), where confidence intervals are more easily determined and which can more readily be used in regression analyses. Interpretation of the ICER and NMB require the choice of a cost-effectiveness ceiling, representing the maximum that society would be willing to pay for an incremental health benefit, and the development of a decision rule based on this maximum. Comparing cost-effectiveness studies from different disciplines requires the use of "universal" effectiveness measures, such as the quality-adjusted life-year (QALY). An understanding of study perspective, the relative strengths of different cost-effectiveness measures, the methods for measuring uncertainty in these estimates, and how to select and use cost-effectiveness ceiling ratios will help the critical reader to determine if a new intervention should be accepted or rejected.

  17. New Low Cost Structure for Dual Axis Mount Solar Tracking System Using Adaptive Solar Sensor

    DEFF Research Database (Denmark)

    Argeseanu, Alin; Ritchie, Ewen; Leban, Krisztina Monika

    2010-01-01

    A solar tracking system is designed to optimize the operation of solar energy receivers. The objective of this paper is proposing a new tracking system structure with two axis. The success strategy of this new project focuses on the economical analysis of solar energy. Therefore it is important...... to determine the most cost effective design, to consider the costs of production and maintenance, and operating. The proposed tracking system uses a new solar sensor position with an adaptive feature....

  18. Childhood Secondhand Smoke Exposure and ADHD-Attributable Costs to the Health and Education System

    Science.gov (United States)

    Max, Wendy; Sung, Hai-Yen; Shi, Yanling

    2014-01-01

    Background: Children exposed to secondhand smoke (SHS) have higher rates of behavioral and cognitive effects, including attention deficit hyperactivity disorder (ADHD), but the costs to the health care and education systems have not been estimated. We estimate these costs for school-aged children aged 5-15. Methods: The relative risk (RR) of ADHD…

  19. A review on cost-effectiveness and cost-utility of psychosocial care in cancer patients

    Directory of Open Access Journals (Sweden)

    Femke Jansen

    2016-01-01

    Full Text Available Several psychosocial care interventions have been found effective in improving psychosocial outcomes in cancer patients. At present, there is increasingly being asked for information on the value for money of this type of intervention. This review therefore evaluates current evidence from studies investigating cost-effectiveness or cost-utility of psychosocial care in cancer patients. A systematic search was conducted in PubMed and Web of Science yielding 539 unique records, of which 11 studies were included in the study. Studies were mainly performed in breast cancer populations or mixed cancer populations. Studied interventions included collaborative care (four studies, group interventions (four studies, individual psychological support (two studies, and individual psycho-education (one study. Seven studies assessed the cost-utility of psychosocial care (based on quality-adjusted-life-years while three studies investigated its cost-effectiveness (based on profile of mood states [mood], Revised Impact of Events Scale [distress], 12-Item Health Survey [mental health], or Fear of Progression Questionnaire [fear of cancer progression]. One study did both. Costs included were intervention costs (three studies, intervention and direct medical costs (five studies, or intervention, direct medical, and direct nonmedical costs (three studies. In general, results indicated that psychosocial care is likely to be cost-effective at different, potentially acceptable, willingness-to-pay thresholds. Further research should be performed to provide more clear information as to which psychosocial care interventions are most cost-effective and for whom. In addition, more research should be performed encompassing potential important cost drivers from a societal perspective, such as productivity losses or informal care costs, in the analyses.

  20. Cost-effectiveness of routine imaging of suspected appendicitis.

    Science.gov (United States)

    D'Souza, N; Marsden, M; Bottomley, S; Nagarajah, N; Scutt, F; Toh, S

    2018-01-01

    Introduction The misdiagnosis of appendicitis and consequent removal of a normal appendix occurs in one in five patients in the UK. On the contrary, in healthcare systems with routine cross-sectional imaging of suspected appendicitis, the negative appendicectomy rate is around 5%. If we could reduce the rate in the UK to similar numbers, would this be cost effective? This study aimed to calculate the financial impact of negative appendicectomy at the Queen Alexandra Hospital and to explore whether a policy of routine imaging of such patients could reduce hospital costs. Materials and methods We performed a retrospective analysis of all appendicectomies over a 1-year period at our institution. Data were extracted on outcomes including appendix histology, operative time and length of stay to calculate the negative appendicectomy rate and to analyse costs. Results A total of 531 patients over 5 years of age had an appendicectomy. The negative appendicectomy rate was 22% (115/531). The additional financial costs of negative appendicectomy to the hospital during this period were £270,861. Universal imaging of all patients with right iliac fossa pain that could result in a 5% negative appendicectomy rate would cost between £67,200 and £165,600 per year but could save £33,896 (magnetic resonance imaging), £105,896 (computed tomography) or £132,296 (ultrasound) depending on imaging modality used. Conclusions Negative appendicectomy is still too frequent and results in additional financial burden to the health service. Routine imaging of patients with suspected appendicitis would not only reduce the negative appendicectomy rate but could lead to cost savings and a better service for our patients.

  1. Solar Water Heating with Low-Cost Plastic Systems (Brochure)

    Energy Technology Data Exchange (ETDEWEB)

    2012-01-01

    Newly developed solar water heating technology can help Federal agencies cost effectively meet the EISA requirements for solar water heating in new construction and major renovations. This document provides design considerations, application, economics, and maintenance information and resources.

  2. The promise--and peril--of integrated cost systems.

    Science.gov (United States)

    Cooper, R; Kaplan, R S

    1998-01-01

    Recent advances in managerial accounting have helped executives get the information they need to make good strategic decisions. But today's enterprise resource planning systems promise even greater benefits--the chance to integrate activity-based costing, operational-control, and financial reporting systems. But managers need to approach integration very thoughtfully, or they could end up with a system that drives decision making in the wrong direction. Operational-control and ABC systems have fundamentally different purposes. Their requirements for accuracy, timeliness, and aggregation are so different that no single, fully integrated approach can be adequate for both purposes. If an integrated system used real-time cost data instead of standard rates in its ABC subsystem, for example, the result would be dangerously distorted messages about individual product profitability--and that's precisely the problem ABC systems were originally designed to address. Proper linkage and feedback between the two systems is possible, however. Through activity-based budgeting, the ABC system is linked directly to operations control: managers can determine the supply and practical capacity of resources in forthcoming periods. Linking operational control to ABC is also possible. The activity-based portion of an operational control system collects information that, while it mustn't be fed directly into the activity-based strategic cost system, can be extremely useful once it's been properly analyzed. Finally, ABC and operational control can be linked to financial reporting to generate cost of goods sold and inventory valuations--but again, with precautions.

  3. Cost of childhood diarrhoea in rural South Africa: exploring cost-effectiveness of universal zinc supplementation.

    Science.gov (United States)

    Chhagan, Meera K; Van den Broeck, Jan; Luabeya, Kany-Kany Angelique; Mpontshane, Nontobeko; Bennish, Michael L

    2014-09-01

    To describe the cost of diarrhoeal illness in children aged 6-24 months in a rural South African community and to determine the threshold prevalence of stunting at which universal Zn plus vitamin A supplementation (VAZ) would be more cost-effective than vitamin A alone (VA) in preventing diarrhoea. We conducted a cost analysis using primary and secondary data sources. Using simulations we examined incremental costs of VAZ relative to VA while varying stunting prevalence. Data on efficacy and societal costs were largely from a South African trial. Secondary data were from local and international published sources. The trial included children aged 6-24 months. The secondary data sources were a South African health economics survey and the WHO-CHOICE (CHOosing Interventions that are Cost Effective) database. In the trial, stunted children supplemented with VAZ had 2·04 episodes (95 % CI 1·37, 3·05) of diarrhoea per child-year compared with 3·92 episodes (95 % CI 3·02, 5·09) in the VA arm. Average cost of illness was $Int 7·80 per episode (10th, 90th centile: $Int 0·28, $Int 15·63), assuming a minimum standard of care (oral rehydration and 14 d of therapeutic Zn). In simulation scenarios universal VAZ had low incremental costs or became cost-saving relative to VA when the prevalence of stunting was close to 20 %. Incremental cost-effectiveness ratios were sensitive to the cost of intervention and coverage levels. This simulation suggests that universal VAZ would be cost-effective at current levels of stunting in parts of South Africa. This requires further validation under actual programmatic conditions.

  4. An Assessment Of The Effectiveness Of Collaborative Cost ...

    African Journals Online (AJOL)

    This paper presents the effects of Collaborative Cost Reduction Model (CCRM) as a control Approach to reduce the high cost implication that causes the slow pace of migration process from IPV4 to IPV6 in Nigeria. This study reveals that CCRM can be applied to achieve Cost Reduction in collocation efforts in ...

  5. Cost-effectiveness of rotavirus vaccination in Turkey

    Directory of Open Access Journals (Sweden)

    Tulin Koksal

    2017-10-01

    Conclusion: At a cost per vaccine course of US$31.5 for monovalent and US$38 for pentavalent vaccine, routine RV vaccination could be potentially cost effective and also cost saving in Turkey. National RV vaccinations will play a significant role in preventing RV infections.

  6. Comparison of high-speed rail and maglev system costs

    Energy Technology Data Exchange (ETDEWEB)

    Rote, D.M.

