Integrated Cost Allocation of Transmission Usage under Electricity Markets

Directory of Open Access Journals (Sweden)

Hermagasantos Zein

2012-08-01

Full Text Available Cost allocation of transmission usage on the power networks is an important issue especially in the modern electricity market mechanism. In this context, all costs that have been embedded in the transmission, embedded cost, should be covered by the transmission users. This paper follows general methods, where generators are fullyresponsible to cover the embedded cost. It proposes a method to determine the cost allocation of transmission usage based on decomposition through the superposition techinique to determine power flow contributions from an integrated base case of the results of the power flow calculations of all transactions, bilateral and nonbilateral contracts. Mathematically, the applied formulations are illustrated clearly in this paper. The proposed method has been tested with 5-bus system and the results are much different compared to a few of the published methods. This is shown by the test results on the 5 bus system. The published methods produce total power flow contributions in each line is greater than the actual. And they earn total revenues approximately 11.6% greater than the embedded cost. While on the proposed method, the power flow contribu tions are equal to the actual and the revenues are equal to the embedded cost. It shows also that the proposed method gives results as expected.

Uptake, outcomes, and costs of antenatal, well-baby, and prevention of mother-to-child transmission of HIV services under routine care conditions in Zambia.

Directory of Open Access Journals (Sweden)

Callie A Scott

Full Text Available BACKGROUND: Zambia adopted Option A for prevention of mother-to-child transmission of HIV (PMTCT in 2010 and announced a move to Option B+ in 2013. We evaluated the uptake, outcomes, and costs of antenatal, well-baby, and PMTCT services under routine care conditions in Zambia after the adoption of Option A. METHODS: We enrolled 99 HIV-infected/HIV-exposed (index mother/baby pairs with a first antenatal visit in April-September 2011 at four study sites and 99 HIV-uninfected/HIV-unexposed (comparison mother/baby pairs matched on site, gestational age, and calendar month at first visit. Data on patient outcomes and resources utilized from the first antenatal visit through six months postpartum were extracted from site registers. Costs in 2011 USD were estimated from the provider's perspective. RESULTS: Index mothers presented for antenatal care at a mean 23.6 weeks gestation; 55% were considered to have initiated triple-drug antiretroviral therapy (ART based on information recorded in site registers. Six months postpartum, 62% of index and 30% of comparison mother/baby pairs were retained in care; 67% of index babies retained had an unknown HIV status. Comparison and index mother/baby pairs utilized fewer resources than under fully guideline-concordant care; index babies utilized more well-baby resources than comparison babies. The average cost per comparison pair retained in care six months postpartum was $52 for antenatal and well-baby services. The average cost per index pair retained was $88 for antenatal, well-baby, and PMTCT services and increased to $185 when costs of triple-drug ART services were included. CONCLUSIONS: HIV-infected mothers present to care late in pregnancy and many are lost to follow up by six months postpartum. HIV-exposed babies are more likely to remain in care and receive non-HIV, well-baby care than HIV-unexposed babies. Improving retention in care, guideline concordance, and moving to Option B+ will result in

18 CFR 37.7 - Auditing Transmission Service Information.

Science.gov (United States)

2010-04-01

... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Auditing Transmission Service Information. 37.7 Section 37.7 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... SYSTEMS § 37.7 Auditing Transmission Service Information. (a) All OASIS database transactions, except...

New transmission interconnection reduces consumer costs

Energy Technology Data Exchange (ETDEWEB)

Anon.

2008-09-15

The Central American electric interconnection system (SIEPAC) project will involve the construction of a 1830 km 230 kV transmission system that will link Guatemala, El Salvador, Honduras, Costa Rica, Nicaragua, and Panama. The system is expected to alleviate the region's power shortages and reduce electricity costs for consumers. Costs for the SIEPAC project have been estimated at $370 million. The system will serve approximately 37 million customers, and will include 15 substations. The contract for building the electrical equipment has been awarded to Schweitzer Engineering Laboratories (SEL) who plan to manufacture components at a plant in Mexico. The equipment will include high speed line protection, automation, and control systems. Line current differential systems and satellite-synchronized clocks will also be used. The new transmission system is expected to be fully operational by 2009. 1 fig.

Northern States Power Company's open transmission tariff from a customer's perspective

International Nuclear Information System (INIS)

Marietta, K.E.; Achinger, S.K.

1993-01-01

In October of 1990, Northern States Power Company (NSP or Company), filed a unique open transmission tariff for both captive customers and through-system transactions. This is an important step towards expanding transmission services in the United States. Many individuals in the utility industry, who may be considering Imposing generation costs on transmission services, have been closely monitoring NSP's case which is currently before the Federal Energy Regulatory Commission (FERC). NSP's innovative generation costs include charges for reactive power production, frequency control, load dispatching, and load following. The results of this case may also have an important impact on the future of open transmission tariffs. Rates for these services depend on the customer's classification as either a captive or through-system consumer. The proposed tariff raises critical issues related to the costing of these transmission services. NSP's methodology has caused serious concern because the proposed tariff would increase transmission costs by an average of 53%. This paper will discuss the benefits of transmission, proposed rates, contract terms, and costing methodologies of NSP's plan

Transmission expansion cost allocation based on cooperative game theory for congestion relief

Energy Technology Data Exchange (ETDEWEB)

Erli, Ge; Takahasi, Kazuhiro; Kurihara, Ikuo [Central Research Inst. of Electric Power Industry, Tokyo (Japan); Luonan Chen [Osaka Sangyo Univ., Osaka (Japan)

2005-01-01

In conventional power systems, upstream and downstream of power were distinct. However, due to the competition, power injection and sink can appear at unexpected locations, and cost sharing for such a new power system configuration must be considered. This paper proposes a scheme for transmission expansion cost allocation among electric market participants by using Core and Nucleolus concepts of game theory, which are developed particularly for the transmission users. A solution of the n-person cooperative game is adopted to distribute the line transmission expansion cost among the players. Congestion is assumed to be the transmission constraint, and expansion of transmission line is expected to relieve transmission congestion. A case study is illustrated to demonstrate the proposed method. (Author)

Transmission pricing and stranded costs in the electric power industry

International Nuclear Information System (INIS)

Baumol, W.J.; Sidak, J.G.

1995-09-01

Stranded costs are those costs that electric utilities are currently permitted to recover through their rates but whose recovery may be impeded or prevented by the advent of competition in the industry. Estimates of these costs run from the tens to the hundreds of billions of dollars. Should regulators permit utilities to recover stranded costs while they take steps to promote competition in the electric power industry. William Baumol and J. Gregory Sidak argue that answer to that question should be yes.The authors show that a transmission price, the price for sending electricity over the transmission grid, can be determined in a manner that is compatible with economic efficiency and clearly neutral in its effects upon all competitors in electricity generation. A correctly constructed regime of transmission pricing may in fact achieve the efficiency and equity goals that justify the recovery of stranded costs

Allocation of the transmission service cost with base in marginal costs of the transmission network expansion; Asignacion del costo del servicio de transmision con base en costos marginales de expansion de la red de transmision

Energy Technology Data Exchange (ETDEWEB)

Ruiz Casillas, Manuel E.; Nieva Gomez, Rolando [Instituto de Investigaciones Electricas, Temixco, Morelos (Mexico)

2001-07-01

The transmission charges to the users must be completely defined in those systems where the restructuring has broken up the traditional functions of the companies; in order to introduce competition in the generation and commercialization segments of the electrical energy. The fundamentals of a method used are explained to assure the transmission service cases between their users. The method is based on the marginal expansion costs of the transmission network. Their more known applications have been in competitive markets of energy, in particular, where the energy price is the same one in all the localities. Nevertheless, it can be used under other forms of organization of the electrical industry. In order to illustrate results, the obtained ones from their application to the most important part of the transmission network of the Mexican system that operates interconnected, are presented. [Spanish] Los cargos de transmision a los usuarios deben estar completamente definidos en aquellos sistemas donde la reestructuracion ha desagregado las funciones tradicionales de las empresas; para introducir competencia en los segmentos de generacion y comercializacion de la energia electrica. Se explican los fundamentos de un metodo utilizado para asegurar los casos del servicio de transmision entre sus usuarios. El metodo se basa en los costos marginales de expansion de la red de transmision. Sus aplicaciones mas conocidas han sido en mercados competitivos de energia, en particular, donde el precio de la energia es el mismo en todas las localidades. Sin embargo, puede utilizarse bajo otras formas de organizacion de la industria electrica. Con el proposito de ilustrar resultados, se muestran los obtenidos de su aplicacion a la parte mas importante de la red de transmision del sistema mexicano que opera interconectada.

Load control services in the management of power system security costs

International Nuclear Information System (INIS)

Jayantilal, A.; Strbac, G.

1999-01-01

The new climate of deregulation in the electricity industry is creating a need for a more transparent cost structure and within this framework the cost of system security has been a subject of considerable interest. Traditionally power system security has been supplied by out-of-merit generation, in the short term, and transmission reinforcement, in the long term. This paper presents a method of analysing the role of load-demand in the management of power system security costs by utilising load control services (LCS). It also proposes a competitive market to enable bidding from various participants within the electricity industry to supply system security. (author)

Transmission usage cost allocation schemes

International Nuclear Information System (INIS)

Abou El Ela, A.A.; El-Sehiemy, R.A.

2009-01-01

This paper presents different suggested transmission usage cost allocation (TCA) schemes to the system individuals. Different independent system operator (ISO) visions are presented using the proportional rata and flow-based TCA methods. There are two proposed flow-based TCA schemes (FTCA). The first FTCA scheme generalizes the equivalent bilateral exchanges (EBE) concepts for lossy networks through two-stage procedure. The second FTCA scheme is based on the modified sensitivity factors (MSF). These factors are developed from the actual measurements of power flows in transmission lines and the power injections at different buses. The proposed schemes exhibit desirable apportioning properties and are easy to implement and understand. Case studies for different loading conditions are carried out to show the capability of the proposed schemes for solving the TCA problem. (author)

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

Science.gov (United States)

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

2013-10-01

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

Assessment of Long-Run Marginal Costing of Transmission and ...

African Journals Online (AJOL)

The Long-Run Marginal Costing (LRMC) technique is used as a cost-reflecting pricing method and finds useful application in the recovery of the total investment cost for the use of a transmission or distribution network. This paper reviews recent applications of this technique based on some examples from United Kingdom, ...

24 CFR 208.112 - Cost.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Cost. 208.112 Section 208.112... MULTIFAMILY SUBSIDIZED PROJECTS § 208.112 Cost. (a) The costs of the electronic transmission of the correctly... cost of contracting for those services, or the cost of centralizing the electronic transmission...

Inflation Dynamics and the Cost Channel of Monetary Transmission

NARCIS (Netherlands)

Chowdhury, I.; Hoffmann, M.; Schabert, A.

2006-01-01

Evidence from vector autoregressions indicates that the impact of interest rate shocks on macroeconomic aggregates can substantially be affected by the so-called cost channel of monetary transmission. In this paper, we apply a structural approach to examine the relevance of the cost channel for

Bi-directional Multi Dimension CAP Transmission for Smart Grid Communication Services

DEFF Research Database (Denmark)

Zhang, Xu; Binti Othman, Maisara; Pang, Xiaodan

2012-01-01

We experimentally demonstrate bi-directional multi dimension carrierless amplitude and phase (CAP) transmission for smart grid communication services based on optical fiber networks. The proposed system is able to support multi-Gb/s transmission with high spectral efficiency.......We experimentally demonstrate bi-directional multi dimension carrierless amplitude and phase (CAP) transmission for smart grid communication services based on optical fiber networks. The proposed system is able to support multi-Gb/s transmission with high spectral efficiency....

Cost and Benefit Analysis of VSC-HVDC Schemes for Offshore Wind Power Transmission

Institute of Scientific and Technical Information of China (English)

Sheng WANG; Chunmei FENG; An WEN; Jun LIANG

2013-01-01

Due to low load factors of wind power generation,it is possible to reduce transmission capacity to minimize the cost of transmission system construction.Two VSC-HVDC schemes for offshore wind farm,called the point to point (PTP) and DC mesh connections are compared in terms of the utilization of transmission system and its cost.A Weibull distribution is used for estimating offshore wind power generation,besides,the cross correlation between wind farms is considered.The wind energy curtailment is analyzed using the capacity output possibility table (COPT).The system power losses,costs of transmission investment and wind energy curtailment are also computed.A statistic model for the wind generation and transmission is built and simulated in MATLAB to validate the study.It is concluded that a DC mesh transmission can reduce the energy curtailment and power losses.Further benefit is achievable as the wind cross correlation between wind farms decreases.

The transmission tariff - the economic tool for the network infrastructure development

International Nuclear Information System (INIS)

Popescu, Vifor Bogdan; Cirlan, Florica; Mihailescu, Florentina

2004-01-01

The free access to the transmission network is one of the key elements of the electricity market development both at the national and regional levels. The operation of the electricity market needs the appropriate development of its basic infrastructure, the transmission network. In the frame work of the electricity market, the network ensures the electricity transmission under reliable conditions, from the generators to the suppliers and eligible consumers and creates market opportunities for its users. One of the main market tools, which may influence the optimal development of the network structure, by an efficient location signal of the large consumers and generators, is the pricing system. The overall costs of the Transmission System Operator (TSO) for providing the transmission service may be distinctly focused by categories as follows: - Costs of the existing transmission network (fixed costs), maintenance and operation costs, capital costs; - Costs of electricity losses (variable costs); - Development costs needed to eliminate the network congestion (variable costs). The recovery of all costs involved by the transmission service is based on regulated tariff system approved by ANRE. By the tariff system, the transmission and system operator aims both to cover the transmission service cost and provide locational signals for all market players which should lead to the efficient grid operation as well as to the optimal development of its structure. The tariff values reflect the polarization existing in the Romanian Power System (PS), namely: surplus power in the South area of the PS (4G zone) and a power deficit in the North areas of the PS (2G and 5G zones). Electricity demand is more evenly distributed in the territory than the electricity generated. This assertion is based on the following statement: - the tariffs value range of electricity delivered in the transmission network is wider, between 1.13 and 2.39 USD/MWh (51%) than the one related to the zones of

Rate of transmission: a major determinant of the cost of clinical mastitis.

Science.gov (United States)

Down, P M; Green, M J; Hudson, C D

2013-10-01

The aim of this research was to use probabilistic sensitivity analysis to evaluate the relative importance of different components of a model designed to estimate the cost of clinical mastitis (CM). A particular focus was placed on the importance of pathogen transmission relative to other factors, such as milk price or treatment costs. A stochastic Monte Carlo model was developed to simulate a case of CM at the cow level and to calculate the associated costs for 5 defined treatment protocols. The 5 treatment protocols modeled were 3 d of antibiotic intramammary treatment, 5 d of antibiotic intramammary treatment, 3 d of intramammary and systemic antibiotic treatment, 3d of intramammary and systemic antibiotic treatment plus 1 d of nonsteroidal antiinflammatory drug treatment, and 5 d of intramammary and systemic antibiotic treatment. Uniform distributions were used throughout the model to enable investigation of the cost of CM over a spectrum of clinically realistic scenarios without specifying which scenario was more or less likely. A risk of transmission parameter distribution, based on literature values, was included to model the effect of pathogen transmission to uninfected cows, from cows that remained subclinically infected after treatment for CM. Spearman rank correlation coefficients were used to evaluate the relationships between model input values and the estimated cost of CM. Linear regression models were used to explore the effect that changes to specific independent variables had on the cost of CM. Risk of transmission was found to have the strongest association with the cost of CM, followed by bacteriological cure rate, cost of culling, and yield loss. Other factors such as milk price, cost of labor, and cost of medicines were of minimal influence in comparison. The cost of CM was similar for all 5 treatment protocols. The results from this study suggest that, when seeking to minimize the economic impact of CM in dairy herds, great emphasis should be

Alberta's transmission development policy : review and recommendations

International Nuclear Information System (INIS)

Stubbings, R.V.

2004-01-01

Alberta's Department of Energy (ADOE) released a policy paper in November 2003 regarding power transmission development for the province. The transmission development policy (TDP) is intended to promote economic growth in Alberta while ensuring consumers with reliable, reasonably priced electricity. This presentation reviewed the main features of the policy and then focused on the allocation of costs to generation customers. The author argued that the proposed changes would result in a sub-optimal development of generation and higher total electricity bills for consumers. He argued that the policy will spare generation customers of any obligation to pay wire-related costs other than local interconnection costs. This would weaken a long-standing ADOE policy which requires generators to pay costs that depend on their location on the transmission system. With the new proposal, generators would not be responsible for ancillary service costs even when they provide direct benefits, and they would pay for system losses on a zonal basis. The author recommended that location charges should be large enough to influence the siting decisions of generators. He also recommended that generators should pay their fare share of transmission use-of-system charges, including ancillary services that provide benefits to generators in the form of a stable, reliable transmission system. 2 tabs., 2 figs

Cost-benefit study of school nursing services.

Science.gov (United States)

Wang, Li Yan; Vernon-Smiley, Mary; Gapinski, Mary Ann; Desisto, Marie; Maughan, Erin; Sheetz, Anne

2014-07-01

In recent years, across the United States, many school districts have cut on-site delivery of health services by eliminating or reducing services provided by qualified school nurses. Providing cost-benefit information will help policy makers and decision makers better understand the value of school nursing services. To conduct a case study of the Massachusetts Essential School Health Services (ESHS) program to demonstrate the cost-benefit of school health services delivered by full-time registered nurses. Standard cost-benefit analysis methods were used to estimate the costs and benefits of the ESHS program compared with a scenario involving no school nursing service. Data from the ESHS program report and other published studies were used. A total of 477 163 students in 933 Massachusetts ESHS schools in 78 school districts received school health services during the 2009-2010 school year. School health services provided by full-time registered nurses. Costs of nurse staffing and medical supplies incurred by 78 ESHS districts during the 2009-2010 school year were measured as program costs. Program benefits were measured as savings in medical procedure costs, teachers' productivity loss costs associated with addressing student health issues, and parents' productivity loss costs associated with student early dismissal and medication administration. Net benefits and benefit-cost ratio were calculated. All costs and benefits were in 2009 US dollars. During the 2009-2010 school year, at a cost of $79.0 million, the ESHS program prevented an estimated $20.0 million in medical care costs, $28.1 million in parents' productivity loss, and $129.1 million in teachers' productivity loss. As a result, the program generated a net benefit of $98.2 million to society. For every dollar invested in the program, society would gain $2.20. Eighty-nine percent of simulation trials resulted in a net benefit. The results of this study demonstrated that school nursing services provided in

47 CFR 25.211 - Analog video transmissions in the Fixed-Satellite Services.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Analog video transmissions in the Fixed-Satellite Services. 25.211 Section 25.211 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES SATELLITE COMMUNICATIONS Technical Standards § 25.211 Analog video transmissions...

Costs of stroke and stroke services: Determinants of patient costs and a comparison of costs of regular care and care organised in stroke services

Directory of Open Access Journals (Sweden)

Koopmanschap Marc A

2003-02-01

Full Text Available Abstract Background Stroke is a major cause of death and long-term disability in Western societies and constitutes a major claim on health care budgets. Organising stroke care in a stroke service has recently been demonstrated to result in better health effects for patients. This paper discusses patient costs after stroke and compares costs between regular and stroke service care. Methods Costs were calculated within the framework of the evaluation of three experiments with stroke services in the Netherlands. Cost calculations are base on medical consumption data and actual costs. Results 598 patients were consecutively admitted to hospital after stroke. The average total costs of care per patient for the 6 month follow-up are estimated at €16,000. Costs are dominated by institutional and accommodation costs. Patients who die after stroke incur less costs. For patients that survive the acute phase, the most important determinants of costs are disability status and having a partner – as they influence patients' stroke careers. These determinants also interact. The most efficient stroke service experiment was most successful in co-ordinating patient flow from hospital to (nursing home, through capacity planning and efficient discharge procedures. In this region the costs of stroke service care are the same as for regular stroke care. The other experiments suffered from waiting lists for nursing homes and home care, leading to "blocked beds" in hospitals and nursing homes and higher costs of care. Costs of co-ordination are estimated at about 3% of total costs of care. Conclusion This paper demonstrates that by organising care for stroke patients in a stroke service, better health effects can be achieved with the same budget. In addition, it provides insight in need, predisposing and enabling factors that determine costs of care after stroke.

76 FR 58517 - Public Health Service Guideline for Reducing Transmission of Human Immunodeficiency Virus (HIV...

Science.gov (United States)

2011-09-21

...-2011-0011] Public Health Service Guideline for Reducing Transmission of Human Immunodeficiency Virus... public comment on the draft Public Health Service Guideline for Reducing Transmission of Human..., Attn: Public Health Service Guideline for Reducing Transmission of Human Immunodeficiency Virus (HIV...

Transmission cost allocation for an efficient tariff action of electricity in a liberalised market

International Nuclear Information System (INIS)

Bassi, C.; Caldon, R.; Lorenzoni, A.

1999-01-01

The work is focused on the evaluation of the costs of an electricity transmission system operator and on their allocation among the users of the grid in liberalized market. After a recall of the goals of an efficient tariff for transmission, an original method for the cost allocation is proposed called ZI. Based on the marginal cost approach, this method could be the base for setting an efficient transmission tariff that at the same time covers costs and stimulates efficient behaviours. The performances of such an approach have been tested on a real 47 bus grid and ZI tariffs have been compared to the traditional postage stamp ones, highlighting the strong differences between them [it

Costs associated with wheeling

International Nuclear Information System (INIS)

Anon.

1991-01-01

Wheeling costs are incurred by all companies that experience a change in power flows over their transmission lines during a specific transaction, whether or not the lines of that company are part of the contract path. The costs of providing wheeling service differ from one system to another and from one kind of wheeling transaction to another. While most transactions may be completed using existing capacity, others may require an increase in line. Depending on the situation, some cost components may be high, low, negative, or not incurred at all. This article discusses two general categories of costs; transactional and capital. The former are all operation, maintenance and opportunity costs incurred in completing a specific transaction assuming the existence of adequate capacity. Capital costs are the costs of major new equipment purchases and lines necessary to provide any increased level of transmission services

Multiarea Transmission Cost Allocation in Large Power Systems Using the Nodal Pricing Control Approach

Directory of Open Access Journals (Sweden)

M. Ghayeni

2010-12-01

Full Text Available This paper proposes an algorithm for transmission cost allocation (TCA in a large power system based on nodal pricing approach using the multi-area scheme. The nodal pricing approach is introduced to allocate the transmission costs by the control of nodal prices in a single area network. As the number of equations is dependent on the number of buses and generators, this method will be very time consuming for large power systems. To solve this problem, the present paper proposes a new algorithm based on multi-area approach for regulating the nodal prices, so that the simulation time is greatly reduced and therefore the TCA problem with nodal pricing approach will be applicable for large power systems. In addition, in this method the transmission costs are allocated to users more equitable. Since the higher transmission costs in an area having a higher reliability are paid only by users of that area in contrast with the single area method, in which these costs are allocated to all users regardless of their locations. The proposed method is implemented on the IEEE 118 bus test system which comprises three areas. Results show that with application of multi-area approach, the simulation time is greatly reduced and the transmission costs are also allocated to users with less variation in new nodal prices with respect to the single area approach.

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

Science.gov (United States)

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

2011-01-01

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

Marginal cost calculation of energy production in hydro thermoelectric systems considering the transmission system

International Nuclear Information System (INIS)

Pereira, M.V.F.; Gorenstin, B.G.; Alvarenga Filho, S.

1989-01-01

The alternatives for calculation of energy marginal cost in hydroelectric systems, considering the transmission one, was analysed, including fundamental concepts; generation/transmission systems, represented by linear power flow model; production marginal costs in hydrothermal systems and computation aspects. (C.G.C.). 11 refs, 5 figs

Transmission pricing: paradigms and methodologies

Energy Technology Data Exchange (ETDEWEB)

Shirmohammadi, Dariush [Pacific Gas and Electric Co., San Francisco, CA (United States); Vieira Filho, Xisto; Gorenstin, Boris [Centro de Pesquisas de Energia Eletrica (CEPEL), Rio de Janeiro, RJ (Brazil); Pereira, Mario V.P. [Power System Research, Rio de Janeiro, RJ (Brazil)

1994-12-31

In this paper we describe the principles of several paradigms and methodologies for pricing transmission services. The paper outlines some of the main characteristics of these paradigms and methodologies such as where they may be used for best results. Due to their popularity, power flow based MW-mile and short run marginal cost pricing methodologies will be covered in some detail. We conclude the paper with examples of the application of these two pricing methodologies for pricing transmission services in Brazil. (author) 25 refs., 2 tabs.

Bridging the gap between theory and practice of transmission pricing

International Nuclear Information System (INIS)

Hughes, W.R.; Felak, R.

1996-01-01

The authors describe some strategies for pricing transmission service. Traditionally, wheeling prices have been postage stamp rates based on the level of megawatt demand; a related approach would assign grid costs to customers based on their respective shares of overall megawatt-miles. Innovative regulators have recently approved transmission rates based on opportunity cost of foregone capacity and the incremental costs of additional capacity needed to enable delivery. Others determined prices designed to reflect short-run congestion costs on the grid. The authors assess these pricing approaches and their effects on the distribution of wealth and economic efficiency for both firm and interruptible services. 3 refs

Transmission Algorithm with QoS Considerations for a Sustainable MPEG Streaming Service

Directory of Open Access Journals (Sweden)

Sang-Hyong Kim

2017-03-01

Full Text Available With the proliferation of heterogeneous networks, there is a need to provide multimedia stream services in a sustainable manner. It is especially critical to maintain the Quality of Service (QoS standards. Existing multimedia streaming services have been studied to guarantee QoS on the receiving side. QoS has not been ensured due to the fact that the loss of streaming data to be transmitted has not been considered in network conditions. With an algorithm that considers the QoS and can reduce the overhead of the network, it will be possible to reduce the transmission error and wastage of communication network resources. In this paper, we propose a scheme that improves the reliability of multimedia transmissions by using an adaptive algorithm that switches between UDP (User Datagram Protocol and TCP (Transmission Control Protocol based on the size of the data. In addition, we present a method that retransmits essential portions of the multimedia data, thus improving transmission efficiency. We simulate an MPEG (Moving Picture Experts Group stream service and evaluate the performance of the proposed adaptive MPEG stream service.

Establishment of reference costs for occupational health services and implementation of cost management in Japanese manufacturing companies.

Science.gov (United States)

Nagata, Tomohisa; Mori, Koji; Aratake, Yutaka; Ide, Hiroshi; Nobori, Junichiro; Kojima, Reiko; Odagami, Kiminori; Kato, Anna; Hiraoka, Mika; Shiota, Naoki; Kobayashi, Yuichi; Ito, Masato; Tsutsumi, Akizumi; Matsuda, Shinya

2016-07-22

We developed a standardized cost estimation method for occupational health (OH) services. The purpose of this study was to set reference OH services costs and to conduct OH services cost management assessments in two workplaces by comparing actual OH services costs with the reference costs. Data were obtained from retrospective analyses of OH services costs regarding 15 OH activities over a 1-year period in three manufacturing workplaces. We set the reference OH services costs in one of the three locations and compared OH services costs of each of the two other workplaces with the reference costs. The total reference OH services cost was 176,654 Japanese yen (JPY) per employee. The personnel cost for OH staff to conduct OH services was JPY 47,993, and the personnel cost for non-OH staff was JPY 38,699. The personnel cost for receipt of OH services-opportunity cost-was JPY 19,747, expense was JPY 25,512, depreciation expense was 34,849, and outsourcing cost was JPY 9,854. We compared actual OH services costs from two workplaces (the total OH services costs were JPY 182,151 and JPY 238,023) with the reference costs according to OH activity. The actual costs were different from the reference costs, especially in the case of personnel cost for non-OH staff, expense, and depreciation expense. Using our cost estimation tool, it is helpful to compare actual OH services cost data with reference cost data. The outcomes help employers make informed decisions regarding investment in OH services.

Recommendations and final report on the Alberta transmission administrator function

International Nuclear Information System (INIS)

Billinton, R.; Wallace, R.B.

1997-01-01

In May 1995, the Electric Utilities Act (EUA) was passed formalizing the Alberta government's policy of electric industry restructuring. The Act established two new important market entities: a power pool and a transmission administrator (TA). Combined, these two entities create the open access required to enable competition in generation. Functionally, the TA acts as a single transmission service agent for all transmission wire owners. The TA leases the wires from owners then provides a province-wide tariff schedule for transmission services to recover the required revenue. Customers can only purchase transmission service from the TA. Both the lease wire cost and the TA tariff schedule must be approved by the regulator

Cost Calculation Model for Logistics Service Providers

Directory of Open Access Journals (Sweden)

Zoltán Bokor

2012-11-01

Full Text Available The exact calculation of logistics costs has become a real challenge in logistics and supply chain management. It is essential to gain reliable and accurate costing information to attain efficient resource allocation within the logistics service provider companies. Traditional costing approaches, however, may not be sufficient to reach this aim in case of complex and heterogeneous logistics service structures. So this paper intends to explore the ways of improving the cost calculation regimes of logistics service providers and show how to adopt the multi-level full cost allocation technique in logistics practice. After determining the methodological framework, a sample cost calculation scheme is developed and tested by using estimated input data. Based on the theoretical findings and the experiences of the pilot project it can be concluded that the improved costing model contributes to making logistics costing more accurate and transparent. Moreover, the relations between costs and performances also become more visible, which enhances the effectiveness of logistics planning and controlling significantly

Marginal pricing of transmission services: An analysis of cost recovery

Energy Technology Data Exchange (ETDEWEB)

Perez-Arriaga, I.J.; Rubio, F.J. [Univ. Pontificia Comillas, Madrid (Spain); Puerta, J.F.; Arceluz, J.; Marin, J. [IBERDROLA, Bilbao (Spain). Unidad de Planificacion Estrategica

1995-02-01

This paper presents an in-depth analysis of network revenues computed with marginal pricing, and in particular it investigates the reasons why marginal prices fail to recover the total incurred network costs in actual power systems. The basic theoretical results are presented and the major causes of the mismatch between network costs and marginal revenues are identified and illustrated with numerical examples, some tutorial and others of realistic size. The regulatory implications of marginal network pricing in the context of competitive electricity markets are analyzed, and suggestions are provided for the meaningful allocation of the costs of the network among its users.

Marginal pricing of transmission services: An analysis of cost recovery

International Nuclear Information System (INIS)

Perez-Arriaga, I.J.; Rubio, F.J.; Puerta, J.F.; Arceluz, J.; Marin, J.

1995-01-01

This paper presents an in-depth analysis of network revenues computed with marginal pricing, and in particular it investigates the reasons why marginal prices fail to recover the total incurred network costs in actual power systems. The basic theoretical results are presented and the major causes of the mismatch between network costs and marginal revenues are identified and illustrated with numerical examples, some tutorial and others of realistic size. The regulatory implications of marginal network pricing in the context of competitive electricity markets are analyzed, and suggestions are provided for the meaningful allocation of the costs of the network among its users

Advertising sexual health services that provide sexually transmissible infection screening for rural young people - what works and what doesn't.

Science.gov (United States)

Gamage, Deepa G; Fuller, Candice A; Cummings, Rosey; Tomnay, Jane E; Chung, Mark; Chen, Marcus; Garrett, Cameryn C; Hocking, Jane S; Bradshaw, Catriona S; Fairley, Christopher K

2011-09-01

'TESTme' is a sexually transmissible infection (STI) screening service for Victorian young people living in rural areas. We evaluated the effectiveness of advertising for this service over an 11-month pilot period. The advertising that was used included websites, a Facebook page, posters, flyers, business cards, wrist bands and professional development sessions for health nurses that occurred throughout the pilot period. We also used once-off methods including advertisements in newspapers, student diaries and short messages to mobile phones. Twenty-eight clients had a consultation through TESTme. Twenty found the service through health professionals, six through the Melbourne Sexual Health Centre (MSHC) web page, one through the Facebook page and one through the student diary. The total direct costs incurred by the centre for advertising were $20850. The advertising cost per client reached for each advertising method was $26 for health professionals, $80 for the MSHC web advertisement, $1408 for Facebook and $790 for the student diary. Other advertising methods cost $12248 and did not attract any clients. Advertising STI health services for rural young people would be best to focus on referrals from other health services or health care websites.

The cost of providing combined prevention and treatment services, including ART, to female sex workers in Burkina Faso.

Directory of Open Access Journals (Sweden)

Fiona Cianci

Full Text Available BACKGROUND: Female Sex workers (FSW are important in driving HIV transmission in West Africa. The Yerelon clinic in Burkina Faso has provided combined preventative and therapeutic services, including anti-retroviral therapy (ART, for FSWs since 1998, with evidence suggesting it has decreased HIV prevalence and incidence in this group. No data exists on the costs of such a combined prevention and treatment intervention for FSW. This study aims to determine the mean cost of service provision per patient year for FSWs attending the Yerelon clinic, and identifies differences in costs between patient groups. METHODS: Field-based retrospective cost analyses were undertaken using top-down and bottom-up costing approaches for 2010. Expenditure and service utilisation data was collated from primary sources. Patients were divided into groups according to full-time or occasional sex-work, HIV status and ART duration. Patient specific service use data was extracted. Costs were converted to 2012 US$. Sensitivity analyses considered removal of all research costs, different discount rates and use of different ART treatment regimens and follow-up schedules. RESULTS: Using the top-down costing approach, the mean annual cost of service provision for FSWs on or off ART was US$1098 and US$882, respectively. The cost for FSWs on ART reduced by 29%, to US$781, if all research-related costs were removed and national ART monitoring guidelines were followed. The bottom-up patient-level costing showed the cost of the service varied greatly across patient groups (US$505-US$1117, primarily due to large differences in the costs of different ART regimens. HIV-negative women had the lowest annual cost at US$505. CONCLUSION: Whilst FSWs may require specialised services to optimise their care and hence, the public health benefits, our study shows that the cost of ART provision within a combined prevention and treatment intervention setting is comparable to providing ART to

Allocation of fixed transmission cost to wheeling transactions by cooperative game theory

International Nuclear Information System (INIS)

Tsukamoto, Yukitoki; Iyoda, Isao

1996-01-01

This paper describes a methodology to allocate the cost of transmission network facilities to wheeling transactions in decentralized power systems. The authors propose that the responsibility placed on transmission facilities involved in each transaction be according to the transmission usage pattern. Their proposal incorporates MW-mile method and considers economies of scale of transmission network facilities. The authors also incorporate a nucleolus scheme in the cooperative game theory to deal with matters of conflict. The applicability of their method is demonstrated in a numerical example

Cost estimation of HVDC transmission system of Bangka's NPP candidates

Science.gov (United States)

Liun, Edwaren; Suparman

2014-09-01

Regarding nuclear power plant development in Bangka Island, it can be estimated that produced power will be oversupply for the Bangka Island and needs to transmit to Sumatra or Java Island. The distance between the regions or islands causing considerable loss of power in transmission by alternating current, and a wide range of technical and economical issues. The objective of this paper addresses to economics analysis of direct current transmission system to overcome those technical problem. Direct current transmission has a stable characteristic, so that the power delivery from Bangka to Sumatra or Java in a large scale efficiently and reliably can be done. HVDC system costs depend on the power capacity applied to the system and length of the transmission line in addition to other variables that may be different.

Service time analysis of secondary packet transmission with opportunistic channel access

KAUST Repository

Usman, Muneer; Yang, Hongchuan; Alouini, Mohamed-Slim

2014-01-01

Cognitive radio transceiver can opportunistically access the underutilized channels of primary systems for new wireless services. The secondary transmission may be interrupted by the primary user's transmission. To facilitate the delay analysis of such secondary packet transmission, we study the resulting extended delivery time for a fixed-size secondary packet that includes both transmission time and waiting time. In particular we derive the exact distribution functions of extended delivery time of secondary transmission for both continuous sensing and periodic sensing cases. Selected numerical results are presented for illustrating the mathematical formulation.

Service time analysis of secondary packet transmission with opportunistic channel access

KAUST Repository

Usman, Muneer

2014-09-01

Cognitive radio transceiver can opportunistically access the underutilized channels of primary systems for new wireless services. The secondary transmission may be interrupted by the primary user\\'s transmission. To facilitate the delay analysis of such secondary packet transmission, we study the resulting extended delivery time for a fixed-size secondary packet that includes both transmission time and waiting time. In particular we derive the exact distribution functions of extended delivery time of secondary transmission for both continuous sensing and periodic sensing cases. Selected numerical results are presented for illustrating the mathematical formulation.

HTGR molten salt sensible energy transmission and storage system design and costs

International Nuclear Information System (INIS)

1981-09-01

This report, which was prepared for Gas-Cooled Reactor Associates by United Engineers and Constructors under Contract No. GCRA/UE and C 81-203, presents the design and cost for a molten salt Sensible Energy Transmission and Storage (SETS) System. Although the reference system for this study is sized to be compatible with an 1170 MW(t) HTGR Nuclear Heat Source, the results and conclusions should be generally applicable to most large scale molten salt energy transmission system applications. A preliminary conceptual design is presented and alternative configurations are discussed. The sensitivity of system costs to variations in important system parameters are also presented. Costs for a reference case conceptual design are reported in constant 1980 dollars and inflated 1995 dollars

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

International Nuclear Information System (INIS)

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

2015-01-01

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

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

Science.gov (United States)

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

2015-10-01

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

Applying Activity Based Costing (ABC) Method to Calculate Cost Price in Hospital and Remedy Services.

Science.gov (United States)

Rajabi, A; Dabiri, A

2012-01-01

Activity Based Costing (ABC) is one of the new methods began appearing as a costing methodology in the 1990's. It calculates cost price by determining the usage of resources. In this study, ABC method was used for calculating cost price of remedial services in hospitals. To apply ABC method, Shahid Faghihi Hospital was selected. First, hospital units were divided into three main departments: administrative, diagnostic, and hospitalized. Second, activity centers were defined by the activity analysis method. Third, costs of administrative activity centers were allocated into diagnostic and operational departments based on the cost driver. Finally, with regard to the usage of cost objectives from services of activity centers, the cost price of medical services was calculated. The cost price from ABC method significantly differs from tariff method. In addition, high amount of indirect costs in the hospital indicates that capacities of resources are not used properly. Cost price of remedial services with tariff method is not properly calculated when compared with ABC method. ABC calculates cost price by applying suitable mechanisms but tariff method is based on the fixed price. In addition, ABC represents useful information about the amount and combination of cost price services.

Universal access, cost recovery, and payment services

OpenAIRE

Sujit Chakravorti; Jeffery W. Gunther; Robert R. Moore

2005-01-01

We suggest a subtle, yet far- reaching, tension in the objectives specified by the Monetary Control Act of 1980 (MCA) for the Federal Reserve’s role in providing retail payment services, such as check processing. Specifically, we argue that the requirement of an overall cost-revenue match, coupled with the goal of ensuring equitable access on a universal basis, partially shifted the burden of cost recovery from high-cost to low-cost service points during the MCA’s early years, thereby allowin...

An integrated framework for transmission cost allocation retaining efficiency concepts

Energy Technology Data Exchange (ETDEWEB)

Lima, J.W. Marangon [Escola Federal de Engenharia de Itajuba, MG (Brazil); Gorenstin, B G; Vieira Filho, X [Centro de Pesquisas de Energia Eletrica (CEPEL), Rio de Janeiro, RJ (Brazil); Chipp, H J; Alvarenga Filho, S [ELETROBRAS, Rio de Janeiro, RJ (Brazil); Hirota, M [Companhia Energetica de Sao Paulo (CESP), SP (Brazil); Pereira, M V.F. [Power System Research, Inc., Rio de Janeiro, RJ (Brazil)

1994-12-31

This paper describes a methodology for allocating transmission costs among utilities and wheeling agents. The proposed approach is based on the extension of marginal cost theory to take into account discrete component sizes and economy of scale, while retaining desirable economic properties such as revenue reconciliation and incentives for all participants to remain in the pool. The methodology is illustrated in case studies with the Brazilian system. (author) 21 refs., 1 fig., 3 tabs.

76 FR 44323 - National Grid Transmission Services Corporation; Bangor Hydro Electric Company; Notice of...

Science.gov (United States)

2011-07-25

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. EL11-49-000] National Grid Transmission Services Corporation; Bangor Hydro Electric Company; Notice of Petition for Declaratory Order Take..., 18 CFR 385.207, National Grid Transmission Services Corporation and Bangor Hydro Electric Company...

48 CFR 46.305 - Cost-reimbursement service contracts.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Cost-reimbursement service... CONTRACT MANAGEMENT QUALITY ASSURANCE Contract Clauses 46.305 Cost-reimbursement service contracts. The contracting officer shall insert the clause at 52.246-5, Inspection of Services—Cost Reimbursement, in...

Compressor-less Hydrogen Transmission Pipelines Deliver Large-scale Stranded Renewable Energy at Competitive Cost

International Nuclear Information System (INIS)

W Leighty; J Holloway; R Merer; B Somerday; C San Marchi; G Keith; D White

2006-01-01

We assume a transmission-constrained world, where large new wind plants and other renewable energies must pay all transmission costs for delivering their energy to distant markets. We modeled a 1,000 MW (1 GW) (name plate) wind plant in the large wind resource of the North America Great Plains, delivering exclusively hydrogen fuel, via a new gaseous hydrogen (GH2) pipeline, to an urban market at least 300 km distant. All renewable electric energy output would be converted, at the source, to hydrogen, via 100 bar output electrolyzers, directly feeding the GH2 transmission pipeline without costly compressor stations at inlet or at midline. The new GH2 pipeline is an alternative to new electric transmission lines. We investigate whether the pipeline would provide valuable energy storage. We present a simple model by which we estimate the cost of wind-source hydrogen fuel delivered to the distant city gate in year 2010, at GW scale. Ammonia, synthetic hydrocarbons, and other substances may also be attractive renewable-source energy carriers, storage media, and fuels; they are not considered in this paper. (authors)

Operating cost model for local service airlines

Science.gov (United States)

Anderson, J. L.; Andrastek, D. A.

1976-01-01

Several mathematical models now exist which determine the operating economics for a United States trunk airline. These models are valuable in assessing the impact of new aircraft into an airline's fleet. The use of a trunk airline cost model for the local service airline does not result in representative operating costs. A new model is presented which is representative of the operating conditions and resultant costs for the local service airline. The calculated annual direct and indirect operating costs for two multiequipment airlines are compared with their actual operating experience.

