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.

An empirical analysis of fiscal federalism implementation and of cost accounting in Italian public administrations

Directory of Open Access Journals (Sweden)

Pina Puntillo

2012-09-01

Full Text Available The concept of cost has been introduced in Italian Administration since the early nineties. There is a copious legislation referring directly or indirectly, to the need, as well as to the utility of measuring the costs of public administration, in deference, to a renewed interpretation of the constitutional principle of Good Performance in pursuance of Article. 97 of the Italian Constitution. The most recent and probably the most significant intervention at institutional level, is the implementation of fiscal federalism as provided by Law. 42, 2009. The core features of fiscal federalism are the transition from historical expenditure to standard costs as a criterion for determining financial needs of public bodies, together with the attempt to establish more meaningful accountability mechanisms, both to policy makers and to public management. The measurement of standard costs represents one of the pillars of fiscal federalism and it will be pursued using the mechanism of "best practice". Full implementation of fiscal federalism, therefore, requires the verification of the operating costs of all public administrations. According to statutory law, regions are also required to provide verification of operating costs, for the successful pursuing of fiscal federalism. The present research is going to assess the level of diffusion of cost accounting in Italian regional public administrations. The methodology used for this paper includes the analysis of regional law as well as interviews to the officials of accounting and auditing offices

75 FR 19179 - Federal Acquisition Regulation; Federal Acquisition Circular 2005-41; Small Entity Compliance Guide

Science.gov (United States)

2010-04-13

... Acquisition Circular 2005-41; Small Entity Compliance Guide AGENCIES: Department of Defense (DoD), General... Federal Acquisition Circular (FAC) 2005-41 which amends the Federal Acquisition Regulation (FAR... projects where the total cost to the Government is $25 million or more in order to promote economy and...

43 CFR 404.40 - What is the non-Federal share of operation, maintenance, and replacement costs?

Science.gov (United States)

2010-10-01

... Cost-Sharing § 404.40 What is the non-Federal share of operation, maintenance, and replacement costs? You are required to pay 100 percent of the operation, maintenance, and replacement costs of any rural... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false What is the non-Federal share of operation...

O custo de arrecadação de tributos federais The cost of federal taxation

Directory of Open Access Journals (Sweden)

Aldo V Bertolucci

2006-08-01

as high as 5.82% of GDP in companies with less than R$ 100 million in sales per year. This paper deals with another operational cost of taxation: the costs the Brazilian Federal Administration has to administer federal taxation. We present a survey of the costs in other countries and in Brazil, attempting to picture the taxation costs incurred by different federal administrative entities. The survey shows that the public administration faces great difficulties to adequately control its accounts and that there is lack of uniformity and transparency. Another aspect is the fact that the Government is involved in more than 90% of judicial processes, being the main responsible for delays in federal courts. The administrative costs of taxation correspond to 1.35% of tax revenues and 0.36% of GDP. The total of operating costs of taxation correspond to 1.11% of GDP or R$ 16.8 billion. Finally, we propose measures to improve the system and reduce its costs.

Direct cost comparison of totally endoscopic versus open ear surgery.

Science.gov (United States)

Patel, N; Mohammadi, A; Jufas, N

2018-02-01

Totally endoscopic ear surgery is a relatively new method for managing chronic ear disease. This study aimed to test the null hypothesis that open and endoscopic approaches have similar direct costs for the management of attic cholesteatoma, from an Australian private hospital setting. A retrospective direct cost comparison of totally endoscopic ear surgery and traditional canal wall up mastoidectomy for the management of attic cholesteatoma in a private tertiary setting was undertaken. Indirect and future costs were excluded. A direct cost comparison of anaesthetic setup and resources, operative setup and resources, and surgical time was performed between the two techniques. Totally endoscopic ear surgery has a mean direct cost reduction of AUD$2978.89 per operation from the hospital perspective, when compared to canal wall up mastoidectomy. Totally endoscopic ear surgery is more cost-effective, from an Australian private hospital perspective, than canal wall up mastoidectomy for attic cholesteatoma.

45 CFR 201.6 - Withholding of payment; reduction of Federal financial participation in the costs of social...

Science.gov (United States)

2010-10-01

... financial participation in the costs of social services and training. 201.6 Section 201.6 Public Welfare... Federal financial participation in the costs of social services and training. (a) When withheld. Further... (AABD) of the Act, Federal financial participation in the costs of social services and training approved...

45 CFR 304.21 - Federal financial participation in the costs of cooperative arrangements with courts and law...

Science.gov (United States)

2010-10-01

... 45 Public Welfare 2 2010-10-01 2010-10-01 false Federal financial participation in the costs of... § 304.21 Federal financial participation in the costs of cooperative arrangements with courts and law... financial participation (FFP) at the applicable matching rate is available in the costs of cooperative...

The Cost of Joint Replacement: Comparing Two Approaches to Evaluating Costs of Total Hip and Knee Arthroplasty.

Science.gov (United States)

Palsis, John A; Brehmer, Thomas S; Pellegrini, Vincent D; Drew, Jacob M; Sachs, Barton L

2018-02-21

In an era of mandatory bundled payments for total joint replacement, accurate analysis of the cost of procedures is essential for orthopaedic surgeons and their institutions to maintain viable practices. The purpose of this study was to compare traditional accounting and time-driven activity-based costing (TDABC) methods for estimating the total costs of total hip and knee arthroplasty care cycles. We calculated the overall costs of elective primary total hip and total knee replacement care cycles at our academic medical center using traditional and TDABC accounting methods. We compared the methods with respect to the overall costs of hip and knee replacement and the costs for each major cost category. The traditional accounting method resulted in higher cost estimates. The total cost per hip replacement was $22,076 (2014 USD) using traditional accounting and was $12,957 using TDABC. The total cost per knee replacement was $29,488 using traditional accounting and was $16,981 using TDABC. With respect to cost categories, estimates using traditional accounting were greater for hip and knee replacement, respectively, by $3,432 and $5,486 for personnel, by $3,398 and $3,664 for space and equipment, and by $2,289 and $3,357 for indirect costs. Implants and consumables were derived from the actual hospital purchase price; accordingly, both methods produced equivalent results. Substantial cost differences exist between accounting methods. The focus of TDABC only on resources used directly by the patient contrasts with the allocation of all operating costs, including all indirect costs and unused capacity, with traditional accounting. We expect that the true costs of hip and knee replacement care cycles are likely somewhere between estimates derived from traditional accounting methods and TDABC. TDABC offers patient-level granular cost information that better serves in the redesign of care pathways and may lead to more strategic resource-allocation decisions to optimize

A general approach to total repair cost limit replacement policies

Directory of Open Access Journals (Sweden)

F. Beichelt

2014-01-01

Full Text Available A common replacement policy for technical systems consists in replacing a system by a new one after its economic lifetime, i.e. at that moment when its long-run maintenance cost rate is minimal. However, the strict application of the economic lifetime does not take into account the individual deviations of maintenance cost rates of single systems from the average cost development. Hence, Beichet proposed the total repair cost limit replacement policy: the system is replaced by a new one as soon as its total repair cost reaches or exceeds a given level. He modelled the repair cost development by functions of the Wiener process with drift. Here the same policy is considered under the assumption that the one-dimensional probability distribution of the process describing the repair cost development is given. In the examples analysed, applying the total repair cost limit replacement policy instead of the economic life-time leads to cost savings of between 4% and 30%. Finally, it is illustrated how to include the reliability aspect into the policy.

Program Potential: Estimates of Federal Energy Cost Savings from Energy Efficient Procurement

Energy Technology Data Exchange (ETDEWEB)

Taylor, Margaret [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Fujita, K. Sydny [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

2012-09-17

In 2011, energy used by federal buildings cost approximately $7 billion. Reducing federal energy use could help address several important national policy goals, including: (1) increased energy security; (2) lowered emissions of greenhouse gases and other air pollutants; (3) increased return on taxpayer dollars; and (4) increased private sector innovation in energy efficient technologies. This report estimates the impact of efficient product procurement on reducing the amount of wasted energy (and, therefore, wasted money) associated with federal buildings, as well as on reducing the needless greenhouse gas emissions associated with these buildings.

76 FR 14570 - Federal Acquisition Regulation; Disclosure and Consistency of Cost Accounting Practices for...

Science.gov (United States)

2011-03-16

...] RIN 9000-AL58 Federal Acquisition Regulation; Disclosure and Consistency of Cost Accounting Practices... Regulation (FAR) to align it with a Cost Accounting Standards (CAS) Board clause, Disclosure and Consistency... the use of the clause, Disclosure and Consistency of Cost Accounting Practices--Foreign Concerns, in...

Ratemaking treatment of decommissioning costs by the Federal Energy Regulatory Commission

International Nuclear Information System (INIS)

Lenart, R.J.

1985-01-01

The Nuclear Regulatory Commission (NRC) has the responsibility for the assurance of funds at the time of decommissioning. The Federal Energy Regulatory Commission (FERC), in conjunction with the State Public Utility Commissions, have the responsibilty to ensure that utilities have just and reasonable rates and an opportunity to collect an appropriate amount of dollars to decommission a nuclear reactor at the conclusion of its service life. Therefore, the Federal Energy Regulatory Commission allows utilities to include nuclear power plant decommissioning costs in rates based on the following ratemaking concepts: (1) that the methodology used by a utility equitably allocates costs between present and future ratepayers who receive service from a nuclear unit; (2) that, given the uncertainty and imprecision that are included in cost estimates for events that will transpire 20-40 years in the future, the FERC chose to err on the low side rather than run the risk of overcharging current customers for future decommissioning expense; and (3) that, as decommissioning experience accumulates, as decommissioning technology improves, and as decommissioning estimates become more refined, utilities would continue to seek revised decommissioning expense allowances from FERC in order to ensure that actual decommissioning costs are recovered over the useful life in which the plant provides service

Freshwater Aquatic Nuisance Species Impacts and Management Costs and Benefits at Federal Water Resources Projects

Science.gov (United States)

2006-09-01

ERDC/TN ANSRP-06-3 September 2006 Freshwater Aquatic Nuisance Species Impacts and Management Costs and Benefits at Federal Water Resources...Cole, R. A. (2006). “ Freshwater aquatic nuisance species impacts and management costs and benefits at Federal Water resources projects,” ANSRP...Projects1 by Richard A. Cole THE ISSUE: A small fraction of the species that inhabit the nation’s fresh waters become aquatic nuisance species (ANS

77 FR 58103 - Federal Acquisition Regulation; Submission for OMB Review; Corporate Aircraft Costs

Science.gov (United States)

2012-09-19

... is determined that an upward adjustment is not required at this time. The historical estimates remain...; Submission for OMB Review; Corporate Aircraft Costs AGENCY: Department of Defense (DOD), General Services... requirement concerning corporate aircraft costs. A notice was published in the Federal Register at 77 FR 20012...

Cost-Effectiveness of Quadrivalent Human Papillomavirus Vaccination in Adolescent Girls in Russian Federation

Directory of Open Access Journals (Sweden)

Alla V. Rudakova

2017-01-01

Full Text Available The human papillomavirus (HPV infection is one of the major risk factor of development of genital warts, a cervical dysplasia, a cervical cancer, and also some other oncologic diseases. The usage  of quadrivalent HPV vaccine in girls reduces the corresponding case  rate and the mortality significantly.The objective of this study is to analyze the cost-effectiveness of quadrivalent HPV vaccination cases of 12-year-old girls in Russian Federation.Methods. A Markov model is used on the basis of epidemiological data in Russian Federation. In base case the cost-effectiveness was  estimated from societal perspective. We assumed that the effect of  vaccination remains throughout all life. The analysis is performed for survival of 12-year-old girls. We considered only effect in the  vaccinated population. Costs for therapy of the diseases associated  with HPV infection corresponded to compulsory health insurance  rates across St. Petersburg for 2017. Costs and life expectancy have been discounted for 3.5% a year.Results. Quadrivalent HPV vaccination of 12-year-old girls in Russian Federation will allow to prevent counting on 100 000 the  vaccinated persons 2918 cases of genital warts, 5095 cases of  cervical dysplasia, 893 cases of invasive cervical cancer, 56 cases of  vulvar cancer, 18 cases of vaginal cancer, 13 cases of anal cancer, 7  cases of oropharyngeal cancer. The vaccination will provide cost  reduction, caused by HPV-associated diseases, for 453.9 million  rubles on 100 000 vaccinated, and 86.5% of the predicted prevented costs will be caused by decrease in incidence of cervical cancer, 9%  — cervical dysplasia, 2.9% — genital warts. The quadrivalent HPV vaccination is associated with an incremental cost-effectiveness ratio (ICER of 247 560 rubles per quality adjusted life-year (QALY and  334 200 rubles per life-year gained (LYG. Thus, in both cases, cost  effectiveness of rotavirus vaccination per 1 QALY

Mitigating costs and the preemptive effect of federal rate orders

International Nuclear Information System (INIS)

Darr, F.P.

1992-01-01

The role of federalism in the regulation of energy production is a long-standing problem. This article is divided into five parts. Following a summary of the case 'New Orleans Public Service, Inc. v. Council of New Orleans' (NOPSI) in Part I the article addresses the statutory and interpretive foundations of the filed rate doctrine described in Part II. Part III discusses the Supreme Court's extension of the doctrine into greater federal management of retail rates and introduces the reaction of the lower courts to the Supreme Court's decisions. Part IV analyzes the NOPSI exception requiring a utility to mitigate the effects of a FERC order in light of the policy distinctions inherent in the filed rate doctrine and the recognized eceptions. Part V addresses a related policy issue of the appropriate venue for challenging state orders to deny costs arising from federal orders. 153 refs

Animal board invited review: Dairy cow lameness expenditures, losses and total cost.

Science.gov (United States)

Dolecheck, K; Bewley, J

2018-03-20

Lameness is one of the most costly dairy cow diseases, yet adoption of lameness prevention strategies remains low. Low lameness prevention adoption might be attributable to a lack of understanding regarding total lameness costs. In this review, we evaluated the contribution of different expenditures and losses to total lameness costs. Evaluated expenditures included labor for treatment, therapeutic supplies, lameness detection and lameness control and prevention. Evaluated losses included non-saleable milk, reduced milk production, reduced reproductive performance, increased animal death, increased animal culling, disease interrelationships, lameness recurrence and reduced animal welfare. The previous literature on total lameness cost estimates was also summarized. The reviewed studies indicated that previous estimates of total lameness costs are variable and inconsistent in the expenditures and losses they include. Many of the identified expenditure and loss categories require further research to accurately include in total lameness cost estimates. Future research should focus on identifying costs associated with specific lameness conditions, differing lameness severity levels, and differing stages of lactation at onset of lameness to provide better total lameness cost estimates that can be useful for decision making at both the herd and individual cow level.

Association of Hospital Costs With Complications Following Total Gastrectomy for Gastric Adenocarcinoma.

Science.gov (United States)

Selby, Luke V; Gennarelli, Renee L; Schnorr, Geoffrey C; Solomon, Stephen B; Schattner, Mark A; Elkin, Elena B; Bach, Peter B; Strong, Vivian E

2017-10-01

Postoperative complications are associated with increased hospital costs following major surgery, but the mechanism by which they increase cost and the categories of care that drive this increase are poorly described. To describe the association of postoperative complications with hospital costs following total gastrectomy for gastric adenocarcinoma. This retrospective analysis of a prospectively collected gastric cancer surgery database at a single National Cancer Institute-designated comprehensive cancer center included all patients undergoing curative-intent total gastrectomy for gastric adenocarcinoma between January 2009 and December 2012 and was conducted in 2015 and 2016. Ninety-day normalized postoperative costs. Hospital accounting system costs were normalized to reflect Medicare reimbursement levels using the ratio of hospital costs to Medicare reimbursement and categorized into major cost categories. Differences between costs in Medicare proportional dollars (MP $) can be interpreted as the amount that would be reimbursed to an average hospital by Medicare if it paid differentially based on types and extent of postoperative complications. In total, 120 patients underwent curative-intent total gastrectomy for stage I through III gastric adenocarcinoma between 2009 and 2012. Of these, 79 patients (65.8%) were men, and the median (interquartile range) age was 64 (52-70) years. The 51 patients (42.5%) who underwent an uncomplicated total gastrectomy had a mean (SD) normalized cost of MP $12 330 (MP $2500), predominantly owing to the cost of surgical care (mean [SD] cost, MP $6830 [MP $1600]). The 34 patients (28.3%) who had a major complication had a mean (SD) normalized cost of MP $37 700 (MP $28 090). Surgical care was more expensive in these patients (mean [SD] cost, MP $8970 [MP $2750]) but was a smaller contributor to total cost (24%) owing to increased costs from room and board (mean [SD] cost, MP $11 940 [MP $8820]), consultations (mean [SD

Capital cost reimbursement to community hospitals under Federal health insurance programs.

Science.gov (United States)

Kinney, E D; Lefkowitz, B

1982-01-01

Issues in current capital cost reimbursement to community hospitals by Medicare and Medicaid are described, and options for change analyzed. Major reforms in the way the federal government pays for capital costs--in particular substitution of other methods of payment for existing depreciation reimbursement--could have significant impact on the structure of the health care system and on government expenditures. While such reforms are likely to engender substantial political opposition, they may be facilitated by broader changes in the reimbursement system.

34 CFR 675.45 - Allowable costs, Federal share, and institutional share.

Science.gov (United States)

2010-07-01

... education, financial self-help, and community service-learning opportunities. (3) Carry out activities in... 34 Education 3 2010-07-01 2010-07-01 false Allowable costs, Federal share, and institutional share. 675.45 Section 675.45 Education Regulations of the Offices of the Department of Education (Continued...

The total lifetime health cost savings of smoking cessation to society

DEFF Research Database (Denmark)

Rasmussen, Gitte Susanne; Prescott, Eva; Sørensen, Thorkild I A

2005-01-01

Smoking cessation has major immediate and long-term health benefits. However, ex-smokers' total lifetime health costs and continuing smokers' costs remain uncompared, and hence the economic savings of smoking cessation to society have not been determined.......Smoking cessation has major immediate and long-term health benefits. However, ex-smokers' total lifetime health costs and continuing smokers' costs remain uncompared, and hence the economic savings of smoking cessation to society have not been determined....

The Cost-Effectiveness of Dual Mobility Implants for Primary Total Hip Arthroplasty: A Computer-Based Cost-Utility Model.

Science.gov (United States)

Barlow, Brian T; McLawhorn, Alexander S; Westrich, Geoffrey H

2017-05-03

Dislocation remains a clinically important problem following primary total hip arthroplasty, and it is a common reason for revision total hip arthroplasty. Dual mobility (DM) implants decrease the risk of dislocation but can be more expensive than conventional implants and have idiosyncratic failure mechanisms. The purpose of this study was to investigate the cost-effectiveness of DM implants compared with conventional bearings for primary total hip arthroplasty. Markov model analysis was conducted from the societal perspective with use of direct and indirect costs. Costs, expressed in 2013 U.S. dollars, were derived from the literature, the National Inpatient Sample, and the Centers for Medicare & Medicaid Services. Effectiveness was expressed in quality-adjusted life years (QALYs). The model was populated with health state utilities and state transition probabilities derived from previously published literature. The analysis was performed for a patient's lifetime, and costs and effectiveness were discounted at 3% annually. The principal outcome was the incremental cost-effectiveness ratio (ICER), with a willingness-to-pay threshold of $100,000/QALY. Sensitivity analyses were performed to explore relevant uncertainty. In the base case, DM total hip arthroplasty showed absolute dominance over conventional total hip arthroplasty, with lower accrued costs ($39,008 versus $40,031 U.S. dollars) and higher accrued utility (13.18 versus 13.13 QALYs) indicating cost-savings. DM total hip arthroplasty ceased being cost-saving when its implant costs exceeded those of conventional total hip arthroplasty by $1,023, and the cost-effectiveness threshold for DM implants was $5,287 greater than that for conventional implants. DM was not cost-effective when the annualized incremental probability of revision from any unforeseen failure mechanism or mechanisms exceeded 0.29%. The probability of intraprosthetic dislocation exerted the most influence on model results. This model

76 FR 14543 - Federal Acquisition Regulation; Proper Use and Management of Cost-Reimbursement Contracts

Science.gov (United States)

2011-03-16

..., Sequence 1] RIN 9000-AL78 Federal Acquisition Regulation; Proper Use and Management of Cost-Reimbursement... other than firm-fixed-price contracts (e.g., cost-reimbursement, time-and-material, and labor-hour...-reimbursement contracts and identifies the following three areas that the Defense Acquisition Regulation Council...

78 FR 17300 - Reform of Federal Policies Relating to Grants and Cooperative Agreements; Cost Principles and...

Science.gov (United States)

2013-03-21

... and II Reform of Federal Policies Relating to Grants and Cooperative Agreements; Cost Principles and... Relating to Grants and Cooperative Agreements; Cost Principles and Administrative Requirements (Including...

45 CFR 2521.45 - What are the limitations on the Federal government's share of program costs?

Science.gov (United States)

2010-10-01

...) Your share of member support costs must be non-Federal cash. (4) The Corporation's share of health care... administration costs. (1) You may provide your share of program operating costs with cash, including other...'s share of program costs? 2521.45 Section 2521.45 Public Welfare Regulations Relating to Public...

The Cost of Family Medicine Residency Training: Impacts of Federal and State Funding.

Science.gov (United States)

Pauwels, Judith; Weidner, Amanda

2018-02-01

Numerous organizations are calling for the expansion of graduate medical education (GME) positions nationally. Developing new residency programs and expanding existing programs can only happen if financial resources are available to pay for the expenses of training beyond what can be generated in direct clinical income by the residents and faculty in the program. The goal of this study was to evaluate trended data regarding the finances of family medicine residency programs to identify what financial resources are needed to sustain graduate medical education programs. A group of family medicine residency programs have shared their financial data since 2002 through a biennial survey of program revenues, expenses, and staffing. Data sets over 12 years were collected and analyzed, and results compared to analyze trends. Overall expenses increased 70.4% during this period. Centers for Medicare and Medicaid Services (CMS) GME revenue per resident increased by 15.7% for those programs receiving these monies. Overall, total revenue per resident, including clinical revenues, state funding, and any other revenue stream, increased 44.5% from 2006 to 2016. The median cost per resident among these programs, excluding federal GME funds, is currently $179,353; this amount has increased over the 12 years by 93.7%. For this study group of family medicine programs, data suggests a cost per resident per year, excluding federal and state GME funding streams, of about $180,000. This excess expense compared to revenue must be met by other agencies, whether from CMS, the Health Resources and Services Administration (HRSA), state expenditures or other sources, through stable long-term commitments to these funding mechanisms to ensure program viability for these essential family medicine programs in the future.

Controlling costs without compromising quality: paying hospitals for total knee replacement.

Science.gov (United States)

Pine, Michael; Fry, Donald E; Jones, Barbara L; Meimban, Roger J; Pine, Gregory J

2010-10-01

Unit costs of health services are substantially higher in the United States than in any other developed country in the world, without a correspondingly healthier population. An alternative payment structure, especially for high volume, high cost episodes of care (eg, total knee replacement), is needed to reward high quality care and reduce costs. The National Inpatient Sample of administrative claims data was used to measure risk-adjusted mortality, postoperative length-of-stay, costs of routine care, adverse outcome rates, and excess costs of adverse outcomes for total knee replacements performed between 2002 and 2005. Empirically identified inefficient and ineffective hospitals were then removed to create a reference group of high-performance hospitals. Predictive models for outcomes and costs were recalibrated to the reference hospitals and used to compute risk-adjusted outcomes and costs for all hospitals. Per case predicted costs were computed and compared with observed costs. Of the 688 hospitals with acceptable data, 62 failed to meet effectiveness criteria and 210 were identified as inefficient. The remaining 416 high-performance hospitals had 13.4% fewer risk-adjusted adverse outcomes (4.56%-3.95%; P costs ($12,773-$11,512; P costs. A payment system based on the demonstrated performance of effective, efficient hospitals can produce sizable cost savings without jeopardizing quality. In this study, 96% of total excess hospital costs resulted from higher routine costs at inefficient hospitals, whereas only 4% was associated with ineffective care.

The cost and impact of the interim federal health program cuts on child refugees in Canada.

Directory of Open Access Journals (Sweden)

Andrea Evans

Full Text Available INTRODUCTION: On June 30, 2012, Interim Federal Health Program (IFHP funding was cut for refugee claimant healthcare. The potential financial and healthcare impacts of these cuts on refugee claimants are unknown. METHODS: We conducted a one-year retrospective chart review spanning 6 months before and after IFHP funding cuts at The Hospital for Sick Children, a tertiary care children's hospital in Toronto. We analyzed emergency room visits characteristics, admission rates, reasons for admission, and financial records including billing from Medavie Blue Cross. RESULTS: There were 173 refugee children visits to the emergency room in the six months before and 142 visits in the six months after funding cuts. The total amount billed to the IFHP program during the one-year of this study was $131,615. Prior to the IFHP cuts, 46% of the total emergency room bills were paid by IFHP compared to 7% after the cuts (p<0.001. INTERPRETATION: After the cuts to the IFHP, The Hospital for Sick Children was unable to obtain federal health coverage for the vast majority of refugee claimant children registered under the IFHP. This preliminary analysis showed that post-IFHP cuts healthcare costs at the largest tertiary pediatric institution in the country increased.

Managing the total cost of risk exposures through risk mapping techniques

International Nuclear Information System (INIS)

Unione, A.J.; Rode, D.M.

1998-01-01

In a competitive power market, power producers are exposed to an increasingly broad spectrum of financial risks. The cumulative impact of these financial risks is known collectively as the Total of Cost of Risk. The concept of Total of Cost of Risk presents the business reality of a company's exposure to potentially devastating financial consequences in an integrated and useful way. In this way, a strategy of managing Total Cost of Risk in the most cost effective way can become a means of ensuring long term business health and security. This paper will examine the use of risk mapping as a tool for visually understanding Total Cost of Risk, thus creating an enhanced situational awareness and an integrated basis for risk management decision. The evaluation process, available through the use of risk maps allows the power producers to pro-actively implement prudent business decisions concerning the design, operation and maintenance of power plants. Risk mapping is thus a means for harmonizing operational objectives, such as improved plant reliability, with corporate strategies and goals in terms of an effective risk management program

77 FR 11778 - Reform of Federal Policies Relating to Grants and Cooperative Agreements; Cost Principles and...

Science.gov (United States)

2012-02-28

... and II Reform of Federal Policies Relating to Grants and Cooperative Agreements; Cost Principles and... available on OMB's Web site at http://www.whitehouse.gov/omb/circulars_default/ . The Cost Principles for... E (Principles for Determining Costs Applicable to Research and Development Under Grants and...

78 FR 7282 - Reform of Federal Policies Relating to Grants and Cooperative Agreements; Cost Principles and...

Science.gov (United States)

2013-02-01

... II Reform of Federal Policies Relating to Grants and Cooperative Agreements; Cost Principles and... further review, the Cost Principles for Hospitals at 45 CFR Part 74, Appendix E. The proposal consolidates... instructed the OMB Director to ``review and where appropriate revise guidance concerning cost principles...

77 FR 17360 - Reform of Federal Policies Relating to Grants and Cooperative Agreements; Cost Principles And...

Science.gov (United States)

2012-03-26

... II Reform of Federal Policies Relating to Grants and Cooperative Agreements; Cost Principles And...; cost principles and administrative requirements (including Single Audit Act). The original comment...-idx?c=ecfr&tpl=/ecfrbrowse/Title02/2cfrv1_02.tpl . The Cost Principles for Hospitals are in the...

Heating Water with Solar Energy Costs Less at the Phoenix Federal Correctional Institution

Energy Technology Data Exchange (ETDEWEB)

2004-09-01

A large solar thermal system installed at the Phoenix Federal Correctional Institution (FCI) in 1998 heats water for the prison and costs less than buying electricity to heat that water. This renewable energy system provides 70% of the facility's annual hot water needs. The Federal Bureau of Prisons did not incur the up-front cost of this system because it was financed through an Energy Savings Performance Contract (ESPC). The ESPC payments are 10% less than the energy savings so that the prison saves an average of$6,700 per year, providing an immediate payback. The solar hot water system produces up to 50,000 gallons of hot water daily, enough to meet the needs of 1,250 inmates and staff who use the kitchen, shower, and laundry facilities.

78 FR 6189 - Federal Acquisition Regulation; Unallowability of Costs Associated With Foreign Contractor Excise...

Science.gov (United States)

2013-01-29

... 9000-AM13 Federal Acquisition Regulation; Unallowability of Costs Associated With Foreign Contractor... contractor in order to reimburse the tax imposed (26 U.S.C. 5000C Note). On February 22, 2012, DoD, GSA, and... with the statute, FAR 31.205-41 is amended to inform the Government and contractors that the costs of...

75 FR 71560 - Defense Federal Acquisition Regulation Supplement; Cost and Software Data Reporting System (DFARS...

Science.gov (United States)

2010-11-24

... also asked what allowance is provided for contractors with accounting software that does not... RIN 0750-AG46 Defense Federal Acquisition Regulation Supplement; Cost and Software Data Reporting... Regulation Supplement (DFARS) to address DoD Cost and Software Data Reporting system requirements for Major...

[Total knee and hip prosthesis: variables associated with costs].

Science.gov (United States)

Herrera-Espiñeira, Carmen; Escobar, Antonio; Navarro-Espigares, José Luis; Castillo, Juan de Dios Lunadel; García-Pérez, Lidia; Godoy-Montijano, Amparo

2013-01-01

The elevated prevalence of osteoarthritis in Western countries, the high costs of hip and knee arthroplasty, and the wide variations in the clinical practice have generated considerable interest in comparing the associated costs before and after surgery. To determine the influence of a number of variables on the costs of total knee and hip arthroplasty surgery during the hospital stay and during the one-year post-discharge. A prospective multi-center study was performed in 15 hospitals from three Spanish regions. Relationships between the independent variables and the costs of hospital stay and postdischarge follow-up were analyzed by using multilevel models in which the "hospital" variable was used to group cases. Independent variables were: age, sex, body mass index, preoperative quality of life (SF-12, EQ-5 and Womac questionnaires), surgery (hip/knee), Charlson Index, general and local complications, number of beds and economic-institutional dependency of the hospital, the autonomous region to which it belongs, and the presence of a caregiver. The cost of hospital stay, excluding the cost of the prosthesis, was 4,734 Euros, and the post-discharge cost was 554 Euros. With regard to hospital stay costs, the variance among hospitals explained 44-46% of the total variance among the patients. With regard to the post-discharge costs, the variability among hospitals explained 7-9% of the variance among the patients. There is considerable potential for reducing the hospital stay costs of these patients, given that more than 44% of the observed variability was not determined by the clinical conditions of the patients but rather by the behavior of the hospitals.

Procedure for estimating permanent total enclosure costs

Energy Technology Data Exchange (ETDEWEB)

Lukey, M.E.; Prasad, C.; Toothman, D.A.; Kaplan, N.

1999-07-01

Industries that use add-on control devices must adequately capture emissions before delivering them to the control device. One way to capture emissions is to use permanent total enclosures (PTEs). By definition, an enclosure which meets the US Environmental Protection Agency's five-point criteria is a PTE and has a capture efficiency of 100%. Since costs play an important role in regulatory development, in selection of control equipment, and in control technology evaluations for permitting purposes, EPA has developed a Control Cost Manual for estimating costs of various items of control equipment. EPA's Manual does not contain any methodology for estimating PTE costs. In order to assist environmental regulators and potential users of PTEs, a methodology for estimating PTE costs was developed under contract with EPA, by Pacific Environmental Services, Inc. (PES) and is the subject of this paper. The methodology for estimating PTE costs follows the approach used for other control devices in the Manual. It includes procedures for sizing various components of a PTE and for estimating capital as well as annual costs. It contains verification procedures for demonstrating compliance with EPA's five-point criteria. In addition, procedures are included to determine compliance with Occupational Safety and Health Administration (OSHA) standards. Meeting these standards is an important factor in properly designing PTEs. The methodology is encoded in Microsoft Exel spreadsheets to facilitate cost estimation and PTE verification. Examples are given throughout the methodology development and in the spreadsheets to illustrate the PTE design, verification, and cost estimation procedures.

Procedure for estimating permanent total enclosure costs

Energy Technology Data Exchange (ETDEWEB)

Lukey, M E; Prasad, C; Toothman, D A; Kaplan, N

1999-07-01

Industries that use add-on control devices must adequately capture emissions before delivering them to the control device. One way to capture emissions is to use permanent total enclosures (PTEs). By definition, an enclosure which meets the US Environmental Protection Agency's five-point criteria is a PTE and has a capture efficiency of 100%. Since costs play an important role in regulatory development, in selection of control equipment, and in control technology evaluations for permitting purposes, EPA has developed a Control Cost Manual for estimating costs of various items of control equipment. EPA's Manual does not contain any methodology for estimating PTE costs. In order to assist environmental regulators and potential users of PTEs, a methodology for estimating PTE costs was developed under contract with EPA, by Pacific Environmental Services, Inc. (PES) and is the subject of this paper. The methodology for estimating PTE costs follows the approach used for other control devices in the Manual. It includes procedures for sizing various components of a PTE and for estimating capital as well as annual costs. It contains verification procedures for demonstrating compliance with EPA's five-point criteria. In addition, procedures are included to determine compliance with Occupational Safety and Health Administration (OSHA) standards. Meeting these standards is an important factor in properly designing PTEs. The methodology is encoded in Microsoft Exel spreadsheets to facilitate cost estimation and PTE verification. Examples are given throughout the methodology development and in the spreadsheets to illustrate the PTE design, verification, and cost estimation procedures.

Effects of the Length of Stay on the Cost of Total Knee and Total Hip Arthroplasty from 2002 to 2013.

Science.gov (United States)

Molloy, Ilda B; Martin, Brook I; Moschetti, Wayne E; Jevsevar, David S

2017-03-01

Utilization of total knee and hip arthroplasty has greatly increased in the past decade in the United States; these are among the most expensive procedures in patients with Medicare. Advances in surgical techniques, anesthesia, and care pathways decrease hospital length of stay. We examined how trends in hospital cost were altered by decreases in length of stay. Procedure, demographic, and economic data were collected on 6.4 million admissions for total knee arthroplasty and 2.8 million admissions for total hip arthroplasty from 2002 to 2013 using the National (Nationwide) Inpatient Sample, a component of the Healthcare Cost and Utilization Project. Trends in mean hospital costs and their association with length of stay were estimated using inflation-adjusted, survey-weighted generalized linear regression models, controlling for patient demographic characteristics and comorbidity. From 2002 to 2013, the length of stay decreased from a mean time of 4.06 to 2.97 days for total knee arthroplasty and from 4.06 to 2.75 days for total hip arthroplasty. During the same time period, the mean hospital cost for total knee arthroplasty increased from $14,988 (95% confidence interval [CI], $14,927 to $15,049) in 2002 to $22,837 (95% CI, $22,765 to $22,910) in 2013 (an overall increase of $7,849 or 52.4%). The mean hospital cost for total hip arthroplasty increased from $15,792 (95% CI, $15,706 to $15,878) in 2002 to $23,650 (95% CI, $23,544 to $23,755) in 2013 (an increase of $7,858 or 49.8%). If length of stay were set at the 2002 mean, the growth in cost for total knee arthroplasty would have been 70.8% instead of 52.4% as observed, and the growth in cost for total hip arthroplasty would have been 67.4% instead of 49.8% as observed. Hospital costs for joint replacement increased from 2002 to 2013, but were attenuated by reducing inpatient length of stay. With demographic characteristics showing an upward trend in the utilization of joint arthroplasty, including a shift

Total cost of ownership: Getting past the 10% solution

International Nuclear Information System (INIS)

Anderson, R.F.

1996-01-01

As the refining industry strives to succeed in a more-competitive world, some fresh ideas are needed to counter the headlines of plant closings, layoffs, and corporate restructurings. Other industries facing the same pressures have discovered opportunities to reduce cost in a more human and effective manner by using some tools borrowed from the Total Quality process to enhance the procurement process. Experience suggests that the purchase cost is a small fraction of the actual cost of a commodity and is often dwarfed by hidden costs. Discovering and eliminating the hidden costs of variation, nonoptimal operations, and poorly aligned vendor relations is vital to economic survival. The purpose of this paper is to suggest some fresh approaches to vendor-customer relations that can dramatically reduce undesired costs

Variation in the cost of care for primary total knee arthroplasties.

Science.gov (United States)

Haas, Derek A; Kaplan, Robert S

2017-03-01

The study examined the cost variation across 29 high-volume US hospitals and their affiliated orthopaedic surgeons for delivering a primary total knee arthroplasty without major complicating conditions. The hospitals had similar patient demographics, and more than 80% of them had statistically-similar Medicare risk-adjusted readmission and complication rates. Hospital and physician personnel costs were calculated using time-driven activity-based costing. Consumable supply costs, such as the prosthetic implant, were calculated using purchase prices, and postacute care costs were measured using either internal costs or external claims as reported by each hospital. Despite having similar patient demographics and readmission and complication rates, the average cost of care for total knee arthroplasty across the hospitals varied by a factor of about 2 to 1. Even after adjusting for differences in internal labor cost rates, the hospital at the 90th percentile of cost spent about twice as much as the one at the 10th percentile of cost. The large variation in costs among sites suggests major and multiple opportunities to transfer knowledge about process and productivity improvements that lower costs while simultaneously maintaining or improving outcomes.

