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Sample records for cost containment policies

  1. Policy options to contain healthcare costs: a review and classification.

    PubMed

    Stadhouders, Niek; Koolman, Xander; Tanke, Marit; Maarse, Hans; Jeurissen, Patrick

    2016-05-01

    Containing health care costs has been a challenge for most OECD member states. We classify 2250 cost containment policies in forty-one groups of policy options. This conceptual framework might act as a toolkit for policymakers that seek to develop strategies for cost control; and for researchers that seek to evaluate them. We found that certain important cost drivers such as wages and capital are being sparsely covered. We distinguish four primary targets to contain costs: volume controls, price controls, budgeting and market oriented policies. Price controls and budgeting, both seen as relatively effective, appear substantially less often in literature than volume controls and market oriented policies. The relative use of each option hardly changed over time, although the health system type did matter. Market oriented policies were more likely to be suggested for countries with public provision of health care, as well as for the US system. In contrast, budgeting policy proposals were more likely to be suggested for countries with market provision systems, such as Canada, Germany and France. Implementation of cost containment policies could lead to convergence of health care systems, except for the US system, if policies are implemented based on the literature. PMID:27066728

  2. Cost containment and the backdraft of competition policies.

    PubMed

    Light, D W

    2001-01-01

    This article offers an explanation of why governments and other purchasers found competition policies attractive, and it summarizes a set of new case studies. Faced with economic slowdown and the need to retrench social services, governments felt their legitimacy threatened and sought a new approach that would legitimize controlling costs. Starting in the 1980s, a group of pro-capitalist "moral entrepreneurs" launched an international business movement focused on reducing waste in governmental and welfare services through competition and privatization. Political leaders in a number of the developed industrialized countries enthusiastically embraced "managed competition" as a way to control the costs of health care services and to make them more accountable. The dangers of implementation and the extensive market failures that are ever-present in medicine, however, led most governments to pull back. Most nations that implemented competition policies experienced a political backdraft of protest from patients and providers that swept them out of office. PMID:11809005

  3. Cracking the Books: Policy Measures to Contain Textbook Costs. Policy Matters: A Higher Education Policy Brief

    ERIC Educational Resources Information Center

    McBain, Lesley

    2009-01-01

    As parents and students struggle with increasing college costs, one issue receiving considerable attention over the past several years has been the rising price of textbooks. The question of whether a relationship exists between textbook pricing and the overall cost of college has attracted notice from consumer interest groups and, subsequently,…

  4. Cracking the Books: Policy Measures to Contain Textbook Costs. Policy Matters: A Higher Education Policy Brief

    ERIC Educational Resources Information Center

    McBain, Lesley

    2009-01-01

    As parents and students struggle with increasing college costs, one issue receiving considerable attention over the past several years has been the rising price of textbooks. The question of whether a relationship exists between textbook pricing and the overall cost of college has attracted notice from consumer interest groups and, subsequently,

  5. Doctors commitment and long-term effectiveness for cost containment policies: lesson learned from biosimilar drugs

    PubMed Central

    Menditto, Enrica; Orlando, Valentina; Coretti, Silvia; Putignano, Daria; Fiorentino, Denise; Ruggeri, Matteo