Marginal pricing of transmission services. An analysis of cost recovery

Energy Technology Data Exchange (ETDEWEB)

Perez-Arriaga, I.J.., Rubio, F.J. [Instituto de Investigacion Technologica, Universidad Pontificia Comillas, Madrid (Spain); Puerta, J.F.; Arceluz, J.; Marin, J. [Unidad de Planificacion Estrategica, Iberdrola, Madrid (Spain)

1996-12-31

The authors present an in-depth analysis of network revenues that are computed with marginal pricing, and investigate the reasons why marginal prices in actual power systems fail to recover total incurred network costs. The major causes of the failure are identified and illustrated with numerical examples. The paper analyzes the regulatory implications of marginal network pricing in the context of competitive electricity markets and provides suggestions for the meaningful allocation of network costs among users. 5 figs., 9 tabs., 8 refs.

Marginal pricing of transmission services. An analysis of cost recovery

International Nuclear Information System (INIS)

Perez-Arriaga, I.J.., Rubio, F.J.; Puerta, J.F.; Arceluz, J.; Marin, J.

1996-01-01

The authors present an in-depth analysis of network revenues that are computed with marginal pricing, and investigate the reasons why marginal prices in actual power systems fail to recover total incurred network costs. The major causes of the failure are identified and illustrated with numerical examples. The paper analyzes the regulatory implications of marginal network pricing in the context of competitive electricity markets and provides suggestions for the meaningful allocation of network costs among users. 5 figs., 9 tabs., 8 refs

Health Services Cost Analyzing in Tabriz Health Centers 2008

Directory of Open Access Journals (Sweden)

Massumeh gholizadeh

2015-08-01

Full Text Available Background and objectives : Health Services cost analyzing is an important management tool for evidence-based decision making in health system. This study was conducted with the purpose of cost analyzing and identifying the proportion of different factors on total cost of health services that are provided in urban health centers in Tabriz. Material and Methods : This study was a descriptive and analytic study. Activity Based Costing method (ABC was used for cost analyzing. This cross–sectional survey analyzed and identified the proportion of different factors on total cost of health services that are provided in Tabriz urban health centers. The statistical population of this study was comprised of urban community health centers in Tabriz. In this study, a multi-stage sampling method was used to collect data. Excel software was used for data analyzing. The results were described with tables and graphs. Results : The study results showed the portion of different factors in various health services. Human factors by 58%, physical space 8%, medical equipment 1.3% were allocated with high portion of expenditures and costs of health services in Tabriz urban health centers. Conclusion : Based on study results, since the human factors included the highest portion of health services costs and expenditures in Tabriz urban health centers, balancing workload with staff number, institutionalizing performance-based management and using multidisciplinary staffs may lead to reduced costs of services. ​

Cost estimation of HVDC transmission system of Bangka’s NPP candidates

Energy Technology Data Exchange (ETDEWEB)

Liun, Edwaren, E-mail: edwaren@batan.go.id; Suparman, E-mail: edwaren@batan.go.id [Centre for Nuclear Energy Development, National Nuclear Energy Agency of Indonesia (Indonesia)

2014-09-30

Regarding nuclear power plant development in Bangka Island, it can be estimated that produced power will be oversupply for the Bangka Island and needs to transmit to Sumatra or Java Island. The distance between the regions or islands causing considerable loss of power in transmission by alternating current, and a wide range of technical and economical issues. The objective of this paper addresses to economics analysis of direct current transmission system to overcome those technical problem. Direct current transmission has a stable characteristic, so that the power delivery from Bangka to Sumatra or Java in a large scale efficiently and reliably can be done. HVDC system costs depend on the power capacity applied to the system and length of the transmission line in addition to other variables that may be different.

Cost estimation of HVDC transmission system of Bangka’s NPP candidates

International Nuclear Information System (INIS)

Liun, Edwaren; Suparman

2014-01-01

Regarding nuclear power plant development in Bangka Island, it can be estimated that produced power will be oversupply for the Bangka Island and needs to transmit to Sumatra or Java Island. The distance between the regions or islands causing considerable loss of power in transmission by alternating current, and a wide range of technical and economical issues. The objective of this paper addresses to economics analysis of direct current transmission system to overcome those technical problem. Direct current transmission has a stable characteristic, so that the power delivery from Bangka to Sumatra or Java in a large scale efficiently and reliably can be done. HVDC system costs depend on the power capacity applied to the system and length of the transmission line in addition to other variables that may be different

Trends in transmission, distribution, and administration costs for U.S. investor-owned electric utilities

International Nuclear Information System (INIS)

Fares, Robert L.; King, Carey W.

2017-01-01

This paper analyzes the cost of transmission, distribution, and administration for U.S. investor-owned electric utilities. We analyze data reported to the Federal Energy Regulatory Commission (FERC) from 1994 to 2014 using linear regression to understand how the number of customers in a utility's territory, annual peak demand, and annual energy sales affect annual TD&A spending. Then, we use Edison Electric Institute data for 1960 to 1992 to show trends in TD&A spending between 1960 and 2014. We find that the number of customers in a utility's territory is the single best predictor for annual TD&A costs. Between 1994 and 2014, the average cost per customer was $119/Customer-Year for transmission, $291/Customer-Year for distribution, and $333/Customer-Year for utility administration. Total TD&A costs per customer have been approximately $700–$800/Customer-Year since 1960, but the cost per kWh of energy sold was significantly higher in the 1960s because the average customer used less than half as much energy annually versus 2014. Thus, TD&A costs per kWh are likely to increase if kWh energy sales decline in the future unless cost recovery is transitioned to a mechanism not based solely on kWh sales. - Highlights: • U.S. investor-owned electric utility delivery costs from 1960? 2014 are investigated. • Transmission, distribution, and utility administrative costs are analyzed separately. • The number of utility customers is the best predictor for annual delivery costs. • Delivery costs per kWh are likely to increase if kWh sales decrease in the future.

Pharmaceutical services cost analysis using time-driven activity-based costing: A contribution to improve community pharmacies' management.

Science.gov (United States)

Gregório, João; Russo, Giuliano; Lapão, Luís Velez

2016-01-01

The current financial crisis is pressing health systems to reduce costs while looking to improve service standards. In this context, the necessity to optimize health care systems management has become an imperative. However, little research has been conducted on health care and pharmaceutical services cost management. Pharmaceutical services optimization requires a comprehensive understanding of resources usage and its costs. This study explores the development of a time-driven activity-based costing (TDABC) model, with the objective of calculating the cost of pharmaceutical services to help inform policy-making. Pharmaceutical services supply patterns were studied in three pharmacies during a weekday through an observational study. Details of each activity's execution were recorded, including time spent per activity performed by pharmacists. Data on pharmacy costs was obtained through pharmacies' accounting records. The calculated cost of a dispensing service in these pharmacies ranged from €3.16 to €4.29. The cost of a counseling service when no medicine was supplied ranged from €1.24 to €1.46. The cost of health screening services ranged from €2.86 to €4.55. The presented TDABC model gives us new insights on management and costs of community pharmacies. This study shows the importance of cost analysis for health care services, specifically on pharmaceutical services, in order to better inform pharmacies' management and the elaboration of pharmaceutical policies. Copyright © 2016 Elsevier Inc. All rights reserved.

Conceptual framework of Tenaga Nasional Berhad (TNB) cost of service (COS) model

Science.gov (United States)

Zainudin, WNRA; Ishak, WWM; Sulaiman, NA

2017-09-01

One of Malaysia Electricity Supply Industry (MESI) objectives is to ensure Tenaga Nasional Berhad (TNB) economic viability based on a fair economic electricity pricing. In meeting such objective, a framework that investigates the effect of cost of service (COS) on revenue is in great need. This paper attempts to present a conceptual framework that illustrate the distribution of the COS among TNB’s various cost centres which are subsequently redistributed in varying quantities among all of its customer categories. A deep understanding on the concepts will ensure optimal allocation of COS elements between different sub activities of energy production processes can be achieved. However, this optimal allocation needs to be achieved with respect to the imposed TNB revenue constraint. Therefore, the methodology used for this conceptual approach is being modelled into four steps. Firstly, TNB revenue requirement is being examined to ensure the conceptual framework addressed the requirement properly. Secondly, the revenue requirement is unbundled between three major cost centres or business units consist of generation, transmission and distribution and the cost is classified based on demand, energy and customers related charges. Finally, the classified costs are being allocated to different customer categories i.e. Household, Commercial, and Industrial. In summary, this paper proposed a conceptual framework on the cost of specific services that TNB currently charging its customers and served as potential input into the process of developing revised electricity tariff rates. On that purpose, the finding of this COS study finds cost to serve customer varies with the voltage level that customer connected to, the timing and the magnitude of customer demand on the system. This COS conceptual framework could potentially be integrated into a particular tariff structure and serve as a useful tool for TNB.

Cost associated with stroke: outpatient rehabilitative services and medication.

Science.gov (United States)

Godwin, Kyler M; Wasserman, Joan; Ostwald, Sharon K

2011-10-01

This study aimed to capture direct costs of outpatient rehabilitative stroke care and medications for a 1-year period after discharge from inpatient rehabilitation. Outpatient rehabilitative services and medication costs for 1 year, during the time period of 2001 to 2005, were calculated for 54 first-time stroke survivors. Costs for services were based on Medicare reimbursement rates. Medicaid reimbursement rates and average wholesale price were used to estimate medication costs. Of the 54 stroke survivors, 40 (74.1%) were categorized as independent, 12 (22.2%) had modified dependence, and 2 (3.7%) were dependent at the time of discharge from inpatient rehabilitation. Average cost for outpatient stroke rehabilitation services and medications the first year post inpatient rehabilitation discharge was $17,081. The corresponding average yearly cost of medication was $5,392, while the average cost of yearly rehabilitation service utilization was $11,689. Cost attributed to medication remained relatively constant throughout the groups. Outpatient rehabilitation service utilization constituted a large portion of cost within each group: 69.7% (dependent), 72.5% (modified dependence), and 66.7% (independent). Stroke survivors continue to incur significant costs associated with their stroke for the first 12 months following discharge from an inpatient rehabilitation setting. Changing public policies affect the cost and availability of care. This study provides a snapshot of outpatient medication and therapy costs prior to the enactment of major changes in federal legislation and serves as a baseline for future studies.

Transmission avoided cost: a new parameter to evaluate the economic competitiveness of generations plants projects

Energy Technology Data Exchange (ETDEWEB)

Ramos, D S [Companhia Energetica de Sao Paulo, SP (Brazil); Albuquerque, J C.R.; Rosenblat, J [ELETROBRAS, Rio de Janeiro, RJ (Brazil)

1994-12-31

The paper presents a new formulation that makes feasible a composition of long run production marginal costs with the long run transmission marginal costs, including the costs related to the interconnection EHV networks and that related to the voltage levels below. The goal top be attained is to have available a more adequate parameter in order to compare production cost related to a plant, that will be connected to a certain voltage level network, to the cost related supplying the sam,e amount of energy from the bulk power system which will be represented by the marginal costs up to the voltage level under consideration. This procedure brings to light the Transmission Avoided Costs concepts, that are stressed throughout the text. The proposed methodology is now being used, in the brazilian Power Sector, as a rule of thumb in order to guide planning decisions about the schedule of new plants that have installed capacity below 30 MW. For plants with higher capacity, the transmission avoided costs are evaluated for each specific case, simulating the system behavior without the quoted hydroelectric plant. This paper focuses, an an application example, the case of the Canoas Hydroelectric Project, recently included in the Generation Expansion Reference Plan after a detailed analysis supported by the methodology described here. (author) 7 refs., 3 tabs.

North-east transmission networks : organization and operations

International Nuclear Information System (INIS)

Roberge, F.

2003-01-01

A review of Quebec's electric power industry was presented along with an outline of non-regulated activity and regulated activities in terms of power generation, transmission, distribution and customer service. Both the transmission and distribution components of Quebec's electric power industry are regulated by the Regie de l'energie. Transmission networks offer access to all wholesalers. Hydro-Quebec TransEnergie was created in 1997 as a functionally independent open access transmission provider with high reliability standards. TransEnergie can address seams issues with neighbouring networks. The three types of services offered in terms of tariffs were also discussed along with data regarding Hydro-Quebec assets, revenue and net income. Hydro-Quebec's relation with the New Brunswick, Ontario, New York and New England were presented along with the issue of congestion and congestion costs. Congestion was defined as an incapacity to deliver energy at low cost because of a limited grid capacity, which results in a need to use more expensive energy. Solutions to decrease congestion include: building new transmission lines; using specialized equipment at existing distribution points; constructing strategically placed power generating stations; reducing the power load; and, increasing network control. The factors that influence investments in transport were also discussed. 1 tab., 9 figs

Cost characteristics of transmission

International Nuclear Information System (INIS)

Anon.

1991-01-01

FERC regulation of transmission is predicated, at least in part, on a belief that, in the absence of regulation, some utilities would be able to exercise monopoly power and the ability to extract monopoly profits. This monopoly power follows from the view that transmission facilities inevitably are a natural monopoly for both economic and social/regulatory reasons. In the first part of this section the authors present the argument that transmission is a natural monopoly. They then consider the impact of this on regulation and the problems that that view creates

Least cost energy services for Australia: Volume 1

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-07-01

The Australian electricity industry is in the process of major structural reforms, the most significant of its 100 year history. The industry is being separated into generation, transmission, distribution and retail supply businesses. Competition will be introduced to the wholesale (generation) and retail supply markets. The remaining monopoly elements of the industry, the networks and retail franchise businesses, will be regulated. This report considers a range of mechanisms to incorporate integrated resource planning (IRP) and demand management (DM) into the proposed competitive electricity markets in Australia. The mechanisms are analysed in terms of international experience and their application in the reformed Australian energy sector. The advantages and disadvantages of a range of mechanisms are discussed in relation to achieving a least cost energy services outcome, pricing reforms, regulation of utilities, and other DM activities outside the utilities. The paper concludes with recommendations for a national approach to DM and IRP in the electricity sector. (author). 22 tabs.

Cost effectiveness and efficiency in assistive technology service delivery.

Science.gov (United States)

Warren, C G

1993-01-01

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

Optimal decoding and information transmission in Hodgkin-Huxley neurons under metabolic cost constraints.

Science.gov (United States)

Kostal, Lubomir; Kobayashi, Ryota

2015-10-01

Information theory quantifies the ultimate limits on reliable information transfer by means of the channel capacity. However, the channel capacity is known to be an asymptotic quantity, assuming unlimited metabolic cost and computational power. We investigate a single-compartment Hodgkin-Huxley type neuronal model under the spike-rate coding scheme and address how the metabolic cost and the decoding complexity affects the optimal information transmission. We find that the sub-threshold stimulation regime, although attaining the smallest capacity, allows for the most efficient balance between the information transmission and the metabolic cost. Furthermore, we determine post-synaptic firing rate histograms that are optimal from the information-theoretic point of view, which enables the comparison of our results with experimental data. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Direct health services costs of providing assisted reproduction services in older women.

Science.gov (United States)

Maheshwari, Abha; Scotland, Graham; Bell, Jacqueline; McTavish, Alison; Hamilton, Mark; Bhattacharya, Siladitya

2010-02-01

To assess the total health service costs incurred for each live birth achieved by older women undergoing IVF compared with costs in younger women. Retrospective cross-sectional analysis. In vitro fertilization unit and maternity hospital in a tertiary care setting. Women who underwent their first cycle of IVF between 1997 and 2006. Bottom-up costs were calculated for all interventions in the IVF cycle. Early pregnancy and antenatal care costs were obtained from National Health Service reference costs, Information Services Division Scotland, and local departmental costs. Cost per live birth. The mean cost per live birth (95% confidence interval [CI]) in women undergoing IVF at the age of > or =40 years was pound 40,320 (pound 27,105- pound 65,036), which is >2.5 times higher than those aged 35-39 years (pound 17,096 [pound 15,635- pound 18,937]). The cost per ongoing pregnancy was almost three times in women aged > or =40 (pound 31,642 [pound 21,241- pound 58,979]) compared with women 35-39 years of age (pound 11,300 [pound 10,006- pound 12,938]). The cost of a live birth after IVF rises significantly at the age of 40 years owing to lower success rates. Most of the extra cost is due to the low success of IVF treatment, but some of it is due to higher rates of early pregnancy loss. Copyright 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Cost Allocation of Transmission Losses in Electric Market Mechanism

Directory of Open Access Journals (Sweden)

Erwin Dermawan

2012-06-01

Full Text Available This paper proposes a new method to calculate cost allocation of transmission losses (losses, based on a certain price of energy (i.e. a marginal price of system. Here is developed a mathematic model through manipulating of the network equation to separate losses. This model uses complex power injection and, does not use approximations and assumptions in determining the cost allocation of losses. Its calculation begins from the results of load flow calculation and then is continued to calculate power distribution from a generator to every load and every line. Finally, to be calculated separating of losses and cost allocation of losses. The proposed method is easy to be understood and applied. An illustration results on IEEE 14-bus system show that the method is always consistent with expectancies and somewhat different with a few reference methods.

Developing a costing framework for palliative care services.

Science.gov (United States)

Mosoiu, Daniela; Dumitrescu, Malina; Connor, Stephen R

2014-10-01

Palliative care services have been reported to be a less expensive alternative to traditional treatment; however, little is known about how to measure the cost of delivering quality palliative care. The purpose of this project was to develop a standardized method for measuring the cost of palliative care delivery that could potentially be replicated in multiple settings. The project was implemented in three stages. First, an interdisciplinary group of palliative care experts identified standards of quality palliative care delivery in the inpatient and home care services. Surveys were conducted of government agencies and palliative care providers to identify payment practices and budgets for palliative care services. In the second phase, unit costs were defined and a costing framework was designed to measure inpatient and home-based palliative care unit costs. The final phase was advocacy for inclusion of calculated costs into the national funding system. In this project, a reliable framework for determining the cost of inpatient and home-based palliative care services was developed. Inpatient palliative care cost in Romania was calculated at $96.58 per day. Home-based palliative care was calculated at $30.37 per visit, $723.60 per month, and $1367.71 per episode of care, which averaged 45 visits. A standardized methodology and framework for costing palliative care are presented. The framework allows a country or provider of care to substitute their own local costs to generate cost information relevant to the health-care system. In Romania, this allowed the palliative care provider community to advocate for a consistent payment system. Copyright © 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Pricing transmission services

International Nuclear Information System (INIS)

Haaden, E.

1995-01-01

The price structure for transmission of electric power through the main lines in Sweden is analyzed. After deregulation of the electricity market, the main transmission lines are owned by a separate national company, with no interests from the power producers. Comparisons are made to ideal marginal price structures. 6 refs

The costs and benefits of Option B+ for the prevention of mother-to-child transmission of HIV.

Science.gov (United States)

Gopalappa, Chaitra; Stover, John; Shaffer, Nathan; Mahy, Mary

2014-01-01

Most countries follow WHO 2010 guidelines for the prevention of mother-to-child transmission (PMTCT) of HIV using either Option A or B for women not yet eligible for antiretroviral therapy (ART). Both of these approaches involve the use of antiretrovirals during pregnancy and breastfeeding. Some countries have adopted a new strategy, Option B+, in which HIV-positive pregnant women are started immediately on ART and continued for life. Option B+ is more costly than Options A or B, but provides additional health benefits. In this article, we estimate the additional costs and effectiveness of Option B+. We developed a deterministic model to simulate births, breastfeeding, and HIV infection in women in four countries, Kenya, Zambia, South Africa, and Vietnam that differ in fertility rate, birth interval, age at first birth, and breastfeeding patterns, but have similar age at HIV infection. We estimated the total PMTCT costs and new child infections under Options A, B, and B+, and measured cost-effectiveness as the incremental PMTCT-related costs per child infection averted. We included adult sexual transmissions averted from ART, the corresponding costs saved, and estimated the total incremental cost per transmission (child and adult) averted. When considering PMTCT-related costs and child infections, Option B+ was the most cost-effective strategy costing between $6000 and $23 000 per infection averted compared with Option A. Option B+ averted more child infections compared with Option B in all four countries and cost less than Option B in Kenya and Zambia. When including adult sexual transmissions averted, Option B+ cost less and averted more infections than Options A and B.

Transmission issues in Alberta

International Nuclear Information System (INIS)

Levson, D.

2002-01-01

This paper outlined the major issues and concerns facing users of the transmission system in Alberta. They include congestion management issues that make investors uncertain about power generation. It is necessary to know the difference between which transmission price signals will be faced by low cost cogeneration at Fort McMurray and Cold Lake coal-fired generation near Edmonton compared to combined cycle gas generation near Calgary. Import and export policy tariffs are another concern. Most new generation opportunities in Alberta require access to export markets, but transmission facilities for export need policy support and appropriate tariffs. It was noted that the past actions of Alberta's Transmission Administrator and balancing pool may be distorting market signals for ancillary service markets, and that loss studies and calculations need upgrading

In-service crosstalk monitoring for dense space division multiplexed multi-core fiber transmission systems

DEFF Research Database (Denmark)

Mizuno, T.; Isoda, A.; Shibahara, K.

2017-01-01

We present in-service inter-core crosstalk monitoring for MCF transmission systems. We transmit 54-WDM PDM-16QAM signals over 111.6-km 32-core DSDM transmission line incorporating cladding-pumped 32-core MC-EYDFA, and demonstrate -30 dB crosstalk monitoring without affecting transmission...

A cost benefit analysis of outsourced laboratory services.

Science.gov (United States)

Bowers, J A

1995-11-01

As healthcare moves toward increased capitation, hospital administrators must be aware of all costs associated with patient services. This article describes the cost benefit analysis process used by northern Indiana hospital consumers during 1994-1995 to evaluate a local laboratory service outsource provider, South Bend Medical Foundation (SBMF). In an effort to meet the best interests of the community at large, three competing hospitals, medical leadership, and the local outsource provider joined forces to ensure that cost effective quality services would be provided. Laboratory utilization patterns for common DRGs were also analyzed. The team created a reconfiguration analysis to help develop benchmark figures for consideration in future contract negotiations.

Cost and outcome analysis of two alcohol detoxification services.

Science.gov (United States)

Parrott, Steve; Godfrey, Christine; Heather, Nick; Clark, Jenny; Ryan, Tony

2006-01-01

To examine the relationship between service use and outcomes (individual and wider consequences) using an economic analysis of a direct-access alcohol detoxification service in Manchester (the Smithfield Centre) and an NHS partial hospitalization programme in Newcastle upon Tyne (Newcastle and North Tyneside Drug and Alcohol Service, Plummer Court). A total of 145 direct-access admissions to the Smithfield Centre and 77 admissions to Plummer Court completed a battery of questionnaires shortly after intake and were followed up 6 months after discharge. Full economic data at follow-up were available for 54 Smithfield admissions and 49 Plummer Court admissions. Mean total cost of treatment per patient was pound1113 at the Smithfield Centre and pound1054 at Plummer Court in 2003-04 prices. Comparing the 6 months before treatment with the 6 months before follow-up, social costs fell by pound331 on average for each patient at Plummer Court but rose by pound1047 for each patient at the Smithfield Centre. When treatment costs and wider social costs were combined, the total cost to society at Smithfield was on average pound2159 per patient whilst at Plummer Court it was pound723 per patient. Combining the cost of treatment with drinking outcomes yielded a net cost per unit reduction in alcohol consumption of pound1.79 at Smithfield and pound1.68 at Plummer Court. Both services delivered a flexible needs-based service to very disadvantaged population at a reasonable cost and were associated with statistically significant reductions in drinking. For some patients, there was evidence of public sector resource savings but for others these detoxification services allowed those not previously in contact with services to meet health and social care needs. These patterns of cost through time are more complex than in previous evaluations of less severely dependent patients and difficult to predict from drinking patterns or patient characteristics. More research is required to judge

Home Health Care: Services and Cost

Science.gov (United States)

Widmer, Geraldine; And Others

1978-01-01

Findings from a study of home care services in one New York district document the value and relatively modest costs of home health care for the chronically ill and dependent elderly. Professional nurses coordinated the care, but most of the direct services were provided by home health aides and housekeepers. (MF)

Managing Food Service Costs and Satisfying Customers.

Science.gov (United States)

Reuther, Anne; Otto, Ione

1987-01-01

Milwaukee Area Technical College, Wisconsin, has four campuses, each with its own food service operation that, combined, serve nearly 3,000 people daily. Several food service-related programs are part of the curriculum. Cost containment and customer satisfaction are the two overriding goals of the food service programs. (MLF)

Marginal ambulatory teaching cost under varying levels of service utilization.

Science.gov (United States)

Panton, D M; Mushlin, A I; Gavett, J W

1980-06-01

The ambulatory component of residency training jointly produces two products, namely, training and patient services. In costing educational programs of this type, two approaches are frequently taken. The first considers the total costs of the educational program, including training and patient services. These costs are usually constructed from historical accounting records. The second approach attempts to cost the joint products separately, based upon estimates of future changes in program costs, if the product in question is added to or removed from the program. The second approach relates to typical decisions facing the managers of medical centers and practices used for teaching purposes. This article reports such a study of costs in a primary-care residency training program in a hospital outpatient setting. The costs of the product, i.e., on-the-job training, are evaluated using a replacement-cost concept under different levels of patient services. The results show that the cost of the product, training, is small at full clinical utilization and is sensitive to changes in the volume of services provided.

An Invocation Cost Optimization Method for Web Services in Cloud Environment

Directory of Open Access Journals (Sweden)

Lianyong Qi

2017-01-01

Full Text Available The advent of cloud computing technology has enabled users to invoke various web services in a “pay-as-you-go” manner. However, due to the flexible pricing model of web services in cloud environment, a cloud user’ service invocation cost may be influenced by many factors (e.g., service invocation time, which brings a great challenge for cloud users’ cost-effective web service invocation. In view of this challenge, in this paper, we first investigate the multiple factors that influence the invocation cost of a cloud service, for example, user’s job size, service invocation time, and service quality level; and afterwards, a novel Cloud Service Cost Optimization Method named CS-COM is put forward, by considering the above multiple impact factors. Finally, a set of experiments are designed, deployed, and tested to validate the feasibility of our proposal in terms of cost optimization. The experiment results show that our proposed CS-COM method outperforms other related methods.

Cost-benefit analysis of the ATM automatic deposit service

Directory of Open Access Journals (Sweden)

Ivica Županović

2015-03-01

Full Text Available Bankers and other financial experts have analyzed the value of automated teller machines (ATM in terms of growing consumer demand, rising costs of technology development, decreasing profitability and market share. This paper presents a step-by-step cost-benefit analysis of the ATM automatic deposit service. The first step is to determine user attitudes towards using ATM automatic deposit service by using the Technology Acceptance Model (TAM. The second step is to determine location priorities for ATMs that provide automatic deposit services using the Analytic Hierarchy Process (AHP model. The results of the previous steps enable a highly efficient application of cost-benefit analysis for evaluating costs and benefits of automatic deposit services. To understand fully the proposed procedure outside of theoretical terms, a real-world application of a case study is conducted.

Ancillary Services Provided from DER

Energy Technology Data Exchange (ETDEWEB)

Campbell, J.B.

2005-12-21

Distributed energy resources (DER) are quickly making their way to industry primarily as backup generation. They are effective at starting and then producing full-load power within a few seconds. The distribution system is aging and transmission system development has not kept up with the growth in load and generation. The nation's transmission system is stressed with heavy power flows over long distances, and many areas are experiencing problems in providing the power quality needed to satisfy customers. Thus, a new market for DER is beginning to emerge. DER can alleviate the burden on the distribution system by providing ancillary services while providing a cost adjustment for the DER owner. This report describes 10 types of ancillary services that distributed generation (DG) can provide to the distribution system. Of these 10 services the feasibility, control strategy, effectiveness, and cost benefits are all analyzed as in the context of a future utility-power market. In this market, services will be provided at a local level that will benefit the customer, the distribution utility, and the transmission company.

7 CFR 62.300 - Fees and other costs for service.

Science.gov (United States)

2010-01-01

... 7 Agriculture 3 2010-01-01 2010-01-01 false Fees and other costs for service. 62.300 Section 62...) Quality Systems Verification Programs Definitions Charges for Service § 62.300 Fees and other costs for service. Fees and other charges will be levied based on the following provisions: (a) Fees for service...

Investigating the Effects of Consumer Innovativeness, Service Quality and Service Switching Costs on Service Loyalty in the Mobile Phone Service Context

Directory of Open Access Journals (Sweden)

Farzana Quoquab

2016-02-01

Full Text Available The objective of this study is to examine the effects of consumer innovativeness, service quality, service switching costs and service satisfaction on service loyalty among mobile phone service users. A cross sectional survey was employed which yielded 535 responses. Structural equation modelling using the AMOS version 2.0 was utilized to test study the hypotheses. Test results reveal that service satisfaction, service switching costs and service quality are the three antecedents that directly influence service loyalty. However, consumer innovativeness does not have any direct effect on service loyalty. Moreover, service satisfaction is found to be a partial mediator between ‘service quality’ and ‘service loyalty’. Findings from this study will develop insights to enable policy-makers, managers and marketers to better strategize and effectively implement loyalty programs and prevent their customers from switching. This will enhance value creation for both their users and for the industry.

Costs and utilization of public sector family planning services in Pakistan.

Science.gov (United States)

Abbas, Khadija; Khan, Adnan Ahmad; Khan, Ayesha

2013-04-01

The public sector provides a third of family planning (FP) services in Pakistan. However, these services are viewed as being underutilized and expensive. We explored the utilization patterns and costs of FP services in the public sector. We used overall budgets and time allocation by health and population departments to estimate the total costs of FP by these departments, costs per woman served, and costs per couple-year of protection (CYP). The public sector is the predominant provider of FP to the poorest and is the main provider of female sterilization services. The overall costs of FP in the public sector are USD 55 per woman served, annually (USD 17 per CYP). Within the public sector, the population welfare departments provide services at USD 72 per woman served, annually (USD 17 per CYP) and the health departments at USD 39 per woman per year (USD 29 per CYP). While the public sector has a critical niche in serving the poor and providing female sterilization, its services are considerably more expensive compared to international and even some Pakistani non-government organization (NGO) costs. This reflects inefficiencies in services provided, client mistrust in the quality of services provided, and inadequate referrals, and will require specific actions for improving referrals and the quality of services.

Delivery Unit Costs for Antiretroviral Treatment and Prevention of Mother-to-Child-Transmission of HIV

Science.gov (United States)

Galárraga, Omar; Wirtz, Veronika J.; Figueroa-Lara, Alejandro; Santa-Ana-Tellez, Yared; Coulibaly, Ibrahima; Viisainen, Kirsi; Medina-Lara, Antonieta; Korenromp, Eline L.

2013-01-01

Background As antiretroviral treatment (ART) for HIV/AIDS is scaled-up globally, information on per-person costs is critical to improve efficiency in service delivery and maximize coverage and health impact. Objective To review studies on delivery unit costs for adult and pediatric ART provision per-patient-year, and prevention of mother-to-child transmission (PMTCT) interventions per mother-infant pair screened or treated, in low- and middle-income countries. Methods Systematic review of English, French and Spanish publications from 2001 to 2009, reporting empirical costing that accounted for at least antiretroviral (ARV) medicines, laboratory testing and personnel. Expenditures were analyzed by country income level and cost component. All costs were standardized to 2009 US dollars. Results Analyses covered 29 eligible, comprehensive costing studies. In the base case, in low-income countries (LIC), median, ART cost per patient-year was $792 (mean: $839, range: $682-$1089); for lower-middle-income countries (LMIC), the median was $932 (mean: $1246, range: $156-$3904); and for upper-middle-income countries (UMIC) the median was $1454 (mean: $2783, range: $1230-$5667). ARV drugs were largest component of overall ART cost in all settings (62%, 50% and 47% in LIC, LMIC and UMIC respectively). Out of 26 ART studies, 14 report which drug regimes were used, and only one study explicitly reported second line treatment costs. The second cost driver was laboratory cost in LIC and LMIC (14% and 19.5%) whereas it was personnel costs in UMIC (26%). Two studies specified the types of laboratory tests costed, and three studies specifically included above-facility-level personnel costs. Three studies reported detailed PMTCT costs, and two studies reported on pediatric ART. Conclusions There is a paucity of data on the full ART and PMTCT delivery unit costs, in particular for low-and middle-income countries. Heterogeneity in activities costed and insufficient detail regarding

Virtual Reference, Real Money: Modeling Costs in Virtual Reference Services

Science.gov (United States)

Eakin, Lori; Pomerantz, Jeffrey

2009-01-01

Libraries nationwide are in yet another phase of belt tightening. Without an understanding of the economic factors that influence library operations, however, controlling costs and performing cost-benefit analyses on services is difficult. This paper describes a project to develop a cost model for collaborative virtual reference services. This…

Selecting cost-effective areas for restoration of ecosystem services.

Science.gov (United States)

Adame, M F; Hermoso, V; Perhans, K; Lovelock, C E; Herrera-Silveira, J A

2015-04-01

Selection of areas for restoration should be based on cost-effectiveness analysis to attain the maximum benefit with a limited budget and overcome the traditional ad hoc allocation of funds for restoration projects. Restoration projects need to be planned on the basis of ecological knowledge and economic and social constraints. We devised a novel approach for selecting cost-effective areas for restoration on the basis of biodiversity and potential provision of 3 ecosystem services: carbon storage, water depuration, and coastal protection. We used Marxan, a spatial prioritization tool, to balance the provision of ecosystem services against the cost of restoration. We tested this approach in a mangrove ecosystem in the Caribbean. Our approach efficiently selected restoration areas that at low cost were compatible with biodiversity targets and that maximized the provision of one or more ecosystem services. Choosing areas for restoration of mangroves on the basis carbon storage potential, largely guaranteed the restoration of biodiversity and other ecosystem services. © 2014 Society for Conservation Biology.

17 CFR 256.01-5 - Determination of service cost accounting.

Science.gov (United States)

2010-04-01

... accounting. Service at cost and fair allocation of costs require, first of all, an accurate accounting for... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Determination of service cost accounting. 256.01-5 Section 256.01-5 Commodity and Securities Exchanges SECURITIES AND EXCHANGE COMMISSION...

Parametric study of variable renewable energy integration in Europe: Advantages and costs of transmission grid extensions

International Nuclear Information System (INIS)

Schaber, Katrin; Steinke, Florian; Mühlich, Pascal; Hamacher, Thomas

2012-01-01

Wind and solar energy will play an important role in the decarbonization of the European electricity generation. However, high shares of these variable renewable energies (VREs) challenge the power system considerably due to their temporal fluctuations and geographical dispersion. In this paper, we systematically analyze transmission grid extensions as an integration measure for VREs in Europe. We show the effects of grid extensions for fundamental properties of the power system as a function of the penetration and mix of wind and solar energy. Backup capacity requirements and overproduction are reduced with a powerful overlay transmission grid. We determine the costs of the grid extensions in dependence of the VRE penetration and mix and find that the grid integration costs remain below 25% of the VRE investment costs for all conceivable VRE configurations. Furthermore, robust design features of future power systems in terms of grid geometry and flexibility requirements for backup technologies are identified. We apply a spatially and temporally highly resolved techno-economic model of the European power system for our analysis. - Highlights: ► Quantification of the advantages and costs of a European overlay transmission grid. ► Grid integration costs for VREs in Europe remain below 6€/MWh. ► Application of a detailed power system model to a wide parameter space.

Transmission access raises unresolved economic issues

International Nuclear Information System (INIS)

Happ, H.H.

1994-01-01

The electric utility industry is in the process of gradual change from a fully regulated industry to one of partial deregulation. Instead of relying on regulation to achieve a fair and equitable price to the consumer for electric energy, the reliance is placed more and more on market forces, through competition, to provide wholesale energy at the best market price. Clearly, open transmission access is required to create a viable competitive wholesale market for new generation resources. This article describes four unresolved, or at least partially unresolved, issues associated with transmission access for wholesale wheeling. Wheeling has been defined as the use of a utility's transmission facilities to transmit power for other buyers and sellers. At least three parties are involved in a wheeling transaction: a seller, a buyer, and one or more wheeling utilities that transmit the power from the seller to the buyer. This article considers wholesale or bulk wheeling only, and does not consider retail wheeling. The four unresolved economic issues described in this article pertain to transmission access: Actual cost of providing transmission services, Methodology or methodologies used in evaluating the cost of wheeling, Contract path versus the actual power flows of the wheel, Issues associated with the formation of transmission regions

Using a Time-Driven Activity-Based Costing Model To Determine the Actual Cost of Services Provided by a Transgenic Core.

Science.gov (United States)

Gerwin, Philip M; Norinsky, Rada M; Tolwani, Ravi J

2018-03-01

Laboratory animal programs and core laboratories often set service rates based on cost estimates. However, actual costs may be unknown, and service rates may not reflect the actual cost of services. Accurately evaluating the actual costs of services can be challenging and time-consuming. We used a time-driven activity-based costing (ABC) model to determine the cost of services provided by a resource laboratory at our institution. The time-driven approach is a more efficient approach to calculating costs than using a traditional ABC model. We calculated only 2 parameters: the time required to perform an activity and the unit cost of the activity based on employee cost. This method allowed us to rapidly and accurately calculate the actual cost of services provided, including microinjection of a DNA construct, microinjection of embryonic stem cells, embryo transfer, and in vitro fertilization. We successfully implemented a time-driven ABC model to evaluate the cost of these services and the capacity of labor used to deliver them. We determined how actual costs compared with current service rates. In addition, we determined that the labor supplied to conduct all services (10,645 min/wk) exceeded the practical labor capacity (8400 min/wk), indicating that the laboratory team was highly efficient and that additional labor capacity was needed to prevent overloading of the current team. Importantly, this time-driven ABC approach allowed us to establish a baseline model that can easily be updated to reflect operational changes or changes in labor costs. We demonstrated that a time-driven ABC model is a powerful management tool that can be applied to other core facilities as well as to entire animal programs, providing valuable information that can be used to set rates based on the actual cost of services and to improve operating efficiency.

Liner Shipping Service Scheduling with Workshift Costs

DEFF Research Database (Denmark)

Reinhardt, Line Blander

while ensuring that given transit time limits for the carried cargo is satisfied, and considering the layover time for containers transshipping between services. Workshift times and cost are included ensuring that changing the port visit time will not introduce an addition cost for the port operations...

78 FR 17652 - Tri-State Generation and Transmission Association, Inc. v. Public Service Company of New Mexico...

Science.gov (United States)

2013-03-22

... Generation and Transmission Association, Inc. v. Public Service Company of New Mexico; Notice of Complaint... CFR 385.206 and 18 CFR 385.212, Tri-State Generation and Transmission Association, Inc. (Complainant), filed a complaint against the Public Service Company of New Mexico (Respondent or PNM) alleging that...

Study protocol for the Integra Initiative to assess the benefits and costs of integrating sexual and reproductive health and HIV services in Kenya and Swaziland

Directory of Open Access Journals (Sweden)

Warren Charlotte E

2012-11-01

Full Text Available Abstract Background In sub-Saharan Africa (SSA there are strong arguments for the provision of integrated sexual and reproductive health (SRH and HIV services. Most HIV transmissions are sexually transmitted or associated with pregnancy, childbirth, and breastfeeding. Many of the behaviours that prevent HIV transmission also prevent sexually transmitted infections and unintended pregnancies. There is potential for integration to increase the coverage of HIV services, as individuals who use SRH services can benefit from HIV services and vice-versa, as well as increase cost-savings. However, there is a dearth of empirical evidence on effective models for integrating HIV/SRH services. The need for robust evidence led a consortium of three organizations – International Planned Parenthood Federation, Population Council and the London School of Hygiene & Tropical Medicine – to design/implement the Integra Initiative. Integra seeks to generate rigorous evidence on the feasibility, effectiveness, cost and impact of different models for delivering integrated HIV/SRH services in high and medium HIV prevalence settings in SSA. Methods/design A quasi-experimental study will be conducted in government clinics in Kenya and Swaziland – assigned into intervention/comparison groups. Two models of service delivery are investigated: integrating HIV care/treatment into 1 family planning and 2 postnatal care. A full economic-costing will be used to assess the costs of different components of service provision, and the determinants of variations in unit costs across facilities/service models. Health facility assessments will be conducted at four time-periods to track changes in quality of care and utilization over time. A two-year cohort study of family planning/postnatal clients will assess the effect of integration on individual outcomes, including use of SRH services, HIV status (known/unknown and pregnancy (planned/unintended. Household surveys within some

[Research progress of ecosystem service flow.

Science.gov (United States)

Liu, Hui Min; Fan, Yu Long; Ding, Sheng Yan

2016-07-01

With the development of social economy, human disturbance has resulted in a variety of ecosystem service degradation or disappearance. Ecosystem services flow plays an important role in delivery, transformation and maintenance of ecosystem services, and becomes one of the new research directions. In this paper, based on the classification of ecosystem services flow, we analyzed ecosystem service delivery carrier, and investigated the mechanism of ecosystem service flow, including the information, property, scale features, quantification and cartography. Moreover, a tentative analysis on cost-effective of ecosystem services flow (such as transportation costs, conversion costs, usage costs and cost of relativity) was made to analyze the consumption cost in ecosystem services flow process. It aimed to analyze dissipation cost in ecosystem services flow process. To a certain extent, the study of ecosystem service flow solved the problem of "double counting" in ecosystem services valuation, which could make a contribution for the sake of recognizing hot supply and consumption spots of ecosystem services. In addition, it would be conducive to maximizing the ecosystem service benefits in the transmission process and putting forward scientific and reasonable ecological compensation.

Cutting costs in your own backyard: opportunities in financial services.

Science.gov (United States)

van Londen, Jan; Zimmerman, Paul

2012-03-01

Hospitals looking to reduce cost and improve performance in financial services should focus on these areas: Treasury banking services costs and fees. The possibility of a revenue-generating vendor payment solution. The accounts payable process.

47 CFR 25.212 - Narrowband analog transmissions, digital transmissions, and video transmissions in the GSO Fixed...

Science.gov (United States)

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Narrowband analog transmissions, digital transmissions, and video transmissions in the GSO Fixed-Satellite Service. 25.212 Section 25.212 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES SATELLITE COMMUNICATIONS...

Specialty and full-service hospitals: a comparative cost analysis.