How do high cost-sharing policies for physician care affect total care costs among people with chronic disease?

Science.gov (United States)

Xin, Haichang; Harman, Jeffrey S; Yang, Zhou

2014-01-01

This study examines whether high cost-sharing in physician care is associated with a differential impact on total care costs by health status. Total care includes physician care, emergency room (ER) visits and inpatient care. Since high cost-sharing policies can reduce needed care as well as unneeded care use, it raises the concern whether these policies are a good strategy for controlling costs among chronically ill patients. This study used the 2007 Medical Expenditure Panel Survey data with a cross-sectional study design. Difference in difference (DID), instrumental variable technique, two-part model, and bootstrap technique were employed to analyze cost data. Chronically ill individuals' probability of reducing any overall care costs was significantly less than healthier individuals (beta = 2.18, p = 0.04), while the integrated DID estimator from split results indicated that going from low cost-sharing to high cost-sharing significantly reduced costs by $12,853.23 more for sick people than for healthy people (95% CI: -$17,582.86, -$8,123.60). This greater cost reduction in total care among sick people likely resulted from greater cost reduction in physician care, and may have come at the expense of jeopardizing health outcomes by depriving patients of needed care. Thus, these policies would be inappropriate in the short run, and unlikely in the long run to control health plans costs among chronically ill individuals. A generous benefit design with low cost-sharing policies in physician care or primary care is recommended for both health plans and chronically ill individuals, to save costs and protect these enrollees' health status.

78 FR 11232 - Notification of a Public Meeting on the Use of Cost Comparisons in Federal Procurement

Science.gov (United States)

2013-02-15

... comparing the relative cost of performance by Federal employees versus contract performance in order to... organization and (b) address the full costs of government and private sector performance. 1. What additional... also can be used to compare the relative cost of each sector's performance without conducting a...

Heating Water with Solar Energy Costs Less at the Phoenix Federal Correctional Institution

Energy Technology Data Exchange (ETDEWEB)

None

2004-09-01

A large solar thermal system installed at the Phoenix Federal Correctional Institution (FCI) in 1998 heats water for the prison and costs less than buying electricity to heat that water. This renewable energy system provides 70% of the facility's annual hot water needs. The Federal Bureau of Prisons did not incur the up-front cost of this system because it was financed through an Energy Savings Performance Contract (ESPC). The ESPC payments are 10% less than the energy savings so that the prison saves an average of $6,700 per year, providing an immediate payback. The solar hot water system produces up to 50,000 gallons of hot water daily, enough to meet the needs of 1,250 inmates and staff who use the kitchen, shower, and laundry facilities. This publication details specifications of the parabolic trough solar system and highlights 5 years of measured performance data.

Strategies for reducing implant costs in the revision total knee arthroplasty episode of care.

Science.gov (United States)

Elbuluk, Ameer M; Old, Andrew B; Bosco, Joseph A; Schwarzkopf, Ran; Iorio, Richard

2017-12-01

Implant price has been identified as a significant contributing factor to high costs associated with revision total knee arthroplasty (rTKA). The goal of this study is to analyze the cost of implants used in rTKAs and to compare this pricing with 2 alternative pricing models. Using our institutional database, we identified 52 patients from January 1, 2014 to December 31, 2014. Average cost of components for each case was calculated and compared to the total hospital cost for that admission. Costs for an all-component revision were then compared to a proposed "direct to hospital" (DTH) standardized pricing model and a fixed price revision option. Potential savings were calculated from these figures. On average, 28% of the total hospital cost was spent on implants for rTKA. The average cost for revision of all components was $13,640 and ranged from $3000 to $28,000. On average, this represented 32.7% of the total hospital cost. Direct to hospital implant pricing could potentially save approximately $7000 per rTKA, and the fixed pricing model could provide a further $1000 reduction per rTKA-potentially saving $8000 per case on implants alone. Alternative implant pricing models could help lower the total cost of rTKA, which would allow hospitals to achieve significant cost containment.

Cost of a measles outbreak in a remote island economy: 2014 Federated States of Micronesia measles outbreak.

Science.gov (United States)

Pike, Jamison; Tippins, Ashley; Nyaku, Mawuli; Eckert, Maribeth; Helgenberger, Louisa; Underwood, J Michael

2017-10-13

After 20years with no reported measles cases, on May 15, 2014 the Centers for Disease Control and Prevention (CDC) was notified of two cases testing positive for measles-specific immunoglobulin M (IgM) antibodies in the Federated States of Micronesia (FSM). Under the Compact of Free Association, FSM receives immunization funding and technical support from the United States (US) domestic vaccination program managed by the Centers for Disease Control and Prevention (CDC). In a collaborative effort, public health officials and volunteers from FSM and the US government worked to respond and contain the measles outbreak through an emergency mass vaccination campaign, contact tracing, and other outbreak investigation activities. Contributions were also made by United Nations Children's Emergency Fund (UNICEF) and World Health Organization (WHO). Total costs incurred as a result of the outbreak were nearly $4,000,000; approximately $10,000 per case. Direct medical costs (≈$141,000) were incurred in the treatment of those individuals infected, as well as lost productivity of the infected and informal caregivers (≈$250,000) and costs to contain the outbreak (≈$3.5 million). We assessed the economic burden of the 2014 measles outbreak to FSM, as well as the economic responsibilities of the US. Although the US paid the majority of total costs of the outbreak (≈67%), examining each country's costs relative to their respective economy illustrates a far greater burden to FSM. We demonstrate that while FSM was heavily assisted by the US in responding to the 2014 Measles Outbreak, the outbreak significantly impacted their economy. FSM's economic burden from the outbreak is approximately equivalent to their entire 2016 Fiscal Year budget dedicated to education. Published by Elsevier Ltd.

Direct costs of unintended pregnancy in the Russian federation.

Science.gov (United States)

Lowin, Julia; Jarrett, James; Dimova, Maria; Ignateva, Victoria; Omelyanovsky, Vitaly; Filonenko, Anna

2015-02-01

In 2010, almost every third pregnancy in Russia was terminated, indicating that unintended pregnancy (UP) is a public health problem. The aim of this study was to estimate the direct cost of UP to the healthcare system in Russia and the proportion attributable to using unreliable contraception. A cost model was built, adopting a generic payer perspective with a 1-year time horizon. The analysis cohort was defined as women of childbearing age between 18 and 44 years actively seeking to avoid pregnancy. Model inputs were derived from published sources or government statistics with a 2012 cost base. To estimate the number of UPs attributable to unreliable methods, the model combined annual typical use failure rates and age-adjusted utilization for each contraceptive method. Published survey data was used to adjust the total cost of UP by the number of UPs that were mistimed rather than unwanted. Scenario analysis considered alternate allocation of methods to the reliable and unreliable categories and estimate of the burden of UP in the target sub-group of women aged 18-29 years. The model estimated 1,646,799 UPs in the analysis cohort (women aged 18-44 years) with an associated annual cost of US$783 million. The model estimated 1,019,371 UPs in the target group of 18-29 years, of which 88 % were attributable to unreliable contraception. The total cost of UPs in the target group was estimated at approximately US$498 million, of which US$441 million could be considered attributable to the use of unreliable methods. The cost of UP attributable to use of unreliable contraception in Russia is substantial. Policies encouraging use of reliable contraceptive methods could reduce the burden of UP.

48 CFR 16.304 - Cost-plus-incentive-fee contracts.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Cost-plus-incentive-fee...-incentive-fee contracts. A cost-plus-incentive-fee contract is a cost-reimbursement contract that provides... allowable costs to total target costs. Cost-plus-incentive-fee contracts are covered in subpart 16.4...

Federal Aircraft Cost and Utilization Data

Data.gov (United States)

General Services Administration — Federal aviation data is submitted quarterly to the Federal Aviation Interactive Reporting System (FARIS) IT application. This is a GSA system which is a secure,...

Resource use and costs associated with opioid-induced constipation following total hip or total knee replacement surgery

Directory of Open Access Journals (Sweden)

Wittbrodt ET

2018-05-01

Full Text Available Eric T Wittbrodt,1 Tong J Gan,2 Catherine Datto,1 Charles McLeskey,1 Meenal Sinha3 1US Medical Affairs, AstraZeneca, Wilmington, DE, USA; 2Department of Anesthesiology, Stony Brook Medicine, Stony Brook, NY, USA; 3Premier Applied Sciences, Premier, Inc., Charlotte, NC, USA Purpose: Constipation is a well-known complication of surgery that can be exacerbated by opioid analgesics. This study evaluated resource utilization and costs associated with opioid-induced constipation (OIC. Patients and methods: This retrospective, observational, and propensity-matched cohort study utilized the Premier Healthcare Database. The study included adults ≥18 years of age undergoing total hip or total knee replacement as inpatients who received an opioid analgesic and were discharged between January 1, 2012, and June 30, 2015. Diagnosis codes identified patients with OIC who were then matched 1:1 to patients without OIC. Generalized linear and logistic regression models were used to compare inpatient resource utilization, total hospital costs, inpatient mortality, and 30-day all-cause readmissions and emergency department visits. Results: Of 788,448 eligible patients, 40,891 (5.2% had OIC. Covariates were well balanced between matched patients with and without OIC (n=40,890 each. In adjusted analyses, patients with OIC had longer hospital lengths of stay (3.6 versus 3.3 days; p<0.001, higher total hospital costs (US$17,479 versus US$16,265; p<0.001, greater risk of intensive care unit admission (odds ratio [OR]=1.12, 95% CI: 1.01–1.24, and increased likelihood of 30-day hospital readmissions (OR=1.16, 95% CI: 1.11–1.22 and emergency department visits (OR=1.38, 95% CI: 1.07–1.79 than patients without OIC. No statistically significant difference was found with inpatient mortality (OR=0.89, 95% CI: 0.59–1.35. Conclusion: OIC was associated with greater resource utilization and hospital costs for patients undergoing primarily elective total hip or total knee

Ferry Lifecycle Cost Model for Federal Land Management Agencies : User's Guide.

Science.gov (United States)

2011-09-30

The Ferry Lifecycle Cost Model (model) is a spreadsheet-based sketch planning tool that estimates capital, operating, and total cost for various vessels that could be used to provide ferry service on a particular route given known service parameters....

Total life-cycle cost analysis of conventional and alternative fueled vehicles

International Nuclear Information System (INIS)

Cardullo, M.W.

1993-01-01

Total Life-Cycle Cost (TLCC) Analysis can indicate whether paying higher capital costs for advanced technology with low operating and/or environmental costs is advantageous over paying lower capital costs for conventional technology with higher operating and/or environmental costs. While minimizing total life-cycle cost is an important consideration, the consumer often identifies non-cost-related benefits or drawbacks that make more expensive options appear more attractive. The consumer is also likely to heavily weigh initial capital costs while giving limited consideration to operating and/or societal costs, whereas policy-makers considering external costs, such as those resulting from environmental impacts, may reach significantly different conclusions about which technologies are most advantageous to society. This paper summarizes a TLCC model which was developed to facilitate consideration of the various factors involved in both individual and societal policy decision making. The model was developed as part of a US Department of Energy Contract and has been revised to reflect changes necessary to make the model more realistic. The model considers capital, operating, salvage, and environmental costs for cars, vans, and buses using conventional and alternative fuels. The model has been developed to operate on an IBM or compatible personal computer platform using the commercial spreadsheet program MicroSoft Excell reg-sign Version 4 for Windows reg-sign and can be easily kept current because its modular structure allows straightforward access to embedded data sets for review and update

Total life cycle cost model for electric power stations

International Nuclear Information System (INIS)

Cardullo, M.W.

1995-01-01

The Total Life Cycle Cost (TLCC) model for electric power stations was developed to provide a technology screening model. The TLCC analysis involves normalizing cost estimates with respect to performance standards and financial assumptions and preparing a profile of all costs over the service life of the power station. These costs when levelized present a value in terms of a utility electricity rate. Comparison of cost and the pricing of the electricity for a utility shows if a valid project exists. Cost components include both internal and external costs. Internal costs are direct costs associated with the purchase, and operation of the power station and include initial capital costs, operating and maintenance costs. External costs result from societal and/or environmental impacts that are external to the marketplace and can include air quality impacts due to emissions, infrastructure costs, and other impacts. The cost stream is summed (current dollars) or discounted (constant dollars) to some base year to yield a overall TLCC of each power station technology on a common basis. While minimizing life cycle cost is an important consideration, it may not always be a preferred method for some utilities who may prefer minimizing capital costs. Such consideration does not always result in technology penetration in a marketplace such as the utility sector. Under various regulatory climates, the utility is likely to heavily weigh initial capital costs while giving limited consideration to other costs such as societal costs. Policy makers considering external costs, such as those resulting from environmental impacts, may reach significantly different conclusions about which technologies are most advantageous to society. The TLCC analysis model for power stations was developed to facilitate consideration of all perspectives

Intensive care unit drug costs in the context of total hospital drug expenditures with suggestions for targeted cost containment efforts.

Science.gov (United States)

Altawalbeh, Shoroq M; Saul, Melissa I; Seybert, Amy L; Thorpe, Joshua M; Kane-Gill, Sandra L

2018-04-01

To assess costs of intensive care unit (ICU) related pharmacotherapy relative to hospital drug expenditures, and to identify potential targets for cost-effectiveness investigations. We offer the unique advantage of comparing ICU drug costs with previously published data a decade earlier to describe changes over time. Financial transactions for all ICU patients during fiscal years (FY) 2009-2012 were retrieved from the hospital's data repository. ICU drug costs were evaluated for each FY. ICU departments' charges were also retrieved and calculated as percentages of total ICU charges. Albumin, prismasate (dialysate), voriconazole, factor VII and alteplase denoted the highest percentages of ICU drug costs. ICU drug costs contributed to an average of 31% (SD 1.0%) of the hospital's total drug costs. ICU drug costs per patient day increased by 5.8% yearly versus 7.8% yearly for non-ICU drugs. This rate was higher for ICU drugs costs at 12% a decade previous. Pharmacy charges contributed to 17.7% of the total ICU charges. Growth rates of costs per year have declined but still drug expenditures in the ICU are consistently a significant driver in this resource intensive environment with a high impact on hospital drug expenditures. Copyright © 2017 Elsevier Inc. All rights reserved.

Cost per case or total cost? The potential of prevention of hand injuries in young children – Retrospective and prospective studies

Directory of Open Access Journals (Sweden)

Carlsson Katarina

2008-07-01

Full Text Available Abstract Background Health-care costs for hand and forearm injuries in young children are poorly documented. We examined costs in 533 children injured years 1996–2003. Methods Health-care costs and costs for lost productivity were retrospectively calculated in children from three catchment areas in Sweden. Seven case categories corresponding to alternative prevention strategies were constructed. Results Over time, diminishing number of ward days reduced the health-care cost per case. Among children, the cost of lost productivity due to parental leave was 14 percent of total cost. Fingertip injuries had low median costs but high total costs due to their frequency. Complex injuries by machine or rifle had high costs per case, and despite a low number of cases, total cost was high. Type of injury, surgery and physiotherapy sessions were associated with variations in health-care cost. Low age and ethnic background had a significant effect on number of ward days. Conclusion The costs per hand injury for children were lower compared to adults due to both lower health-care costs and to the fact that parents had comparatively short periods of absence from work. Frequent simple fingertip injuries and rare complex injuries induce high costs for society. Such costs should be related to costs for prevention of these injuries.

It Is a Brave New World: Alternative Payment Models and Value Creation in Total Joint Arthroplasty: Creating Value for TJR, Quality and Cost-Effectiveness Programs.

Science.gov (United States)

Chen, Kevin K; Harty, Jonathan H; Bosco, Joseph A

2017-06-01

The increasing cost of our country's healthcare is not sustainable. To address this crisis, the federal government is transiting healthcare reimbursement from the traditional volume-based system to a value-based system. As such, increasing healthcare value has become an essential point of discussion for all healthcare stakeholders. The purpose of this study is to discuss the importance of healthcare value as a means to achieve this goal of value-based medicine and 3 methods to create value in total joint arthroplasty. These methods are to: (1) improve outcomes greater than the increased costs to achieve this improvement, (2) decrease costs without affecting outcomes, and (3) decrease costs while simultaneously improving outcomes. Following these guidelines will help practitioners thrive in a bundled care environment. Copyright © 2017 Elsevier Inc. All rights reserved.

Retail clinic utilization associated with lower total cost of care.

Science.gov (United States)

Sussman, Andrew; Dunham, Lisette; Snower, Kristen; Hu, Min; Matlin, Olga S; Shrank, William H; Choudhry, Niteesh K; Brennan, Troyen

2013-04-01

To better understand the impact of retail clinic use on a patient's annual total cost of care. A propensity score matched-pair, cohort design was used to analyze healthcare spending patterns among CVS Caremark employees in the year following a visit to a MinuteClinic, the retail clinics inside CVS pharmacies. De-identified medical and pharmacy claims for CVS Caremark employees and their dependents who received care at a retail clinic between June 1, 2009, and May 31, 2010, were matched to those of subjects who received care elsewhere. High-dimensional propensity score and greedy matching techniques were used to create a 1-to-1 matched cohort that was analyzed using generalized linear regression models. Individuals using a retail clinic had a lower total cost of care (-$262; 95% confidence interval, -$510 to -$31; P = .025) in the year following their clinic visit than individuals who received care in other settings. This savings was primarily due to lower medical expenses at physicians' offices ($77 savings, P = .008) and hospital inpatient care ($121 savings, P = .049). The 6022 retail clinic users also had 142 (12%) fewer emergency department visits (P = .01), though this was not related to significant cost savings. This study found that retail clinic use was associated with lower overall total cost of care compared with that at alternative sites. Savings may extend beyond the retail clinic visit itself to other types of medical utilization.

Determining the total cost of reverse supply chain operations for original equipment manufacturers

DEFF Research Database (Denmark)

Larsen, Samuel Brüning; Jacobsen, Peter

2014-01-01

When original equipment manufacturers (OEM) examine whether or not to invest in a reverse supply chain (RSC), managers need insight into not only the cost savings and new revenue streams the RSC enables, but also the total cost of the RSC itself. Using case study research the study examines what...... cost parameters constitute the total cost (TC) of the RSC. The specific RSC that the study seeks the TC for consists of 1) end-product refurbishing, 2) component refurbishing, and 3) sales of used materials back to original suppliers or independent recyclers for materials recycling....

Patterns of pharmacotherapy and health care utilization and costs prior to total hip or total knee replacement in patients with osteoarthritis.

Science.gov (United States)

Berger, Ariel; Bozic, Kevin; Stacey, Brett; Edelsberg, John; Sadosky, Alesia; Oster, Gerry

2011-08-01

To examine patterns of pharmacotherapy and health care utilization and costs prior to total knee replacement (TKR) or total hip replacement (THR) in patients with osteoarthritis (OA). Using a large US health insurance claims database, we identified all patients with OA who were ages ≥40 years and had undergone TKR or THR between January 1, 2006 and December 31, 2007. Patients with care utilization and costs over the 2-year period preceding surgery. A total of 16,527 patients met all study entry criteria. Their mean ± SD age was 56.6 ± 6.1 years, and 56% of them were women. In the 2 years preceding surgery, 55% of patients received prescription nonsteroidal antiinflammatory drugs, 58% received opioids, and 50% received injections of corticosteroids. The numbers of patients receiving these drugs increased steadily during the presurgery period. The mean ± SD total health care costs in the 2 years preceding surgery were $19,466 ± 29,869, of which outpatient care, inpatient care, and pharmacotherapy represented 45%, 20%, and 20%, respectively. Costs increased from $2,094 in the eighth calendar quarter prior to surgery to $3,100 in the final quarter. Patients with OA who undergo THR or TKR have relatively high levels of use of pain-related pharmacotherapy and high total health care costs in the 2-year period preceding surgery. Levels of utilization and cost increase as the date of surgery approaches. Copyright © 2011 by the American College of Rheumatology.

A decision-making framework for total ownership cost management of complex systems: A Delphi study

Science.gov (United States)

King, Russel J.

This qualitative study, using a modified Delphi method, was conducted to develop a decision-making framework for the total ownership cost management of complex systems in the aerospace industry. The primary focus of total ownership cost is to look beyond the purchase price when evaluating complex system life cycle alternatives. A thorough literature review and the opinions of a group of qualified experts resulted in a compilation of total ownership cost best practices, cost drivers, key performance factors, applicable assessment methods, practitioner credentials and potential barriers to effective implementation. The expert panel provided responses to the study questions using a 5-point Likert-type scale. Data were analyzed and provided to the panel members for review and discussion with the intent to achieve group consensus. As a result of the study, the experts agreed that a total ownership cost analysis should (a) be as simple as possible using historical data; (b) establish cost targets, metrics, and penalties early in the program; (c) monitor the targets throughout the product lifecycle and revise them as applicable historical data becomes available; and (d) directly link total ownership cost elements with other success factors during program development. The resultant study framework provides the business leader with incentives and methods to develop and implement strategies for controlling and reducing total ownership cost over the entire product life cycle when balancing cost, schedule, and performance decisions.

Pre-fracture individual characteristics associated with high total health care costs after hip fracture.

Science.gov (United States)

Schousboe, J T; Paudel, M L; Taylor, B C; Kats, A M; Virnig, B A; Dowd, B E; Langsetmo, L; Ensrud, K E

2017-03-01

Older women with pre-fracture slow walk speed, high body mass index, and/or a high level of multimorbidity have significantly higher health care costs after hip fracture compared to those without those characteristics. Studies to investigate if targeted health care interventions for these individuals can reduce hip fracture costs are warranted. The aim of this study is to estimate the associations of individual pre-fracture characteristics with total health care costs after hip fracture, using Study of Osteoporotic Fractures (SOF) cohort data linked to Medicare claims. Our study population was 738 women age 70 and older enrolled in Medicare Fee for Service (FFS) who experienced an incident hip fracture between January 1, 1992 and December 31, 2009. We assessed pre-fracture individual characteristics at SOF study visits and estimated costs of hospitalizations, skilled nursing facility and inpatient rehabilitation stays, home health care visits, and outpatient utilization from Medicare FFS claims. We used generalized linear models to estimate the associations of predictor variables with total health care costs (2010 US dollars) after hip fracture. Median total health care costs for 1 year after hip fracture were $35,536 (inter-quartile range $24,830 to $50,903). Multivariable-adjusted total health care costs for 1 year after hip fracture were 14 % higher ($5256, 95 % CI $156 to $10,356) in those with walk speed total health care costs after hip fracture in older women. Studies to investigate if targeted health care interventions for these individuals can reduce the costs of hip fractures are warranted.

Hybrid Cloud Computing Architecture Optimization by Total Cost of Ownership Criterion

Directory of Open Access Journals (Sweden)

Elena Valeryevna Makarenko

2014-12-01

Full Text Available Achieving the goals of information security is a key factor in the decision to outsource information technology and, in particular, to decide on the migration of organizational data, applications, and other resources to the infrastructure, based on cloud computing. And the key issue in the selection of optimal architecture and the subsequent migration of business applications and data to the cloud organization information environment is the question of the total cost of ownership of IT infrastructure. This paper focuses on solving the problem of minimizing the total cost of ownership cloud.

Minimizing total costs of forest roads with computer-aided design ...

Indian Academy of Sciences (India)

imum total road costs, while conforming to design specifications, environmental ..... quality, and enhancing fish and wildlife habitat, an appropriate design ..... Soil, Water and Timber Management: Forest Engineering Solutions in Response to.

Comparative cost analyses: total flow vs other power conversion systems for the Salton Sea Geothermal Resource

Energy Technology Data Exchange (ETDEWEB)

Wright, G.W.

1978-09-18

Cost studies were done for Total Flow, double flash, and multistage flash binary systems for electric Energy production from the Salton Sea Geothermal Resource. The purpose was to provide the Department of energy's Division of Geothermal Energy with information by which to judge whether to continue development of the Total Flow system. Results indicate that the Total Flow and double flash systems have capital costs of $1,135 and $1,026 /kW with energy costs of 40.9 and 39.7 mills/kW h respectively. The Total Flow and double flash systems are not distinguishable on a cost basis alone; the multistage flash binary system, with capital cost of $1,343 /kW and energy cost of 46.9 mills/kW h, is significantly more expensive. If oil savings are considered in the total analysis, the Total Flow system could save 30% more oil than the double flash system, $3.5 billion at 1978 oil prices.

50 CFR 85.40 - Cost sharing.

Science.gov (United States)

2010-10-01

... Use/Acceptance of Funds § 85.40 Cost sharing. (a) The Federal share shall not exceed 75% of total... grant objectives and represent the current market value of noncash contributions furnished as part of...

The impact of federalism on the healthcare system in terms of efficiency, equity, and cost containment: the case of Switzerland.

Science.gov (United States)

Crivelli, Luca; Salari, Paola

2014-01-01

According to the economic theory of federalism (Oates 1999), a decentralized decision to collectively fund and supply the quantity and quality of public services will increase economic welfare as long as three conditions are fulfilled: preferences and production costs of the different local constituencies are heterogeneous; local governments are better informed than the central agency because of their proximity to the citizens; and the competition between local governments exerts a significant impact on the performance of the local administration and on the ability of public agencies to implement policy innovation. Federalism also presents some negative aspects, including the opportunity costs of decentralization, which materialize in terms of unexploited economies of scale; the emergence of spillover effects among jurisdictions; and the risk of cost-shifting exercises from one layer of the government to the other. Finally, competition between fiscal regimes can affect the level of equity. The literature considers fiscal federalism as a mechanism for controlling the size of the public sector and for constraining the development of redistributive measures. The present paper reviews the impact that federalism has on the efficiency, equity, and cost containment of the healthcare system in Switzerland, a country with a strongly decentralized political system that is based on federalism and the institutions of direct democracy, a liberal economic culture, and a well-developed tradition of mutualism and social security (generous social expenditure and welfare system). By analyzing the empirical evidence available for Switzerland, we expect to draw some general policy lessons that might also be useful for other countries.

[Preliminary analysis of total cost and life quality for elder patients with femoral neck fracture].

Science.gov (United States)

Liu, Haonan; He, Liang; Zhang, Guilin; Gong, Xiaofeng; Li, Ning

2015-09-01

To analyze the total cost and life quality of the femoral neck fracture patients who received different surgery and supplement comprehensive data of osteoporotic fracture. One hundred and five patients above 60-year old who were diagnosed femoral neck fracture and received operation in Department of Orthopedics ＆ Traumatology, Beijing Jishuitan Hospital were admitted into our study from August 2013 to December. According to the type of surgery there were 52 and 53 cases in internal fixation (IF) group and hemiarthroplasty (HA) group respectively. At first we collected the medical expense of the patients before and during hospitalization. And then the 1-year medical and non-medical expenses were collected by the cost diary ever 3 months after discharge. At the last follow-up we evaluated the life quality by the EuroQol-5 Dimensions (EQ-5D) and calculated the total cost. Outcome All the patients completed the operation successfully. No nonunion or delayed union cases in IF group, and no cases received revision surgery in both groups. The total average cost was 59 584.9 yuan including 79.1% medical cost and 20.9% non-medical cost. The primary treatment cost accounts for 84.1% of the medical cost. The cost for home care accounts for 90.7% of the non-medical care. The total and medical cost of IF group just account for 40.3% and 38.5% of the HA group and the non-medical showed no significant difference between the 2 groups (P>0.05). In addition the data of life quality and walking capability also showed no significant difference. The main cost for the femoral neck fracture is medical expense in 1-year follow-up. Both surgeries can provide satisfactory outcome, however IF may be more cost-effective compared to the HA because of the less total cost.

Key Aspects of the Federal Direct Loan Program's Cost Estimates: Department of Education. Report to Congressional Requesters.

Science.gov (United States)

Calbom, Linda M.; Ashby, Cornelia M.

Because of concerns about the Department of Education's reliance on estimates to project costs of the William D. Ford Federal Direct Loan Program (FDLP) and a lack of historical information on which to base those estimates, Congress asked the General Accounting Office (GAO) to review how the department develops its cost estimates for the program,…

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.

Reduction of Total Ownership Costs (R-TOC) Best Practices Guide

National Research Council Canada - National Science Library

Reed, Danny

2003-01-01

The purpose of the Reduction of Total Ownership Costs (R-TOC) program is to achieve readiness improvements in weapon systems by improving the reliability of the systems or the efficiency of the processes used to support...

evaluation of total annual costs of heat exchanger networks using

African Journals Online (AJOL)

user

after solving the first problem using RPA based heat integration gave a minimum total annual cost (TAC) of $237, ... mathematical programming and non-RPA based Hint software. ... The concept of pinch analysis evolved over the years.

Transportation Infrastructure: Managing the Costs of Large-Dollar Highway Projects

Science.gov (United States)

1997-02-01

The General Accounting Office (GAO) was requested to assess the effectiveness of the Federal Highway Administration's (FHWA's) oversight of the costs of large-dollar highway and bridge projects (those with a total estimated cost of over $100 million)...

48 CFR 9904.406 - Cost accounting standard-cost accounting period.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Cost accounting standard-cost accounting period. 9904.406 Section 9904.406 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT...

78 FR 8526 - Information Collection Being Reviewed by the Federal Communications Commission

Science.gov (United States)

2013-02-06

..., Federal Communications Commission, via the Internet at [email protected] . To submit your PRA comments... benefits. Total Annual Burden: 12,000 hours. Total Annual Cost: $600,000. Privacy Act Impact Assessment: N... frequencies to avoid interference. Without a database, there would be no record of WMTS usage because WMTS...

Clinical benefit and cost effectiveness of total knee arthroplasty in the older patient

Directory of Open Access Journals (Sweden)

Krummenauer F

2009-02-01

Full Text Available Abstract Purpose Total knee arthroplasty (TKA is an effective, but also cost-intensive health care procedure for the elderly. Furthermore, bearing demographic changes in Western Europe in mind, TKA-associated financial investment for health care insurers will increase notably and thereby catalyze discussions on ressource allocation to Orthopedic surgery. To derive a quantitative rationale for such discussions within Western Europe's health care systems, a prospective assessment of both the benefit of TKA from a patient's perspective as well as its cost effectiveness from a health care insurer's perspective was implemented. Methods A prospective cost effectiveness trial recruited a total of 65 patients (60% females, who underwent TKA in 2006; median age of patients was 66 years (interquartile range 61 - 74 years. Before and three months after surgery patients were interviewed by means of the EuroQol-5D and the WOMAC questionnaires to assess their individual benefit due to TKA and the subsequent inpatient rehabilitation. Both questionnaires' benefit estimates were transformed into the number of gained quality adjusted life years [QALYs]. Total direct cost estimates for the overall care were based on German DRG and rehabilitation cost rates [€]. The primary clinical endpoint of the investigation was the individual number of QALYs gained by TKA based on the WOMAC interview; the primary health economic endpoint was the marginal cost effectiveness ratio (MCER relating the costs to the associated gain in quality of life [€/QALY]. Results Total direct costs for the overall procedure were estimed 9549 € in median. The WOMAC based interview revealed an overall gain of 4.59 QALYs (interquartile range 2.39 - 6.21 QALYs, resulting in marginal costs of 1795 €/QALY (1488 - 3288 €/QALY. The corresponding EuroQol based estimates were 2.93 QALYs (1.75 - 5.59 QALYs and 3063 €/QALY (1613 - 5291 €/QALY. Logistic regression modelling identified the

Using value-based total cost of ownership (TCO) measures to inform subsystem trade-offs

Science.gov (United States)

Radziwill, Nicole M.; DuPlain, Ronald F.

2010-07-01

Total Cost of Ownership (TCO) is a metric from management accounting that helps expose both the direct and indirect costs of a business decision. However, TCO can sometimes be too simplistic for "make vs. buy" decisions (or even choosing between competing design alternatives) when value and extensibility are more critical than total cost. A three-dimensional value-based TCO, which was developed to clarify product decisions for an observatory prior to Final Design Review (FDR), will be presented in this session. This value-based approach incorporates priority of requirements, satisfiability of requirements, and cost, and can be easily applied in any environment.

Cost-effectiveness of positive contrast and nuclear arthrography in patients who underwent total hip arthroplasty

International Nuclear Information System (INIS)

Swan, J.S.; Braunstein, E.M.; Capello, W.; Wellman, H.

1989-01-01

The authors have compared the cost effectiveness of contrast arthrography (CA) and nuclear arthrography (NA), in which In-111 chloride is injected with the contrast material, of total hip arthroplasties. Their series included 48 cases of surgically proved loose femoral components. The cost per true-positive result was obtained by taking the total cost of the examinations in surgically proved cases and dividing by the number of true-position cases. The cost of CA was $297 and the cost of NA was $335. For CA, the cost per true positive was $1,018, and for the NA the cost per true positive was $946. In spite of higher initial cost, NA is more cost effective than CA on a cost per true-positive case basis. NA is cost effective in evaluating hip arthroplasties in which there is suspicion of a loose femoral component

The evaluation of the modernization cost of the transport infrastructure of the Northern Sea Route in the Arctic zone of the Russian Federation

Science.gov (United States)

Radushinsky, Dmitry; Mottaeva, Asiiat; Andreeva, Larisa; Dyakova, Galina

2017-10-01

The paper is aimed to figure out the cost of modernization of the transport infrastructure of the Northern Sea Route. Main unfavorable factors, such as fall in prices for energy resources and the necessity of the implementation of ecologically safe and energy efficient technologies are taken into account. It is estimated that the development of Northern Sea Route financial model should also reflect the of effect of introduction of sanctions against the Russian Federation since 2014. The systematize the current conditions for the implementation of the, a survey of expert has been conducted. The total amount of cost appreciation, according to experts, is estimated from 50 to 70% of the base amount of planned investments in different areas. This result could be taken into account while making a proposals to potential investors.

En differentieret tilgang til total cost of ownership (TCO)

DEFF Research Database (Denmark)

Zachariassen, Frederik

2010-01-01

Økonomistyring er en nødvendig brik i forsøget på at kunne styre dele af eller hele forsyningskæden, og til dette bruges diverse økonomistyringsværktøjer. Denne artikel omhandler økonomistyringsværktøjet 'total cost of ownership', og hvordan dette kan bruges til at forbedre samarbejdet med...

Custo do transplante hepático no Hospital de Clínicas da Universidade Federal do Paraná Cost of liver transplantation at the Clinical Hospital of the Federal University of Parana, Brazil

Directory of Open Access Journals (Sweden)

J.C.U. Coelho

1997-03-01

Full Text Available OBJETIVO. Determinar o custo do transplante hepático no Hospital de Clínicas da Universidade Federal do Paraná. MÉTODO. Os dados do prontuário de 24 pacientes submetidos a 25 transplantes hepáticos foram avaliados do dia da internação para o transplante hepático até a data da alta hospitalar ou óbito para determinar o número de dias de internação, o local de internação, a quantidade de material e medicamentos usados, os exames complementares e procedimentos realizados. Honorários médicos não foram incluídos no estudo. RESULTADOS. A idade dos pacientes variou de 6 a 56 anos, tendo seis deles menos que 14 anos de idade. Cinco pacientes foram a óbito durante a internação hospitalar. Retransplante foi realizado em somente um paciente. O custo médio da retirada do fígado do doador foi de US$ 2,783.19. O custo total do transplante hepático variou amplamente entre os pacientes, na dependência de ocorrência de complicações pós-operatórias, do número de dias de internação hospitalar e da quantidade de transfusão de hemoderivados. O custo total variou de US$ 6,359.84 a US$ 75,434.18, com média de US$ 21,505.53. O item mais caro do transplante hepático foi o custo com a hemoterapia, seguido do custo com medicamentos e diária hospitalar. CONCLUSÃO. O custo do transplante hepático varia muito entre os pacientes e pode ser realizado no Brasil a um custo inferior ao relatado nos Estados Unidos e na Europa.PURPOSE - To determine the cost of liver transplantation at the Clinical Hospital of the Federal University of Parana. METHODS - The data of 24 patients subjected to 25 liver transplantations were evaluated from the day of hospital admission until the day of discharge to determine the length of hospitalization, quantity of material and medications used, and exams and procedures performed. Professional fees were not included in the study. RESULTS - The age of the patients varied from 6 to 56 years. Six patients were

Federalism, the economic-industrial health care complex and high-cost pharmaceutical assistance in Brazil.