    2015-01-01

    Background Agency is a pervasive feature of the health care market, with doctors acting as agents for both patients and the health care system. In a context of scarce resources, doctors are required to take opportunity cost into account when prescribing treatments, while cost containment policies cannot overlook their active role in determining health care resource allocation. This paper addresses this issue, investigating the effects of cost containment measures in the market of biosimilar drugs that represent a viable and cost-saving strategy for the reduction of health care expenditure. The analysis focuses on a particular region in Italy, where several timely policies to incentivize biosimilar prescribing were launched. Methods Drugs were identified by the anatomical therapeutic chemical classification system. Information about biosimilar drugs and their originator biological products was extracted from the IMS Health regional database. Drug consumption was expressed in terms of counting units, while expenditure was evaluated in Euro (€). The market penetration of biosimilars was analyzed by year and quarterly. Results In the Campania region of Italy, the effects of cost containment policies, launched between 2009 and 2013, showed the prescription of biosimilars strongly increasing in 2010 until prescribing levels reached and exceeded the market share of the reference biological products in 2012. After a slight reduction, a plateau was observed at the beginning of 2013. At the same time, the use of the originator products had been decreasing until the first quarter of 2011. However, after a 1-year plateau, this trend was reversed, with a new increase in the consumption of the originators observed. Conclusion Results show that the cost containment policies, applied to cut health expenditure “to cure and not to care”, did not produce the cultural change necessary to make these policies effective in the long run. Therefore, top-down policies for cost containment are not successful; rather, a bottom-up approach based on consensus among professionals should become the preferred option. PMID:26635482

  6. Cost Containment in Europe

    PubMed Central

    Culyer, A. J.

    1989-01-01

    Health care cost containment is not in itself a sensible policy objective, because any assessment of the appropriateness of health care expenditure in aggregate, as of that on specific programs, requires a balancing of costs and benefits at the margin. International data on expenditures can, however, provide indications of the likely impact on costs and expenditures of structural features of health care systems. Data from the Organization for Economic Cooperation and Development for both European countries and a wider set are reviewed, and some current policies in Europe that are directed at controlling health care costs are outlined. PMID:10313433

  7. Length of hospital stay in Japan 1971-2008: hospital ownership and cost-containment policies.

    PubMed

    Kato, Naoko; Kondo, Masahide; Okubo, Ichiro; Hasegawa, Toshihiko

    2014-04-01

    The average length of stay (LOS) is considered one of the most significant indicators of hospital management. The steep decline in the average LOS among Japanese hospitals since the 1980s is considered to be due to cost-containment policies directed at reducing LOS. Japan's hospital sector is characterised by a diversity of ownership types. We took advantage of this context to examine different hospital behaviours associated with ownership types. Analysing government data published from 1971 to 2008 for the effect of a series of cost-containment policies aimed at reducing LOS revealed distinctly different paths behind the declines in LOS between privately owned and publicly owned hospitals. In the earlier years, private hospitals focused on providing long-term care to the elderly, while in the later years, they made a choice between providing long-term care and providing acute care with reduced LOS and bonus payments. By contrast, the majority of public hospitals opted to provide acute care with reduced LOS in line with public targets. PMID:24462343

  8. Expenditure limits and cost containment.

    PubMed

    Ginsburg, P B

    1993-01-01

    The Clinton administration's proposal for health care reform would tie limits on premiums and, indirectly, provider payment rates to a national health care budget. An expenditure limit (or global budget) is a mechanism to calibrate the parameters of underlying cost containment policies. This article analyzes provider rate setting and managed competition and discusses how they can be guided by expenditure limits. Particular attention is paid to health systems that include elements of both traditional fee-for-service insurance and organized systems of care. Success in containing costs also will require additional policies that can supplement rate setting and managed competition to achieve specific goals to slow spending growth. PMID:8288402

  9. Special Education in First Nations Schools in Canada: Policies of Cost Containment

    ERIC Educational Resources Information Center

    Phillips, Ron

    2010-01-01

    The education of First Nations students in Canada on reserve is the legal responsibility of the federal government. This article reviews and critiques the federal government's past and current special education policies and practices in regard to First Nations schools throughout Canada. The author has found that rather than establishing a…

  10. State Strategies to Contain Costs in the Early Intervention Program: Policy and Evidence

    ERIC Educational Resources Information Center

    Grant, Roy

    2005-01-01

    Part C of the Individuals with Disabilities Education Act allows states to create family-centered developmental services for infants and toddlers (birth-3 yrs) with delays. Part C Early Intervention (EI) programs have grown enormously in size and cost since becoming operational in 1994. In this article, the author describes strategies that states…