    1998-07-01

    This paper compares the two modes of transportation, and notes important similarities and differences in the technologies and in how they can be implemented to their best advantage. Problems with making fair comparisons of the costs and benefits are discussed and cost breakdowns based on data reported in the literature are presented and discussed in detail. Cost data from proposed and actual construction projects around the world are summarized and discussed. Results from the National Maglev Initiative and the recently-published Commercial Feasibility Study are included in the discussion. Finally, estimates will be given of the expected cost differences between HSR and maglev systems implemented under simple and complex terrain conditions. The extent to which the added benefits of maglev technology offset the added costs is examined.

  7. Dengue dynamics and vaccine cost-effectiveness in Brazil.

    Science.gov (United States)

    Durham, David P; Ndeffo Mbah, Martial L; Medlock, Jan; Luz, Paula M; Meyers, Lauren A; Paltiel, A David; Galvani, Alison P

    2013-08-20

    Recent Phase 2b dengue vaccine trials have demonstrated the safety of the vaccine and estimated the vaccine efficacy with further trials underway. In anticipation of vaccine roll-out, cost-effectiveness analysis of potential vaccination policies that quantify the dynamics of disease transmission are fundamental to the optimal allocation of available doses. We developed a dengue transmission and vaccination model and calculated, for a range of vaccination costs and willingness-to-pay thresholds, the level of vaccination coverage necessary to sustain herd-immunity, the price at which vaccination is cost-effective and is cost-saving, and the sensitivity of our results to parameter uncertainty. We compared two vaccine efficacy scenarios, one a more optimistic scenario and another based on the recent lower-than-expected efficacy from the latest clinical trials. We found that herd-immunity may be achieved by vaccinating 82% (95% CI 58-100%) of the population at a vaccine efficacy of 70%. At this efficacy, vaccination may be cost-effective for vaccination costs up to US$ 534 (95% CI $369-1008) per vaccinated individual and cost-saving up to $204 (95% CI $39-678). At the latest clinical trial estimates of an average of 30% vaccine efficacy, vaccination may be cost-effective and cost-saving at costs of up to $237 (95% CI $159-512) and $93 (95% CI $15-368), respectively. Our model provides an assessment of the cost-effectiveness of dengue vaccination in Brazil and incorporates the effect of herd immunity into dengue vaccination cost-effectiveness. Our results demonstrate that at the relatively low vaccine efficacy from the recent Phase 2b dengue vaccine trials, age-targeted vaccination may still be cost-effective provided the total vaccination cost is sufficiently low. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. THE BROOKHAVEN NATIONAL LABORATORY PERFLUOROCARBON TRACER TECHNOLOGY: A PROVEN AND COST EFFECTIVE METHOD TO VERIFY INTEGRITY AND MONITOR LONG TERM PERFORMANCE OF WALLS, FLOORS, CAPS, AND COVER SYSTEMS.

    Energy Technology Data Exchange (ETDEWEB)

    HEISER, J.; SULLIVAN, T.

    2002-03-11

    Currently, containment system failures are detected by monitoring wells downstream of the waste site. Clearly this approach is inefficient, as the contaminants will have migrated from the disposal area before they are detected. Methods that indicate early cover failure (prior to contaminant release) or predict impending cover failure are needed. The Brookhaven National Laboratory (BNL) Perfluorocarbon Tracer (PFT) technology can measure performance changes and integrity losses as the cover ages. This allows early detection of cover failure or pending failure so that repair or replacement can be made before contaminants leave the disposal cell. The PFT technology has been successfully applied to four subsurface barrier problems, one leak detection problem from underground ducts, and one surface cover problem. Testing has demonstrated that the PFTs are capable of accurately detecting and locating leaks down to fractions of an inch. The PFT technology has several advantages over competing approaches. The ability to simultaneously use multiple PFTs separates it from other gas tracer technologies. Using multiple tracers provides independent confirmation of flaw location, helps to clearly define transport pathways, and can be used for confirmatory testing (e.g., repeat the test using a new tracer). The PFT tests provide a direct measure of flaws in a barrier, whereas other measurements (pressure, moisture content, temperature, subsidence) provide indirect measures that need interpretation. The focus of the six PFT demonstrations has been on engineering aspects of the technology with the intent of finding if a flaw existed in the barrier. Work remains to be done on the scientific basis for this technology. This includes determining PFT diffusion rates through various materials (soils and barrier) as a function of moisture content, determining the effects of barometric pumping on PFT flow for cover systems, and determining wind effects on side slopes of cover systems and

  9. Factors Effect Direct Cost of Hospital Foodservices and Approximate Cost Analyze

    Directory of Open Access Journals (Sweden)

    Fatma Çelik

    2006-01-01

    Full Text Available The aim of this study was to investigate the cost of foodservice for the university hospital by taking into account of the criteria’s of well diet balanced using information technology. The data explain cost of food were obtained from input, output of hospital food barn that processed by hospital information system for 1995, 2000-2004 years. All details for calculating the net expenditure of food and direct cost of nutrition services were obtained from hospital information system that records all data on line. The energy and nutrient values of daily food served were calculated using the output of hospital food barn by the computer software that was developed. It was found that, our hospital catering system supplied a daily food ration of 2728 kcal and 98,1 gr protein/person in 2004.It has found that the cost of food was increased 10 times from 1995 to 2004. The expenditure of food groups that used in the hospital was 58.96% percent in the total cost of all nutrition services. The big part (28.92% of food expenditure was red meat and pulses. It has been thought that the daily approximate food cost for per person was 3,15 YTL. The total approximate cost could be estimated by adding the cost of staffs and the various managing expenditures to the approximate food cost. These data would be used to make the hospital foodservices private.In conclusion, to be successful in managing hospital food services depends on regular inspection and to take all costs under control daily. To present the results of cost analysis for hospitals will increase the quality of foodservices and will be possible to compare with the others.

  10. Cost and cost-effectiveness of conventional and liquid-based ...

    African Journals Online (AJOL)

    Background. South Africa has a high prevalence of cervical cancer. Early detection can significantly reduce the burden of this disease. New screening technologies to detect cervical pathology have become available in recent years. Objectives. To determine the cost and cost-effectiveness of liquid-based cytology (LBC) ...

  11. The Kyoto Protocol Is Cost-effective

    Directory of Open Access Journals (Sweden)

    Marino Gatto

    2002-06-01

    Full Text Available Despite recent advances, there is a high degree of uncertainty concerning the climate change that would result from increasing atmospheric greenhouse gas concentrations. Also, opponents of the Kyoto Protocol raised the key objection that reducing emissions would impose an unacceptable economic burden on businesses and consumers. Based on an analysis of alternative scenarios for electricity generation in Italy, we show that if the costs in terms of damage to human health, material goods, agriculture, and the environment caused by greenhouse gas emissions are included in the balance, the economic argument against Kyoto is untenable. Most importantly, the argument holds true even if we exclude global external costs (those due to global warming, and account for local external costs only (such as those due to acidic precipitation and lung diseases resulting from air pollution.

  12. Evaluation of Externality Costs in Life-Cycle Optimization of Municipal Solid Waste Management Systems

    DEFF Research Database (Denmark)

    Martinez Sanchez, Veronica; Levis, James W.; Damgaard, Anders

    2017-01-01

    The development of sustainable solid waste management (SWM) systems requires consideration of both economic and environmental impacts. Societal life-cycle costing (S-LCC) provides a quantitative framework to estimate both economic and environmental impacts, by including "budget costs......" and "externality costs". Budget costs include market goods and services (economic impact), whereas externality costs include effects outside the economic system (e.g., environmental impact). This study demonstrates the applicability of S-LCC to SWM life-cycle optimization through a case study based on an average...... suburban U.S. county of 500 000 people generating 320 000 Mg of waste annually. Estimated externality costs are based on emissions of CO2, CH4, N2O, PM2.5, PM10, NOx, SO2, VOC, CO, NH3, Hg, Pb, Cd, Cr (VI), Ni, As, and dioxins. The results indicate that incorporating S-LCC into optimized SWM strategy...

  13. Transmission embedded cost allocation methodology with consideration of system reliability

    International Nuclear Information System (INIS)

    Hur, D.; Park, J.-K.; Yoo, C.-I.; Kim, B.H.

    2004-01-01

    In a vertically integrated utility industry, the cost of reliability, as a separate service, has not received much rigorous analysis. However, as a cornerstone of restructuring the industry, the transmission service pricing must change to be consistent with, and supportive of, competitive wholesale electricity markets. This paper focuses on the equitable allocation of transmission network embedded costs including the transmission reliability cost based on the contributions of each generator to branch flows under normal conditions as well as the line outage impact factor under a variety of load levels. A numerical example on a six-bus system is given to illustrate the applications of the proposed methodology. (author)

  14. Cost-effectiveness, feed utilization and body composition of african ...

    African Journals Online (AJOL)

    Cost-effectiveness, feed utilization and body composition of african sharptooth catfish ( Clarias gariepinus , Burchell 1822) fingerlings fed locally formulated and commercial pelleted diets in tarpaulin tanks.