Science.gov (United States)

da Fonseca, Elize Massard; Costa, Nilson do Rosario

2015-04-01

Brazil has a relevant, although relatively unknown, special medicines programme that distributes high-cost products, such as drugs needed for cancer treatments. In 2009, the purchase of these medicines became the responsibility of the Brazilian Federal Government. Until then, there were no clear norms regarding the responsibilities, in terms of the management/financing of these medicines, of the Brazilian Federal Government and of the states themselves. This qualitative study analyses the policy process needed to transfer this programme to the central government. The study examines the reports of the Tripartite Commission between 2000 and 2012, and in-depth interviews with eleven key informants were conducted. The study demonstrates that throughout the last decade, institutional changes have been made in regard to the federal management of these programmes (such as recentralisation of the purchasing of medicines). It concludes that these changes can be explained because of the efficiency of the coordinating mechanisms of the Federal Government. These findings reinforce the idea that the Ministry of Health is the main driver of public health policies, and it has opted for the recentralisation of activities as a result of the development project implicit in the agenda of the Industrial and Economic Heal.

The Relationship between Cost Leadership Strategy, Total Quality Management Applications and Financial Performance

Directory of Open Access Journals (Sweden)

Ali KURT

2016-03-01

Full Text Available Firms need to implement some competition strategies and total quality management applications to overcome the fierce competition among others. The purpose of this study is to show the relationship between cost leadership strategy, total quality management applications and firms’ financial performance with literature review and empirical analysis. 449 questionnaires were conducted to the managers of 142 big firms. The data gathered was assessed with AMOS. As a result, the relationship between cost leadership strategy, total quality management applications and firms’ financial performance has been gathered. In addition, the relationship between TQM applications and financial performance has also been gathered.

ANALYSIS OF CHP POTENTIAL AT FEDERAL SITES

Energy Technology Data Exchange (ETDEWEB)

HADLEY, S.W.

2002-03-11

of these criteria. Executive Order 13123 directs federal facilities to use CHP when life-cycle costs indicate energy reduction goals will be met. FEMP can assist facilities to conduct this analysis. The model developed for this report estimates the magnitude of CHP that could be implemented under various performance and economic assumptions associated with different applications. This model may be useful for other energy technologies. It can be adapted to estimate the market potential in federal buildings for any energy system based on the cost and performance parameters that a user desires to assess. The model already incorporates a standard set of parameters based on available data for federal buildings including total building space, building type, energy use intensity, fuel costs, and the performance of many prime movers commonly used in CHP applications. These and other variables can be adjusted to meet user needs or updated in the future as new data become available.

Total hip arthroplasty revision due to infection: a cost analysis approach.

Science.gov (United States)

Klouche, S; Sariali, E; Mamoudy, P

2010-04-01

The treatment of total hip arthroplasty (THA) infections is long and costly. However,the number of studies in the literature analysing the real cost of THA revision in relation to their etiology, including infection, is limited. The aim of this retrospective study was to determine the cost of revision of infected THA and to compare these costs to those of primary THA and revision of non-infected THA. We performed a retrospective cost analysis for the year 2006 using an identical analytic accounting system in each hospital department (according to internal criteria) based on allotment of direct costs and receipts for each department. From January to December 2006, 424 primary THA, 57 non-infected THA revisions and 40 THA revisions due to infection were performed. The different cost areas of the patient's treatment were identified.This included preoperative medical work-up, medicosurgical management during hospital stay,a second stay in an orthopedic rehabilitation hospital (ORH) and post-hospitalisation antibiotic therapy after revision due to infection, as well as home-based hospitalisation (HH) costs, if this was the selected alternative option. We used the national health insurance fee schedule found in the "Common classification of medical procedures" and the "General nomenclature of professional procedures" applicable in France since September 1, 2005. Hospital costs included direct costs (hospital overhead costs) and indirect costs, (medical, surgical, technical settings and net general service expenses). The calculation of HH costs and ORH costs were based on the average daily charge of these departments. The cost of primary THA was used as the reference.We then compared our surgical costs with those found for the corresponding comparable hospital stay groups (Groupes homogènes de séjour). The average hospital stay (AHS) was 7.5 +/- 1.8 days for primary THA, 8.9 +/- 2.2 days for non-infected revisions and 30.6 +/- 14.9 days for revisions due to infection

Supplier managed inventory in the OEM supply chain : the impact of relationship types on total costs and cost distribution

NARCIS (Netherlands)

Nyen, van P.L.M.; Bertrand, J.W.M.; Ooijen, van H.P.G.; Vandaele, N.J.

2009-01-01

We investigate the impact of four variants of supplier managed inventory on total costs and cost distribution in a capital goods supply chain consisting of a parts supplier who delivers parts to an original equipment manufacturer’s assembly plant. The four supplier managed inventory variants differ

Permanent magnet design for magnetic heat pumps using total cost minimization

Science.gov (United States)

Teyber, R.; Trevizoli, P. V.; Christiaanse, T. V.; Govindappa, P.; Niknia, I.; Rowe, A.

2017-11-01

The active magnetic regenerator (AMR) is an attractive technology for efficient heat pumps and cooling systems. The costs associated with a permanent magnet for near room temperature applications are a central issue which must be solved for broad market implementation. To address this problem, we present a permanent magnet topology optimization to minimize the total cost of cooling using a thermoeconomic cost-rate balance coupled with an AMR model. A genetic algorithm identifies cost-minimizing magnet topologies. For a fixed temperature span of 15 K and 4.2 kg of gadolinium, the optimal magnet configuration provides 3.3 kW of cooling power with a second law efficiency (ηII) of 0.33 using 16.3 kg of permanent magnet material.

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

International Nuclear Information System (INIS)

1985-04-01

The total-system life-cycle cost (TSLCC) analysis for the Department of Energy's Civilian Radioactive Waste Management Progrram is an ongoing activity that helps determine whether the revenue-producing mechanism established by the Nuclear Waste Policy Act of 1982 is sufficient to cover the cost of the program. This report is an input into the third evaluation of the adequacy of the fee. The total-system cost for the reference waste-management program in this analysis is estimated to be 24 to 30 billion (1984) dollars. For the sensitivity cases studied in this report, the costs could be as high as 35 billion dollars and as low as 21 billion dollars. Because factors like repository location, the quantity of waste generated, transportation-cask technology, and repository startup dates exert substantial impacts on total-system costs, there are several tradeoffs between these factors, and these tradeoffs can greatly influence the total cost of the program. The total-system cost for the reference program described in this report is higher by 3 to 5 billion dollars, or 15 to 20%, than the cost for the reference program of the TSLCC analysis of April 1984. More than two-thirds of this increase is in the cost of repository construction and operation. These repository costs have increased because of changing design concepts, different assumptions about the effort required to perform the necessary activities, and a change in the source data on which the earlier analysis was based. Development and evaluation costs have similarly increased because of a net addition to the work content. Transportation costs have increased because of different assumptions about repository locations and several characteristics of the transportation system. It is expected that the estimates of total-system costs will continue to change in response to both an evolving program strategy and better definition of the work required to achieve the program objectives

75 FR 33987 - Disposing of Unneeded Federal Real Estate Increasing Sales Proceeds, Cutting Operating Costs, and...

Science.gov (United States)

2010-06-16

... operations and maintenance costs. Past attempts at reducing the Federal Government's civilian real property..., save energy and water, and further reduce greenhouse gas pollution, I hereby direct executive... eliminating all forms of Government waste and to leading by example as our Nation transitions to a clean...

Student Loan Programs. As Federal Costs of Loan Consolidation Rise, Other Options Should be Examined. Report to Congressional Requesters.

Science.gov (United States)

General Accounting Office, Washington, DC.

In this report GAO recommends that the Secretary of Education assess the advantages of consolidation loans for borrowers and the government in light of program costs and identify options for reducing federal costs. Options could include targeting the program to borrowers at risk of default and extending existing consolidation alternatives to more…

evaluation of total annual costs of heat exchanger networks using

African Journals Online (AJOL)

This study presents pinch analysis of some heat exchanger networks (HENs) problems using Hint integration (HINT) software. Three examples reported to have been solved using different approaches by various researchers to obtain the least possible total annual cost (TAC) were solved using the Hint software. In this work ...

Total cost estimates for large-scale wind scenarios in UK

International Nuclear Information System (INIS)

Dale, Lewis; Milborrow, David; Slark, Richard; Strbac, Goran

2004-01-01

The recent UK Energy White Paper suggested that the Government should aim to secure 20% of electricity from renewable sources by 2020. A number of estimates of the extra cost of such a commitment have been made, but these have not necessarily included all the relevant cost components. This analysis sets out to identify these and to calculate the extra cost to the electricity consumer, assuming all the renewable electricity is sourced from wind energy. This enables one of the more controversial issues--the implications of wind intermittency--to be addressed. The basis of the assumptions associated with generating costs, extra balancing costs and distribution and transmission system reinforcement costs are all clearly identified and the total costs of a '20% wind' scenario are compared with a scenario where a similar amount of energy is generated by gas-fired plant. This enables the extra costs of the renewables scenario to be determined. The central estimate of the extra costs to electricity consumers is just over 0.3 p/kW h in current prices (around 5% extra on average domestic unit prices). Sensitivity analyses examine the implications of differing assumptions. The extra cost would rise if the capital costs of wind generation fall slower than anticipated, but would fall if gas prices rise more rapidly than has been assumed, or if wind plant are more productive. Even if it is assumed that wind has no capacity displacement value, the added cost to the electricity consumer rises by less than 0.1 p/kW h. It is concluded that there does not appear to be any technical reason why a substantial proportion of the country's electricity requirements could not be delivered by wind

Impact Of Health Care Delivery System Innovations On Total Cost Of Care.

Science.gov (United States)

Smith, Kevin W; Bir, Anupa; Freeman, Nikki L B; Koethe, Benjamin C; Cohen, Julia; Day, Timothy J

2017-03-01

Using delivery system innovations to advance health care reform continues to be of widespread interest. However, it is difficult to generalize about the success of specific types of innovations, since they have been examined in only a few studies. To gain a broader perspective, we analyzed the results of forty-three ambulatory care programs funded by the first round of the Center for Medicare and Medicaid Innovation's Health Care Innovations Awards. The innovations' impacts on total cost of care were estimated by independent evaluators using multivariable difference-in-differences models. Through the first two years, most of the innovations did not show a significant effect on total cost of care. Using meta-regression, we assessed the effects on costs of five common components of these innovations. Innovations that used health information technology or community health workers achieved the greatest cost savings. Savings were also relatively large in programs that targeted clinically fragile patients-clinically complex populations at risk for disease progression. While the magnitude of these effects was often substantial, none achieved conventional levels of significance in our analyses. Meta-analyses of a larger number of delivery system innovations are needed to more clearly establish their potential for patient care cost savings. Project HOPE—The People-to-People Health Foundation, Inc.

The adoption of total cost of ownership for sourcing decisions - a structural equations analysis

NARCIS (Netherlands)

Wouters, Marc; Anderson, James C.; Wynstra, Finn

2005-01-01

This study investigates the adoption of total cost of ownership (TCO) analysis to improve sourcing decisions. TCO can be seen as an application of activity based costing (ABC) that quantifies the costs that are involved in acquiring and using purchased goods or services. TCO supports purchasing

Primary vs Conversion Total Hip Arthroplasty: A Cost Analysis

Science.gov (United States)

Chin, Garwin; Wright, David J.; Snir, Nimrod; Schwarzkopf, Ran

2018-01-01

Introduction Increasing hip fracture incidence in the United States is leading to higher occurrences of conversion total hip arthroplasty (THA) for failed surgical treatment of the hip. In spite of studies showing higher complication rates in conversion THA, the Centers for Medicare and Medicaid services currently bundles conversion and primary THA under the same diagnosis-related group. We examined the cost of treatment of conversion THA compared with primary THA. Our hypothesis is that conversion THA will have higher cost and resource use than primary THA. Methods Fifty-one consecutive conversion THA patients (Current Procedure Terminology code 27132) and 105 matched primary THA patients (Current Procedure Terminology code 27130) were included in this study. The natural log-transformed costs for conversion and primary THA were compared using regression analysis. Age, gender, body mass index, American Society of Anesthesiologist, Charlson comorbidity score, and smoker status were controlled in the analysis. Conversion THA subgroups formed based on etiology were compared using analysis of variance analysis. Results Conversion and primary THAs were determined to be significantly different (P conversion THA has significantly greater cost and resource use than primary THA. In order to prevent disincentives for treating these complex surgical patients, reclassification of conversion THA is needed, as they do not fit together with primary THA. PMID:26387923

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.

48 CFR 9904.414 - Cost accounting standard-cost of money as an element of the cost of facilities capital.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Cost accounting standard... Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING...

75 FR 46936 - Notice of Public Information Collection(s) Being Reviewed by the Federal Communications...

Science.gov (United States)

2010-08-04

... roamers whose equipment conforms to the Advanced Mobile Phone Service (AMPS) standard. This requirement... the Internet at [email protected] and to the Federal Communications Commission via email.... Total Annual Burden: 2,832 hours. Total Annual Cost: N/A. Privacy Act Impact Assessment: N/A. Nature and...

Time-driven activity based costing of total knee replacement surgery at a London teaching hospital.

Science.gov (United States)

Chen, Alvin; Sabharwal, Sanjeeve; Akhtar, Kashif; Makaram, Navnit; Gupte, Chinmay M

2015-12-01

The aim of this study was to conduct a time-driven activity based costing (TDABC) analysis of the clinical pathway for total knee replacement (TKR) and to determine where the major cost drivers lay. The in-patient pathway was prospectively mapped utilising a TDABC model, following 20 TKRs. The mean age for these patients was 73.4 years. All patients were ASA grade I or II and their mean BMI was 30.4. The 14 varus knees had a mean deformity of 5.32° and the six valgus knee had a mean deformity of 10.83°. Timings were prospectively collected as each patient was followed through the TKR pathway. Pre-operative costs including pre-assessment and joint school were £ 163. Total staff costs for admission and the operating theatre were £ 658. Consumables cost for the operating theatre were £ 1862. The average length of stay was 5.25 days at a total cost of £ 910. Trust overheads contributed £ 1651. The overall institutional cost of a 'noncomplex' TKR in patients without substantial medical co-morbidities was estimated to be £ 5422, representing a profit of £ 1065 based on a best practice tariff of £ 6487. The major cost drivers in the TKR pathway were determined to be theatre consumables, corporate overheads, overall ward cost and operating theatre staffing costs. Appropriate discounting of implant costs, reduction in length of stay by adopting an enhanced recovery programme and control of corporate overheads through the use of elective orthopaedic treatment centres are proposed approaches for reducing the overall cost of treatment. Copyright © 2015 Elsevier B.V. All rights reserved.

Cost of Radiotherapy Versus NSAID Administration for Prevention of Heterotopic Ossification After Total Hip Arthroplasty

International Nuclear Information System (INIS)

Strauss, Jonathan B.; Chen, Sea S.; Shah, Anand P.; Coon, Alan B.; Dickler, Adam

2008-01-01

Purpose: Heterotopic ossification (HO), or abnormal bone formation, is a common sequela of total hip arthroplasty. This abnormal bone can impair joint function and must be surgically removed to restore mobility. HO can be prevented by postoperative nonsteroidal anti-inflammatory drug (NSAID) use or radiotherapy (RT). NSAIDs are associated with multiple toxicities, including gastrointestinal bleeding. Although RT has been shown to be more efficacious than NSAIDs at preventing HO, its cost-effectiveness has been questioned. Methods and Materials: We performed an analysis of the cost of postoperative RT to the hip compared with NSAID administration, taking into account the costs of surgery for HO formation, treatment-induced morbidity, and productivity loss from missed work. The costs of RT, surgical revision, and treatment of gastrointestinal bleeding were estimated using the 2007 Medicare Fee Schedule and inpatient diagnosis-related group codes. The cost of lost wages was estimated using the 2006 median salary data from the U.S. Census Bureau. Results: The cost of administering RT was estimated at $899 vs. $20 for NSAID use. After accounting for the additional costs associated with revision total hip arthroplasty and gastrointestinal bleeding, the corresponding estimated costs were $1,208 vs. $930. Conclusion: If the costs associated with treatment failure and treatment-induced morbidity are considered, the cost of NSAIDs approaches that of RT. Other NSAID morbidities and quality-of-life differences that are difficult to quantify add to the cost of NSAIDs. These considerations have led us to recommend RT as the preferred modality for use in prophylaxis against HO after total hip arthroplasty, even when the cost is considered

Time-based analysis of total cost of patient episodes: a case study of hip replacement.

Science.gov (United States)

Peltokorpi, Antti; Kujala, Jaakko

2006-01-01

Healthcare in the public and private sectors is facing increasing pressure to become more cost-effective. Time-based competition and work-in-progress have been used successfully to measure and improve the efficiency of industrial manufacturing. Seeks to address this issue. Presents a framework for time based management of the total cost of a patient episode and apply it to the six sigma DMAIC-process development approach. The framework is used to analyse hip replacement patient episodes in Päijät-Häme Hospital District in Finland, which has a catchment area of 210,000 inhabitants and performs an average of 230 hip replacements per year. The work-in-progress concept is applicable to healthcare--notably that the DMAIC-process development approach can be used to analyse the total cost of patient episodes. Concludes that a framework, which combines the patient-in-process and the DMAIC development approach, can be used not only to analyse the total cost of patient episode but also to improve patient process efficiency. Presents a framework that combines patient-in-process and DMAIC-process development approaches, which can be used to analyse the total cost of a patient episode in order to improve patient process efficiency.

12 CFR Appendix K to Part 226 - Total Annual Loan Cost Rate Computations for Reverse Mortgage Transactions

Science.gov (United States)

2010-01-01

... Appendix K to Part 226—Total Annual Loan Cost Rate Computations for Reverse Mortgage Transactions (a... loan cost rate for various transactions, as well as instructions, explanations, and examples for.... (2) Term of the transaction. For purposes of total annual loan cost disclosures, the term of a...

Preliminary estimates of the total-system cost for the restructured program: An addendum to the May 1989 analysis of the total-system life cycle cost for the Civilian Radioactive Waste Management Program

International Nuclear Information System (INIS)

1990-12-01

The total-system life-cycle cost (TSLCC) analysis for the Department of Energy's (DOE) Civilian Radioactive Waste Management Program is an ongoing activity that helps determine whether the revenue-producing mechanism established by the Nuclear Waste Policy Act of 1982 - a fee levied on electricity generated and sold by commercial nuclear power plants - is sufficient to cover the cost of the program. This report provides cost estimates for the sixth annual evaluation of the adequacy of the fee. The costs contained in this report represent a preliminary analysis of the cost impacts associated with the Secretary of Energy's Report to Congress on Reassessment of the Civilian Radioactive Waste Management Program issued in November 1989. The major elements of the restructured program announced in this report which pertain to the program's life-cycle costs are: a prioritization of the scientific investigations program at the Yucca Mountain candidate site to focus on identification of potentially adverse conditions, a delay in the start of repository operations until 2010, the start of limited waste acceptance at the monitored retrievable storage (MRS) facility in 1998, and the start of waste acceptance at the full-capability MRS facility in 2,000. Based on the restructured program, the total-system cost for the system with a repository at the candidate site at Yucca Mountain in Nevada, a facility for monitored retrievable storage (MRS), and a transportation system is estimated at $26 billion (expressed in constant 1988 dollars). In the event that a second repository is required and is authorized by the Congress, the total-system cost is estimated at $34 to $35 billion, depending on the quantity of spent fuel and high-level waste (HLW) requiring disposal. 17 figs., 17 tabs

48 CFR 9904.411 - Cost accounting standard-accounting for acquisition costs of material.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Cost accounting standard-accounting for acquisition costs of material. 9904.411 Section 9904.411 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND...

Total inpatient treatment costs in patients with severe burns: towards a more accurate reimbursement model.

Science.gov (United States)

Mehra, Tarun; Koljonen, Virve; Seifert, Burkhardt; Volbracht, Jörk; Giovanoli, Pietro; Plock, Jan; Moos, Rudolf Maria

2015-01-01

Reimbursement systems have difficulties depicting the actual cost of burn treatment, leaving care providers with a significant financial burden. Our aim was to establish a simple and accurate reimbursement model compatible with prospective payment systems. A total of 370 966 electronic medical records of patients discharged in 2012 to 2013 from Swiss university hospitals were reviewed. A total of 828 cases of burns including 109 cases of severe burns were retained. Costs, revenues and earnings for severe and nonsevere burns were analysed and a linear regression model predicting total inpatient treatment costs was established. The median total costs per case for severe burns was tenfold higher than for nonsevere burns (179 949 CHF [167 353 EUR] vs 11 312 CHF [10 520 EUR], interquartile ranges 96 782-328 618 CHF vs 4 874-27 783 CHF, p <0.001). The median of earnings per case for nonsevere burns was 588 CHF (547 EUR) (interquartile range -6 720 - 5 354 CHF) whereas severe burns incurred a large financial loss to care providers, with median earnings of -33 178 CHF (30 856 EUR) (interquartile range -95 533 - 23 662 CHF). Differences were highly significant (p <0.001). Our linear regression model predicting total costs per case with length of stay (LOS) as independent variable had an adjusted R2 of 0.67 (p <0.001 for LOS). Severe burns are systematically underfunded within the Swiss reimbursement system. Flat-rate DRG-based refunds poorly reflect the actual treatment costs. In conclusion, we suggest a reimbursement model based on a per diem rate for treatment of severe burns.

48 CFR 9905.501 - Cost accounting standard-consistency in estimating, accumulating and reporting costs by...

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Cost accounting standard....501 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST...

Cost-effectivness analysis of total thyroidectomy vs radioiodine for Graves disease

Directory of Open Access Journals (Sweden)

Prokić Anđelka

2013-01-01

Full Text Available Among the patients suffering from hyperthyroidism 60-80% have Graves' disease. The initial therapy of Graves's disease are antithyroid drugs. If the remission is not achieved after 12-18 months, the patients should be directed to surgical treatment or to the therapy with radioactive iodine. The aim of this study was to compare cost/effectiveness ratios for radioactive iodine and total thyroidectomy. The analysis was made using Markov model, from the perspective of Republic Fund for Health Insurance in Serbia. Duration of one cycle in the model is six months, and the time horizon is 30 years. Monte Carlo simulation was performed for 1000 virtual patients as well as the analysis of sensitivity with the variation of parameters ± 50%. For total thyroidectomy the insurance should provide 138.389,72 RSD / 57, 83 QALY i.e. 2.393,04 dinars for one quality-adjusted life year, and for radioactive iodine the insurance should provide 110.043,64 RSD / 57,82 QALY i.e. 1.903,37 dinars for one quality-adjusted life year. This economic analysis showed that radioactive iodine has better ratio of costs to clinical effectiveness as opposed to total thyroidectomy.

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

International Nuclear Information System (INIS)

1989-05-01

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

Total cost of ownership in the services sector: A case study

NARCIS (Netherlands)

K. Hurkens (Krisje); W. van der Valk (Wendy); J.Y.F. Wynstra (Finn)

2006-01-01

textabstractFew detailed studies exist of the trade-offs to be made when developing a comprehensive, strategically focused total cost of ownership (TCO) model. Moreover, most studies of TCO have been conducted in manufacturing firms, with little or no TCO research directed toward service

49 CFR 268.7 - Federal/State share and restrictions on the uses of Federal Maglev Funds.

Science.gov (United States)

2010-10-01

... of Federal Maglev Funds. 268.7 Section 268.7 Transportation Other Regulations Relating to... Federal Maglev Funds. (a) Federal share. The Federal share of Full Projects Costs shall be not more than 2...) Restrictions on the uses of Federal Maglev Funds. (1) Federal Maglev Funds may be applied only to Eligible...

Changes in Federal Water Project Repayment Policies Can Reduce Federal Costs.

Science.gov (United States)

1981-08-07

a reimburs - able purpose, the users should share in cost recovery. RECOMMENDATIONS To provide for equitable cost reimbursement on underutilized...Department of the Interior’s Bureau of Reclamation that do not ensure fair and timely recovery of water projects’ reimbursable costs. We made this...such costs for reimbursable project purposes and considering them in future water price determinations, agencies often reas- signed them to

The total lifetime costs of smoking

DEFF Research Database (Denmark)

Rasmussen, S.R.; Prescott, E.; Sørensen, T.I.A.

2004-01-01

Net costs of smoking in a lifetime perspective and, hence, the economic interests in antismoking policies have been questioned. It has been proposed that the health-related costs of smoking are balanced by smaller expenditure due to shorter life expectancy.......Net costs of smoking in a lifetime perspective and, hence, the economic interests in antismoking policies have been questioned. It has been proposed that the health-related costs of smoking are balanced by smaller expenditure due to shorter life expectancy....

Project schedule and cost estimate report

International Nuclear Information System (INIS)

1988-03-01

All cost tables represent obligation dollars, at both a constant FY 1987 level and an estimated escalation level, and are based on the FY 1989 DOE Congressional Budget submittal of December 1987. The cost tables display the total UMTRA Project estimated costs, which include both Federal and state funding. The Total Estimated Cost (TEC) for the UMTRA Project is approximately $992.5 million (in 1987 escalated dollars). Project schedules have been developed that provide for Project completion by September 1994, subject to Congressional approval extending DOE's authorization under Public Law 95-604. The report contains site-specific demographic data, conceptual design assumptions, preliminary cost estimates, and site schedules. A general project overview is also presented, which includes a discussion of the basis for the schedule and cost estimates, contingency assumptions, work breakdown structure, and potential project risks. The schedules and cost estimates will be revised as necessary to reflect appropriate decisions relating to relocation of certain tailings piles, or other special design considerations or circumstances (such as revised EPA groundwater standards), and changes in the Project mission. 27 figs', 97 tabs

Striking the Right Balance: Federal Infrastructure Transfer Programs, 2002–2015

Directory of Open Access Journals (Sweden)

Bev Dahlby

2015-11-01

Full Text Available Over the last 13 years, the federal government has helped fund a wide array of infrastructure programs: A total of 8,012 projects across the country between 2002 and 2015, funded to the tune of $20.3 billion. A substantial portion of that was done in the name of recession “stimulus.” But far from all of it. And, for better or worse, federal programs have become a permanent feature of fiscal federalism. The only question now is, whether Ottawa has been spending federal taxpayer money as effectively as possible when it does fund these projects. As it turns out, federal handouts for projects in Canadian provinces and municipalities have been relatively well deployed. An analysis finds that a greater amount of federal matching funds were dedicated to projects where provinces faced a higher marginal cost of public funds than the federal government, helping to at least somewhat minimize the negative economic impacts of the additional tax burden. And that a greater amount of funds was dedicated to projects that enhanced economic productivity, such as transit and roads, which increase the probability for national spillover benefits due to the potential for increased federal tax revenue, unlike quality-oflife projects (such as recreation projects that do not. However, the persistent fiscal imbalance in the provinces’ and the federal government’s marginal cost of raising public funds can only continue to exacerbate the demands from provinces for federal matching funds. Despite federal fiscal equalization programs that provide transfers to provinces with below-average per capita tax bases, there remain notable horizontal fiscal imbalances across the provinces, and a vertical imbalance between lower and higher government levels. Recent estimates calculate the federal government’s marginal cost to be 1.17, compared to a range of 1.41 for Alberta to 3.60 for Ontario, more than three times as high as the federal government’s cost. There are already

Self-reported Function, Health Resource Use, and Total Health Care Costs Among Medicare Beneficiaries With Glaucoma.

Science.gov (United States)

Prager, Alisa J; Liebmann, Jeffrey M; Cioffi, George A; Blumberg, Dana M

2016-04-01

The effect of glaucoma on nonglaucomatous medical conditions and resultant secondary health care costs is not well understood. To assess self-reported medical conditions, the use of medical services, and total health care costs among Medicare beneficiaries with glaucoma. Longitudinal observational study of 72,587 Medicare beneficiaries in the general community using the Medicare Current Beneficiary Survey (2004-2009). Coding to extract data started in January 2015, and analyses were performed between May and July 2015. Self-reported health, the use of health care services, adjusted mean annual total health care costs per person, and adjusted mean annual nonoutpatient costs per person. Participants were 72,587 Medicare beneficiaries 65 years or older with (n = 4441) and without (n = 68,146) a glaucoma diagnosis in the year before collection of survey data. Their mean age was 76.9 years, and 43.2% were male. Patients with glaucoma who responded to survey questions on visual disability were stratified into those with (n = 1748) and without (n = 2639) self-reported visual disability. Medicare beneficiaries with glaucoma had higher adjusted odds of inpatient hospitalizations (odds ratio [OR], 1.27; 95% CI, 1.17-1.39; P total health care costs and $2599 (95% CI, $1985-$3212; P total and nonoutpatient medical costs. Perception of vision loss among patients with glaucoma may be associated with depression, falls, and difficulty walking. Reducing the prevalence and severity of glaucoma may result in improvements in associated nonglaucomatous medical conditions and resultant reduction in health care costs.

48 CFR 9905.502 - Cost accounting standard-consistency in allocating costs incurred for the same purpose by...

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Cost accounting standard... 9905.502 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST...

48 CFR 9904.401 - Cost accounting standard-consistency in estimating, accumulating and reporting costs.

Science.gov (United States)

2010-10-01

... Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.401 Cost... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Cost accounting standard...

Bearing Procurement Analysis Method by Total Cost of Ownership Analysis and Reliability Prediction

Science.gov (United States)

Trusaji, Wildan; Akbar, Muhammad; Sukoyo; Irianto, Dradjad

2018-03-01

In making bearing procurement analysis, price and its reliability must be considered as decision criteria, since price determines the direct cost as acquisition cost and reliability of bearing determine the indirect cost such as maintenance cost. Despite the indirect cost is hard to identify and measured, it has high contribution to overall cost that will be incurred. So, the indirect cost of reliability must be considered when making bearing procurement analysis. This paper tries to explain bearing evaluation method with the total cost of ownership analysis to consider price and maintenance cost as decision criteria. Furthermore, since there is a lack of failure data when bearing evaluation phase is conducted, reliability prediction method is used to predict bearing reliability from its dynamic load rating parameter. With this method, bearing with a higher price but has higher reliability is preferable for long-term planning. But for short-term planning the cheaper one but has lower reliability is preferable. This contextuality can give rise to conflict between stakeholders. Thus, the planning horizon needs to be agreed by all stakeholder before making a procurement decision.

A METHOD OF THE MINIMIZING OF THE TOTAL ACQUISITIONS COST WITH THE INCREASING VARIABLE DEMAND

Directory of Open Access Journals (Sweden)

ELEONORA IONELA FOCȘAN

2015-12-01

Full Text Available Over time, mankind has tried to find different ways of costs reduction. This subject which we are facing more often nowadays, has been detailed studied, without reaching a general model, and also efficient, regarding the costs reduction. Costs reduction entails a number of benefits over the entity, the most important being: increase revenue and default to the profit, increase productivity, a higher level of services / products offered to clients, and last but not least, the risk mitigation of the economic deficit. Therefore, each entity search different modes to obtain most benefits, for the company to succeed in a competitive market. This article supports the companies, trying to make known a new way of minimizing the total cost of acquisitions, by presenting some hypotheses about the increasing variable demand, proving them, and development of formulas for reducing the costs. The hypotheses presented in the model described below, can be maximally exploited to obtain new models of reducing the total cost, according to the modes of the purchase of entities which approach it.

Efforts to Support Consumer Enrollment Decisions Using Total Cost Estimators: Lessons from the Affordable Care Act’s Marketplaces.

Science.gov (United States)

Giovannelli, Justin; Curran, Emily

2017-02-01

Issue: Policymakers have sought to improve the shopping experience on the Affordable Care Act’s marketplaces by offering decision support tools that help consumers better understand and compare their health plan options. Cost estimators are one such tool. They are designed to provide consumers a personalized estimate of the total cost--premium, minus subsidy, plus cost-sharing--of their coverage options. Cost estimators were available in most states by the start of the fourth open enrollment period. Goal: To understand the experiences of marketplaces that offer a total cost estimator and the interests and concerns of policymakers from states that are not using them. Methods: Structured interviews with marketplace officials, consumer enrollment assisters, technology vendors, and subject matter experts; analysis of the total cost estimators available on the marketplaces as of October 2016. Key findings and conclusions: Informants strongly supported marketplace adoption of a total cost estimator. Marketplaces that offer an estimator faced a range of design choices and varied significantly in their approaches to resolving them. Interviews suggested a clear need for additional consumer testing and data analysis of tool usage and for sustained outreach to enrollment assisters to encourage greater use of the estimators.

Changes in Energy Cost and Total External Work of Muscles in Elite Race Walkers Walking at Different Speeds

Directory of Open Access Journals (Sweden)

Chwała Wiesław

2014-12-01

Full Text Available The aim of the study was to assess energy cost and total external work (total energy depending on the speed of race walking. Another objective was to determine the contribution of external work to total energy cost of walking at technical, threshold and racing speed in elite competitive race walkers.

Analysis of the total system life cycle cost for the Civilian Radioactive Waste Management Program: Volume 2, Supporting information

International Nuclear Information System (INIS)

1987-06-01

This report provides cost estimates for the fifth evaluation of the adequacy of the fee and is consistent with the program strategy and plans. The total-system cost for the reference cases in the improved-performance system is estimated at $32.1 to $38.2 billion (expressed in constant 1986 collars) over the entire life of the system, or $1.5 to $1.6 billion more than that of the authorized system (i.e., the system without an MRS facility). The current estimate of the total-system cost for the reference cases in the improved-performance system is $3.8 to $5.4 billion higher than the estimate for the same system in the 1986 TSLCC analysis. In the case with the maximum increase, nearly all of the higher cost is due to a $5.2-billion increase in the costs of development and evaluation (D and E); all other system costs are essentially unchanged. The cost difference between the improved-performance system and the authorized system is smaller than the difference estimated in last year's TSLCC analysis. Volume 2 presents the detailed results for the 1987 analysis of the total-system life cycle cost (TSLCC). It consists of four sections: Section A presents the yearly flows of waste between waste-management facilities for the 12 aggregate logistics cases that were studied; Section B presents the annual total-system costs for each of the 30 TSLCC cases by major cost category; Section C presents the annual costs for the disposal of 16,000 canisters of defense high-level waste (DHLW) by major cost category for each of the 30 TSLCC cases; and Section D presents a summary of the cost-allocation factors that were calculated to determine the defense waste share of the total-system costs

Cost Analysis of Total Joint Arthroplasty Readmissions in a Bundled Payment Care Improvement Initiative.

Science.gov (United States)

Clair, Andrew J; Evangelista, Perry J; Lajam, Claudette M; Slover, James D; Bosco, Joseph A; Iorio, Richard

2016-09-01

The Bundled Payment for Care Improvement (BPCI) Initiative is a Centers for Medicare and Medicaid Services program designed to promote coordinated and efficient care. This study seeks to report costs of readmissions within a 90-day episode of care for BPCI Initiative patients receiving total knee arthroplasty (TKA) or total hip arthroplasty (THA). From January 2013 through December 2013, 1 urban, tertiary, academic orthopedic hospital admitted 664 patients undergoing either primary TKA or THA through the BPCI Initiative. All patients readmitted to our hospital or an outside hospital within 90-days from the index episode were identified. The diagnosis and cost for each readmission were analyzed. Eighty readmissions in 69 of 664 patients (10%) were identified within 90-days. There were 53 readmissions (45 patients) after THA and 27 readmissions (24 patients) after TKA. Surgical complications accounted for 54% of THA readmissions and 44% of TKA readmissions. These complications had an average cost of $36,038 (range, $6375-$60,137) for THA and $38,953 (range, $4790-$104,794) for TKA. Eliminating the TKA outlier of greater than $100,000 yields an average cost of $27,979. Medical complications of THA and TKA had an average cost of $22,775 (range, $5678-$82,940) for THA and $24,183 (range, $3306-$186,069) for TKA. Eliminating the TKA outlier of greater than $100,000 yields an average cost of $11,682. Hospital readmissions after THA and TKA are common and costly. Identifying the causes for readmission and assessing the cost will guide quality improvement efforts. Copyright © 2016 Elsevier Inc. All rights reserved.

Linking the spare parts management with the total costs of ownership: An agenda for future research

Directory of Open Access Journals (Sweden)

Orlando Duran

2016-12-01

Full Text Available Purpose: This manuscript explores the link between Spare Parts Management and Total Costs of Ownership or Life Cycle Costs (LCC. Design/methodology/approach: First, this work enumerates the different managerial decisions instances in spare parts management that are present during the life cycle of a physical asset. Second, we analyse how those decision instances could affect the TCO of a physical asset (from the economic point of view. Finally, we propose a conceptual framework for incorporating the spare parts management into a TCO model. Findings: The recent literature lacks discussions on the integration of spare parts management with the Total Costs of Ownership (TCO. Based in an extensive literature revision we can declare that the computation of costs related to spare parts management has been neglected by TCO models. Originality/value: The contribution of this paper is twofold. First, a literature review and identification of a series of spare parts management decision instances and its relationship with TCOs is presented in this paper. Second, a conceptual framework is suggested for linking those decisions instances to a total cost of ownership perspective. Some research questions and future research challenges are presented at the end of this work.

Linking the spare parts management with the total costs of ownership: An agenda for future research

International Nuclear Information System (INIS)

Duran, O.; Roda, I.; Macchi, M.