  11. Costs and cost containment in nursing homes.

    PubMed Central

    Smith, H L; Fottler, M D

    1981-01-01

    The study examines the impact of structural and process variables on the cost of nursing home care and the utilization of various cost containment methods in 43 california nursing homes. Several predictors were statistically significant in their relation to cost per patient day. A diverse range of cost containment techniques was discovered along with strong predictors of the utilization of these techniques by nursing home administrators. The trade-off between quality of care and cost of care is discussed. PMID:7228713

  12. Provider payments and patient charges as policy tools for cost-containment: How successful are they in high-income countries?

    PubMed

    Carrin, Guy; Hanvoravongchai, Piya

    2003-07-31

    In this paper, we focus on those policy instruments with monetary incentives that are used to contain public health expenditure in high-income countries. First, a schematic view of the main cost-containment methods and the variables in the health system they intend to influence is presented. Two types of instruments to control the level and growth of public health expenditure are considered: (i) provider payment methods that influence the price and quantity of health care, and (ii) cost-containment measures that influence the behaviour of patients. Belonging to the first type of instruments, we have: fee-for-service, per diem payment, case payment, capitation, salaries and budgets. The second type of instruments consists of patient charges and reference price systems for pharmaceuticals. Secondly, we provide an overview of experience in high-income countries that use or have used these particular instruments. Finally, the paper assesses the overall potential of these instruments in cost-containment policies. PMID:12914661

  13. Provider payments and patient charges as policy tools for cost-containment: How successful are they in high-income countries?

    PubMed Central

    Carrin, Guy; Hanvoravongchai, Piya

    2003-01-01

    In this paper, we focus on those policy instruments with monetary incentives that are used to contain public health expenditure in high-income countries. First, a schematic view of the main cost-containment methods and the variables in the health system they intend to influence is presented. Two types of instruments to control the level and growth of public health expenditure are considered: (i) provider payment methods that influence the price and quantity of health care, and (ii) cost-containment measures that influence the behaviour of patients. Belonging to the first type of instruments, we have: fee-for-service, per diem payment, case payment, capitation, salaries and budgets. The second type of instruments consists of patient charges and reference price systems for pharmaceuticals. Secondly, we provide an overview of experience in high-income countries that use or have used these particular instruments. Finally, the paper assesses the overall potential of these instruments in cost-containment policies. PMID:12914661

  14. Cost containment and the physician.

    PubMed

    Angell, M

    1985-09-01

    The rapid rise in health care costs is receiving a good deal of attention these days. Proposed responses include the deliberate rationing of expensive medical technologies, such as organ transplantation, and a redirection of our efforts toward preventive care. Although preventive care may improve our health, it cannot be assumed to reduce medical costs, since a later death may be as expensive as an earlier one. I suggest that a major and rapidly growing component of medical costs stems from the widespread application of tests and procedures when they are of no demonstrated benefit and may even be harmful. Identifying and curtailing such unnecessary medical care, rather than rationing beneficial technologies, should be the thrust of cost-containment efforts. Fee schedules should be revised so that they neither encourage nor discourage the use of tests and procedures; we should undertake systematic studies to assess technologies and practices; and we should make every effort to discourage the practice of defensive medicine. The involvement of physicians in rationing is not only premature; it is also inconsistent with our role as advocates for the health of our patients. PMID:3927017

  15. Innovative Feed-In Tariff Designs that Limit Policy Costs

    SciTech Connect

    Kreycik, Claire; Couture, Toby D.; Cory, Karlynn S.

    2011-06-01

    Feed-in tariffs (FITs) are the most prevalent policy used globally to reduce development risks, cut financing costs, and grow the renewable energy industry. However, concerns over escalating costs in jurisdictions with FIT policies have led to increased attention on cost control. Using case studies and market-focused analysis, this report from the National Renewable Energy Laboratory (NREL) examines strengths and weaknesses of three cost-containment tools: (1) caps, (2) payment level adjustment mechanisms, and (3) auction-based designs. The report provides useful insights on containing costs for policymakers and regulators in the United States and other areas where FIT policies are in development.