  15. The Effects of the Emission Cost on Route Choices of International Container Ships

    Directory of Open Access Journals (Sweden)

    Hyangsook Lee

    2016-01-01

    Full Text Available Maritime freight shipping has increased significantly and air pollution from international ships has grown accordingly, having serious environmental effects all over the world. This paper analyzes the effects of the emission cost on ocean route choices, focusing on international container ships. First, the paper formulates a freight network model that captures decisions and interactions of ocean carriers and port terminal operators in the maritime freight transport system. Then, the emission cost is calculated based on an activity-based approach as a component of the ocean transportation cost function. A case study is examined to find if the emission cost affects ocean route choices. The results indicate that the optimal ocean route and transportation cost are changed distinctively due to the emission cost. The research discusses how the emission cost plays a role in route changes and why ocean carriers have to consider these costs in their routing decisions.

  16. The Almajiri educational system in Nigeria: cost and challenges ...

    African Journals Online (AJOL)

    This paper highlights the cost and challenges of the Almajiri system of education in Nigeria. The paper theoretically examines pertinent issues arising from its conduct and administration. Although the Almajiri system of education in Nigeria has attracted very large number of children in the Northern part of the country, it has ...

  17. Solutions for cost effective assessment of software based instrumentation and control systems in nuclear power plants. Report prepared within the framework of the Technical Working Group on Nuclear Power Plant Control and Implementation

    International Nuclear Information System (INIS)

    2002-12-01

    The introduction of software based instrumentation and control (I and C) systems for use in nuclear power plants, mainly due to I and C modernization activities, has raised many issues of safety and economics. Many of these issues have been raised in the IAEA Technical Working Group on Nuclear Power Plant Control and Instrumentation (TWG-NPPCI) meetings and by other organizations, such as the OECD and the European Commission. One increasingly important issue is the need for engineering solutions to justify them for the cost effective assessment and deployment of software based I and C systems. To address this important issue, the IAEA put together the Co-ordinated Research Project (CRP) on Solutions for Cost Effective Assessments of Software based I and C Systems. The overall objective of the project is to facilitate the cost effective assessment of software based I and C systems in nuclear power plants. This is necessary to address obsolescence issues, to introduce new beneficial functionality, and to improve overall performance. The engineering solutions developed in this CRP will contribute to this overall objective. The objective of the CRP was reached through co-ordinated research and collected experience in the areas of project management; requirements specifications; use of software explicitly designed for nuclear applications, use of commercial off the shelf (COTS) products, generic pre-qualification of systems and components; safety and reliability enhancements; verification and validation; and licensing impact. This TECDOC is the result of the research and collected experience put together under this CRP. The CRP participants gave presentations on their work performed as part of this CRP at the various meetings of the group. The first meeting of the CRP was held in Vienna on 8-12 November 1999 in which the participants developed the objectives, scope, and outline of this report. The second meeting was held in Halden, Norway on 4-8 December 2000 and the

  18. Resolving the "Cost-Effective but Unaffordable" Paradox: Estimating the Health Opportunity Costs of Nonmarginal Budget Impacts.

    Science.gov (United States)

    Lomas, James; Claxton, Karl; Martin, Stephen; Soares, Marta

    2018-03-01

    Considering whether or not a proposed investment (an intervention, technology, or program of care) is affordable is really asking whether the benefits it offers are greater than its opportunity cost. To say that an investment is cost-effective but not affordable must mean that the (implicit or explicit) "threshold" used to judge cost-effectiveness does not reflect the scale and value of the opportunity costs. Existing empirical estimates of health opportunity costs are based on cross-sectional variation in expenditure and mortality outcomes by program budget categories (PBCs) and do not reflect the likely effect of nonmarginal budget impacts on health opportunity costs. The UK Department of Health regularly updates the needs-based target allocation of resources to local areas of the National Health Service (NHS), creating two subgroups of local areas (those under target allocation and those over). These data provide the opportunity to explore how the effects of changes in health care expenditure differ with available resources. We use 2008-2009 data to evaluate two econometric approaches to estimation and explore a range of criteria for accepting subgroup specific effects for differences in expenditure and outcome elasticities across the 23 PBCs. Our results indicate that health opportunity costs arising from an investment imposing net increases in expenditure are underestimated unless account is taken of likely nonmarginal effects. They also indicate the benefits (reduced health opportunity costs or increased value-based price of a technology) of being able to "smooth" these nonmarginal budget impacts by health care systems borrowing against future budgets or from manufacturers offering "mortgage" type arrangements. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  19. Cost-effective tunable 1310nm DWDM transmitter

    Science.gov (United States)

    Chorchos, Łukasz; Turkiewicz, Jarosław P.

    2015-09-01

    The growing demand for higher data rate transmissions in local and metropolitan area networks is main reason of developing effective and inexpensive transmission systems. In this paper, study about the possibility to realize 1310 nm tunable DWDM transmitter using commercially available low-cost DFB lasers is presented. Extensive DFB lasers characterization has been performed which led to establish relationships between laser current, operational temperature, emitted wavelength and power. An algorithm to find the laser settings for a desired wavelength grid has been proposed and tested. Generation of the 1310nm DWDM channels with frequency spacing between 120 and 240GHz has been demonstrated.

  20. Cost effectiveness of dilute chemical decontamination

    International Nuclear Information System (INIS)

    LeSurf, J.E.; Weyman, G.D.

    The basic principles of dilute chemical decontamination are described, as well as the method of application. Methods of computing savings in radiation dose and costs are presented, with results from actual experience and illustrative examples. It is concluded that dilute chemical decontamination is beneficial in many cases. It reduces radiation exposure of workers, saves money, and simplifies maintenance work

  1. New Approaches in Reuseable Booster System Life Cycle Cost Modeling

    Science.gov (United States)

    Zapata, Edgar

    2013-01-01

    This paper presents the results of a 2012 life cycle cost (LCC) study of hybrid Reusable Booster Systems (RBS) conducted by NASA Kennedy Space Center (KSC) and the Air Force Research Laboratory (AFRL). The work included the creation of a new cost estimating model and an LCC analysis, building on past work where applicable, but emphasizing the integration of new approaches in life cycle cost estimation. Specifically, the inclusion of industry processes/practices and indirect costs were a new and significant part of the analysis. The focus of LCC estimation has traditionally been from the perspective of technology, design characteristics, and related factors such as reliability. Technology has informed the cost related support to decision makers interested in risk and budget insight. This traditional emphasis on technology occurs even though it is well established that complex aerospace systems costs are mostly about indirect costs, with likely only partial influence in these indirect costs being due to the more visible technology products. Organizational considerations, processes/practices, and indirect costs are traditionally derived ("wrapped") only by relationship to tangible product characteristics. This traditional approach works well as long as it is understood that no significant changes, and by relation no significant improvements, are being pursued in the area of either the government acquisition or industry?s indirect costs. In this sense then, most launch systems cost models ignore most costs. The alternative was implemented in this LCC study, whereby the approach considered technology and process/practices in balance, with as much detail for one as the other. This RBS LCC study has avoided point-designs, for now, instead emphasizing exploring the trade-space of potential technology advances joined with potential process/practice advances. Given the range of decisions, and all their combinations, it was necessary to create a model of the original model

  2. New Approaches in Reusable Booster System Life Cycle Cost Modeling

    Science.gov (United States)

    Zapata, Edgar

    2013-01-01

    This paper presents the results of a 2012 life cycle cost (LCC) study of hybrid Reusable Booster Systems (RBS) conducted by NASA Kennedy Space Center (KSC) and the Air Force Research Laboratory (AFRL). The work included the creation of a new cost estimating model and an LCC analysis, building on past work where applicable, but emphasizing the integration of new approaches in life cycle cost estimation. Specifically, the inclusion of industry processes/practices and indirect costs were a new and significant part of the analysis. The focus of LCC estimation has traditionally been from the perspective of technology, design characteristics, and related factors such as reliability. Technology has informed the cost related support to decision makers interested in risk and budget insight. This traditional emphasis on technology occurs even though it is well established that complex aerospace systems costs are mostly about indirect costs, with likely only partial influence in these indirect costs being due to the more visible technology products. Organizational considerations, processes/practices, and indirect costs are traditionally derived ("wrapped") only by relationship to tangible product characteristics. This traditional approach works well as long as it is understood that no significant changes, and by relation no significant improvements, are being pursued in the area of either the government acquisition or industry?s indirect costs. In this sense then, most launch systems cost models ignore most costs. The alternative was implemented in this LCC study, whereby the approach considered technology and process/practices in balance, with as much detail for one as the other. This RBS LCC study has avoided point-designs, for now, instead emphasizing exploring the trade-space of potential technology advances joined with potential process/practice advances. Given the range of decisions, and all their combinations, it was necessary to create a model of the original model

  3. FY 1998 report on the results of the New Sunshine Project - Development of the commercialization technology of the photovoltaic power system. Verification study of the photovoltaic power system - Research on engineering methods for cost effective PV installation; 1998 nendo taiyoko hatsuden system jitsuyoka gijutsu kaihatsu seika hokokusho. Taiyoko hatsuden system no jissho kenkyu (tashu secchi koho no kenkyu kaihatsu)

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-03-01

    For the purpose of promoting installations of PV system and making use of the unused space for which a rise in the PV demand equal to that in houses, building roofs, etc. is expected, examination/research for much newer forms of land installation are proceeded with, and evaluation/verification of reliability/durability are conducted of new installation processes using thin film solar cells, adhesives, etc. In this fiscal year, study of the development/verification of low cost floating pedestal was promoted, and at the same time, examinational study of forms of land installation was made. As to the development of low cost floating pedestal, the module type flexible floating pedestal was developed as a small prototype pedestal and tested for installation in a pool. Survey was also carried out of geometry, mooring systems, materials, design conditions, and existing instances of different floats, and measures were studied for the effective use of the floating system. In relation to reliability and durability evaluation of the new installation process, the verification operation of evaluation facilities for various installation processes was continued, and the power generation capacity was made clear in special forms of installation such as installations on vertical/horizontal surfaces. And the study was made of the large area frameless structure, building use double glass structure, and durability of the adhesive/adhesive tape process of thin film solar cells. (NEDO)

  4. Potential of remote multiplexing systems in reducing cabling cost and complexity in nuclear power stations

    International Nuclear Information System (INIS)

    Stirling, A.J.; L'Archeveque, J.V.R.