2016-01-01

Purpose: This manuscript explores the link between Spare Parts Management and Total Costs of Ownership or Life Cycle Costs (LCC). Design/methodology/approach: First, this work enumerates the different managerial decisions instances in spare parts management that are present during the life cycle of a physical asset. Second, we analyse how those decision instances could affect the TCO of a physical asset (from the economic point of view). Finally, we propose a conceptual framework for incorporating the spare parts management into a TCO model. Findings: The recent literature lacks discussions on the integration of spare parts management with the Total Costs of Ownership (TCO). Based in an extensive literature revision we can declare that the computation of costs related to spare parts management has been neglected by TCO models. Originality/value: The contribution of this paper is twofold. First, a literature review and identification of a series of spare parts management decision instances and its relationship with TCOs is presented in this paper. Second, a conceptual framework is suggested for linking those decisions instances to a total cost of ownership perspective. Some research questions and future research challenges are presented at the end of this work.

Linking the spare parts management with the total costs of ownership: An agenda for future research

Energy Technology Data Exchange (ETDEWEB)

Duran, O.; Roda, I.; Macchi, M.

2016-07-01

Purpose: This manuscript explores the link between Spare Parts Management and Total Costs of Ownership or Life Cycle Costs (LCC). Design/methodology/approach: First, this work enumerates the different managerial decisions instances in spare parts management that are present during the life cycle of a physical asset. Second, we analyse how those decision instances could affect the TCO of a physical asset (from the economic point of view). Finally, we propose a conceptual framework for incorporating the spare parts management into a TCO model. Findings: The recent literature lacks discussions on the integration of spare parts management with the Total Costs of Ownership (TCO). Based in an extensive literature revision we can declare that the computation of costs related to spare parts management has been neglected by TCO models. Originality/value: The contribution of this paper is twofold. First, a literature review and identification of a series of spare parts management decision instances and its relationship with TCOs is presented in this paper. Second, a conceptual framework is suggested for linking those decisions instances to a total cost of ownership perspective. Some research questions and future research challenges are presented at the end of this work.

Episode of Care Payments in Total Joint Arthroplasty and Cost Minimization Strategies.

Science.gov (United States)

Nwachukwu, Benedict U; O'Donnell, Evan; McLawhorn, Alexander S; Cross, Michael B

2016-02-01

Total joint arthroplasty (TJA) is receiving significant attention in the US health care system for cost containment strategies. Specifically, payer organizations have embraced and are implementing bundled payment schemes in TJA. Consequently, hospitals and providers involved in the TJA care cycle have sought to adapt to the new financial pressures imposed by episode of care payment models by analyzing what components of the total "event" of a TJA are most essential to achieve a good outcome after TJA. As part of this review, we analyze and discuss a health economic study by Snow et al. As part of their study, the authors aimed to understand the association between preoperative physical therapy (PT) and post-acute care resource utilization, and its effect on the total cost of care during total joint arthroplasty. The purpose of this current review therefore is to (1) describe and analyze the findings presented by Snow et al. and (2) provide a framework for analyzing and critiquing economic analyses in orthopedic surgery. The study under review, while having important strengths, has several notable limitations that are important to keep in mind when making policy and coverage decisions. We support cautious interpretation and application of study results, and we encourage maintained attention to economic analysis in orthopedics as well as continued care path redesign to maximize value for patients and health care providers.

Clinical and cost effectiveness-related aspects of retransfusion in total hip and knee arthroplasty.

Science.gov (United States)

Dobosz, Bartłomiej; Dutka, Julian; Dutka, Lukasz; Maleta, Paweł

2012-01-01

An increasing demand for blood products forces the rationalisation of management and conservation of blood. The aim of the study is to evaluate the possibility of retransfusion of blood conservation and the cost-effectiveness of this procedure when employed in Total Hip Replacement and Total Knee Arthroplasty. This prospective cohort study involved two groups of patients. Group I comprised 50 patients who underwent blood retransfusion and in several cases had supplementary allogeneic transfusion. Group II, a control group, consisted of 50 patients who did not receive retransfusion. The retransfusion in Group I enabled the recovery of a mean amount of 364.5 ml (± 52.7) of blood in THR patients and 403.8 ml (± 110.7) in TKA patients. Demand for allogeneic blood transfusions in Group I versus Group II was 46% lower in THR patients and 42% lower in TKA patients. The blood recovered for retransfusion is biologically valuable with regard to cellular elements and plasma chemistries. In the costs evaluation, the total savings in Group I were 5,000 PLN. Retransfusion of recuperated blood from postoperative drainage tubing is a simple and safe method that provides clinical and cost-effectiveness advantages.

77 FR 43542 - Cost Accounting Standards: Cost Accounting Standards 412 and 413-Cost Accounting Standards...

Science.gov (United States)

2012-07-25

... rule that revised Cost Accounting Standard (CAS) 412, ``Composition and Measurement of Pension Cost... Accounting Standards: Cost Accounting Standards 412 and 413--Cost Accounting Standards Pension Harmonization Rule AGENCY: Cost Accounting Standards Board, Office of Federal Procurement Policy, Office of...

48 CFR 49.113 - Cost principles.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Cost principles. 49.113 Section 49.113 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACT MANAGEMENT TERMINATION OF CONTRACTS General Principles 49.113 Cost principles. The cost principles and procedures in the...

FEDERAL PENSIONS: Judicial Survivors Annuities System Costs

National Research Council Canada - National Science Library

2002-01-01

...) specifying that we review certain aspects of the Judicial Survivors' Annuities System (JSAS), which is one of several survivor benefit plans applicable to particular groups of federal employees...

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

Science.gov (United States)

2010-10-01

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

48 CFR 9904.402 - Cost accounting standard-consistency in allocating costs incurred for the same purpose.

Science.gov (United States)

2010-10-01

... Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.402 Cost... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Cost accounting standard...

Use of predefined biochemical admission profiles does not reduce the number of tests or total cost

DEFF Research Database (Denmark)

Pareek, Manan; Haidl, Felix; Folkestad, Lars

2014-01-01

The objective of this pilot study was to evaluate whether the use of predefined biochemical profiles as an alternative to individually ordered blood tests by the treating physicians resulted in fewer tests or a lower total cost.......The objective of this pilot study was to evaluate whether the use of predefined biochemical profiles as an alternative to individually ordered blood tests by the treating physicians resulted in fewer tests or a lower total cost....

Mobile Phone Health Applications for the Federal Sector.

Science.gov (United States)

Burrows, Christin S; Weigel, Fred K

2016-01-01

As the US healthcare system moves toward a mobile care model, mobile phones will play a significant role in the future of healthcare delivery. Today, 90% of American adults own a mobile phone and 64% own a smartphone, yet many healthcare organizations are only beginning to explore the opportunities in which mobile phones can improve and streamline care. After searching Google Scholar, the Association for Computing Machinery Database, and PubMed for articles related to mobile phone health applications and cell phone text message health, we selected articles and studies related to the application of mobile phones in healthcare. From our initial review, we identified the potential application areas and continued to refine our search, identifying a total of 55 articles for additional review and analysis. From the literature, we identified 3 main themes for mobile phone implementation in improving healthcare: primary, preventive, and population health. We recommend federal health leaders pursue the value and potential in these areas; not only because 90% of Americans already own mobile phones, but also because mobile phone integration can provide substantial access and potential cost savings. From the positive findings of multiple studies in primary, preventive, and population health, we propose a 5-year federal implementation plan to integrate mobile phone capabilities into federal healthcare delivery. Our proposal has the potential to improve access, reduce costs, and increase patient satisfaction, therefore changing the way the federal sector delivers healthcare by 2021.

The Relationship between Cost Leadership Strategy, Total Quality Management Applications and Financial Performance

OpenAIRE

Ali KURT; Cemal ZEHİR

2016-01-01

Firms need to implement some competition strategies and total quality management applications to overcome the fierce competition among others. The purpose of this study is to show the relationship between cost leadership strategy, total quality management applications and firms’ financial performance with literature review and empirical analysis. 449 questionnaires were conducted to the managers of 142 big firms. The data gathered was assessed with AMOS. As a result, the relationship between ...

Quality-Adjusted Cost Functions for Child-Care Centers.

OpenAIRE

Mocan, H Naci

1995-01-01

Using a newly compiled data set, this paper estimates multi- product translog cost functions for 399 child care centers from California, Colorado, Connecticut, and North Carolina. Quality of child care is controlled by a quality index, which has been shown to be positively related to child outcomes by previous research. Nonprofit centers that receive public money, either from the state or federal government, (which is tied to higher standards), have total variable costs that are 18 percent hi...

[Macroeconomic costs of eye diseases].

Science.gov (United States)

Hirneiß, C; Kampik, A; Neubauer, A S

2014-05-01

Eye diseases that are relevant regarding their macroeconomic costs and their impact on society include cataract, diabetic retinopathy, age-related maculopathy, glaucoma and refractive errors. The aim of this article is to provide a comprehensive overview of direct and indirect costs for major eye disease categories for Germany, based on existing literature and data sources. A semi-structured literature search was performed in the databases Medline and Embase and in the search machine Google for relevant original papers and reviews on costs of eye diseases with relevance for or transferability to Germany (last research date October 2013). In addition, manual searching was performed in important national databases and information sources, such as the Federal Office of Statistics and scientific societies. The direct costs for these diseases add up to approximately 2.6 billion Euros yearly for the Federal Republic of Germany, including out of the pocket payments from patients but excluding optical aids (e.g. glasses). In addition to those direct costs there are also indirect costs which are caused e.g. by loss of employment or productivity or by a reduction in health-related quality of life. These indirect costs can only be roughly estimated. Including the indirect costs for the eye diseases investigated, a total yearly macroeconomic cost ranging between 4 and 12 billion Euros is estimated for Germany. The costs for the eye diseases cataract, diabetic retinopathy, age-related maculopathy, glaucoma and refractive errors have a macroeconomic relevant dimension. Based on the predicted demographic changes with an ageing society an increase of the prevalence and thus also an increase of costs for eye diseases is expected in the future.

The peculiar economics of federal energy management

International Nuclear Information System (INIS)

Canes, Michael E.

2016-01-01

US federal agency energy managers face different constraints than do comparable private sector managers. They are faced with energy consumption goals mandated via legislation or directed via Presidential Executive Order that encourage if not compel them to invest more in energy efficiency or renewables than would be cost effective from a private sector perspective. To make such investments, they also are provided access to private capital that is additional to their agency budgets. The encouragement to invest beyond what is cost effective may be a source of waste in some instances, and the financing mechanisms appear more expensive than necessary. A rough estimate of the magnitude of the waste is offered, as well as a mechanism to reduce the costs of agency access to capital. - Highlights: •Legislative and regulatory initiatives that constrain federal agency energy investments. •Economic calculus facing a federal agency energy manager. •Magnitude of federal energy investments and of possible waste. •Financing mechanisms and how their costs might be reduced.

78 FR 72884 - Information Collection Being Reviewed by the Federal Communications Commission Under Delegated...

Science.gov (United States)

2013-12-04

... required by the Paperwork Reduction Act (PRA) of 1995 (44 U.S.C. 3501-3520), the Federal Communications... currently approved collection. Respondents: Business or other for-profit entities. Number of Respondents and...: 10 hours. Total Annual Cost: $13,500. Privacy Act Impact Assessment: No impact(s). [[Page 72885...

Guidance for Federal Agencies on Executive Order 13693 - Federal Fleet Management

Energy Technology Data Exchange (ETDEWEB)

None, None

2017-01-02

Document contains guidance on the federal fleet requirements of Executive Order 13693: Planning for Federal Sustainability in the Next Decade and helps federal agencies subject to the executive order develop an overall approach for reducing total fleet greenhouse gas (GHG) emissions and fleet-wide per-mile GHG emissions.

Facilitating Sound, Cost-Effective Federal Energy Management

Energy Technology Data Exchange (ETDEWEB)

FEMP

2016-07-01

Fact sheet offers an overview of the Federal Energy Management Program (FEMP), which provides agencies and organizations with the information, tools, and assistance they need to achieve their energy-related requirements and goals through specialized initiatives.

Quality Indicators for the Total Testing Process.

Science.gov (United States)

Plebani, Mario; Sciacovelli, Laura; Aita, Ada

2017-03-01

ISO 15189:2012 requires the use of quality indicators (QIs) to monitor and evaluate all steps of the total testing process, but several difficulties dissuade laboratories from effective and continuous use of QIs in routine practice. An International Federation of Clinical Chemistry and Laboratory Medicine working group addressed this problem and implemented a project to develop a model of QIs to be used in clinical laboratories worldwide to monitor and evaluate all steps of the total testing process, and decrease error rates and improve patient services in laboratory testing. All laboratories are invited, at no cost, to enroll in the project and contribute to harmonized management at the international level. Copyright © 2016 Elsevier Inc. All rights reserved.

Lighting technology specifications for relighting federal buildings

International Nuclear Information System (INIS)

Harris, L.; Purcell, C.W.; Gordon, H.; McKay, H.

1993-01-01

The Department of Energy's Federal Relighting Initiative, under the Federal Energy Management Program (FEMP), now offers a comprehensive process to assist agencies in meeting the DOE energy mandate that states that Federal facilities shall use 20% less energy by the year 2000, based on 1985 consumption, and shall improve lighting to increase productivity with relighting projects. The process provides a systematic approach in the screening, selection, design, implementation and evaluation of relighting projects. The Master Specifications help assure the acquisition of high-quality, life-cycle cost-effective lighting systems. The process begins with the screening of the agency's building stock to identify the most promising relighting candidates and concludes with implementation support and system performance assessment. The tools developed by FRI are designed to assist agencies during each phase of the relighting process. The tools are based upon the Federal life-cycle cost approach, thereby complying with 10 CFR, part 436, and the Federal life-cycle cost requirement

Time-driven Activity-based Cost of Fast-Track Total Hip and Knee Arthroplasty

DEFF Research Database (Denmark)

Andreasen, Signe E; Holm, Henriette B; Jørgensen, Mira

2017-01-01

this between 2 departments with different logistical set-ups. METHODS: Prospective data collection was analyzed using the time-driven activity-based costing method (TDABC) on time consumed by different staff members involved in patient treatment in the perioperative period of fast-track THA and TKA in 2 Danish...... orthopedic departments with standardized fast-track settings, but different logistical set-ups. RESULTS: Length of stay was median 2 days in both departments. TDABC revealed minor differences in the perioperative settings between departments, but the total cost excluding the prosthesis was similar at USD......-track methodology, the result could be a more cost-effective pathway altogether. As THA and TKA are potentially costly procedures and the numbers are increasing in an economical limited environment, the aim of this study is to present baseline detailed economical calculations of fast-track THA and TKA and compare...

Predicting temporal trends in total absenteeism rates for civil service employees of a federal public health agency.

Science.gov (United States)

Spears, D Ross; McNeil, Carrie; Warnock, Eli; Trapp, Jonathan; Oyinloye, Oluremi; Whitehurst, Vanessa; Decker, K C; Chapman, Sandy; Campbell, Morris; Meechan, Paul

2014-06-01

This study evaluates the predictability in temporal absences trends due to all causes (total absenteeism) among employees at a federal agency. The objective is to determine how leave trends vary within the year, and determine whether trends are predictable. Ten years of absenteeism data from an attendance system were analyzed for rates of total absence. Trends over a 10-year period followed predictable and regular patterns during a given year that correspond to major holiday periods. Temporal trends in leave among small, medium, and large facilities compared favorably with the agency as a whole. Temporal trends in total absenteeism rates for an organization can be determined using its attendance system. The ability to predict employee absenteeism rates can be extremely helpful for management in optimizing business performance and ensuring that an organization meets its mission.

COST-EFFECTIVENESS OF APIXABAN AS COMPARED WITH WARFARIN AND ACETYLSALICYLIC ACID IN PATIENTS WITH NON-VALVULAR ATRIAL FIBRILLATION IN THE RUSSIAN FEDERATION

Directory of Open Access Journals (Sweden)

A. V. Rudakova

2015-09-01

Full Text Available Background. For prevention of thromboembolic events in patients with non-valvular atrial fibrillation (NVAF the following types of antithrombotic therapy are used: anticoagulant therapy with vitamin K antagonists (such as warfarin, antiplatelet therapy (such as acetylsalicylic acid and novel oral anticoagulants such as apixaban, rivaroxaban and dabigatran. Administration of vitamin K antagonists (VKA is complicated by the need for individual dose adjustment and frequent monitoring of international normalized ratio (INR. Both warfarin and acetylsalicylic acid are widely used for thrombosis prevention in patients with NVAF in the Russian Federation.Aim. To evaluate the cost-effectiveness ratio of apixaban compared with warfarin and acetylsalicylic acid in patients with NVAF from the Russian Federation national health care system perspective.Material and methods. This analysis used a Markov model that allowed estimation of the incremental cost-effectiveness ratio (ICER for apixaban as compared with warfarin and acetylsalicylic acid over lifetime horizon in VKA suitable and VKA unsuitable patients with NVAF respectively. The model enclosed cardiovascular event rates based on the results of the randomized clinical trials comparing clinical effectiveness and safety of apixaban with warfarin (ARISTOTLE and acetylsalicylic acid (AVERROES. The following cardiovascular events were taken into consideration: ischemic and hemorrhagic stroke, systemic embolism, intracranial hemorrhage, other major bleeds, clinically relevant non-major bleeds and myocardial infarction. Direct medical costs were determined based on the rates of the compulsory national medical insurance system. The price of the antithrombotic drugs was taken as a weighted average tender price for the year 2013. In the model both costs and benefits (quality-adjusted life years and life-years were discounted at 3.5%. Cost-effectiveness threshold was set at 1.4 million rubles per quality

COST-EFFECTIVENESS OF APIXABAN AS COMPARED WITH WARFARIN AND ACETYLSALICYLIC ACID IN PATIENTS WITH NON-VALVULAR ATRIAL FIBRILLATION IN THE RUSSIAN FEDERATION

Directory of Open Access Journals (Sweden)

A. V. Rudakova

2014-01-01

Full Text Available Background. For prevention of thromboembolic events in patients with non-valvular atrial fibrillation (NVAF the following types of antithrombotic therapy are used: anticoagulant therapy with vitamin K antagonists (such as warfarin, antiplatelet therapy (such as acetylsalicylic acid and novel oral anticoagulants such as apixaban, rivaroxaban and dabigatran. Administration of vitamin K antagonists (VKA is complicated by the need for individual dose adjustment and frequent monitoring of international normalized ratio (INR. Both warfarin and acetylsalicylic acid are widely used for thrombosis prevention in patients with NVAF in the Russian Federation.Aim. To evaluate the cost-effectiveness ratio of apixaban compared with warfarin and acetylsalicylic acid in patients with NVAF from the Russian Federation national health care system perspective.Material and methods. This analysis used a Markov model that allowed estimation of the incremental cost-effectiveness ratio (ICER for apixaban as compared with warfarin and acetylsalicylic acid over lifetime horizon in VKA suitable and VKA unsuitable patients with NVAF respectively. The model enclosed cardiovascular event rates based on the results of the randomized clinical trials comparing clinical effectiveness and safety of apixaban with warfarin (ARISTOTLE and acetylsalicylic acid (AVERROES. The following cardiovascular events were taken into consideration: ischemic and hemorrhagic stroke, systemic embolism, intracranial hemorrhage, other major bleeds, clinically relevant non-major bleeds and myocardial infarction. Direct medical costs were determined based on the rates of the compulsory national medical insurance system. The price of the antithrombotic drugs was taken as a weighted average tender price for the year 2013. In the model both costs and benefits (quality-adjusted life years and life-years were discounted at 3.5%. Cost-effectiveness threshold was set at 1.4 million rubles per quality

Total staff costs to implement a decision support system in nursing

Directory of Open Access Journals (Sweden)

Valéria Castilho

2014-01-01

Full Text Available OBJECTIVE: to identify the direct labor (DL costs to put in practice a decision support system (DSS in nursing at the University Hospital of the University of São Paulo (HU-USP. METHOD: the development of the DSS was mapped in four sub-processes: Conception, Elaboration, Construction and Transition. To calculate the DL, the baseline salary per professional category was added to the five-year additional remuneration, representation fees and social charges, and then divided by the number of hours contracted, resulting in the hour wage/professional, which was multiplied by the time spend on each activity in the sub-processes. RESULTS: the DL cost corresponded to R$ 752,618.56 (100%, R$ 26,000.00 (3.45% of which were funded by a funding agency, while R$ 726,618.56 (96,55% came from Hospital and University resources. CONCLUSION: considering the total DL cost, 72.1% related to staff wages for the informatics consulting company and 27.9% to the DL of professionals at the HU and the School of Nursing.

48 CFR 12.214 - Cost Accounting Standards.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Cost Accounting Standards. 12.214 Section 12.214 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION... Items 12.214 Cost Accounting Standards. Cost Accounting Standards (CAS) do not apply to contracts and...

45 CFR 2541.220 - Allowable costs.

Science.gov (United States)

2010-10-01

... accounting standards that comply with cost principles acceptable to the Federal agency. ... the grantee or subgrantee. (b) Applicable cost principles. For each kind of organization, there is a set of Federal principles for determining allowable costs. Allowable costs will be determined in...

33 CFR 203.47 - Modifications to non-Federal flood control works.

Science.gov (United States)

2010-07-01

... be constructed at additional Federal and non-Federal expense in conjunction with approved.... Engineering and design costs will be at Corps cost. (a) Cash contributions. Non-Federal contributions will be... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Modifications to non-Federal...

Advance payments on the cost of the federal repository for radioactive waste

Energy Technology Data Exchange (ETDEWEB)

Strabburg, W

1979-03-01

Under W. Germany's Atomic Energy Act, the federal government is responsible for the final storage of radioactive wastes. Other steps of the back end fuel cycle must be implemented by private industry. Under the act, the government is entitled to charge for the costs of the erection and operation of any final repositories. To cover the initial investment involved in preparation and planning, the government is requesting advance payments from those wishing to use the repositories in the future. However, there is no legal basis for advance payments to be made, at least until an operating permit has been granted for the planned back-end fuel cycle center. Utilities operating nuclear power plants cannot be forced to make advance storage payments, and even an amendment to the Atomic Energy Act will not change the situation. (in German) (15 references)

Evaluation of the environmental costs in the fields power and traffic. Recommendations of the Federal Environmental Agency; Schaetzung der Umweltkosten in den Bereichen Energie und Verkehr. Empfehlungen des Umweltbundesamtes

Energy Technology Data Exchange (ETDEWEB)

NONE

2012-08-15

The scientific evidence for the estimation of environmental costs was steadily improved in the recent years. The Federal Environment Agency (Dessau-Rosslau, Federal Republic of Germany) summarizes the scientific progress in this field by means of the methods convention. Environmental costs are macro-economically very important. Emissions of greenhouse gases, air pollutants and noise pollution, land use and the consumption of scarce resources result in high costs for health and environment. Estimates of environmental costs point out the negative impacts of a neglected environmental protection and substantiate the necessity to pursue the ambitious environmental targets. Environmental costs are also suitable for the assessment of measures and instruments of the environmental protection. Municipalities, businesses and households also can use estimates of environmental costs - especially for environment-related investment decisions.

Is total pancreatectomy as feasible, safe, efficacious, and cost-effective as pancreaticoduodenectomy? A single center, prospective, observational study.

Science.gov (United States)

Casadei, Riccardo; Ricci, Claudio; Taffurelli, Giovanni; Guariniello, Anna; Di Gioia, Anthony; Di Marco, Mariacristina; Pagano, Nico; Serra, Carla; Calculli, Lucia; Santini, Donatella; Minni, Francesco

2016-09-01

Total pancreatectomy is actually considered a viable option in selected patients even if large comparative studies between partial versus total pancreatectomy are not currently available. Our aim was to evaluate whether total pancreatectomy can be considered as feasible, safe, efficacious, and cost-effective as pancreaticoduodenectomy. A single center, prospective, observational trial, regarding postoperative outcomes, long-term results, and cost-effectiveness, in a tertiary referral center was conducted, comparing consecutive patients who underwent elective total pancreatectomy and/or pancreaticoduodenectomy. Seventy-three consecutive elective total pancreatectomies and 184 pancreaticoduodenectomies were compared. There were no significant differences regarding postoperative outcomes and overall survival. The quality of life, evaluated in 119 patients according to the EQ-5D-5L questionnaire, showed that there were no significant differences regarding the five items considered. The mean EQ-5D-5L score was similar in the two procedures (total pancreatectomy = 0.872, range 0.345-1.000; pancreaticoduodenectomy = 0.832, range 0.393-1.000; P = 0.320). The impact of diabetes according to the Problem Areas in Diabetes (PAID) questionnaire did not show any significant differences except for question 13 (total pancreatectomy = 0.60; pancreaticoduodenectomy = 0.19; P = 0.022). The cost-effectiveness analysis suggested that the quality-adjusted life year was not significantly different between the two procedures (total pancreatectomy = 0.910, range 0.345-1.000; pancreaticoduodenectomy = 0.910, range -0.393-1.000; P = 0.320). From this study, it seems reasonable to suggest that total pancreatectomy can be considered as safe, feasible, and efficacious as PD and acceptable in terms of cost-effectiveness.

48 CFR 570.110 - Cost or pricing data and information other than cost or pricing data.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Cost or pricing data and information other than cost or pricing data. 570.110 Section 570.110 Federal Acquisition Regulations System... PROPERTY General 570.110 Cost or pricing data and information other than cost or pricing data. (a) The...

Improving Federal Response to Drought.

Science.gov (United States)

Wilhite, Donald A.; Rosenberg, Norman J.; Glantz, Michael H.

1986-03-01

Severe and widespread drought occurred over a large portion of the United States between 1974 and 1977. Impacts on agriculture and other industries, as well as local water supplies, were substantial. The federal government responded with forty assistance programs administered by sixteen federal agencies. Assistance was provided primarily in the form of loans and grants to people, businesses and governments experiencing hardship caused by drought. The total cost of the program is estimated at $7-8 billion.Federal response to the mid-1970s drought was largely untimely, ineffective and poorly coordinated. Four recommendations are offered that, if implemented, would improve future drought assessment and response efforts: 1) reliable and timely informational products and dissemination plans; 2) improved impact assessment techniques, especially in the agricultural sector, for use by government to identify periods of enhanced risk and to trigger assistance measures; 3) administratively centralized drought declaration procedures that are well publicized and consistently applied; and 4) standby assistance measures that encourage appropriate levels of risk management by producers and that are equitable, consistent and predictable. The development of a national drought plan that incorporates these four items is recommended. Atmospheric scientists have an important role to play in the collection and interpretation of near-real time weather data for use by government decision makers.

76 FR 61660 - Cost Accounting Standards: Clarification of the Exemption From Cost Accounting Standards for Firm...

Science.gov (United States)

2011-10-05

... Accounting Standards: Clarification of the Exemption From Cost Accounting Standards for Firm-Fixed-Price... Management and Budget (OMB), Office of Federal Procurement Policy, Cost Accounting Standards Board. ACTION: Proposed rule. SUMMARY: The Office of Federal Procurement Policy (OFPP), Cost Accounting Standards (CAS...

Wound research funding from alternative sources of federal funds in 2012.

Science.gov (United States)

Baquerizo Nole, Katherine L; Yim, Elizabeth; Van Driessche, Freya; Davidson, Jeffrey M; Martins-Green, Manuela; Sen, Chandan K; Tomic-Canic, Marjana; Kirsner, Robert S

2014-01-01

Chronic wounds represent a major healthcare burden, costing $25 billion annually, and are associated with high mortality. We previously reported that cutaneous wound healing represented only 0.1% ($29.8 million) of the National Institutes of Health budget. This current study focuses on quantifying the contribution by federal agencies other than the National Institutes of Health for fiscal year 2012. Federal databases including USA Spending, Veterans Affairs, Tracking Accountability in Government Grants Systems, Health Services Research Projects in Progress, and Patient-Centered Outcomes Research Institute, were searched for individual projects addressing wound healing. Twenty-seven projects were identified, totaling funding of $16,588,623 (median: $349,856). Four sponsor institutions accounted for 74% of awarded funds: Department of the Army, National Science Foundation, Department of Veterans Affairs, and Agency for Healthcare Research & Quality. Research projects and cooperative agreements comprised 44% and 37% of awarded grants. New applications and continuing projects represented 52% and 37%. Wound healing represented 0.15% of total medical research funded by the non-National Institutes of Health federal sector. Compared with potential impact on US public health, federal investment in wound research is exiguous. This analysis will draw attention to a disproportionately low investment in wound research and its perils to American public health. © 2014 by the Wound Healing Society.

1986 Federal Interim Storage fee study: a technical and economic analysis

International Nuclear Information System (INIS)

1986-09-01

JAI examined alternative methods for structuring charges for federal interim storage (FIS) services and concluded that the combined interests of the Department and the users would be best served, and costs most appropriately recovered, by a two-part fee involving an Initial Payment upon execution of a contract for FIS services followed by a Final Payment upon delivery of the spent fuel to the Department. The Initial Payment would be an advance payment covering the pro rata share of preoperational costs, including (1) the capital costs of the required transfer facilities and storage area, (2) development costs, (3) government administrative costs including storage fund management, (4) impact aid payments made in accordance with Section 136(e) of the Act, and (5) module costs (i.e., storage casks, drywells or silos). The Final Payment would be made at the time of delivery of the spent fuel to the Department and would be calculated to cover the sum of the following: (1) any under- or over-estimation in the costs used to calculate the Initial Payment of the fee (including savings due to rod consolidation), and (2) the total estimated cost of operation and decommissioning of the FIS facilities (including government administrative costs, storage fund management and impact aid). The module costs were included in the Initial Payment to preclude the possible need to obtain appropriations for federal funds to support the purchase of the modules in advance of receipt of the Final Payment. Charges for the transport of spent fuel from the reactor site to FIS facilities would be separately assessed at actual cost since these will be specific to each reactor site and destination

Determining the Cost-Savings Threshold and Alignment Accuracy of Patient-Specific Instrumentation in Total Ankle Replacements.

Science.gov (United States)

Hamid, Kamran S; Matson, Andrew P; Nwachukwu, Benedict U; Scott, Daniel J; Mather, Richard C; DeOrio, James K

2017-01-01

Traditional intraoperative referencing for total ankle replacements (TARs) involves multiple steps and fluoroscopic guidance to determine mechanical alignment. Recent adoption of patient-specific instrumentation (PSI) allows for referencing to be determined preoperatively, resulting in less steps and potentially decreased operative time. We hypothesized that usage of PSI would result in decreased operating room time that would offset the additional cost of PSI compared with standard referencing (SR). In addition, we aimed to compare postoperative radiographic alignment between PSI and SR. Between August 2014 and September 2015, 87 patients undergoing TAR were enrolled in a prospectively collected TAR database. Patients were divided into cohorts based on PSI vs SR, and operative times were reviewed. Radiographic alignment parameters were retrospectively measured at 6 weeks postoperatively. Time-driven activity-based costing (TDABC) was used to derive direct costs. Cost vs operative time-savings were examined via 2-way sensitivity analysis to determine cost-saving thresholds for PSI applicable to a range of institution types. Cost-saving thresholds defined the price of PSI below which PSI would be cost-saving. A total of 35 PSI and 52 SR cases were evaluated with no significant differences identified in patient characteristics. Operative time from incision to completion of casting in cases without adjunct procedures was 127 minutes with PSI and 161 minutes with SR ( P cost-savings threshold range at our institution of $863 below which PSI pricing would provide net cost-savings. Two-way sensitivity analysis generated a globally applicable cost-savings threshold model based on institution-specific costs and surgeon-specific time-savings. This study demonstrated equivalent postoperative TAR alignment with PSI and SR referencing systems but with a significant decrease in operative time with PSI. Based on TDABC and associated sensitivity analysis, a cost-savings threshold

Cost-Effective Mobile-Based Healthcare System for Managing Total Joint Arthroplasty Follow-Up.

Science.gov (United States)

Bitsaki, Marina; Koutras, George; Heep, Hansjoerg; Koutras, Christos

2017-01-01

Long-term follow-up care after total joint arthroplasty is essential to evaluate hip and knee arthroplasty outcomes, to provide information to physicians and improve arthroplasty performance, and to improve patients' health condition. In this paper, we aim to improve the communication between arthroplasty patients and physicians and to reduce the cost of follow-up controls based on mobile application technologies and cloud computing. We propose a mobile-based healthcare system that provides cost-effective follow-up controls for primary arthroplasty patients through questions about symptoms in the replaced joint, questionnaires (WOMAC and SF-36v2) and the radiological examination of knee or hip joint. We also perform a cost analysis for a set of 423 patients that were treated in the University Clinic for Orthopedics in Essen-Werden. The estimation of healthcare costs shows significant cost savings (a reduction of 63.67% for readmission rate 5%) in both the University Clinic for Orthopedics in Essen-Werden and the state of North Rhine-Westphalia when the mobile-based healthcare system is applied. We propose a mHealth system to reduce the cost of follow-up assessments of arthroplasty patients through evaluation of diagnosis, self-monitoring, and regular review of their health status.

Creeping Federalization

DEFF Research Database (Denmark)

Sweeney, Richard J.

2003-01-01

that make taxharmonization difficult to impose. Other types of harmonization have a less clear-cut costbenefitanalysis. A federal commercial code that is uniform across member states reducestransaction and information costs, compared to leaving important code issues to memberstates; further, many states may...

48 CFR 239.7406 - Cost or pricing data and information other than cost or pricing data.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Cost or pricing data and information other than cost or pricing data. 239.7406 Section 239.7406 Federal Acquisition Regulations System... ACQUISITION OF INFORMATION TECHNOLOGY Telecommunications Services 239.7406 Cost or pricing data and...

Analysis of the total system life cycle cost for the Civilian Radioactive Waste Management Program. Volume 1. The analysis and its results

International Nuclear Information System (INIS)

1986-04-01

The total-system life-cycle cost (TSLCC) analysis for the Department of Energy's (DOE) Civilian Radioactive Waste Management Program is an ongoing activity that helps determine whether the revenue-producing mechanism established by the Nuclear Waste Policy Act of 1982 is sufficient to cover the cost of the program. This report provides cost estimates for the fourth evaluation of the adequacy of the fee. The total-system cost for the reference authorized-system program is estimated to be 24 to 32 billion (1985) dollars. The total-system cost for the reference improved-performance system is estimated to be 26 to 34 billion dollars. A number of sensitivity cases were analyzed. For the authorized system, the costs for the sensitivity cases studied range from 21 to 39 billion dollars. For the improved-performance system, which includes a facility for monitored retrievable storage, the total-system cost in the sensitivity cases is estimated to be as high as 41 billion dollars. The factors that affect costs more than any other single factor for both the authorized and the improved-performance systems are delays in repository startup. A preliminary analysis of the impact of extending the burnup of nuclear fuel in the reactor was also performed; its results indicate that the impact is insignificant: the total-system cost is essentially unchanged from the comparable constant-burnup cases. The current estimate of the the total-system cost for the reference authorized system is zero to 3 billion dollars (9%) higher than the estimate for the reference system in the January 1985 TSLCC analysis

7 CFR 3015.51 - Acceptable contributions and costs.

Science.gov (United States)

2010-01-01

.... This includes allowable costs supported by non-Federal grants or by cash donations from non-Federal... 7 Agriculture 15 2010-01-01 2010-01-01 false Acceptable contributions and costs. 3015.51 Section... FINANCIAL OFFICER, DEPARTMENT OF AGRICULTURE UNIFORM FEDERAL ASSISTANCE REGULATIONS Cost-Sharing or Matching...

76 FR 53378 - Cost Accounting Standards: Accounting for Insurance Costs

Science.gov (United States)

2011-08-26

... Accounting Standards: Accounting for Insurance Costs AGENCY: Cost Accounting Standards Board (Board), Office... Discontinuation of Rulemaking. SUMMARY: The Office of Federal Procurement Policy (OFPP), Cost Accounting Standards... development of an amendment to Cost Accounting Standard (CAS) 416 regarding the use of the term ``catastrophic...

48 CFR 9904.405 - Accounting for unallowable costs.

Science.gov (United States)

2010-10-01

... costs. 9904.405 Section 9904.405 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.405 Accounting for unallowable costs. ...

45 CFR 1157.22 - Allowable costs.

Science.gov (United States)

2010-10-01

... Procedures, or uniform cost accounting standards that comply with cost principles acceptable to the Federal... AGREEMENTS TO STATE AND LOCAL GOVERNMENTS Post-Award Requirements Financial Administration § 1157.22... cost principles. For each kind of organization, there is a set of Federal principles for determining...

49 CFR 18.22 - Allowable costs.

Science.gov (United States)

2010-10-01

... Procedures, or uniform cost accounting standards that comply with cost principles acceptable to the Federal... COOPERATIVE AGREEMENTS TO STATE AND LOCAL GOVERNMENTS Post-Award Requirements Financial Administration § 18.22... cost principles. For each kind of organization, there is a set of Federal principles for determining...