Science.gov (United States)

Carey, Kathleen; Burgess, James F; Young, Gary J

2008-10-01

To compare the costs of physician-owned cardiac, orthopedic, and surgical single specialty hospitals with those of full-service hospital competitors. The primary data sources are the Medicare Cost Reports for 1998-2004 and hospital inpatient discharge data for three of the states where single specialty hospitals are most prevalent, Texas, California, and Arizona. The latter were obtained from the Texas Department of State Health Services, the California Office of Statewide Health Planning and Development, and the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project. Additional data comes from the American Hospital Association Annual Survey Database. We identified all physician-owned cardiac, orthopedic, and surgical specialty hospitals in these three states as well as all full-service acute care hospitals serving the same market areas, defined using Dartmouth Hospital Referral Regions. We estimated a hospital cost function using stochastic frontier regression analysis, and generated hospital specific inefficiency measures. Application of t-tests of significance compared the inefficiency measures of specialty hospitals with those of full-service hospitals to make general comparisons between these classes of hospitals. Results do not provide evidence that specialty hospitals are more efficient than the full-service hospitals with whom they compete. In particular, orthopedic and surgical specialty hospitals appear to have significantly higher levels of cost inefficiency. Cardiac hospitals, however, do not appear to be different from competitors in this respect. Policymakers should not embrace the assumption that physician-owned specialty hospitals produce patient care more efficiently than their full-service hospital competitors.

Association of antipsychotic polypharmacy with health service cost: a register-based cost analysis

DEFF Research Database (Denmark)

Baandrup, Lone; Sørensen, Jan; Lublin, Henrik Kai Francis

2012-01-01

at the two cross-sectional dates was recorded and used as proxy of polypharmacy exposure during the preceding year. A multivariate generalised linear model was fitted with total costs of primary and secondary health service use as dependent variable, and antipsychotic polypharmacy, diagnosis, age, gender......, disease duration, psychiatric inpatient admissions, and treatment site as covariates. RESULTS: The sample consisted of 736 outpatients with a diagnosis in the schizophrenia spectrum. Antipsychotic polypharmacy was associated with significantly higher total health service costs compared with monotherapy...

Mental health services costs within the Alberta criminal justice system.

Science.gov (United States)

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

2016-01-01

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

Cost-effectiveness of antiviral therapy during late pregnancy to prevent perinatal transmission of hepatitis B virus

Directory of Open Access Journals (Sweden)

Wenjun Wang

2016-03-01

Full Text Available Background. Hepatitis B virus (HBV infections are perinatally transmitted from chronically infected mothers. Supplemental antiviral therapy during late pregnancy with lamivudine (LAM, telbivudine (LdT, or tenofovir (TDF can substantially reduce perinatal HBV transmission compared to postnatal immunoprophylaxis (IP alone. However, the cost-effectiveness of these measures is not clear. Aim. This study evaluated the cost-effectiveness from a societal perspective of supplemental antiviral agents for preventing perinatal HBV transmission in mothers with high viral load (>6 log10 copies/mL. Methods. A systematic review and network meta-analysis were performed for the risk of perinatal HBV transmission with antiviral therapies. A decision analysis was conducted to evaluate the clinical and economic outcomes in China of four competing strategies: postnatal IP alone (strategy IP, or in combination with perinatal LAM (strategy LAM + IP, LdT (strategy LdT + IP, or TDF (strategy TDF + IP. Antiviral treatments were administered from week 28 of gestation to 4 weeks after birth. Outcomes included treatment-related costs, number of infections, and quality-adjusted life years (QALYs. One- and two-way sensitivity analyses were performed to identify influential clinical and cost-related variables. Probabilistic sensitivity analyses were used to estimate the probabilities of being cost-effective for each strategy. Results. LdT + IP and TDF + IP averted the most infections and HBV-related deaths, and gained the most QALYs. IP and TDF + IP were dominated as they resulted in less or equal QALYs with higher associated costs. LdT + IP had an incremental $2,891 per QALY gained (95% CI [$932–$20,372] compared to LAM + IP (GDP per capita for China in 2013 was $6,800. One-way sensitivity analyses showed that the cost-effectiveness of LdT + IP was only sensitive to the relative risk of HBV transmission comparing LdT + IP with LAM + IP. Probabilistic sensitivity analyses

In-Service Aircraft Transmission Life Modeling for Improved Flight Safety, Phase I

Data.gov (United States)

National Aeronautics and Space Administration — It is proposed to develop an accurate, in-service transmission life-estimation system for the prediction of remaining component and system life for a helicopter...

What Do Information Technology Support Services Really Cost?

Science.gov (United States)

Leach, Karen; Smallen, David

1998-01-01

A study examined the cost of information-technology support services in higher education institutions. The report describes the project's origins and work to date and reports initial results in three areas: network services, desktop repair services, and administrative information systems, looking in each case at economies of scale, outsourcing…

In-Service Aircraft Transmission Life Modeling for Improved Flight Safety, Phase II

Data.gov (United States)

National Aeronautics and Space Administration — It is proposed to develop an accurate, in-service transmission life-use estimation system for the prediction of remaining component and system life for a helicopter...

18 CFR 2.20 - Good faith requests for transmission services and good faith responses by transmitting utilities.

Science.gov (United States)

2010-04-01

... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Good faith requests for transmission services and good faith responses by transmitting utilities. 2.20 Section 2.20 Conservation of... Power Act § 2.20 Good faith requests for transmission services and good faith responses by transmitting...

On the relation between cost and service models for general inventory systems

NARCIS (Netherlands)

Houtum, van G.J.J.A.N.; Zijm, W.H.M.

2000-01-01

In this paper, we present a systematic overview of possible relations between cost and service models for fairly general single- and multi-stage inventory systems. In particular, we relate various types of penalty costs in pure cost models to equivalent types of service measures in service models.

Long term warranty and after sales service concept, policies and cost models

CERN Document Server

Rahman, Anisur

2015-01-01

This volume presents concepts, policies and cost models for various long-term warranty and maintenance contracts. It offers several numerical examples for estimating costs to both the manufacturer and consumer. Long-term warranties and maintenance contracts are becoming increasingly popular, as these types of aftersales services provide assurance to consumers that they can enjoy long, reliable service, and protect them from defects and the potentially high costs of repairs. Studying long-term warranty and service contracts is important to manufacturers and consumers alike, as offering long-term warranty and maintenance contracts produce additional costs for manufacturers / service providers over the product’s service life. These costs must be factored into the price, or the manufacturer / dealer will incur losses instead of making a profit. On the other hand, the buyer / consumer needs to weigh the cost of maintaining it over its service life and to decide whether or not these policies are worth purchasing....

Open access and network services -- A global approach

International Nuclear Information System (INIS)

Cook, A.S.; Merrill, H.M.

1995-01-01

Utilities functioning in a competitive electricity market are required to provide unbundled services. This paper describes how to make unbundled transmission services available in a competitive electricity market. Methods are presented for developing the long-run marginal cost of transmission and for pricing stand-by and top-up electricity supply. The methods are illustrated with case studies based on current data

Gaz Metropolitain's experience in regards to transmission access

International Nuclear Information System (INIS)

Noel, J.-P.

1994-01-01

The natural gas industry in Canada is briefly reviewed as it applies to the sale of transported gas in Quebec. The deregulation of the industry which occurred in 1985 brought many changes to the relationships among natural gas consumers, suppliers, transmission companies, and distribution utilities. It is noted that only the producers' natural gas sale price has been deregulated, not the rates of transmission companies or distributors. Deregulation offered two possibilities for natural gas users in Quebec: the client can contract a transmission service between the Alberta (source of supply) and Quebec borders, separately from contracting a delivery service from Gaz Metropolitain, the company supplying the vast majority of natural gas in Quebec; or the client can contract those two services from Gaz Metropolitain who then gathers the gas at the Alberta border. The adoption of Gaz Metropolitain services to meet the need for transmission access are discussed in the areas of supply contracts, and services offered (buy/sell, rate unbundling, delivery). The opportunities and risks for the customer are assessed in the areas of costs, speculation on transportation capacity, operational flexibility, and the possiblity of unused capacities. Opportunities and issues for the distributor include maintenance of client satisfaction, shortening of the duration of contracts, maintenance of the role of the distributor in natural gas sales, take-or-pay commitments, rate unbundling, accounting methods, inventories, and pricing

Cost analysis, cost recovery, marketing and fee-based services a guide for the health sciences librarian

CERN Document Server

Wood, M Sandra

2013-01-01

This outstanding volume won the 1986 Ida and George Eliot Prize--awarded by the Medical Library Association for the work judged most effective in furthering medical librarianship. Library professionals review the controversy behind fee-for-service programs and provide a rationale for incorporating them into contemporary library philosophies of service. Some fee-based services are necessary for survival in a society that treats information as a marketable commodity; this comprehensive book gives practical advice on cost analysis, cost recovery and marketing of reference services, and presents i

The costs and potential savings of a novel telepaediatric service in Queensland

Directory of Open Access Journals (Sweden)

Scuffham Paul

2007-03-01

Full Text Available Abstract Background There are few cost-minimisation studies in telemedicine. We have compared the actual costs of providing a telepaediatric service to the potential costs if patients had travelled to see the specialist in person. Methods In November 2000, we established a novel telepaediatric service for selected regional hospitals in Queensland. Instead of transferring patients to Brisbane, the majority of referrals to specialists in Brisbane were dealt with via videoconference. Since the service began, 1499 consultations have been conducted for a broad range of paediatric sub-specialities including burns, cardiology, child development, dermatology, diabetes, endocrinology, gastroenterology, nephrology, neurology, oncology, orthopaedics, paediatric surgery and psychiatry. Results During a five year period, the total cost of providing 1499 consultations through the telepaediatric service was A$955,996. The estimated potential cost of providing an outpatient service to the same number of patients at the Royal Children's Hospital in Brisbane was A$1,553,264; thus, telepaediatric services resulted in a net saving of approximately A$600,000 to the health service provider. Conclusion Telepaediatrics was a cheaper method for the delivery of outpatient services when the workload exceeded 774 consultations. A sensitivity analysis showed that the threshold point was most sensitive to changes related to patient travel costs, coordinator salaries and videoconference equipment costs. The study showed substantial savings for the health department, mainly due to reduced costs associated with patient travel.

A cost-consequences analysis of a primary care librarian question and answering service.

Directory of Open Access Journals (Sweden)

Jessie McGowan

Full Text Available BACKGROUND: Cost consequences analysis was completed from randomized controlled trial (RCT data for the Just-in-time (JIT librarian consultation service in primary care that ran from October 2005 to April 2006. The service was aimed at providing answers to clinical questions arising during the clinical encounter while the patient waits. Cost saving and cost avoidance were also analyzed. The data comes from eighty-eight primary care providers in the Ottawa area working in Family Health Networks (FHNs and Family Health Groups (FHGs. METHODS: We conducted a cost consequences analysis based on data from the JIT project. We also estimated the potential economic benefit of JIT librarian consultation service to the health care system. RESULTS: The results show that the cost per question for the JIT service was $38.20. The cost could be as low as $5.70 per question for a regular service. Nationally, if this service was implemented and if family physicians saw additional patients when the JIT service saved them time, up to 61,100 extra patients could be seen annually. A conservative estimate of the cost savings and cost avoidance per question for JIT was $11.55. CONCLUSIONS: The cost per question, if the librarian service was used at full capacity, is quite low. Financial savings to the health care system might exceed the cost of the service. Saving physician's time during their day could potentially lead to better access to family physicians by patients. Implementing a librarian consultation service can happen quickly as the time required to train professional librarians to do this service is short.

Contracting for health services in New Zealand: a transaction cost analysis.

Science.gov (United States)

Ashton, T

1998-02-01

The splitting of the functions of purchaser and provider in the New Zealand health system in 1993 necessitated the use of explicit contracts between the two parties. This paper examines contracting experiences during the first two years of operation. The study focuses on four services: rest homes, primary care clinics, surgical services, and acute mental health services. The insights of transaction cost economics form the theoretical framework. The objective of this study was to examine whether the transaction costs associated with contracting vary across the four different services, and whether different types of contracts and contractual relationships are emerging as transactors attempt to reduce these costs. Information was collected in a series of 53 interviews with purchasers and providers, together with any relevant documentation. The results suggest that the costs of contracting are indeed greater for some services than for others. Other variables such as the style of negotiations, the type and specificity of contracts and the degree of monitoring also differ across the four services. At this early stage of the reform process, there was little evidence that purchasers and providers were attempting to reduce transaction costs by negotiating more flexible, longer-term, relational contracts. The main benefit from contracting to date has been improved accountability of service providers.

The effect of Ontario's transmission system policies on cogeneration projects

International Nuclear Information System (INIS)

Carr, J.

1999-01-01

The impact that the establishment of transmission tariffs would have on the viability of cogeneration projects in Ontario was discussed. The proposal to establish such tariffs on the basis of a 'postage stamp' rate would ensure that all electricity users have access to electricity at the same price. However, this would unfairly penalize short-haul transmission transactions and would possibly result in the inappropriate location of new generation facilities. Electricity users would ultimately be burdened with these inefficiencies. This presentation also discussed another public policy which proposes to determine what parts of the electricity system should have their costs recovered at postage stamp rates. The costs would include not only transmission charges but also distribution and generation costs. The restructuring of Ontario Hydro into the Ontario Power Generation Company (OPGC) and the Ontario Hydro Services Company (OHSC) and its impact on the cogeneration projects was also discussed

Health Outcomes and Costs of Social Work Services: A Systematic Review.

Science.gov (United States)

Steketee, Gail; Ross, Abigail M; Wachman, Madeline K

2017-12-01

Efforts to reduce expensive health service utilization, contain costs, improve health outcomes, and address the social determinants of health require research that demonstrates the economic value of health services in population health across a variety of settings. Social workers are an integral part of the US health care system, yet the specific contributions of social work to health and cost-containment outcomes are unknown. The social work profession's person-in-environment framework and unique skillset, particularly around addressing social determinants of health, hold promise for improving health and cost outcomes. To systematically review international studies of the effect of social work-involved health services on health and economic outcomes. We searched 4 databases (PubMed, PsycINFO, CINAHL, Social Science Citation Index) by using "social work" AND "cost" and "health" for trials published from 1990 to 2017. Abstract review was followed by full-text review of all studies meeting inclusion criteria (social work services, physical health, and cost outcomes). Of the 831 abstracts found, 51 (6.1%) met criteria. Full text review yielded 16 studies involving more than 16 000 participants, including pregnant and pediatric patients, vulnerable low-income adults, and geriatric patients. We examined study quality, health and utilization outcomes, and cost outcomes. Average study quality was fair. Studies of 7 social work-led services scored higher on quality ratings than 9 studies of social workers as team members. Most studies showed positive effects on health and service utilization; cost-savings were consistent across nearly all studies. Despite positive overall effects on outcomes, variability in study methods, health problems, and cost analyses render generalizations difficult. Controlled hypothesis-driven trials are needed to examine the health and cost effects of specific services delivered by social workers independently and through interprofessional team

Quality of Security Service Costing Demonstration for the MSHN Project

National Research Council Canada - National Science Library

Spyropoulou, Evdoxia

2000-01-01

.... Each service has two costs: an initialization cost and a run-time cost. The demonstration illustrates the costs incurred as network modes and security levels are changed. High level and detailed specifications are provided.

Least cost pathways to a low carbon electricity system for Australia: impacts of transmission augmentation and extension

Science.gov (United States)

Dargaville, R. J.

2016-12-01

Designing the pathway to a low carbon energy system is complex, requiring consideration of the variable nature of renewables at the hourly timescale, emission intensity and ramp rate constraints of dispatchable technologies (both fossil and renewable) and transmission and distribution network limitations. In this work, an optimization framework taking into account these considerations has been applied to find the lowest cost ways to reduce carbon emissions by either 80% or 100% in 2050 while keeping the system operating reliably along the way. Technologies included are existing and advanced coal and gas technologies (with and without carbon capture and storage), rooftop PV, utility scale PV, concentrating solar thermal, hydro with and without pumped storage, bioenergy, and nuclear. In this study we also also the optimisation to increase transmission capacity along existing lines, and to extend key trunk lines into currently unserved areas. These augementations and extensions come at a cost. The otpimisation chooses these options when the benefits of accessing high quality renewable energy resources outweights the costs. Results show that for the 80% emission reduction case, there is limited need for transmission capacity increase, and that the existing grid copes well with the increased flows due to conversion to distrubuted renewable energy resources. However, in the 100% case the increased reliance on renewables means that signficant transmission augmentation is beneficial to the overall cost. This strongly suggests that it is important to understand the long term emission target early so that infrastructure investments can be optimised.

[Financing, organization, costs and services performance of the Argentinean health sub-systems.

Science.gov (United States)

Yavich, Natalia; Báscolo, Ernesto Pablo; Haggerty, Jeannie

2016-01-01

To analyze the relationship between health system financing and services organization models with costs and health services performance in each of Rosario's health sub-systems. The financing and organization models were characterized using secondary data. Costs were calculated using the WHO/SHA methodology. Healthcare quality was measured by a household survey (n=822). Public subsystem:Vertically integrated funding and primary healthcare as a leading strategy to provide services produced low costs and individual-oriented healthcare but with weak accessibility conditions and comprehensiveness. Private subsystem: Contractual integration and weak regulatory and coordination mechanisms produced effects opposed to those of the public sub-system. Social security: Contractual integration and strong regulatory and coordination mechanisms contributed to intermediate costs and overall high performance. Each subsystem financing and services organization model had a strong and heterogeneous influence on costs and health services performance.

Economic comparison of HVDC transmission and coal transport for Kalimantan - Sulawesi power system expansion

International Nuclear Information System (INIS)

Edwaren Liun

2016-01-01

Due to the load characteristics on many regions in Indonesia, the electrical system is often inefficient. In areas far from an interconnected network, for example isolated island, the choice of low cost fueled plants such as coal can not be applied, while the oil fueled has a very high generation cost and high burdened on subsidies. As a result, those area are still use oil fueled plant by limiting the generator flame time and consumers do not receive satisfactory service. This paper aims to analyze the extent to which the benefit of HVDC transmission system from Kalimantan to Sulawesi so that consumers could get better services and able to produce in order to improve their welfare. The method used in this analysis is a literature study and perform calculations based on existing formula. The result shows that in term of direct cost, HVDC system which covers transmission line, converter and loses cost, yield in a range of 0.46 - 0.60 USD¢/kWh for the capacity within 500 - 2000 Mwe. While coal transportation cost is in the range of 0.544 - 0.645 USD¢/kWh for long barge between 270 - 300 feet. Therefore, for the region of Indonesia which consist lots of islands and remote areas, power supply using HVDC transmission from area with more evolved electrical system could enable more economical, so that remote region also got excellent electrical services to improve the well-being and incomes of the population. (author)

Comparison of the Ministry of Health's tariffs with the cost of radiology services using the activity-based costing method.

Science.gov (United States)

Kalhor, Rohollah; Amini, Saeed; Emami, Majid; Kakasoltani, Keivan; Rhamani, Nasim; Kalhor, Leila

2016-02-01

Efficient use of resources in organizations is one of the most important duties of managers. Appropriate allocation of resources can help managers to do this well. The aim of this study was to determine the cost of radiology services and to compare it with governmental tariffs (introduced by the Ministry of Health in Iran). This was a descriptive and applied study that was conducted using the retrospective approach. First, activity centers were identified on the basis of five main groups of hospital activities. Then, resources and resource drivers, activities, and hospital activity drivers were identified. At the next step, the activities related to the delivery of radiology process were identified. Last, through allocation of activities cost to the cost objects, the cost price of 66 services that were delivered in the radiology department were calculated. The data were collected by making checklists, using the hospital's information system, observations, and interviews. Finally, the data were analyzed using the non-parametric Wilcoxon test, Microsoft Excel, and SPSS software, version 18. The findings showed that from the total cost of wages, materials, and overhead obtained, the unit cost of the 66 cost objects (delivered services) in the Radiology Department were calculated using the ABC method (Price of each unit of Nephrostogram obtained $15.8 and Cystogram obtained $18.4). The Kolmogorov-Smirnov test indicated that the distribution of data of cost price using the ABC method was not normal (p = 0.000). The Wilcoxon test showed that there was a significant difference between the cost of services and the tariff of radiology services (p = 0.000). The cost of delivered services in radiology departments was significantly higher than approved tariffs of the Ministry of Health, which can have a negative impact on the quality of services.

A survey of cost accounting in service-oriented computing

NARCIS (Netherlands)

de Medeiros, Robson W.A.; Rosa, Nelson S.; Campos, Glaucia M.M.; Ferreira Pires, Luis

Nowadays, companies are increasingly offering their business services through computational services on the Internet in order to attract more customers and increase their revenues. However, these services have financial costs that need to be managed in order to maximize profit. Several models and

Cost containment in laundry and linen service.

Science.gov (United States)

Ellis, B

1978-03-16

One major problem looms among all others in the area of laundry and linen service, whether a hospital has an in-house operation, is part of a shared or central laundry, or uses a commercial service. That is the costly problem of controling linen consumption and replacement. A recent seminar offers some insight into reasons for the problem and some possible solutions.

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

Science.gov (United States)

Cartwright, William S

2008-03-01

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

The cost effectiveness of NHS physiotherapy support for occupational health (OH) services.

Science.gov (United States)

Phillips, Ceri J; Phillips Nee Buck, Rhiannon; Main, Chris J; Watson, Paul J; Davies, Shân; Farr, Angela; Harper, Christie; Noble, Gareth; Aylward, Mansel; Packman, Julie; Downton, Matt; Hale, Janine

2012-02-23

Musculoskeletal pain is detrimental to quality of life (QOL) and disruptive to activities of daily living. It also places a major economic burden on healthcare systems and wider society. In 2006, the Welsh Assembly Government (WAG) established a three tiered self-referral Occupational Health Physiotherapy Pilot Project (OHPPP) comprising: 1.) telephone advice and triage, 2.) face-to-face physiotherapy assessment and treatment if required, and 3.) workplace assessment and a return-to-work facilitation package as appropriate. This study aimed to evaluate the feasibility and cost-effectiveness of the pilot service. A pragmatic cohort study was undertaken, with all OHPPP service users between September 2008 and February 2009 being invited to participate. Participants were assessed on clinical status, yellow flags, sickness absence and work performance at baseline, after treatment and at 3 month follow up. Cost-effectiveness was evaluated from both top-down and bottom-up perspectives and cost per Quality Adjusted Life Year (cost/QALY) was calculated. The cost-effectiveness analysis assessed the increase in service cost that would be necessary before the cost-effectiveness of the service was compromised. A total of 515 patients completed questionnaires at baseline. Of these, 486 were referred for face to face assessment with a physiotherapist and were included in the analysis for the current study. 264 (54.3%) and 199 (40.9%) were retained at end of treatment and 3 month follow up respectively. An improvement was observed at follow up in all the clinical outcomes assessed, as well as a reduction in healthcare resource usage and sickness absence, and improvement in self-reported work performance. Multivariate regression indicated that baseline and current physical health were associated with work-related outcomes at follow up. The costs of the service were £194-£360 per service user depending on the method used, and the health gains contributed to a cost/QALY of £1386

Overcoming Language Barriers in Health Care: Costs and Benefits of Interpreter Services

Science.gov (United States)

Jacobs, Elizabeth A.; Shepard, Donald S.; Suaya, Jose A.; Stone, Esta-Lee

2004-01-01

Objectives. We assessed the impact of interpreter services on the cost and the utilization of health care services among patients with limited English proficiency. Methods. We measured the change in delivery and cost of care provided to patients enrolled in a health maintenance organization before and after interpreter services were implemented. Results. Compared with English-speaking patients, patients who used the interpreter services received significantly more recommended preventive services, made more office visits, and had more prescriptions written and filled. The estimated cost of providing interpreter services was $279 per person per year. Conclusions. Providing interpreter services is a financially viable method for enhancing delivery of health care to patients with limited English proficiency. PMID:15117713

An Invocation Cost Optimization Method for Web Services in Cloud Environment

OpenAIRE

Qi, Lianyong; Yu, Jiguo; Zhou, Zhili

2017-01-01

The advent of cloud computing technology has enabled users to invoke various web services in a “pay-as-you-go” manner. However, due to the flexible pricing model of web services in cloud environment, a cloud user’ service invocation cost may be influenced by many factors (e.g., service invocation time), which brings a great challenge for cloud users’ cost-effective web service invocation. In view of this challenge, in this paper, we first investigate the multiple factors that influence the in...

A Transmission-Cost-Based Model to Estimate the Amount of Market-Integrable Wind Resources

DEFF Research Database (Denmark)

Morales González, Juan Miguel; Pinson, Pierre; Madsen, Henrik

2012-01-01

are made to share the expenses in transmission derived from their integration, they may see the doors of electricity markets closed for not being competitive enough. This paper presents a model to decide the amount of wind resources that are economically exploitable at a given location from a transmission......In the pursuit of the large-scale integration of wind power production, it is imperative to evaluate plausible frictions among the stochastic nature of wind generation, electricity markets, and the investments in transmission required to accommodate larger amounts of wind. If wind producers......-cost perspective. This model accounts for the uncertain character of wind by using a modeling framework based on stochastic optimization, simulates market barriers by means of a bi-level structure, and considers the financial risk of investments in transmission through the conditional value-at-risk. The major...

A novel beamforming based model of coverage and transmission costing in IEEE 802.11 WLAN networks

Directory of Open Access Journals (Sweden)

Mehdi Guessous

2017-09-01

Full Text Available IEEE 802.11 WLAN indoor networks face major inherent and environmental issues such as interference, noise, and obstacles. At the same time, they must provide a maximal service performance in highly changing radio environments and conformance to various applications’ requirements. For this purpose, they require a solid design approach that considers both inputs from the radio interface and the upper-layer services at every design step. The modelization of radio area coverage is a key component in this process and must build on feasible work hypotheses. It should be able also to interpret highly varying characteristics of dense indoor environments, technology advances, service design best practices, end-to-end integration with other network parts: Local Area Network (LAN, Wide Area Network (WAN or Data Center Network (DCN. This work focuses on Radio Resource Management (RRM as a key tool to achieve a solid design in WLAN indoor environments by planning frequency channel assignment, transmit directions and corresponding power levels. Its scope is limited to tackle co-channel interference but can be easily extended to address cross-channel ones. In this paper, we consider beamforming and costing techniques to augment conventional RRM’s Transmit Power Control (TPC procedures that market-leading vendors has implemented and related research has worked on. We present a novel approach of radio coverage modelization and prove its additions to the cited related-work’s models. Our solution model runs three algorithms to evaluate transmission opportunities of Wireless Devices (WD under the coverage area. It builds on realistic hypotheses and a thorough system operation’s understanding to evaluate such an opportunity to transmit, overcomes limitations from compared related-work’s models, and integrates a hierarchical costing system to match Service Level Agreement (SLA expectations. The term “opportunity” in this context relates also to the new

Comparing methodologies for the allocation of overhead and capital costs to hospital services.

Science.gov (United States)

Tan, Siok Swan; van Ineveld, Bastianus Martinus; Redekop, William Ken; Hakkaart-van Roijen, Leona

2009-06-01

Typically, little consideration is given to the allocation of indirect costs (overheads and capital) to hospital services, compared to the allocation of direct costs. Weighted service allocation is believed to provide the most accurate indirect cost estimation, but the method is time consuming. To determine whether hourly rate, inpatient day, and marginal mark-up allocation are reliable alternatives for weighted service allocation. The cost approaches were compared independently for appendectomy, hip replacement, cataract, and stroke in representative general hospitals in The Netherlands for 2005. Hourly rate allocation and inpatient day allocation produce estimates that are not significantly different from weighted service allocation. Hourly rate allocation may be a strong alternative to weighted service allocation for hospital services with a relatively short inpatient stay. The use of inpatient day allocation would likely most closely reflect the indirect cost estimates obtained by the weighted service method.

Cost analysis for the implementation of a medication review with follow-up service in Spain.

Science.gov (United States)

Noain, Aranzazu; Garcia-Cardenas, Victoria; Gastelurrutia, Miguel Angel; Malet-Larrea, Amaia; Martinez-Martinez, Fernando; Sabater-Hernandez, Daniel; Benrimoj, Shalom I

2017-08-01

Background Medication review with follow-up (MRF) is a professional pharmacy service proven to be cost-effective. Its broader implementation is limited, mainly due to the lack of evidence-based implementation programs that include economic and financial analysis. Objective To analyse the costs and estimate the price of providing and implementing MRF. Setting Community pharmacy in Spain. Method Elderly patients using poly-pharmacy received a community pharmacist-led MRF for 6 months. The cost analysis was based on the time-driven activity based costing model and included the provider costs, initial investment costs and maintenance expenses. The service price was estimated using the labour costs, costs associated with service provision, potential number of patients receiving the service and mark-up. Main outcome measures Costs and potential price of MRF. Results A mean time of 404.4 (SD 232.2) was spent on service provision and was extrapolated to annual costs. Service provider cost per patient ranged from €196 (SD 90.5) to €310 (SD 164.4). The mean initial investment per pharmacy was €4594 and the mean annual maintenance costs €3,068. Largest items contributing to cost were initial staff training, continuing education and renting of the patient counselling area. The potential service price ranged from €237 to €628 per patient a year. Conclusion Time spent by the service provider accounted for 75-95% of the final cost, followed by initial investment costs and maintenance costs. Remuneration for professional pharmacy services provision must cover service costs and appropriate profit, allowing for their long-term sustainability.

Stop wheeling and start dealing. Resolving the transmission dilemma

International Nuclear Information System (INIS)

Ruff, L.E.

1996-01-01

The author distinguishes the role of a Gridco that owns actual transmission assets from that of a Poolco that must dispatch generation and transmission optimally to meet time- and space-differentiated customer demands. He contends that present wheeling orders that convert high-voltage wires of generation and transmission companies into 'open access' transmission providers while maintaining their control of dispatch are skewed; rather, the Poolco must charge the same prices for comparable transmission services provided to any customer. Transmission plant must always be dispatched in a least-cost fashion; contracts-for-differences enable customers to hedge against extreme price fluctuations that may arise. Poolco payments should be made to an independent Gridco as compensation for providing its physical grid; necessary revenues must be recovered from Poolco customers. 6 figs

Stop wheeling and start dealing. Resolving the transmission dilemma

Energy Technology Data Exchange (ETDEWEB)

Ruff, L.E. [Putnam, Hayes and Bartlett, Inc., Washington, DC (United States)

1996-12-31

The author distinguishes the role of a Gridco that owns actual transmission assets from that of a Poolco that must dispatch generation and transmission optimally to meet time- and space-differentiated customer demands. He contends that present wheeling orders that convert high-voltage wires of generation and transmission companies into `open access` transmission providers while maintaining their control of dispatch are skewed; rather, the Poolco must charge the same prices for comparable transmission services provided to any customer. Transmission plant must always be dispatched in a least-cost fashion; contracts-for-differences enable customers to hedge against extreme price fluctuations that may arise. Poolco payments should be made to an independent Gridco as compensation for providing its physical grid; necessary revenues must be recovered from Poolco customers. 6 figs.

A Transmission Company at the Cross-Roads

Energy Technology Data Exchange (ETDEWEB)

Heinrich, Christian [Thyssengas GmbH, (Germany)

1998-12-31

This presentation discusses the role of the gas transmission companies. Gas pipelines are usually tailor-made for a specified gas flow and a specified point of delivery and cannot be used cost-effectively for other purposes. This means that producer and importer are much closer linked than for any other energy and both have a strong common interest in meeting their long-term obligations. The risks connected with the investments in the infrastructure are shared among the partners in the supply chain. In Germany, gas has always had to compete with oil, electricity or coal. Gas has been able to replace oil to a great extent since, being an integrated package of commodity and services, it has offered far more than just gas molecules. The traditional sharing of roles between exploration/production on the one hand and import/distribution/market development on the other hand has proved its worth in the past decades although it has taken different forms in different countries. The liberalization laws of the EU are influencing the current buyer`s market. As a result, the transmission companies are at a crossroads. They must face the question whether they are the most efficient and cost-effective providers of the services required in the value-added chain. In addition to gas delivery, they must also offer a variety of new services in line with the customer`s needs and at a competitive price. The transmission companies will be the right partners for both producers and end consumers

Activity-Based Costing in User Services of an Academic Library.

Science.gov (United States)

Ellis-Newman, Jennifer

2003-01-01

The rationale for using Activity-Based Costing (ABC) in a library is to allocate indirect costs to products and services based on the factors that most influence them. This paper discusses the benefits of ABC to library managers and explains the steps involved in implementing ABC in the user services area of an Australian academic library.…

The cost effectiveness of NHS physiotherapy support for occupational health (OH services

Directory of Open Access Journals (Sweden)

Phillips Ceri J

2012-02-01

Full Text Available Abstract Background Musculoskeletal pain is detrimental to quality of life (QOL and disruptive to activities of daily living. It also places a major economic burden on healthcare systems and wider society. In 2006, the Welsh Assembly Government (WAG established a three tiered self-referral Occupational Health Physiotherapy Pilot Project (OHPPP comprising: 1. telephone advice and triage, 2. face-to-face physiotherapy assessment and treatment if required, and 3. workplace assessment and a return-to-work facilitation package as appropriate. This study aimed to evaluate the feasibility and cost-effectiveness of the pilot service. Methods A pragmatic cohort study was undertaken, with all OHPPP service users between September 2008 and February 2009 being invited to participate. Participants were assessed on clinical status, yellow flags, sickness absence and work performance at baseline, after treatment and at 3 month follow up. Cost-effectiveness was evaluated from both top-down and bottom-up perspectives and cost per Quality Adjusted Life Year (cost/QALY was calculated. The cost-effectiveness analysis assessed the increase in service cost that would be necessary before the cost-effectiveness of the service was compromised. Results A total of 515 patients completed questionnaires at baseline. Of these, 486 were referred for face to face assessment with a physiotherapist and were included in the analysis for the current study. 264 (54.3% and 199 (40.9% were retained at end of treatment and 3 month follow up respectively. An improvement was observed at follow up in all the clinical outcomes assessed, as well as a reduction in healthcare resource usage and sickness absence, and improvement in self-reported work performance. Multivariate regression indicated that baseline and current physical health were associated with work-related outcomes at follow up. The costs of the service were £194-£360 per service user depending on the method used, and the

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...

Bulk Electric Load Cost Calculation Methods: Iraqi Network Comparative Study

Directory of Open Access Journals (Sweden)

Qais M. Alias

2016-09-01

Full Text Available It is vital in any industry to regain the spent capitals plus running costs and a margin of profits for the industry to flourish. The electricity industry is an everyday life touching industry which follows the same finance-economic strategy. Cost allocation is a major issue in all sectors of the electric industry, viz, generation, transmission and distribution. Generation and distribution service costing’s well documented in the literature, while the transmission share is still of need for research. In this work, the cost of supplying a bulk electric load connected to the EHV system is calculated. A sample basic lump-average method is used to provide a rough costing guide. Also, two transmission pricing methods are employed, namely, the postage-stamp and the load-flow based MW-distance methods to calculate transmission share in the total cost of each individual bulk load. The three costing methods results are then analyzed and compared for the 400kV Iraqi power grid considered for a case study.

Costs of providing tuberculosis diagnosis and treatment services in Viet Nam.

Science.gov (United States)

Minh, H V; Mai, V Q; Nhung, N V; Hoi, L V; Giang, K B; Chung, L H; Kien, V D; Duyen, N T; Ngoc, N B; Anh, T T; Phuong, T B; Ngan, T T; Khanh, P H

2017-09-01

To estimate the cost of providing tuberculosis (TB) diagnosis and treatment packages at different levels of health facilities in Viet Nam. This was a retrospective costing study from the providers' perspective using a standard costing approach. We included typical services for TB diagnosis and treatment based on standard protocols. The least expensive TB service was the 6-month isoniazid preventive therapy regimen for latent tuberculous infection provided by district health centres (US$7.20-14.30, accounting for 0.3-0.7% of Viet Nam's per capita gross domestic product [GDP] of US$2052.30 in 2014). The cost of diagnosing and treating a patient with drug-susceptible TB (the most common type of TB) ranged between US$51.20 and US$180.70, and represented 2.5-8.8% of Viet Nam's per capita GDP in 2014. The most expensive TB service was the diagnosis and treatment of a multidrug-resistant TB case (US$1568.20-2391.20), accounting for 76.4-116.5% of Viet Nam's per capita GDP in 2014). The cost of TB diagnosis and treatment services in Viet Nam varied according to level of health facility, type of TB, different costing options, and different staff cost scenarios.

Differential Game Analyses of Logistics Service Supply Chain Coordination by Cost Sharing Contract

Directory of Open Access Journals (Sweden)

Haifeng Zhao

2014-01-01

Full Text Available Cooperation of all the members in a supply chain plays an important role in logistics service. The service integrator can encourage cooperation from service suppliers by sharing their cost during the service, which we assume can increase the sales by accumulating the reputation of the supply chain. A differential game model is established with the logistics service supply chain that consists of one service integrator and one supplier. And we derive the optimal solutions of the Nash equilibrium without cost sharing contract and the Stackelberg equilibrium with the integrator as the leader who partially shares the cost of the efforts of the supplier. The results make the benefits of the cost sharing contract in increasing the profits of both players as well as the whole supply chain explicit, which means that the cost sharing contract is an effective coordination mechanism in the long-term relationship of the members in a logistics service supply chain.

Strategic cost management, contingent factors and performance in services

Directory of Open Access Journals (Sweden)

Odysseas Pavlatos

2018-06-01

Full Text Available The purpose of this paper is to investigate the relationship between contextual factors identified from contingency-based research, the extent of the use of strategic cost management (SCM techniques and business performance in services. An empirical survey was conducted on a sample of 88 services in Greece. The analysis of the survey data indicates that the use of strategic cost management techniques in services can be considered quite satisfactory. By drawing on the grounds of contingency theory, five factors were identified as potentially exhibiting an emergent relationship with strategic cost management. The five factors are; (1 Perceived environmental uncertainty, (2 Structure, (3 Organizational life cycle stage, (4 Strategy and (5 Size. The survey revealed that SCM usage is positively affected by these five contingent factors, while SCM usage, in turn, positively affects performance. A significant mediating effect of SCM usage on performance is evident.

Health Outcomes and Costs of Social Work Services: A Systematic Review

Science.gov (United States)

Ross, Abigail M.; Wachman, Madeline K.

2017-01-01

Background. Efforts to reduce expensive health service utilization, contain costs, improve health outcomes, and address the social determinants of health require research that demonstrates the economic value of health services in population health across a variety of settings. Social workers are an integral part of the US health care system, yet the specific contributions of social work to health and cost-containment outcomes are unknown. The social work profession’s person-in-environment framework and unique skillset, particularly around addressing social determinants of health, hold promise for improving health and cost outcomes. Objectives. To systematically review international studies of the effect of social work–involved health services on health and economic outcomes. Search Methods. We searched 4 databases (PubMed, PsycINFO, CINAHL, Social Science Citation Index) by using “social work” AND “cost” and “health” for trials published from 1990 to 2017. Selection Criteria. Abstract review was followed by full-text review of all studies meeting inclusion criteria (social work services, physical health, and cost outcomes). Data Collection and Analysis. Of the 831 abstracts found, 51 (6.1%) met criteria. Full text review yielded 16 studies involving more than 16 000 participants, including pregnant and pediatric patients, vulnerable low-income adults, and geriatric patients. We examined study quality, health and utilization outcomes, and cost outcomes. Main Results. Average study quality was fair. Studies of 7 social work–led services scored higher on quality ratings than 9 studies of social workers as team members. Most studies showed positive effects on health and service utilization; cost-savings were consistent across nearly all studies. Conclusions. Despite positive overall effects on outcomes, variability in study methods, health problems, and cost analyses render generalizations difficult. Controlled hypothesis-driven trials are needed to

Costs of a school-based dental mobile service in South Africa.

Science.gov (United States)

Molete, M P; Chola, L; Hofman, K J

2016-10-19

The burden of untreated tooth decay remains high and oral healthcare utilisation is low for the majority of children in South Africa. There is need for alternative methods of improving access to low cost oral healthcare. The mobile dental unit of the University of the Witwatersrand (Wits) has been operational for over 25 years, providing alternative oral healthcare to children and adults who otherwise would not have access. The aim of this study was to conduct a cost-analysis of a school based oral healthcare program in the Wits mobile dental unit. The objectives were to estimate the general costs of the school based program, costs of oral healthcare per patient and the economic implications of providing services at scale. In 2012, the Wits mobile dental unit embarked on a 5 month project to provide oral healthcare in four schools located around Johannesburg. Cost and service use data were retrospectively collected from the program records for the cost analysis, which was undertaken from a provider perspective. The costs considered included both financial and economic costs. Capital costs were annualised and discounted at 6 %. One way sensitivity tests were conducted for uncertain parameters. The total economic costs were R813.701 (US$76,048). The cost of screening and treatment per patient were R331 (US$31) and R743 (US$69) respectively. Furthermore, fissure sealants cost the least out of the treatments provided. The sensitivity analysis indicated that the Wits mobile dental unit was cost efficient at 25 % allocation of staff time and that a Dental Therapy led service could save costs by 9.1 %. Expanding the services to a wider population of children and utilising Dental Therapists as key personnel could improve the efficiency of mobile dental healthcare provision.

Business aspects and cost advantages of partnering for fossil engineering services

International Nuclear Information System (INIS)

Featham, M.D.; Sensenig, R.G.

1995-01-01

In today's environment where utility companies are attempting to reduce costs, alternative cost competitive approaches are being adopted to traditional fossil power plant engineering. One approach is to utilize Partnering of multiple organizations to provide cost competitive and quality engineering services. An approach to Partnering that involves Florida Power Corporation Partnering with multiple architect/engineers to provide the fossil plant engineering services is described in this paper

The calculation of costs of postal network and universal postal service based on standard and average cost principles

Directory of Open Access Journals (Sweden)

Blagojević Mladenka Z.

2017-01-01

Full Text Available The provision of universal postal service involves high costs for operator, especially in rural areas. The aim of this paper is to propose and test tool for managing the cost of providing universal postal service and maintaining the postal network in order to facilitate understanding of the problem in the sector. The proposed approach use standard prices and standard quantities (the redefined number of postal units, the number of employees, etc. as well as average costs for calculation of the costs of the universal postal service and postal network. The methodology provides the efficiency analysis, benchmarking and identification of causes of poor performance of management and resource allocation. It can be used for postal operators that do not have modern accounting systems.

Unit cost of medical services at different hospitals in India.