    1977-03-01

    Control and instrumentation cabling accounts for nearly 1% of the capital cost of a CANDU generating station. This study of cabling requirements, methods and costs for nuclear reactors, shows that efficient design and scale economies make CANDU wiring costs (per field point) among the lowest for comparable applications. Although attractive in other reactors, commercially available remote multiplexing systems are not, as yet, cost effective for general use in CANDU stations. The report, with its comprehensive tabulation of remote multiplexing equipment, and analysis of cabling procedures describes an approach for re-evaluating the tradeoff between remote multiplexing and conventional wiring as conditions change. (author)

  5. The effect of pediatric knowledge on hospice care costs.

    Science.gov (United States)

    Lindley, Lisa C; Mixer, Sandra J; Cozad, Melanie J

    2014-05-01

    The cost of hospice care is rising. Although providing care for children at end of life may be costly for hospices, it is unclear whether or not gaining pediatric knowledge and even establishing a pediatric program may be done cost effectively. The purpose of our study was to examine the effect of possessing pediatric knowledge (i.e., pediatric program, pediatric experience) on core hospice care costs. Using 2002 to 2008 California hospice data, the findings of the regression analysis suggest that having pediatric knowledge does not significantly increase nursing, physician, and medical social service costs. Having a pediatric program was related to increased counseling costs. Our findings shed important light on the minimal costs incurred when hospices decide to develop pediatric knowledge.

  6. Optimized low-cost-array field designs for photovoltaic systems

    Science.gov (United States)

    Post, H. N.; Carmichael, D. C.; Castle, J. A.

    A comprehensive program to define and develop array field subsystems which can achieve the lowest possible lifecycle costs is discussed. The major activity of this program is described, namely, the design and development of optimized, modular array fields for photovoltaic (PV) systems. As part of this activity, design criteria and performance requirements for specific array subsystems including support structures, foundations, intermodule connections, field wiring, lightning protection, system grounding, site preparation, and monitoring and control were defined and evaluated. Similarly, fully integrated flat-panel array field designs, optimized for lowest lifecycle costs, were developed for system sizes ranging from 20 to 500 kW sub p. Key features, subsystem requirements, and projected costs for these array field designs are presented and discussed.

  7. Prototyping low-cost and flexible vehicle diagnostic systems

    Directory of Open Access Journals (Sweden)

    Marisol GARCÍA-VALLS

    2016-12-01

    Full Text Available Diagnostic systems are software and hardware-based equipment that interoperate with an external monitored system. Traditionally, they have been expensive equipment running test algorithms to monitor physical properties of, e.g., vehicles, or civil infrastructure equipment, among others. As computer hardware is increasingly powerful (whereas its cost and size is decreasing and communication software becomes easier to program and more run-time efficient, new scenarios are enabled that yield to lower cost monitoring solutions. This paper presents a low cost approach towards the development of a diagnostic systems relying on a modular component-based approach and running on a resource limited embedded computer. Results on a prototype implementation are shown that validate the presented design, its flexibility, performance, and communication latency.

  8. Cost effectiveness analysis of indoor radon control measures

    International Nuclear Information System (INIS)

    Fujimoto, Kenzo

    1989-01-01

    The problem of radon 222 in buildings as a contributor to radiation exposure is described. Five different control methods and the dose reductions that would result from each are analysed. The annualized cost for each control measure was evaluated and the cost effectiveness of each control measure was calculated on the basis of dollars per person-sievert dose reduction. The use of unipolar ion generators for particle removal appears to be the most cost effective and the use of ceiling fans to increase air circulation the least cost effective. 3 figs., 1 tab

  9. Reducing Inventory System Costs by Using Robust Demand Estimators

    OpenAIRE

    Raymond A. Jacobs; Harvey M. Wagner

    1989-01-01

    Applications of inventory theory typically use historical data to estimate demand distribution parameters. Imprecise knowledge of the demand distribution adds to the usual replenishment costs associated with stochastic demands. Only limited research has been directed at the problem of choosing cost effective statistical procedures for estimating these parameters. Available theoretical findings on estimating the demand parameters for (s, S) inventory replenishment policies are limited by their...

  10. The cost-effectiveness of public postsecondary education subsidies.

    Science.gov (United States)

    Muennig, P; Fahs, M

    2001-02-01

    Although educational attainment is a well-recognized covariate of health status, it is rarely thought of as a tool to be used to improve health. Since fewer than 40% of U.S. citizens have a college degree, it may be possible for the government to improve the health status of the population by assuming a larger burden of the cost of postsecondary education. This paper examines the costs and health effects of a government subsidy for public postsecondary education institutions. All high school graduates in 1997 were included in a decision analysis model as a hypothetical cohort. Data from the U.S. Department of Education, the World Health Organization, and the National Center for Health Statistics were used as model inputs. Results. Relative to the present educational system, a federal subsidy for public and private colleges equal to the amount now paid by students for tuition and living expenses would save $6,176 and avert 0.0018 of a disability-adjusted life-year (DALY) per person annually if enrollment increased 5%. The overall savings among 1997 high school graduates would be $17.1 billion and 4,992 DALYs would be averted per year relative to the present educational system. If enrollment increased by just 3%, $3,743 would be saved and 0.0011 DALYs would be averted per person. An enrollment increase of 7% would lead to savings of $8,610 and 0.0025 DALYs would be averted per person relative to the present educational system. If the government were to offer a full subsidy for college tuition at public universities, both lives and money would be saved, so long as enrollment levels increased. Providing a free postsecondary education for students attending public schools may be more cost-effective than most health investments. Copyright 2001 American Health Foundation and Academic Press.

  11. Linking quality of care and training costs: cost-effectiveness in health professions education.

    Science.gov (United States)

    Tolsgaard, Martin G; Tabor, Ann; Madsen, Mette E; Wulff, Camilla B; Dyre, Liv; Ringsted, Charlotte; Nørgaard, Lone N

    2015-12-01

    To provide a model for conducting cost-effectiveness analyses in medical education. The model was based on a randomised trial examining the effects of training midwives to perform cervical length measurement (CLM) as compared with obstetricians on patients' waiting times. (CLM), as compared with obstetricians. The model included four steps: (i) gathering data on training outcomes, (ii) assessing total costs and effects, (iii) calculating the incremental cost-effectiveness ratio (ICER) and (iv) estimating cost-effectiveness probability for different willingness to pay (WTP) values. To provide a model example, we conducted a randomised cost-effectiveness trial. Midwives were randomised to CLM training (midwife-performed CLMs) or no training (initial management by midwife, and CLM performed by obstetrician). Intervention-group participants underwent simulation-based and clinical training until they were proficient. During the following 6 months, waiting times from arrival to admission or discharge were recorded for women who presented with symptoms of pre-term labour. Outcomes for women managed by intervention and control-group participants were compared. These data were then used for the remaining steps of the cost-effectiveness model. Intervention-group participants needed a mean 268.2 (95% confidence interval [CI], 140.2-392.2) minutes of simulator training and a mean 7.3 (95% CI, 4.4-10.3) supervised scans to attain proficiency. Women who were scanned by intervention-group participants had significantly reduced waiting time compared with those managed by the control group (n = 65; mean difference, 36.6 [95% CI 7.3-65.8] minutes; p = 0.008), which corresponded to an ICER of 0.45 EUR minute(-1) . For WTP values less than EUR 0.26 minute(-1) , obstetrician-performed CLM was the most cost-effective strategy, whereas midwife-performed CLM was cost-effective for WTP values above EUR 0.73 minute(-1) . Cost-effectiveness models can be used to link quality of care to

  12. Involvement in the US criminal justice system and cost implications for persons treated for schizophrenia

    Directory of Open Access Journals (Sweden)

    Faries Douglas E

    2010-01-01

    Full Text Available Abstract Background Individuals with schizophrenia may have a higher risk of encounters with the criminal justice system than the general population, but there are limited data on such encounters and their attendant costs. This study assessed the prevalence of encounters with the criminal justice system, encounter types, and the estimated cost attributable to these encounters in the one-year treatment of persons with schizophrenia. Methods This post-hoc analysis used data from a prospective one-year cost-effectiveness study of persons treated with antipsychotics for schizophrenia and related disorders in the United States. Criminal justice system involvement was assessed using the Schizophrenia Patients Outcome Research Team (PORT client survey and the victimization subscale of the Lehman Quality of Life Interview (QOLI. Direct cost of criminal justice system involvement was estimated using previously reported costs per type of encounter. Patients with and without involvement were compared on baseline characteristics and direct annual health care and criminal justice system-related costs. Results Overall, 278 (46% of 609 participants reported at least 1 criminal justice system encounter. They were more likely to be substance users and less adherent to antipsychotics compared to participants without involvement. The 2 most prevalent types of encounters were being a victim of a crime (67% and being on parole or probation (26%. The mean annual per-patient cost of involvement was $1,429, translating to 6% of total annual direct health care costs for those with involvement (11% when excluding crime victims. Conclusions Criminal justice system involvement appears to be prevalent and costly for persons treated for schizophrenia in the United States. Findings highlight the need to better understand the interface between the mental health and the criminal justice systems and the related costs, in personal, societal, and economic terms.