78 FR 25184 - Federal Housing Administration (FHA): Section 232 Healthcare Facility Insurance Program...

Science.gov (United States)

2013-04-30

..., Federalism Executive Order 13132 (entitled ``Federalism'') prohibits an agency from publishing any rule that has federalism implications if the rule either: (1) Imposes substantial direct compliance costs on... have federalism implications and does not impose substantial direct compliance costs on state and local...

Effect of Body Mass Index and Psychosocial Traits on Total Knee Replacement Costs in Patients with Osteoarthritis.

Science.gov (United States)

Waimann, Christian A; Fernandez-Mazarambroz, Rodrigo J; Cantor, Scott B; Lopez-Olivo, Maria A; Barbo, Andrea G; Landon, Glenn C; Siff, Sherwin J; Lin, Heather; Suarez-Almazor, Maria E

2016-08-01

Clinical and psychosocial attributes are associated with clinical outcomes after total knee replacement (TKR) surgery in patients with osteoarthritis (OA), but their relationship with TKR-related costs is less clear. Our objective was to evaluate the effect of clinical and psychosocial attributes on TKR costs. We conducted a 6-month prospective cohort study of patients with knee OA who underwent TKR. We examined baseline demographic, clinical [body mass index (BMI) and comorbidities], and psychosocial attributes (social support, locus of control, coping, depression, anxiety, stress, and self-efficacy); baseline and 6-month OA clinical outcomes [Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and function]; and 6-month direct and indirect TKR-related costs. Multiple regression was performed to identify determinants of TKR-related costs. We included 212 patients; 66% were women, 71% were white, and the mean age was 65.2 years. The mean baseline WOMAC pain score was 55 (SD 19) and WOMAC function score was 54 (SD 20). Mean total TKR-related costs were US$30,831 (SD $9893). Multivariate regression analyses showed that increasing BMI and anxiety levels and decreasing levels of positive social interactions were associated with increased costs. A lower cost scenario with a lower range of normal BMI (19.5), highest positive social interaction, and no anxiety predicted TKR costs to be $22,247. Predicted costs in obese patients (BMI 36) with lowest positive social interaction and highest anxiety were $58,447. Increased baseline BMI, anxiety, and poor social support lead to higher TKR-related costs in patients with knee OA. Preoperative interventions targeting these factors may reduce TKR-related costs, and therefore be cost-effective.

Analysis of the total system life cycle cost for the Civilian Radioactive Waste Management Program: Volume 1, The analysis and its results

International Nuclear Information System (INIS)

1987-06-01

This report provides cost estimates for the fifth evaluation of the adequacy of the fee and is consistent with the program strategy and plans. The total-system cost for the reference cases in the improved-performance system is estimated at $32.1 to $38.2 billion (expressed in constant 1986 dollars) over the entire life of the system...or $1.5 to $1.6 billion more than that of the authorized system (i.e., the system without an MRS facility). The current estimate of the total-system cost for the reference cases in the improved-performance system is $3.8 to $5.4 billion higher than the estimate for the same system in the 1986 TSLCC analysis. In the case with the maximum increase, nearly all of the higher cost is due to a $5.2-billion increase in the costs of development and evaluation (D and E); all other system costs are essentially unchanged. The cost difference between the improved-performance system and the authorized system is smaller than the difference estimated in last year's TSLCC analysis. Volume 2 presents the detailed results for the 1987 analysis of the total-system life cycle cost (TSLCC). It consists of four sections: Section A presents the yearly flows of waste between waste-management facilities for the 12 aggregate logistics cases that were studied; Section B presents the annual total-system costs for each of the 30 TSLCC cases by major cost category; Section C presents the annual costs for the disposal of 16,000 canisters of defense high-level waste (DHLW) by major cost category for each of the 30 TSLCC cases; and Section D presents a summary of the cost-allocation factors that were calculated to determine the defense waste share of the total-system costs

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

DEFF Research Database (Denmark)

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

2016-01-01

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

The cost-benefit of federal investment in preventing Clostridium difficile infections through the use of a multifaceted infection control and antimicrobial stewardship program.

Science.gov (United States)

Slayton, Rachel B; Scott, R Douglas; Baggs, James; Lessa, Fernanda C; McDonald, L Clifford; Jernigan, John A

2015-06-01

To determine the potential epidemiologic and economic value of the implementation of a multifaceted Clostridium difficile infection (CDI) control program at US acute care hospitals Markov model with a 5-year time horizon Patients whose data were used in our simulations were limited to hospitalized Medicare beneficiaries ≥65 years old. CDI is an important public health problem with substantial associated morbidity, mortality, and cost. Multifaceted national prevention efforts in the United Kingdom, including antimicrobial stewardship, patient isolation, hand hygiene, environmental cleaning and disinfection, and audit, resulted in a 59% reduction in CDI cases reported from 2008 to 2012. Our analysis was conducted from the federal perspective. The intervention we modeled included the following components: antimicrobial stewardship utilizing the Antimicrobial Use and Resistance module of the National Healthcare Safety Network (NHSN), use of contact precautions, and enhanced environmental cleaning. We parameterized our model using data from CDC surveillance systems, the AHRQ Healthcare Cost and Utilization Project, and literature reviews. To address uncertainty in our parameter estimates, we conducted sensitivity analyses for intervention effectiveness and cost, expenditures by other federal partners, and discount rate. Each simulation represented a cohort of 1,000 hospitalized patients over 1,000 trials. RESULTS In our base case scenario with 50% intervention effectiveness, we estimated that 509,000 CDI cases and 82,000 CDI-attributable deaths would be prevented over a 5-year time horizon. Nationally, the cost savings across all hospitalizations would be $2.5 billion (95% credible interval: $1.2 billion to $4.0 billion). The potential benefits of a multifaceted national CDI prevention program are sizeable from the federal perspective.

Cost of post-operative intravenous iron therapy in total lower limb arthroplasty: a retrospective, matched cohort study

Science.gov (United States)

Muñoz, Manuel; Gómez-Ramírez, Susana; Martín-Montañez, Elisa; Naveira, Enrique; Seara, Javier; Pavía, José

2014-01-01

Background Requirements for allogeneic red cell transfusion after total lower limb arthroplasty are still high (20–50%), and post-operative intravenous iron has been shown to reduce transfusion requirements for this surgery. We performed a cost analysis to ascertain whether this alternative is also likely to be cost-effective. Materials and methods Data from 182 matched-pairs of total lower limb arthroplasty patients, managed with a restrictive transfusion protocol and without (control group) or with post-operative intravenous iron (iron group), were retrospectively reviewed. Acquisition and administration costs of iron (iron sucrose or ferric carboxymaltose) and allogeneic red cell concentrates, haemoglobin measurements, and prolonged stay in hospital were used for blood management cost analysis. Results Patients in the iron group received 600 mg intravenous iron, without clinically relevant incidents, and had a lower allogeneic transfusion rate (11.5% vs 26.4% for the iron and control groups, respectively; p=0.001). The reduction in transfusion rate was more pronounced in anaemic patients (17% vs 40%; p=0.015) than in non-anaemic ones (9.6% vs 21.2%; p=0.011). There were no differences with respect to post-operative infection rate. Patients receiving allogeneic transfusion stayed in hospital longer (+1.9 days [95% CI: 1.2–2.6]). As intravenous iron reduces the allogeneic transfusion rate, both iron formulations were cost-neutral in the different cost scenarios (−25.5 to 62.1 €/patient for iron sucrose, and −51.1 to 64.4 €/patient for ferric carboxymaltose). Discussion In patients presenting with or without pre-operative anaemia, post-operative intravenous iron after total lower limb arthroplasty seems to be safe and is associated with reduced transfusion rates, without incremental costs. For anaemic patients, its efficacy could be increased by associating some other blood-saving method. PMID:24120595

Assessing the Total cost of ownership of ERP systems : Case study analysis on the factors behind customer costs in recent minor implementations

OpenAIRE

Rydgård, Göran; Palmberg, Nils

2010-01-01

This master’s thesis presents a model for calculating the total cost of ownership (TCO) of relatively small ERP implementations, including two years of running the system. The main factors affecting the cost items in the model are also analyzed, based in part on four case projects that the consultancy company Acando has carried out recently and in part on literature. The case projects were investigated through interviews with key actors in the projects from Acando and the customer, and throug...

Quantifying the total cost of infrastructure to enable environmentally preferable decisions: the case of urban roadway design

Science.gov (United States)

Gosse, Conrad A.; Clarens, Andres F.

2013-03-01

Efforts to reduce the environmental impacts of transportation infrastructure have generally overlooked many of the efficiencies that can be obtained by considering the relevant engineering and economic aspects as a system. Here, we present a framework for quantifying the burdens of ground transportation in urban settings that incorporates travel time, vehicle fuel and pavement maintenance costs. A Pareto set of bi-directional lane configurations for two-lane roadways yields non-dominated combinations of lane width, bicycle lanes and curb parking. Probabilistic analysis and microsimulation both show dramatic mobility reductions on road segments of insufficient width for heavy vehicles to pass bicycles without encroaching on oncoming traffic. This delay is positively correlated with uphill grades and increasing traffic volumes and inversely proportional to total pavement width. The response is nonlinear with grade and yields mixed uphill/downhill optimal lane configurations. Increasing bicycle mode share is negatively correlated with total costs and emissions for lane configurations allowing motor vehicles to safely pass bicycles, while the opposite is true for configurations that fail to facilitate passing. Spatial impacts on mobility also dictate that curb parking exhibits significant spatial opportunity costs related to the total cost Pareto curve. The proposed framework provides a means to evaluate relatively inexpensive lane reconfiguration options in response to changing modal share and priorities. These results provide quantitative evidence that efforts to reallocate limited pavement space to bicycles, like those being adopted in several US cities, could appreciably reduce costs for all users.

Quantifying the total cost of infrastructure to enable environmentally preferable decisions: the case of urban roadway design

International Nuclear Information System (INIS)

Gosse, Conrad A; Clarens, Andres F

2013-01-01

Efforts to reduce the environmental impacts of transportation infrastructure have generally overlooked many of the efficiencies that can be obtained by considering the relevant engineering and economic aspects as a system. Here, we present a framework for quantifying the burdens of ground transportation in urban settings that incorporates travel time, vehicle fuel and pavement maintenance costs. A Pareto set of bi-directional lane configurations for two-lane roadways yields non-dominated combinations of lane width, bicycle lanes and curb parking. Probabilistic analysis and microsimulation both show dramatic mobility reductions on road segments of insufficient width for heavy vehicles to pass bicycles without encroaching on oncoming traffic. This delay is positively correlated with uphill grades and increasing traffic volumes and inversely proportional to total pavement width. The response is nonlinear with grade and yields mixed uphill/downhill optimal lane configurations. Increasing bicycle mode share is negatively correlated with total costs and emissions for lane configurations allowing motor vehicles to safely pass bicycles, while the opposite is true for configurations that fail to facilitate passing. Spatial impacts on mobility also dictate that curb parking exhibits significant spatial opportunity costs related to the total cost Pareto curve. The proposed framework provides a means to evaluate relatively inexpensive lane reconfiguration options in response to changing modal share and priorities. These results provide quantitative evidence that efforts to reallocate limited pavement space to bicycles, like those being adopted in several US cities, could appreciably reduce costs for all users. (letter)

48 CFR 31.205-46 - Travel costs.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Travel costs. 31.205-46....205-46 Travel costs. (a) Costs for transportation, lodging, meals, and incidental expenses. (1) Costs... at the time of travel as set forth in the— (i) Federal Travel Regulation, prescribed by the General...

76 FR 38548 - Competitive and Noncompetitive Nonformula Federal Assistance Programs-Administrative Provisions...

Science.gov (United States)

2011-07-01

... non-Federal cost-share is a percentage of project cost, not Federal funds awarded. List of Subjects in... follows: Sec. 3430.705 Funding restrictions. (a) Facility costs. Funds made available under this subpart... amended to make minor revisions to the facility cost prohibition for purposes of consistency with other...

48 CFR 9904.416 - Accounting for insurance costs.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Accounting for insurance costs. 9904.416 Section 9904.416 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD... ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.416 Accounting for insurance costs. ...

Energy conservation. Federal shared energy savings contracting

International Nuclear Information System (INIS)

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

1989-04-01

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

50 CFR 80.12 - Cost sharing.

Science.gov (United States)

2010-10-01

... of cash or in-kind contributions. (c) The non-Federal share of project costs may not be derived from... 50 Wildlife and Fisheries 6 2010-10-01 2010-10-01 false Cost sharing. 80.12 Section 80.12 Wildlife... WILDLIFE RESTORATION AND DINGELL-JOHNSON SPORT FISH RESTORATION ACTS § 80.12 Cost sharing. Federal...

12 CFR 932.2 - Total capital requirement.

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Total capital requirement. 932.2 Section 932.2 Banks and Banking FEDERAL HOUSING FINANCE BOARD FEDERAL HOME LOAN BANK RISK MANAGEMENT AND CAPITAL STANDARDS FEDERAL HOME LOAN BANK CAPITAL REQUIREMENTS § 932.2 Total capital requirement. (a) Each Bank shall...

New directions in federal energy management

International Nuclear Information System (INIS)

Ginsberg, M.

1993-01-01

The fuel embargo of 1973, followed by the oil disruption of 1979 heightened national security concerns over the availability and price of foreign oil to sustain all sectors of the U.S. economy. As a result of our growing dependence on foreign oil and diminishing resources at home, the Federal government has worked since 1974 to identify and implement a variety of measures to reduce energy consumption in Federal buildings and operations. Federal energy expenditures peaked at almost $14 billion in 1982 but has now been reduced to approximately $10 billion a year. However, much more needs to be done. Since the 1973 oil embargo, a series of legislative initiatives and Presidential authorities established the Federal Energy Management Program (FEMP) and then expanded it to address a broad range of energy-related issues affecting the Federal sector. Administered by the U.S. Department of Energy, FEMP coordinates the design and implementation of energy-saving programs for Federal buildings and operations. This includes working with other Federal agencies through interagency committees to interpret and implement Federal policy, to provide technical assistance to other Federal agencies, and to collect and report Federal energy consumption data to Congress. In addition, with the passage of the Clean Air Act Amendments of 1990, concerns over global climate change and a range of man-made and natural pollutants, environmental issues now play a critical role in our nation's energy policy. As a major consumer of energy, the Federal sector can serve as an important model for other sectors of the economy as a result of some of the innovative and cost-effective measures planned or currently underway. My talk today will focus on the Federal government's plans to ensure the energy efficient design and operation of Federal facilities, with an emphasis on life-cycle cost analyses

48 CFR 9905.506 - Cost accounting period-Educational institutions.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Cost accounting period-Educational institutions. 9905.506 Section 9905.506 Federal Acquisition Regulations System COST ACCOUNTING... AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS FOR EDUCATIONAL INSTITUTIONS 9905.506 Cost...

Total direct cost, length of hospital stay, institutional discharges and their determinants from rehabilitation settings in stroke patients.

Science.gov (United States)

Saxena, S K; Ng, T P; Yong, D; Fong, N P; Gerald, K

2006-11-01

Length of hospital stay (LOHS) is the largest determinant of direct cost for stroke care. Institutional discharges (acute care and nursing homes) from rehabilitation settings add to the direct cost. It is important to identify potentially preventable medical and non-medical reasons determining LOHS and institutional discharges to reduce the direct cost of stroke care. The aim of the study was to ascertain the total direct cost, LOHS, frequency of institutional discharges and their determinants from rehabilitation settings. Observational study was conducted on 200 stroke patients in two rehabilitation settings. The patients were examined for various socio-demographic, neurological and clinical variables upon admission to the rehabilitation hospitals. Information on total direct cost and medical complications during hospitalization were also recorded. The outcome variables measured were total direct cost, LOHS and discharges to institutions (acute care and nursing home facility) and their determinants. The mean and median LOHS in our study were 34 days (SD = 18) and 32 days respectively. LOHS and the cost of hospital stay were significantly correlated. The significant variables associated with LOHS on multiple linear regression analysis were: (i) severe functional impairment/functional dependence Barthel Index institutional discharges (22 to acute care and 17 to nursing homes). On multivariate analysis the significant predictors of discharges to institutions from rehabilitation hospitals were medical complications (OR = 4.37; 95% CI 1.01-12.53) and severe functional impairment/functional dependence. (OR = 5.90, 95% CI 2.32-14.98). Length of hospital stay and discharges to institutions from rehabilitation settings are significantly determined by medical complications. Importance of adhering to clinical pathway/protocol for stroke care is further discussed.

Construction cost impact analysis of the U.S. Department of Energy mandatory performance standards for new federal commercial and multi-family, high-rise residential buildings

International Nuclear Information System (INIS)

Di Massa, F.V.; Hadley, D.L.; Halverson, M.A.

1993-12-01

In accordance with federal legislation, the U.S. Department of Energy (DOE) has conducted a project to demonstrate use of its Energy Conservation Voluntary Performance Standards for Commercial and Multi-Family High-Rise Residential Buildings; Mandatory for New Federal Buildings; Interim Rule (referred to in this report as DOE-1993). A key requisite of the legislation requires DOE to develop commercial building energy standards that are cost effective. During the demonstration project, DOE specifically addressed this issue by assessing the impacts of the standards on (1) construction costs, (2) builders (and especially small builders) of multi-family, high-rise buildings, and (3) the ability of low-to moderate-income persons to purchase or rent units in such buildings. This document reports on this project

Analysing uncertainty around costs of innovative medical technologies: the case of fibrin sealant (QUIXIL) for total knee replacement.

NARCIS (Netherlands)

Steuten, Lotte Maria Gertruda; Vallejo-Torres, Laura; Bastide, Philippe; Buxton, Martin J.

2009-01-01

This paper presents a relatively simple cost model comparing the costs of using a commercial fibrin sealant (QUIXIL®) in addition to conventional haemostatic treatment vs. conventional treatment alone in total knee replacement (TKR) surgery, and demonstrates and discusses how one- and two-way

48 CFR 9903.101 - Cost Accounting Standards.

Science.gov (United States)

2010-10-01

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

Cost-Effectiveness of Reverse Total Shoulder Arthroplasty Versus Arthroscopic Rotator Cuff Repair for Symptomatic Large and Massive Rotator Cuff Tears.

Science.gov (United States)

Makhni, Eric C; Swart, Eric; Steinhaus, Michael E; Mather, Richard C; Levine, William N; Bach, Bernard R; Romeo, Anthony A; Verma, Nikhil N

2016-09-01

To compare the cost-effectiveness within the United States health care system of arthroscopic rotator cuff repair versus reverse total shoulder arthroplasty in patients with symptomatic large and massive rotator cuff tears without cuff-tear arthropathy. An expected-value decision analysis was constructed comparing the costs and outcomes of patients undergoing arthroscopic rotator cuff repair and reverse total shoulder arthroplasty for large and massive rotator cuff tears (and excluding cases of cuff-tear arthropathy). Comprehensive literature search provided input data to extrapolate costs and health utility states for these outcomes. The primary outcome assessed was that of incremental cost-effectiveness ratio (ICER) of reverse total shoulder arthroplasty versus rotator cuff repair. For the base case, both arthroscopic rotator cuff repair and reverse total shoulder were superior to nonoperative care, with an ICER of $15,500/quality-adjusted life year (QALY) and $37,400/QALY, respectively. Arthroscopic rotator cuff repair was dominant over primary reverse total shoulder arthroplasty, with lower costs and slightly improved clinical outcomes. Arthroscopic rotator cuff repair was the preferred strategy as long as the lifetime progression rate from retear to end-stage cuff-tear arthropathy was less than 89%. However, when the model was modified to account for worse outcomes when reverse shoulder arthroplasty was performed after a failed attempted rotator cuff repair, primary reverse total shoulder had superior outcomes with an ICER of $90,000/QALY. Arthroscopic rotator cuff repair-despite high rates of tendon retearing-for patients with large and massive rotator cuff tears may be a more cost-effective initial treatment strategy when compared with primary reverse total shoulder arthroplasty and when assuming no detrimental impact of previous surgery on outcomes after arthroplasty. Clinical judgment should still be prioritized when formulating treatment plans for these

Multi-Product Total Cost of Function for Higher Education: A Case of Bible Colleges.

Science.gov (United States)

Koshal, Rajindar K.; Koshal, Manjulika; Gupta, Ashok

2001-01-01

This study empirically estimates a multiproduct total cost function and output relationship for comprehensive U.S. universities. Statistical results for 184 Bible colleges suggest that there are both economies of scale and of scope in higher education. Additionally, product-specific economies of scope exist for all output levels and activities.…

77 FR 45592 - Notice of Submission for OMB Review; Federal Student Aid; Federal Perkins Loan Program Master...

Science.gov (United States)

2012-08-01

... loans for eligible students to pay the costs of a student's attendance at an eligible institution of... DEPARTMENT OF EDUCATION Notice of Submission for OMB Review; Federal Student Aid; Federal Perkins... technology. Please note that written comments received in response to this notice will be considered public...

48 CFR 16.405 - Cost-reimbursement incentive contracts.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Cost-reimbursement incentive contracts. 16.405 Section 16.405 Federal Acquisition Regulations System FEDERAL ACQUISITION...-reimbursement incentive contracts. See 16.301 for requirements applicable to all cost-reimbursement contracts...

Cost Effectiveness of On-site versus Off-site Depression Collaborative Care in Rural Federally Qualified Health Centers

Science.gov (United States)

Pyne, Jeffrey M.; Fortney, John C.; Mouden, Sip; Lu, Liya; Hudson, Teresa J; Mittal, Dinesh

2018-01-01

Objective Collaborative care for depression is effective and cost-effective in primary care settings. However, there is minimal evidence to inform the choice of on-site versus off-site models. This study examined the cost-effectiveness of on-site practice-based collaborative care (PBCC) versus off-site telemedicine-based collaborative care (TBCC) for depression in Federally Qualified Health Centers (FQHCs). Methods Multi-site randomized pragmatic comparative cost-effectiveness trial. 19,285 patients were screened for depression, 14.8% (n=2,863) screened positive (PHQ9 ≥10) and 364 were enrolled. Telephone interview data were collected at baseline, 6-, 12-, and 18-months. Base case analysis used Arkansas FQHC healthcare costs and secondary analysis used national cost estimates. Effectiveness measures were depression-free days and quality-adjusted life years (QALYs) derived from depression-free days, Medical Outcomes Study SF-12, and Quality of Well Being scale (QWB). Nonparametric bootstrap with replacement methods were used to generate an empirical joint distribution of incremental costs and QALYs and acceptability curves. Results Mean base case FQHC incremental cost-effectiveness ratio (ICER) using depression-free days was $10.78/depression-free day. Mean base case ICERs using QALYs ranged from $14,754/QALY (depression-free day QALY) to $37,261/QALY (QWB QALY). Mean secondary national ICER using depression-free days was $8.43/depression-free day and using QALYs ranged from $11,532/QALY (depression-free day QALY) to $29,234/QALY (QWB QALY). Conclusions These results support the cost-effectiveness of the TBCC intervention in medically underserved primary care settings. Results can inform the decision about whether to insource (make) or outsource (buy) depression care management in the FQHC setting within the current context of Patient-Centered Medical Home, value-based purchasing, and potential bundled payments for depression care. The www.clinicaltrials.gov # for

Leveraging Real-World Evidence in Disease-Management Decision-Making with a Total Cost of Care Estimator.

Science.gov (United States)

Nguyen, Thanh-Nghia; Trocio, Jeffrey; Kowal, Stacey; Ferrufino, Cheryl P; Munakata, Julie; South, Dell

2016-12-01

Health management is becoming increasingly complex, given a range of care options and the need to balance costs and quality. The ability to measure and understand drivers of costs is critical for healthcare organizations to effectively manage their patient populations. Healthcare decision makers can leverage real-world evidence to explore the value of disease-management interventions in shifting total cost trends. To develop a real-world, evidence-based estimator that examines the impact of disease-management interventions on the total cost of care (TCoC) for a patient population with nonvalvular atrial fibrillation (NVAF). Data were collected from a patient-level real-world evidence data set that uses the IMS PharMetrics Health Plan Claims Database. Pharmacy and medical claims for patients meeting the inclusion or exclusion criteria were combined in longitudinal cohorts with a 180-day preindex and 360-day follow-up period. Descriptive statistics, such as mean and median patient costs and event rates, were derived from a real-world evidence analysis and were used to populate the base-case estimates within the TCoC estimator, an exploratory economic model that was designed to estimate the potential impact of several disease-management activities on the TCoC for a patient population with NVAF. Using Microsoft Excel, the estimator is designed to compare current direct costs of medical care to projected costs by varying assumptions on the impact of disease-management activities and applying the associated changes in cost trends to the affected populations. Disease-management levers are derived from literature-based concepts affecting costs along the NVAF disease continuum. The use of the estimator supports analyses across 4 US geographic regions, age, cost types, and care settings during 1 year. All patients included in the study were continuously enrolled in their health plan (within the IMS PharMetrics Health Plan Claims Database) between July 1, 2010, and June 30

Cost Savings of Nuclear Power with Total Fuel Reprocessing

International Nuclear Information System (INIS)

Solbrig, Charles W.; Benedict, Robert W.

2006-01-01

The cost of fast reactor (FR) generated electricity with pyro-processing is estimated in this article. It compares favorably with other forms of energy and is shown to be less than that produced by light water reactors (LWR's). FR's use all the energy in natural uranium whereas LWR's utilize only 0.7% of it. Because of high radioactivity, pyro-processing is not open to weapon material diversion. This technology is ready now. Nuclear power has the same advantage as coal power in that it is not dependent upon a scarce foreign fuel and has the significant additional advantage of not contributing to global warming or air pollution. A jump start on new nuclear plants could rapidly allow electric furnaces to replace home heating oil furnaces and utilize high capacity batteries for hybrid automobiles: both would reduce US reliance on oil. If these were fast reactors fueled by reprocessed fuel, the spent fuel storage problem could also be solved. Costs are derived from assumptions on the LWR's and FR's five cost components: 1) Capital costs: LWR plants cost $106/MWe. FR's cost 25% more. Forty year amortization is used. 2) The annual O and M costs for both plants are 9% of the Capital Costs. 3) LWR fuel costs about 0.0035 $/kWh. Producing FR fuel from spent fuel by pyro-processing must be done in highly shielded hot cells which is costly. However, the five foot thick concrete walls have the advantage of prohibiting diversion. LWR spent fuel must be used as feedstock for the FR initial core load and first two reloads so this FR fuel costs more than LWR fuel. FR fuel costs much less for subsequent core reloads ( 6 /MWe. The annual cost for a 40 year licensed plant would be 2.5 % of this or less if interest is taken into account. All plants will eventually have to replace those components which become radiation damaged. FR's should be designed to replace parts rather than decommission. The LWR costs are estimated to be 2.65 cents/kWh. FR costs are 2.99 cents/kWh for the first

Health care prices, the federal budget, and economic growth.

Science.gov (United States)

Monaco, R M; Phelps, J H

1995-01-01

Rising health care spending, led by rising prices, has had an enormous impact on the economy, especially on the federal budget. Our work shows that if rapid growth in health care prices continues, under current institutional arrangements, real economic growth and employment will be lower during the next two decades than if health price inflation were somehow reduced. How big the losses are and which sectors bear the brunt of the costs vary depending on how society chooses to fund the federal budget deficit that stems from the rising cost of federal health care programs.

Insurer Competition In Federally Run Marketplaces Is Associated With Lower Premiums.

Science.gov (United States)

Jacobs, Paul D; Banthin, Jessica S; Trachtman, Samuel

2015-12-01

Federal subsidies for health insurance premiums sold through the Marketplaces are tied to the cost of the benchmark plan, the second-lowest-cost silver plan. According to economic theory, the presence of more competitors should lead to lower premiums, implying smaller federal outlays for premium subsidies. The long-term impact of the Affordable Care Act on government spending will depend on the cost of these premium subsidies over time, with insurer participation and the level of competition likely to influence those costs. We studied insurer participation and premiums during the first two years of the Marketplaces. We found that the addition of a single insurer in a county was associated with a 1.2 percent lower premium for the average silver plan and a 3.5 percent lower premium for the benchmark plan in the federally run Marketplaces. We found that the effect of insurer entry was muted after two or three additional entrants. These findings suggest that increased insurer participation in the federally run Marketplaces reduces federal payments for premium subsidies. Project HOPE—The People-to-People Health Foundation, Inc.

Direct hospital costs of total laparoscopic hysterectomy compared with fast-track open hysterectomy at a tertiary hospital: a retrospective case-controlled study.

Science.gov (United States)

Rhou, Yoon J J; Pather, Selvan; Loadsman, John A; Campbell, Neil; Philp, Shannon; Carter, Jonathan

2015-12-01

To assess the direct intraoperative and postoperative costs in women undergoing total laparoscopic hysterectomy and fast-track open hysterectomy. A retrospective review of the direct hospital-related costs in a matched cohort of women undergoing total laparoscopic hysterectomy (TLH) and fast-track open hysterectomy (FTOH) at a tertiary hospital. All costs were calculated, including the cost of advanced high-energy laparoscopic devices. The effect of the learning curve on cost in laparoscopic hysterectomy was also assessed, as was the hospital case-weighted cost, which was compared with the actual cost. Fifty women were included in each arm of the study. TLH had a higher intraoperative cost, but a lower postoperative cost than FTOH (AUD$3877 vs AUD$2776 P funding model in our hospital is inaccurate when compared to directly calculated hospital costs. © 2013 The Authors ANZJOG © 2013 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

22 CFR 135.22 - Allowable costs.

Science.gov (United States)

2010-04-01

... Procedures, or uniform cost accounting standards that comply with cost principles acceptable to the Federal... AGREEMENTS TO STATE AND LOCAL GOVERNMENTS Post-Award Requirements Financial Administration § 135.22 Allowable... principles. For each kind of organization, there is a set of Federal principles for determining allowable...

48 CFR 9903.307 - Cost Accounting Standards Preambles.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Cost Accounting Standards Preambles. 9903.307 Section 9903.307 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD... ACCOUNTING STANDARDS CONTRACT COVERAGE CAS Rules and Regulations 9903.307 Cost Accounting Standards Preambles...

Do illness rating systems predict discharge location, length of stay, and cost after total hip arthroplasty?

Directory of Open Access Journals (Sweden)

Sarah E. Rudasill, BA

2018-06-01

Conclusions: These findings suggest that although ASA classifications predict discharge location and SOI scores predict length of stay and total costs, other factors beyond illness rating systems remain stronger predictors of discharge for THA patients.

Promoting cooperative federalism through state shared savings.

Science.gov (United States)

Weil, Alan

2013-08-01

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

A Comparative Cost Analysis of Commodity Foods from the U. S. Department of Agriculture in the National School Lunch Program

Science.gov (United States)

Peterson, Cora

2009-01-01

Schools that participate in the National School Lunch Program receive a portion of their federal funding as commodity foods rather than cash payments. This research compared the product costs and estimated total procurement costs of commodity and commercial foods from the school district perspective using data from 579 Minnesota ordering sites in…

Integrated batch production and maintenance scheduling for multiple items processed on a deteriorating machine to minimize total production and maintenance costs with due date constraint

Directory of Open Access Journals (Sweden)

Zahedi Zahedi

2016-04-01

Full Text Available This paper discusses an integrated model of batch production and maintenance scheduling on a deteriorating machine producing multiple items to be delivered at a common due date. The model describes the trade-off between total inventory cost and maintenance cost as the increase of production run length. The production run length is a time bucket between two consecutive preventive maintenance activities. The objective function of the model is to minimize total cost consisting of in process and completed part inventory costs, setup cost, preventive and corrective maintenance costs and rework cost. The problem is to determine the optimal production run length and to schedule the batches obtained from determining the production run length in order to minimize total cost.

Efficiency and Cost Analysis of Cell Saver Auto Transfusion System in Total Knee Arthroplasty

Directory of Open Access Journals (Sweden)

Mustafa Gökhan Bilgili

2014-06-01

Full Text Available Background: Blood loss and replacement is still a controversial issue in major orthopaedic surgery. Allogenic blood transfusion may cause legal problems and concerns regarding the transmission of transfusion-related diseases. Cellsaver Systems (CSS were developed as an alternative to allogenic transfusion but CSS transfusion may cause coagulation, infection and haemodynamic instability. Aims: Our aim was to analyse the efficiency and cost analysis of a cell saver auto-transfusion system in the total knee arthroplasty procedure. Study Design: Retrospective comparative study. Methods: Those patients who were operated on by unilateral, cemented total knee arthroplasty (TKA were retrospectively evaluated. Group 1 included 37 patients who were treated using the cell saver system, and Group 2 involved 39 patients who were treated by allogenic blood transfusion. The groups were compared in terms of preoperative haemoglobin and haematocrit levels, blood loss and transfusion amount, whether allogenic transfusion was made, degree of deformity, body mass index and cost. Results: No significant results could be obtained in the statistical comparisons made in terms of the demographic properties, deformity properties, preoperative laboratory values, transfusion amount and length of hospital stay of the groups. Average blood loss was calculated to be less in Group 1 (p<0.05 and cost was higher in Group 1 (p<0.05. Conclusion: Cell saver systems do not decrease the amount of allogenic blood transfusion and costs more. Therefore, the routine usage of the auto-transfusion systems is a controversial issue. Cell saver system usage does not affect allogenic blood transfusion incidence or allogenic blood transfusion volume. It was found that preoperative haemoglobin and body mass index rates may affect allogenic blood transfusion. Therefore, it is foreseen that auto-transfusion systems could be useful in patients with low haemoglobin level and body mass index.

20 CFR 627.435 - Cost principles and allowable costs.

Science.gov (United States)

2010-04-01

... system, including the costs of hearings and appeals, and related expenses such as lawyers' fees. Legal...) Legal expenses for the prosecution of claims against the Federal Government, including appeals to an... incurred by the SJTCC, HRIC, PIC's, and other advisory councils or committees; (3) Advertising costs; (4...

Como Solicitar la Asistencia Economica Federal para Estudiantes (How To Apply for Federal Student Aid).

Science.gov (United States)

Office of Federal Student Aid (ED), Washington, DC.

This guide, written in Spanish, discusses reasons for going to college, how to pay for college, and how to apply for federal student aid in a series of brief, clear illustrations. Following outlines of financial benefits of college, college costs, and space to note costs for the student's area, the guide outlines these steps in the application…

Predictors for total medical costs for acute hemorrhagic stroke patients transferred to the rehabilitation ward at a regional hospital in Taiwan.

Science.gov (United States)

Chen, Chien-Min; Ke, Yen-Liang

2016-02-01

One-third of the acute stroke patients in Taiwan receive rehabilitation. It is imperative for clinicians who care for acute stroke patients undergoing inpatient rehabilitation to identify which medical factors could be the predictors of the total medical costs. The aim of this study was to identify the most important predictors of the total medical costs for first-time hemorrhagic stroke patients transferred to inpatient rehabilitation using a retrospective design. All data were retrospectively collected from July 2002 to June 2012 from a regional hospital in Taiwan. A stepwise multivariate linear regression analysis was used to identify the most important predictors for the total medical costs. The medical records of 237 patients (137 males and 100 females) were reviewed. The mean total medical cost per patient was United States dollar (USD) 5939.5 ± 3578.5.The following were the significant predictors for the total medical costs: impaired consciousness [coefficient (B), 1075.7; 95% confidence interval (CI) = 138.5-2012.9], dysphagia [coefficient (B), 1025.8; 95% CI = 193.9-1857.8], number of surgeries [coefficient (B), 796.4; 95% CI = 316.0-1276.7], pneumonia in the neurosurgery ward [coefficient (B), 2330.1; 95% CI = 1339.5-3320.7], symptomatic urinary tract infection (UTI) in the rehabilitation ward [coefficient (B), 1138.7; 95% CI = 221.6-2055.7], and rehabilitation ward stay [coefficient (B), 64.9; 95% CI = 31.2-98.7] (R(2) = 0.387). Our findings could help clinicians to understand that cost reduction may be achieved by minimizing complications (pneumonia and UTI) in these patients.

75 FR 53127 - Federal Acquisition Regulation; Federal Acquisition Circular 2005-45; Introduction

Science.gov (United States)

2010-08-30

... summarizes the Federal Acquisition Regulation (FAR) rules agreed to by the Civilian Agency Acquisition... Chambers. Cost or Pricing Data. III American Recovery 2009-008 Davis. and Reinvestment Act of 2009 (the Recovery Act)-- Buy American Requirements for Construction Materials. SUPPLEMENTARY INFORMATION: Summaries...

48 CFR 28.307 - Insurance under cost-reimbursement contracts.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Insurance under cost-reimbursement contracts. 28.307 Section 28.307 Federal Acquisition Regulations System FEDERAL ACQUISITION...-reimbursement contracts. Cost-reimbursement contracts (and subcontracts, if the terms of the prime contract are...

48 CFR 49.303-4 - Adjustment of indirect costs.

Science.gov (United States)

2010-10-01

... costs. 49.303-4 Section 49.303-4 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACT MANAGEMENT TERMINATION OF CONTRACTS Additional Principles for Cost-Reimbursement Contracts... compute indirect costs for other contracts performed during the applicable accounting period. [48 FR 42447...