  16. Laboratory cost and utilization containment.

    PubMed

    Steiner, J W; Root, J M; White, D C

    1991-01-01

    The authors analyzed laboratory costs and utilization in 3,771 cases of Medicare inpatients admitted to a New England academic medical center ("the Hospital") from October 1, 1989 to September 30, 1990. The data were derived from the Hospital's Decision Resource System comprehensive data base. The authors established a historical reference point for laboratory costs as a percentage of total inpatient costs using 1981-82 Medicare claims data and cost report information. Inpatient laboratory costs were estimated at 9.5% of total inpatient costs for pre-Diagnostic Related Groups (DRGs) Medicare discharges. Using this reference point and adjusting for the Hospital's 1990 case mix, the "expected" laboratory cost was 9.3% of total cost. In fact, the cost averaged 11.5% (i.e., 24% above the expected cost level), and costs represented an even greater percentage of DRG reimbursement at 12.9%. If we regard the reimbursement as a total cost target (to eliminate losses from Medicare), then that 12.9% is 39% above the "expected" laboratory proportion of 9.3%. The Hospital lost an average of $1,091 on each DRG inpatient. The laboratory contributed 29% to this loss per case. Compared to other large hospitals, the Hospital was slightly (3%) above the mean direct cost per on-site test and significantly (58%) above the mean number of inpatient tests per inpatient day compared to large teaching hospitals. The findings suggest that careful laboratory cost analyses will become increasingly important as the proportion of patients reimbursed in a fixed manner grows. The future may hold a prospective zero-based laboratory budgeting process based on predictable patterns of DRG admissions or other fixed-reimbursement admission and laboratory utilization patterns. PMID:10113716

  17. Innovative Feed-In Tariff Designs that Limit Policy Costs

    SciTech Connect

    Kreycik, C.; Couture, T. D.; Cory, K. S.

    2011-06-01

    Feed-in tariffs (FITs) are the most prevalent renewable energy policy used globally to date, and there are many benefits to the certainty offered in the marketplace to reduce development risks and associated financing costs and to grow the renewable energy industry. However, concerns over escalating costs in jurisdictions with FIT policies have led to increased attention on cost control in renewable energy policy design. In recent years, policy mechanisms for containing FIT costs have become more refined, allowing policymakers to exert greater control on policy outcomes and on the resulting costs to ratepayers. As policymakers and regulators in the United States begin to explore the use of FITs, careful consideration must be given to the ways in which policy design can be used to balance the policies' advantages while bounding its costs. This report explores mechanisms that policymakers have implemented to limit FIT policy costs. If designed clearly and transparently, such mechanisms can align policymaker and market expectations for project deployment. Three different policy tools are evaluated: (1) caps, (2) payment level adjustment mechanisms, and (3) auction-based designs. The report employs case studies to explore the strengths and weaknesses of these three cost containment tools. These tools are then evaluated with a set of criteria including predictability for policymakers and the marketplace and the potential for unintended consequences.

  18. Cost Containment: An Economist's View

    PubMed Central

    Neuhauser, Duncan

    1980-01-01

    Rising medical care costs are not the problem they seem to be, in part because quality of care is not considered. The problem may be more the absence of choice of alternative health benefit packages with price differences. The future of health services in the United States will have more competing alternatives requiring physicians to be more cost conscious. PMID:6992461

  19. Utility and energy cost containment

    SciTech Connect

    Newhouse, R.

    1996-09-01

    One of the most lucrative areas for improving bottom line profitability is related to an organization`s costs for utilities and energy. Such things as gas, electric, water, and telephones are treasure chests of cost reduction opportunities. In the past, these items have been viewed as a fixed expense or basic mundane commodity. In recent years, these items have become a large portion of product cost and now must be examined on a continual basis. A formal income improvement program to capture and report on the savings is a requirement for remaining competitive in a global economy. This paper describes areas of potential inefficiency in terms of energy useage and resulting costs to industry.