  13. Involvement in the US criminal justice system and cost implications for persons treated for schizophrenia.

    Science.gov (United States)

    Ascher-Svanum, Haya; Nyhuis, Allen W; Faries, Douglas E; Ball, Daniel E; Kinon, Bruce J

    2010-01-28

    Individuals with schizophrenia may have a higher risk of encounters with the criminal justice system than the general population, but there are limited data on such encounters and their attendant costs. This study assessed the prevalence of encounters with the criminal justice system, encounter types, and the estimated cost attributable to these encounters in the one-year treatment of persons with schizophrenia. This post-hoc analysis used data from a prospective one-year cost-effectiveness study of persons treated with antipsychotics for schizophrenia and related disorders in the United States. Criminal justice system involvement was assessed using the Schizophrenia Patients Outcome Research Team (PORT) client survey and the victimization subscale of the Lehman Quality of Life Interview (QOLI). Direct cost of criminal justice system involvement was estimated using previously reported costs per type of encounter. Patients with and without involvement were compared on baseline characteristics and direct annual health care and criminal justice system-related costs. Overall, 278 (46%) of 609 participants reported at least 1 criminal justice system encounter. They were more likely to be substance users and less adherent to antipsychotics compared to participants without involvement. The 2 most prevalent types of encounters were being a victim of a crime (67%) and being on parole or probation (26%). The mean annual per-patient cost of involvement was $1,429, translating to 6% of total annual direct health care costs for those with involvement (11% when excluding crime victims). Criminal justice system involvement appears to be prevalent and costly for persons treated for schizophrenia in the United States. Findings highlight the need to better understand the interface between the mental health and the criminal justice systems and the related costs, in personal, societal, and economic terms.

  14. Physical Protection System Upgrades - Optimizing for Performance and Cost

    International Nuclear Information System (INIS)

    Hicks, Mary Jane; Bouchard, Ann M.

    1999-01-01

    CPA--Cost and Performance Analysis--is an architecture that supports analysis of physical protection systems and upgrade options. ASSESS (Analytic System and Software for Evaluating Security Systems), a tool for evaluating performance of physical protection systems, currently forms the cornerstone for evaluating detection probabilities and delay times of the system. Cost and performance data are offered to the decision-maker at the systems level and to technologists at the path-element level. A new optimization engine has been attached to the CPA methodology to automate analyses of many combinations (portfolios) of technologies. That engine controls a new analysis sequencer that automatically modifies ASSESS PPS files (facility descriptions), automatically invokes ASSESS Outsider analysis and then saves results for post-processing. Users can constrain the search to an upper bound on total cost, to a lower bound on level of performance, or to include specific technologies or technology types. This process has been applied to a set of technology development proposals to identify those portfolios that provide the most improvement in physical security for the lowest cost to install, operate and maintain at a baseline facility

  15. Physical Protection System Upgrades - Optimizing for Performance and Cost

    Energy Technology Data Exchange (ETDEWEB)

    Bouchard, Ann M.; Hicks, Mary Jane

    1999-07-09

    CPA--Cost and Performance Analysis--is an architecture that supports analysis of physical protection systems and upgrade options. ASSESS (Analytic System and Software for Evaluating Security Systems), a tool for evaluating performance of physical protection systems, currently forms the cornerstone for evaluating detection probabilities and delay times of the system. Cost and performance data are offered to the decision-maker at the systems level and to technologists at the path-element level. A new optimization engine has been attached to the CPA methodology to automate analyses of many combinations (portfolios) of technologies. That engine controls a new analysis sequencer that automatically modifies ASSESS PPS files (facility descriptions), automatically invokes ASSESS Outsider analysis and then saves results for post-processing. Users can constrain the search to an upper bound on total cost, to a lower bound on level of performance, or to include specific technologies or technology types. This process has been applied to a set of technology development proposals to identify those portfolios that provide the most improvement in physical security for the lowest cost to install, operate and maintain at a baseline facility.

  16. Cost-effectiveness analysis of radon remediation in schools

    International Nuclear Information System (INIS)

    Kennedy, C.A.; Gray, A.M.

    2000-01-01

    sensitivity analysis show that the ratio is particularly sensitive to assumptions of two parameters including: the average capital cost of remediation and the discount rates chosen for the life yells. The overall model presented in this study can be applied to any other area, and alternative regional parameter estimates can be substituted if these are available. As the sensitivity analysis shows, however, remediation is likely to prove cost-effective even if these parameter estimates are substantially different. These results should help to inform further discussion of policy setting for radon remediation in various settings. It provides an empirical example of the type of economic analysis encouraged by both the UK NRPB (1986) and the ICRP (1983). General information on the average costs of remediation and potential savings to the health care system will be helpful as increasing numbers of local authorities start planning remediation programmes for the schools under their care. This study also highlights the need for the evaluation of other schools remediation-based radon-induced lung cancer prevention programmes in other countries using similar methodological techniques. (author)

  17. Fuel Cell System for Transportation -- 2005 Cost Estimate

    Energy Technology Data Exchange (ETDEWEB)

    Wheeler, D.

    2006-10-01

    Independent review report of the methodology used by TIAX to estimate the cost of producing PEM fuel cells using 2005 cell stack technology. The U.S. Department of Energy (DOE) Hydrogen, Fuel Cells and Infrastructure Technologies Program Manager asked the National Renewable Energy Laboratory (NREL) to commission an independent review of the 2005 TIAX cost analysis for fuel cell production. The NREL Systems Integrator is responsible for conducting independent reviews of progress toward meeting the DOE Hydrogen Program (the Program) technical targets. An important technical target of the Program is the proton exchange membrane (PEM) fuel cell cost in terms of dollars per kilowatt ($/kW). The Program's Multi-Year Program Research, Development, and Demonstration Plan established $125/kW as the 2005 technical target. Over the last several years, the Program has contracted with TIAX, LLC (TIAX) to produce estimates of the high volume cost of PEM fuel cell production for transportation use. Since no manufacturer is yet producing PEM fuel cells in the quantities needed for an initial hydrogen-based transportation economy, these estimates are necessary for DOE to gauge progress toward meeting its targets. For a PEM fuel cell system configuration developed by Argonne National Laboratory, TIAX estimated the total cost to be $108/kW, based on assumptions of 500,000 units per year produced with 2005 cell stack technology, vertical integration of cell stack manufacturing, and balance-of-plant (BOP) components purchased from a supplier network. Furthermore, TIAX conducted a Monte Carlo analysis by varying ten key parameters over a wide range of values and estimated with 98% certainty that the mean PEM fuel cell system cost would be below DOE's 2005 target of $125/kW. NREL commissioned DJW TECHNOLOGY, LLC to form an Independent Review Team (the Team) of industry fuel cell experts and to evaluate the cost estimation process and the results reported by TIAX. The results of

  18. Innovative and cost effective spatial positioning

    OpenAIRE

    Schwieger, Volker; Lilje, Mikael

    2013-01-01

    Access to land, improving land use and mapping are all dependent on that land is mapped and surveyed. This presentation will focus on surveying of land and the base infrastructure needed for the surveying task. The authors will show how geodetic marks may be replaced by new infrastructures like active control networks (e.g. GNSS CORS networks). Apart from the technical basics of these networks, the economic benefit of a CORS network will be outlined with respect to costs and surveying instrum...

  19. Cost effective campaigning in social networks

    Science.gov (United States)

    Kotnis, Bhushan; Kuri, Joy

    2016-05-01

    Campaigners are increasingly using online social networking platforms for promoting products, ideas and information. A popular method of promoting a product or even an idea is incentivizing individuals to evangelize the idea vigorously by providing them with referral rewards in the form of discounts, cash backs, or social recognition. Due to budget constraints on scarce resources such as money and manpower, it may not be possible to provide incentives for the entire population, and hence incentives need to be allocated judiciously to appropriate individuals for ensuring the highest possible outreach size. We aim to do the same by formulating and solving an optimization problem using percolation theory. In particular, we compute the set of individuals that are provided incentives for minimizing the expected cost while ensuring a given outreach size. We also solve the problem of computing the set of individuals to be incentivized for maximizing the outreach size for given cost budget. The optimization problem turns out to be non trivial; it involves quantities that need to be computed by numerically solving a fixed point equation. Our primary contribution is, that for a fairly general cost structure, we show that the optimization problems can be solved by solving a simple linear program. We believe that our approach of using percolation theory to formulate an optimization problem is the first of its kind.