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

Energy Technology Data Exchange (ETDEWEB)

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

2015-03-01

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

48 CFR 9904.420 - Accounting for independent research and development costs and bid and proposal costs.

Science.gov (United States)

2010-10-01

... Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.420 Accounting for independent research and development costs and bid and proposal costs. ...

31 CFR 29.345 - Cost-of-living adjustments.

Science.gov (United States)

2010-07-01

... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Cost-of-living adjustments. 29.345 Section 29.345 Money and Finance: Treasury Office of the Secretary of the Treasury FEDERAL BENEFIT... Federal Benefit Payments § 29.345 Cost-of-living adjustments. Cost-of-living increases are applied...

Nuclear supervision - Administration by the federal states on behalf of the Federal Government or direct federal administration for optimum achievement

International Nuclear Information System (INIS)

Renneberg, W.

2005-01-01

One year ago, Federal Minister for the Environment Juergen Trittin expressed doubt about the long-term viability of the federal states' acting on behalf of the federal government in the field of atomic energy law administration. An alternative to this type of administration was mentioned, namely direct execution by the feral government, and a thorough examination was announced. This was to show which type of administration would achieve maximum safety for the residual operating lives of nuclear power plants. Kienbaum Management Consultants were commissioned to evaluate the current status and potential alternative structures. That study was performed within the framework of one of the key projects in reactor safety of the Federal Ministry for the Environment, Nature Conservation, and Nuclear Safety (BMU), namely the reform of nuclear administration. Further steps to be taken by the BMU by the end of this parliamentary term are presented. The federal state are to be approached in an attempt to conduct an unbiased discussion of the pros and cons of the alternatives to administration by the federal states on behalf of the federal government. Questions will be clarified which need to be examined in depth before direct administration by the federal government can be introduced. These include constitutional matters and matters of costing in financing the higher-level federal authority as well as specific questions about the organization of that authority. The purpose is to elaborate, by the end of this parliamentary term, a workable concept of introducing direct federal administration of nuclear safety. (orig.)

75 FR 64684 - Cost Accounting Standards: Elimination of the Exemption From Cost Accounting Standards for...

Science.gov (United States)

2010-10-20

... cost accounting standards governing the measurement, assignment, and allocation of costs to contracts... Accounting Standards: Elimination of the Exemption From Cost Accounting Standards for Contracts Executed and... and Budget (OMB), Office of Federal Procurement Policy, Cost Accounting Standards Board. ACTION...

48 CFR 970.3102-05-46 - Travel costs.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Travel costs. 970.3102-05....3102-05-46 Travel costs. (a) Costs for transportation, lodging, meals, and incidental expenses. (1... rates in effect at the time of travel as set forth in the— (i) Federal Travel Regulation, prescribed by...

48 CFR 52.246-5 - Inspection of Services-Cost-Reimbursement.

Science.gov (United States)

2010-10-01

...-Cost-Reimbursement. 52.246-5 Section 52.246-5 Federal Acquisition Regulations System FEDERAL... Provisions and Clauses 52.246-5 Inspection of Services—Cost-Reimbursement. As prescribed in 46.305, insert... furnishing of services, when a cost-reimbursement contract is contemplated: Inspection of Services—Cost...

48 CFR 52.246-3 - Inspection of Supplies-Cost-Reimbursement.

Science.gov (United States)

2010-10-01

...-Cost-Reimbursement. 52.246-3 Section 52.246-3 Federal Acquisition Regulations System FEDERAL... Provisions and Clauses 52.246-3 Inspection of Supplies—Cost-Reimbursement. As prescribed in 46.303, insert... furnishing of supplies, when a cost-reimbursement contract is contemplated: Inspection of Supplies—Cost...

48 CFR 9904.413 - Adjustment and allocation of pension cost.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Adjustment and allocation of pension cost. 9904.413 Section 9904.413 Federal Acquisition Regulations System COST ACCOUNTING... AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.413 Adjustment and allocation of pension...

48 CFR 216.405 - Cost-reimbursement incentive contracts.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Cost-reimbursement incentive contracts. 216.405 Section 216.405 Federal Acquisition Regulations System DEFENSE ACQUISITION... Contracts 216.405 Cost-reimbursement incentive contracts. ...

Vector Production in an Academic Environment: A Tool to Assess Production Costs

Science.gov (United States)

Boeke, Aaron; Doumas, Patrick; Reeves, Lilith; McClurg, Kyle; Bischof, Daniela; Sego, Lina; Auberry, Alisha; Tatikonda, Mohan

2013-01-01

Abstract Generating gene and cell therapy products under good manufacturing practices is a complex process. When determining the cost of these products, researchers must consider the large number of supplies used for manufacturing and the personnel and facility costs to generate vector and maintain a cleanroom facility. To facilitate cost estimates, the Indiana University Vector Production Facility teamed with the Indiana University Kelley School of Business to develop a costing tool that, in turn, provides pricing. The tool is designed in Microsoft Excel and is customizable to meet the needs of other core facilities. It is available from the National Gene Vector Biorepository. The tool allows cost determinations using three different costing methods and was developed in an effort to meet the A21 circular requirements for U.S. core facilities performing work for federally funded projects. The costing tool analysis reveals that the cost of vector production does not have a linear relationship with batch size. For example, increasing the production from 9 to18 liters of a retroviral vector product increases total costs a modest 1.2-fold rather than doubling in total cost. The analysis discussed in this article will help core facilities and investigators plan a cost-effective strategy for gene and cell therapy production. PMID:23360377

48 CFR 49.603-3 - Cost-reimbursement contracts-complete termination, if settlement includes cost.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Cost-reimbursement... Termination Forms and Formats 49.603-3 Cost-reimbursement contracts—complete termination, if settlement includes cost. [Insert the following in Block 14 of SF 30 for settlement of cost-reimbursement contracts...

Efficiency and cost analysis of cell saver auto transfusion system in total knee arthroplasty.

Science.gov (United States)

Bilgili, Mustafa Gökhan; Erçin, Ersin; Peker, Gökhan; Kural, Cemal; Başaran, Serdar Hakan; Duramaz, Altuğ; Avkan, Cevdet

2014-06-01

Blood loss and replacement is still a controversial issue in major orthopaedic surgery. Allogenic blood transfusion may cause legal problems and concerns regarding the transmission of transfusion-related diseases. Cellsaver Systems (CSS) were developed as an alternative to allogenic transfusion but CSS transfusion may cause coagulation, infection and haemodynamic instability. Our aim was to analyse the efficiency and cost analysis of a cell saver auto-transfusion system in the total knee arthroplasty procedure. Retrospective comparative study. Those patients who were operated on by unilateral, cemented total knee arthroplasty (TKA) were retrospectively evaluated. Group 1 included 37 patients who were treated using the cell saver system, and Group 2 involved 39 patients who were treated by allogenic blood transfusion. The groups were compared in terms of preoperative haemoglobin and haematocrit levels, blood loss and transfusion amount, whether allogenic transfusion was made, degree of deformity, body mass index and cost. No significant results could be obtained in the statistical comparisons made in terms of the demographic properties, deformity properties, preoperative laboratory values, transfusion amount and length of hospital stay of the groups. Average blood loss was calculated to be less in Group 1 (pblood transfusion and costs more. Therefore, the routine usage of the auto-transfusion systems is a controversial issue. Cell saver system usage does not affect allogenic blood transfusion incidence or allogenic blood transfusion volume. It was found that preoperative haemoglobin and body mass index rates may affect allogenic blood transfusion. Therefore, it is foreseen that auto-transfusion systems could be useful in patients with low haemoglobin level and body mass index.

Autologous Stem Cell Transplantation in Patients With Multiple Myeloma: An Activity-based Costing Analysis, Comparing a Total Inpatient Model Versus an Early Discharge Model.

Science.gov (United States)

Martino, Massimo; Console, Giuseppe; Russo, Letteria; Meliado', Antonella; Meliambro, Nicola; Moscato, Tiziana; Irrera, Giuseppe; Messina, Giuseppe; Pontari, Antonella; Morabito, Fortunato

2017-08-01

Activity-based costing (ABC) was developed and advocated as a means of overcoming the systematic distortions of traditional cost accounting. We calculated the cost of high-dose chemotherapy and autologous stem cell transplantation (ASCT) in patients with multiple myeloma using the ABC method, through 2 different care models: the total inpatient model (TIM) and the early-discharge outpatient model (EDOM) and compared this with the approved diagnosis related-groups (DRG) Italian tariffs. The TIM and EDOM models involved a total cost of €28,615.15 and €16,499.43, respectively. In the TIM model, the phase with the greatest economic impact was the posttransplant (recovery and hematologic engraftment) with 36.4% of the total cost, whereas in the EDOM model, the phase with the greatest economic impact was the pretransplant (chemo-mobilization, apheresis procedure, cryopreservation, and storage) phase, with 60.4% of total expenses. In an analysis of each episode, the TIM model comprised a higher absorption than the EDOM. In particular, the posttransplant represented 36.4% of the total costs in the TIM and 17.7% in EDOM model, respectively. The estimated reduction in cost per patient using an EDOM model was over €12,115.72. The repayment of the DRG in Calabrian Region for the ASCT procedure is €59,806. Given the real cost of the transplant, the estimated cost saving per patient is €31,190.85 in the TIM model and €43,306.57 in the EDOM model. In conclusion, the actual repayment of the DRG does not correspond to the real cost of the ASCT procedure in Italy. Moreover, using the EDOM, the cost of ASCT is approximately the half of the TIM model. Copyright © 2017 Elsevier Inc. All rights reserved.

48 CFR 9904.408 - Accounting for costs of compensated personal absence.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Accounting for costs of compensated personal absence. 9904.408 Section 9904.408 Federal Acquisition Regulations System COST ACCOUNTING... AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.408 Accounting for costs of compensated...

Skilled Nursing Facility Partnerships May Decrease 90-Day Costs in a Total Joint Arthroplasty Episode Under the Bundled Payments for Care Improvement Initiative.

Science.gov (United States)

Behery, Omar A; Kouk, Shalen; Chen, Kevin K; Mullaly, Kathleen A; Bosco, Joseph A; Slover, James D; Iorio, Richard; Schwarzkopf, Ran

2018-03-01

The Bundled Payments for Care Improvement initiative was developed to reduce costs associated with total joint arthroplasty through a single payment for all patient care from index admission through a 90-day post-discharge period, including care at skilled nursing facilities (SNFs). The aim of this study is to investigate whether forming partnerships between hospitals and SNFs could lower the post-discharge costs. We hypothesize that institutionally aligned SNFs have lower post-discharge costs than non-aligned SNFs. A cohort of 615 elective, primary total hip and knee arthroplasty subjects discharged to an SNF under the Bundled Payments for Care Improvement from 2014 to 2016 were included in our analysis. Patients were grouped into one of the 3 categories of SNF alignment: group 1: non-partners; group 2: agreement-based partners; group 3: institution-owned partners. Demographics, comorbidities, length of stay (LOS) at SNF, and associated costs during the 90-day post-operative period were compared between the 3 groups. Mean index hospital LOS was statistically shortest in group 3 (mean 2.7 days vs 3.5 for groups 1 and 2, P = .001). SNF LOS was also shortest in group 3 (mean 11 days vs 19 and 21 days in groups 2 and 1 respectively, P Total SNF costs and total 90-day costs were both significantly lower in group 3 compared with groups 1 and 2 (P total 90-day costs, without increased risk of readmissions, compared with other SNFs. Copyright © 2017 Elsevier Inc. All rights reserved.

48 CFR 970.3102-05-30 - Patent costs.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Patent costs. 970.3102-05-30 Section 970.3102-05-30 Federal Acquisition Regulations System DEPARTMENT OF ENERGY AGENCY....3102-05-30 Patent costs. ...

The cost of post-operative shed blood salvage after total knee arthroplasty: an analysis of 1,093 consecutive procedures

Science.gov (United States)

Muñoz, Manuel; Ariza, Daniel; Campos, Arturo; Martín-Montañez, Elisa; Pavía, José

2013-01-01

Background Requirements for allogeneic red cell transfusion after total knee arthroplasty are still high (20–50%), and salvage and reinfusion of unwashed, filtered post-operative shed blood is an established method for reducing transfusion requirements following this operation. We performed a cost analysis to ascertain whether this alternative is likely to be cost-effective. Materials and methods Data from 1,093 consecutive primary total knee arthroplasties, managed with (reinfusion group, n=763) or without reinfusion of unwashed salvaged blood (control group, n=330), were retrospectively reviewed. The costs of low-vacuum drains, shed blood collection canisters (Bellovac ABT®, Wellspect HealthCare and ConstaVac CBC II®, Stryker), shed blood reinfusion, acquisition and transfusion of allogeneic red cell concentrate, haemoglobin measurements, and prolonged length of hospital stay were used for the blood management cost analysis. Results Patients in the reinfusion group received 152±64 mL of red blood cells from postoperatively salvaged blood, without clinically relevant incidents, and showed a lower allogeneic transfusion rate (24.5% vs 8.5%, for the control and reinfusion groups, respectively; p =0.001). There were no differences in post-operative infection rates. Patients receiving allogeneic transfusions stayed in hospital longer (+1.9 days [95% CI: 1.2 to 2.6]). As reinfusion of unwashed salvaged blood reduced the allogeneic transfusion rate, both reinfusion systems may provide net savings in different cost scenarios (€ 4.6 to € 106/patient for Bellovac ABT, and € −51.9 to € 49.9/patient for ConstaVac CBCII). Discussion Return of unwashed salvaged blood after total knee arthroplasty seems to save costs in patients with pre-operative haemoglobin between 12 and 15 g/dL. It is not cost-saving in patients with a pre-operative haemoglobin >15 g/dL, whereas in those with a pre-operative haemoglobin cost-saving, its efficacy could be increased by

Using Electromagnetic Algorithm for Total Costs of Sub-contractor Optimization in the Cellular Manufacturing Problem

Directory of Open Access Journals (Sweden)

Mohammad Reza Shahriari

2016-12-01

Full Text Available In this paper, we present a non-linear binary programing for optimizing a specific cost in cellular manufacturing system in a controlled production condition. The system parameters are determined by the continuous distribution functions. The aim of the presented model is to optimize the total cost of imposed sub-contractors to the manufacturing system by determining how to allocate the machines and parts to each seller. In this system, DM could control the occupation level of each machine in the system. For solving the presented model, we used the electromagnetic meta-heuristic algorithm and Taguchi method for determining the optimal algorithm parameters.

Federal Government Electronic Bulletin Boards: An Assessment with Policy Recommendations.

Science.gov (United States)

Bertot, John Carlo; McClure, Charles R.

1993-01-01

Identifies and analyzes federal government electronic bulletin boards; assesses the types of information available to users, including costs and technological access issues; discusses federal information policy; and considers the role of federal bulletin boards in accessing and managing electronic government information. (Contains 29 references.)…

48 CFR 9904.415 - Accounting for the cost of deferred compensation.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Accounting for the cost of deferred compensation. 9904.415 Section 9904.415 Federal Acquisition Regulations System COST ACCOUNTING... AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.415 Accounting for the cost of deferred...

76 FR 68040 - Federal Acquisition Regulation; Labor Relations Costs

Science.gov (United States)

2011-11-02

.... FOR FURTHER INFORMATION CONTACT: Mr. Edward N. Chambers, Procurement Analyst, at (202) 501-3221, for... allowed for reimbursement under the well-established Federal procurement scheme, which already contains... contractor business ethics. L. Regulatory Flexibility Act Comment: Two respondents stated that the rule fails...

The role of the Federal Relighting Initiative in emission controls

International Nuclear Information System (INIS)

Nicholls, A.K.; Purcell, C.W.; Friedman, J.R.

1992-10-01

The Department of Energy's (DOE) Federal Relighting Initiative (FRI), under the Federal Energy Management Program (FEMP), has developed a comprehensive process to assist federal agencies in meeting the nation's energy mandate. This mandate states that federal facilities must use 20% less energy by the year 2000, based on 1985 consumption levels. Because lighting accounts for about 40% of total federal electricity consumption, the FRI was conceived to help reduce energy use in this important area while improving lighting quality and increasing productivity through relighting. Selected federal rules and regulations provide guidance on the types of energy efficiency techniques required, life-cycle costing methods and lighting levels that should be employed to achieve the federal mandate. Although the central focus of this paper is on the environment, this paper takes the perspective that the energy efficiency gains achieved through the FRI would produce both environmental and economic benefits for the United States. For example, improvements in energy efficiency would reduce electricity demand, and would consequently reduce the emissions associated with fossil fuel combustion for power production. These reduced emissions include carbon dioxide, which is associated with the potential for global climate change, and heavy metals, which pose a potential health threat to humans and aquatic ecosystems. Economic benefits of the FRI would include reduced federal expenditures on energy or, possibly, avoiding new power plant construction.This paper begins with a brief overview of the FRI process. Next, current lighting energy use in federal buildings is evaluated and the potential future energy savings achievable through full implementation of the FRI are estimated. The paper then translates these energy savings into avoided emissions of carbon dioxide and heavy metals and into avoided fuel expenditures

Assessment of cost sharing in the Pima County Marketplace.

Science.gov (United States)

Jennings, Nicholas B; Eng, Howard J

2017-01-01

The Patient Protection and Affordable Care Act established health insurance marketplaces to allow consumers to make educated decisions about their health care coverage. During the first open enrollment period in 2013, the federally facilitated marketplace in Pima County, Arizona listed 119 plans, making it one of the most competitive markets in the country. This study compares these plans based on differences in consumer cost sharing, including deductibles, co-pays and premiums. Consumer costs were reviewed using specific cases including a normal delivery pregnancy, the management of Type II Diabetes, and the utilization of specialty drugs to treat Hepatitis C. Total cost of care was calculated as the cost of managing the condition or event plus the cost of monthly premiums, evaluated as a single individual age 27. Evaluating a plan on premium alone is not sufficient as cost sharing can dramatically raise the cost of care. A rating system and better cost transparency tools could provider easier access to pertinent information for consumers. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

48 CFR 731.205-46 - Travel costs.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Travel costs. 731.205-46 Section 731.205-46 Federal Acquisition Regulations System AGENCY FOR INTERNATIONAL DEVELOPMENT GENERAL....205-46 Travel costs. It is USAID policy to require prior written approval of international travel by...

Associations between preoperative physical therapy and post-acute care utilization patterns and cost in total joint replacement.

Science.gov (United States)

Snow, Richard; Granata, Jaymes; Ruhil, Anirudh V S; Vogel, Karen; McShane, Michael; Wasielewski, Ray

2014-10-01

Health-care costs following acute hospital care have been identified as a major contributor to regional variation in Medicare spending. This study investigated the associations of preoperative physical therapy and post-acute care resource use and its effect on the total cost of care during primary hip or knee arthroplasty. Historical claims data were analyzed using the Centers for Medicare & Medicaid Services Limited Data Set files for Diagnosis Related Group 470. Analysis included descriptive statistics of patient demographic characteristics, comorbidities, procedures, and post-acute care utilization patterns, which included skilled nursing facility, home health agency, or inpatient rehabilitation facility, during the ninety-day period after a surgical hospitalization. To evaluate the associations, we used bivariate and multivariate techniques focused on post-acute care use and total episode-of-care costs. The Limited Data Set provided 4733 index hip or knee replacement cases for analysis within the thirty-nine-county Medicare hospital referral cluster. Post-acute care utilization was a significant variable in the total cost of care for the ninety-day episode. Overall, 77.0% of patients used post-acute care services after surgery. Post-acute care utilization decreased if preoperative physical therapy was used, with only 54.2% of the preoperative physical therapy cohort using post-acute care services. However, 79.7% of the non-preoperative physical therapy cohort used post-acute care services. After adjusting for demographic characteristics and comorbidities, the use of preoperative physical therapy was associated with a significant 29% reduction in post-acute care use, including an $871 reduction of episode payment driven largely by a reduction in payments for skilled nursing facility ($1093), home health agency ($527), and inpatient rehabilitation ($172). The use of preoperative physical therapy was associated with a 29% decrease in the use of any post-acute care

24 CFR 85.22 - Allowable costs.

Science.gov (United States)

2010-04-01

... uniform cost accounting standards that comply with cost principles acceptable to the Federal agency. ... TRIBAL GOVERNMENTS Post-Award Requirements Financial Administration § 85.22 Allowable costs. (a... increment above allowable costs) to the grantee or subgrantee. (b) Applicable cost principles. For each kind...

43 CFR 12.62 - Allowable costs.

Science.gov (United States)

2010-10-01

... uniform cost accounting standards that comply with cost principles acceptable to the Federal agency. ... COST PRINCIPLES FOR ASSISTANCE PROGRAMS Uniform Administrative Requirements for Grants and Cooperative... increment above allowable costs) to the grantee or subgrantee. (b) Applicable cost principles. For each kind...

48 CFR 4.705-1 - Financial and cost accounting records.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Financial and cost accounting records. 4.705-1 Section 4.705-1 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION GENERAL ADMINISTRATIVE MATTERS Contractor Records Retention 4.705-1 Financial and cost accounting...

48 CFR 42.801 - Notice of intent to disallow costs.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Notice of intent to disallow costs. 42.801 Section 42.801 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACT MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES Disallowance of Costs 42.801 Notice of...

48 CFR 52.215-16 - Facilities Capital Cost of Money.

Science.gov (United States)

2010-10-01

... Money. 52.215-16 Section 52.215-16 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION....215-16 Facilities Capital Cost of Money. As prescribed in 15.408(h), insert the following provision: Facilities Capital Cost of Money (JUN 2003) (a) Facilities capital cost of money will be an allowable cost...

The true costs of participatory sanitation: Evidence from community-led total sanitation studies in Ghana and Ethiopia.

Science.gov (United States)

Crocker, Jonny; Saywell, Darren; Shields, Katherine F; Kolsky, Pete; Bartram, Jamie

2017-12-01

Evidence on sanitation and hygiene program costs is used for many purposes. The few studies that report costs use top-down costing methods that are inaccurate and inappropriate. Community-led total sanitation (CLTS) is a participatory behavior-change approach that presents difficulties for cost analysis. We used implementation tracking and bottom-up, activity-based costing to assess the process, program costs, and local investments for four CLTS interventions in Ghana and Ethiopia. Data collection included implementation checklists, surveys, and financial records review. Financial costs and value-of-time spent on CLTS by different actors were assessed. Results are disaggregated by intervention, cost category, actor, geographic area, and project month. The average household size was 4.0 people in Ghana, and 5.8 people in Ethiopia. The program cost of CLTS was $30.34-$81.56 per household targeted in Ghana, and $14.15-$19.21 in Ethiopia. Most program costs were from training for three of four interventions. Local investments ranged from $7.93-$22.36 per household targeted in Ghana, and $2.35-$3.41 in Ethiopia. This is the first study to present comprehensive, disaggregated costs of a sanitation and hygiene behavior-change intervention. The findings can be used to inform policy and finance decisions, plan program scale-up, perform cost-effectiveness and benefit studies, and compare different interventions. The costing method is applicable to other public health behavior-change programs. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Reducing Length of Stay, Direct Cost, and Readmissions in Total Joint Arthroplasty Patients With an Outcomes Manager-Led Interprofessional Team.

Science.gov (United States)

Arana, Melissa; Harper, Licia; Qin, Huanying; Mabrey, Jay

The purpose of this quality improvement project was to determine whether an outcomes manager-led interprofessional team could reduce length of stay and direct cost without increasing 30-day readmission rates in the total joint arthroplasty patient population. The goal was to promote interprofessional relationships combined with collaborative practice to promote coordinated care with improved outcomes. Results from this project showed that length of stay (total hip arthroplasty [THA] reduced by 0.4 days and total knee arthroplasty [TKA] reduced by 0.6 days) and direct cost (THA reduced by $1,020 per case and TKA reduced by $539 per case) were significantly decreased whereas 30-day readmission rates of both populations were not significantly increased.

Social profile and cost analysis of deep infection following total hip replacement surgery

Directory of Open Access Journals (Sweden)

Vera Lucia Frazão

Full Text Available ABSTRACT OBJECTIVE: To characterize the socio-economic and demographic profile of patients undergoing surgery for revision total hip arthroplasty regarding the diagnosis of deep prosthetic infection. METHODS: Twenty patients were retrospectively studied, admitted in the period between 2009 and 2010 by the Hip Surgery Group with the diagnosis of deep prosthetic infection, whose proposed treatment was surgical. This study was carried out in the presence of the patient by completing two forms applied by the social worker of the Group. RESULTS: In a 20-patient sample, 40% were male, 45% were working age, 50% of patients originated from the capital, 85% depended on benefits, 70% were retired, 60% of patients were from this hospital, and 40% were from other services. The average cost of patients to the public system was R$ 55,821.62 per patient and the total spent on treatment of patients in the study exceeded one million Brazilian reals, totalling R$ 1,116,432.40. CONCLUSION: Infection from total hip arthroplasty generates a major expense to the social security system and to the public healthcare system. Physicians must always be alert to the possible risk factors and perioperative care, striving to minimize this complication.

Total cost of ownership of electric vehicles compared to conventional vehicles: A probabilistic analysis and projection across market segments

International Nuclear Information System (INIS)

Wu, Geng; Inderbitzin, Alessandro; Bening, Catharina

2015-01-01

While electric vehicles (EV) can perform better than conventional vehicles from an environmental standpoint, consumers perceive them to be more expensive due to their higher capital cost. Recent studies calculated the total cost of ownership (TCO) to evaluate the complete cost for the consumer, focusing on individual vehicle classes, powertrain technologies, or use cases. To provide a comprehensive overview, we built a probabilistic simulation model broad enough to capture most of a national market. Our findings indicate that the comparative cost efficiency of EV increases with the consumer's driving distance and is higher for small than for large vehicles. However, our sensitivity analysis shows that the exact TCO is subject to the development of vehicle and operating costs and thus uncertain. Although the TCO of electric vehicles may become close to or even lower than that of conventional vehicles by 2025, our findings add evidence to past studies showing that the TCO does not reflect how consumers make their purchase decision today. Based on these findings, we discuss policy measures that educate consumers about the TCO of different vehicle types based on their individual preferences. In addition, measures improving the charging infrastructure and further decreasing battery cost are discussed. - Highlights: • Calculates the total cost of ownership across competing vehicle technologies. • Uses Monte Carlo simulation to analyse distributions and probabilities of outcomes. • Contains a comprehensive assessment across the main vehicle classes and use cases. • Indicates that cost efficiency of technology depends on vehicle class and use case. • Derives specific policy measures to facilitate electric vehicle diffusion

A Framework for Federated Two-Factor Authentication Enabling Cost-Effective Secure Access to Distributed Cyberinfrastructure

Energy Technology Data Exchange (ETDEWEB)

Ezell, Matthew A [ORNL; Rogers, Gary L [University of Tennessee, Knoxville (UTK); Peterson, Gregory D. [University of Tennessee, Knoxville (UTK)

2012-01-01

As cyber attacks become increasingly sophisticated, the security measures used to mitigate the risks must also increase in sophistication. One time password (OTP) systems provide strong authentication because security credentials are not reusable, thus thwarting credential replay attacks. The credential changes regularly, making brute-force attacks significantly more difficult. In high performance computing, end users may require access to resources housed at several different service provider locations. The ability to share a strong token between multiple computing resources reduces cost and complexity. The National Science Foundation (NSF) Extreme Science and Engineering Discovery Environment (XSEDE) provides access to digital resources, including supercomputers, data resources, and software tools. XSEDE will offer centralized strong authentication for services amongst service providers that leverage their own user databases and security profiles. This work implements a scalable framework built on standards to provide federated secure access to distributed cyberinfrastructure.

44 CFR 13.22 - Allowable costs.

Science.gov (United States)

2010-10-01

... uniform cost accounting standards that comply with cost principles acceptable to the Federal agency. ... STATE AND LOCAL GOVERNMENTS Post-Award Requirements Financial Administration § 13.22 Allowable costs. (a... increment above allowable costs) to the grantee or subgrantee. (b) Applicable cost principles. For each kind...

36 CFR 1207.22 - Allowable costs.

Science.gov (United States)

2010-07-01

... uniform cost accounting standards that comply with cost principles acceptable to the Federal agency. ... GOVERNMENTS Post-Award Requirements Financial Administration § 1207.22 Allowable costs. (a) Limitation on use... increment above allowable costs) to the grantee or subgrantee. (b) Applicable cost principles. For each kind...

48 CFR 931.205 - Selected costs.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Selected costs. 931.205... REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations 931.205 Selected costs. ...

48 CFR 1231.205 - Selected costs.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Selected costs. 1231.205... REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations 1231.205 Selected costs. ...

48 CFR 31.205 - Selected costs.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Selected costs. 31.205... REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations 31.205 Selected costs. ...

48 CFR 1331.205 - Selected costs.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Selected costs. 1331.205... REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations 1331.205 Selected costs. ...

48 CFR 631.205 - Selected costs.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Selected costs. 631.205... REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts with Commercial Organizations 631.205 Selected costs. ...

Federal databases

International Nuclear Information System (INIS)

Welch, M.J.; Welles, B.W.

1988-01-01

Accident statistics on all modes of transportation are available as risk assessment analytical tools through several federal agencies. This paper reports on the examination of the accident databases by personal contact with the federal staff responsible for administration of the database programs. This activity, sponsored by the Department of Energy through Sandia National Laboratories, is an overview of the national accident data on highway, rail, air, and marine shipping. For each mode, the definition or reporting requirements of an accident are determined and the method of entering the accident data into the database is established. Availability of the database to others, ease of access, costs, and who to contact were prime questions to each of the database program managers. Additionally, how the agency uses the accident data was of major interest

48 CFR 1316.405 - Cost-reimbursement incentive contracts.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Cost-reimbursement incentive contracts. 1316.405 Section 1316.405 Federal Acquisition Regulations System DEPARTMENT OF COMMERCE CONTRACTING METHODS AND CONTRACT TYPES TYPES OF CONTRACTS Incentive Contracts 1316.405 Cost-reimbursement...

48 CFR 916.405 - Cost-reimbursement incentive contracts.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Cost-reimbursement incentive contracts. 916.405 Section 916.405 Federal Acquisition Regulations System DEPARTMENT OF ENERGY CONTRACTING METHODS AND CONTRACT TYPES TYPES OF CONTRACTS Incentive Contracts 916.405 Cost-reimbursement...

48 CFR 31.205-20 - Interest and other financial costs.

Science.gov (United States)

2010-10-01

... financial costs. 31.205-20 Section 31.205-20 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION GENERAL CONTRACTING REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations 31.205-20 Interest and other financial costs. Interest on borrowings (however represented), bond...

Analysis of costs for compliance with Federal Radiation Protection Guidance for Occupational Exposure. Volume 2: case study analysis of the impacts of proposed radiation protection guidance for workers

International Nuclear Information System (INIS)

1983-11-01

This report contains the writeups of case studies conducted in support of an effort to estimate costs and economic impacts of proposed Federal Radiation Protection Guidance for Occupational Exposures. The purpose of the case studies was to develop background information on representative organizations necessary to determine the impact of the proposed guidelines on selected industries. This information was used, together with other data, to estimate the aggregate costs of compliance with the proposed guidelines. The cost estimates are contained in a companion report

Functional and oncologic outcomes after excision of the total femur in primary bone tumors: Results with a low cost total femur prosthesis

Directory of Open Access Journals (Sweden)

Ajay Puri

2012-01-01

Full Text Available Background: The extent of tumor may necessitate resection of the complete femur rarely to achieve adequate oncologic clearance in bone sarcomas. We present our experience with reconstruction in such cases using an indigenously manufactured, low-cost, total femoral prosthesis (TFP. We assessed the complications of the procedure, the oncologic and functional outcomes, and implant survival. Materials and Methods: Eight patients (four males and four females with a mean age of 32 years, operated between December 2003 and June 2009, had a TFP implanted. The diagnosis included osteogenic sarcoma (5, Ewing′s sarcoma (1, and chondrosarcoma (2. Mean followup was 33 months (9-72 months for all and 40 months (24-72 months in survivors. They were evaluated by Musculoskeletal Tumor Society score, implant survival as well as patient survival. Results: There was one local recurrence and five of seven patients are currently alive at the time of last followup. The Musculoskeletal Tumor Society score for patients ranged from 21 to 25 with a mean of 24 (80%. The implant survival was 88% at 5 years with only one TFP needing removal because of infection. Conclusions: A TFP in appropriately indicated patients with malignant bone tumors is oncologically safe. A locally manufactured, cost-effective implant provided consistent and predictable results after excision of the total femur with good functional outcomes.

48 CFR 228.307 - Insurance under cost-reimbursement contracts.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Insurance under cost-reimbursement contracts. 228.307 Section 228.307 Federal Acquisition Regulations System DEFENSE ACQUISITION....307 Insurance under cost-reimbursement contracts. ...

24 CFR 84.27 - Allowable costs.

Science.gov (United States)

2010-04-01

... to the entity incurring the costs. Thus, allowability of costs incurred by State, local or federally..., “Cost Principles for State and Local Governments.” The allowability of costs incurred by non-profit...-Profit Organizations.” The allowability of costs incurred by institutions of higher education is...

Cost of goods sold and total cost of delivery for oral and parenteral vaccine packaging formats.

Science.gov (United States)

Sedita, Jeff; Perrella, Stefanie; Morio, Matt; Berbari, Michael; Hsu, Jui-Shan; Saxon, Eugene; Jarrahian, Courtney; Rein-Weston, Annie; Zehrung, Darin

2018-03-14

Despite limitations of glass packaging for vaccines, the industry has been slow to implement alternative formats. Polymer containers may address many of these limitations, such as breakage and delamination. However, the ability of polymer containers to achieve cost of goods sold (COGS) and total cost of delivery (TCOD) competitive with that of glass containers is unclear, especially for cost-sensitive low- and lower-middle-income countries. COGS and TCOD models for oral and parenteral vaccine packaging formats were developed based on information from subject matter experts, published literature, and Kenya's comprehensive multiyear plan for immunization. Rotavirus and inactivated poliovirus vaccines (IPV) were used as representative examples of oral and parenteral vaccines, respectively. Packaging technologies evaluated included glass vials, blow-fill-seal (BFS) containers, preformed polymer containers, and compact prefilled auto-disable (CPAD) devices in both BFS and preformed formats. For oral vaccine packaging, BFS multi-monodose (MMD) ampoules were the least expensive format, with a COGS of $0.12 per dose. In comparison, oral single-dose glass vials had a COGS of $0.40. BFS MMD ampoules had the lowest TCOD of oral vaccine containers at $1.19 per dose delivered, and ten-dose glass vials had a TCOD of $1.61 per dose delivered. For parenteral vaccines, the lowest COGS was achieved with ten-dose glass vials at $0.22 per dose. In contrast, preformed CPAD devices had the highest COGS at $0.60 per dose. Ten-dose glass vials achieved the lowest TCOD of the parenteral vaccine formats at $1.56 per dose delivered. Of the polymer containers for parenteral vaccines, BFS MMD ampoules achieved the lowest TCOD at $1.89 per dose delivered, whereas preformed CPAD devices remained the most expensive format, at $2.25 per dose delivered. Given their potential to address the limitations of glass and reduce COGS and TCOD, polymer containers deserve further consideration as alternative

48 CFR 1816.405 - Cost-reimbursement incentive contracts.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Cost-reimbursement incentive contracts. 1816.405 Section 1816.405 Federal Acquisition Regulations System NATIONAL AERONAUTICS... 1816.405 Cost-reimbursement incentive contracts. [62 FR 3478, Jan. 23, 1997. Redesignated at 62 FR...

Financing end-use solar technologies in a restructured electricity industry: Comparing the cost of public policies

International Nuclear Information System (INIS)

Jones, E.; Eto, J.

1997-09-01

Renewable energy technologies are capital intensive. Successful public policies for promoting renewable energy must address the significant resources needed to finance them. Public policies to support financing for renewable energy technologies must pay special attention to interactions with federal, state, and local taxes. These interactions are important because they can dramatically increase or decrease the effectiveness of a policy, and they determine the total cost of a policy to society as a whole. This report describes a comparative analysis of the cost of public policies to support financing for two end-use solar technologies: residential solar domestic hot water heating (SDHW) and residential rooftop photovoltaic (PV) systems. The analysis focuses on the cost of the technologies under five different ownership and financing scenarios. Four scenarios involve leasing the technologies to homeowners in return for a payment that is determined by the financing requirements of each form of ownership. For each scenario, the authors examine nine public policies that might be used to lower the cost of these technologies: investment tax credits (federal and state), production tax credits (federal and state), production incentives, low-interest loans, grants (taxable and two types of nontaxable), direct customer payments, property and sales tax reductions, and accelerated depreciation

48 CFR 970.3102-05-30-70 - Patent costs and technology transfer costs.

Science.gov (United States)

2010-10-01

... technology transfer costs. 970.3102-05-30-70 Section 970.3102-05-30-70 Federal Acquisition Regulations System... Principles and Procedures 970.3102-05-30-70 Patent costs and technology transfer costs. (a) For management and operating contracts that do not include the clause at 970.5227-3, Technology Transfer Mission, the...