Directory of Open Access Journals (Sweden)

Susmita Chatterjee

Full Text Available Institutional care is a growing component of health care costs in low- and middle-income countries, but local health planners in these countries have inadequate knowledge of the costs of different medical services. In India, greater utilisation of hospital services is driven both by rising incomes and by government insurance programmes that cover the cost of inpatient services; however, there is still a paucity of unit cost information from Indian hospitals. In this study, we estimated operating costs and cost per outpatient visit, cost per inpatient stay, cost per emergency room visit, and cost per surgery for five hospitals of different types across India: a 57-bed charitable hospital, a 200-bed private hospital, a 400-bed government district hospital, a 655-bed private teaching hospital, and a 778-bed government tertiary care hospital for the financial year 2010-11. The major cost component varied among human resources, capital costs, and material costs, by hospital type. The outpatient visit cost ranged from Rs. 94 (district hospital to Rs. 2,213 (private hospital (USD 1 = INR 52. The inpatient stay cost was Rs. 345 in the private teaching hospital, Rs. 394 in the district hospital, Rs. 614 in the tertiary care hospital, Rs. 1,959 in the charitable hospital, and Rs. 6,996 in the private hospital. Our study results can help hospital administrators understand their cost structures and run their facilities more efficiently, and we identify areas where improvements in efficiency might significantly lower unit costs. The study also demonstrates that detailed costing of Indian hospital operations is both feasible and essential, given the significant variation in the country's hospital types. Because of the size and diversity of the country and variations across hospitals, a large-scale study should be undertaken to refine hospital costing for different types of hospitals so that the results can be used for policy purposes, such as revising

Unit Cost of Medical Services at Different Hospitals in India

Science.gov (United States)

Chatterjee, Susmita; Levin, Carol; Laxminarayan, Ramanan

2013-01-01

Institutional care is a growing component of health care costs in low- and middle-income countries, but local health planners in these countries have inadequate knowledge of the costs of different medical services. In India, greater utilisation of hospital services is driven both by rising incomes and by government insurance programmes that cover the cost of inpatient services; however, there is still a paucity of unit cost information from Indian hospitals. In this study, we estimated operating costs and cost per outpatient visit, cost per inpatient stay, cost per emergency room visit, and cost per surgery for five hospitals of different types across India: a 57-bed charitable hospital, a 200-bed private hospital, a 400-bed government district hospital, a 655-bed private teaching hospital, and a 778-bed government tertiary care hospital for the financial year 2010–11. The major cost component varied among human resources, capital costs, and material costs, by hospital type. The outpatient visit cost ranged from Rs. 94 (district hospital) to Rs. 2,213 (private hospital) (USD 1 = INR 52). The inpatient stay cost was Rs. 345 in the private teaching hospital, Rs. 394 in the district hospital, Rs. 614 in the tertiary care hospital, Rs. 1,959 in the charitable hospital, and Rs. 6,996 in the private hospital. Our study results can help hospital administrators understand their cost structures and run their facilities more efficiently, and we identify areas where improvements in efficiency might significantly lower unit costs. The study also demonstrates that detailed costing of Indian hospital operations is both feasible and essential, given the significant variation in the country’s hospital types. Because of the size and diversity of the country and variations across hospitals, a large-scale study should be undertaken to refine hospital costing for different types of hospitals so that the results can be used for policy purposes, such as revising payment rates

Regional Transmission Projects: Finding Solutions

Energy Technology Data Exchange (ETDEWEB)

The Keystone Center

2005-06-15

The Keystone Center convened and facilitated a year-long Dialogue on "Regional Transmission Projects: Finding Solutions" to develop recommendations that will help address the difficult and contentious issues related to expansions of regional electric transmission systems that are needed for reliable and economic transmission of power within and across regions. This effort brought together a cross-section of affected stakeholders and thought leaders to address the problem with the collective wisdom of their experience and interests. Transmission owners sat at the table with consumer advocates and environmental organizations. Representatives from regional transmission organizations exchanged ideas with state and federal regulators. Generation developers explored common interests with public power suppliers. Together, the Dialogue participants developed consensus solutions about how to begin unraveling some of the more intractable issues surrounding identification of need, allocation of costs, and reaching consensus on siting issues that can frustrate the development of regional transmission infrastructure. The recommendations fall into three broad categories: 1. Recommendations on appropriate institutional arrangements and processes for achieving regional consensus on the need for new or expanded transmission infrastructure 2. Recommendations on the process for siting of transmission lines 3. Recommendations on the tools needed to support regional planning, cost allocation, and siting efforts. List of Dialogue participants: List of Dialogue Participants: American Electric Power American Transmission Company American Wind Energy Association California ISO Calpine Corporation Cinergy Edison Electric Institute Environmental Defense Federal Energy Regulatory Commission Great River Energy International Transmission Company ISO-New England Iowa Public Utility Board Kanner & Associates Midwest ISO National Association of Regulatory Utility Commissioners National Association

48 CFR 5152.245-9001 - Government property for installation support services (cost-reimbursement contracts).

Science.gov (United States)

2010-10-01

... installation support services (cost-reimbursement contracts). 5152.245-9001 Section 5152.245-9001 Federal... CONTRACT CLAUSES 5152.245-9001 Government property for installation support services (cost-reimbursement... Installation Support Services (Cost-Reimbursement Contracts) (OCT 1989) (DEV) (a) Government-furnished property...

Cost-effectiveness of midwifery services vs. medical services in Quebec. LEquipe dEvaluation des Projets-Pilotes Sages-Femmes.

Science.gov (United States)

Reinharz, D; Blais, R; Fraser, W D; Contandriopoulos, A P

2000-01-01

This study compared the cost-effectiveness of midwife services provided in birth centres operating as pilot projects with current hospital-based medical services in the province of Quebec. One thousand midwives' clients were matched with 1,000 physicians' clients on the basis of socio-demographic characteristics and obstetrical risk. Direct costs for the prenatal, intrapartum and postpartum periods were estimated. Effectiveness was assessed on the basis of three clinical indicators and four indices related to the individualization of care as assessed by women. Results show that the costs of midwife services were barely lower than or equal to those of physician services, but cost-effectiveness ratios were to the advantage of the midwife group, except for one clinical indicator (neonatal ventilation). Overall, this study provides rational support for the process of legalizing midwifery in the province.

Transmission : roadway to a competitive electricity market

Energy Technology Data Exchange (ETDEWEB)

Thon, S. [AltaLink L.P., AB (Canada)

2002-07-01

Having a variety of suppliers, marketers and retailers is the key to developing a successful electricity market which is more competitive on pricing, with less price volatility, more innovative customer products and higher levels of customer services. Some areas of Alberta are developing their own power markets with limited capacity to interact. These include Pincher Creek, Empress, Calgary, Edmonton, and Fort McMurray. It was noted that increasing transmission capacity is the key to ensuring a bigger and more competitive electricity market. Transmission constraints only encourage a small number of suppliers to control the market. The current cost of transmission capacity accounts for less than 5 per cent of an average residential customer's bill, but it plays a major role in providing more choice to competitive electricity suppliers. Developing more transmission capacity will create an even more competitive market that benefits both consumers and suppliers. Prices in Alberta have been very volatile in the past couple of years because of supply and demand issues, and there is a need to increase market liquidity. Alberta's Transmission Administrator is looking to expand the transmission network to alleviate constraints and to lower the cost of power generation, regardless of location. These expansions are not expected to affect customers' bills by more than 2 to 3 per cent. Such transmission concerns are being felt all over North America. The Federal Energy Regulatory Commission (FERC) in the United States also recognizes the link between transmission and creating a competitive electricity market.

Hidden Costs in Paediatric Psychiatry Consultation Liaison Services

LENUS (Irish Health Repository)

Kehoe, C

2018-03-01

It is recognised that children attending paediatric services have an increased rate of mental health (MH) problems1. Hospital based Mental Health services, interchangeably termed Psychiatric Consultation Liaison Services (PCLS), or Psychological Medicine, exist in the large hospitals, and collaborate with their paediatric colleagues, offering assessment and intervention as required. However, PCLS may also have a role in providing Emergency MH assessments for young people presenting to the Emergency Department (ED), a role independent of their paediatric colleagues. In some cases, these children will need to be admitted to an acute paediatric bed for the management of their mental health illness or psychological distress, awaiting transfer to a child psychiatry specialised bed, or discharge to community services. The profile and costs of these cases are inadequately captured by both HSE CAMHS Annual Reporting System3,4 and the Healthcare Pricing Office (HIPE)2 as they often inadequately record MH referrals. This study explores the costs associated with a cohort of patients presenting to a large paediatric hospital ED, and managed by PCLS, in a one-year period.

Defense Finance and Accounting Service Administration of Unit Costs

National Research Council Canada - National Science Library

Lay, F

1996-01-01

...) of products or outputs produced. Audit Objectives. We conducted this part of our audit to find out whether unit costs for goods and services provided by DFAS were determined in accordance with DoD policies and based on actual costs incurred...

Cost analysis and exploratory cost-effectiveness of youth-friendly sexual and reproductive health services in the Republic of Moldova

Science.gov (United States)

2014-01-01

Background Youth-friendly sexual and reproductive health services (YFHS) have high priority in many countries. Yet, little is known about the cost and cost-effectiveness of good quality YFHS in resource limited settings. This paper analyses retrospectively costs and potential cost-effectiveness of four well performing youth-friendly health centres (YFHC) in Moldova. This study assesses: (1) what were the costs of YFHSs at centre level, (2) how much would scaling-up to a national good quality YFHS programme cost, and (3) was the programme potentially cost-effective? Methods Four well performing YFHCs were selected for the study. YFHS costs were analysed per centre, funding source, service and person reached. The costing results were extrapolated to estimate cost of a good quality national YFHS programme in Moldova. A threshold analysis was carried out to estimate the required impact level for the YFHSs to break-even (become cost saving). Results Average annual cost of a well performing YFHC was USD 26,000 in 2011. 58% was financed by the National Health Insurance Company and the rest by external donors (42%). Personnel salaries were the largest expense category (47%). The annual implementation costs of a good quality YFHSs in all 38 YFHCs of Moldova were estimated to be USD 1.0 million. The results of the threshold analysis indicate that the annual break-even impact points in a YFHC for: 1) STI services would be >364 averted STIs, 2) early pregnancy and contraceptive services >178 averted unwanted pregnancies, and 3) HIV services only >0.65 averted new HIV infections. Conclusions The costing results highlight the following: 1) significant additional resources would be required for implementation of a good quality national YFHS programme, 2) the four well performing YFHCs rely heavily on external funding (42%), 3) which raises questions about financial sustainability of the programme. At the same time results of the threshold analysis are encouraging. The result

Cost analysis and exploratory cost-effectiveness of youth-friendly sexual and reproductive health services in the Republic of Moldova.

Science.gov (United States)

Kempers, Jari; Ketting, Evert; Lesco, Galina

2014-07-21

Youth-friendly sexual and reproductive health services (YFHS) have high priority in many countries. Yet, little is known about the cost and cost-effectiveness of good quality YFHS in resource limited settings. This paper analyses retrospectively costs and potential cost-effectiveness of four well performing youth-friendly health centres (YFHC) in Moldova. This study assesses: (1) what were the costs of YFHSs at centre level, (2) how much would scaling-up to a national good quality YFHS programme cost, and (3) was the programme potentially cost-effective? Four well performing YFHCs were selected for the study. YFHS costs were analysed per centre, funding source, service and person reached. The costing results were extrapolated to estimate cost of a good quality national YFHS programme in Moldova. A threshold analysis was carried out to estimate the required impact level for the YFHSs to break-even (become cost saving). Average annual cost of a well performing YFHC was USD 26,000 in 2011. 58% was financed by the National Health Insurance Company and the rest by external donors (42%). Personnel salaries were the largest expense category (47%). The annual implementation costs of a good quality YFHSs in all 38 YFHCs of Moldova were estimated to be USD 1.0 million. The results of the threshold analysis indicate that the annual break-even impact points in a YFHC for: 1) STI services would be >364 averted STIs, 2) early pregnancy and contraceptive services >178 averted unwanted pregnancies, and 3) HIV services only >0.65 averted new HIV infections. The costing results highlight the following: 1) significant additional resources would be required for implementation of a good quality national YFHS programme, 2) the four well performing YFHCs rely heavily on external funding (42%), 3) which raises questions about financial sustainability of the programme. At the same time results of the threshold analysis are encouraging. The result suggest that, together the three SRH

Transmission investment and planning in deregulated market environment : a literature survey (part 2)

International Nuclear Information System (INIS)

Wen, F.; Wu, F.F.

2005-01-01

This paper is the second half of a 2-part paper that provided details of a comprehensive survey of issues related to transmission investment and expansion planning in the electricity market. Results of the survey suggested that transmission regulation is needed to provide a fair playing field for competition and to ensure that transmission networks are optimally expanded while also meeting reliability constraints. Regulations will create further incentives for cost reduction while ensuring that regulated firms have assurance of cost recovery. Transmission planning should be controlled or monitored by a government organization or regulator. Legislation is needed to ensure that regulatory authorities can enforce reliability criteria. Mandatory reliability standards and metrics for reliability services should be implemented. The economic benefits of transmission expansion in a deregulated market should be modelled using non-deterministic approaches. It was concluded that transmission expansion plans should be able to meet future transmission capacity requirements, secure returns on investment, and ensure reliability levels for customers. Various international transmission expansion plans were also provided. 38 refs

Activity-Based Costing in the After Press Services Industry

Science.gov (United States)

Shevasuthisilp, Suntichai; Punsathitwong, Kosum

2009-10-01

This research was conducted to apply activity-based costing (ABC) in an after press service company in Chiang Mai province, Thailand. The company produces all of its products by one-stop service (such as coating, stitching, binding, die cutting, and gluing). All products are made to order, and have different sizes and patterns. A strategy of low price is used to compete in the marketplace. After cost analysis, the study found that the company has high overhead (36.5% of total cost). The company's problem is its use of traditional cost accounting, which has low accuracy in assigning overhead costs. If management uses this information when pricing customer orders, losses may occur because real production costs may be higher than the selling price. Therefore, the application of ABC in cost analysis can help executives receive accurate cost information; establish a sound pricing strategy; and improve the manufacturing process by determining work activities which have excessively high production costs. According to this research, 6 out of 56 items had a production cost higher than the selling price, leading to losses of 123,923 baht per year. Methods used to solve this problem were: reducing production costs; establishing suitable prices; and creating a sales promotion with lower prices for customers whose orders include processes involving unused capacity. These actions will increase overall sales of the company, and allow more efficient use of its machinery.

A cost function analysis of child health services in four districts in Malawi.

Science.gov (United States)

Johns, Benjamin; Munthali, Spy; Walker, Damian G; Masanjala, Winford; Bishai, David

2013-05-10

Recent analyses show that donor funding for child health is increasing, but little information is available on actual costs to deliver child health care services. Understanding how unit costs scale with service volume in Malawi can help planners allocate budgets as health services expand. Data on facility level inputs and outputs were collected at 24 health centres in four districts of Malawi visiting a random sample of government and a convenience sample of Christian Health Association of Malawi (CHAM) health centres. In the cost function, total outputs, quality, facility ownership, average salaries and case mix are used to predict total cost. Regression analysis identifies marginal cost as the coefficient relating cost to service volume intensity. The marginal cost per patient seen for all health centres surveyed was US$ 0.82 per additional patient visit. Average cost was US$ 7.16 (95% CI: 5.24 to 9.08) at government facilities and US$ 10.36 (95% CI: 4.92 to 15.80) at CHAM facilities per child seen for any service. The first-line anti-malarial drug accounted for over 30% of costs, on average, at government health centres. Donors directly financed 40% and 21% of costs at government and CHAM health centres, respectively. The regression models indicate higher total costs are associated with a greater number of outpatient visits but that many health centres are not providing services at optimal volume given their inputs. They also indicate that CHAM facilities have higher costs than government facilities for similar levels of utilization. We conclude by discussing ways in which efficiency may be improved at health centres. The first option, increasing the total number of patients seen, appears difficult given existing high levels of child utilization; increasing the volume of adult patients may help spread fixed and semi-fixed costs. A second option, improving the quality of services, also presents difficulties but could also usefully improve performance.

Cost Analysis of Operation Theatre Services at an Apex Tertiary Care Trauma Centre of India.

Science.gov (United States)

Siddharth, Vijaydeep; Kumar, Subodh; Vij, Aarti; Gupta, Shakti Kumar

2015-12-01

Operating room services are one of the major cost and revenue-generating centres of a hospital. The cost associated with the provisioning of operating department services depends on the resources consumed and the unit costs of those resources. The objective of this study was to calculate the cost of operation theatre services at Jai Prakash Narayan Apex Trauma Centre, AIIMS, New Delhi. The study was carried out at the operation theatre department of Jai Prakash Narayan Apex Trauma Centre (JPNATC), AIIMS from April 2010 to March 2011 after obtaining approval from concerned authorities. This study was observational and descriptive in nature. Traditional (average or gross) costing methodology was used to arrive at the cost for the provisioning of operation theatre (OT) services. Cost was calculated under two heads; as capital and operating cost. Annualised cost of capital assets was calculated according to the methodology prescribed by the World Health Organization and operating costs were taken on actual basis; thereafter, per day cost of OT services was obtained. The average number of surgeries performed in the trauma centre per day is 13. The annual cost of providing operating room services at JPNATC, New Delhi was calculated to be 197,298,704 Indian rupees (INR) (US$ 3,653,679), while the per hour cost was calculated to be INR 22,626.92 (US$ 419). Majority of the expenditures were for human resource (33.63 %) followed by OT capital cost (31.90 %), consumables (29.97 %), engineering maintenance cost (2.55 %), support services operating cost (1.22 %) and support services capital cost (0.73 %). Of the total cost towards the provisioning of OT services, 32.63 % was capital cost while 67.37 % is operating cost. The results of this costing study will help in the future planning of resource allocation within the financial constraints (US$ 1 = INR 54).

The economics of planning electricity transmission to accommodate renewables: Using two-stage optimisation to evaluate flexibility and the cost of disregarding uncertainty

International Nuclear Information System (INIS)

Weijde, Adriaan Hendrik van der; Hobbs, Benjamin F.

2012-01-01

Aggressive development of renewable electricity sources will require significant expansions in transmission infrastructure. We present a stochastic two-stage optimisation model that captures the multistage nature of transmission planning under uncertainty and use it to evaluate interregional grid reinforcements in Great Britain (GB). In our model, a proactive transmission planner makes investment decisions in two time periods, each time followed by a market response. Uncertainty is represented by economic, technology, and regulatory scenarios, and first-stage investments must be made before it is known which scenario will occur. The model allows us to identify expected cost-minimising first-stage investments, as well as estimate the value of information, the cost of ignoring uncertainty, and the value of flexibility. Our results show that ignoring risk in planning transmission for renewables has quantifiable economic consequences, and that considering uncertainty can yield decisions that have lower expected costs than traditional deterministic planning methods. In the GB case, the value of information and cost of disregarding uncertainty in transmission planning were of the same order of magnitude (approximately £100 M, in present worth terms). Further, the best plan under a risk-neutral decision criterion can differ from the best under risk-aversion. Finally, a traditional sensitivity analysis-based robustness analysis also yields different results than the stochastic model, although the former's expected cost is not much higher.

7 CFR 160.204 - Fees for extra cost and hourly rate service.

Science.gov (United States)

2010-01-01

... 7 Agriculture 3 2010-01-01 2010-01-01 false Fees for extra cost and hourly rate service. 160.204... STORES REGULATIONS AND STANDARDS FOR NAVAL STORES Specific Fees Payable for Services Rendered § 160.204 Fees for extra cost and hourly rate service. The fees specified in §§ 160.201 and 160.202 apply to the...

Estimating the Cost of Providing Foundational Public Health Services.

Science.gov (United States)

Mamaril, Cezar Brian C; Mays, Glen P; Branham, Douglas Keith; Bekemeier, Betty; Marlowe, Justin; Timsina, Lava

2017-12-28

To estimate the cost of resources required to implement a set of Foundational Public Health Services (FPHS) as recommended by the Institute of Medicine. A stochastic simulation model was used to generate probability distributions of input and output costs across 11 FPHS domains. We used an implementation attainment scale to estimate costs of fully implementing FPHS. We use data collected from a diverse cohort of 19 public health agencies located in three states that implemented the FPHS cost estimation methodology in their agencies during 2014-2015. The average agency incurred costs of $48 per capita implementing FPHS at their current attainment levels with a coefficient of variation (CV) of 16 percent. Achieving full FPHS implementation would require $82 per capita (CV=19 percent), indicating an estimated resource gap of $34 per capita. Substantial variation in costs exists across communities in resources currently devoted to implementing FPHS, with even larger variation in resources needed for full attainment. Reducing geographic inequities in FPHS may require novel financing mechanisms and delivery models that allow health agencies to have robust roles within the health system and realize a minimum package of public health services for the nation. © Health Research and Educational Trust.

The Cost of Health Services Delivery in Health Houses of Alborz: A Case Study

Directory of Open Access Journals (Sweden)

Javad Ghoddousinejad

2015-07-01

Full Text Available Background and Objectives : Health houses play an active role to improve health status of rural population.Furthermore, it is important to know the costs of provided services. This research was designed to determine the costs of healthcare delivery in health houses of ALBORZ district. Material and Methods : In this cross-sectional descriptive study, Activity Based Costing (ABC was used to analyze the costs of services. Results : The average Direct Costs (DC of healthcare delivery in health houses was estimated 37033365 Rials. Direct and Indirect Costs (IC of service delivery in health houses were 65.91% and 34.09% of Total Costs (TC respectively. Conclusion : Since human resources play the most important role in determining the costs of health services delivery in healthcare, reforming payment mechanisms would be a suitable solution to reduce extra costs. Moreover, in order to decrease extra costs, it is essential to modify activities and eliminate parallel tasks.

The cost and utilisation patterns of a pilot sign language interpreter service for primary health care services in South Africa.

Directory of Open Access Journals (Sweden)

Tryphine Zulu

Full Text Available The World Health Organisation estimates disabling hearing loss to be around 5.3%, while a study of hearing impairment and auditory pathology in Limpopo, South Africa found a prevalence of nearly 9%. Although Sign Language Interpreters (SLIs improve the communication challenges in health care, they are unaffordable for many signing Deaf people and people with disabling hearing loss. On the other hand, there are no legal provisions in place to ensure the provision of SLIs in the health sector in most countries including South Africa. To advocate for funding of such initiatives, reliable cost estimates are essential and such data is scarce. To bridge this gap, this study estimated the costs of providing such a service within a South African District health service based on estimates obtained from a pilot-project that initiated the first South African Sign Language Interpreter (SASLI service in health-care.The ingredients method was used to calculate the unit cost per SASLI-assisted visit from a provider perspective. The unit costs per SASLI-assisted visit were then used in estimating the costs of scaling up this service to the District Health Services. The average annual SASLI utilisation rate per person was calculated on Stata v.12 using the projects' registry from 2008-2013. Sensitivity analyses were carried out to determine the effect of changing the discount rate and personnel costs.Average Sign Language Interpreter services' utilisation rates increased from 1.66 to 3.58 per person per year, with a median of 2 visits, from 2008-2013. The cost per visit was US$189.38 in 2013 whilst the estimated costs of scaling up this service ranged from US$14.2million to US$76.5million in the Cape Metropole District. These cost estimates represented 2.3%-12.2% of the budget for the Western Cape District Health Services for 2013.In the presence of Sign Language Interpreters, Deaf Sign language users utilise health care service to a similar extent as the

The cost and utilisation patterns of a pilot sign language interpreter service for primary health care services in South Africa.

Science.gov (United States)

Zulu, Tryphine; Heap, Marion; Sinanovic, Edina

2017-01-01

The World Health Organisation estimates disabling hearing loss to be around 5.3%, while a study of hearing impairment and auditory pathology in Limpopo, South Africa found a prevalence of nearly 9%. Although Sign Language Interpreters (SLIs) improve the communication challenges in health care, they are unaffordable for many signing Deaf people and people with disabling hearing loss. On the other hand, there are no legal provisions in place to ensure the provision of SLIs in the health sector in most countries including South Africa. To advocate for funding of such initiatives, reliable cost estimates are essential and such data is scarce. To bridge this gap, this study estimated the costs of providing such a service within a South African District health service based on estimates obtained from a pilot-project that initiated the first South African Sign Language Interpreter (SASLI) service in health-care. The ingredients method was used to calculate the unit cost per SASLI-assisted visit from a provider perspective. The unit costs per SASLI-assisted visit were then used in estimating the costs of scaling up this service to the District Health Services. The average annual SASLI utilisation rate per person was calculated on Stata v.12 using the projects' registry from 2008-2013. Sensitivity analyses were carried out to determine the effect of changing the discount rate and personnel costs. Average Sign Language Interpreter services' utilisation rates increased from 1.66 to 3.58 per person per year, with a median of 2 visits, from 2008-2013. The cost per visit was US$189.38 in 2013 whilst the estimated costs of scaling up this service ranged from US$14.2million to US$76.5million in the Cape Metropole District. These cost estimates represented 2.3%-12.2% of the budget for the Western Cape District Health Services for 2013. In the presence of Sign Language Interpreters, Deaf Sign language users utilise health care service to a similar extent as the hearing population

Can home care services achieve cost savings in long-term care for older people?

Science.gov (United States)

Greene, V L; Ondrich, J; Laditka, S

1998-07-01

To determine whether efficient allocation of home care services can produce net long-term care cost savings. Hazard function analysis and nonlinear mathematical programming. Optimal allocation of home care services resulted in a 10% net reduction in overall long-term care costs for the frail older population served by the National Long-Term Care (Channeling) Demonstration, in contrast to the 12% net cost increase produced by the demonstration intervention itself. Our findings suggest that the long-sought goal of overall cost-neutrality or even cost-savings through reducing nursing home use sufficiently to more than offset home care costs is technically feasible, but requires tighter targeting of services and a more medically oriented service mix than major home care demonstrations have implemented to date.

Ecosystem services and opportunity costs shift spatial priorities for conserving forest biodiversity.

Directory of Open Access Journals (Sweden)

Matthias Schröter

Full Text Available Inclusion of spatially explicit information on ecosystem services in conservation planning is a fairly new practice. This study analyses how the incorporation of ecosystem services as conservation features can affect conservation of forest biodiversity and how different opportunity cost constraints can change spatial priorities for conservation. We created spatially explicit cost-effective conservation scenarios for 59 forest biodiversity features and five ecosystem services in the county of Telemark (Norway with the help of the heuristic optimisation planning software, Marxan with Zones. We combined a mix of conservation instruments where forestry is either completely (non-use zone or partially restricted (partial use zone. Opportunity costs were measured in terms of foregone timber harvest, an important provisioning service in Telemark. Including a number of ecosystem services shifted priority conservation sites compared to a case where only biodiversity was considered, and increased the area of both the partial (+36.2% and the non-use zone (+3.2%. Furthermore, opportunity costs increased (+6.6%, which suggests that ecosystem services may not be a side-benefit of biodiversity conservation in this area. Opportunity cost levels were systematically changed to analyse their effect on spatial conservation priorities. Conservation of biodiversity and ecosystem services trades off against timber harvest. Currently designated nature reserves and landscape protection areas achieve a very low proportion (9.1% of the conservation targets we set in our scenario, which illustrates the high importance given to timber production at present. A trade-off curve indicated that large marginal increases in conservation target achievement are possible when the budget for conservation is increased. Forty percent of the maximum hypothetical opportunity costs would yield an average conservation target achievement of 79%.

Ecosystem Services and Opportunity Costs Shift Spatial Priorities for Conserving Forest Biodiversity

Science.gov (United States)

Schröter, Matthias; Rusch, Graciela M.; Barton, David N.; Blumentrath, Stefan; Nordén, Björn

2014-01-01

Inclusion of spatially explicit information on ecosystem services in conservation planning is a fairly new practice. This study analyses how the incorporation of ecosystem services as conservation features can affect conservation of forest biodiversity and how different opportunity cost constraints can change spatial priorities for conservation. We created spatially explicit cost-effective conservation scenarios for 59 forest biodiversity features and five ecosystem services in the county of Telemark (Norway) with the help of the heuristic optimisation planning software, Marxan with Zones. We combined a mix of conservation instruments where forestry is either completely (non-use zone) or partially restricted (partial use zone). Opportunity costs were measured in terms of foregone timber harvest, an important provisioning service in Telemark. Including a number of ecosystem services shifted priority conservation sites compared to a case where only biodiversity was considered, and increased the area of both the partial (+36.2%) and the non-use zone (+3.2%). Furthermore, opportunity costs increased (+6.6%), which suggests that ecosystem services may not be a side-benefit of biodiversity conservation in this area. Opportunity cost levels were systematically changed to analyse their effect on spatial conservation priorities. Conservation of biodiversity and ecosystem services trades off against timber harvest. Currently designated nature reserves and landscape protection areas achieve a very low proportion (9.1%) of the conservation targets we set in our scenario, which illustrates the high importance given to timber production at present. A trade-off curve indicated that large marginal increases in conservation target achievement are possible when the budget for conservation is increased. Forty percent of the maximum hypothetical opportunity costs would yield an average conservation target achievement of 79%. PMID:25393951

Secure and Reliable IPTV Multimedia Transmission Using Forward Error Correction

Directory of Open Access Journals (Sweden)

Chi-Huang Shih

2012-01-01

Full Text Available With the wide deployment of Internet Protocol (IP infrastructure and rapid development of digital technologies, Internet Protocol Television (IPTV has emerged as one of the major multimedia access techniques. A general IPTV transmission system employs both encryption and forward error correction (FEC to provide the authorized subscriber with a high-quality perceptual experience. This two-layer processing, however, complicates the system design in terms of computational cost and management cost. In this paper, we propose a novel FEC scheme to ensure the secure and reliable transmission for IPTV multimedia content and services. The proposed secure FEC utilizes the characteristics of FEC including the FEC-encoded redundancies and the limitation of error correction capacity to protect the multimedia packets against the malicious attacks and data transmission errors/losses. Experimental results demonstrate that the proposed scheme obtains similar performance compared with the joint encryption and FEC scheme.

Cost of delivering health care services at primary health facilities in Ghana

Directory of Open Access Journals (Sweden)

Maxwell Ayindenaba Dalaba

2017-11-01

Full Text Available Abstract Background There is limited knowledge on the cost of delivering health services at primary health care facilities in Ghana which is posing a challenge in resource allocations. This study therefore estimated the cost of providing health care in primary health care facilities such as Health Centres (HCs and Community-based Health Planning and Services (CHPS in Ghana. Methods The study was cross-sectional and quantitative data was collected from the health provider perspective. Data was collected between July and August, 2016 at nine primary health facilities (six CHPS and three HCs from the Upper West region of Ghana. All health related costs for the year 2015 and revenue generated for the period were collected. Data were captured and analysed using Microsoft excel. Costs of delivery health services were estimated. In addition, unit costs such as cost per Outpatient Department (OPD attendance were estimated. Results The average annual cost of delivering health services through CHPS and HCs was US$10,923 and US$44,638 respectively. Personnel cost accounted for the largest proportion of cost (61% for CHPS and 59% for HC. The cost per OPD attendance was higher at CHPS (US$8.79 than at HCs (US$5.16. The average Internally Generated Funds (IGF recorded for the period at CHPS and HCs were US$2327 and US$ 15,795 respectively. At all the facilities, IGFs were greatly lower than costs of running the health facilities. Also, at both the CHPS and HCs, the National Health Insurance Scheme (NHIS reimbursement was the main source of revenue accounting for over 90% total IGF. Conclusions The average annual cost of delivering primary health services through CHPS and HCs is US$10,923 and US$44,638 respectively and personnel cost accounts for the major cost. The government should be guided by these findings in their financial planning, decision making and resource allocation in order to improve primary health care in the country. However, more similar

Variation in the costs of delivering routine immunization services in Peru.

Science.gov (United States)

Walker, D; Mosqueira, N R; Penny, M E; Lanata, C F; Clark, A D; Sanderson, C F B; Fox-Rushby, J A

2004-09-01

Estimates of vaccination costs usually provide only point estimates at national level with no information on cost variation. In practice, however, such information is necessary for programme managers. This paper presents information on the variations in costs of delivering routine immunization services in three diverse districts of Peru: Ayacucho (a mountainous area), San Martin (a jungle area) and Lima (a coastal area). We consider the impact of variability on predictions of cost and reflect on the likely impact on expected cost-effectiveness ratios, policy decisions and future research practice. All costs are in 2002 prices in US dollars and include the costs of providing vaccination services incurred by 19 government health facilities during the January-December 2002 financial year. Vaccine wastage rates have been estimated using stock records. The cost per fully vaccinated child ranged from 16.63-24.52 U.S. Dollars in Ayacucho, 21.79-36.69 U.S. Dollars in San Martin and 9.58-20.31 U.S. Dollars in Lima. The volume of vaccines administered and wastage rates are determinants of the variation in costs of delivering routine immunization services. This study shows there is considerable variation in the costs of providing vaccines across geographical regions and different types of facilities. Information on how costs vary can be used as a basis from which to generalize to other settings and provide more accurate estimates for decision-makers who do not have disaggregated data on local costs. Future studies should include sufficiently large sample sizes and ensure that regions are carefully selected in order to maximize the interpretation of cost variation.

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.

Customer satisfaction : Cost driver or value driver? Empirical evidence from the financial services industry

NARCIS (Netherlands)

Terpstra, Maarten; Verbeeten, Frank H M

2014-01-01

We investigate the relation between customer satisfaction, customer servicing costs, and customer value in a financial services firm. We find that customer satisfaction is positively associated with future customer servicing costs, as well as with customer value. The relation between customer

Customer satisfaction: Cost driver or value driver? Empirical evidence from the financial services industry

NARCIS (Netherlands)

Terpstra, M.; Verbeeten, F.H.M.

2014-01-01

We investigate the relation between customer satisfaction, customer servicing costs, and customer value in a financial services firm. We find that customer satisfaction is positively associated with future customer servicing costs, as well as with customer value. The relation between customer

Low-cost sensor integrators for measuring the transmissivity of complex canopies to photosynthetically active radiation

International Nuclear Information System (INIS)

Newman, S.M.

1985-01-01

A system has been designed, tested and evaluated for measuring the transmissivities of complex canopies to photosynthetically active radiation (PAR). The system consists of filtered silicon photocells in cosine corrected mounts with outputs integrated by the use of chemical coulometers. The reading accumulated by the coulometers was taken electronically by the use of microcomputers. The low-cost sensor integrators, which do not require batteries, performed as expected and proved ideal for the study of agroforestry systems in remote areas. Information on the PAR transmissivity of a temperate agroforestry system in the form of an intercropped orchard is also presented. (author)

Cost analysis and exploratory cost-effectiveness of youth-friendly sexual and reproductive health services in the Republic of Moldova

NARCIS (Netherlands)

Kempers, J.; Ketting, E.; Lesco, G.

2014-01-01

BACKGROUND: Youth-friendly sexual and reproductive health services (YFHS) have high priority in many countries. Yet, little is known about the cost and cost-effectiveness of good quality YFHS in resource limited settings. This paper analyses retrospectively costs and potential cost-effectiveness of

Rural emergency medical technician pre-hospital electrocardiogram transmission.

Science.gov (United States)

Powell, A M; Halon, J M; Nelson, J

2014-01-01

Emergent care of the acute heart attack patient continues to be at the forefront of quality and cost reduction strategies throughout the healthcare industry. Although the average cardiac door-to-balloon (D2B) times have decreased substantially over the past few years, there are still vast disparities found in D2B times in populations that reside in rural areas. Such disparities are mostly related to prolonged travel time and subsequent delays in cardiac catherization lab team activation. Urban ambulance companies that are routinely staffed with paramedic level providers have been successful in the implementation of pre-hospital 12-lead electrocardiogram (ECG) protocols as a strategy to reduce D2B times. The authors sought to evaluate the evidence related to the risk and benefits associated with the replication of an ECG transmission protocol in a small rural emergency medical service. The latter is staffed with emergency medical technician-basics (EMT-B), emergency medical technician-advanced (EMT-A), and emergency medical technician-intermediate (EMT-I) level. The evidence reviewed was limited to studies with relevant data regarding the challenges and complexities of the ECG transmission process, the difficulties associated with ECG transmission in rural settings, and ECG transmission outcomes by provider level. The evidence supports additional research to further evaluate the feasibility of ECG transmission at the non-paramedic level. Multiple variables must be investigated including equipment cost, utilization, and rural transmission capabilities. Clearly, pre-hospital ECG transmission and early activation of the cardiac catheterization laboratory are critical components to successfully decreasing D2B times.

Long-term effects of penicillin resistance and fitness cost on pneumococcal transmission dynamics in a developed setting

Directory of Open Access Journals (Sweden)

Diana Tilevik

2016-05-01

Full Text Available Background: The increasing prevalence of penicillin non-susceptible pneumococci (PNSP throughout the world threatens successful treatment of infections caused by this important bacterial pathogen. The rate at which PNSP clones spread in the community is thought to mainly be determined by two key determinants; the volume of penicillin use and the magnitude of the fitness cost in the absence of treatment. The aim of the study was to determine the impacts of penicillin consumption and fitness cost on pneumococcal transmission dynamics in a developed country setting. Methods: An individual-based network model based on real-life demographic data was constructed and applied in a developed country setting (Sweden. A population structure with transmission of carriage taking place within relevant mixing groups, i.e. families, day care groups, school classes, and other close contacts, was considered to properly assess the transmission dynamics for susceptible and PNSP clones. Several scenarios were simulated and model outcomes were statistically analysed. Results: Model simulations predicted that with an outpatient penicillin use corresponding to the sales in Sweden 2010 (118 recipes per 1,000 inhabitants per year, the magnitude of a fitness cost for resistance must be at least 5% to offset the advantage of penicillin resistance. Moreover, even if there is a fitness cost associated with penicillin resistance, a considerable reduction of penicillin usage appears to be required to significantly decrease the incidence of PNSP in a community. Conclusion: The frequency of PNSP clones is hard to reverse by simply reducing the penicillin consumption even if there is a biological cost associated with resistance. However, because penicillin usage does promote further spread of PNSP clones, it is important to keep down penicillin consumption considering future resistance problems.

Treatment Cost Analysis Tool (TCAT) for estimating costs of outpatient treatment services.

Science.gov (United States)

Flynn, Patrick M; Broome, Kirk M; Beaston-Blaakman, Aaron; Knight, Danica K; Horgan, Constance M; Shepard, Donald S

2009-02-01

A Microsoft Excel-based workbook designed for research analysts to use in a national study was retooled for treatment program directors and financial officers to allocate, analyze, and estimate outpatient treatment costs in the U.S. This instrument can also be used as a planning and management tool to optimize resources and forecast the impact of future changes in staffing, client flow, program design, and other resources. The Treatment Cost Analysis Tool (TCAT) automatically provides feedback and generates summaries and charts using comparative data from a national sample of non-methadone outpatient providers. TCAT is being used by program staff to capture and allocate both economic and accounting costs, and outpatient service costs are reported for a sample of 70 programs. Costs for an episode of treatment in regular, intensive, and mixed types of outpatient treatment were $882, $1310, and $1381 respectively (based on 20% trimmed means and 2006 dollars). An hour of counseling cost $64 in regular, $85 intensive, and $86 mixed. Group counseling hourly costs per client were $8, $11, and $10 respectively for regular, intensive, and mixed. Future directions include use of a web-based interview version, much like some of the commercially available tax preparation software tools, and extensions for use in other modalities of treatment.

Strategies to Prevent MRSA Transmission in Community-Based Nursing Homes: A Cost Analysis.

Science.gov (United States)

Roghmann, Mary-Claire; Lydecker, Alison; Mody, Lona; Mullins, C Daniel; Onukwugha, Eberechukwu

2016-08-01

OBJECTIVE To estimate the costs of 3 MRSA transmission prevention scenarios compared with standard precautions in community-based nursing homes. DESIGN Cost analysis of data collected from a prospective, observational study. SETTING AND PARTICIPANTS Care activity data from 401 residents from 13 nursing homes in 2 states. METHODS Cost components included the quantities of gowns and gloves, time to don and doff gown and gloves, and unit costs. Unit costs were combined with information regarding the type and frequency of care provided over a 28-day observation period. For each scenario, the estimated costs associated with each type of care were summed across all residents to calculate an average cost and standard deviation for the full sample and for subgroups. RESULTS The average cost for standard precautions was $100 (standard deviation [SD], $77) per resident over a 28-day period. If gown and glove use for high-risk care was restricted to those with MRSA colonization or chronic skin breakdown, average costs increased to $137 (SD, $120) and $125 (SD, $109), respectively. If gowns and gloves were used for high-risk care for all residents in addition to standard precautions, the average cost per resident increased substantially to $223 (SD, $127). CONCLUSIONS The use of gowns and gloves for high-risk activities with all residents increased the estimated cost by 123% compared with standard precautions. This increase was ameliorated if specific subsets (eg, those with MRSA colonization or chronic skin breakdown) were targeted for gown and glove use for high-risk activities. Infect Control Hosp Epidemiol 2016;37:962-966.

The determinants of hospital cost: a cost-volume-profit analysis of health services in the occupied territories: Palestine.

Science.gov (United States)

Younis, Mustafa Z; Jaber, Samer; Smith, Pamela C; Hartmann, Michael; Bongyu, Moye

2010-06-01

The purpose of this study is to examine the unit costs of a multi-service hospital in Palestine for the period 2005-2007. We investigate the cost structure of the Rafidya Hospital located in Nablus city, for both inpatient and outpatient departments. This study uses cost-volume-profit (CVP) analysis, also known as breakeven analysis. CVP analysis requires examining total costs, along with fixed and variable costs. CVP analysis illuminates how changes in assumptions about cost behaviour and the relevant range in which those assumptions are valid affect the relationships among revenues, variable costs and fixed costs at various production levels. For the hospital of interest, we find that fixed costs account for 70% of total costs, and variable costs were 30% of total costs. Inpatient departments accounted for 86% of total costs, and outpatient departments were 14% of total costs. Results of the breakeven analysis illustrate that several departments charge sufficient fees to cover all unit costs. Results provide useful information about unit cost based on four categories: (1) unit cost per admission of each department, (2) unit cost per patient day of each department, (3) unit cost per admission with annual capital cost of each department and (4) unit cost per patient day with annual capital cost. Our results provide hospital cost information that can be used by decision-makers to provide and expand healthcare services, in an effort to increase sustainability and profitability. The use of cost analysis by administrators and regulators will improve the quality of financial information, as well as enhance the efficient use of scarce resources.