  20. Specialty-specific admission: a cost-effective intervention?

    LENUS (Irish Health Repository)

    Slattery, E

    2012-02-01

    INTRODUCTION: Cost effectiveness of healthcare has become an important component in its delivery. Current practices need to be assessed and measured for variations that may lead to financial savings. Speciality specific admission is known not only to lead improved clinical outcomes but also to lead important cost reductions. METHODS: All patients admitted to an Irish teaching hospital via the emergency department over a 2-year period with a gastroenterology (GI) related illness were included in this analysis.GI illness was classified using the Disease related grouping (DRG) system. Mean length of stay (LOS) and patient level costing (PLC) were calculated. Differences between DRGs with respect to speciality (i.e. specialist vs. non-specialist) were calculated for the five commonest DRGs. RESULTS: Significant variations in LOS and PLC were demonstrated in the DRGs. Mean LOS varied with increasing complexity, from 3.2 days for non-complex GI haemorrhage to 14.4 days for complex alcohol related cirrhosis as expected. A substantial difference in LOS within DRG groups was demonstrated by large standard deviations in the mean (up to 8.1 days in some groups) and was independent of complexity of cases. PLC also varied widely in both complex and non-complex cases with standard deviations of up to 17,342 noted. Specialty-specific admission was associated with shorter LOS for most GI admissions. CONCLUSION: Significant disparity exists for both LOS and PLC for most GI diagnoses. Specialty-specific admissions are associated with reduced LOS. Specialty-specific admission would appear to be cost-effective which may also lead to improved clinical outcomes.

  1. [Cost-effectiveness of Antipsychotics in the Maintenance Treatment of Schizophrenia in Colombia].

    Science.gov (United States)

    Quitian Reyes, Hoover; Arciniegas Barrera, Jair Alberto; Bohórquez Peñaranda, Adriana; Gómez Restrepo, Carlos

    2016-01-01

    Assess the cost-effectiveness of the antipsychotics for treatment of schizophrenia. A five-year Markov model was built form patients with schizophrenia on the stage of maintenance. Costs were taken from the perspective of the Colombian health care system (Sistema General de Seguridad Social en Salud). The effectiveness was measured in years of life under the same maintenance plan. The Markov model indicated clozapine as the as the most cost-effective alternative between the first line antipsychotics and haloperidol is it when comparing other antipsychotics. Clozapine it's the cost-effectiveness strategy among the first line of antipsychotics and haloperidol is it among the other antipsychotics. Strategies prioritizing the use of cost-effective antipsychotics could improve the resources allocation in the Colombian health care system. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  2. Cost-effectiveness of online positive psychology: Randomized controlled trial

    NARCIS (Netherlands)

    Bolier, Linda; Majo, Cristina; Smit, Filip; Westerhof, Gerben Johan; Haverman, Merel; Walburg, J.A.; Riper, Heleen; Bohlmeijer, Ernst Thomas

    2014-01-01

    As yet, no evidence is available about the cost-effectiveness of positive psychological interventions. When offered via the Internet, these interventions may be particularly cost-effective, because they are highly scalable and do not rely on scant resources such as therapists’ time. Alongside a

  3. Cost-effectiveness analysis of Mectizan treatment Programmes for ...

    African Journals Online (AJOL)

    Objectives: This study analyzed the operational costs of two Mectizan treatment strategies in relation to their effectiveness. Methods: The study was conducted in 24 communities located in Irewole and Egbeda districts of Osun and Oyo State, Nigeria respectively. Cost-effectiveness analysis included retrospective analysis of ...

  4. Cost effectiveness of facility and home based HIV voluntary ...

    African Journals Online (AJOL)

    EB

    Methods: Data on costs and effectiveness of facility- and home-based HIV VCT intervention strategies was collected in two sub-Counties in rural southwestern Uganda. Costing was performed using the ingredients approach. Effectiveness was measured as the number of HIV sero-positive clients identified. Incremental.

  5. Costs and water quality effects of wastewater treatment plant centralization

    Energy Technology Data Exchange (ETDEWEB)

    Macal, C.M.; Broomfield, B.J.

    1980-01-01

    The costs and water quality impacts of two regional configurations of municipal wastewater treatment plants in Northeastern Illinois are compared. In one configuration, several small treatment plants are consolidated into a smaller number of regional facilities. In the other, the smaller plants continue to operate. Costs for modifying the plants to obtain various levels of pollutant removal are estimated using a simulation model that considers the type of equipment existing at the plants and the costs of modifying that equipment to obtain a range of effluent levels for various pollutants. A dynamic water-quality/hydrology simulation model is used to determine the water quality effects of the various treatment technologies and pollutant levels. Cost and water quality data are combined and the cost-effectiveness of the two treatment configurations is compared. The regionalized treatment-plant configuration is found to be the more cost-effective.

  6. Reliability/Cost Evaluation on Power System connected with Wind Power for the Reserve Estimation

    DEFF Research Database (Denmark)

    Lee, Go-Eun; Cha, Seung-Tae; Shin, Je-Seok

    2012-01-01

    Wind power is ideally a renewable energy with no fuel cost, but has a risk to reduce reliability of the whole system because of uncertainty of the output. If the reserve of the system is increased, the reliability of the system may be improved. However, the cost would be increased. Therefore...... the reserve needs to be estimated considering the trade-off between reliability and economic aspects. This paper suggests a methodology to estimate the appropriate reserve, when wind power is connected to the power system. As a case study, when wind power is connected to power system of Korea, the effects...

  7. An Introduction to the NCHEMS Costing and Data Management System. Technical Report No. 55.

    Science.gov (United States)

    Haight, Mike; Martin, Ron

    The NCHEMS Costing and Data Management System is designed to assist institutions in the implementation of cost studies. There are at least two kinds of cost studies: historical cost studies which display cost-related data that reflect actual events over a specific prior time period, and predictive cost studies which forecast costs that will be…

  8. A cost-effectiveness analysis of two different antimicrobial stewardship programs.

    Science.gov (United States)

    Okumura, Lucas Miyake; Riveros, Bruno Salgado; Gomes-da-Silva, Monica Maria; Veroneze, Izelandia

    2016-01-01

    There is a lack of formal economic analysis to assess the efficiency of antimicrobial stewardship programs. Herein, we conducted a cost-effectiveness study to assess two different strategies of Antimicrobial Stewardship Programs. A 30-day Markov model was developed to analyze how cost-effective was a Bundled Antimicrobial Stewardship implemented in a university hospital in Brazil. Clinical data derived from a historical cohort that compared two different strategies of antimicrobial stewardship programs and had 30-day mortality as main outcome. Selected costs included: workload, cost of defined daily doses, length of stay, laboratory and imaging resources used to diagnose infections. Data were analyzed by deterministic and probabilistic sensitivity analysis to assess model's robustness, tornado diagram and Cost-Effectiveness Acceptability Curve. Bundled Strategy was more expensive (Cost difference US$ 2119.70), however, it was more efficient (US$ 27,549.15 vs 29,011.46). Deterministic and probabilistic sensitivity analysis suggested that critical variables did not alter final Incremental Cost-Effectiveness Ratio. Bundled Strategy had higher probabilities of being cost-effective, which was endorsed by cost-effectiveness acceptability curve. As health systems claim for efficient technologies, this study conclude that Bundled Antimicrobial Stewardship Program was more cost-effective, which means that stewardship strategies with such characteristics would be of special interest in a societal and clinical perspective. Copyright © 2016 Elsevier Editora Ltda. All rights reserved.

  9. A cost-effectiveness analysis of two different antimicrobial stewardship programs

    Directory of Open Access Journals (Sweden)

    Lucas Miyake Okumura

    2016-05-01

    Full Text Available There is a lack of formal economic analysis to assess the efficiency of antimicrobial stewardship programs. Herein, we conducted a cost-effectiveness study to assess two different strategies of Antimicrobial Stewardship Programs. A 30-day Markov model was developed to analyze how cost-effective was a Bundled Antimicrobial Stewardship implemented in a university hospital in Brazil. Clinical data derived from a historical cohort that compared two different strategies of antimicrobial stewardship programs and had 30-day mortality as main outcome. Selected costs included: workload, cost of defined daily doses, length of stay, laboratory and imaging resources used to diagnose infections. Data were analyzed by deterministic and probabilistic sensitivity analysis to assess model's robustness, tornado diagram and Cost-Effectiveness Acceptability Curve. Bundled Strategy was more expensive (Cost difference US$ 2119.70, however, it was more efficient (US$ 27,549.15 vs 29,011.46. Deterministic and probabilistic sensitivity analysis suggested that critical variables did not alter final Incremental Cost-Effectiveness Ratio. Bundled Strategy had higher probabilities of being cost-effective, which was endorsed by cost-effectiveness acceptability curve. As health systems claim for efficient technologies, this study conclude that Bundled Antimicrobial Stewardship Program was more cost-effective, which means that stewardship strategies with such characteristics would be of special interest in a societal and clinical perspective.