32 CFR 33.22 - Allowable costs.

Science.gov (United States)

2010-07-01

... accounting standards that comply with cost principles acceptable to the Federal agency. ... Post-Award Requirements Financial Administration § 33.22 Allowable costs. (a) Limitation on use of... allowable costs) to the grantee or subgrantee. (b) Applicable cost principles. For each kind of organization...

49 CFR 266.11 - Allowable costs.

Science.gov (United States)

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Allowable costs. 266.11 Section 266.11... TRANSPORTATION ACT § 266.11 Allowable costs. Allowable costs include only the following costs which are properly allocable to the work performed: Planning and program operation costs which are allowed under Federal...

Joint federal initiative for demonstration of on-site innovative technologies

International Nuclear Information System (INIS)

Marsh, J.; Munro, J.F.; McKinnon, C.; Coyle, G.J.

1994-01-01

The Federal Government needs to develop and implement new technologies to support its environmental and waste management programs. The incentive is threefold: First, new technologies are needed to accomplish many cleanup and waste management tasks. Second, the development and implementation of new technologies is expected to reduce significantly total cleanup costs. Third, the development of new environmental technologies can help secure national economic advantages by making U.S. industry more competitive in terms of global environmental markets. The Federal Advisory Committee to Develop On-Site Innovative Technologies (DOIT) initiative reinvents inter-governmental relations by stressing the solving of environmental problems through partnerships rather than through confrontation. This overview -- which is essentially a shortened and slightly modified version of the recent Coordinating Group Report to the DOIT Committee --describes the waste management challenges facing the Nation, discusses the innovative solutions offered by DOIT, outlines progress of the initiative to date, and identifies critical next steps

The cost and impact of the interim federal health program cuts on child refugees in Canada.

Science.gov (United States)

Evans, Andrea; Caudarella, Alexander; Ratnapalan, Savithiri; Chan, Kevin

2014-01-01

On June 30, 2012, Interim Federal Health Program (IFHP) funding was cut for refugee claimant healthcare. The potential financial and healthcare impacts of these cuts on refugee claimants are unknown. We conducted a one-year retrospective chart review spanning 6 months before and after IFHP funding cuts at The Hospital for Sick Children, a tertiary care children's hospital in Toronto. We analyzed emergency room visits characteristics, admission rates, reasons for admission, and financial records including billing from Medavie Blue Cross. There were 173 refugee children visits to the emergency room in the six months before and 142 visits in the six months after funding cuts. The total amount billed to the IFHP program during the one-year of this study was $131,615. Prior to the IFHP cuts, 46% of the total emergency room bills were paid by IFHP compared to 7% after the cuts (pinstitution in the country increased.

48 CFR 52.249-6 - Termination (Cost-Reimbursement).

Science.gov (United States)

2010-10-01

...-Reimbursement). 52.249-6 Section 52.249-6 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION....249-6 Termination (Cost-Reimbursement). As prescribed in 49.503(a)(1), insert the following clause: Termination (Cost-Reimbursement) (MAY 2004) (a) The Government may terminate performance of work under this...

48 CFR 3028.307 - Insurance under cost-reimbursement contracts.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Insurance under cost-reimbursement contracts. 3028.307 Section 3028.307 Federal Acquisition Regulations System DEPARTMENT OF HOMELAND... Insurance 3028.307 Insurance under cost-reimbursement contracts. ...

48 CFR 231.205 - Selected costs.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Selected costs. 231.205... OF DEFENSE GENERAL CONTRACTING REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations 231.205 Selected costs. ...

The classification, cost categories and the system of accounting for uranium resources in the Russian Federation and CIS countries

International Nuclear Information System (INIS)

Naumov, S.S.; Shumilin, M.V.

1998-01-01

In 1992 the uranium resource classification systems of Kazakhstan, Russian Federation, Ukraine and Uzbekistan are the same as the system used in the former Soviet Union. The Soviet Union adopted this system as a state law in 1981. Under this system resources are reported as ''in situ'' with no allowance for mining or milling losses and resource depletion. The resources are subdivided according to the degree of exploration and economic value. The classification system divides resources into 7 categories. This includes 3 categories of explored resources (A, B, and C); one of preliminary assessment (C2); and 3 as prognosticated or speculative (P1, P2 and P3). Further analyses and classification is used to determine the readiness for production. This system is used to define the inventory of ''State Balance''. Examples are given for classifying vein-type and rollfront-type sandstone hosted deposits. A discussion of how resources are classified by cost category is given. It is stated, however, that any coincidence between the cost categories used in the former Soviet Union and the cost categories of the IAEA system are ''purely accidental''. (author)

Bus Lifecycle Cost Model for Federal Land Management Agencies.

Science.gov (United States)

2011-09-30

The Bus Lifecycle Cost Model is a spreadsheet-based planning tool that estimates capital, operating, and maintenance costs for various bus types over the full lifecycle of the vehicle. The model is based on a number of operating characteristics, incl...

48 CFR 9904.409 - Cost accounting standard-depreciation of tangible capital assets.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Cost accounting standard... ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.409 Cost accounting standard...

29 CFR 97.22 - Allowable costs.

Science.gov (United States)

2010-07-01

... accounting standards that comply with cost principles acceptable to the Federal agency. [53 FR 8069, 8087... LOCAL GOVERNMENTS Post-Award Requirements Financial Administration § 97.22 Allowable costs. (a... increment above allowable costs) to the grantee or subgrantee. (b) Applicable cost principles. For each kind...

21 CFR 1403.22 - Allowable costs.

Science.gov (United States)

2010-04-01

.... Contract Cost Principles and Procedures, or uniform cost accounting standards that comply with cost... COOPERATIVE AGREEMENTS TO STATE AND LOCAL GOVERNMENTS Post-Award Requirements Financial Administration § 1403...) Applicable cost principles. For each kind of organization, there is a set of Federal principles for...

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

Science.gov (United States)

2012-11-09

...; Information Collection; Travel Costs AGENCY: Department of Defense (DOD), General Services Administration (GSA... requirement concerning Travel Costs. Public comments are particularly invited on: Whether this collection of...- 0088, Travel Costs by any of the following methods: Regulations.gov : http://www.regulations.gov...

Production of solidified high level wastes: a cost comparison of solidification processes

International Nuclear Information System (INIS)

1977-06-01

Differential cost estimates of the annual operating and maintenance costs and the capital costs for five HLW Waste Solidification Alternates were developed. The annual operating and maintenance cost estimates included the cost of labor, consumables, utilities, shipping casks, shipping and disposal at a federal repository. The capital cost included the cost of the component, installation and building. The differential cost estimates do not include equipment and facilities which are either shared with the reprocessing facility or are common between all of the alternates. Total annual cost differential between the five waste form alternates is summarized in tabular form. The Borosilicate Glass Alternate has the lowest total annual cost. The other alternates have higher costs which range from $6.6 M to $7.4 M per year higher than the Glass alternate with the Supercalcine being the highest cost at $7.4 M per year differential. The major items in the cost estimates are then disposal costs in the operating cost estimates and the HLW Storage Tanks in the capital cost estimates. The Supercalcine Multibarrier Alternate ships 180 canisters per year more than the other alternates and consequently has a significantly higher operating cost. However, off-setting this the Supercalcine Multibarrier Alternate does not require HLW Storage Tanks for decay because of the high heat conductivity of this product and correspondingly the capital cost for this alternate is significantly lower than the other alternates. The radiological risk values are correlated with the cost evaluation normalized to cost ($)/MWe-yr

2 CFR 215.27 - Allowable costs.

Science.gov (United States)

2010-01-01

... 2 Grants and Agreements 1 2010-01-01 2010-01-01 false Allowable costs. 215.27 Section 215.27... § 215.27 Allowable costs. For each kind of recipient, there is a set of Federal principles for determining allowable costs. Allowability of costs shall be determined in accordance with the cost principles...

23 CFR 140.505 - Reimbursable costs.

Science.gov (United States)

2010-04-01

... 23 Highways 1 2010-04-01 2010-04-01 false Reimbursable costs. 140.505 Section 140.505 Highways... Administrative Settlement Costs-Contract Claims § 140.505 Reimbursable costs. (a) Federal funds may participate in administrative settlement costs which are: (1) Incurred after notice of claim, (2) Properly...

48 CFR 31.202 - Direct costs.

Science.gov (United States)

2010-10-01

... REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations 31.202 Direct... amount as an indirect cost if the accounting treatment— (1) Is consistently applied to all final cost... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Direct costs. 31.202...

45 CFR 602.22 - Allowable costs.

Science.gov (United States)

2010-10-01

... CFR part 31. Contract Cost Principles and Procedures, or uniform cost accounting standards that comply.... (b) Applicable cost principles. For each kind of organization, there is a set of Federal principles... principles applicable to the organization incurring the costs. The following chart lists the kinds of...

48 CFR 30.603 - Changes to disclosed or established cost accounting practices.

Science.gov (United States)

2010-10-01

... established cost accounting practices. 30.603 Section 30.603 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION GENERAL CONTRACTING REQUIREMENTS COST ACCOUNTING STANDARDS ADMINISTRATION CAS Administration 30.603 Changes to disclosed or established cost accounting practices. ...

77 FR 69422 - Cost Accounting Standards: Revision of the Exemption From Cost Accounting Standards for Contracts...

Science.gov (United States)

2012-11-19

... Accounting Standards: Revision of the Exemption From Cost Accounting Standards for Contracts and Subcontracts... Federal Procurement Policy (OFPP), Cost Accounting Standards (CAS) Board. ACTION: Proposed rule. SUMMARY... J. M. Wong, Director, Cost Accounting Standards Board (telephone: 202-395-6805; email: Raymond_wong...

1984 Federal Interim Storage fee study: a technical and economic analysis

International Nuclear Information System (INIS)

Engel, R.L.

1984-07-01

JAI examined alternative methods for structuring charges for Federal Interim Storage (FIS) services were examined and the conclusion reached that the combined interests of the Department and the users would be best served, and costs most appropriately recovered, by a two-part fee involving an Initial Payment upon execution of a contract for FIS services followed by a Final Payment upon delivery of the spent fuel to the Department. The Initial Payment would be an advance payment covering the pro rata share of preoperational costs, including (1) the capital costs of the required transfer facilities and storage area, (2) development costs, (3) government administrative costs including storage fund management, and (4) impact aid payments made in accordance with section 136(e) of the Act. The Final Payment would be made at the time of delivery of the spent fuel to the Department and would be calculated to cover the sum of the following: (1) any under-or over-estimation in the costs used to calculate the Initial Payment of the fee including savings due to rod consolidation), (2) module costs (i.e., storage casks, drywells, or silos), and (3) the total estimated cost of operation and decommissioning of the FIS facilities (including government administrative costs, storage fund management and impact aid). Charges for the transport of spent fuel from the reactor site to FIS facilities would be separately assessed at cost since these will be specific to each reactor site and destination

Thermal Energy for Space Cooling--Federal Technology Alert

Energy Technology Data Exchange (ETDEWEB)

Brown, Daryl R.

2000-12-31

Cool storage technology can be used to significantly reduce energy costs by allowing energy-intensive, electrically driven cooling equipment to be predominantly operated during off peak hours when electricity rates are lower. This Federal Technology Alert, which is sponsored by DOE's Federal Energy Management Program (FEMP), describes the basic types of cool storage technologies and cooling system integration options. In addition, it defines the savings potential in the federal sector, presents application advice, and describes the performance experience of specific federal users. The results of a case study of a GSA building using cool storage technology are also provided.

41 CFR 105-71.122 - Allowable costs.

Science.gov (United States)

2010-07-01

... uniform cost accounting standards that comply with cost principles acceptable to the Federal agency. ... GOVERNMENTS 71.12-Post-Award Requirements/Financial Administration § 105-71.122 Allowable costs. (a... increment above allowable costs) to the grantee or subgrantee. (b) Applicable cost principles. For each kind...

48 CFR 31.205-32 - Precontract costs.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Precontract costs. 31.205... CONTRACTING REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations 31.205-32 Precontract costs. Precontract costs means costs incurred before the effective date of the...

50 CFR 85.41 - Allowable costs.

Science.gov (United States)

2010-10-01

... 50 Wildlife and Fisheries 6 2010-10-01 2010-10-01 false Allowable costs. 85.41 Section 85.41... Use/Acceptance of Funds § 85.41 Allowable costs. (a) Allowable grant costs are limited to those costs... applicable Federal cost principles in 43 CFR 12.60(b). Purchase of informational signs, program signs, and...

The Odyssey Approach for Optimizing Federated SPARQL Queries

DEFF Research Database (Denmark)

Montoya, Gabriela; Skaf-Molli, Hala; Hose, Katja

2017-01-01

. Nevertheless, these plans may still exhibit a high number of intermediate results or high execution times because of heuristics and inaccurate cost estimations. In this paper, we present Odyssey, an approach that uses statistics that allow for a more accurate cost estimation for federated queries and therefore...

2010 Northwest Federal Market Assessment Report

Energy Technology Data Exchange (ETDEWEB)

Scanlon, Tim; Sandusky, William F.

2011-09-01

The primary intent of this market assessment is to provide insights on the effectiveness of current energy efficiency and renewable energy program offerings available to Federal sites in the region. The level of detail, quality and currency of the data used in this market assessment varies significantly by Federal agency and energy efficiency service provider. Limited access to some Federal sites, limited availability of key points of contact, time/resource constraints, and other considerations limited the total number of Federal agencies and energy efficiency service providers participating in the survey.

Funding a California Superfund site with minimal state or federal money

International Nuclear Information System (INIS)

Mullaney, M.; Lemcke, H.

1996-01-01

The remediation of abandoned waste sites is a difficult task with limited funding from local, state and federal governments. It has become necessary for site managers and property owners to locate novel sources of funding and services to remediate these sites. An example of such a site is Pacific States Steel Corporation (PSSC) in Union City, California. PSSC abruptly closed its doors in 1978. The former employees (pensioners) of PSSC, won a civil suit in Federal Court for reinstatement of their medical benefits. The Federal Court took control of PSSC's largest remaining asset: a 93 acre site which was covered with slag, dilapidated buildings, a petroleum contaminated cooling pond, asbestos, PCBs, 800 barrels containing unknown fluids, heavy metals, non hazardous solid waste, and other wastes. A court-appointed Special Master submitted to the Court a plan to clean up and develop the 93 acre site to its highest and best use in order to pay the pensioners and other creditors. Total cleanup costs were estimated at over $30 million. Currently, approximately 31 acres are ready for development and 62 acres have all but two structures removed. All above ground waste streams have been remediated or contained

Hidden costs of nuclear power

International Nuclear Information System (INIS)

England, R.W.

1979-01-01

Mr. England contends that these hidden costs add up to a figure much higher than those that appear in the electric utilities' profit and loss account - costs that are borne by Federal taxpayers, by nuclear industry workers, and by all those people who must share their environment with nuclear facilities. Costs he details are additional deaths and illnesses resulting from exposure to radiation, and the use of tax dollars to clean up the lethal garbage produced by those activities. He asserts that careless handling of uranium ore and mill tailings in past years has apparently resulted in serious public health problems in those mining communities. In another example, Mr. England states that the failure to isolate uranium tailings physically from their environment has probably contributed to an acute leukemia rate in Mesa County, Colorado. He mentions much of the technology development for power reactors being done by the Federal government, not by private reactor manufacturers - thus, again, hidden costs that do not show up in electric bills of customers. The back end of the nuclear fuel cycle as a place for Federally subsidized research and development is discussed briefly. 1 figure, 2 tables

10 CFR 600.222 - Allowable costs.

Science.gov (United States)

2010-01-01

... part 31. Contract Cost Principles and Procedures, or uniform cost accounting standards that comply with... OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS FINANCIAL ASSISTANCE RULES Uniform Administrative...) Applicable cost principles. For each kind of organization, there is a set of Federal principles for...

48 CFR 47.306-2 - Lowest overall transportation costs.

Science.gov (United States)

2010-10-01

... transportation costs. 47.306-2 Section 47.306-2 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACT MANAGEMENT TRANSPORTATION Transportation in Supply Contracts 47.306-2 Lowest overall transportation costs. (a) For the evaluation of offers, the transportation officer shall give to the contracting...

48 CFR 31.205-14 - Entertainment costs.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Entertainment costs. 31... CONTRACTING REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations 31.205-14 Entertainment costs. Costs of amusement, diversions, social activities, and any directly...

45 CFR 95.631 - Cost identification for purpose of FFP claims.

Science.gov (United States)

2010-10-01

... INSURANCE PROGRAMS) Automatic Data Processing Equipment and Services-Conditions for Federal Financial Participation (FFP) Federal Financial Participation in Costs of Adp Acquisitions § 95.631 Cost identification... 45 Public Welfare 1 2010-10-01 2010-10-01 false Cost identification for purpose of FFP claims. 95...

48 CFR 970.1504-4 - Special cost or pricing areas.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Special cost or pricing areas. 970.1504-4 Section 970.1504-4 Federal Acquisition Regulations System DEPARTMENT OF ENERGY AGENCY... cost or pricing areas. ...

Prevalence, health care utilization, and costs of fibromyalgia, irritable bowel, and chronic fatigue syndromes in the military health system, 2006-2010.

Science.gov (United States)

Jeffery, Diana D; Bulathsinhala, Lakmini; Kroc, Michelle; Dorris, Joseph

2014-09-01

We compared prevalence, health care utilization, and costs over time for nonelderly adults diagnosed with fibromyalgia syndrome (FMS), irritable bowel syndrome (IBS), and chronic fatigue syndrome (CFS) in relation to timing of federal approvals for FMS drugs. We used military health care claims from October 2006 to September 2010. Retrospective, multiple-year comparisons were conducted using trend analyses, and time series regression-based generalized linear models. Over 5 years, FMS prevalence rates increased from 0.307% to 0.522%, whereas IBS and CFS prevalence rates remained stable. The largest increase in FMS prevalence occurred between 2007 and 2008. Health care utilization was higher for FMS cases compared to IBS and CFS cases. Over 5 years, the total cost for FMS-related care increased $163.2 million, whereas IBS costs increased $14.9 million and CFS cost increased $3.7 million. Between 2006 and 2010, total pharmacy cost for FMS cases increased from $55 million ($3,641/person) to $96.3 million ($3,557/person). Although cause and effect cannot be established, the advent of federally approved drugs for FMS in concert with pharmaceutical industry marketing of these drugs coincide with the observed changes in prevalence, health care utilization, and costs of FMS relative to IBS and CFS. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

48 CFR 31.205-26 - Material costs.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Material costs. 31.205-26... CONTRACTING REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations 31.205-26 Material costs. (a) Material costs include the costs of such items as raw materials, parts...

48 CFR 1631.203 - Indirect costs.

Science.gov (United States)

2010-10-01

... Section 1631.203 Federal Acquisition Regulations System OFFICE OF PERSONNEL MANAGEMENT FEDERAL EMPLOYEES HEALTH BENEFITS ACQUISITION REGULATION GENERAL CONTRACTING REQUIREMENTS CONTRACT COST PRINCIPLES AND... general practice in the insurance industry. [70 FR 31391, June 1, 2005] ...

28 CFR 66.22 - Allowable costs.

Science.gov (United States)

2010-07-01

... part 31. Contract Cost Principles and Procedures, or uniform cost accounting standards that comply with... AND COOPERATIVE AGREEMENTS TO STATE AND LOCAL GOVERNMENTS Post-Award Requirements Financial...) Applicable cost principles. For each kind of organization, there is a set of Federal principles for...

48 CFR 52.215-12 - Subcontractor Certified Cost or Pricing Data.

Science.gov (United States)

2010-10-01

... Cost or Pricing Data. 52.215-12 Section 52.215-12 Federal Acquisition Regulations System FEDERAL... Provisions and Clauses 52.215-12 Subcontractor Certified Cost or Pricing Data. As prescribed in 15.408(d), insert the following clause: Subcontractor Certified Cost or Pricing Data (OCT 2010) (a) Before awarding...

48 CFR 52.216-26 - Payments of Allowable Costs Before Definitization.

Science.gov (United States)

2010-10-01

... and placed in the production process for use on the contract; (iii) Direct labor; (iv) Direct travel; (v) Other direct in-house costs; and (vi) Properly allocable and allowable indirect costs as shown on... Costs Before Definitization. 52.216-26 Section 52.216-26 Federal Acquisition Regulations System FEDERAL...

48 CFR 970.3102-05 - Selected costs.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Selected costs. 970.3102... SUPPLEMENTARY REGULATIONS DOE MANAGEMENT AND OPERATING CONTRACTS Contract Cost Principles and Procedures 970.3102-05 Selected costs. ...

48 CFR 1331.205-32 - Precontract costs.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Precontract costs. 1331... CONTRACTING REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations 1331.205-32 Precontract costs. If precontract costs are anticipated, pursuant to negotiations and in...

48 CFR 1699.70 - Cost accounting standards.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Cost accounting standards... EMPLOYEES HEALTH BENEFITS ACQUISITION REGULATION CLAUSES AND FORMS COST ACCOUNTING STANDARDS Cost Accounting Standards 1699.70 Cost accounting standards. With respect to all experience-rated contracts currently...

Cost-Effectiveness Analysis of Total Hip Arthroplasty Performed by a Canadian Short-Stay Surgical Team in Ecuador.

Science.gov (United States)

Schlegelmilch, Michael; Rashiq, Saifee; Moreau, Barbara; Jarrín, Patricia; Tran, Bach; Chuck, Anderson

2017-01-01

Few charitable overseas surgical missions produce cost-effectiveness analyses of their work. We compared the pre- and postoperative health status for 157 total hip arthroplasty (THA) patients operated on from 2007 to 2011 attended by an annual Canadian orthopedic mission to Ecuador to determine the quality-adjusted life years (QALYs) gained. The costs of each mission are known. The cost per surgery was divided by the average lifetime QALYs gained to estimate an incremental cost-effectiveness ratio (ICER) in Canadian dollars per QALY. The average lifetime QALYs (95% CI) gained were 1.46 (1.4-1.5), 2.5 (2.4-2.6), and 2.9 (2.7-3.1) for unilateral, bilateral, and staged (two THAs in different years) operations, respectively. The ICERs were $4,442 for unilateral, $2,939 for bilateral, and $4392 for staged procedures. Seventy percent of the mission budget was spent on the transport and accommodation of volunteers. THA by a Canadian short-stay surgical team was highly cost-effective, according to criteria from the National Institute for Health and Care Excellence and the World Health Organization. We encourage other international missions to provide similar cost-effectiveness data to enable better comparison between mission types and between mission and nonmission care.

23 CFR 140.807 - Reimbursable costs.

Science.gov (United States)

2010-04-01

... 23 Highways 1 2010-04-01 2010-04-01 false Reimbursable costs. 140.807 Section 140.807 Highways... Highway Agency Audit Expense § 140.807 Reimbursable costs. (a) Federal funds may be used to reimburse an SHA for the following types of project related audit costs: (1) Salaries, wages, and related costs...

Federal fees and contracts for storage and disposal of spent LWR fuel

International Nuclear Information System (INIS)

Clark, H.J.

1979-01-01

The methodology for establishing a fee for federal spent fuel storage and disposal services is explained along with a presentation of the cost centers and cost data used to calculate the fee. Results of the initial fee calculation and the attendant sensitivity studies are also reviewed. The current status of the fee update is presented. The content of the proposed contract for federal services is briefly reviewed

48 CFR 1830.7002-2 - Cost of money calculations.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Cost of money calculations. 1830.7002-2 Section 1830.7002-2 Federal Acquisition Regulations System NATIONAL AERONAUTICS AND SPACE... Employed for Facilities in Use and For Facilities Under Construction 1830.7002-2 Cost of money calculations...

38 CFR 43.22 - Allowable costs.

Science.gov (United States)

2010-07-01

... accounting standards that comply with cost principles acceptable to the Federal agency. ... Requirements Financial Administration § 43.22 Allowable costs. (a) Limitation on use of funds. Grant funds may... the grantee or subgrantee. (b) Applicable cost principles. For each kind of organization, there is a...

15 CFR 24.22 - Allowable costs.

Science.gov (United States)

2010-01-01

... Part 31. Contract Cost Principles and Procedures, or uniform cost accounting standards that comply with... GRANTS AND COOPERATIVE AGREEMENTS TO STATE AND LOCAL GOVERNMENTS Post-Award Requirements Financial...) Applicable cost principles. For each kind of organization, there is a set of Federal principles for...

7 CFR 3016.22 - Allowable costs.

Science.gov (United States)

2010-01-01

... uniform cost accounting standards that comply with cost principles acceptable to the Federal agency. ... Regulations of the Department of Agriculture (Continued) OFFICE OF THE CHIEF FINANCIAL OFFICER, DEPARTMENT OF... GOVERNMENTS Post-Award Requirements Financial Administration § 3016.22 Allowable costs. (a) Limitation on use...

20 CFR 437.22 - Allowable costs.

Science.gov (United States)

2010-04-01

... CFR Part 31. Contract Cost Principles and Procedures, or uniform cost accounting standards that comply... COOPERATIVE AGREEMENTS TO STATE AND LOCAL GOVERNMENTS Post-Award Requirements Financial Administration § 437...) Applicable cost principles. For each kind of organization, there is a set of Federal principles for...

45 CFR 1174.22 - Allowable costs.

Science.gov (United States)

2010-10-01

... Part 31. Contract Cost Principles and Procedures, or uniform cost accounting standards that comply with... COOPERATIVE AGREEMENTS TO STATE AND LOCAL GOVERNMENTS Post-Award Requirements Financial Administration § 1174...) Applicable cost principles. For each kind of organization, there is a set of Federal principles for...

45 CFR 1183.22 - Allowable costs.

Science.gov (United States)

2010-10-01

... Part 31. Contract Cost Principles and Procedures, or uniform cost accounting standards that comply with... COOPERATIVE AGREEMENTS TO STATE AND LOCAL GOVERNMENTS Post-Award Requirements Financial Administration § 1183...) Applicable cost principles. For each kind of organization, there is a set of Federal principles for...

14 CFR 1273.22 - Allowable costs.

Science.gov (United States)

2010-01-01

... CFR part 31, Contract Cost Principles and Procedures, or uniform cost accounting standards that comply... GRANTS AND COOPERATIVE AGREEMENTS TO STATE AND LOCAL GOVERNMENTS Post-Award Requirements Financial.... (b) Applicable cost principles. For each kind of organization, there is a set of Federal principles...

48 CFR 1231.205-32 - Precontract costs.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Precontract costs. 1231... CONTRACTING REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations 1231.205-32 Precontract costs. (a) The decision to incur precontract costs is that of the contractor. No...

48 CFR 30.101 - Cost Accounting Standards.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Cost Accounting Standards... CONTRACTING REQUIREMENTS COST ACCOUNTING STANDARDS ADMINISTRATION General 30.101 Cost Accounting Standards. (a... Accounting Standards (CAS) and to disclose in writing and follow consistently their cost accounting practices...

10 CFR 436.18 - Measuring cost-effectiveness.

Science.gov (United States)

2010-01-01

... 10 Energy 3 2010-01-01 2010-01-01 false Measuring cost-effectiveness. 436.18 Section 436.18 Energy... Procedures for Life Cycle Cost Analyses § 436.18 Measuring cost-effectiveness. (a) In accordance with this section, each Federal agency shall measure cost-effectiveness by combining cost data established under...

Determining the True Cost to Deliver Total Hip and Knee Arthroplasty Over the Full Cycle of Care: Preparing for Bundling and Reference-Based Pricing.

Science.gov (United States)

DiGioia, Anthony M; Greenhouse, Pamela K; Giarrusso, Michelle L; Kress, Justina M

2016-01-01

The Affordable Care Act accelerates health care providers' need to prepare for new care delivery platforms and payment models such as bundling and reference-based pricing (RBP). Thriving in this environment will be difficult without knowing the true cost of care delivery at the level of the clinical condition over the full cycle of care. We describe a project in which we identified true costs for both total hip and total knee arthroplasty. With the same tool, we identified cost drivers in each segment of care delivery and collected patient experience information. Combining cost and experience information with outcomes data we already collect allows us to drive costs down while protecting outcomes and experiences, and compete successfully in bundling and RBP programs. Copyright © 2016 Elsevier Inc. All rights reserved.

14 CFR 151.41 - Project costs.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Project costs. 151.41 Section 151.41... FEDERAL AID TO AIRPORTS Rules and Procedures for Airport Development Projects § 151.41 Project costs. (a) For the purposes of subparts B and C, project costs consist of any costs involved in accomplishing a...

76 FR 32242 - Federal Employees' Retirement System; Normal Cost Percentages

Science.gov (United States)

2011-06-03

... generally accepted actuarial practices and standards (using dynamic assumptions). Subpart D of part 841 of... changes to the economic assumptions used in the dynamic actuarial valuations of FERS. The Board reviewed... by the federal retirement programs administered by the U.S. Department of Defense and the Social...

40 CFR 31.22 - Allowable costs.

Science.gov (United States)

2010-07-01

... accounting standards that comply with cost principles acceptable to the Federal agency. ... Requirements Financial Administration § 31.22 Allowable costs. (a) Limitation on use of funds. Grant funds may... the grantee or sub-grantee. (b) Applicable cost principles. For each kind of organization, there is a...

34 CFR 80.22 - Allowable costs.

Science.gov (United States)

2010-07-01

... CFR part 31. Contract Cost Principles and Procedures, or uniform cost accounting standards that comply... COOPERATIVE AGREEMENTS TO STATE AND LOCAL GOVERNMENTS Post-Award Requirements Financial Administration § 80.22... kind of organization, there is a set of Federal principles for determining allowable costs. For the...

48 CFR 30.604 - Processing changes to disclosed or established cost accounting practices.

Science.gov (United States)

2010-10-01

... disclosed or established cost accounting practices. 30.604 Section 30.604 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION GENERAL CONTRACTING REQUIREMENTS COST ACCOUNTING STANDARDS ADMINISTRATION CAS Administration 30.604 Processing changes to disclosed or established cost accounting practices...

48 CFR 31.205-4 - Bonding costs.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Bonding costs. 31.205-4... REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations 31.205-4 Bonding costs. (a) Bonding costs arise when the Government requires assurance against financial loss to itself...

78 FR 17647 - Annual Notice of Interest Rates of Federal Student Loans Made Under the Federal Family Education...

Science.gov (United States)

2013-03-22

... DEPARTMENT OF EDUCATION Annual Notice of Interest Rates of Federal Student Loans Made Under the.... Department of Education published in the Federal Register (78 FR 5433) a notice announcing the interest rates... bill rate Margin Total rate First disbursed on or after disbursed interest rate (percent) (percent...

TUBERCULOSIS IN SIBERIAN AND FAR EASTERN FEDERAL DISTRICTS (2007-2016

Directory of Open Access Journals (Sweden)

T. V. Alekseeva

2017-01-01

Full Text Available The article describes changes in the main tuberculosis epidemiological indicators in Siberian and Far Eastern Federal Districts over the last decade. The rate of changes was analyzed for 21 regions within two districts, total number and structure of those followed up by phthisiologists in 2007-2016 were compared. TB situation has not significantly improved since the drug resistance and HIV infection become more and more frequent, providing an indirect impact on the epidemiological indicators. It is very difficult to treat such categories of patients and these difficulties do not allow enhancing treatment efficiency and cause an abrupt growth of the costs per one patient, both financial and organizational ones.

75 FR 30301 - Jurisdictional Separations and Referral to the Federal-State Joint Board

Science.gov (United States)

2010-06-01

... FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 36 [CC Docket No. 80-286; FCC 10-89] Jurisdictional Separations and Referral to the Federal-State Joint Board AGENCY: Federal Communications Commission. ACTION... relationships and jurisdictional cost allocation factors used in jurisdictional separations. Extending the...

Energy management for cost reduction in the production. TEEM - Total Energy Efficiency Management; Energiemanagement zur Kostensenkung in der Produktion. TEEM - Total Energy Efficiency Management

Energy Technology Data Exchange (ETDEWEB)

Westkaemper, Engelbert; Verl, Alexander (eds.)

2009-07-01

Within the workshop of the Fraunhofer Institute for Manufacturing Engineering and Automation IPA (Stuttgart, Federal Republic of Germany) at 6th October, 2009, in Stuttgart the following lectures were held: (1) Presentation of Fraunhofer Institute for Manufacturing Engineering and Automation IPA (Engelbert Westkaemper); (2) TEEM - Total Energy Efficiency Management - ''With energy management to an energy efficient production'' (Alexander Schloske); (3) DIN EN 16001 Introduction of an energy management system - utilization and advantages for companies (Sylvia Wahren); (4) Analysis of the energy efficiency with power flow - Support and implementation at factory planning and optimization of production (Klaus Erlach); (5) Total Energy Efficiency Management - Approaches at the company Kaercher in injection moulding for example (Axel Leschtar); (6) Modelling the embodied product energy (Shahin Rahimifard); (7) Acquisition of energy data in the production - Technologies and possibilities (Joachim Neher); (8) Active energy management by means of an ''energy control centre'' - Analysis of the real situation and upgrading measures in the production using coating plants as an example (Wolfgang Klein); (9) Visualisation and simulation of energy values in the digital factory (Carmen Constantinescu, Axel Bruns).

48 CFR 52.246-8 - Inspection of Research and Development-Cost-Reimbursement.

Science.gov (United States)

2010-10-01

... Development-Cost-Reimbursement. 52.246-8 Section 52.246-8 Federal Acquisition Regulations System FEDERAL... Provisions and Clauses 52.246-8 Inspection of Research and Development—Cost-Reimbursement. As prescribed in... (b) a cost-reimbursement contract is contemplated; unless use of the clause is impractical and the...

48 CFR 15.406-2 - Certificate of current cost or pricing data.

Science.gov (United States)

2010-10-01

... cost or pricing data. 15.406-2 Section 15.406-2 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 15.406-2 Certificate of current cost or pricing data. (a) When certified cost or pricing data are...

47 CFR 36.621 - Study area total unseparated loop cost.

Science.gov (United States)

2010-10-01

... deducting the accumulated depreciation and noncurrent deferred Federal income taxes attributable to C&WF... by the study area's authorized interstate rate of return. (2) Depreciation expense attributable to C... reported in § 36.611(d). (4) Corporate Operations Expenses, Operating Taxes and the benefits and rent...

Allocation of Federal Airport and Airway Costs for FY 1985.

Science.gov (United States)

1986-12-01

functions in order to provide complete estimates of long-run marginal costs: o Depreciation , o The cost of capital, o The cost of non-labor inputs used to...accepted accounting principles ( GAAP )1 0 and normal business practice. While many R&D projects appear to be related to actual hardware development... depreciation are not. 3 An estimate was developed of the expected number of units of service consumed by each user group per flight. The estimated

48 CFR 1352.215-76 - Cost or pricing data.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Cost or pricing data. 1352.215-76 Section 1352.215-76 Federal Acquisition Regulations System DEPARTMENT OF COMMERCE CLAUSES AND... pricing data. As prescribed in 48 CFR 1315.204-570(b)(4), insert the following provision: Cost or Pricing...

48 CFR 31.205-12 - Economic planning costs.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Economic planning costs... GENERAL CONTRACTING REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations 31.205-12 Economic planning costs. Economic planning costs are the costs of general long-range...

Federal health services grants, 1985.

Science.gov (United States)

Zwick, D I

1986-01-01

Federal health services grants amounted to about $1.8 billion in fiscal year 1985. The total amount was about $100 million less, about 6 percent, than in 1980. Reductions in the health planning program accounted for most of the decline in absolute dollars. The four formula grants to State agencies amounted to about $1.0 billion in 1985, about 60 percent of the total. The largest formula grants were for maternal and child health services and for alcohol, drug abuse, and mental health services. Project grants to selected State and local agencies amounted to about $.8 billion. There was 12 such grants in 1985 (compared with 34 in 1980). The largest, for community health services, equaled almost half the total. In real, inflation-adjusted dollars, the decline in Federal funds for these programs exceeded a third during the 5-year period. The overall dollar total in real terms in 1985 approximated the 1970 level. The ratio of formula grants to project grants in 1985 was similar to that in 1965. Studies of the impact of changes in Federal grants have found that while the development of health programs has been seriously constrained in most cases, their nature has not been substantially altered. In some cases broader program approaches and allocations have been favored. Established modes of operations and administration have generally been strengthened. Some efficiencies but few savings in administration have been identified. Replacement of reduced Federal funding by the States has been modest but has increased over time, especially for direct service activities. These changes reflect the important influence of professionalism in the health fields and the varying strengths of political interest and influence among program supporters. The long-term impact on program innovation is not yet clear.

48 CFR 31.205-36 - Rental costs.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Rental costs. 31.205-36... CONTRACTING REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations 31.205-36 Rental costs. (a) This subsection is applicable to the cost of renting or leasing real or...