  20. ''Measuring the Costs of Climate Change Policies''

    SciTech Connect

    Montgomery, W. D.; Smith, A. E.; Biggar, S. L.; Bernstein, P.M.

    2003-05-09

    Studies of the costs of climate change policies have utilized a variety of measures or metrics for summarizing costs. The leading economic models have utilized GNP, GDP, the ''area under a marginal cost curve,'' the discounted present value of consumption, and a welfare measure taken directly from the utility function of the model's representative agent (the ''Equivalent Variation''). Even when calculated using a single model, these metrics do not necessarily give similar magnitudes of costs or even rank policies consistently. This paper discusses in non-technical terms the economic concepts lying behind each concept, the theoretical basis for expecting each measure to provide a consistent ranking of policies, and the reasons why different measures provide different rankings. It identifies a method of calculating the ''Equivalent Variation'' as theoretically superior to the other cost metrics in ranking policies. When regulators put forward new economic or regulatory policies, there is a need to compare the costs and benefits of these new policies to existing policies and other alternatives to determine which policy is most cost-effective. For command and control policies, it is quite difficult to compute costs, but for more market-based policies, economists have had a great deal of success employing general equilibrium models to assess a policy's costs. Not all cost measures, however, arrive at the same ranking. Furthermore, cost measures can produce contradictory results for a specific policy. These problems make it difficult for a policy-maker to determine the best policy. For a cost measures to be of value, one would like to be confident of two things. First one wants to be sure whether the policy is a winner or loser. Second, one wants to be confident that a measure produces the correct policy ranking. That is, one wants to have confidence in a policy measure's ability to correctly rank policies from most beneficial to most harmful. This paper analyzes empirically these two properties of different costs measures as they pertain to assessing the costs of the carbon abatement policies, especially the Kyoto Protocol, under alternative assumptions about implementation.

  1. College Cost Containment Project. Final Report.

    ERIC Educational Resources Information Center

    Lemke, Darrell

    In response to serious concerns about the dramatic increases in college and university costs, the Department of Education solicited proposals in May 1987 for innovative projects to explore means of cost reduction or containment which promise significant cost savings, whether accrued in the short- or long-term. The solicitation for cost containment…

  2. Cost Containment Cookbook for Public School Construction.

    ERIC Educational Resources Information Center

    2001

    This document is intended to be a "cookbook" of the numerous elements which collectively influence the cost containment of school construction projects. Each element is meant to indicate an action in the process that the school district should pay attention to and ensure is properly accomplished. The elements influencing cost containment are…

  3. The Thankless Task of Cost Containment.

    ERIC Educational Resources Information Center

    Reed, William S.

    1999-01-01

    Pressure for cost containment is growing at even very financially healthy colleges and universities. Institutions need to think concurrently about cost containment in terms of temporary, mid-term, and permanent changes to institutional operations and priorities. It may be productive to reframe the issue as "funding priorities" rather than as "cost…

  4. [Cost effectiveness of workplace smoking policies].

    PubMed

    Raaijmakers, Tamara; van den Borne, Inge

    2003-01-01

    This study reviews the motivations of companies to set out a policy for controlling smoking, the economic benefits for the company resulting from such a policy and the costs, broken down by European Union countries. The literature on the costs of implementing a policy related to smoking at the workplace is reviewed. The main objective of policies related to smoking at the workplace is that of safeguarding employees from environmental tobacco smoke. Other reasons are cutting costs, improving the company image, and reducing absenteeism, occupational accidents, internal quarrels and extra costs due to cigarette smoking, protection against environmental tobacco smoke does not entail any higher costs for companies, and economic advantages are visible. The benefits are by far greater than the costs involved, particularly on a long-range basis, and seem to be greater when smoking at the workplace is completely prohibited and no smoking areas are set. PMID:12696390