  10. Cost Effectiveness of Field Trauma Triage among Injured Adults Served by Emergency Medical Services

    Science.gov (United States)

    Newgard, Craig D; Yang, Zhuo; Nishijima, Daniel; McConnell, K John; Trent, Stacy; Holmes, James F; Daya, Mohamud; Mann, N Clay; Hsia, Renee Y; Rea, Tom; Wang, N Ewen; Staudenmayer, Kristan; Delgado, M Kit

    2016-01-01

    Background The American College of Surgeons Committee on Trauma sets national targets for the accuracy of field trauma triage at ≥ 95% sensitivity and ≥ 65% specificity, yet the cost-effectiveness of realizing these goals is unknown. We evaluated the cost-effectiveness of current field trauma triage practices compared to triage strategies consistent with the national targets. Study Design This was a cost-effectiveness analysis using data from 79,937 injured adults transported by 48 emergency medical services (EMS) agencies to 105 trauma and non-trauma hospitals in 6 regions of the Western U.S. from 2006 through 2008. Incremental differences in survival, quality adjusted life years (QALYs), costs, and the incremental cost-effectiveness ratio (ICER; costs per QALY gained) were estimated for each triage strategy over a 1-year and lifetime horizon using a decision analytic Markov model. We considered an ICER threshold of less than $100,000 to be cost-effective. Results For these 6 regions, a high sensitivity triage strategy consistent with national trauma policy (sensitivity 98.6%, specificity 17.1%) would cost $1,317,333 per QALY gained, while current triage practices (sensitivity 87.2%, specificity 64.0%) cost $88,000 per QALY gained compared to a moderate sensitivity strategy (sensitivity 71.2%, specificity 66.5%). Refining EMS transport patterns by triage status improved cost-effectiveness. At the trauma system level, a high-sensitivity triage strategy would save 3.7 additional lives per year at a 1-year cost of $8.78 million, while a moderate sensitivity approach would cost 5.2 additional lives and save $781,616 each year. Conclusions A high-sensitivity approach to field triage consistent with national trauma policy is not cost effective. The most cost effective approach to field triage appears closely tied to triage specificity and adherence to triage-based EMS transport practices. PMID:27178369

  11. A low cost PSD-based monocular motion capture system

    Science.gov (United States)

    Ryu, Young Kee; Oh, Choonsuk

    2007-10-01

    This paper describes a monocular PSD-based motion capture sensor to employ with commercial video game systems such as Microsoft's XBOX and Sony's Playstation II. The system is compact, low-cost, and only requires a one-time calibration at the factory. The system includes a PSD(Position Sensitive Detector) and active infrared (IR) LED markers that are placed on the object to be tracked. The PSD sensor is placed in the focal plane of a wide-angle lens. The micro-controller calculates the 3D position of the markers using only the measured intensity and the 2D position on the PSD. A series of experiments were performed to evaluate the performance of our prototype system. From the experimental results we see that the proposed system has the advantages of the compact size, the low cost, the easy installation, and the high frame rates to be suitable for high speed motion tracking in games.

  12. Preliminary Tests of a New Low-Cost Photogrammetric System

    Science.gov (United States)

    Santise, M.; Thoeni, K.; Roncella, R.; Sloan, S. W.; Giacomini, A.

    2017-11-01

    This paper presents preliminary tests of a new low-cost photogrammetric system for 4D modelling of large scale areas for civil engineering applications. The system consists of five stand-alone units. Each of the units is composed of a Raspberry Pi 2 Model B (RPi2B) single board computer connected to a PiCamera Module V2 (8 MP) and is powered by a 10 W solar panel. The acquisition of the images is performed automatically using Python scripts and the OpenCV library. Images are recorded at different times during the day and automatically uploaded onto a FTP server from where they can be accessed for processing. Preliminary tests and outcomes of the system are discussed in detail. The focus is on the performance assessment of the low-cost sensor and the quality evaluation of the digital surface models generated by the low-cost photogrammetric systems in the field under real test conditions. Two different test cases were set up in order to calibrate the low-cost photogrammetric system and to assess its performance. First comparisons with a TLS model show a good agreement.

  13. PRELIMINARY TESTS OF A NEW LOW-COST PHOTOGRAMMETRIC SYSTEM

    Directory of Open Access Journals (Sweden)

    M. Santise

    2017-11-01

    Full Text Available This paper presents preliminary tests of a new low-cost photogrammetric system for 4D modelling of large scale areas for civil engineering applications. The system consists of five stand-alone units. Each of the units is composed of a Raspberry Pi 2 Model B (RPi2B single board computer connected to a PiCamera Module V2 (8 MP and is powered by a 10 W solar panel. The acquisition of the images is performed automatically using Python scripts and the OpenCV library. Images are recorded at different times during the day and automatically uploaded onto a FTP server from where they can be accessed for processing. Preliminary tests and outcomes of the system are discussed in detail. The focus is on the performance assessment of the low-cost sensor and the quality evaluation of the digital surface models generated by the low-cost photogrammetric systems in the field under real test conditions. Two different test cases were set up in order to calibrate the low-cost photogrammetric system and to assess its performance. First comparisons with a TLS model show a good agreement.

  14. Battery energy storage systems life cycle costs case studies

    Energy Technology Data Exchange (ETDEWEB)

    Swaminathan, S.; Miller, N.F.; Sen, R.K. [SENTECH, Inc., Bethesda, MD (United States)

    1998-08-01

    This report presents a comparison of life cycle costs between battery energy storage systems and alternative mature technologies that could serve the same utility-scale applications. Two of the battery energy storage systems presented in this report are located on the supply side, providing spinning reserve and system stability benefits. These systems are compared with the alternative technologies of oil-fired combustion turbines and diesel generators. The other two battery energy storage systems are located on the demand side for use in power quality applications. These are compared with available uninterruptible power supply technologies.

  15. Financial Burdens and Economic Costs in Expanding Urban Water Systems

    Science.gov (United States)

    Moreau, David H.; Snyder, Thomas P.

    1987-07-01

    Rates of growth of demand, lengths of financing periods, real interest rates, and the types of facilities are shown to be important variables in evaluating the equity (or inequity) between established residents and new-development residents when urban water and sewer facilities are expanded with public financing. Established residents pay less than the economic cost of facilities when facilities that can be efficiently expanded in an incremental manner are subject to demands that are growing at rates that are less than the real interest rate. They pay more than the economic cost when growth occurs at higher rates. When facilities are expanded at multiyear intervals with excess capacity, payments are equated to costs at lower growth rates. Similarly, increasing real costs of facilities shift that breakpoint to lower growth rates. Modest one-time changes can be used to offset burdens on established residents when inequities do occur. Inflation has little effect on these results.

  16. [Road traffic accidents in an urban area: linkage between municipal police data-base and routinely collected medical data to assess adverse health effects, health system activities and costs].

    Science.gov (United States)

    Barchielli, Alessandro; Balzi, Daniela

    2007-01-01

    to evaluate the informative capability of merging data from police and medical data-sets in the assessment of adverse health effects and costs for the health system of road traffic accidents in an urban area (Florence City). record linkage between the road traffic accidents data-base of Municipal Police and routinely collected medical data (emergency department access and hospital admission data-bases). Municipal Police data-base collects information (i.e: dynamics and localization of road traffic accident, emergency department or hospital of access, etc.) about road traffic accidents casualties occurred in Florence City (completeness: about 97% of events). Florence City, year 2002. information about emergency department access or hospital admission were found for 74.8% (4,001/5,350) of people classified as "injured" in the Municipal Police data-base: 72.8% (3,895 subjects) treated in an emergency department and 12.3% (656 subjects) hospitalised. Among patients with medical information, 81.9% was treated in emergency departments for less severe injuries, 1.8% had a fracture treated in the emergency department and 16.3% was hospitalised. Fractures (42.7% of all hospitalisations) and head injuries (33.5%) were the most frequent discharge diagnoses. On the basis of diagnosis and of the length of hospital stay, we estimate that about 1% road traffic accidents casualties (fatalities not included) had very severe outcome or disability. The cost for the health system of treatment of people injured in road traffic accidents can be estimated at about 2.2 millions of euros (1.3% of total hospitalisations cost per year for residents in Florence). The characteristics of medical data-sets suggest an underestimation of the actual number of emergency department accesses. It is unlikely that this underestimation notably affects the results for the low severity of the majority of emergency departments accesses. record linkage between Municipal Police and routinely collected medical

  17. Low-cost storage options for solar hydrogen systems for remote area power supply

    International Nuclear Information System (INIS)

    Suhaib Muhammad Ali; John Andrews

    2006-01-01

    Equipment for storing hydrogen gas under pressure typically accounts for a significant proportion of the total capital cost of solar-hydrogen systems for remote area power supply (RAPS). RAPS remain a potential early market for renewable energy - hydrogen systems because of the relatively high costs of conventional energy sources in remote regions. In the present paper the storage requirements of PV-based solar-hydrogen RAPS systems employing PEM electrolysers and fuel cells to meet a range of typical remote area daily and annual demand profiles are investigated using a spread sheet-based simulation model. It is found that as the costs of storage are lowered the requirement for longer-term storage from summer to winter is increased with consequent potential gains in the overall economics of the solar-hydrogen system. In many remote applications, there is ample space for hydrogen storages with relatively large volumes. Hence it may be most cost-effective to store hydrogen at low to medium pressures achievable by using PEM electrolysers directly to generate the hydrogen at the pressures required, without a requirement for separate electrically-driven compressors. The latter add to system costs while requiring significant parasitic electricity consumption. Experimental investigations into a number of low-cost storage options including plastic tanks and low-to-medium pressure metal and composite cylinders are reported. On the basis of these findings, the economics of solar-hydrogen RAPS systems employing large-volume low-cost storage are investigated. (authors)

  18. COST BENEFIT ANALYSIS OF A DG INTEGRATED SYSTEM: CASE STUDY

    Directory of Open Access Journals (Sweden)

    Ch. V. S. S. SAILAJA

    2017-09-01

    Full Text Available Distributed Generation is capable of meeting the load of the consumers partially or completely. Depending on the type of DG involved it can be operated in interconnected mode and islanded mode. The availability of numerous alternatives present for the DG technologies and large initial investments necessitates a detailed cost benefit analysis for the implementation of DG technologies. In this work an attempt has been made to study the costs involved in implementing the DG technologies. A practical system having two kinds of distributed generation i.e., Diesel Generator and solar photovoltaic system for its back up purpose is considered. A detailed cost analysis of the two DG technologies is carried out.