76 FR 49365 - Cost Accounting Standards: Elimination of the Exemption From Cost Accounting Standards for...

Science.gov (United States)

2011-08-10

... Accounting Standards: Elimination of the Exemption From Cost Accounting Standards for Contracts and...: Office of Management and Budget (OMB), Office of Federal Procurement Policy (OFPP), Cost Accounting... Accounting Standards (CAS) Board, is publishing a final rule to eliminate the exemption from regulations...

Cask system maintenance in the Federal Waste Management System

International Nuclear Information System (INIS)

Pope, R.B.; Rennich, M.J.; Medley, L.G.; Attaway, C.R.

1991-01-01

In early 1988, in support of the development of the transportation system for the Office of Civilian Radioactive Waste Management System (OCRWM), a feasibility study was undertaken to define a the concept for a stand-alone, ''green-field'' facility for maintaining the Federal Waste Management System (FWMS) casks. This study provided and initial layout facility design, an estimate of the construction costs, and an acquisition schedule for a Cask Maintenance Facility (CMF). It also helped to define the interfaces between the transportation system and the waste generators, the repository, and a Monitored Retrievable Storage (MRS) facility. The data, design, and estimated costs derived from the study have been organized for use in the total transportation system decision-making process. Most importantly, they also provide a foundation for continuing design and planning efforts. The feasibility study was based on an assumed stand-alone, ''green-field'' configuration. This design approach provides a comprehensive design evaluation, to guide the development of a cost estimate and to permit flexibility in locating the facility. The following sections provide background information on cask system maintenance, briefly summarizes some of the functional requirements that a CMF must satisfy, provides a physical description of the CMF, briefly discusses the cost and schedule estimates and then reviews the findings of the efforts undertaken since the feasibility study was completed. 15 refs., 3 figs

32 CFR 37.570 - What must I do if a CAS-covered participant accounts differently for its own and the Federal...

Science.gov (United States)

2010-07-01

... that are subject to the Cost Accounting Standards (CAS) in part 30 of the Federal Acquisition... organization subject to the FAR cost principles in 48 CFR parts 31 and 231 proposes to charge: (1) Its share of... Federal Government procurement contracts, as allowed under the FAR cost principles; and (2) The Federal...

76 FR 31395 - Federal Acquisition Regulation; Sustainable Acquisition

Science.gov (United States)

2011-05-31

..., landfill gas, ocean (including tidal, wave, current, and thermal), municipal solid waste, or new... maintenance costs; (4) Ensure that rehabilitation of Federally-owned historic buildings utilizes best...

Methodology of Evaluation of the Impact of Picking Area Location on the Total Costs of Warehouse

Directory of Open Access Journals (Sweden)

Apsalons Raitis

2017-12-01

Full Text Available The picking system and the layout of the picking area are the key drivers for the evaluation of a warehouse picking cost. There are five variants for organizing the picking process of orders in a warehouse. The choice of a specific variant depends on the total cost of picking. The picking cost is evaluated within an uninterrupted picking process. It means that no stock out occurs in the time period of the picking process. The storing area and the picking area are created as two separate zones for picking quantities of the customer’s orders; the principle of division of orders is observed strictly. Referring to the locations of stock keeping units (SKU, two approaches of the layout of SKU in the picking area can be estimated. The first one is the single picking location for each single SKU, where replenishment is realized in the picking process. The second one - various picking locations for each single SKU, and the replenishment here is realized just only prior to a picking process or after it. The main benefits of the economy of the picking cost as far as these two approaches are concerned are the shortest picking route in the first case and one common replenishment option in the second case.

Benefits of using customized instrumentation in total knee arthroplasty: results from an activity-based costing model.

Science.gov (United States)

Tibesku, Carsten O; Hofer, Pamela; Portegies, Wesley; Ruys, C J M; Fennema, Peter

2013-03-01

The growing demand for total knee arthroplasty (TKA) associated with the efforts to contain healthcare expenditure by advanced economies necessitates the use of economically effective technologies in TKA. The present analysis based on activity-based costing (ABC) model was carried out to estimate the economic value of patient-matched instrumentation (PMI) compared to standard surgical instrumentation in TKA. The costs of the two approaches, PMI and standard instrumentation in TKA, were determined by the use of ABC which measures the cost of a particular procedure by determining the activities involved and adding the cost of each activity. Improvement in productivity due to increased operating room (OR) turn-around times was determined and potential additional revenue to the hospital by the efficient utilization of gained OR time was estimated. Increased efficiency in the usage of OR and utilization of surgical trays were noted with patient-specific approach. Potential revenues to the hospital were estimated with the use of PMI by efficient utilization of time saved in OR. Additional revenues of 78,240 per year were estimated considering utilization of gained OR time to perform surgeries other than TKA. The analysis suggests that use of PMI in TKA is economically effective when compared to standard instrumentation.

48 CFR 9903.302-1 - Cost accounting practice.

Science.gov (United States)

2010-10-01

..., or measurement of cost. (a) Measurement of cost, as used in this part, encompasses accounting methods... practice. Examples of cost accounting practices which involve measurement of costs are— (1) The use of... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Cost accounting practice...

Incidence, risk factors and the healthcare cost of falls postdischarge after elective total hip and total knee replacement surgery: protocol for a prospective observational cohort study

Science.gov (United States)

Hill, Anne-Marie; Ross-Adjie, Gail; McPhail, Steven M; Monterosso, Leanne; Bulsara, Max; Etherton-Beer, Christopher; Powell, Sarah-Jayne; Hardisty, Gerard

2016-01-01

Introduction The number of major joint replacement procedures continues to increase in Australia. The primary aim of this study is to determine the incidence of falls in the first 12 months after discharge from hospital in a cohort of older patients who undergo elective total hip or total knee replacement. Methods and analyses A prospective longitudinal observational cohort study starting in July 2015, enrolling patients aged ≥60 years who are admitted for elective major joint replacement (n=267 total hip replacement, n=267 total knee replacement) and are to be discharged to the community. Participants are followed up for 12 months after hospital discharge. The primary outcome measure is the rate of falls per thousand patient-days. Falls data will be collected by 2 methods: issuing a falls diary to each participant and telephoning participants monthly after discharge. Secondary outcomes include the rate of injurious falls and health-related quality of life. Patient-rated outcomes will be measured using the Oxford Hip or Oxford Knee score. Generalised linear mixed modelling will be used to examine the falls outcomes in the 12 months after discharge and to examine patient and clinical characteristics predictive of falls. An economic evaluation will be conducted to describe the nature of healthcare costs in the first 12 months after elective joint replacement and estimate costs directly attributable to fall events. Ethics and dissemination The results will be disseminated through local site networks and will inform future services to support older people undergoing hip or knee joint replacement and also through peer-reviewed publications and medical conferences. This study has been approved by The University of Notre Dame Australia and local hospital human research ethics committees. Trial registration number ACTRN12615000653561; Pre-results. PMID:27412102

DEVELOPMENT AND EVALUATION OF MEASURES TO REDUCE COSTS OF REGIONAL LOANS SERVICING

Directory of Open Access Journals (Sweden)

Pavel Arkadyevitch Galanskiy

2014-10-01

Full Text Available The paper discusses major problems of current concern connected with controlling direct obligations of Russian regions (the model of debt servicing cost parameter optimization has been worked out, and their key solutions. The methods offered to analyze debts and manage them are applicable to any Russian Federation regions characterized by budget deficit and forced to cover it using borrowed funds. The important leverage found and their impacts on sub-federal debt servicing cost are also treated in the article.Objective: to identify the direction and impact degree of various parameters on the cost of sub-federal loans.Methodology: there were used general scientific methods: analysis and synthesis, comparison, generalization, systematic approach.Results: main parameters that influence the cost of sub-federal loans servicing and allow its most effective reduction have been identified.

48 CFR 52.215-17 - Waiver of Facilities Capital Cost of Money.

Science.gov (United States)

2010-10-01

... Capital Cost of Money. 52.215-17 Section 52.215-17 Federal Acquisition Regulations System FEDERAL... Provisions and Clauses 52.215-17 Waiver of Facilities Capital Cost of Money. As prescribed in 15.408(i), insert the following clause: Waiver of Facilities Capital Cost of Money (OCT 1997) The Contractor did not...

23 CFR 140.906 - Labor costs.

Science.gov (United States)

2010-04-01

... 23 Highways 1 2010-04-01 2010-04-01 false Labor costs. 140.906 Section 140.906 Highways FEDERAL... Railroad Work § 140.906 Labor costs. (a) General. (1) Salaries and wages, at actual or average rates, and... reimbursable when supported by adequate records. This shall include labor costs associated with preliminary...

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

Directory of Open Access Journals (Sweden)

Nelson Machado

2010-08-01

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

1985 Federal Interim Storage Fee Study: a technical and economic analysis

International Nuclear Information System (INIS)

1985-09-01

JAI examined alternative methods for structuring charges for FIS services and concluded that the combined interests of the Deaprtment and the users would be best served, and costs most appropriately recovered, by a two-part fee involving an Initial Payment upon execution of a contract for FIS services followed by a Final Payment upon delivery of the spent fuel to the Department. The Initial Payment would be an advance payment covering the pro rata share of preoperational costs, including (1) the capital costs of the required transfer facilities and storage area, (2) development costs, (3) government administrative costs including storage fund management, (4) impact aid payments made in accordance with section 136(e) of the Act, and (5) module costs (i.e., storage casks, drywells or silos). The Final Payment would be made at the time of delivery of the spent fuel to the Department and would be calculated to cover the sum of the following: (1) any under-or over-estimation in the costs used to calculate the Initial Payment of the fee (including savings due to rod consolidation), and (2) the total estimated cost of operation and decommissioning of the FIS facilities (including government administrative costs, storage fund management and impact aid). The module costs were included in the Initial Payment to preclude the possible need to obtain appropriations for federal funds to support the purchase of the modules in advance of receipt of the Final Payment. Charges for the transport of spent fuel from the reactor site to FIS facilities would be separately assessed at actual cost since these will be specific to each reactor site and destination

Health Clinic Cost Reports

Data.gov (United States)

U.S. Department of Health & Human Services — Healthcare Cost Report Information System (HCRIS) Dataset - Independent Rural Health Clinic and Freestanding Federally Qualified Health Center (HCLINIC).This data...

Total Joint Arthroplasty Patients' Education on Financial Issues and Its Connection to Reported Out-of-Pocket Costs-A European Study.

Science.gov (United States)

Copanitsanou, Panagiota; Valkeapää, Kirsi; Cabrera, Esther; Katajisto, Jouko; Leino-Kilpi, Helena; Sigurdardottir, Arun K; Unosson, Mitra; Zabalegui, Adelaida; Lemonidou, Chryssoula

2017-04-01

Total joint arthroplasty is accompanied by significant costs. In nursing, patient education on financial issues is considered important. Our purpose was to examine the possible association between the arthroplasty patients' financial knowledge and their out-of-pocket costs. Descriptive correlational study in five European countries. Patient data were collected preoperatively and at 6 months postoperatively, with structured, self-administered instruments, regarding their expected and received financial knowledge and out-of-pocket costs. There were 1,288 patients preoperatively, and 352 at 6 months. Patients' financial knowledge expectations were higher than knowledge received. Patients with high financial knowledge expectations and lack of fulfillment of these expectations had lowest costs. There is need to establish programs for improving the financial knowledge of patients. Patients with fulfilled expectations reported higher costs and may have followed and reported their costs in a more precise way. In the future, this association needs multimethod research. © 2016 Wiley Periodicals, Inc.

48 CFR 416.405 - Cost-reimbursement incentive contracts.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Cost-reimbursement incentive contracts. 416.405 Section 416.405 Federal Acquisition Regulations System DEPARTMENT OF...-reimbursement incentive contracts. ...

48 CFR 52.229-8 - Taxes-Foreign Cost-Reimbursement Contracts.

Science.gov (United States)

2010-10-01

...-Reimbursement Contracts. 52.229-8 Section 52.229-8 Federal Acquisition Regulations System FEDERAL ACQUISITION... Clauses 52.229-8 Taxes—Foreign Cost-Reimbursement Contracts. As prescribed in 29.402-2(a), insert the following clause: Taxes—Foreign Cost-Reimbursement Contracts (MAR 1990) (a) Any tax or duty from which the...

48 CFR 352.216-70 - Additional cost principles.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Additional cost principles... Additional cost principles. As prescribed in 316.307(j), the Contracting Officer shall insert the following clause: Additional Cost Principles (January 2006) (a) Bid and proposal (B & P) costs. (1) B & P costs are...

48 CFR 31.205-27 - Organization costs.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Organization costs. 31.205... CONTRACTING REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations 31.205-27 Organization costs. (a) Except as provided in paragraph (b) of this section, expenditures in...

Evaluation of the Influence of the Logistic Operations Reliability on the Total Costs of a Supply Chain

Directory of Open Access Journals (Sweden)

Lukinskiy Valery

2016-12-01

Full Text Available Nowadays in logistics integral processes between the material and related flows in supply chains are getting developed more and more. However, in spite of increasing volume of statistical data which reflect the integral processes, the influence evaluation issues of the logistic operations reliability indexes on the total logistics costs remain open and require the corresponding researches implementation.

Credibility and trust in federal facility cleanups

International Nuclear Information System (INIS)

Raynes, D.B.

1995-01-01

The most important indicator of a well-managed site cleanup effort may no longer be funding or scientific expertise. While support for federal facility cleanup has included appropriations of more than $10 billion annually, these expenditures alone are unlikely to assure progress toward environmental remediation. open-quotes Trustclose quotes is now overwhelmingly mentioned as a prerequisite for progress with site cleanup in DOE's weapons complex. In part, federal budget deficits are forcing participants to focus on factors that build consensus and lead to cost-effective cleanup actions. In some cases, the stakeholders at cleanup sites are making efforts to work cooperatively with federal agencies. A report by 40 representatives of federal agencies, tribal and state governments, associations, and others developed recommendations to create a open-quotes new era of trust and consensus-building that allows all parties to get on with the job of cleaning up federal facilities in a manner that reflects the priorities and concerns of all stakeholders.close quotes Changes are underway affecting how federal agencies work with federal and state regulators reflecting this concept of shared responsibility for conducting cleanup. This paper addresses these changes and provides examples of the successes and failures underway

Incorporating a total cost perspective intothe purchasing strategy : A case study of amedium sized retail compan

OpenAIRE

EKSTRÖM, MARCUS; FAHNEHJELM, CAROLINA

2016-01-01

The retail industry is today characterized by downward price pressure, and the increasedcompetition in the industry has led to pressure on profit margins. Purchasing and supply chainmanagement have become areas of increased strategic importance and play a crucial role inthe business performance. This study aims to extend previous literature in these fields byproviding the existing research with an empirical study on how the purchasing strategy canincorporate a total cost perspective of the su...

Federal Environmental Remediation Contractual and Insurance-Based Risk Allocation Schemes: Are They Getting the Job Done?

Science.gov (United States)

2005-08-31

possible rewards," and "[t]he DOE Mixed Waste Market alone has major growth potential $8 billion realizable by 1999 and a total market valued at $300...contribution from other liable parties). 22 Meghrig v. KFC Western, Inc., 516 U.S. 479, 483 (1996). 23 See 42 U.S.C. § 6902(b). 24 See 42 U.S.C. § 6924(v...solid market for federal environmental remediation services. With cost and time estimates like those provided by DOE ($225 billion to complete the EM

75 FR 35098 - Federal Employees' Retirement System; Normal Cost Percentages

Science.gov (United States)

2010-06-21

... normal cost percentages and requests for actuarial assumptions and data to the Board of Actuaries, care of Gregory Kissel, Actuary, Office of Planning and Policy Analysis, Office of Personnel Management... Regulations, regulates how normal costs are determined. Recently, the Board of Actuaries of the Civil Service...

Blood Transfusion During Total Ankle Arthroplasty Is Associated With Increased In-Hospital Complications and Costs.

Science.gov (United States)

Ewing, Michael A; Huntley, Samuel R; Baker, Dustin K; Smith, Kenneth S; Hudson, Parke W; McGwin, Gerald; Ponce, Brent A; Johnson, Michael D

2018-04-01

Total ankle arthroplasty (TAA) is an increasingly used, effective treatment for end-stage ankle arthritis. Although numerous studies have associated blood transfusion with complications following hip and knee arthroplasty, its effects following TAA are largely unknown. This study uses data from a large, nationally representative database to estimate the association between blood transfusion and inpatient complications and hospital costs following TAA. Using the Nationwide Inpatient Sample (NIS) database from 2004 to 2014, 25 412 patients who underwent TAA were identified, with 286 (1.1%) receiving a blood transfusion. Univariate analysis assessed patient and hospital factors associated with blood transfusion following TAA. Patients requiring blood transfusion were more likely to be female, African American, Medicare recipients, and treated in nonteaching hospitals. Average length of stay for patients following transfusion was 3.0 days longer, while average inpatient cost was increased by approximately 50%. Patients who received blood transfusion were significantly more likely to suffer from congestive heart failure, peripheral vascular disease, hypothyroidism, coagulation disorder, or anemia. Acute renal failure was significantly more common among patients receiving blood transfusion ( P < .001). Blood transfusions following TAA are infrequent and are associated with multiple medical comorbidities, increased complications, longer hospital stays, and increased overall cost. Level III: Retrospective, comparative study.

The lifetime costs of overweight and obesity in childhood and adolescence: a systematic review.

Science.gov (United States)

Hamilton, D; Dee, A; Perry, I J

2018-04-01

Research into lifetime costs of obesity in childhood is growing. This review synthesizes that knowledge. A computerized search of the international literature since 2000 was conducted. Mean total lifetime healthcare and productivity costs were estimated and inflated to 2014 Irish euros. This resulted in 13 published articles. The methodology used in these studies varied widely, and only one study estimated both healthcare and productivity costs. Cognizant of this heterogeneity, the mean total lifetime cost of a child or adolescent with obesity was €149,206 (range, €129,410 to €178,933) for a boy and €148,196 (range, €136,576 to €173,842) for a girl. This was divided into an average of €16,229 (range, €6,580 to €35,810) in healthcare costs and €132,977 (range, €122,830 to €143,123) in productivity losses for boys and €19,636 (range, €8,016 to €45,283) and €128,560, respectively, for girls. Income penalty accounted for the greater part of productivity costs, amounting to €97,118 (range, €86,971 to €107,264) per male adolescent with obesity and €126,108 per female adolescent. Healthcare costs and income penalty appear greater in girls while costs because of workdays lost seem greater in boys. There is proportionality between body mass index and costs. Productivity costs are greater than healthcare costs. © 2017 World Obesity Federation.

Noninvasive Hemoglobin Monitoring: A Rapid, Reliable, and Cost-Effective Method Following Total Joint Replacement.

Science.gov (United States)

Martin, J Ryan; Camp, Christopher L; Stitz, Amber; Young, Ernest Y; Abdel, Matthew P; Taunton, Michael J; Trousdale, Robert T

2016-03-02

Noninvasive hemoglobin (nHgb) monitoring was initially introduced in the intensive care setting as a means of rapidly assessing Hgb values without performing a blood draw. We conducted a prospective analysis to compare reliability, cost, and patient preference between nHgb monitoring and invasive Hgb (iHgb) monitoring performed via a traditional blood draw. We enrolled 100 consecutive patients undergoing primary or revision total hip or total knee arthroplasty. On postoperative day 1, nHgb and iHgb values were obtained within thirty minutes of one another. iHgb and nHgb values, cost, patient satisfaction, and the duration of time required to obtain each reading were recorded. The concordance correlation coefficient (CCC) was utilized to evaluate the agreement of the two Hgb measurement methods. Paired t tests and Wilcoxon signed-rank tests were utilized to compare mean Hgb values, time, and pain for all readings. The mean Hgb values did not differ significantly between the two measurement methods: the mean iHgb value (and standard deviation) was 11.3 ± 1.4 g/dL (range, 8.2 to 14.3 g/dL), and the mean nHgb value was 11.5 ± 1.8 g/dL (range, 7.0 to 16.0 g/dL) (p = 0.11). The CCC between the two Hgb methods was 0.69. One hundred percent of the patients with an nHgb value of ≥ 10.5 g/dL had an iHgb value of >8.0 g/dL. The mean time to obtain an Hgb value was 0.9 minute for the nHgb method and 51.1 minutes for the iHgb method (p measurement, resulting in a savings of $26 per Hgb assessment when the noninvasive method is used. Noninvasive Hgb monitoring was found to be more efficient, less expensive, and preferred by patients compared with iHgb monitoring. Providers could consider screening total joint arthroplasty patients with nHgb monitoring and only order iHgb measurement if the nHgb value is protocol had been applied to the first blood draw in our 100 patients, approximately $2000 would have been saved. Extrapolated to the U.S. total joint arthroplasty practice

A Cost-Effectiveness Analysis of Reverse Total Shoulder Arthroplasty versus Hemiarthroplasty for the Management of Complex Proximal Humeral Fractures in the Elderly.

Science.gov (United States)

Osterhoff, Georg; O'Hara, Nathan N; D'Cruz, Jennifer; Sprague, Sheila A; Bansback, Nick; Evaniew, Nathan; Slobogean, Gerard P

2017-03-01

There is ongoing debate regarding the optimal surgical treatment of complex proximal humeral fractures in elderly patients. To evaluate the cost-effectiveness of reverse total shoulder arthroplasty (RTSA) compared with hemiarthroplasty (HA) in the management of complex proximal humeral fractures, using a cost-utility analysis. On the basis of data from published literature, a cost-utility analysis was conducted using decision tree and Markov modeling. A single-payer perspective, with a willingness-to-pay (WTP) threshold of Can$50,000 (Canadian dollars), and a lifetime time horizon were used. The incremental cost-effectiveness ratio (ICER) was used as the study's primary outcome measure. In comparison with HA, the incremental cost per quality-adjusted life-year gained for RTSA was Can$13,679. One-way sensitivity analysis revealed the model to be sensitive to the RTSA implant cost and the RTSA procedural cost. The ICER of Can$13,679 is well below the WTP threshold of Can$50,000, and probabilistic sensitivity analysis demonstrated that 92.6% of model simulations favored RTSA. Our economic analysis found that RTSA for the treatment of complex proximal humeral fractures in the elderly is the preferred economic strategy when compared with HA. The ICER of RTSA is well below standard WTP thresholds, and its estimate of cost-effectiveness is similar to other highly successful orthopedic strategies such as total hip arthroplasty for the treatment of hip arthritis. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

48 CFR 9904.410 - Allocation of business unit general and administrative expenses to final cost objectives.

Science.gov (United States)

2010-10-01

... unit general and administrative expenses to final cost objectives. 9904.410 Section 9904.410 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING...

Financial Performance of Health Insurers: State-Run Versus Federal-Run Exchanges.

Science.gov (United States)

Hall, Mark A; McCue, Michael J; Palazzolo, Jennifer R

2018-06-01

Many insurers incurred financial losses in individual markets for health insurance during 2014, the first year of Affordable Care Act mandated changes. This analysis looks at key financial ratios of insurers to compare profitability in 2014 and 2013, identify factors driving financial performance, and contrast the financial performance of health insurers operating in state-run exchanges versus the federal exchange. Overall, the median loss of sampled insurers was -3.9%, no greater than their loss in 2013. Reduced administrative costs offset increases in medical losses. Insurers performed better in states with state-run exchanges than insurers in states using the federal exchange in 2014. Medical loss ratios are the underlying driver more than administrative costs in the difference in performance between states with federal versus state-run exchanges. Policy makers looking to improve the financial performance of the individual market should focus on features that differentiate the markets associated with state-run versus federal exchanges.

States reducing solar's soft costs

Energy Technology Data Exchange (ETDEWEB)

Meehan, Chris

2012-07-01

In 2012 the costs of modules will drop below the balance of system costs or 'soft costs' of solar in the US. Federal policy that nationalizes permitting processes could reduce some of the soft costs, but is unlikely. That's why states like California, Colorado, Connecticut and Vermont passed own laws to reduce soft costs by speeding solar permitting and reducing fees. (orig.)

48 CFR 970.3102-05-4 - Bonding costs.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Bonding costs. 970.3102-05... SUPPLEMENTARY REGULATIONS DOE MANAGEMENT AND OPERATING CONTRACTS Contract Cost Principles and Procedures 970.3102-05-4 Bonding costs. (d) The allowability of bonding costs shall be determined pursuant to 970.5228...

48 CFR 3452.216-70 - Additional cost principles.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Additional cost principles... Clauses 3452.216-70 Additional cost principles. Insert the following clause in solicitations and contracts as prescribed in 3416.307(b): Additional Cost Principles (AUG 1987) (a) Bid and Proposal Costs. Bid...

Federal Interim Storage program

International Nuclear Information System (INIS)

Johnson, E.R.; McBride, J.A.

1984-01-01

The DOE has developed a program for providing Federal Interim Storage servies for spent nuclear fuel which complies with the requirements of the Nuclear Waste Policy Act of 1982. Although very little constructive activity in providing storage facilities can be undertaken by DOE until fuel has been certified by NRC as eligible for FIS, DOE planning and background information is such as to provide reasonable assurance that its obligations can be fulfilled when the required certifications have been issued. A fee structure providing fuel recovery of all costs associated with the FIS program, as required by the Act, has been developed. It provides for an equitable distribution of costs among users, based on the quantity of fuel requiring storage

48 CFR 31.205-34 - Recruitment costs.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Recruitment costs. 31.205....205-34 Recruitment costs. (a) Subject to paragraph (b) of this subsection, the following costs are... positions; or (2) Includes material that is not relevant for recruitment purposes, such as extensive...

Federal Highway Administration 100-year coating study.

Science.gov (United States)

2012-11-01

The Federal Highway Administration 100-Year Coating Study was initiated in August 2009 to search for durable : coating systems at a reasonable cost. The objective of the study was to identify and evaluate coating materials that can : provide 100 year...

Removal costs and claims under the Oil Pollution Act of 1990

International Nuclear Information System (INIS)

Smith, R.E.

1993-01-01

The Oil Pollution Act of 1990 (OPA 90), enacted on August 18, 1990, changed the nature of federal response to oil spills and substantially increased the remedies available to those damaged by oil spills. Prior to OPA 90, the authority for federal oil spill response was found in section 311 of the Federal Water Pollution Control Act (FWPCA), and the funding for federal responses was provided through a revolving fund established under section 311(k). OPA 90 modified section 311 to authorize the President to open-quotes direct and monitor all Federal, State, and private actions to remove a dischargeclose quotes of oil. OPA 90 also authorized the use of the Oil Spill Liability Trust Fund (OSLTF) for federal removal costs, among other uses, thereby significantly increasing the funding available for federal response activities. The effect of OPA 90 is evolving. There are more cases, more removal costs, and more efforts to recover those costs from responsible parties. There are provisions for compensation for claims but relatively few claims so far. It is expected that the next two years will see substantial increases in the number of claims

48 CFR 31.205-10 - Cost of money.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Cost of money. 31.205-10....205-10 Cost of money. (a) General. Cost of money— (1) Is an imputed cost that is not a form of...) Refers to— (i) Facilities capital cost of money (48 CFR 9904.414); and (ii) Cost of money as an element...

From Policy to Compliance: Federal Energy Efficient Product Procurement

Energy Technology Data Exchange (ETDEWEB)

DeMates, Laurèn [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Scodel, Anna [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

2017-09-06

Federal buyers are required to purchase energy-efficient products in an effort to minimize energy use in the federal sector, save the federal government money, and spur market development of efficient products. The Federal Energy Management Program (FEMP)’s Energy Efficient Product Procurement (EEPP) Program helps federal agencies comply with the requirement to purchase energy-efficient products by providing technical assistance and guidance and setting efficiency requirements for certain product categories. Past studies have estimated the savings potential of purchasing energy-efficient products at over $500 million per year in energy costs across federal agencies.1 Despite the strong policy support for EEPP and resources available, energy-efficient product purchasing operates within complex decision-making processes and operational structures; implementation challenges exist that may hinder agencies’ ability to comply with purchasing requirements. The shift to purchasing green products, including energy-efficient products, relies on “buy in” from a variety of potential actors throughout different purchasing pathways. Challenges may be especially high for EEPP relative to other sustainable acquisition programs given that efficient products frequently have a higher first cost than non-efficient ones, which may be perceived as a conflict with fiscal responsibility, or more simply problematic for agency personnel trying to stretch limited budgets. Federal buyers may also face challenges in determining whether a given product is subject to EEPP requirements. Previous analysis on agency compliance with EEPP, conducted by the Alliance to Save Energy (ASE), shows that federal agencies are getting better at purchasing energy-efficient products. ASE conducted two reviews of relevant solicitations for product and service contracts listed on Federal Business Opportunities (FBO), the centralized website where federal agencies are required to post procurements greater

Nuclear supervision - Administration by the federal states on behalf of the Federal Government or direct federal administration for optimum achievement; Atomaufsicht - Bundesautragsverwaltung oder Bundeseigenverwaltung aus der Sicht optimaler Aufgabenerfuellung

Energy Technology Data Exchange (ETDEWEB)

Renneberg, W. [Bundesministerium fuer Umwelt, Naturschutz und Reaktorsicherheit, Bonn (Germany)

2005-01-01

One year ago, Federal Minister for the Environment Juergen Trittin expressed doubt about the long-term viability of the federal states' acting on behalf of the federal government in the field of atomic energy law administration. An alternative to this type of administration was mentioned, namely direct execution by the feral government, and a thorough examination was announced. This was to show which type of administration would achieve maximum safety for the residual operating lives of nuclear power plants. Kienbaum Management Consultants were commissioned to evaluate the current status and potential alternative structures. That study was performed within the framework of one of the key projects in reactor safety of the Federal Ministry for the Environment, Nature Conservation, and Nuclear Safety (BMU), namely the reform of nuclear administration. Further steps to be taken by the BMU by the end of this parliamentary term are presented. The federal state are to be approached in an attempt to conduct an unbiased discussion of the pros and cons of the alternatives to administration by the federal states on behalf of the federal government. Questions will be clarified which need to be examined in depth before direct administration by the federal government can be introduced. These include constitutional matters and matters of costing in financing the higher-level federal authority as well as specific questions about the organization of that authority. The purpose is to elaborate, by the end of this parliamentary term, a workable concept of introducing direct federal administration of nuclear safety. (orig.)

75 FR 53135 - Federal Acquisition Regulation; Definition of Cost or Pricing Data

Science.gov (United States)

2010-08-30

...; Definition of Cost or Pricing Data AGENCIES: Department of Defense (DoD), General Services Administration... ``certified cost or pricing data'' and ``data other than certified cost or pricing data'', and to clarify requirements for submission of cost or pricing data. DATES: Effective Date: October 1, 2010. FOR FURTHER...

48 CFR 352.231-70 - Precontract costs.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Precontract costs. 352.231... SOLICITATION PROVISIONS AND CONTRACT CLAUSES Text of Provisions and Clauses 352.231-70 Precontract costs. As prescribed in 48 CFR 1331.205-32, insert the following clause: Precontract Costs (APR 2010) The contractor is...

48 CFR 30.606 - Resolving cost impacts.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Resolving cost impacts. 30... impacts. (a) General. (1) The CFAO shall coordinate with the affected contracting officers before negotiating and resolving the cost impact when the estimated cost impact on any of their contracts is at least...

48 CFR 1515.404-475 - Cost realism.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Cost realism. 1515.404-475... METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 1515.404-475 Cost realism. The EPA structured approach is not required when the contracting officer is evaluating cost realism in a competitive...

48 CFR 31.205-42 - Termination costs.

Science.gov (United States)

2010-10-01

... nonrecurring labor, material, and related overhead costs incurred in the early part of production and result... the settlement proposal as a direct charge, such costs shall not also be included in overhead. Initial... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Termination costs. 31.205...

75 FR 60258 - Federal Acquisition Regulation; Termination for Default Reporting

Science.gov (United States)

2010-09-29

..., Sequence 1] RIN 9000-AL45 Federal Acquisition Regulation; Termination for Default Reporting AGENCIES... terminations for cause or default and defective cost or pricing data, into the Past Performance Information... defective cost or pricing data and terminations for cause or default into the FAPIIS module of the PPIRS...

CAIRSENSE-Atlanta Low Cost Sensor Evaluation Versus Reference Monitors

Data.gov (United States)

U.S. Environmental Protection Agency — Short time interval comparisons of low cost sensor response and corresponding Federal Reference or Federal Equivalent Monitors at an NCOR site located in proximity...

Oil and gas pipeline construction cost analysis and developing regression models for cost estimation

Science.gov (United States)

Thaduri, Ravi Kiran

In this study, cost data for 180 pipelines and 136 compressor stations have been analyzed. On the basis of the distribution analysis, regression models have been developed. Material, Labor, ROW and miscellaneous costs make up the total cost of a pipeline construction. The pipelines are analyzed based on different pipeline lengths, diameter, location, pipeline volume and year of completion. In a pipeline construction, labor costs dominate the total costs with a share of about 40%. Multiple non-linear regression models are developed to estimate the component costs of pipelines for various cross-sectional areas, lengths and locations. The Compressor stations are analyzed based on the capacity, year of completion and location. Unlike the pipeline costs, material costs dominate the total costs in the construction of compressor station, with an average share of about 50.6%. Land costs have very little influence on the total costs. Similar regression models are developed to estimate the component costs of compressor station for various capacities and locations.

Time-driven Activity-based Costing More Accurately Reflects Costs in Arthroplasty Surgery.

Science.gov (United States)

Akhavan, Sina; Ward, Lorrayne; Bozic, Kevin J

2016-01-01

Cost estimates derived from traditional hospital cost accounting systems have inherent limitations that restrict their usefulness for measuring process and quality improvement. Newer approaches such as time-driven activity-based costing (TDABC) may offer more precise estimates of true cost, but to our knowledge, the differences between this TDABC and more traditional approaches have not been explored systematically in arthroplasty surgery. The purposes of this study were to compare the costs associated with (1) primary total hip arthroplasty (THA); (2) primary total knee arthroplasty (TKA); and (3) three surgeons performing these total joint arthroplasties (TJAs) as measured using TDABC versus traditional hospital accounting (TA). Process maps were developed for each phase of care (preoperative, intraoperative, and postoperative) for patients undergoing primary TJA performed by one of three surgeons at a tertiary care medical center. Personnel costs for each phase of care were measured using TDABC based on fully loaded labor rates, including physician compensation. Costs associated with consumables (including implants) were calculated based on direct purchase price. Total costs for 677 primary TJAs were aggregated over 17 months (January 2012 to May 2013) and organized into cost categories (room and board, implant, operating room services, drugs, supplies, other services). Costs derived using TDABC, based on actual time and intensity of resources used, were compared with costs derived using TA techniques based on activity-based costing and indirect costs calculated as a percentage of direct costs from the hospital decision support system. Substantial differences between cost estimates using TDABC and TA were found for primary THA (USD 12,982 TDABC versus USD 23,915 TA), primary TKA (USD 13,661 TDABC versus USD 24,796 TA), and individually across all three surgeons for both (THA: TDABC = 49%-55% of TA total cost; TKA: TDABC = 53%-55% of TA total cost). Cost

Management of End-Stage Ankle Arthritis: Cost-Utility Analysis Using Direct and Indirect Costs.

Science.gov (United States)

Nwachukwu, Benedict U; McLawhorn, Alexander S; Simon, Matthew S; Hamid, Kamran S; Demetracopoulos, Constantine A; Deland, Jonathan T; Ellis, Scott J

2015-07-15

Total ankle replacement and ankle fusion are costly but clinically effective treatments for ankle arthritis. Prior cost-effectiveness analyses for the management of ankle arthritis have been limited by a lack of consideration of indirect costs and nonoperative management. The purpose of this study was to compare the cost-effectiveness of operative and nonoperative treatments for ankle arthritis with inclusion of direct and indirect costs in the analysis. Markov model analysis was conducted from a health-systems perspective with use of direct costs and from a societal perspective with use of direct and indirect costs. Costs were derived from the 2012 Nationwide Inpatient Sample (NIS) and expressed in 2013 U.S. dollars; effectiveness was expressed in quality-adjusted life years (QALYs). Model transition probabilities were derived from the available literature. The principal outcome measure was the incremental cost-effectiveness ratio (ICER). In the direct-cost analysis for the base case, total ankle replacement was associated with an ICER of $14,500/QALY compared with nonoperative management. When indirect costs were included, total ankle replacement was both more effective and resulted in $5900 and $800 in lifetime cost savings compared with the lifetime costs following nonoperative management and ankle fusion, respectively. At a $100,000/QALY threshold, surgical management of ankle arthritis was preferred for patients younger than ninety-six years and total ankle replacement was increasingly more cost-effective in younger patients. Total ankle replacement, ankle fusion, and nonoperative management were the preferred strategy in 83%, 12%, and 5% of the analyses, respectively; however, our model was sensitive to patient age, the direct costs of total ankle replacement, the failure rate of total ankle replacement, and the probability of arthritis after ankle fusion. Compared with nonoperative treatment for the management of end-stage ankle arthritis, total ankle

48 CFR 428.307 - Insurance under cost-reimbursement contracts.