  5. The Hospital's Perspective on Cost Containment

    PubMed Central

    McMahon, Alex

    1980-01-01

    Cost containment has long been a concern of hospitals and the American Hospital Association (AHA). In recent years, however, cost containment has assumed a special prominence in hospitals, becoming both a political and social necessity. The hospitals' and AHA's activities in cost containment fall into four major categories: first, the Voluntary Effort to Contain Health Care Costs, of which AHA is a founding partner; second, administrative effectiveness; third, capital effectiveness, and, finally, medical effectiveness. Some programs to promote administrative effectiveness are shared administrative services, energy conservation, careful attention to staffing patterns and management effectiveness review. Capital effectiveness involves technology assessment and other means of deciding how to make the most of the hospital's dollar. Medical effectiveness can be accomplished by such methods as medical audits, utilization reviews and shared clinical services. PMID:7385850

  6. Rural nurses. Part I, Surviving cost containment.

    PubMed

    Fuszard, B; Slocum, L I; Wiggers, D E

    1990-04-01

    Rural nurses from 13 small hospitals share their work lives and concerns. Five years of cost-containment have left them undaunted, but they worry about the financial viability of their hospitals. Their unique brand of nurse shortage has added an additional load that appears surmountable only through financial means, which have also disappeared through cost-containment. This is the story of "frontier nurses" and their fight to maintain an American institution. PMID:2324838

  7. Valuation effects of health cost containment measures.

    PubMed

    Strange, M L; Ezzell, J R

    2000-01-01

    This study reports the findings of research into the valuation effects of health cost containment activities by publicly traded corporations. The motivation for this study was employers' increasing cost of providing health care insurance to their employees and employers' efforts to contain those costs. A 1990 survey of corporate health benefits indicated that these costs represented 25 percent of employers' net earnings and this would rise by the year 2000 if no actions were taken to reduce cost. Health cost containment programs that are implemented by firms should be seen by shareholders as a wealth maximizing effort. As such, this should be reflected in share price. This study employed standard event study methodology where the event is a media announcement or report regarding an attempt by a firm to contain the costs of providing health insurance and other health related benefits to employees. It examined abnormal returns on a number of event days and for a number of event intervals. Of the daily and interval returns that are least significant at the 10 percent level, virtually all are negative. Cross-sectional analysis shows that the abnormal returns are related negatively to a unionization variable. PMID:10961833

  8. 7 CFR 246.16a - Infant formula cost containment.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 4 2010-01-01 2010-01-01 false Infant formula cost containment. 246.16a Section 246... AND CHILDREN State Agency Provisions § 246.16a Infant formula cost containment. (a) Who must use cost containment procedures for infant formula? All State agencies must continuously operate a cost...

  9. Health Care Cost Containment. A Seminar on Health Cost Containment, March 14-15, 1985, Washington, D.C.

    ERIC Educational Resources Information Center

    Council of State Governments, Lexington, KY.

    This document presents the texts of speeches from a conference on health care cost containment. Topics presented include Medicare solvency, capitated programs, diagnostic related groups (DRGs), Medicaid restructuring, long term care financing, private sector cost containment strategies, British health cost containment, health maintenance…

  10. Space Planning: A Basis for Cost Containment.

    ERIC Educational Resources Information Center

    Snyder, Fred A.; And Others

    Decreasing budgets and enrollments, the reluctance of state legislatures to provide funds for higher education facilities, and the rising costs of energy necessitate the development of space ownership management. Three patterns of space planning problems have developed at different colleges: (1) costly, underutilized facilities due to optimistic…