  19. Cost-effectiveness of varenicline for smoking cessation

    DEFF Research Database (Denmark)

    Keiding, Hans

    2009-01-01

    Smoking cessation therapies are among the most cost-effective preventive healthcare measures. Varenicline is a relatively new drug developed especially for this purpose, and it has been shown to achieve better quit rates than nicotine replacement therapies and the non-nicotine-based drug, bupropion......, which has been in use for some years. The cost-effectiveness of varenicline depends on the cost of the therapy and the cost-savings achieved through reduced morbidity and mortality; several investigations, based on the situation in different countries, indicate that varenicline either finances itself...

  20. Cost Effectiveness Analysis, A DTIC Bibliography.

    Science.gov (United States)

    1980-07-01

    IDY-C) and !if* CyCle& c-t as Indicators Of Defense efficiency are o-iented (LCC; iralmctlions: ---cattons and suboort costs: witKin Oe!St!ng cscita... JOEL 0. of Military Corrections; An for Aircraft Carriers and Surface 44. AssessmEnt of Program Evaloit ions Combatanits.Forecasting Depot*Overhaul...GUERRA. JOEL A. P>RSONAL AUTHOR INDEX-22 - UNCLASSIFiED Z0117 CUE-WUE UNCLASSIFIED * US Army. Air Force. ar~d Niz..y RPA -HAR1KINdS. WILLIAM D_ An

  1. Cost-effectiveness of Rotavirus vaccination in Vietnam

    Directory of Open Access Journals (Sweden)

    Goldie Sue J

    2009-01-01

    Full Text Available Abstract Background Rotavirus is the most common cause of severe diarrhea leading to hospitalization or disease-specific death among young children. New rotavirus vaccines have recently been approved. Some previous studies have provided broad qualitative insights into the health and economic consequences of introducing the vaccines into low-income countries, representing several features of rotavirus infection, such as varying degrees of severity and age-dependency of clinical manifestation, in their model-based analyses. We extend this work to reflect additional features of rotavirus (e.g., the possibility of reinfection and varying degrees of partial immunity conferred by natural infection, and assess the influence of the features on the cost-effectiveness of rotavirus vaccination. Methods We developed a Markov model that reflects key features of rotavirus infection, using the most recent data available. We applied the model to the 2004 Vietnamese birth cohort and re-evaluated the cost-effectiveness (2004 US dollars per disability-adjusted life year [DALY] of rotavirus vaccination (Rotarix® compared to no vaccination, from both societal and health care system perspectives. We conducted univariate sensitivity analyses and also performed a probabilistic sensitivity analysis, based on Monte Carlo simulations drawing parameter values from the distributions assigned to key uncertain parameters. Results Rotavirus vaccination would not completely protect young children against rotavirus infection due to the partial nature of vaccine immunity, but would effectively reduce severe cases of rotavirus gastroenteritis (outpatient visits, hospitalizations, or deaths by about 67% over the first 5 years of life. Under base-case assumptions (94% coverage and $5 per dose, the incremental cost per DALY averted from vaccination compared to no vaccination would be $540 from the societal perspective and $550 from the health care system perspective. Conclusion

  2. Cost-effectiveness of Rotavirus vaccination in Vietnam.

    Science.gov (United States)

    Kim, Sun-Young; Goldie, Sue J; Salomon, Joshua A

    2009-01-21

    Rotavirus is the most common cause of severe diarrhea leading to hospitalization or disease-specific death among young children. New rotavirus vaccines have recently been approved. Some previous studies have provided broad qualitative insights into the health and economic consequences of introducing the vaccines into low-income countries, representing several features of rotavirus infection, such as varying degrees of severity and age-dependency of clinical manifestation, in their model-based analyses. We extend this work to reflect additional features of rotavirus (e.g., the possibility of reinfection and varying degrees of partial immunity conferred by natural infection), and assess the influence of the features on the cost-effectiveness of rotavirus vaccination. We developed a Markov model that reflects key features of rotavirus infection, using the most recent data available. We applied the model to the 2004 Vietnamese birth cohort and re-evaluated the cost-effectiveness (2004 US dollars per disability-adjusted life year [DALY]) of rotavirus vaccination (Rotarix) compared to no vaccination, from both societal and health care system perspectives. We conducted univariate sensitivity analyses and also performed a probabilistic sensitivity analysis, based on Monte Carlo simulations drawing parameter values from the distributions assigned to key uncertain parameters. Rotavirus vaccination would not completely protect young children against rotavirus infection due to the partial nature of vaccine immunity, but would effectively reduce severe cases of rotavirus gastroenteritis (outpatient visits, hospitalizations, or deaths) by about 67% over the first 5 years of life. Under base-case assumptions (94% coverage and $5 per dose), the incremental cost per DALY averted from vaccination compared to no vaccination would be $540 from the societal perspective and $550 from the health care system perspective. Introducing rotavirus vaccines would be a cost-effective public

  3. Guaranteed Cost Finite-Time Control of Fractional-Order Positive Switched Systems

    Directory of Open Access Journals (Sweden)

    Leipo Liu

    2017-01-01

    Full Text Available The problem of guaranteed cost finite-time control of fractional-order positive switched systems (FOPSS is considered in this paper. Firstly, a new cost function is defined. Then, by constructing linear copositive Lyapunov functions and using the average dwell time (ADT approach, a state feedback controller and a static output feedback controller are constructed, respectively, and sufficient conditions are derived to guarantee that the corresponding closed-loop systems are guaranteed cost finite-time stable (GCFTS. Such conditions can be easily solved by linear programming. Finally, two examples are given to illustrate the effectiveness of the proposed method.

  4. Guaranteed Cost Finite-Time Control of Discrete-Time Positive Impulsive Switched Systems

    Directory of Open Access Journals (Sweden)

    Leipo Liu

    2018-01-01

    Full Text Available This paper considers the guaranteed cost finite-time boundedness of discrete-time positive impulsive switched systems. Firstly, the definition of guaranteed cost finite-time boundedness is introduced. By using the multiple linear copositive Lyapunov function (MLCLF and average dwell time (ADT approach, a state feedback controller is designed and sufficient conditions are obtained to guarantee that the corresponding closed-loop system is guaranteed cost finite-time boundedness (GCFTB. Such conditions can be solved by linear programming. Finally, a numerical example is provided to show the effectiveness of the proposed method.

  5. Investigation of Cost and Energy Optimization of Drinking Water Distribution Systems.

    Science.gov (United States)

    Cherchi, Carla; Badruzzaman, Mohammad; Gordon, Matthew; Bunn, Simon; Jacangelo, Joseph G

    2015-11-17

    Holistic management of water and energy resources through energy and water quality management systems (EWQMSs) have traditionally aimed at energy cost reduction with limited or no emphasis on energy efficiency or greenhouse gas minimization. This study expanded the existing EWQMS framework and determined the impact of different management strategies for energy cost and energy consumption (e.g., carbon footprint) reduction on system performance at two drinking water utilities in California (United States). The results showed that optimizing for cost led to cost reductions of 4% (Utility B, summer) to 48% (Utility A, winter). The energy optimization strategy was successfully able to find the lowest energy use operation and achieved energy usage reductions of 3% (Utility B, summer) to 10% (Utility A, winter). The findings of this study revealed that there may be a trade-off between cost optimization (dollars) and energy use (kilowatt-hours), particularly in the summer, when optimizing the system for the reduction of energy use to a minimum incurred cost increases of 64% and 184% compared with the cost optimization scenario. Water age simulations through hydraulic modeling did not reveal any adverse effects on the water quality in the distribution system or in tanks from pump schedule optimization targeting either cost or energy minimization.

  6. Childhood secondhand smoke exposure and ADHD-attributable costs to the health and education system.

    Science.gov (United States)

    Max, Wendy; Sung, Hai-Yen; Shi, Yanling

    2014-10-01

    Children exposed to secondhand smoke (SHS) have higher rates of behavioral and cognitive effects, including attention deficit hyperactivity disorder (ADHD), but the costs to the health care and education systems have not been estimated. We estimate these costs for school-aged children aged 5-15. The relative risk (RR) of ADHD from SHS exposure was obtained from our previous work. SHS exposure was measured using 2 alternative approaches--reported exposure and serum cotinine-measured exposure. RRs and SHS exposure were used to determine the number of children with SHS-attributable ADHD, and mean costs of ADHD-related health care and education services were applied to obtain SHS-attributable health care and education costs. Annual health care costs of SHS-attributable ADHD ranged from $644 million (using reported SHS exposure) to $2.05 billion (using cotinine-measured exposure). SHS-attributable costs to the education system ranged from $2.90 to $9.23 billion. The costs of SHS-attributable ADHD to the education system may total more than 4 times the costs for health care. The h