The Cost analysis of cervical cancer screening services provided by Damavand health center in 2013

Directory of Open Access Journals (Sweden)

Arezoo Chouhdari

2015-03-01

Full Text Available Background: Today, the health sector in many countries is facing with severe resource constraints; hence it is absolutely necessary that cost-benefit and cost-effectiveness assessment have a major role in design of health services. The purpose of this study was to evaluate the cost-benefit and effectiveness of cervical cancer screening service (Pap smear test done by the health centers in Damavand County in 2013.  Methods: This is a descriptive study with cross-sectional method. All data was extracted from existing documents in Damavand health network.Cost of service screening for doing Pap smear test (manpower costs of performing the service, the cost of transferring samples, water, electricity, telephone and gas was estimated in all health centers then results, were compared with the incomes of this service.  Results: Screening program coverage was 22.3%, 6.9% and 6.05% in 2011, 2012 and 2013 respectively. All costs and incomes of units performing Pap smear screening test were calculated. Entire costs and incomes of this service during 2013 were respectively 303,009,000 and 11,640,000 RLS equal $12,227 and $496.73. Therefore, the cost-benefit ratio of this screening test was approximately 0.040.  Conclusion: The costs of units performing cervical cancer screening test in Damavand Health Center were much more than this benefit and because of a none-positive Pap smear test in spite of high cost, performing this test in Damavand health centers was not cost effective.

Pricing in M/M/1 queues when cost of waiting in queue differs from cost of waiting in service

Directory of Open Access Journals (Sweden)

Görkem Sarıyer

2016-11-01

Full Text Available Service providers can adjust the entrance price to the state of the demand in real life service systems where the customers' decision to receive the service, is based on this price, state of demand and other system parameters. We analyzed service provider's short and long term pricing problems in unobservable M/M/1 queues having the rational customers, where, for customers, the unit cost of waiting in the queue is higher than unit cost of waiting in the service. We showed that waiting in the queue has a clear negative effect on customers’ utilities, hence the service provider's price values. We also showed that, in the short term, monopolistic pricing is optimal for congested systems with high server utilization levels, whereas in the long term, market capturing pricing is more profitable.

Economy of electric power transmission

International Nuclear Information System (INIS)

Manzoni, G.; Delfanti, M.

2008-01-01

An analysis is presented of the impact of H V and Ehv transmission costs on the final value of the kWh supplied, with reference both to transmission systems of the European type and to long distance point-to-point transmission links. The analysis is extended to A C transmission by underground cables and to Hvdc submarine and aerial links. In the European power system, the impact of transmission costs results to be usually modest, but it may become important in the case of network congestions [it

Cost characteristics of tilt-rotor, conventional air and high speed rail short-haul intercity passenger service

Science.gov (United States)

Schoendorfer, David L.; Morlok, Edward K.

1985-01-01

The cost analysis done to support an assessment of the potential for a small tilt-rotor aircraft to operate in short-haul intercity passenger service is described in detail. Anticipated costs of tilt-rotor air service were compared to the costs of two alternatives: conventional air and high speed rail (HSR). Costs were developed for corridor service, varying key market characteristics including distance, passenger volumes, and minimum frequency standards. The resulting cost vs output information can then be used to compare modal costs for essentially identical service quality and passenger volume or for different service levels and volumes for each mode, as appropriate. Extensive sensitivity analyses are performed. The cost-output features of these technologies are compared. Tilt-rotor is very attractive compared to HSR in terms of costs over the entire range of volume. It also has costs not dramatically different from conventional air, but tilt-rotor costs are generally higher. Thus some of its other advantages, such as the VTOL capability, must offset the cost disadvantage for it to be a preferred or competitive mode in any given market. These issues are addressed in the companion report which considers strategies for tilt-rotor development in commercial air service.

Cost-efficient evaluation of ambulance services for community ...

African Journals Online (AJOL)

A total of 12,674 victims were transported to different tares of hospital and referrals ... The mean cost-efficiency (technical) of Machakos ambulance transport services was 90.6% (C.I 82.7% - 98.2%). ... EMAIL FULL TEXT EMAIL FULL TEXT

A review of typhoid fever transmission dynamic models and economic evaluations of vaccination.

Science.gov (United States)

Watson, Conall H; Edmunds, W John

2015-06-19

Despite a recommendation by the World Health Organization (WHO) that typhoid vaccines be considered for the control of endemic disease and outbreaks, programmatic use remains limited. Transmission models and economic evaluation may be informative in decision making about vaccine programme introductions and their role alongside other control measures. A literature search found few typhoid transmission models or economic evaluations relative to analyses of other infectious diseases of similar or lower health burden. Modelling suggests vaccines alone are unlikely to eliminate endemic disease in the short to medium term without measures to reduce transmission from asymptomatic carriage. The single identified data-fitted transmission model of typhoid vaccination suggests vaccines can reduce disease burden substantially when introduced programmatically but that indirect protection depends on the relative contribution of carriage to transmission in a given setting. This is an important source of epidemiological uncertainty, alongside the extent and nature of natural immunity. Economic evaluations suggest that typhoid vaccination can be cost-saving to health services if incidence is extremely high and cost-effective in other high-incidence situations, when compared to WHO norms. Targeting vaccination to the highest incidence age-groups is likely to improve cost-effectiveness substantially. Economic perspective and vaccine costs substantially affect estimates, with disease incidence, case-fatality rates, and vaccine efficacy over time also important determinants of cost-effectiveness and sources of uncertainty. Static economic models may under-estimate benefits of typhoid vaccination by omitting indirect protection. Typhoid fever transmission models currently require per-setting epidemiological parameterisation to inform their use in economic evaluation, which may limit their generalisability. We found no economic evaluation based on transmission dynamic modelling, and no

Low cost Polymer Optical Fibre based transmission system for feeding integrated broadband wireless in-house LANs

NARCIS (Netherlands)

Ng'Oma, A.; Koonen, A.M.J.; Tafur Monroy, I.; Boom, van den H.P.A.; Smulders, P.F.M.; Khoe, G.D.; Visser, D. Taco; Lenstra, Daan; Schouten, F. Hugo

2002-01-01

A bi-directional transmission system using low cost Polymer Optical Fibre (POF) to feed the required large number of radio access points in next-generation integrated broadband wireless in-house LANs is proposed. Results from simulations and experiments show that, by tuning system parameters, a

A cost-constrained model of strategic service quality emphasis in nursing homes.

Science.gov (United States)

Davis, M A; Provan, K G

1996-02-01

This study employed structural equation modeling to test the relationship between three aspects of the environmental context of nursing homes; Medicaid dependence, ownership status, and market demand, and two basic strategic orientations: low cost and differentiation based on service quality emphasis. Hypotheses were proposed and tested against data collected from a sample of nursing homes operating in a single state. Because of the overwhelming importance of cost control in the nursing home industry, a cost constrained strategy perspective was supported. Specifically, while the three contextual variables had no direct effect on service quality emphasis, the entire model was supported when cost control orientation was introduced as a mediating variable.

The cost of chronic pain: an analysis of a regional pain management service in Ireland.

Science.gov (United States)

Gannon, Brenda; Finn, David P; O'Gorman, David; Ruane, Nancy; McGuire, Brian E

2013-10-01

The objective of the study was to collect data on the direct and indirect economic cost of chronic pain among patients attending a pain management clinic in Ireland. A tertiary pain management clinic serving a mixed urban and rural area in the West of Ireland. Data were collected from 100 patients using the Client Services Receipt Inventory and focused on direct and indirect costs of chronic pain. Patients were questioned about health service utilization, payment methods, and relevant sociodemographics. Unit costs were multiplied by resource use data to obtain full costs. Cost drivers were then estimated. Our study showed a cost per patient of US$24,043 over a 12-month period. Over half of this was attributable to wage replacement costs and lost productivity in those unable to work because of pain. Hospital stays and outpatient hospital services were the main drivers for health care utilization costs, together accounting for 63% of the direct medical costs per study participant attending the pain clinic. The cost of chronic pain among intensive service users is significant, and when extrapolated to a population level, these costs represent a very substantial economic burden. Wiley Periodicals, Inc.

Non-Dam Alternatives for Delivering Water Services at Least Cost and Risk

Directory of Open Access Journals (Sweden)

Michael P. Totten

2010-06-01

We present evidence that a value-adding and risk-minimising water planning process can be achieved by shifting from the conventional focus on supply expansion to one that concentrates on efficiently delivering services at and near the point of use. The State of California has two decades of experience with this approach, demonstrating that market-based policy and regulatory innovations can unleash efficiency gains resulting in more utility water services and energy services delivered with less supply expansion at lower costs, while minimising climate-change risk, pollution and the social cost that accompany large infrastructural projects. Efficiency in delivered water services could be accomplished with investments in the range of US$10-25 billion annually, while obviating the need for spending hundreds of billions of dollars on more expensive hydropower and related infrastructural expansion projects. The shift to a regulatory system that encompasses cost-effective end-use efficiency improvements in delivering water and energy services could eliminate the need for an estimated half of all proposed dams globally, thus allowing for the maintenance of other ecosystem service benefits and offer the best hopes of meeting basic human needs for water at a more achievable level of investment.

Cost-effective up to 40 Gbit/s transmission performance of 1310 nm directly modulated lasers for short to medium range distances

NARCIS (Netherlands)

Huiszoon, B.; Jonker, R.J.W.; Bennekom, van P.K.; Khoe, G.D.; Waardt, de H.

2005-01-01

This paper presents successful 20 and 40 Gb/s potentially low-cost transmission experiments using 1310 nm directly modulated distributed feedback lasers (DMLs) in the very-short- to medium-range distances. This paper will recommend operating conditions for error-free transmission at these bit rates

The delivery of low-cost, low-carbon rural energy services

Energy Technology Data Exchange (ETDEWEB)

Casillas, Christian E., E-mail: cecasillas@berkeley.edu [Energy and Resources Group, University of California, Berkeley (United States); Kammen, Daniel M. [Energy and Resources Group, University of California, Berkeley (United States); Goldman School of Public Policy, University of California, Berkeley, CA 94720 (United States); The World Bank, Washington, DC 20433 (United States)

2011-08-15

The provision of both electrical and mechanical energy services can play a critical role in poverty alleviation for the almost two billion rural users who currently lack access to electricity. Distributed generation using diesel generators remains a common means of electricity provision for rural communities throughout the world. Due to rising fuel costs, the need to address poverty, and consequences of global warming, it is necessary to develop cost efficient means of reducing fossil fuel consumption in isolated diesel microgrids. Based on a case study in Nicaragua, a set of demand and supply side measures are ordered by their annualized costs in order to approximate an energy supply curve. The curve highlights significant opportunities for reducing the costs of delivering energy services while also transitioning to a carbon-free electrical system. In particular, the study demonstrates the significant cost savings resulting from the implementation of conventional metering, efficient residential lighting, and electricity generation using renewable energy sources. - Highlights: > We present a case study of conservation measures implemented in a diesel microgrid. > An energy conservation and supply curve is constructed using additional measures. > Energy efficiency and renewable energy result in cost savings and carbon abatement. > We discuss weaknesses of energy supply and carbon abatement curve calculations

Distribution costs -- the cost of local delivery

International Nuclear Information System (INIS)

Winger, N.; Zarnett, P.; Carr, J.

2000-01-01

Most of the power transmission system in the province of Ontario is owned and operated as a regulated monopoly by Ontario Hydro Services Company (OHSC). Local distribution systems deliver to end-users from bulk supply points within a service territory. OHSC distributes to approximately one million, mostly rural customers, while the approximately 250 municipal utilities together serve about two million, mostly urban customers. Under the Energy Competition Act of 1998 local distribution companies will face some new challenges, including unbundled billing systems, a broader range of distribution costs, increased costs, made up of corporate taxes or payments in lieu of taxes and added costs for regulatory affairs. The consultants provide a detailed discussion of the components of distribution costs, the three components of the typical budget process (capital expenditures, (CAPEX), operating and maintenance (O and M) and administration and corporate (GA and C), a summary of some typical distribution costs in Ontario, and the estimated impacts of the Energy Competition Act (ECA) compliance on charges and rates. Various mitigation strategies are also reviewed. Among these are joint ventures by local distribution companies to reduce ECA compliance costs, re-examination of controllable costs, temporary reduction of the allowable return on equity (ROE) by 50 per cent, and/or reducing the competitive transition charge (CTC). It is estimated that either one of these two reductions could eliminate the full amount of the five to seven per cent uplift in delivered energy service costs. The conclusion of the consultants is that local distribution delivery charges will make up a greater proportion of end-user cost in the future than it has in the past. An increase to customers of about five per cent is expected when the competitive electricity market opens and unbundled billing begins. The cost increase could be mitigated by a combination of actions that would be needed for about

Guide to resource conservation and cost savings opportunities in the food service sector

Energy Technology Data Exchange (ETDEWEB)

NONE

1998-03-01

Opportunities for conserving energy and water, as well as reducing waste, within the 24,000 establishment-strong food service sector in Ontario are identified. Operators are encouraged to take advantage of these opportunities to lower their costs while conserving valuable resources at the same time. In preparing this guide, site visits were carried out at six food service facilities in Ontario. Information about how much money is generally spent on energy, water and waste management by food service operators is provided. The amount and type of waste generated by these facilities is also described. The volatility of the commercial food service market place was identified as one of the major impediments to energy conservation. It was found that most owners of the food service facilities make business decisions based on the lowest first costs, irrespective of longer-term energy efficiency and operating costs. 31 refs., 13 tabs., 9 figs., 4 appendices.

The cost minimization analysis of an outreach dental service: a pilot ...

African Journals Online (AJOL)

For people with limited or no access to oral health care services, outreach dental services may be used to reduce oral health inequality. There is however paucity of information on the economic analysis of outreach dental services in sub Saharan Africa. Objective: To report a cost minimization analysis of an outreach dental ...

Evaluating the cost-effectiveness of combination antiretroviral therapy for the prevention of mother-to-child transmission of HIV in Uganda

NARCIS (Netherlands)

Kuznik, Andreas; Lamorde, Mohammed; Hermans, Sabine; Castelnuovo, Barbara; Auerbach, Brandon; Semeere, Aggrey; Sempa, Joseph; Ssennono, Mark; Ssewankambo, Fred; Manabe, Yukari C.

2012-01-01

Objective To model the cost-effectiveness in Uganda of combination antiretroviral therapy (ART) to prevent mother-to-child transmission of human immunodeficiency virus (HIV). Methods The cost-effectiveness of ART was evaluated on the assumption that ART reduces the risk of an HIV-positive pregnant

22 CFR 92.68 - Foreign Service fees and incidental costs in the taking of evidence.

Science.gov (United States)

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Foreign Service fees and incidental costs in... SERVICES NOTARIAL AND RELATED SERVICES Depositions and Letters Rogatory § 92.68 Foreign Service fees and incidental costs in the taking of evidence. The fees for the taking of evidence by officers of the Foreign...

The impact of NHS based primary care complementary therapy services on health outcomes and NHS costs: a review of service audits and evaluations

Directory of Open Access Journals (Sweden)

Wye Lesley

2009-03-01

Full Text Available Abstract Background The aim of this study was to review evaluations and audits of primary care complementary therapy services to determine the impact of these services on improving health outcomes and reducing NHS costs. Our intention is to help service users, service providers, clinicians and NHS commissioners make informed decisions about the potential of NHS based complementary therapy services. Methods We searched for published and unpublished studies of NHS based primary care complementary therapy services located in England and Wales from November 2003 to April 2008. We identified the type of information included in each document and extracted comparable data on health outcomes and NHS costs (e.g. prescriptions and GP consultations. Results Twenty-one documents for 14 services met our inclusion criteria. Overall, the quality of the studies was poor, so few conclusions can be made. One controlled and eleven uncontrolled studies using SF36 or MYMOP indicated that primary care complementary therapy services had moderate to strong impact on health status scores. Data on the impact of primary care complementary therapy services on NHS costs were scarcer and inconclusive. One controlled study of a medical osteopathy service found that service users did not decrease their use of NHS resources. Conclusion To improve the quality of evaluations, we urge those evaluating complementary therapy services to use standardised health outcome tools, calculate confidence intervals and collect NHS cost data from GP medical records. Further discussion is needed on ways to standardise the collection and reporting of NHS cost data in primary care complementary therapy services evaluations.

128 Gb/s TWDM PON system using dispersion-supported transmission method

Science.gov (United States)

Bindhaiq, Salem; Zulkifli, Nadiatulhuda; Supa'at, Abusahmah M.; Idrus, Sevia M.; Salleh, M. S.

2017-11-01

Time and wavelength division multiplexed passive optical network (TWDM-PON) trend is considered as the most extraordinary trend of the next generation solution to accommodate exponential traffic growth for converged new services. In this paper, we briefly review recent progress on TWDM-PON system through the use of low cost directly modulated lasers (DMLs) transmission for various line rate transmissions to date. Furthermore, through simulation, we propose and evaluate a cost effective way to upgrade TWDM-PON up to a symmetric capacity of 128 Gb/s using fiber Bragg gratings (FBGs) in optical line terminal (OLT) as a paramount dispersion manager in high speed light-wave systems in both upstream and downstream directions. A low cost and potential chirpless directed modulated grating laser (DMGL) is employed for downstream link and DML with a single delay-interferometer (DI) is employed for upstream link. After illustrating the demonstrated system architecture and configuration, we present the results and analysis to prove the system feasibility. The results show that a successful transmission is achieved over 40 km single mode fiber with a power budget of 33.7 dB, which could support 1:256 splitting ratio.

Cost of Services Provided by the National Breast and Cervical Cancer Early Detection Program

Science.gov (United States)

Ekwueme, Donatus U.; Subramanian, Sujha; Trogdon, Justin G.; Miller, Jacqueline W.; Royalty, Janet E.; Li, Chunyu; Guy, Gery P.; Crouse, Wesley; Thompson, Hope; Gardner, James G.

2015-01-01

BACKGROUND The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) is the largest cancer screening program for low-income women in the United States. This study updates previous estimates of the costs of delivering preventive cancer screening services in the NBCCEDP. METHODS We developed a standardized web-based cost-assessment tool to collect annual activity-based cost data on screening for breast and cervical cancer in the NBCCEDP. Data were collected from 63 of the 66 programs that received funding from the Centers for Disease Control and Prevention during the 2006/2007 fiscal year. We used these data to calculate costs of delivering preventive public health services in the program. RESULTS We estimated the total cost of all NBCCEDP services to be $296 (standard deviation [SD], $123) per woman served (including the estimated value of in-kind donations, which constituted approximately 15% of this total estimated cost). The estimated cost of screening and diagnostic services was $145 (SD, $38) per women served, which represented 57.7% of the total cost excluding the value of in-kind donations. Including the value of in-kind donations, the weighted mean cost of screening a woman for breast cancer was $110 with an office visit and $88 without, the weighted mean cost of a diagnostic procedure was $401, and the weighted mean cost per breast cancer detected was $35,480. For cervical cancer, the corresponding cost estimates were $61, $21, $415, and $18,995, respectively. CONCLUSIONS These NBCCEDP cost estimates may help policy makers in planning and implementing future costs for various potential changes to the program. PMID:25099904

Gas Transport Services. West European Gas Transmission Tariff Comparisons

International Nuclear Information System (INIS)

2006-07-01

Since 1999, the Dutch gas transmission company, Gastransport Services (GTS), has commissioned an independent consultant to prepare reports comparing gas transportation tariffs across Western Europe on an annual basis. This report describes the tariffs in force at 1 February 2006. The previous report was published in May 2005, and reported on the tariffs which were in force at 1 January 2005. Since then several companies have published revised carriage arrangements, or have adjusted their tariffs (e.g. to reflect inflation, or for other reasons). In this report we compare the GTS tariff with the transportation tariffs in eleven other countries: Austria, Belgium, Denmark, France, Germany, Ireland, Italy, Luxembourg, Spain, Sweden, and the United Kingdom. This means that all West European countries with Third Party Access to gas transmission systems (except Finland) are covered in this report. In this main part of the report, we concentrate on showing charts which illustrate the comparisons of tariffs, at various distances, volumes and load factors. This gives an overall picture of the tariffs offered by each company, rather than concentrating on particular cases. The detailed calculations for each of the 45 cases are shown in the Appendix to this report, and the conclusions from the cases are shown in a colour-coded chart in the Summary and Conclusions.

76 FR 49841 - Transmission Planning and Cost Allocation by Transmission Owning and Operating Public Utilities

Science.gov (United States)

2011-08-11

... Commission-approved RTOs and ISOs. The Commission stated that it expected all non-public utility transmission... transmission planning processes that public utility transmission providers in regions outside of RTOs and ISOs...

Optimizing quality, service, and cost through innovation.

Science.gov (United States)

Walker, Kathleen; Allen, Jennifer; Andrews, Richard

2011-01-01

With dramatic increases in health care costs and growing concerns about the quality of health care services, nurse executives are seeking ways to transform their organizations to improve operational and financial performance while enhancing quality care and patient safety. Nurse leaders are challenged to meet new cost, quality and service imperatives, and change cannot be achieved by traditional approaches, it must occur through innovation. Imagine an organization that can mitigate a $56 million loss in revenue and claim the following successes: Increase admissions by a 8 day and a $5.5 million annualized increase by repurposing existing space. Decrease emergency department holding hours by an average of 174 hours a day, with a labor savings of $502,000 annually. Reduce overall inpatient length of stay by 0.5 day with total compensation running $4.2 million less than the budget for first quarter of 2010. Grow emergency department volume 272 visits greater than budgeted for first quarter of 2010. Complete admission assessments and diagnostics in 90 minutes. This article will address how these outcomes were achieved by transforming care delivery, creating a patient transition center, enhancing outreach referrals, and revising admission processes through collaboration and innovation.

Comparative cost-effectiveness of Option B+ for prevention of mother-to-child transmission of HIV in Malawi.

Science.gov (United States)

Tweya, Hannock; Keiser, Olivia; Haas, Andreas D; Tenthani, Lyson; Phiri, Sam; Egger, Matthias; Estill, Janne

2016-03-27

To estimate the cost-effectiveness of prevention of mother-to-child transmission (MTCT) of HIV with lifelong antiretroviral therapy (ART) for pregnant and breastfeeding women ('Option B+') compared with ART during pregnancy or breastfeeding only unless clinically indicated ('Option B'). Mathematical modelling study of first and second pregnancy, informed by data from the Malawi Option B+ programme. Individual-based simulation model. We simulated cohorts of 10 000 women and their infants during two subsequent pregnancies, including the breastfeeding period, with either Option B+ or B. We parameterized the model with data from the literature and by analysing programmatic data. We compared total costs of antenatal and postnatal care, and lifetime costs and disability-adjusted life-years of the infected infants between Option B+ and Option B. During the first pregnancy, 15% of the infants born to HIV-infected mothers acquired the infection. With Option B+, 39% of the women were on ART at the beginning of the second pregnancy, compared with 18% with Option B. For second pregnancies, the rates MTCT were 11.3% with Option B+ and 12.3% with Option B. The incremental cost-effectiveness ratio comparing the two options ranged between about US$ 500 and US$ 1300 per DALY averted. Option B+ prevents more vertical transmissions of HIV than Option B, mainly because more women are already on ART at the beginning of the next pregnancy. Option B+ is a cost-effective strategy for PMTCT if the total future costs and lost lifetime of the infected infants are taken into account.

The cost determinants of routine infant immunization services: a meta-regression analysis of six country studies.

Science.gov (United States)

Menzies, Nicolas A; Suharlim, Christian; Geng, Fangli; Ward, Zachary J; Brenzel, Logan; Resch, Stephen C

2017-10-06

Evidence on immunization costs is a critical input for cost-effectiveness analysis and budgeting, and can describe variation in site-level efficiency. The Expanded Program on Immunization Costing and Financing (EPIC) Project represents the largest investigation of immunization delivery costs, collecting empirical data on routine infant immunization in Benin, Ghana, Honduras, Moldova, Uganda, and Zambia. We developed a pooled dataset from individual EPIC country studies (316 sites). We regressed log total costs against explanatory variables describing service volume, quality, access, other site characteristics, and income level. We used Bayesian hierarchical regression models to combine data from different countries and account for the multi-stage sample design. We calculated output elasticity as the percentage increase in outputs (service volume) for a 1% increase in inputs (total costs), averaged across the sample in each country, and reported first differences to describe the impact of other predictors. We estimated average and total cost curves for each country as a function of service volume. Across countries, average costs per dose ranged from $2.75 to $13.63. Average costs per child receiving diphtheria, tetanus, and pertussis ranged from $27 to $139. Within countries costs per dose varied widely-on average, sites in the highest quintile were 440% more expensive than those in the lowest quintile. In each country, higher service volume was strongly associated with lower average costs. A doubling of service volume was associated with a 19% (95% interval, 4.0-32) reduction in costs per dose delivered, (range 13% to 32% across countries), and the largest 20% of sites in each country realized costs per dose that were on average 61% lower than those for the smallest 20% of sites, controlling for other factors. Other factors associated with higher costs included hospital status, provision of outreach services, share of effort to management, level of staff training

Cost-effective FITL technologies for small business and residential customers

Science.gov (United States)

Andersen, Niels E.; Woolnough, Peter; Seidenberg, Juergen; Ferreira, Mario F. S.

1995-02-01

FIRST is a RACE project where 5 main European telecoms operators, 4 equipment manufacturers and one university have joined up to define and test in a field trial in Portugal a cost effective Optical Access Network. The main design target has been a system which gives cost effective provision of wideband services for small and medium business customers. The system however, incorporates provision of telephone, ISDN and analog and digital video for residential customers as well. Technologies have been chosen with the objective of providing a simple, robust and flexible system where initial deployment costs are low and closely related to the service take up. The paper describes the main technical features of the system and network applications which shows how the system may be introduced in network planning. The system is based on Passive Optical Network technology where video is distributed in the 1550 nm window and telecoms services transmitted at 1300 nm in full duplex mode. The telecoms system provides high capacity, flexibility in loop length and robustness towards outside plant performance. The Subcarrier Multiple Access (SCMA) method is used for upstream transmission of bi-directional telecoms services. SCMA has advantages compared to the Time Division Multiple Access technology used in other systems. Bandwidth/cost tradeoff is better and the lower requirements to the outside plant increases the overall cost benefit. Optical beat noise due to overlapping of laser spectra which may be a problem for this technology has been addressed with success through the use of a suitable modulation and control technique. This technology is further validated in the field trial. The video system provides cost effective long distance transmission on standard fiber with externally modulated lasers and cascaded amplifiers. Coexistence of analog and digital video on one fiber with different modulation schemes i.e. BPSK, QPSK and 64 QAM have been validated. Total life cycle cost

Preterm birth-associated cost of early intervention services: an analysis by gestational age.

Science.gov (United States)

Clements, Karen M; Barfield, Wanda D; Ayadi, M Femi; Wilber, Nancy

2007-04-01

Characterizing the cost of preterm birth is important in assessing the impact of increasing prematurity rates and evaluating the cost-effectiveness of therapies to prevent preterm delivery. To assess early intervention costs that are associated with preterm births, we estimated the program cost of early intervention services for children who were born in Massachusetts, by gestational age at birth. Using the Pregnancy to Early Life Longitudinal Data Set, birth certificates for infants who were born in Massachusetts between July 1999 and June 2000 were linked to early intervention claims through 2003. We determined total program costs, in 2003 dollars, of early intervention and mean cost per surviving infant by gestational age. Costs by plurality, eligibility criteria, provider discipline, and annual costs for children's first 3 years also were examined. Overall, 14,033 of 76,901 surviving infants received early intervention services. Program costs totaled almost $66 million, with mean cost per surviving infant of $857. Mean cost per infant was highest for children who were 24 to 31 weeks' gestational age ($5393) and higher for infants who were 32 to 36 weeks' gestational age ($1578) compared with those who were born at term ($725). Cost per surviving infant generally decreased with increasing gestational age. Among children in early intervention, mean cost per child was higher for preterm infants than for term infants. At each gestational age, mean cost per surviving infant was higher for multiples than for singletons, and annual early intervention costs were higher for toddlers than for infants. Compared with their term counterparts, preterm infants incurred higher early intervention costs. This information along with data on birth trends will inform budget forecasting for early intervention programs. Costs that are associated with early childhood developmental services must be included when considering the long-term costs of prematurity.

Costing and pricing electric power reserve services. Final report

International Nuclear Information System (INIS)

Kirsch, L.D.; Rajaraman, R.; Clark, C.

1997-12-01

In the competitive electric power markets of the imminent future, reserves will be the second largest generation service in terms of their revenues and profits. Because reserves will be more widely traded than at present, they will be provided by the cheapest available sources regardless of the ownership of those sources. Price will determine the willingness of generators and consumers to provide reserve services; and it may also determine the willingness of reserve users to purchase reserve services. This report presents a methodology by which generation firms and merchant firms can profitably cost and price the reserve services that they offer. The methodology is generally applicable to a wide range of market structures that such firms might face

Ancillary reactive power service allocation cost in deregulated markets: a methodology

International Nuclear Information System (INIS)

Hernandez, J. Horacio Tovar; Jimenez-Guzman, Miguel; Gutierrez-Alcaraz, Guillermo

2005-01-01

This paper presents a methodology to allocate reactive power costs in deregulated markets. Reactive power supply service is decomposed into voltage regulation and reactive power spinning reserve. The proposed methodology is based on sensitivities and the postage-stamp method in order to allocate the total costs service among all participants. With the purpose of achieving this goal, the system operator identifies voltage support and/or reactive power requirements, and looks out for suitable providers. One case study is presented here to illustrate the methodology over a simplified southeastern Mexican grid. (Author)

Towards an optimal transmission system

International Nuclear Information System (INIS)

Calviou, M.

2005-01-01

This presentation provided background on National Grid USA and discussed transmission investment in the United States (US) and United Kingdom. It also discussed barriers to transmission investments and improvements, thoughts on solutions and a long-term vision. The presentation identified that transmission investment should follow from clear reliability rules designed to promote better operation and management; investment does not necessarily mean new rights-of-way; and transmission investment should target benefits to customers. It was stated that US transmission investment levels have decreased. A comparison between US and UK transmission investment was presented along with a chart of increasing US congestion costs. Barriers to investment in US transmission include vertical integration; misperception of transmission as a market product; federal and state jurisdiction issues; fragmentation in transmission ownership and operation; rate cap based plans that impact transmission; lack of clarity in cost allocation; and the site selection process. Possible solutions include policy and incentives, promoting independence and resolving structural issues. tabs., figs

Can the real opportunity cost stand up: displaced services, the straw man outside the room.

Science.gov (United States)

Eckermann, Simon; Pekarsky, Brita

2014-04-01

In current literature, displaced services have been suggested to provide a basis for determining a threshold value for the effects of a new technology as part of a reimbursement process when budgets are fixed. We critically examine the conditions under which displaced services would represent an economically meaningful threshold value. We first show that if we assume that the least cost-effective services are displaced to finance a new technology, then the incremental cost-effectiveness ratio (ICER) of the displaced services (d) only coincides with that related to the opportunity cost of adopting that new technology, the ICER of the most cost-effective service in expansion (n), under highly restrictive conditions-namely, complete allocative efficiency in existing provision of health care interventions. More generally, reimbursement of new technology with a fixed budget comprises two actions; adoption and financing through displacement and the effect of reimbursement is the net effect of these two actions. In order for the reimbursement process to be a pathway to allocative efficiency within a fixed budget, the net effect of the strategy of reimbursement is compared with the most cost-effective alternative strategy for reimbursement: optimal reallocation, the health gain maximizing expansion of existing services financed by the health loss minimizing contraction. The shadow price of the health effects of a new technology, βc = (1/n + 1/d - 1/m)(-1), accounts for both imperfect displacement (the ICER of the displaced service, d < m, the ICER of the least cost-effective of the existing services in contraction) and the allocative inefficiency (n < m) characteristic of health systems.

COST-EFFECTIVENESS ANALYSIS OF OUTSOURCING SERVICES IN REGARD TO Foreign ECONOMIC ACTIVITY OF ENTERPRISES

Directory of Open Access Journals (Sweden)

Evgenia Sergeevna Gracheva

2017-06-01

Full Text Available Despite enterprises, which render outsourcing services, appeared on the Russian services market with the beginning of market relations, there are not many researches that deal with competition and cost-effectiveness analyses of outsourcing services in regard to foreign economic activity. Economic integration of Russian business into international economic relations leads to complication of all national foreign economic complex and to the necessity of international economic infrastructure development. One of its most important parts are both services which deal with execution of support international economic operations (interpreting and translation services, transport services, customs services etc. and conducting foreign economic activity for client-enterprise (complex outsourcing FEA. Welcoming environment is formed nowadays for outsourcing business development in regard to foreign economic activity. It dictates the need for more thorough study of this type of business activity and development of indicators system for cost-effectiveness analysis of outsourcing in regard to foreign economic activity. Purpose – to define the complex outsourcing FEA, to develop the indicators system for cost-effectiveness analysis of outsourcing services in regard to foreign economic activity. Methodology: in article following scientific methods are used: functional method and statistical method. Results: is given authorial definition of complex outsourcing FEA, is developed the indicators system for cost-effectiveness analysis of outsourcing. Practical implications: the results of this research may be used by the businesses, which render outsourcing and intermediary services in regard to foreign economic activity.

Who should carry the cost of ecosystem service provision? A pan-European citizens’ view

DEFF Research Database (Denmark)

Prokofieva, Irina; Mavsar, Robert; Bartczak, Anna

2014-01-01

accepted concept in theory, the legitimacy of which nevertheless has not yet been challenged in practice. In our study, we conducted an extensive survey in five European countries – Finland, Denmark, Poland, Italy and Spain – with the aim to explore citizens’ opinions of who should carry the costs...... of ecosystem services provision. The ecosystem services in question were biodiversity, recreation, carbon sequestration, water quality, and scenic beauty. Our results show that the majority of respondents in all studied countries generally think that the costs of enhanced provision of ecosystem services shall......The underlying notion of payments for environmental services is that beneficiaries of environmental services (directly or indirectly) financially support their provision by covering at least part of the costs landowners incur to generate them. This so-called “beneficiary-pay principle” is a widely...

A Method for Estimating Costs and Benefits of Space Assembly and Servicing By Astronauts and Robots

Science.gov (United States)

Purves, Lloyd R.; Benfield, Mark (Technical Monitor)

2002-01-01

One aspect of designing future space missions is to determine whether Space Assembly and Servicing (SAS) is useful and, if so, what combination of robots and astronauts provides the most effective means of accomplishing it. Certain aspects of these choices, such as the societal value of developing the means for humans to live in space, do not lend themselves to quantification. However, other SAS costs and benefits can be quantified in a manner that can help select the most cost-effective SAS approach. Any space facility, whether it is assembled and serviced or not, entails an eventual replacement cost due to wear and obsolescence. Servicing can reduce this cost by limiting replacement to only failed or obsolete components. However, servicing systems, such as space robots, have their own logistics cost, and astronauts can have even greater logistics requirements. On the other hand, humans can be more capable than robots at performing dexterous and unstructured tasks, which can reduce logistics costs by allowing a reduction in mass of replacement components. Overall, the cost-effectiveness of astronaut SAS depends on its efficiency; and, if astronauts have to be wholly justified by their servicing usefulness, then the serviced space facility has to be large enough to fully occupy them.

Are Free Maternity Services Completely Free of Costs?

Science.gov (United States)

Acharya, Jeevan

2016-02-01

The Government of Nepal revised free maternity health services, "Aama Surakshya Karyakram", beginning at the start of Fiscal Year 2012/13, which specifies the services to be funded, the tariffs for reimbursement, and the system for claiming and reporting on free deliveries each month. This study was designed to investigate the amount of monetary expenditure incurred by families using apparently free maternity services. Between August 2014 and December 2014, a hospital-based cross-sectional study was conducted at Manipal Teaching Hospital and Western Regional Hospital. Nepalese women were not involved with family finances and had very little knowledge of income or expenditures. Therefore, face-to-face interviews with 384 postpartum mothers with their husbands or the head of the family household were conducted at the time of discharge by using a pre-tested semi-structural questionnaire. The average monthly family income was 19,272.4 NRs (189.01 US$), the median duration of hospital stay was 4 days (range, 2-19 days), and the median patient expenditure was equivalent to 13% of annual family income. The average total visible cost was 3,887.07 NRs (38.1 US$). When the average total hidden cost of 27,288.5 NRs (267.6 US$) was added, then the average total maternity care expenditure was 31,175.6 NRs (305.76 US$), with an average cost per day of 7,167.5 NRs (70.29 US$). The mean patient expenditure on food and drink, clothes, transport, and medicine was equivalent to 53.07%, 9.8%. 7.3%, and 5.6% of the mean total maternity care expenditure, respectively. The earnings lost by respondent women, husbands, and heads of household were 5,963.7 NRs (58.4 US$), 7,429.3 NRs (72.9 US$), and 6,175.9 NRs (60.6 US$), respectively. The free maternity service in Nepal has high out-of-pocket expenditures, and did not represent a system completely free of costs. Therefore, arrangements should be made by hospitals free of cost to provide medicine that is not included as essential during

Quality Dimensions, Value, Service Cost and Recommendation Behaviour: Evidence from the Nigerian Cellular Industry

Directory of Open Access Journals (Sweden)

Abolaji Joachim Abiodun

2014-09-01

Full Text Available The present study proposed and test a model that connects both affective and cognitive factors in cellular service to customers’ recommendation behavior. Results of the analysis of data collected through questionnaire from 293 respondents with cellular phones and active account in the Nigerian cellular industry indicate that core cellular service dimensions, service cost (price and hedonic values are significant determinants of customers’ recommendation behavior. In addition, the study found that customer service and utilitarian value exert negative effect on recommendation behavior. It seems that strengthening the performance of service providers on core service attributes, service cost (price and the entertainment and emotion evoking aspects of cellular service is of more value in partnering with customer to enlarge customer base through recommendation

Cost-price estimation of clinical laboratory services based on activity-based costing: A case study from a developing country.

Science.gov (United States)

Mouseli, Ali; Barouni, Mohsen; Amiresmaili, Mohammadreza; Samiee, Siamak Mirab; Vali, Leila

2017-04-01

It is believed that laboratory tariffs in Iran don't reflect the real costs. This might expose private laboratories at financial hardship. Activity Based Costing is widely used as a cost measurement instrument to more closely approximate the true cost of operations. This study aimed to determine the real price of different clinical tests of a selected private clinical laboratory. This study was a cross sectional study carried out in 2015. The study setting was the private laboratories in the city of Kerman, Iran. Of 629 tests in the tariff book of the laboratory (relative value), 188 tests were conducted in the laboratory that used Activity Based Costing (ABC) methodology to estimate cost-price. Analyzing and cost-price estimating of laboratory services were performed by MY ABCM software Version 5.0. In 2015, the total costs were $641,645. Direct and indirect costs were 78.3% and 21.7% respectively. Laboratory consumable costs by 37% and personnel costs by 36.3% had the largest share of the costing. Also, group of hormone tests cost the most $147,741 (23.03%), and other tests group cost the least $3,611 (0.56%). Also after calculating the cost of laboratory services, a comparison was made between the calculated price and the private sector's tariffs in 2015. This study showed that there was a difference between costs and tariffs in the private laboratory. One way to overcome this problem is to increase the number of laboratory tests with regard to capacity of the laboratories.

The relationship between staff skill mix, costs and outcomes in intermediate care services

Directory of Open Access Journals (Sweden)

Martin Graham P

2010-07-01

Full Text Available Abstract Background The purpose of this study was to assess the relationship between skill mix, patient outcomes, length of stay and service costs in older peoples' intermediate care services in England. Methods We undertook multivariate analysis of data collected as part of the National Evaluation of Intermediate Care Services. Data were analysed on between 337 and 403 older people admitted to 14 different intermediate care teams. Independent variables were the numbers of different types of staff within a team and the ratio of support staff to professionally qualified staff within teams. Outcome measures include the Barthel index, EQ-5D, length of service provision and costs of care. Results Increased skill mix (raising the number of different types of staff by one is associated with a 17% reduction in service costs (p = 0.011. There is weak evidence (p = 0.090 that a higher ratio of support staff to qualified staff leads to greater improvements in EQ-5D scores of patients. Conclusions This study provides limited evidence on the relationship between multidisciplinary skill mix and outcomes in intermediate care services.

The marginal social cost of headway for a scheduled service

DEFF Research Database (Denmark)

Fosgerau, Mogens

2009-01-01

waiting time costs as well as schedule delay costs measured relative to their desired time of arrival at the destination. They may either arrive at the station to choose just the next departure or they may plan for a specific departure in which case they incur also a planning cost. Then planning......This brief paper derives the marginal social cost of headway for a scheduled service, i.e. the cost for users of marginal increases to the time interval between departures. In brief we may call it the value of headway in analogy with the value of travel time and the value of reliability. Users have...... for a specific departure is costly but becomes more attractive at longer headways. Simple expressions for the user cost result. In particular, the marginal cost of headway is large at short headways and smaller at long headways. The difference in marginal costs is the value of time multiplied by half the headway....

Cost-effectiveness of alternative changes to a national blood collection service.

Science.gov (United States)

Willis, S; De Corte, K; Cairns, J A; Zia Sadique, M; Hawkins, N; Pennington, M; Cho, G; Roberts, D J; Miflin, G; Grieve, R

2018-05-16

To evaluate the cost-effectiveness of changing opening times, introducing a donor health report and reducing the minimum inter-donation interval for donors attending static centres. Evidence is required about the effect of changes to the blood collection service on costs and the frequency of donation. This study estimated the effect of changes to the blood collection service in England on the annual number of whole-blood donations by current donors. We used donors' responses to a stated preference survey, donor registry data on donation frequency and deferral rates from the INTERVAL trial. Costs measured were those anticipated to differ between strategies. We reported the cost per additional unit of blood collected for each strategy versus current practice. Strategies with a cost per additional unit of whole blood less than £30 (an estimate of the current cost of collection) were judged likely to be cost-effective. In static donor centres, extending opening times to evenings and weekends provided an additional unit of whole blood at a cost of £23 and £29, respectively. Introducing a health report cost £130 per additional unit of blood collected. Although the strategy of reducing the minimum inter-donation interval had the lowest cost per additional unit of blood collected (£10), this increased the rate of deferrals due to low haemoglobin (Hb). The introduction of a donor health report is unlikely to provide a sufficient increase in donation frequency to justify the additional costs. A more cost-effective change is to extend opening hours for blood collection at static centres. © 2018 The Authors. Transfusion Medicine published by John Wiley & Sons Ltd on behalf of British Blood Transfusion Society.

Technical dependability of obstetric ultrasound transmission via ISDN.

Science.gov (United States)

Nores, J; Athanassiou, A; Malone, F D; D'Alton, M E

1997-01-01

To evaluate the dependability of a live telemedicine link for the transmission of obstetric ultrasonograms using a commercial telephone network. We established an integrated services digital network (ISDN), consisting of three dedicated telephone lines from three satellite offices, to our central prenatal diagnostic center. All patients had a sonographic evaluation recorded on videotape by a trained sonographer. A live interactive video telemedicine link was then established, and a perinatologist directed the sonographer through the scan. A report was issued on the basis of the telemedicine examination. The number of calls required to obtain satisfactory real-time images was recorded, as were the reasons for suboptimal transmissions. The first 150 transmissions were excluded from this study. The results in the subsequent 100 patients who agreed to participate were analyzed. We were able to provide obstetric interpretations in all 100 patients scheduled to be examined using the telemedicine link. A single connection was required in 85 cases, two calls in 5 cases, three calls in 8 cases, four calls in 1 case, and five calls in another case. A repeat call was required in 20 cases because of poor image transmission; other repeat calls were caused by failure to connect (5 cases), calls disconnected (2 cases), and no image transmission (2 cases). The provision of telemedicine services for obstetric ultrasonography in the community is feasible, but the need for repeat connections because of technical failures needs to be incorporated into cost and time analyses in order to provide a measure of the system's efficiency.

Transmission pricing in privately-owned electricity grids: An illustration from the Argentine electricity pool

International Nuclear Information System (INIS)

Abdala, Manuel A.

2008-01-01

The Argentine electricity reform of 1992 offers an interesting example of decentralized transmission pricing arrangements within a competitive system. This paper is a shortened version of an original analysis made in 1994 of the regulation of the Argentine transmission system, with emphasis on investment cost allocation rules. To make up for the limitation of short-run marginal cost (SRMC) pricing, incentives on service quality were put in place, including penalties for lack of line availability. The mechanism for capacity expansion, based on ad-hoc rules for allocations of investment costs, had the potential to produce non-optimal investment outcomes, as such rules ignored beneficiaries on the demand side. For fine tuning of this system, I proposed an alternative rule based on traditional welfare analysis that broadens the universe of identified beneficiaries, and thus can be expected to produce a fairer outcome on investment cost allocation, reducing the potential risks of non-optimal investment. A brief postscript comments on the paper from the perspective of 2007. (author)

Cost-effectiveness of dryland forest restoration evaluated by spatial analysis of ecosystem services

Science.gov (United States)

Birch, Jennifer C.; Newton, Adrian C.; Aquino, Claudia Alvarez; Cantarello, Elena; Echeverría, Cristian; Kitzberger, Thomas; Schiappacasse, Ignacio; Garavito, Natalia Tejedor

2010-01-01

Although ecological restoration is widely used to combat environmental degradation, very few studies have evaluated the cost-effectiveness of this approach. We examine the potential impact of forest restoration on the value of multiple ecosystem services across four dryland areas in Latin America, by estimating the net value of ecosystem service benefits under different reforestation scenarios. The values of selected ecosystem services were mapped under each scenario, supported by the use of a spatially explicit model of forest dynamics. We explored the economic potential of a change in land use from livestock grazing to restored native forest using different discount rates and performed a cost–benefit analysis of three restoration scenarios. Results show that passive restoration is cost-effective for all study areas on the basis of the services analyzed, whereas the benefits from active restoration are generally outweighed by the relatively high costs involved. These findings were found to be relatively insensitive to discount rate but were sensitive to the market value of carbon. Substantial variation in values was recorded between study areas, demonstrating that ecosystem service values are strongly context specific. However, spatial analysis enabled localized areas of net benefits to be identified, indicating the value of this approach for identifying the relative costs and benefits of restoration interventions across a landscape. PMID:21106761

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

Science.gov (United States)

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

2016-01-01

With the commitment of the national government to provide universal healthcare at cheap and affordable prices in India, public healthcare services are being strengthened in India. However, there is dearth of cost data for provision of health services through public system like primary & community health centres. In this study, we aim to bridge this gap in evidence by assessing the total annual and per capita cost of delivering the package of health services at PHC and CHC level. Secondly, we determined the per capita cost of delivering specific health services like cost per antenatal care visit, per institutional delivery, per outpatient consultation, per bed-day hospitalization etc. We undertook economic costing of fourteen public health facilities (seven PHCs and CHCs each) in three North-Indian states viz., Haryana, Himachal Pradesh and Punjab. Bottom-up costing method was adopted for collection of data on all resources spent on delivery of health services in selected health facilities. Analysis was undertaken using a health system perspective. The joint costs like human resource, capital, and equipment were apportioned as per the time value spent on a particular service. Capital costs were discounted and annualized over the estimated life of the item. Mean annual costs and unit costs were estimated along with their 95% confidence intervals using bootstrap methodology. The overall annual cost of delivering services through public sector primary and community health facilities in three states of north India were INR 8.8 million (95% CI: 7,365,630-10,294,065) and INR 26.9 million (95% CI: 22,225,159.3-32,290,099.6), respectively. Human resources accounted for more than 50% of the overall costs at both the level of PHCs and CHCs. Per capita per year costs for provision of complete package of preventive, curative and promotive services at PHC and CHC were INR 170.8 (95% CI: 131.6-208.3) and INR162.1 (95% CI: 112-219.1), respectively. The study estimates can be used

Alternative approaches to transmission investment

Energy Technology Data Exchange (ETDEWEB)

Welch, J.L. [International Transmission Co., Detroit, MI (United States)

2004-07-01

The International Transmission Company (ITC) is an independent power transmission company that owns, operates and maintains the high voltage transmission system in southeastern Michigan. The company's current focus is on investing in the transmission infrastructure to improve reliability, relieve congestion, improve access to generation and reduce energy costs for consumers. There is a need for investment in power transmission. Trends indicate that power transactions are on the rise while transmission investment is lagging because pricing protocols are inadequate and there is no regional tariff mechanism to allocate the benefits of new investment. The presentation reviewed the applicability of FTRs to transmission owners and the pitfalls of participant funding pricing. It also outlined the regional benefit allocation mechanism (RBAM) with an illustrative example. It was concluded that existing pricing policies must be improved to address the growing need for transmission investment. RBAM is needed to help investors recover costs from project beneficiaries. figs.

A DDC Bibliography on Cost/Benefits of Technical Information Services and Technology Transfer.

Science.gov (United States)

Defense Documentation Center, Alexandria, VA.

This bibliography is a compilation of literature existing in both the government and public sectors and concerning Cost/Benefits of Technical information Services and Technology Transfer. Not only was the cost-benefit to the user reflected, but consideration was given to the initial cost of information collections, the cost of processing the…

Comparative Cost Analysis of Four Interventions to Prevent HIV Transmission in Bandung, Indonesia

Directory of Open Access Journals (Sweden)

Eveline J.M. Verstraaten

2017-11-01

Full Text Available Background: the costs of HIV/AIDS interventions in Indonesia are largely unknown. Knowing these costs is an important input for policy makers in the decision-making of setting priorities among HIV/AIDS interventions. The aim of this analysis is to determine the costs of four HIV/AIDS interventions in Bandung, Indonesia in 2015, to inform the local AIDS commission. Methods: data on utilization and costs of the different interventions were collected in a sexual transmitted infections (STI-clinic and the KPA, the local HIV/AIDS commission, for the period of January 2015-December 2015. The costs were estimated from a societal perspective, using a micro-costing approach. Results: the total annualized costs for condom distribution, mobile voluntary counselling and testing (VCT, religious based information, communication, and education (IEC and STI services equalled US$56,926, US$2,985, US$1,963 and US$5,865, respectively. Conclusion: this analysis has provided cost estimates of four different HIV/AIDS interventions in Bandung, Indonesia. Additionally, it has estimated the costs of scaling up these interventions. Together, this provides important information for policy makers vis-à-vis the implementation of these interventions. However, an evaluation of the effectiveness of these interventions is needed to estimate the cost-effectiveness.

The hidden costs of self-management services in the accounting activity of a company

Directory of Open Access Journals (Sweden)

Dan Ioan TOPOR

2017-05-01

Full Text Available This article addresses relevant aspects regarding the hidden costs of self-management services in the accounting area, within the accounting department of a company. With this aim, the authors conducted a study using a questionnaire, whose results were analyzed and interpreted. The hidden costs of the self-management of business accounting services observed in the accounting department of the company have been assessed and the causes of their generating sources were identified and analyzed. The debate of these hidden costs involved the treating of notions that exist in the accounting language, but are still not sufficiently explored by the specialists in the area. We also presented and analyzed the causes of the hidden costs of self-management in the accounting activity, as well as a reporting document for failures, arising from the case study. The article ends with the authors' conclusions regarding the hidden costs of self-management services in the accounting area.

Demonstration of DFT-spread 256QAM-OFDM signal transmission with cost-effective directly modulated laser.

Science.gov (United States)

Li, Fan; Yu, Jianjun; Fang, Yuan; Dong, Ze; Li, Xinying; Chen, Lin

2014-04-07

We experimentally demonstrated a 256-ary quadrature amplitude modulation (256QAM) direct-detection optical orthogonal frequency division multiplexing (DDO-OFDM) transmission system utilizing a cost-effective directly modulated laser (DML). Intra-symbol frequency-domain averaging (ISFA) is applied to suppress in-band noise while the channel response estimation and Discrete Fourier Transform-spread (DFT-spread) is used to reduce the peak-to-average power ratio (PAPR) of the transmitted OFDM signal. The bit-error ratio (BER) of 15-Gbit/s 256QAM-OFDM signal has been measured after 20-km SSMF transmission that is less than 7% forward-error-correction (FEC) threshold of 3.8 × 10(-3) as the launch power into fiber is set at 6dBm. For 11.85-Gbit/s 256QAM-OFDM signal, with the aid of ISFA-based channel estimation and PAPR reduction enabled by DFT-spread, the BER after 20-km SSMF transmission can be improved from 6.4 × 10(-3) to 6.8 × 10(-4) when the received optical power is -6dBm.

Cost-Effectiveness Analysis of a Mobile Ear Screening and Surveillance Service versus an Outreach Screening, Surveillance and Surgical Service for Indigenous Children in Australia.

Directory of Open Access Journals (Sweden)

Kim-Huong Nguyen

Full Text Available Indigenous Australians experience a high rate of ear disease and hearing loss, yet they have a lower rate of service access and utilisation compared to their non-Indigenous counterparts. Screening, surveillance and timely access to specialist ear, nose and throat (ENT services are key components in detecting and preventing the recurrence of ear diseases. To address the low access and utilisation rate by Indigenous Australians, a collaborative, community-based mobile telemedicine-enabled screening and surveillance (MTESS service was trialled in Cherbourg, the third largest Indigenous community in Queensland, Australia. This paper aims to evaluate the cost-effectiveness of the MTESS service using a lifetime Markov model that compares two options: (i the Deadly Ears Program alone (current practice involving an outreach ENT surgical service and screening program, and (ii the Deadly Ears Program supplemented with the MTESS service. Data were obtained from the Deadly Ears Program, a feasibility study of the MTESS service and the literature. Incremental cost-utility ratios were calculated from a societal perspective with both costs (in 2013-14 Australian dollars and quality-adjusted life years (QALYs discounted at 5% annually. The model showed that compared with the Deadly Ears Program, the probability of an acceptable cost-utility ratio at a willingness-to-pay threshold of $50,000/QALY was 98% for the MTESS service. This cost effectiveness arises from preventing hearing loss in the Indigenous population and the subsequent reduction in associated costs. Deterministic and probability sensitivity analyses indicated that the model was robust to parameter changes. We concluded that the MTESS service is a cost-effective strategy. It presents an opportunity to resolve major issues confronting Australia's health system such as the inequitable provision and access to quality healthcare for rural and remotes communities, and for Indigenous Australians

Cost-Effectiveness Analysis of a Mobile Ear Screening and Surveillance Service versus an Outreach Screening, Surveillance and Surgical Service for Indigenous Children in Australia.

Science.gov (United States)

Nguyen, Kim-Huong; Smith, Anthony C; Armfield, Nigel R; Bensink, Mark; Scuffham, Paul A

2015-01-01

Indigenous Australians experience a high rate of ear disease and hearing loss, yet they have a lower rate of service access and utilisation compared to their non-Indigenous counterparts. Screening, surveillance and timely access to specialist ear, nose and throat (ENT) services are key components in detecting and preventing the recurrence of ear diseases. To address the low access and utilisation rate by Indigenous Australians, a collaborative, community-based mobile telemedicine-enabled screening and surveillance (MTESS) service was trialled in Cherbourg, the third largest Indigenous community in Queensland, Australia. This paper aims to evaluate the cost-effectiveness of the MTESS service using a lifetime Markov model that compares two options: (i) the Deadly Ears Program alone (current practice involving an outreach ENT surgical service and screening program), and (ii) the Deadly Ears Program supplemented with the MTESS service. Data were obtained from the Deadly Ears Program, a feasibility study of the MTESS service and the literature. Incremental cost-utility ratios were calculated from a societal perspective with both costs (in 2013-14 Australian dollars) and quality-adjusted life years (QALYs) discounted at 5% annually. The model showed that compared with the Deadly Ears Program, the probability of an acceptable cost-utility ratio at a willingness-to-pay threshold of $50,000/QALY was 98% for the MTESS service. This cost effectiveness arises from preventing hearing loss in the Indigenous population and the subsequent reduction in associated costs. Deterministic and probability sensitivity analyses indicated that the model was robust to parameter changes. We concluded that the MTESS service is a cost-effective strategy. It presents an opportunity to resolve major issues confronting Australia's health system such as the inequitable provision and access to quality healthcare for rural and remotes communities, and for Indigenous Australians. Additionally, it may

18 CFR 2.22 - Pricing policy for transmission services provided under the Federal Power Act.

Science.gov (United States)

2010-04-01

... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Pricing policy for... INTERPRETATIONS Statements of General Policy and Interpretations Under the Federal Power Act § 2.22 Pricing policy... Policy Statement on its pricing policy for transmission services provided under the Federal Power Act...

Costs of publicly provided maternity services in Rosario, Argentina

Directory of Open Access Journals (Sweden)

Borghi Josephine

2003-01-01

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

Mobile Messaging Services-Based Personal Electrocardiogram Monitoring System

Directory of Open Access Journals (Sweden)

Ashraf A. Tahat

2009-01-01

Full Text Available A mobile monitoring system utilizing Bluetooth and mobile messaging services (MMS/SMSs with low-cost hardware equipment is proposed. A proof of concept prototype has been developed and implemented to enable transmission of an Electrocardiogram (ECG signal and body temperature of a patient, which can be expanded to include other vital signs. Communication between a mobile smart-phone and the ECG and temperature acquisition apparatus is implemented using the popular personal area network standard specification Bluetooth. When utilizing MMS for transmission, the mobile phone plots the received ECG signal and displays the temperature using special application software running on the client mobile phone itself, where the plot can be captured and saved as an image before transmission. Alternatively, SMS can be selected as a transmission means, where in this scenario, dedicated application software is required at the receiving device. The experimental setup can be operated for monitoring from anywhere in the globe covered by a cellular network that offers data services.

Mobile messaging services-based personal electrocardiogram monitoring system.

Science.gov (United States)

Tahat, Ashraf A

2009-01-01

A mobile monitoring system utilizing Bluetooth and mobile messaging services (MMS/SMSs) with low-cost hardware equipment is proposed. A proof of concept prototype has been developed and implemented to enable transmission of an Electrocardiogram (ECG) signal and body temperature of a patient, which can be expanded to include other vital signs. Communication between a mobile smart-phone and the ECG and temperature acquisition apparatus is implemented using the popular personal area network standard specification Bluetooth. When utilizing MMS for transmission, the mobile phone plots the received ECG signal and displays the temperature using special application software running on the client mobile phone itself, where the plot can be captured and saved as an image before transmission. Alternatively, SMS can be selected as a transmission means, where in this scenario, dedicated application software is required at the receiving device. The experimental setup can be operated for monitoring from anywhere in the globe covered by a cellular network that offers data services.

Strategic Generation with Conjectured Transmission Price Responses in a Mixed Transmission Pricing System. Part 2. Application

International Nuclear Information System (INIS)

Wals, A.F.; Hobbs, B.F.; Rijkers, F.A.M.

2004-05-01

The conjectured transmission price response model presented in the first of this two-paper series considers the expectations of oligopolistic generators regarding how demands for transmission services affect the prices of those services. Here, the model is applied to northwest Europe, simulating a mixed transmission pricing system including export fees, a path-based auction system for between-country interfaces, and implicit congestion-based pricing of internal country constraints. The path-based system does not give credit for counterflows when calculating export capability. The application shows that this no-netting policy can exacerbate the economic inefficiencies caused by oligopolistic pricing by generators. The application also illustrates the effects of different generator conjectures regarding rival supply responses and transmission prices. If generators anticipate that their increased demand for transmission services will increase transmission prices, then competitive intensity diminishes and energy prices rise. In the example here, the effect of this anticipation is to double the price increase that results from oligopolistic (Cournot) competition among generators

The Cost and Cost-Effectiveness of Scaling up Screening and Treatment of Syphilis in Pregnancy: A Model

Science.gov (United States)

Kahn, James G.; Jiwani, Aliya; Gomez, Gabriela B.; Hawkes, Sarah J.; Chesson, Harrell W.; Broutet, Nathalie; Kamb, Mary L.; Newman, Lori M.

2014-01-01

Background Syphilis in pregnancy imposes a significant global health and economic burden. More than half of cases result in serious adverse events, including infant mortality and infection. The annual global burden from mother-to-child transmission (MTCT) of syphilis is estimated at 3.6 million disability-adjusted life years (DALYs) and $309 million in medical costs. Syphilis screening and treatment is simple, effective, and affordable, yet, worldwide, most pregnant women do not receive these services. We assessed cost-effectiveness of scaling-up syphilis screening and treatment in existing antenatal care (ANC) programs in various programmatic, epidemiologic, and economic contexts. Methods and Findings We modeled the cost, health impact, and cost-effectiveness of expanded syphilis screening and treatment in ANC, compared to current services, for 1,000,000 pregnancies per year over four years. We defined eight generic country scenarios by systematically varying three factors: current maternal syphilis testing and treatment coverage, syphilis prevalence in pregnant women, and the cost of healthcare. We calculated program and net costs, DALYs averted, and net costs per DALY averted over four years in each scenario. Program costs are estimated at $4,142,287 – $8,235,796 per million pregnant women (2010 USD). Net costs, adjusted for averted medical care and current services, range from net savings of $12,261,250 to net costs of $1,736,807. The program averts an estimated 5,754 – 93,484 DALYs, yielding net savings in four scenarios, and a cost per DALY averted of $24 – $111 in the four scenarios with net costs. Results were robust in sensitivity analyses. Conclusions Eliminating MTCT of syphilis through expanded screening and treatment in ANC is likely to be highly cost-effective by WHO-defined thresholds in a wide range of settings. Countries with high prevalence, low current service coverage, and high healthcare cost would benefit most. Future analyses can be

Voluntary transmission access: The PSI proposal

International Nuclear Information System (INIS)

Norris, J.E.

1990-01-01

This article examines a proposal from PSI Energy, Inc. (formerly Public Service Company of Indiana) to allow open access to its power transmission facilities and the response of the Federal Energy Regulatory Commission's response to that proposal. The topics discussed include transmission tariffs, competition, market share, expansion of transmission capacity and its funding, and reciprocal agreements to provide similar service

[Cost-effectiveness and cost-benefit analysis on strategy for preventing mother-to-child transmission of hepatitis B virus].

Science.gov (United States)

Cai, Y L; Zhang, S X; Yang, P C; Lin, Y

2016-06-01

Through cost-benefit analysis (CBA), cost-effectiveness analysis (CEA) and quantitative optimization analysis to understand the economic benefit and outcomes of strategy regarding preventing mother-to-child transmission (PMTCT) on hepatitis B virus. Based on the principle of Hepatitis B immunization decision analytic-Markov model, strategies on PMTCT and universal vaccination were compared. Related parameters of Shenzhen were introduced to the model, a birth cohort was set up as the study population in 2013. The net present value (NPV), benefit-cost ratio (BCR), incremental cost-effectiveness ratio (ICER) were calculated and the differences between CBA and CEA were compared. A decision tree was built as the decision analysis model for hepatitis B immunization. Three kinds of Markov models were used to simulate the outcomes after the implementation of vaccination program. The PMTCT strategy of Shenzhen showed a net-gain as 38 097.51 Yuan/per person in 2013, with BCR as 14.37. The universal vaccination strategy showed a net-gain as 37 083.03 Yuan/per person, with BCR as 12.07. Data showed that the PMTCT strategy was better than the universal vaccination one and would end with gaining more economic benefit. When comparing with the universal vaccination program, the PMTCT strategy would save 85 100.00 Yuan more on QALY gains for every person. The PMTCT strategy seemed more cost-effective compared with the one under universal vaccination program. In the CBA and CEA hepatitis B immunization programs, the immunization coverage rate and costs of hepatitis B related diseases were the most important influencing factors. Outcomes of joint-changes of all the parameters in CEA showed that PMTCT strategy was a more cost-effective. The PMTCT strategy gained more economic benefit and effects on health. However, the cost of PMTCT strategy was more than the universal vaccination program, thus it is important to pay attention to the process of PMTCT strategy and the universal

Options for pricing ancillary services in a deregulated power system

Science.gov (United States)

Yamin, Hatim Yahya

2001-07-01

GENCOs in restructured systems are compensated for selling energy in the market. In a restructured market, a mechanism is required to entice participants in the market to provide ancillary services and to ensure adequate compensation that would guarantee its economic viability. The ISO controls the dispatch of generation, manages the reliability of the transmission grid, provides open access to the transmission, buys and provides ancillary services as required, coordinates day-ahead, hour-ahead schedules and performs real time balancing of load and generation, settles real time imbalances and ancillary services sales and purchases. The ISO, also, administers congestion management protocols for the transmission grid. Since the ISO does not own any generating units it must ensure that there is enough reserves for maintaining reliability according to FERC regulations, and sufficient unloaded generating capacity for balancing services in a real-time market. The ISO could meet these requirements by creating a competitive market for ancillary services, which are metered and remain unbundled to provide an accurate compensation for each supplier and cost to each consumer, In this study, we give an overview for restructuring and ancillary services in a restructured power marketplace. Also, we discuss the effect of GENCOs' actions in the competitive energy and ancillary service markets. In addition, we propose an auction market design for hedging ancillary service costs in California market. Furthermore, we show how to include the n-1 and voltage contingencies in security constrained unit commitment. Finally, we present two approaches for GENCOs' unit commitment in a restructured power market; one is based on game theory and the other is based on market price forecasting. In each of the two GENCOs' unit commitment approaches, we discuss the GENCOs' optimal bidding strategies in energy and ancillary service markets to maximize the GENCOs' profit.

78 FR 27307 - Establishment of Class A TV Service and Cable Television Rate Regulation; Cost of Service Rules...

Science.gov (United States)

2013-05-10

... FEDERAL COMMUNICATIONS COMMISSION 47 CFR Parts 73 and 76 [MM Docket No. 00-10; FCC 01-123 and MM Docket No. 93-215; FCC 95-502] Establishment of Class A TV Service and Cable Television Rate Regulation; Cost of Service Rules--Clarification Regarding Information Collection Requirements; Correction AGENCY...

Costs of denied health care services and of the lawsuits filed to obtain them in Medellín, 2009

Directory of Open Access Journals (Sweden)

Emmanuel Nieto L

2011-07-01

Full Text Available Objective: to retrace the legal route of writs for the protection of constitutional rights involving health care services and to determine the cost of such processes and those of the health care services invoked in a sample of such writs taken in Medellín city. Methods: a descriptive study with a qualitative focus for retracing the legal route of the writs, and a quantitative approach for the purpose of cost estimation. The 2009 SOAT (Mandatory Car Insurance fees were used for assessing the cost of the health care services. As for the assessment of the legal costs, we used the micro-costing approach together with the activity-based costing methodology. Results: for each $100 corresponding to the cost of the services denied by the health care services provider, the Medellín judicial system spent around $48 on each legal process. In more than half of the cases, the cost of the legal action was higher than the services’ cost. Discussion: the cost of the legal process involving the writs for the protection of constitutional rights regarding health care services that were filed in the country between 1999 and 2009 could represent 2% of the budget circulating throughout the entire health system. This cost is just a part of the transaction costs generated by the health care services providers’ breach of the social contract established by the Colombian Constitution. Furthermore, in most cases there is also a breach of the private contract between these service providers and the health system users.

Analysis of health services cost at the dental clinic of the San Marcos University.

OpenAIRE

Madrid Chumacero, Marco Tulio; Echeandía Arellano, Juana V.

2014-01-01

The objectives of this study were: To establish the unitary services cost in Dentistry, To describe simplest way to determine the costs structure approximated for each dental service offered at the clinic. They it was compared with the welfare rates at the dental clinic of the UNMSM, the results were the following ones: 1. Diagnosis: in the four cost activities is higher compared with the official rates, demonstrating "minimum utilities" that goes up from 0,21 to s. 15.96. 2. Radiology: in th...

Cost-effectiveness of strategies to prevent methicillin-resistant Staphylococcus aureus transmission and infection in an intensive care unit.

Science.gov (United States)

Gidengil, Courtney A; Gay, Charlene; Huang, Susan S; Platt, Richard; Yokoe, Deborah; Lee, Grace M

2015-01-01

OBJECTIVE To create a national policy model to evaluate the projected cost-effectiveness of multiple hospital-based strategies to prevent methicillin-resistant Staphylococcus aureus (MRSA) transmission and infection. DESIGN Cost-effectiveness analysis using a Markov microsimulation model that simulates the natural history of MRSA acquisition and infection. PATIENTS AND SETTING Hypothetical cohort of 10,000 adult patients admitted to a US intensive care unit. METHODS We compared 7 strategies to standard precautions using a hospital perspective: (1) active surveillance cultures; (2) active surveillance cultures plus selective decolonization; (3) universal contact precautions (UCP); (4) universal chlorhexidine gluconate baths; (5) universal decolonization; (6) UCP + chlorhexidine gluconate baths; and (7) UCP+decolonization. For each strategy, both efficacy and compliance were considered. Outcomes of interest were: (1) MRSA colonization averted; (2) MRSA infection averted; (3) incremental cost per colonization averted; (4) incremental cost per infection averted. RESULTS A total of 1989 cases of colonization and 544 MRSA invasive infections occurred under standard precautions per 10,000 patients. Universal decolonization was the least expensive strategy and was more effective compared with all strategies except UCP+decolonization and UCP+chlorhexidine gluconate. UCP+decolonization was more effective than universal decolonization but would cost $2469 per colonization averted and $9007 per infection averted. If MRSA colonization prevalence decreases from 12% to 5%, active surveillance cultures plus selective decolonization becomes the least expensive strategy. CONCLUSIONS Universal decolonization is cost-saving, preventing 44% of cases of MRSA colonization and 45% of cases of MRSA infection. Our model provides useful guidance for decision makers choosing between multiple available hospital-based strategies to prevent MRSA transmission.

Case-mix tool, costs and effectiveness in improving primary care mental health and substance abuse services.

Science.gov (United States)

Riihimäki, Kirsi; Heiska-Johansson, Ainomaija; Ketola, Eeva

2018-02-01

Despite its importance in improving care and developing services, high-quality data evaluating cost-effectiveness and services in different case-mix populations is scarce in primary care. The objective was to investigate the service use of those mental health and substance abuse patients, who use lots of services. Primary health care diagnosis-related groups (pDRG) is a tool to evaluate service provider system and improve efficiency, productivity and quality. We viewed all pDRG results available from the year 2015 concerning municipal mental health and substance abuse services. In primary care mental health and substance abuse services, the most common ICD-10-codes were depression and substance abuse. One-fifth of patients produced 57% of costs. Their medium of appointments was 16 per year versus 6 per year of all patients. Only 54% of their diagnoses were recorded in the electronic health records versus 75% of all patients. They made 5.7 different pDRG episodes, including 1.8 episodes of depression, per patient. The average episode cost for this patient group was 301€. pDRG makes health care production transparent also in mental health and substance abuse services. It is easy to identify patients, who use a lot of services and thus induce the majority of costs, and focus on their needs in managing and developing services.

Cost of delivering secondary-level health care services through public sector district hospitals in India

Science.gov (United States)

Prinja, Shankar; Balasubramanian, Deepak; Jeet, Gursimer; Verma, Ramesh; Kumar, Dinesh; Bahuguna, Pankaj; Kaur, Manmeet; Kumar, Rajesh

2017-01-01

Background & objectives: Despite an impetus for strengthening public sector district hospitals for provision of secondary health care in India, there is lack of robust evidence on cost of services provided through these district hospitals. In this study, an attempt was made to determine the unit cost of an outpatient visit consultation, inpatient bed-day of hospitalization, surgical procedure and overall per-capita cost of providing secondary care through district hospitals. Methods: Economic costing of five randomly selected district hospitals in two north Indian States - Haryana and Punjab, was undertaken. Cost analysis was done using a health system perspective and employing bottom-up costing methodology. Quantity of all resources - capital or recurrent, used for delivering services was measured and valued. Median unit costs were estimated along with their 95 per cent confidence intervals. Sensitivity analysis was undertaken to assess the effect of uncertainties in prices and other assumptions; and to generalize the findings for Indian set-up. Results: The overall annual cost of delivering secondary-level health care services through a public sector district hospital in north India was 11,44,13,282 [US Dollars (USD) 2,103,185]. Human resources accounted for 53 per cent of the overall cost. The unit cost of an inpatient bed-day, surgical procedure and outpatient consultation was 844 (USD 15.5), i; 3481 (USD 64) and 170 (USD 3.1), respectively. With the current set of resource allocation, per-capita cost of providing health care through district hospitals in north India was 139 (USD 2.5). Interpretation & conclusions: The estimates obtained in our study can be used for Fiscal planning of scaling up secondary-level health services. Further, these may be particularly useful for future research such as benefit-incidence analysis, cost-effectiveness analysis and national health accounts including disease-specific accounts in India. PMID:29355142

Cost of delivering secondary-level health care services through public sector district hospitals in India.

Science.gov (United States)

Prinja, Shankar; Balasubramanian, Deepak; Jeet, Gursimer; Verma, Ramesh; Kumar, Dinesh; Bahuguna, Pankaj; Kaur, Manmeet; Kumar, Rajesh

2017-09-01

Despite an impetus for strengthening public sector district hospitals for provision of secondary health care in India, there is lack of robust evidence on cost of services provided through these district hospitals. In this study, an attempt was made to determine the unit cost of an outpatient visit consultation, inpatient bed-day of hospitalization, surgical procedure and overall per-capita cost of providing secondary care through district hospitals. Economic costing of five randomly selected district hospitals in two north Indian States - Haryana and Punjab, was undertaken. Cost analysis was done using a health system perspective and employing bottom-up costing methodology. Quantity of all resources - capital or recurrent, used for delivering services was measured and valued. Median unit costs were estimated along with their 95 per cent confidence intervals. Sensitivity analysis was undertaken to assess the effect of uncertainties in prices and other assumptions; and to generalize the findings for Indian set-up. The overall annual cost of delivering secondary-level health care services through a public sector district hospital in north India was ' 11,44,13,282 [US Dollars (USD) 2,103,185]. Human resources accounted for 53 per cent of the overall cost. The unit cost of an inpatient bed-day, surgical procedure and outpatient consultation was ' 844 (USD 15.5), ' 3481 (USD 64) and ' 170 (USD 3.1), respectively. With the current set of resource allocation, per-capita cost of providing health care through district hospitals in north India was ' 139 (USD 2.5). The estimates obtained in our study can be used for Fiscal planning of scaling up secondary-level health services. Further, these may be particularly useful for future research such as benefit-incidence analysis, cost-effectiveness analysis and national health accounts including disease-specific accounts in India.

Cost-effectiveness of national mandatory screening of all admissions to English National Health Service hospitals for meticillin-resistant Staphylococcus aureus: a mathematical modelling study.

Science.gov (United States)

Robotham, Julie V; Deeny, Sarah R; Fuller, Chris; Hopkins, Susan; Cookson, Barry; Stone, Sheldon

2016-03-01

In December, 2010, National Health Service (NHS) England introduced national mandatory screening of all admissions for meticillin-resistant Staphylococcus aureus (MRSA). We aimed to assess the effectiveness and cost-effectiveness of this policy, from a regional or national health-care decision makers' perspective, compared with alternative screening strategies. We used an individual-based dynamic transmission model parameterised with national MRSA audit data to assess the effectiveness and cost-effectiveness of admission screening of patients in English NHS hospitals compared with five alternative strategies (including no screening, checklist-activated screening, and high-risk specialty-based screening), accompanied by patient isolation and decolonisation, over a 5 year time horizon. We evaluated strategies for different NHS hospital types (acute, teaching, and specialist), MRSA prevalence, and transmission potentials using probabilistic sensitivity analyses. Compared with no screening, mean cost per quality-adjusted life-year (QALY) of screening all admissions was £89,000-148,000 (range £68,000-222,000), and this strategy was consistently more costly and less effective than alternatives for all hospital types. At a £30,000/QALY willingness-to-pay threshold and current prevalence, only the no-screening strategy was cost effective. The next best strategies were, in acute and teaching hospitals, targeting of high-risk specialty admissions (30-40% chance of cost-effectiveness; mean incremental cost-effectiveness ratios [ICERs] £45,200 [range £35,300-61,400] and £48,000/QALY [£34,600-74,800], respectively) and, in specialist hospitals, screening these patients plus risk-factor-based screening of low-risk specialties (a roughly 20% chance of cost-effectiveness; mean ICER £62,600/QALY [£48,000-89,400]). As prevalence and transmission increased, targeting of high-risk specialties became the optimum strategy at the NHS willingness-to-pay threshold (£30,000/QALY

Negotiated settlements with a cost of service backstop: The consequences for depreciation

International Nuclear Information System (INIS)

Fellows, G. Kent

2011-01-01

The movement from traditional regulatory hearings to negotiated settlements represents both a departure from cost of service regulation and a relaxation of regulatory oversight. Under negotiation parties are able to renegotiate inclusions in their cost of service while simultaneously creating a profit margin for the regulated firm where none existed under the cost of service outcome of a traditional hearing. This paper constructs a model to illustrate the existence of positive gains to pipeline and shipper from the re-allocation of expenses through time in the regulated pipeline services market in Canada. Behaviour consistent with the model is observable in anecdotal and econometric evidence gathered from the library of the National Energy Board of Canada, responsible for pipeline toll regulation in Canada. Empirical investigation by into settlement procedures in the Florida electricity market reveals similar findings; however, this analysis represents the first attempt to model the behaviour formally. The econometric analysis uses new data collected and compiled specifically for this exercise. - Research highlights: → Regulated firms' preference for negotiated settlements over litigation is examined. → A mathematical framework for the impact of settlements on profits is established. → Deferred depreciation is identified as a likely outcome of negotiated settlements. → The hypothesis of deferred depreciation is tested using Canadian Pipeline Data.

Estimating the costs of the vaccine supply chain and service delivery for selected districts in Kenya and Tanzania.

Science.gov (United States)

Mvundura, Mercy; Lorenson, Kristina; Chweya, Amos; Kigadye, Rosemary; Bartholomew, Kathryn; Makame, Mohammed; Lennon, T Patrick; Mwangi, Steven; Kirika, Lydia; Kamau, Peter; Otieno, Abner; Murunga, Peninah; Omurwa, Tom; Dafrossa, Lyimo; Kristensen, Debra

2015-05-28

Having data on the costs of the immunization system can provide decision-makers with information to benchmark the costs when evaluating the impact of new technologies or programmatic innovations. This paper estimated the supply chain and immunization service delivery costs and cost per dose in selected districts in Kenya and Tanzania. We also present operational data describing the supply chain and service delivery points (SDPs). To estimate the supply chain costs, we collected resource-use data for the cold chain, distribution system, and health worker time and per diems paid. We also estimated the service delivery costs, which included the time cost of health workers to provide immunization services, and per diems and transport costs for outreach sessions. Data on the annual quantities of vaccines distributed to each facility, and the occurrence and duration of stockouts were collected from stock registers. These data were collected from the national store, 2 regional and 4 district stores, and 12 SDPs in each country for 2012. Cost per dose for the supply chain and immunization service delivery were estimated. The average annual costs per dose at the SDPs were $0.34 (standard deviation (s.d.) $0.18) for Kenya when including only the vaccine supply chain costs, and $1.33 (s.d. $0.82) when including immunization service delivery costs. In Tanzania, these costs were $0.67 (s.d. $0.35) and $2.82 (s.d. $1.64), respectively. Both countries experienced vaccine stockouts in 2012, bacillus Calmette-Guérin vaccine being more likely to be stocked out in Kenya, and oral poliovirus vaccine in Tanzania. When stockouts happened, they usually lasted for at least one month. Tanzania made investments in 2011 in preparation for planned vaccine introductions, and their supply chain cost per dose is expected to decline with the new vaccine introductions. Immunization service delivery costs are a significant portion of the total costs at the SDPs. Copyright © 2015 Elsevier Ltd. All

HVDC power transmission technology assessment

Energy Technology Data Exchange (ETDEWEB)

Hauth, R.L.; Tatro, P.J.; Railing, B.D. [New England Power Service Co., Westborough, MA (United States); Johnson, B.K.; Stewart, J.R. [Power Technologies, Inc., Schenectady, NY (United States); Fink, J.L.

1997-04-01

The purpose of this study was to develop an assessment of the national utility system`s needs for electric transmission during the period 1995-2020 that could be met by future reduced-cost HVDC systems. The assessment was to include an economic evaluation of HVDC as a means for meeting those needs as well as a comparison with competing technologies such as ac transmission with and without Flexible AC Transmission System (FACTS) controllers. The role of force commutated dc converters was to be assumed where appropriate. The assessment begins by identifying the general needs for transmission in the U.S. in the context of a future deregulated power industry. The possible roles for direct current transmission are then postulated in terms of representative scenarios. A few of the scenarios are illustrated with the help of actual U.S. system examples. non-traditional applications as well as traditional applications such as long lines and asynchronous interconnections are discussed. The classical ``break-even distance`` concept for comparing HVDC and ac lines is used to assess the selected scenarios. The impact of reduced-cost converters is reflected in terms of the break-even distance. This report presents a comprehensive review of the functional benefits of HVDC transmission and updated cost data for both ac and dc system components. It also provides some provocative thoughts on how direct current transmission might be applied to better utilize and expand our nation`s increasingly stressed transmission assets.

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

Science.gov (United States)

2012-10-24

... regional transmission organizations (RTOs) are required to follow regarding the availability of long-term.... P 649. \\51\\ Id. P 746. \\52\\ As Transmission Access Policy Study Group also recognizes, not all RTOs...

Preventing Obesity in the USA: Impact on Health Service Utilization and Costs.

Science.gov (United States)

Cecchini, Michele; Sassi, Franco

2015-07-01

With more than two-thirds of the US population overweight or obese, the obesity epidemic is a major threat for population health and the financial sustainability of the healthcare service. Whether, and to what extent, effective prevention interventions may offer the opportunity to 'bend the curve' of rising healthcare costs is still an object of debate. This study evaluates the potential economic impact of a set of prevention programmes, including education, counselling, long-term drug treatment, regulation (e.g. of advertising or labelling) and fiscal measures, on national healthcare expenditure and use of healthcare services in the USA. The study was carried out as a retrospective evaluation of alternative scenarios compared with a 'business as usual' scenario. An advanced econometric approach involving the use of logistic regression and generalized linear models was used to calculate the number of contacts with key healthcare services (inpatient, outpatient, drug prescriptions) and the associated cost. Analyses were carried out on the Medical Expenditure Panel Survey (1997-2010). In 2010, prevention interventions had the potential to decrease total healthcare expenditure by up to $US2 billion. This estimate does not include the implementation costs. The largest share of savings is produced by reduced use and costs of inpatient care, followed by reduced use of drugs. Reduction in expenditure for outpatient care would be more limited. Private insurance schemes benefit from the largest savings in absolute terms; however, public insurance schemes benefit from the largest cost reduction per patient. People in the lowest income groups show the largest economic benefits. Prevention interventions aimed at tackling obesity and associated risk factors may produce a significant decrease in the use of healthcare services and expenditure. Savings become substantial when a long-term perspective is taken.

The impact of local public services and geographical cost of living differences on poverty estimates

OpenAIRE

Aaberge, Rolf; Langørgen, Audun; Mogstad, Magne; Østensen, Marit

2008-01-01

Abstract: Despite a broad consensus on the need to account for the value of public services and geographical cost of living differences on the measurement of poverty, there is little reliable evidence on how these factors actually affect poverty estimates. Unlike the standard approach in studies of the distribution of public services, this paper employs a method for valuing sector-specific local public services that accounts for differences between municipalities in the costs and capacity ...

Cost function for the natural gas transmission, industry: further considerations

International Nuclear Information System (INIS)

Massol, Olivier

2009-01-01

This article studies the cost function for the natural gas transmission industry. 60 years ago, Hollis B. Chenery published an important contribution that demonstrated how, in that particular industry, the production function of micro-economic theory can be rewritten with engineering variables (Chenery, 1949). In 2008, an article published in The Engineering Economist (Yepez, 2008) provided a refreshing revival on Chenery's seminal thoughts. In addition to a tribute to the late H.B. Chenery, this document offers some further comments and extensions on Yepez (2008). It provides a statistically estimated characterisation of the long-run scale economies and a discussion on the short-run economics of the duplication of existing equipments. As a first extension, we study the optimal design for infrastructure that is planned to transport a seasonally-varying flow of natural gas. The second extension analyzes the optimal degree of excess capacity to be built into a new infrastructure by a firm that expects a random rise in its output during the infrastructure's lifetime. (author)

A systematic review of the unit costs of allied health and community services used by older people in Australia

Directory of Open Access Journals (Sweden)

Farag Inez

2013-02-01

Full Text Available Abstract Background An economic evaluation of interventions for older people requires accurate assessment of costing and consideration of both acute and long-term services. Accurate information on the unit cost of allied health and community services is not readily available in Australia however. This systematic review therefore aims to synthesise information available in the literature on the unit costs of allied health and community services that may be utilised by an older person living in Australia. Method A comprehensive search of Medline, Embase, CINAHL, Google Scholar and Google was undertaken. Specialised economic databases were also reviewed. In addition Australian Government Department websites were inspected. The search identified the cost of specified allied health services including: physiotherapy, occupational therapy, dietetics, podiatry, counselling and home nursing. The range of community services included: personal care, meals on wheels, transport costs and domestic services. Where the information was not available, direct contact with service providers was made. Results The number of eligible studies included in the qualitative synthesis was fourty-nine. Calculated hourly rates for Australian allied health services were adjusted to be in equivalent currency and were as follows as follows: physiotherapy $157.75, occupational therapy $150.77, dietetics $163.11, psychological services $165.77, community nursing $105.76 and podiatry $129.72. Conclusions Utilisation of the Medicare Benefits Scheduled fee as a broad indicator of the costs of services, may lead to underestimation of the real costs of services and therefore to inaccuracies in economic evaluation.

The cost-effectiveness of preventing mother-to-child transmission of HIV in low- and middle-income countries: systematic review

Directory of Open Access Journals (Sweden)

Johri Mira

2011-02-01

Full Text Available Abstract Background Although highly effective prevention interventions exist, the epidemic of paediatric HIV continues to challenge control efforts in resource-limited settings. We reviewed the cost-effectiveness of interventions to prevent mother-to-child transmission (MTCT of HIV in low- and middle-income countries (LMICs. This article presents syntheses of evidence on the costs, effects and cost-effectiveness of HIV MTCT strategies for LMICs from the published literature and evaluates their implications for policy and future research. Methods Candidate studies were identified through a comprehensive database search including PubMed, Embase, Cochrane Library, and EconLit restricted by language (English or French, date (January 1st, 1994 to January 17th, 2011 and article type (original research. Articles reporting full economic evaluations of interventions to prevent or reduce HIV MTCT were eligible for inclusion. We searched article bibliographies to identify additional studies. Two authors independently assessed eligibility and extracted data from studies retained for review. Study quality was appraised using a modified BMJ checklist for economic evaluations. Data were synthesised in narrative form. Results We identified 19 articles published in 9 journals from 1996 to 2010, 16 concerning sub-Saharan Africa. Collectively, the articles suggest that interventions to prevent paediatric infections are cost-effective in a variety of LMIC settings as measured against accepted international benchmarks. In concentrated epidemics where HIV prevalence in the general population is very low, MTCT strategies based on universal testing of pregnant women may not compare well against cost-effectiveness benchmarks, or may satisfy formal criteria for cost-effectiveness but offer a low relative value as compared to competing interventions to improve population health. Conclusions and Recommendations Interventions to prevent HIV MTCT are compelling on economic

Cost-benefit analysis of establishing and operating radiation oncology services in Fiji.

Science.gov (United States)

Kim, Eunkyoung; Cho, Yoon-Min; Kwon, Soonman; Park, Kunhee

2017-10-01

Rising demand for services of cancer patients has been recognised by the Government of Fiji as a national health priority. Increasing attention has been paid to the lack of service of radiation therapy or radiotherapy in Fiji. This study aims to estimate and compare the costs and benefits of introducing radiation oncology services in Fiji from the societal perspective. Time horizon for cost-benefit analysis (CBA) was 15 years from 2021 to 2035. The benefits and costs were converted to the present values of 2016. Estimates for the CBA model were taken from previous studies and expert opinions and data obtained from field visits to Fiji in January 2016. Sensitivity analyses with changing assumptions were undertaken. The estimated net benefit, applying the national minimum wage (NMW) to measure monetary value for life-year gained, was -31,624,421 FJD with 0.69 of benefit-cost (B/C) ratio. If gross national income (GNI) per capita was used for the value of life years, net benefit was 3,975,684 FJD (B/C ratio: 1.04). With a pessimistic scenario, establishing the center appeared to be not cost-beneficial, and the net benefit was -53,634,682 FJD (B/C ratio: 0.46); net benefit with an optimistic scenario was estimated 23,178,189 FJD (B/C ratio: 1.20). Based on the CBA results from using GNI per capita instead of the NMW, this project would be cost-beneficial. Introducing a radiation oncology center in Fiji would have potential impacts on financial sustainability, financial protection, and accessibility and equity of the health system. Copyright © 2017 World Health Organization. Published by Elsevier Ltd.. All rights reserved.

Value-based benefit-cost of local DSM

International Nuclear Information System (INIS)

Stein, V.

1995-01-01

Value-based benefits and costs of demand-side management (DSM) were discussed in the context of local electricity resource planning in downtown Toronto. The analysis considered the effects on local customer interruption as a result of DSM, and the deferment in need for local transmission and distribution upgrades. The life cycle and cash flow benefits and costs of DSM were discussed from the perspectives of the electric utility, the DSM-participating and non-participating customers, and society as a whole. Cashflow and lifecycle analyses results were reconciled. The Toronto Integrated Electrical Service (TIES) study, the basis for this paper, was described. Two main conclusions were reached, i.e. since the savings in the generationg system as a whole were far greater than the local savings,the value of a specific DSM program would be similar across a utility's service area, and (2) while cashflow analysis illustrated the short and medium term benefits and costs in a way most people intuitively understand, in effect,the lifecycle-cost estimates produce a clearer indicator of long-run economics

Transmission economic expansion and congestion relief : a case study

Energy Technology Data Exchange (ETDEWEB)

Chao, H.; Trinh, L.H.; Moore, M. [ABB Consulting, Raleigh, NC (United States); Brown, L.; Patel, K. [SDG and E, San Diego, CA (United States)

2006-07-01

Transmission capacity additions have lagged behind load growth and generation expansion in the United States. This paper provided an economic analysis of various transmission upgrade options designed to address anticipated congestion of the electricity grid. A market-based transmission planning method was used to assess the economics of transmission expansion. The analysis accounted for the minimum costs of generation dispatch to satisfy transmission constraints, as well as a locational marginal price for each bus in the system. Marginal congestion costs for all major transmission facilities were monitored and recorded. Hourly simulations of load, generation, and transmission system interactions were conducted. Contract costs and economic measures were then calculated for each scenario run. A case study for the Sunrise Powerlink project was used to demonstrate the efficacy of the method. The study demonstrated that the Sunrise Powerlink project will eliminate significant congestion in California load centers. Results also showed that the analytical method provided critical information for decision-makers in weighing the costs with benefits for transmission projects. 5 refs., 2 tabs., 1 fig.

Cost evaluation of reproductive and primary health care mobile service delivery for women in two rural districts in South Africa.

Directory of Open Access Journals (Sweden)

Kathryn Schnippel

Full Text Available Cervical cancer screening is a critical health service that is often unavailable to women in under-resourced settings. In order to expand access to this and other reproductive and primary health care services, a South African non-governmental organization established a van-based mobile clinic in two rural districts in South Africa. To inform policy and budgeting, we conducted a cost evaluation of this service delivery model.The evaluation was retrospective (October 2012-September 2013 for one district and April-September 2013 for the second district and conducted from a provider cost perspective. Services evaluated included cervical cancer screening, HIV counselling and testing, syndromic management of sexually transmitted infections (STIs, breast exams, provision of condoms, contraceptives, and general health education. Fixed costs, including vehicle purchase and conversion, equipment, operating costs and mobile clinic staffing, were collected from program records and public sector pricing information. The number of women accessing different services was multiplied by ingredients-based variable costs, reflecting the consumables required. All costs are reported in 2013 USD.Fixed costs accounted for most of the total annual costs of the mobile clinics (85% and 94% for the two districts; the largest contributor to annual fixed costs was staff salaries. Average costs per patient were driven by the total number of patients seen, at $46.09 and $76.03 for the two districts. Variable costs for Pap smears were higher than for other services provided, and some services, such as breast exams and STI and tuberculosis symptoms screening, had no marginal cost.Staffing costs are the largest component of providing mobile health services to rural communities. Yet, in remote areas where patient volumes do not exceed nursing staff capacity, incorporating multiple services within a cervical cancer screening program is an approach to potentially expand access to

Policy Framework for Covering Preventive Services Without Cost Sharing: Saving Lives and Saving Money?

Science.gov (United States)

Chen, Stephanie C; Pearson, Steven D

2016-08-01

The US Affordable Care Act mandates that private insurers cover a list of preventive services without cost sharing. The list is determined by 4 expert committees that evaluate the overall health effect of preventive services. We analyzed the process by which the expert committees develop their recommendations. Each committee uses different criteria to evaluate preventive services and none of the committees consider cost systematically. We propose that the existing committees adopt consistent evidence review methodologies and expand the scope of preventive services reviewed and that a separate advisory committee be established to integrate economic considerations into the final selection of free preventive services. The comprehensive framework and associated criteria are intended to help policy makers in the future develop a more evidence-based, consistent, and ethically sound approach.

Provider cost analysis supports results-based contracting out of maternal and newborn health services: an evidence-based policy perspective.

Science.gov (United States)

Hatcher, Peter; Shaikh, Shiraz; Fazli, Hassan; Zaidi, Shehla; Riaz, Atif

2014-11-13

There is dearth of evidence on provider cost of contracted out services particularly for Maternal and Newborn Health (MNH). The evidence base is weak for policy makers to estimate resources required for scaling up contracting. This paper ascertains provider unit costs and expenditure distribution at contracted out government primary health centers to inform the development of optimal resource envelopes for contracting out MNH services. This is a case study of provider costs of MNH services at two government Rural Health Centers (RHCs) contracted out to a non-governmental organization in Pakistan. It reports on four selected Basic Emergency Obstetrical and Newborn Care (BEmONC) services provided in one RHC and six Comprehensive Emergency Obstetrical and Newborn Care (CEmONC) services in the other. Data were collected using staff interviews and record review to compile resource inputs and service volumes, and analyzed using the CORE Plus tool. Unit costs are based on actual costs of MNH services and are calculated for actual volumes in 2011 and for volumes projected to meet need with optimal resource inputs. The unit costs per service for actual 2011 volumes at the BEmONC RHC were antenatal care (ANC) visit USD$ 18.78, normal delivery US$ 84.61, newborn care US$ 16.86 and a postnatal care (PNC) visit US$ 13.86; and at the CEmONC RHC were ANC visit US$ 45.50, Normal Delivery US$ 148.43, assisted delivery US$ 167.43, C-section US$ 183.34, Newborn Care US$ 41.07, and PNC visit US$ 27.34. The unit costs for the projected volumes needed were lower due to optimal utilization of resources. The percentage distribution of expenditures at both RHCs was largest for salaries of technical staff, followed by salaries of administrative staff, and then operating costs, medicines, medical and diagnostic supplies. The unit costs of MNH services at the two contracted out government rural facilities remain higher than is optimal, primarily due to underutilization. Provider cost analysis

Prices on electricity and transmission of electricity

International Nuclear Information System (INIS)

2002-01-01

This publication contains data on prices of electric energy and transmission of electricity valid on 1 January 2002. The purpose is to illustrate the price changes on the electricity market in terms of prices for different customer categories. All companies holding network concessions for areas and all companies trading in electricity are included in this report, which is produced on an annual basis. The prices for transmission services 1 January 2002 were on the whole unchanged compared to the preceding year. For households the mean annual cost was SEK 856 for flats, SEK 4,194 one- or two-family houses with electric heating and SEK 1,881 without electric heating. (1 SEK ∼ 0.1 USD). Electricity prices rose considerably on 1 January 2002 compared to the year before. The mean price per kWh for households according to standard agreement was SEK 0.356 for deliveries to flats, SEK 0.296 for apartments in one- or two-family houses with electric heating and SEK 0.316 without electric heating. That means that the mean annual cost increased by SEK 171 for flats. For one- or two-family houses with electric heating, costs increased by SEK 1,424, and by SEK 379 for those houses without electric heating. The high costs of electricity may be explained in part by the development on the Nordic Power Exchange (Nord Pool), where the spot price increased by 75 per cent during 2001. The price development for household customers during 1996-2002 is shown in a diagram

Costs and outcomes of VCT delivery models in the context of scaling up services in Indonesia

NARCIS (Netherlands)

Siregar, A.Y.M.; Komarudin, D.; Wisaksana, R.; Crevel, R. van; Baltussen, R.M.P.M.

2011-01-01

OBJECTIVE: To evaluate costs and outcomes of voluntary counselling and testing (VCT) service delivery models in urban Indonesia. METHODS: We collected primary data on utilization, costs and outcomes of VCT services in a hospital clinic (568 clients), HIV community clinic (28 clients), sexually

Big Comsats for big jobs at low user cost. [considering wrist telephony, electronic mail transmission and educational television applications

Science.gov (United States)

Bekey, I.

1979-01-01

Three examples are used to illustrate what is possible with large space systems: (1) personal communications using wrist telephones, (2) electronic transmission of mail, and (3) wide dissemination of educational TV. Design concepts and costs are explored and compared to alternative ground-based concepts.

Opportunities for reproductive tourism: cost and quality advantages of Turkey in the provision of in-vitro Fertilization (IVF) services.

Science.gov (United States)

Yildiz, M Said; Khan, M Mahmud

2016-08-12

The scale and scope of medical tourism have expanded rapidly over the last few decades. Turkey is becoming an important player in this market because of its relatively better service quality and large comparative cost advantage. This paper compares cost, quality and effectiveness of in-vitro fertilization (IVF) in the USA and in Turkey. The data from Turkey were obtained from a hospital specializing in IVF services and the US data came from secondary sources. Package price offered by the dominant IVF-service provider to international patients in Turkey was used as a measure of cost for Turkey while IVF-specific service prices were used to estimate the cost for USA. To compare quality and effectiveness of IVF services, a number of general clinical quality indicators and IVF success rate were used. Indicators of quality, cost and success rate in the Turkish hospital were found to be better than the corresponding indicators in US hospitals. The cost difference of IVF services between USA and Turkey is so significant that the overall cost of obtaining the service from Turkey remains lower even with additional expenses for travel and accommodation. Cost-effectiveness ratio of IVF treatment per successful clinical pregnancy was much lower in Turkey than in the USA. It appears that cost and quality are the two most important factors affecting demand for health care services by international patients in Turkey. Like other important players in the medical tourism market, Turkey should be able to take advantage of its success in IVF, a highly specialized niche market, to transform its health system into an important exporter of general health services.

Opportunities for reproductive tourism: cost and quality advantages of Turkey in the provision of in-vitro Fertilization (IVF services

Directory of Open Access Journals (Sweden)

M. Said Yildiz

2016-08-01

Full Text Available Abstract Background The scale and scope of medical tourism have expanded rapidly over the last few decades. Turkey is becoming an important player in this market because of its relatively better service quality and large comparative cost advantage. Methods This paper compares cost, quality and effectiveness of in-vitro fertilization (IVF in the USA and in Turkey. The data from Turkey were obtained from a hospital specializing in IVF services and the US data came from secondary sources. Package price offered by the dominant IVF-service provider to international patients in Turkey was used as a measure of cost for Turkey while IVF-specific service prices were used to estimate the cost for USA. To compare quality and effectiveness of IVF services, a number of general clinical quality indicators and IVF success rate were used. Results Indicators of quality, cost and success rate in the Turkish hospital were found to be better than the corresponding indicators in US hospitals. The cost difference of IVF services between USA and Turkey is so significant that the overall cost of obtaining the service from Turkey remains lower even with additional expenses for travel and accommodation. Conclusions Cost-effectiveness ratio of IVF treatment per successful clinical pregnancy was much lower in Turkey than in the USA. It appears that cost and quality are the two most important factors affecting demand for health care services by international patients in Turkey. Like other important players in the medical tourism market, Turkey should be able to take advantage of its success in IVF, a highly specialized niche market, to transform its health system into an important exporter of general health services.

Transmission line undergrounding : rate impact investigation and analysis

International Nuclear Information System (INIS)

2004-01-01

In response to concerns expressed by the residents of Markham, Ontario regarding the possible environmental and health impacts of a proposed 230 kV overhead transmission line, Hydro One Networks Inc. (HONI) has proposed to place the line underground as an alternative. This analysis was prepared to evaluate the potential impacts on transmission rates and consumer prices related to changes in the level of underground construction of transmission lines by HONI, as opposed to overhead construction. The report presents the approach to data collection; cost estimates and projections; the modeling and projecting of HONI's regulated rate base and revenue requirement on a basis that reflects the manner in which its future transmission rates are expected to be established; estimates of the incremental cost of undergrounding reflecting a range of reasonable assumptions; and a comparison of the resulting transmission costs and total customer bill. To address the issue of potential demand in other municipalities for additional undergrounding, the study also examined the cumulative effects of ten years' incremental undergrounding costs (i.e. effects on 2014 rates). It was concluded that if HONI were to implement an undergrounding program beginning in 2005, resulting in the installation of 80 km of underground lines by 2014, and shared costs by all users of HONI's system through the network transmission charges, the 2014 transmission rates would be higher. 5 tabs

Potential cost-effectiveness of schistosomiasis treatment for reducing HIV transmission in Africa--the case of Zimbabwean women.

Directory of Open Access Journals (Sweden)

Martial L Ndeffo Mbah

Full Text Available Epidemiological data from Zimbabwe suggests that genital infection with Schistosoma haematobium may increase the risk of HIV infection in young women. Therefore, the treatment of Schistosoma haematobium with praziquantel could be a potential strategy for reducing HIV infection. Here we assess the potential cost-effectiveness of praziquantel as a novel intervention strategy against HIV infection.We developed a mathematical model of female genital schistosomiasis (FGS and HIV infections in Zimbabwe that we fitted to cross-sectional data of FGS and HIV prevalence of 1999. We validated our epidemic projections using antenatal clinic data on HIV prevalence. We simulated annual praziquantel administration to school-age children. We then used these model predictions to perform a cost-effectiveness analysis of annual administration of praziquantel as a potential measure to reduce the burden of HIV in sub-Saharan Africa.We showed that for a variation of efficacy between 30-70% of mass praziquantel administration for reducing the enhanced risk of HIV transmission per sexual act due to FGS, annual administration of praziquantel to school-age children in Zimbabwe could result in net savings of US$16-101 million compared with no mass treatment of schistosomiasis over a ten-year period. For a variation in efficacy between 30-70% of mass praziquantel administration for reducing the acquisition of FGS, annual administration of praziquantel to school-age children could result in net savings of US$36-92 million over a ten-year period.In addition to reducing schistosomiasis burden, mass praziquantel administration may be a highly cost-effective way of reducing HIV infections in sub-Saharan Africa. Program costs per case of HIV averted are similar to, and under some conditions much better than, other interventions that are currently implemented in Africa to reduce HIV transmission. As a cost-saving strategy, mass praziquantel administration should be prioritized

Cost calculator methods for estimating casework time in child welfare services: A promising approach for use in implementation of evidence-based practices and other service innovations.

Science.gov (United States)

Holmes, Lisa; Landsverk, John; Ward, Harriet; Rolls-Reutz, Jennifer; Saldana, Lisa; Wulczyn, Fred; Chamberlain, Patricia

2014-04-01

Estimating costs in child welfare services is critical as new service models are incorporated into routine practice. This paper describes a unit costing estimation system developed in England (cost calculator) together with a pilot test of its utility in the United States where unit costs are routinely available for health services but not for child welfare services. The cost calculator approach uses a unified conceptual model that focuses on eight core child welfare processes. Comparison of these core processes in England and in four counties in the United States suggests that the underlying child welfare processes generated from England were perceived as very similar by child welfare staff in California county systems with some exceptions in the review and legal processes. Overall, the adaptation of the cost calculator for use in the United States child welfare systems appears promising. The paper also compares the cost calculator approach to the workload approach widely used in the United States and concludes that there are distinct differences between the two approaches with some possible advantages to the use of the cost calculator approach, especially in the use of this method for estimating child welfare costs in relation to the incorporation of evidence-based interventions into routine practice.

75 FR 37883 - Transmission Planning and Cost Allocation by Transmission Owning and Operating Public Utilities

Science.gov (United States)

2010-06-30

... transmission providers, including Commission-approved regional transmission organizations (RTOs) and... granted extensions. 12. As a result of these compliance filings, RTOs and ISOs have enhanced their... outside of RTOs and ISOs have relied on to comply with certain requirements of Order No. 890 are the North...

Opportunity costs and local health service spending decisions: a qualitative study from Wales.

Science.gov (United States)

Karlsberg Schaffer, Sarah; Sussex, Jon; Hughes, Dyfrig; Devlin, Nancy

2016-03-25

All health care systems face the need to find the resources to meet new demands such as a new, cost-increasing health technology. In England and Wales, when a health technology is recommended by the National Institute for Health and Care Excellence (NICE), the National Health Service (NHS) is mandated to provide the funding to accommodate it within three months of publication of the recommendation. Identifying what, in practice, is foregone when new cost-increasing technologies are introduced is important for understanding the effects of health technology assessment (HTA) decisions on the NHS or any other health care system. Our objective was to investigate how in practice local NHS commissioners in Wales accommodated financial "shocks" arising from technology appraisals (TAs) issued by NICE and from other cost pressures. Semi-structured interviews were conducted with Finance Directors and Medical Directors from all seven Local Health Boards (LHBs) in NHS Wales. These interviews covered prioritisation processes, as well as methods of financing NICE TAs and other financial shocks at each LHB. We then undertook a systematic identification of themes and topics from the information recorded. The study relates to the period October 2010 to March 2013. The financial impact of NICE TAs is generally anticipated and planned for in advance and the majority of LHBs have contingency funds available to cope with these and other financial shocks within-period. Efficiency savings (defined as reductions in costs with no assumed reductions in quality) were a source of funds for cost pressures of all kinds. Service displacements were not linkable to particular NICE TAs and there appears to be a general lack of explicit prioritisation activities. The Welsh Government has, on occasion, explicitly or implicitly acted as the funder of last resort. Services may be displaced as part of a response to the cumulative impact of all types of cost pressures, including cost-increasing health

The revenue generated from clinical chemistry and hematology laboratory services as determined using activity-based costing (ABC) model.

Science.gov (United States)

Adane, Kasaw; Abiy, Zenegnaw; Desta, Kassu

2015-01-01

The rapid and continuous growth of health care cost aggravates the frequently low priority and less attention given in financing laboratory services. The poorest countries have the highest out-of-pocket spending as a percentage of income. Higher charges might provide a greater potential for revenue. If fees raise quality sufficiently, it can enhance usage. Therefore, estimating the revenue generated from laboratory services could help in capacity building and improved quality service provision. Panel study design was used to determine revenue generated from clinical chemistry and hematology services at Tikur Anbessa Specialized Teaching Hospital, Addis Ababa, Ethiopia. Activity-Based Costing (ABC) model was used to determine the true cost of tests performed from October 2011 to December 2011 in the hospital. The principle of Activity-based Costing is that activities consume resources and activities consumed by services which incur the costs and hence service takes the cost of resources. All resources with costs are aggregated with the established casual relationships. The process maps designed was restructured in consultation with the senior staffs working and/or supervising the laboratory and pretested checklists were used for observation. Moreover, office documents, receipts and service bills were used while collecting data. The amount of revenue collected from services was compared with the cost of each subsequent test and the profitability or return on investment (ROI) of services was calculated. Data were collected, entered, cleaned, and analyzed using Microsoft Excel 2007 software program and Statistical Software Package for Social Sciences version 19 (SPSS). Paired sample t test was used to compare the price and cost of each test. P-value less than 0.05 were considered as statistically significant. A total of 25,654 specimens were analyzed during 3 months of regular working hours. The total numbers of clinical chemistry and hematology tests performed during

Optimizing transmission from distant wind farms

International Nuclear Information System (INIS)

Pattanariyankool, Sompop; Lave, Lester B.

2010-01-01

We explore the optimal size of the transmission line from distant wind farms, modeling the tradeoff between transmission cost and benefit from delivered wind power. We also examine the benefit of connecting a second wind farm, requiring additional transmission, in order to increase output smoothness. Since a wind farm has a low capacity factor, the transmission line would not be heavily loaded, on average; depending on the time profile of generation, for wind farms with capacity factor of 29-34%, profit is maximized for a line that is about 3/4 of the nameplate capacity of the wind farm. Although wind generation is inexpensive at a good site, transmitting wind power over 1600 km (about the distance from Wyoming to Los Angeles) doubles the delivered cost of power. As the price for power rises, the optimal capacity of transmission increases. Connecting wind farms lowers delivered cost when the wind farms are close, despite the high correlation of output over time. Imposing a penalty for failing to deliver minimum contracted supply leads to connecting more distant wind farms.

A model to estimate the cost of the National Essential Public Health Services Package in Beijing, China.

Science.gov (United States)

Yin, Delu; Wong, Sabrina T; Chen, Wei; Xin, Qianqian; Wang, Lihong; Cui, Mingming; Yin, Tao; Li, Ruili; Zheng, Xiaoguo; Yang, Huiming; Yu, Juanjuan; Chen, Bowen; Yang, Weizhong

2015-06-06

In order to address several health challenges, the Chinese government issued the National Essential Public Health Services Package (NEPHSP) in 2009. In China's large cities, the lack of funding for community health centers and consequent lack of comprehensive services and high quality care has become a major challenge. However, no study has been carried out to estimate the cost of delivering the services in the package. This project was to develop a cost estimation approach appropriate to the context and use it to calculate the cost of the NEPHSP in Beijing in 2011. By adjusting models of cost analysis of primary health care and workload indicators of staffing need developed by the World Health Organization, a model was developed to estimate the cost of the services in the package through an intensive interactive process. A total of 17 community health centers from eight administrative districts in Beijing were selected. Their service volume and expenditure data in 2010 were used to evaluate the costs of providing the NEPHSP in Beijing based on the applied model. The total workload of all types of primary health care in 17 sample centers was equivalent to the workload requirement for 14,056,402 standard clinic visits. The total expenditure of the 17 sample centers was 26,329,357.62 USD in 2010. The cost of the workload requirement of one standard clinic visit was 1.87 USD. The workload of the NEPHSP was equivalent to 5,514,777 standard clinic visits (39.23 % of the total workload). The model suggests that the cost of the package in Beijing was 7.95 USD per capita in 2010. The cost of the NEPHSP in urban areas was lower than suburban areas: 7.31 and 8.65 USD respectively. The average investment of 3.97 USD per capita in NEPHSP was lower than the amount needed to meet its running costs. NEPHSP in Beijing is therefore underfunded. Additional investment is needed, and a dynamic cost estimate mechanism should be introduced to ensure services remain adequately funded.

Marginal cost pricing of electricity

International Nuclear Information System (INIS)

Edsbaecker, G.

1980-01-01

The discipline is economics and the phenomenon is the power system. The purpose of this system is to produce, transmit and consume electricity in such a way that the sum of consumers and suppliers surplus in maximized. This is accomplished by the means of marginal cost pricing. The concepts of the power system and the relations prevailing between and among them are picked out, defined and analyzed in the frames of economic theory and operations research. Methods are developed aiming at efficient prices so that the short run function of the power system is managed in such a way that the sum of conumers and suppliers surplus is maximized within the framwork of this system, i.e. value of service of the power system is maximized. The task of developing such methods is accomplished subject to mixed production resources, transmission losses, periodic demand and also when there is lack of information concerning future and cost conditions. The main results are methods which take to account the conditions stated above. Methods not only allowing for traditional cost minimizing but also for maximation of value of service including a process of reaching optimum by gradual adaption when demand and cost curves are not known in advance. (author)

Technical and economic feasibility of superconducting power transmission: a case study

International Nuclear Information System (INIS)

Forsyth, E.B.; Mulligan, G.A.; Beck, J.W.; Williams, J.A.

1975-01-01

The long-range plans of the Long Island Lighting Company include the installation of 4600 MW of generation capacity at nuclear sites on eastern Long Island by the 1990's. A single site, Shoreham, was chosen for this study which would require transmission facilities to the Ruland Road substation, 43 miles away. Conventional 345 kV overhead and underground circuits are planned for this service. For the case study three superconducting cable schemes have been investigated which reflect various technical options. The superconducting cables have been designed to meet acceptable normal and contingency load flow conditions and to withstand maximum short circuit faults. A cost analysis has been made of the complete installation, providing a valuable comparison of the estimated cost of this new technology with conventional methods. The most favorable cost comparison is a two-circuit 345 kV superconducting system, which appears to be about one-half the cost of an all underground 345 kV high pressure oil-filled cable system. No reactive compensation will be required for the superconducting system, whereas extensive compensation is required for HPOF cables over the same distance. The cost estimate for the two-circuit superconducting system is about twice that of 345 kV overhead transmission, which would consist of two double circuits and one single circuit, assuming right-of-way could be obtained. (U.S.)

Cost of Treatment of Hospitalized Patients with Diabetes in Prenda Hospital Medicine Service, Angola

Directory of Open Access Journals (Sweden)

António Zangulo

2017-07-01

Full Text Available Introduction: Diabetes has a major impact on morbidity and mortality today. It is estimated that by 2040, about 642 million people are affected worldwide, of which, 34.2 million are from sub-Saharan countries. The direct annual cost of diabetes health care worldwide is estimated at about 153 billion dollars. These patients represent 30% to 40% of all admissions to emergency services, leading to high values of hospital expenditure. We aim to evaluate the cost of treatment of patients with diabetes admitted to Prenda Hospital Medicine Service in 2012. Methods: Retrospective analytical observational study, with data collected from the clinical processes of medical service (age and gender, length of hospitalization, resources consumed, cost of treatment per patient and discharge. Results: Out of 121 patients, the majority was female (n = 70, 57.9%. The age group of 36 to 45 years old was the most frequent among these patients (n = 26, 21.5%. November was the month that recorded the largest number of admissions (n = 17, 14%. About 45.5% were hospitalized during five to eight days, on average for nine days. The majority (76.9% was discharged due to health condition improvement. The price of materials used for treatment of the disease had high variation, and 31 550.15 kwanzas was spent to acquire them. The direct cost per patient per day was 4170.11 kwanzas and the estimated annual cost of care of diabetic patients admitted to Prenda Hospital was 45 525 490.9 kwanzas in 2012. Discussion and Conclusion: These results are in accordance with other studies, indicating a relevant cost of treatment of diabetic patients admitted to Prenda Hospital Medicine Service in 2012.

Essays on electricity transmission investment and financial transmission rights

Science.gov (United States)

Shang, Wenzhuo

The U.S. electric power industry has been going through fundamental restructuring and realignment since the 1990's. Many issues and problems have emerged during the transition, and both economists and engineers have been looking for the solutions fervently. In this dissertation, which consists primarily of three essays, we apply economics theory and techniques to the power industry and address two related issues, transmission investment and financial transmission rights (FTRs). The first essay takes the decentralized perspective and investigates the efficiency attribute of market-based transmission investment under perfect competition. We clarify, for the first time, the nature of the externality created by loop flows that causes transmission investment to be inefficient. Our findings have important implications for better understanding of transmission market design and creating incentives for efficient transmission investment. In the second essay, we define several rules for allocating transmission investment cost within the framework of cooperative game theory. These rules provide fair, stable or efficient cost allocations in theory and are good benchmarks against which the allocation mechanism in practice can be compared and improved upon. In the last essay, we make exploratory efforts in analyzing and assessing empirically the performance of the Midwest independent system operator (MISO) FTR auction market. We reveal some stylized facts about this young market and find that it is not efficient under the risk-neutrality assumption. We also point out and correct the drawbacks in previous related work and suggest about more complete empirical work in future. In all, this dissertation makes both theoretic and empirical analysis of the two hot issues related to the power industry and comes up with findings that have important implications for the development of this industry.

A Novel Short-Term Maintenance Strategy for Power Transmission and Transformation Equipment Based on Risk-Cost-Analysis

Directory of Open Access Journals (Sweden)

Hang Yang

2017-11-01

Full Text Available Current studies on preventive condition-based maintenance of power transmission and transformation equipment mainly focus on mid-term or long-term maintenance, and cannot meet the requirements of short-term especially temporary maintenance. In order to solve the defects of the present preventive maintenance strategies, according to the engineering application and based on risk-cost analysis, a short-term maintenance strategy is proposed in this manuscript. For the equipment working in bad health condition, its active maintenance costs and operation risk costs are evaluated, respectively. Then the latest maintenance time is calculated in accordance with the principle that its operation risk costs are no higher than active maintenance costs. Utilizing the latest maintenance time, the best maintenance time is calculated by setting the maximum relative earnings of postponing maintenance as the target, which provides the operation staffs with comprehensive maintenance-decision support. In the end, different cases on the IEEE 24-bus system are simulated. The effectiveness and advantages of the proposed strategy are demonstrated by the simulation results.

Service models and realization of differentiated services networks

Science.gov (United States)

Elizondo, Antonio J.; Garcia Osma, Maria L.; Einsiedler, Hans J.; Roth, Rudolf; Smirnov, Michael I.; Bartoli, Maurizio; Castelli, Paolo; Varga, Balazs; Krampell, Magnus

2001-07-01

Internet Service Providers need to offer Quality of Service (QoS) to fulfil the requirements of applications of their customers. Moreover, in a competitive market environment costs must be low. The selected service model must be effective and low in complexity, but it should still provide high quality and service differentiation, that the current Internet is not yet capable to support. The Differentiated Services (DiffServ) Architecture has been proposed for enabling a range of different Classes of Service (CoS). In the EURESCOM project P1006 several European service providers co-operated to examine various aspects involved in the introduction of service differentiation using the DiffServ approach. The project explored a set of service models for Expedited Forwarding (EF) and Assured Forwarding (AF) and identified requirements for network nodes. Besides, we addressed also measurement issues, charging and accounting issues. Special attention has been devoted to requirements of elastic traffic that adapts its sending rate to congestion state and available bandwidth. QoS mechanisms must prove Transmission Control Protocol (TCP) friendliness. TCP performance degrades under multiple losses. Since RED based queue management may still cause multiple discards, a modified marking scheme called Capped Leaky Bucket is proposed to improve the performance of elastic applications.

Optimal pricing policies for services with consideration of facility maintenance costs

Science.gov (United States)

Yeh, Ruey Huei; Lin, Yi-Fang

2012-06-01

For survival and success, pricing is an essential issue for service firms. This article deals with the pricing strategies for services with substantial facility maintenance costs. For this purpose, a mathematical framework that incorporates service demand and facility deterioration is proposed to address the problem. The facility and customers constitute a service system driven by Poisson arrivals and exponential service times. A service demand with increasing price elasticity and a facility lifetime with strictly increasing failure rate are also adopted in modelling. By examining the bidirectional relationship between customer demand and facility deterioration in the profit model, the pricing policies of the service are investigated. Then analytical conditions of customer demand and facility lifetime are derived to achieve a unique optimal pricing policy. The comparative statics properties of the optimal policy are also explored. Finally, numerical examples are presented to illustrate the effects of parameter variations on the optimal pricing policy.

Prices on electricity and transmission of electricity

International Nuclear Information System (INIS)

2003-01-01

This publication contains data on prices of electric energy and transmission of electricity valid from 1 January 2003. The purpose is to illustrate the price changes on the electricity market in terms of prices for different customer categories. All companies holding network concessions for areas and all companies trading in electricity are included in this report, which is produced on an annual basis.The prices for transmission services 1 January 2003 were on the whole unchanged compared to the preceding year. For households the mean annual cost was SEK 882 for flats, SEK 4 335 for one- or two-family houses with electric heating and SEK 1 925 for those without electric heating. Electricity prices rose considerably on 1 January 2003 compared to the year before. The mean price per kWh for households with standard agreements was SEK 0.519 for deliveries to flats, SEK 0.447 for one- or two-family houses with electric heating and SEK 0.471 without electric heating. As a result, the mean annual cost increased by SEK 326 for flats, SEK 3 012 for one- or two-family houses with electric heating, and by SEK 774 for those houses without electric heating. The high costs of electricity may be explained in part by the development on the Nordic Power Exchange (Nord Pool), where the spot price increased by about 290 per cent during 2002 (1 USD is about 8 SEK)

18 CFR 35.35 - Transmission infrastructure investment.

Science.gov (United States)

2010-04-01

... purpose of benefiting consumers by ensuring reliability and reducing the cost of delivered power by... either ensure reliability or reduce the cost of delivered power by reducing transmission congestion... investment; and (ii) An adjustment to the book value of transmission assets being sold to a Transco to remove...

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

Science.gov (United States)

Cid P, Camilo; Bastías S, Gabriel

2014-02-01

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

Cost analysis of two community-based HIV testing service modalities led by a Non-Governmental Organization in Cape Town, South Africa.

Science.gov (United States)

Meehan, Sue-Ann; Beyers, Nulda; Burger, Ronelle

2017-12-02

In South Africa, the financing and sustainability of HIV services is a priority. Community-based HIV testing services (CB-HTS) play a vital role in diagnosis and linkage to HIV care for those least likely to utilise government health services. With insufficient estimates of the costs associated with CB-HTS provided by NGOs in South Africa, this cost analysis explored the cost to implement and provide services at two NGO-led CB-HTS modalities and calculated the costs associated with realizing key HIV outputs for each CB-HTS modality. The study took place in a peri-urban area where CB-HTS were provided from a stand-alone centre and mobile service. Using a service provider (NGO) perspective, all inputs were allocated by HTS modality with shared costs apportioned according to client volume or personnel time. We calculated the total cost of each HTS modality and the cost categories (personnel, capital and recurring goods/services) across each HTS modality. Costs were divided into seven pre-determined project components, used to examine cost drivers. HIV outputs were analysed for each HTS modality and the mean cost for each HIV output was calculated per HTS modality. The annual cost of the stand-alone and mobile modalities was $96,616 and $77,764 respectively, with personnel costs accounting for 54% of the total costs at the stand-alone. For project components, overheads and service provision made up the majority of the costs. The mean cost per person tested at stand-alone ($51) was higher than at the mobile ($25). Linkage to care cost at the stand-alone ($1039) was lower than the mobile ($2102). This study provides insight into the cost of an NGO led CB-HTS project providing HIV testing and linkage to care through two CB-HIV testing modalities. The study highlights; (1) the importance of including all applicable costs (including overheads) to ensure an accurate cost estimate that is representative of the full service implementation cost, (2) the direct link between test

Simultaneous transmission of accurate time, stable frequency, data, and sensor system over one fiber with ITU 100 GHz grid

Science.gov (United States)

Horvath, Tomas; Munster, Petr; Vojtech, Josef; Velc, Radek; Oujezsky, Vaclav

2018-01-01

Optical fiber is the most used medium for current telecommunication networks. Besides data transmissions, special advanced applications like accurate time or stable frequency transmissions are more common, especially in research and education networks. On the other hand, new applications like distributed sensing are in ISP's interest because e.g. such sensing allows new service: protection of fiber infrastructure. Transmission of all applications in a single fiber can be very cost efficient but it is necessary to evaluate possible interaction before real application and deploying the service, especially if standard 100 GHz grid is considered. We performed laboratory measurement of simultaneous transmission of 100 G data based on DP-QPSK modulation format, accurate time, stable frequency and sensing system based on phase sensitive OTDR through two types of optical fibers, G.655 and G.653. These fibers are less common than G.652 fiber but thanks to their slightly higher nonlinear character, there are suitable for simulation of the worst case which can arise in a real network.

Room Service Improves Nutritional Intake and Increases Patient Satisfaction While Decreasing Food Waste and Cost.

Science.gov (United States)

McCray, Sally; Maunder, Kirsty; Krikowa, Renee; MacKenzie-Shalders, Kristen

2018-02-01

Room service is a foodservice model that has been increasingly implemented across health care facilities in an effort to improve patient satisfaction and reduce food waste. In 2013, Mater Private Hospital Brisbane, Australia, was the first hospital in Australia to implement room service, with the aim of improving patient nutrition care and reducing costs. The aim of this study was to comprehensively evaluate the nutritional intake, plate waste, patient satisfaction, and patient meal costs of room service compared to a traditional foodservice model. A retrospective analysis of quality-assurance data audits was undertaken to assess patient nutritional intake between a facility utilizing a traditional foodservice model and a facility utilizing room service and in a pre-post study design to assess plate waste, patient satisfaction, and patient meal costs before and after the room service implementation. Audit data were collected for eligible adult inpatients in Mater Private Hospital Brisbane and Mater Hospital Brisbane, Australia, between July 2012 and May 2015. The primary outcome measures were nutritional intake, plate waste, patient satisfaction, and patient meal costs. Independent samples t-tests and χ 2 analyses were conducted between pre and post data for continuous data and categorical data, respectively. Pearson χ 2 analysis of count data for sex and reasons for plate waste for data with counts more than five was used to determine asymptotic (two-sided) significance and n-1 χ 2 used for the plate waste analysis. Significance was assessed at P<0.05. This study reported an increased nutritional intake, improved patient satisfaction, and reduced plate waste and patient meal costs with room service compared to a traditional foodservice model. Comparison of nutritional intake between a traditional foodservice model (n=85) and room service (n=63) showed statistically significant increases with room service in both energy (1,306 kcal/day vs 1,588 kcal/day; P=0

Open Access Transmission Tariff: Effective December 18, 1998 (Revised June 16, 1999).

Energy Technology Data Exchange (ETDEWEB)

United States. Bonneville Power Administration.

1999-06-16

Bonneville will provide Network Integration Transmission Service pursuant to the terms and conditions contained in this Tariff and Service Agreement. The service that Bonneville will provide under this Tariff allows a Transmission Customer to integrate, economically dispatch and regulate its current and planned Network Resources to serve its Network Load. Network Integration Transmission Service also may be used by the Transmission Customer to deliver nonfirm energy purchases to its Network Load without additional charge. To the extent that the transmission path for moving power from a Network Resource to a Network Load includes the Eastern and Southern Interties, the terms and conditions for service over such intertie facilities are provided under Part 2 of this Tariff. Also, transmission service for third-party sales which are not designated as Network Load will be provided under Bonneville's Point-to-Point Transmission Service (Part 2 of this Tariff).

Cost-effectiveness Analysis of an Aftercare Service vs Treatment-As-Usual for Patients with Severe Mental Disorders.

Science.gov (United States)

Barfar, Eshagh; Sharifi, Vandad; Amini, Homayoun; Mottaghipour, Yasaman; Yunesian, Masud; Tehranidoost, Mehdi; Sobhebidari, Payam; Rashidian, Arash

2017-09-01

There have been claims that community mental health principles leads to the maintenance of better health and functioning in patients and can be more economical for patients with severe and chronic mental disorders. Economic evaluation studies have been used to assess the cost-effectiveness of national health programs, or to propose efficient strategies for health care delivery. The current study is intended to test the cost-effectiveness of an Aftercare Service when compared with Treatment-As-Usual for patients with severe mental disorders in Iran. This study was a parallel group randomized controlled trial. A total of 160 post-discharge eligible patients were randomized into two equal patient groups, Aftercare Service (that includes either Home Visiting Care, or Telephone Follow-up for outpatient treatment) vs Treatment-As-Usual, using stratified balanced block randomization method. All patients were followed for 12 months after discharge. The perspective of the present study was the societal perspective. The outcome measures were the rate of readmission at the hospitals after discharge, psychotic symptoms, manic symptoms, depressive symptoms, illness severity, global functioning, quality of life, and patients' satisfaction with the services. The costs included the intervention costs and the patient and family costs in the evaluation period. There was no significant difference in effectiveness measures between the two groups. The Aftercare Service arm was about 66,000 US$ cheaper than Treatment-As-Usual arm. The average total cost per patient in the Treatment-As-Usual group was about 4651 USD, while it was reduced to 3823 US$ in the Aftercare Service group; equivalent to a cost reduction of about 800 USD per patient per year. Given that there was no significant difference in effectiveness measures between the two groups (slightly in favor of the intervention), the Aftercare Service was cost-effective. The most important limitation of the study was the relatively

Social cost-efficient service quality. Integrating customer valuation in incentive regulation. Evidence from the case of Norway

Energy Technology Data Exchange (ETDEWEB)

Growitsch, Christian; Mueller, Christine; Wissner, Matthias [WIK, Department Energy Markets and Energy Regulation, Rhoendorfer Str. 68, 53604 Bad Honnef (Germany); Jamasb, Tooraj [University of Cambridge, Faculty of Economics (United Kingdom)

2010-05-15

In order to overcome the perverse incentives of excessive maintenance reductions and insufficient network investments arising with incentive regulation of electricity distribution companies, regulators throughout Europe have started regulating service quality. In this paper, we explore the impact of incorporating customers' willingness-to-pay for service quality in benchmarking models on cost efficiency of distribution networks. Therefore, we examine the case of Norway, which features this approach to service quality regulation. We use the data envelopment analysis technique to analyse the effectiveness of such regulatory instruments. Moreover, we discuss the extent to which this indirect regulatory instrument motivates a socially desired service quality level. The results indicate that internalising external or social cost of service quality does not seem to have played an important role in improving cost efficiency in Norwegian distribution utilities. (author)

Social cost-efficient service quality-Integrating customer valuation in incentive regulation: Evidence from the case of Norway

Energy Technology Data Exchange (ETDEWEB)

Growitsch, Christian, E-mail: c.growitsch@wik.or [WIK, Department Energy Markets and Energy Regulation, Rhoendorfer Str. 68, 53604 Bad Honnef (Germany); Jamasb, Tooraj [University of Cambridge, Faculty of Economics (United Kingdom); Mueller, Christine; Wissner, Matthias [WIK, Department Energy Markets and Energy Regulation, Rhoendorfer Str. 68, 53604 Bad Honnef (Germany)

2010-05-15

In order to overcome the perverse incentives of excessive maintenance reductions and insufficient network investments arising with incentive regulation of electricity distribution companies, regulators throughout Europe have started regulating service quality. In this paper, we explore the impact of incorporating customers' willingness-to-pay for service quality in benchmarking models on cost efficiency of distribution networks. Therefore, we examine the case of Norway, which features this approach to service quality regulation. We use the data envelopment analysis technique to analyse the effectiveness of such regulatory instruments. Moreover, we discuss the extent to which this indirect regulatory instrument motivates a socially desired service quality level. The results indicate that internalising external or social cost of service quality does not seem to have played an important role in improving cost efficiency in Norwegian distribution utilities.

Social cost-efficient service quality-Integrating customer valuation in incentive regulation: Evidence from the case of Norway

International Nuclear Information System (INIS)

Growitsch, Christian; Jamasb, Tooraj; Mueller, Christine; Wissner, Matthias

2010-01-01

In order to overcome the perverse incentives of excessive maintenance reductions and insufficient network investments arising with incentive regulation of electricity distribution companies, regulators throughout Europe have started regulating service quality. In this paper, we explore the impact of incorporating customers' willingness-to-pay for service quality in benchmarking models on cost efficiency of distribution networks. Therefore, we examine the case of Norway, which features this approach to service quality regulation. We use the data envelopment analysis technique to analyse the effectiveness of such regulatory instruments. Moreover, we discuss the extent to which this indirect regulatory instrument motivates a socially desired service quality level. The results indicate that internalising external or social cost of service quality does not seem to have played an important role in improving cost efficiency in Norwegian distribution utilities.

Service utilisation and costs of language impairment in children: The early language in Victoria Australian population-based study.

Science.gov (United States)

Le, Ha N D; Gold, Lisa; Mensah, Fiona; Eadie, Patricia; Bavin, Edith L; Bretherton, Lesley; Reilly, Sheena

2017-08-01

To examine (1) the patterns of service use and costs associated with language impairment in a community cohort of children from ages 4-9 years and (2) the relationship between language impairment and health service utilisation. Participants were children and caregivers of six local government areas in Melbourne participating in the community-based Early Language in Victoria Study (ELVS). Health service use was reported by parents. Costs were valued in Australian dollars in 2014, from the government and family perspectives. Depending on age, the Australian adapted Clinical Evaluation of Language Fundamentals - Pre-school, 2nd Edition (CELF-P2) or the CELF, 4th Edition (CELF4) was used to assess expressive and receptive language. At 5, 7 and 9 years respectively 21%, 11% and 8% of families reported using services for speech and/or language concerns. The annual costs associated with using services averaged A$612 (A$255 to government, A$357 to family) at 5 years and A$992 (A$317 to government, A$675 to family) at 7 years. Children with persistent language impairment had significantly higher service costs than those with typical language. Language impairment in 4-9-year-old children is associated with higher use of services and costs to both families and government compared to typical language.

Effect of reducing cost sharing for outpatient care on children's inpatient services in Japan.

Science.gov (United States)

Kato, Hirotaka; Goto, Rei

2017-08-15

Assessing the impact of cost sharing on healthcare utilization is a critical issue in health economics and health policy. It may affect the utilization of different services, but is yet to be well understood. This paper investigates the effects of reducing cost sharing for outpatient services on hospital admissions by exploring a subsidy policy for children's outpatient services in Japan. Data were extracted from the Japanese Diagnosis Procedure Combination database for 2012 and 2013. A total of 366,566 inpatients from 1390 municipalities were identified. The impact of expanding outpatient care subsidy on the volume of inpatient care for 1390 Japanese municipalities was investigated using the generalized linear model with fixed effects. A decrease in cost sharing for outpatient care has no significant effect on overall hospital admissions, although this effect varies by region. The subsidy reduces the number of overall admissions in low-income areas, but increases it in high-income areas. In addition, the results for admissions by type show that admissions for diagnosis increase particularly in high-income areas, but emergency admissions and ambulatory-care-sensitive-condition admissions decrease in low-income areas. These results suggest that outpatient and inpatient services are substitutes in low-income areas but complements in high-income ones. Although the subsidy for children's healthcare would increase medical costs, it would not improve the health status in high-income areas. Nevertheless, it could lead to some health improvements in low-income areas and, to some extent, offset costs by reducing admissions in these regions.

IMPLEMENTATION OF THE ABC COSTING IN A SERVICES PROVIDER COMPANY

Directory of Open Access Journals (Sweden)

Luiz Ricardo Aguena Jacintho Gil de Castro

2012-12-01

Full Text Available This paper describes the implementation of the Activity-Based Cost (ABC method in a company of taxes and accounting services and outlines the positive and negative aspects encountered during implementation. It should be taken into account that this work has been developed in the fiscal area of cost verification. Bibliographical references, internal company documents and interviews with industry officials and the administrator responsible for the company were used. In the evolving of operations, the costs of the fiscal area and their main activities have been described monthly and through this information, drivers have been developed and the ABC (Activity-Based Costing method has been adopted. With the implementation it became clear that the system provides better visualization for the decision making process, it also provided learning for the company, so that the method should be used for an undetermined period of time.

Valuation of Electric Power System Services and Technologies

Energy Technology Data Exchange (ETDEWEB)

Kintner-Meyer, Michael C. W. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Homer, Juliet S. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Balducci, Patrick J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Weimar, Mark R. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

2017-08-01

Accurate valuation of existing and new technologies and grid services has been recognized to be important to stimulate investment in grid modernization. Clear, transparent, and accepted methods for estimating the total value (i.e., total benefits minus cost) of grid technologies and services are necessary for decision makers to make informed decisions. This applies to home owners interested in distributed energy technologies, as well as to service providers offering new demand response services, and utility executives evaluating best investment strategies to meet their service obligation. However, current valuation methods lack consistency, methodological rigor, and often the capabilities to identify and quantify multiple benefits of grid assets or new and innovative services. Distributed grid assets often have multiple benefits that are difficult to quantify because of the locational context in which they operate. The value is temporally, operationally, and spatially specific. It varies widely by distribution systems, transmission network topology, and the composition of the generation mix. The Electric Power Research Institute (EPRI) recently established a benefit-cost framework that proposes a process for estimating multiple benefits of distributed energy resources (DERs) and the associated cost. This document proposes an extension of this endeavor that offers a generalizable framework for valuation that quantifies the broad set of values for a wide range of technologies (including energy efficiency options, distributed resources, transmission, and generation) as well as policy options that affect all aspects of the entire generation and delivery system of the electricity infrastructure. The extension includes a comprehensive valuation framework of monetizable and non-monetizable benefits of new technologies and services beyond the traditional reliability objectives. The benefits are characterized into the following categories: sustainability, affordability, and

Cost and impact of a quality improvement programme in mental health services.

Science.gov (United States)

Beecham, Jennifer; Ramsay, Angus; Gordon, Kate; Maltby, Sophie; Walshe, Kieran; Shaw, Ian; Worrall, Adrian; King, Sarah

2010-04-01

To estimate the cost and impact of a centrally-driven quality improvement initiative in four UK mental health communities. Total costs in year 1 were identified using documentation, a staff survey, semi-structured interviews and discussion groups. Few outcome data were collected within the programme so thematic analysis was used to identify the programme's impact within its five broad underlying principles. The survey had a 40% response. Total costs ranged between pound164,000 and pound458,000 per site, plus staff time spent on workstreams. There was a very hazy view of the resources absorbed and poor recording of expenditure and activity. The initiative generated little demonstrable improvements in service quality but some participants reported changes in attitudes. Given the difficult contexts, short time-scales and capacity constraints, the programme's lack of impact is not surprising. It may, however, represent a worthwhile investment in cultural change which might facilitate improvements in how services are delivered.

Integration of prevention of mother-to-child HIV transmission into maternal health services in Senegal.

Science.gov (United States)

Cisse, C

2017-06-01

The objective of this study was to assess the level of integration of prevention of mother-to-child HIV transmission (PMTCT) in facilities providing services for maternal, newborn, and child health (MNCH) and reproductive health (RH) in Senegal. The survey, conducted from August through November, 2014, comprised five parts : a literature review to assess the place of this integration in the health policies, standards, and protocols in effect in Senegal; an analysis by direct observation of attitudes and practices of 25 healthcare providers at 5 randomly-selected obstetrics and gynecology departments representative of different levels of the health pyramid; a questionnaire evaluating knowledge and attitudes of 10 providers about the integration of PMTCT services into MNCH/RH facilities; interviews to collect the opinions of 70 clients, including 16 HIV-positive, about the quality of PMTCT services they received; and a questionnaire evaluating knowledge and opinions of 14 policy-makers/managers of health programs focusing on mothers and children about this integration. The literature review revealed several constraints impeding this integration : the policy documents, standards, and protocols of each of the programs involved do not clearly indicate the modalities of this integration; the programs are housed in two different divisions while the national Program against the Human Immunodeficiency Virus reports directly to the Prime Minister; program operations remains generally vertical; the resources for the different programs are not sufficiently shared; there is no integrated training module covering integrated management of pregnancy and delivery; and supervision for each of the different programs is organized separately.The observation of the providers supporting women during pregnancy, during childbirth, and in the postpartum period, showed an effort to integrate PMTCT into the MNCH/RH services delivered daily to clients. But this desire is hampered by many

Efficiency and environmental factors in the US electricity transmission industry

International Nuclear Information System (INIS)

Llorca, Manuel; Orea, Luis; Pollitt, Michael G.

2016-01-01

The electricity industry in most developed countries has been restructured over recent decades with the aim of improving both service quality and firm performance. Regulated segments (e.g. transmission) still provide the infrastructure for the competitive segments and represent a significant share of the total price paid by final customers. However there is a lack of empirical studies that analyse firms' performance in the electricity transmission sector. In this paper an empirical analysis of US electricity transmission companies is conducted for the period 2001–2009. We use alternative stochastic frontier models that allow us to identify the determinants of firms' inefficiency. These models also permit us to control for weather conditions, potentially one of the most decisive uncontrollable factors in electricity transmission. Our results suggest that weather conditions clearly have an influence on transmission costs and that there is room for improvement in the management of US electricity transmission systems. Regulators should also be aware that more adverse conditions generate higher levels of inefficiency, and that achieving long-term efficiency improvements tends to worsen firms' short-term relative performance. - Highlights: • We analyse firms' performance in the US electricity transmission industry. • Alternative SFA models are estimated to identify determinants of firms' efficiency. • Our results indicate that firms' efficiency has declined and diverged over time. • We find that more adverse conditions generate higher levels of inefficiency.

Study of the full-service and low-cost carriers network configuration

Directory of Open Access Journals (Sweden)

Oriol Lordan

2014-10-01

Full Text Available Purpose: The network strategies used by airline carriers have been a recurring subject in air transport research. The aim of this paper is to investigate the relationship between the different operational characteristics of the airline and its route network configuration. Design/methodology/approach: The two main airline carrier typologies - Full-Service and Low-Cost carriers – are analysed using empirical models developed on complex network research relating them to the business model of the airlines. Findings and Originality/value: Just in Europe, one can differentiate between Full-Service and Low-Cost Carriers by complex network analyses. In this process, it has been also found that new concept Low-Cost Carriers, such as Vueling, have network properties closer to Full-Service Carriers. Research limitations/implications: This paper has a limited sample, as includes 26 airline case studies from Europe, United States and Asia. Practical implications: The analysis carried out in this research can help to the assessment of the evolution of the strategies of airline carriers, and has also operational implications, since the configuration of an airline route network can determine its resilience to attacks and errors. Social implications: A better understanding of the properties of airline route networks can benefit airlines, passengers and another stakeholders of the air transport industry. Originality/value: Current research on air transport networks has only considered the global or regional level, but few studies have addressed the study of airline transport networks, and its relationship with their business model.

Delivery of antiretroviral treatment services in India: Estimated costs incurred under the National AIDS Control Programme.

Science.gov (United States)

Agarwal, Reshu; Rewari, Bharat Bhushan; Shastri, Suresh; Nagaraja, Sharath Burugina; Rathore, Abhilakh Singh

2017-04-01

Competing domestic health priorities and shrinking financial support from external agencies necessitates that India's National AIDS Control Programme (NACP) brings in cost efficiencies to sustain the programme. In addition, current plans to expand the criteria for eligibility for antiretroviral therapy (ART) in India will have significant financial implications in the near future. ART centres in India provide comprehensive services to people living with HIV (PLHIV): those fulfilling national eligibility criteria and receiving ART and those on pre-ART care, i.e. not on ART. ART centres are financially supported (i) directly by the NACP; and (ii) indirectly by general health systems. This study was conducted to determine (i) the cost incurred per patient per year of pre-ART and ART services at ART centres; and (ii) the proportion of this cost incurred by the NACP and by general health systems. The study used national data from April 2013 to March 2014, on ART costs and non-ART costs (human resources, laboratory tests, training, prophylaxis and management of opportunistic infections, hospitalization, operational, and programme management). Data were extracted from procurement records and reports, statements of expenditure at national and state level, records and reports from ART centres, databases of the National AIDS Control Organisation, and reports on use of antiretroviral drugs. The analysis estimates the cost for ART services as US$ 133.89 (?8032) per patient per year, of which 66% (US$ 88.66, ?5320) is for antiretroviral drugs and 34% (US$ 45.23, ?2712) is for non-ART recurrent expenditure, while the cost for pre-ART care is US$ 33.05 (?1983) per patient per year. The low costs incurred for patients in ART and pre-ART care services can be attributed mainly to the low costs of generic drugs. However, further integration with general health systems may facilitate additional cost saving, such as in human resources.

76 FR 72003 - Calendar Year 2011 Cost of Outpatient Medical, Dental, and Cosmetic Surgery Services Furnished by...

Science.gov (United States)

2011-11-21

... Cosmetic Surgery Services Furnished by Department of Defense Medical Treatment Facilities; Certain Rates... recovery from tortiously liable third persons for the cost of outpatient medical, dental, and cosmetic... of the full cost of all services provided. The outpatient medical, dental, and cosmetic surgery...

Marginal cost calculation of energy production in hydro thermoelectric systems considering the transmission system; Calculo do custo marginal de producao de energia em sistemas hidrotermoeletricos levando em consideracao a rede de transmissao

Energy Technology Data Exchange (ETDEWEB)

Pereira, M V.F. [Pontificia Univ. Catolica do Rio de Janeiro, RJ (Brazil); Gorenstin, B G [Centro de Pesquisas de Energia Eletrica, Rio de Janeiro, RJ (Brazil); Alvarenga Filho, S [ELETROBRAS, Rio de Janeiro, RJ (Brazil)

1990-12-31

The alternatives for calculation of energy marginal cost in hydroelectric systems, considering the transmission one, was analysed, including fundamental concepts; generation/transmission systems, represented by linear power flow model; production marginal costs in hydrothermal systems and computation aspects. (C.G.C.). 11 refs, 5 figs.

Strategic Generation with Conjectured Transmission Price Responses in a Mixed Transmission Pricing System. Part 1. Formulation

International Nuclear Information System (INIS)

Hobbs, B.F.; Rijkers, F.A.M.

2004-05-01

The conjectured supply function (CSF) model calculates an oligopolistic equilibrium among competing generating companies (GenCos), presuming that GenCos anticipate that rival firms will react to price increases by expanding their sales at an assumed rate. The CSF model is generalized here to include each generator's conjectures concerning how the price of transmission services (point-to-point service and constrained interfaces) will be affected by the amount of those services that the generator demands. This generalization reflects the market reality that large producers will anticipate that they can favorably affect transmission prices by their actions. The model simulates oligopolistic competition among generators while simultaneously representing a mixed transmission pricing system. This mixed system includes fixed transmission tariffs, congestion-based pricing of physical transmission constraints (represented as a linearized dc load flow), and auctions of interface capacity in a path-based pricing system. Pricing inefficiencies, such as export fees and no credit for counterflows, can be simulated. The model is formulated as a linear mixed complementarity problem, which enables very large market models to be solved. In the second paper of this two-paper series, the capabilities of the model are illustrated with an application to northwest Europe, where transmission pricing is based on such a mixture of approaches

78 FR 62709 - Calendar Year 2013 Cost of Outpatient Medical, Dental, and Cosmetic Surgery Services Furnished by...

Science.gov (United States)

2013-10-22

... Cosmetic Surgery Services Furnished by Department of Defense Medical Treatment Facilities; Certain Rates... recovery from tortiously liable third persons for the cost of outpatient medical, dental and cosmetic... of the full cost of all services provided. The CY13 Outpatient Medical, Dental, and Cosmetic Surgery...

Accounting for costs, QALYs, and capacity constraints: using discrete-event simulation to evaluate alternative service delivery and organizational scenarios for hospital-based glaucoma services.

Science.gov (United States)

Crane, Glenis J; Kymes, Steven M; Hiller, Janet E; Casson, Robert; Martin, Adam; Karnon, Jonathan D

2013-11-01

Decision-analytic models are routinely used as a framework for cost-effectiveness analyses of health care services and technologies; however, these models mostly ignore resource constraints. In this study, we use a discrete-event simulation model to inform a cost-effectiveness analysis of alternative options for the organization and delivery of clinical services in the ophthalmology department of a public hospital. The model is novel, given that it represents both disease outcomes and resource constraints in a routine clinical setting. A 5-year discrete-event simulation model representing glaucoma patient services at the Royal Adelaide Hospital (RAH) was implemented and calibrated to patient-level data. The data were sourced from routinely collected waiting and appointment lists, patient record data, and the published literature. Patient-level costs and quality-adjusted life years were estimated for a range of alternative scenarios, including combinations of alternate follow-up times, booking cycles, and treatment pathways. The model shows that a) extending booking cycle length from 4 to 6 months, b) extending follow-up visit times by 2 to 3 months, and c) using laser in preference to medication are more cost-effective than current practice at the RAH eye clinic. The current simulation model provides a useful tool for informing improvements in the organization and delivery of glaucoma services at a local level (e.g., within a hospital), on the basis of expected effects on costs and health outcomes while accounting for current capacity constraints. Our model may be adapted to represent glaucoma services at other hospitals, whereas the general modeling approach could be applied to many other clinical service areas.

Stigma as experienced by women accessing prevention of parent to child transmission of HIV services in Karnataka, India

Science.gov (United States)

Rahangdale, Lisa; Banandur, Pradeep; Sreenivas, Amita; Turan, Janet; Washington, Reynold; Cohen, Craig R.

2010-01-01

In Karnataka, India only one-third of HIV-infected pregnant women received antiretroviral prophylaxis at delivery in 2007 through the state government’s prevention of parent-to-child HIV transmission (PPTCT) program. The current qualitative study explored the role of HIV-associated stigma as a barrier to accessing PPTCT services in the rural northern Karnataka district of Bagalkot using in depth interviews and focus group discussions with HIV-infected women who had participated in the PPTCT program, male and female family members, and HIV service providers. Participants discussed personal experiences, community perceptions of HIV, and decision-making related to accessing PPTCT services. They described stigma towards HIV-infected individuals from multiple sources: healthcare workers, community members, family and self. Stigma-related behaviors were based on fears of HIV transmission through personal contact and moral judgment. Experience and/or fears of discrimination led pregnant women to avoid using PPTCT interventions. Government, cultural and historical factors are described as the roots of much the stigma-related behavior in this setting. Based on these formative data, PPTCT program planners should consider further research and interventions aimed at diminishing institutional and interpersonal HIV-associated stigma experienced by pregnant women. PMID:20635247

A cost function for the natural gas transmission industry: further considerations

International Nuclear Information System (INIS)

Massol, O.

2009-09-01

This article studies the cost function for the natural gas transmission industry. 60 years ago, Hollis B. Chenery published an important contribution that demonstrated how, in that particular industry, the production function of micro-economic theory can be rewritten with engineering variables (Chenery, 1949). In 2008, an article published in The Engineering Economist (Yepez, 2008) provided a refreshing revival on Chenery's seminal thoughts. In addition to a tribute to the late H.B. Chenery, this document offers some further comments and extensions on Yepez (2008). It provides a statistically estimated characterisation of the long-run scale economies and a discussion on the short-run economics of the duplication of existing equipments. As a first extension, we study the optimal design for infrastructure that is planned to transport a seasonally-varying flow of natural gas. The second extension analyzes the optimal degree of excess capacity to be built into a new infrastructure by a firm that expects a random rise in its output during the infrastructure's lifetime. (author)

Effects of Health-Care Services and Commodities Cost on the ...

African Journals Online (AJOL)

2017-09-14

Sep 14, 2017 ... services and commodities cost on the patients at the primary health facilities in Zaria .... This is a social security system that guarantees the provision of needed ..... tourism to India, Dubai, London, America, and even to some other ..... Mudyarabikwa O. An examination of public sector subsidies to the private ...

Comparative cost-effectiveness of Option B+ for prevention of mother to child transmission of HIV in Malawi: Mathematical modelling study

Science.gov (United States)

Tweya, Hannock; Keiser, Olivia; Haas, Andreas D.; Tenthani, Lyson; Phiri, Sam; Egger, Matthias; Estill, Janne

2016-01-01

Objective To estimate the cost-effectiveness of prevention of mother to child transmission (MTCT) of HIV with lifelong antiretroviral therapy (ART) for pregnant and breastfeeding women (‘Option B+’) compared to ART during pregnancy or breastfeeding only unless clinically indicated (‘Option B’). Design Mathematical modelling study of first and second pregnancy, informed by data from the Malawi Option B+ programme. Methods Individual-based simulation model. We simulated cohorts of 10,000 women and their infants during two subsequent pregnancies, including the breastfeeding period, with either Option B+ or B. We parameterised the model with data from the literature and by analysing programmatic data. We compared total costs of ante-natal and post-natal care, and lifetime costs and disability-adjusted life-years (DALYs) of the infected infants between Option B+ and Option B. Results During the first pregnancy, 15% of the infants born to HIV-infected mothers acquired the infection. With Option B+, 39% of the women were on ART at the beginning of the second pregnancy, compared to 18% with Option B. For second pregnancies, the rates MTCT were 11.3% with Option B+ and 12.3% with Option B. The incremental cost-effectiveness ratio comparing the two options ranged between about US$ 500 and US$ 1300 per DALY averted. Conclusion Option B+ prevents more vertical transmissions of HIV than Option B, mainly because more women are already on ART at the beginning of the next pregnancy. Option B+ is a cost-effective strategy for PMTCT if the total future costs and lost lifetime of the infected infants are taken into account. PMID:26691682

Using the simplified case mix tool (sCMT) to identify cost in special care dental services to support commissioning.

Science.gov (United States)

Duane, B G; Freeman, R; Richards, D; Crosbie, S; Patel, P; White, S; Humphris, G

2017-03-01

To commission dental services for vulnerable (special care) patient groups effectively, consistently and fairly an evidence base is needed of the costs involved. The simplified Case Mixed Tool (sCMT) can assess treatment mode complexity for these patient groups. To determine if the sCMT can be used to identify costs of service provision. Patients (n=495) attending the Sussex Community NHS Trust Special Care Dental Service for care were assessed using the sCMT. sCMT score and costs (staffing, laboratory fees, etc.) besides patient age, whether a new patient and use of general anaesthetic/intravenous sedation. Statistical analysis (adjusted linear regression modelling) compared sCMT score and costs then sensitivity analyses of the costings to age, being a new patient and sedation use were undertaken. Regression tables were produced to present estimates of service costs. Costs increased with sCMT total scale and single item values in a predictable manner in all analyses except for 'cooperation'. Costs increased with the use of IV sedation; with each rising level of the sCMT, and with complexity in every sCMT category, except cooperation. Costs increased with increase in complexity of treatment mode as measured by sCMT scores. Measures such as the sCMT can provide predictions of the resource allocations required when commissioning special care dental services. Copyright© 2017 Dennis Barber Ltd.

Cost-Benefit Analysis of Radiation Therapy Services at Tripler Army Medical Center

National Research Council Canada - National Science Library

Diehl, Diane S

2004-01-01

The purpose of this analysis was to examine the costs and benefits associated with continuance of "in-house" radiation therapy services to eligible beneficiaries at Tripler Army Medical Center (TAMC...

A cost-effective and serviceable ATLAST 9.2m telescope architecture

Science.gov (United States)

Feinberg, Lee D.; Jones, Andrew; Mosier, Gary; Rioux, Norman; Redding, Dave; Kienlen, Mike

2014-08-01

The ATLAST 9.2m architecture has evolved to be more cost effective while also meeting a more thorough understanding of the driving science requirements. The new approach can fit in an existing Delta IV Heavy rocket and makes extensive use of heritage and selective use of technology in order to minimize development time and cost. We have performed a more thorough look at how to meet the stability requirements for both thermal and dynamics and have an approach consistent with an initial error budget. In addition, we have developed concepts to support robotic or human servicing in a cost effective manner through a modular approach that relies on simple, external access and metrology. These refinements to the architecture enable a cost-effective, long-lifecycle, and relatively low risk approach to development.

Economic Aspect of HVDC Transmission System for Indonesia Consideration in Nuclear Power Development

International Nuclear Information System (INIS)

Edwaren Liun

2009-01-01

As a country with hundreds million people, Indonesia needs to generate large scale power and distribute it to thorough country to improve gross domestic product of the population. In the power transmission domain, the High Voltage Direct Current (HVDC) transmission system should be considered for the next decades concerning any technical and economical problems with HVAC transmission. HVDC transmission system is the answer for the Indonesian condition. This system can connect the high energy potential regions to the high energy demand regions. HVDC is the most efficient to transport energy from one region to another one region. Dismantling and removing assets costs are included to the estimated for capital costs, while the environmental and property costs are the costs of securing designations and resource consents, and valuation and legal advice for the HVDC investment. Although converter terminals are expensive however, for long transmissions HVDC system can compensate the costs over breakeven distance through very efficient transmission system. Efficiency of HVDC is appearing from conductor wire, supporting tower, low energy loses and free space used by route of the transmission line. HVDC system is also free from some problem, concerning stability, inductive and capacitive load components, phase differences and frequency system. In the economic aspect the HVDC capital costs for the transmission options comprise estimates of the cost to design, purchase and construct new HVDC transmission components. While operating and maintenance costs of HVDC assets comprise the costs for replacement the old existing overhead transmission lines, underground and submarine cables, and HVDC converter station components. (author)

Cost-volume-profit analysis and expected benefit of health services: a study of cardiac catheterization services.

Science.gov (United States)

Younis, Mustafa Z; Jabr, Samer; Smith, Pamela C; Al-Hajeri, Maha; Hartmann, Michael

2011-01-01

Academic research investigating health care costs in the Palestinian region is limited. Therefore, this study examines the costs of the cardiac catheterization unit of one of the largest hospitals in Palestine. We focus on costs of a cardiac catheterization unit and the increasing number of deaths over the past decade in the region due to cardiovascular diseases (CVDs). We employ cost-volume-profit (CVP) analysis to determine the unit's break-even point (BEP), and investigate expected benefits (EBs) of Palestinian government subsidies to the unit. Findings indicate variable costs represent 56 percent of the hospital's total costs. Based on the three functions of the cardiac catheterization unit, results also indicate that the number of patients receiving services exceed the break-even point in each function, despite the unit receiving a government subsidy. Our findings, although based on one hospital, will permit hospital management to realize the importance of unit costs in order to make informed financial decisions. The use of break-even analysis will allow area managers to plan minimum production capacity for the organization. The economic benefits for patients and the government from the unit may encourage government officials to focus efforts on increasing future subsidies to the hospital.

FRAMEWORK: ACTIVITY-BASED COSTING IN SERVICES

Directory of Open Access Journals (Sweden)

Nara Medianeira Stefano

2014-07-01

Full Text Available Organizations have a constant need to be prepared to continue competing, which shows the search for alternatives for their stay in the market. It has become a common goal in today's business environment, to improve efficiency and restructure organization, turning it effective. In this context, information about costs has become increasingly important to support and justify the process of decision-making. This article is aimed at structuring a bibliography portfolio to treat the application of the ABC method in service and contribute to discussions within the scientific community. The methodology followed a three-stage procedure: Planning, execution and Synthesis. International databases were used to collect information (ISI Web of Knowledge and Scopus. As a result, we obtained a bibliography portfolio of 21 articles (with scientific recognition dealing with the proposed theme.

A mathematical model of Clostridium difficile transmission in medical wards and a cost-effectiveness analysis comparing different strategies for laboratory diagnosis and patient isolation.

Directory of Open Access Journals (Sweden)

Vered Schechner

Full Text Available Clostridium difficile infection (CDI is a common and potentially fatal healthcare-associated infection. Improving diagnostic tests and infection control measures may prevent transmission. We aimed to determine, in resource-limited settings, whether it is more effective and cost-effective to allocate resources to isolation or to diagnostics.We constructed a mathematical model of CDI transmission based on hospital data (9 medical wards, 350 beds between March 2010 and February 2013. The model consisted of three compartments: susceptible patients, asymptomatic carriers and CDI patients. We used our model results to perform a cost-effectiveness analysis, comparing four strategies that were different combinations of 2 test methods (the two-step test and uniform PCR and 2 infection control measures (contact isolation in multiple-bed rooms or single-bed rooms/cohorting. For each strategy, we calculated the annual cost (of CDI diagnosis and isolation for a decrease of 1 in the average daily number of CDI patients; the strategy of the two-step test and contact isolation in multiple-bed rooms was the reference strategy.Our model showed that the average number of CDI patients increased exponentially as the transmission rate increased. Improving diagnosis by adopting uniform PCR assay reduced the average number of CDI cases per day per 350 beds from 9.4 to 8.5, while improving isolation by using single-bed rooms reduced the number to about 1; the latter was cost saving.CDI can be decreased by better isolation and more sensitive laboratory methods. From the hospital perspective, improving isolation is more cost-effective than improving diagnostics.

A mathematical model of Clostridium difficile transmission in medical wards and a cost-effectiveness analysis comparing different strategies for laboratory diagnosis and patient isolation.

Science.gov (United States)

Schechner, Vered; Carmeli, Yehuda; Leshno, Moshe

2017-01-01

Clostridium difficile infection (CDI) is a common and potentially fatal healthcare-associated infection. Improving diagnostic tests and infection control measures may prevent transmission. We aimed to determine, in resource-limited settings, whether it is more effective and cost-effective to allocate resources to isolation or to diagnostics. We constructed a mathematical model of CDI transmission based on hospital data (9 medical wards, 350 beds) between March 2010 and February 2013. The model consisted of three compartments: susceptible patients, asymptomatic carriers and CDI patients. We used our model results to perform a cost-effectiveness analysis, comparing four strategies that were different combinations of 2 test methods (the two-step test and uniform PCR) and 2 infection control measures (contact isolation in multiple-bed rooms or single-bed rooms/cohorting). For each strategy, we calculated the annual cost (of CDI diagnosis and isolation) for a decrease of 1 in the average daily number of CDI patients; the strategy of the two-step test and contact isolation in multiple-bed rooms was the reference strategy. Our model showed that the average number of CDI patients increased exponentially as the transmission rate increased. Improving diagnosis by adopting uniform PCR assay reduced the average number of CDI cases per day per 350 beds from 9.4 to 8.5, while improving isolation by using single-bed rooms reduced the number to about 1; the latter was cost saving. CDI can be decreased by better isolation and more sensitive laboratory methods. From the hospital perspective, improving isolation is more cost-effective than improving diagnostics.

The Health Costs and Diseases in Medical Services Insurance Organization, Tehran Province, 1386 (2008

Directory of Open Access Journals (Sweden)

Ali Shojaei

2012-01-01

Full Text Available Objectives: The current research in addition to study of the diseases in the elders, surveys the health costs of these diseases. Methods & Materials: Study of the cost information and related diseases in (MSIO- Medical Services Insurance Organization, Tehran province, surveys costs and Medical Services of this group on 183093 hospitalized files. Results: 31% of hospital`s referrals and 37% of inpatient costs related to elders and display the expensive Services of this group of the Insured. The mean costs of every hospitalization in elderly groups were 4634384 rials, which was more than total mean costs, from all groups. Diagnostic code I27 (other cardio-vascular diseases, I20 (Angina pectoris, H25 (cataract, I25 (chronic IHD, I50 (heart failure, devote first to fifth grade of the prevalent Diagnosis cods (ICD in the aged group older than 60 and displays the most prevalence of the cardio-vascular system diseases in the elders. The most common surgical Code (California code in elderly (above 60 yrs. was related to Coronary Angioplasty, with its mean cost of 9116371 rials. And then was Cataract. 15% of the Global files are related to the elders which is equal to 23% of the charges of these files in this group of the elders. Extraction of Lens (Intra-capsular and extra-capsular Lens Insertion (57 code One-lateral Inguinal Hernia with or without excision of Hydrocele or Spermatocele except Incarcerated Inguinal Hernia (Global code 28, cholecystectomy with or without cholangiography or exploration of Biliary ducts (Global code 27 from first to third grade of the prevalent Global surgeries of the elders. Statistical test displays the Pierson coherent between the age and residence period and paid costs, There is a little positive coherent between the age and residence period in hospital and paid costs. Conclusion: These reviews show the results of the current study (the prevalent in-patient causes are adapted to the performed studies in this field and

Considering FACTS in Optimal Transmission Expansion Planning

Directory of Open Access Journals (Sweden)

K. Soleimani

2017-10-01

Full Text Available The expansion of power transmission systems is an important part of the expansion of power systems that requires enormous investment costs. Since the construction of new transmission lines is very expensive, it is necessary to choose the most efficient expansion plan that ensures system security with a minimal number of new lines. In this paper, the role of Flexible AC Transmission System (FACTS devices in the effective operation and expansion planning of transmission systems is examined. Effort was taken to implement a method based on sensitivity analysis to select the optimal number and location of FACTS devices, lines and other elements of the transmission system. Using this method, the transmission expansion plan for a 9 and a 39 bus power system was performed with and without the presence of FACTS with the use of DPL environment in Digsilent software 15.1. Results show that the use of these devices reduces the need for new transmission lines and minimizes the investment cost.

Costs and benefits of implementing child survival services at a private mining company in Peru.

Science.gov (United States)

Foreit, K G; Haustein, D; Winterhalter, M; La Mata, E

1991-08-01

Costs and savings of child health services were studied in a private mining company in Peru. Despite considerable outlays for medical services, few children under age 5 were vaccinated, and half of their illnesses went untreated. Children who were attended at the company clinic usually received unnecessary medication. As a result of the study, the company hired additional staff to provide integrated maternal-child preventive health care and family planning and contracted for intensive training and periodic on-site supervision. In less than 2 years, vaccination coverage reached 75%, and virtually all children under age 1 were enrolled in growth monitoring. Prescriptions were reduced by 24%, including a 67% drop in antimicrobials. The cost of the new services was $13,200 for the first 2 years. Approximately $6800 has been saved in pharmaceuticals prescribed for respiratory infection and diarrhea. Recently, two more mines adopted maternal and child health and family planning services. It is hoped that cost-benefit arguments will encourage other companies to incorporate aggressive child survival measures into their health plans.

Canby Area Service Project substation and associated transmission line

International Nuclear Information System (INIS)

1992-02-01

Bonneville Power Administration (BPA) provides power to Surprise Valley Electrification Corporation (SVEC) in Modoc County, California. BPA uses PacificCorp's substation and transmission facilities between Alturas and Canby, California to transfer power to SVEC's Canby Substation. In the next year, SVEC expects increased industrial, agricultural, and residential electric loads on their 69-kV transmission system south of Canby. SVEC's substation can accommodate only about 10 percent of the expected additional electric load. BPA's proposed action is intended to meet SVEC's increasing electric load. BPA proposes to meet SVEC's increasing energy load by tapping into BPA's existing BPA Malin-Warner 230-kV transmission line, and building an 7.9-mile transmission line to a new BPA substation. BPA proposes to build the new substation next to the west side of SVEC's Canby Substation (Figure 1). This new substation will allow SVEC to move the additional power over their existing transmission or distribution lines. This report is the environmental assessment of the potential impact of the proposed project. The assessment determined that no ''environmental impact statement'' is not required

Transmission pricing and expansion methodology: lessons from Argentina

International Nuclear Information System (INIS)

Anderson, K.P.; McCarthy, A.

1999-01-01

This paper focuses on the pricing of electric transmission service in Argentina and on the mechanisms for expanding the transmission system as of late 1998. We also discuss the pricing of energy and generating capacity, since locational differences in their prices constitute charges for transmission service. We find that the methods in place for pricing transmission service are, in the main, consistent with the principles of efficient pricing but that the incentives and mechanisms established for expanding transmission are deficient in some respects. Most notable is the failure to provide for transmission rights, given the system's heavy reliance on user-driven expansion. We find that Argentina can improve upon its pioneering effort to implement user-driven expansion and indeed is exploring ways to do so. The most important tasks are to investigate (a) whether a system of financial transmission rights can be made to work as part of the process of user-driven expansion and (b) whether a backstop role for centrally planned expansion can be preserved without inhibiting or preempting the user-driven process. (author)

The influence of costs and benefits' analysis on service strategy formulation: Learnings from the shipping industry

DEFF Research Database (Denmark)

Pagoropoulos, Aris; Kjær, Louise Laumann; Andersen, Jakob Axel Bejbro

2017-01-01

. This paper assesses how the analysis of costs and benefits of Product-Service Systems (PSS) as servitized offerings influences the formulation of service strategies in the shipping industry. The study examines both the manufacturer and customer perspectives using two case studies from the shipping sector....... Life Cycle Costing (LCC) was used as a tool to assess the associated costs and benefits of two proposed PSS. Based on the results of the LCC, the drivers and barriers of the actual transformation processes were explored through workshops and interviews served to map the perspectives of both...

An Analysis of the Cost Accounting System for the Depot Maintenance Service, Air Force Industrial Fund.

Science.gov (United States)

1987-09-01

AN A NALYSIS OF THE COST ACCOUNTING SYSTEM FOR THE DEPOT 1/1 MRINTENANCE SERVI..(U) MIR FORCE INST OF TECH IIGHT-PTTERSON RFB OH SCHOOL OF SYST.. 0 L...I "VV h S~ ~~i FiLE COV, THSI CIO ~OF AN ANALYSIS OF THE COST ACCOUNTING SYSTEM FOR THE DEPOT MAINTENANCE SERVICE, AIR FORCE INDUSTRIAL FUND...Patterson Air Force Base, Ohio ~ p~UOW~~ ’ I ~ 1 12 02 0 AFIT/GLM/LSY/87S-83 AN ANALYSIS OF THE COST ACCOUNTING SYSTEM FOR THE DEPOT MAINTENANCE SERVICE, AIR

Stakeholders’ perceptions on factors influencing male involvement in prevention of mother to child transmission of HIV services in Blantyre, Malawi

OpenAIRE

Nyondo, Alinane Linda; Chimwaza, Angela Faith; Muula, Adamson Sinjani

2014-01-01

Background Male Involvement (MI) in the Prevention of Mother to Child Transmission (PMTCT) of Human Immunodeficiency Virus (HIV) services is essential in a patriarchal society where men are decision makers of the household. Male partners have a role in the woman’s risk of acquiring HIV, uptake of HIV testing and participation in Mother to Child Transmission (MTCT) prevention programmes. Although MI is important for uptake of PMTCT interventions, it remains low in Africa. The purpose of this s...