  11. A team approach to cost containment.

    PubMed

    Williams, Jeni

    2008-04-01

    Strategies for involving clinicians in efforts to reduce labor and supply chain expenses include: Working with nurse managers to develop an operations or productivity report that is truly useful. Establishing biweekly reporting of labor utilization per unit. Adding clinicians to your materials management and finance teams. Helping physicians understand the cost profiles of the products they are using and their impact on cost of care. Being patient while securing buy-in. PMID:18441971

  12. 39 CFR 551.8 - Cost offset policy.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Service UNITED STATES POSTAL SERVICE POSTAGE PROGRAMS SEMIPOSTAL STAMP PROGRAM § 551.8 Cost offset policy. (a) Postal Service policy is to recover from the differential revenue for each semipostal stamp those costs that are determined to be attributable to the semipostal stamp and that would not normally...

  13. 39 CFR 551.8 - Cost offset policy.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Service UNITED STATES POSTAL SERVICE POSTAGE PROGRAMS SEMIPOSTAL STAMP PROGRAM § 551.8 Cost offset policy. (a) Postal Service policy is to recover from the differential revenue for each semipostal stamp those costs that are determined to be attributable to the semipostal stamp and that would not normally...

  14. 39 CFR 551.8 - Cost offset policy.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Service UNITED STATES POSTAL SERVICE POSTAGE PROGRAMS SEMIPOSTAL STAMP PROGRAM § 551.8 Cost offset policy. (a) Postal Service policy is to recover from the differential revenue for each semipostal stamp those costs that are determined to be attributable to the semipostal stamp and that would not normally...

  15. 39 CFR 551.8 - Cost offset policy.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Service UNITED STATES POSTAL SERVICE POSTAGE PROGRAMS SEMIPOSTAL STAMP PROGRAM § 551.8 Cost offset policy. (a) Postal Service policy is to recover from the differential revenue for each semipostal stamp those costs that are determined to be attributable to the semipostal stamp and that would not normally...

  16. 39 CFR 551.8 - Cost offset policy.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Service UNITED STATES POSTAL SERVICE POSTAGE PROGRAMS SEMIPOSTAL STAMP PROGRAM § 551.8 Cost offset policy. (a) Postal Service policy is to recover from the differential revenue for each semipostal stamp those costs that are determined to be attributable to the semipostal stamp and that would not normally...

  17. Containing the costs of the EMF problem

    SciTech Connect

    Florig, H.K. )

    1992-07-24

    The uncertainty surrounding possible health effects of power-frequency electric and magnetic fields (EMF's) is fueling a costly controversy over the safety of high voltage transmission lines, neighborhood power-distribution circuits, home and office wiring, elelctrical appliances, and office equipment. Mounting public concerns are driven primarily by a number of epidemiological studies that show increased risks of cancer among populations thought to experience unusual patterns of EMF exposure. Because the scientific evidence on EMF bioeffects is both complicated and contradictory, regulatory bodies and scientific standard-setting organizations have been unable to reach consensus on prescriptive approaches to EMF risk management. Although scientific opinion varies widely about whether the EMF-cancer connection is real, public apprehension over potential EMF hazards has prompted a host of political, legal, and market reactions.

  18. The costs of future polio risk management policies.

    PubMed

    Tebbens, Radboud J Duintjer; Sangrujee, Nalinee; Thompson, Kimberly M

    2006-12-01

    Decisionmakers need information about the anticipated future costs of maintaining polio eradication as a function of the policy options under consideration. Given the large portfolio of options, we reviewed and synthesized the existing cost data relevant to current policies to provide context for future policies. We model the expected future costs of different strategies for continued vaccination, surveillance, and other costs that require significant potential resource commitments. We estimate the costs of different potential policy portfolios for low-, middle-, and high-income countries to demonstrate the variability in these costs. We estimate that a global transition from routine immunization with oral poliovirus vaccine (OPV) to inactivated poliovirus vaccine (IPV) would increase the costs of managing polio globally, although routine IPV use remains less costly than routine OPV use with supplemental immunization activities. The costs of surveillance and a stockpile, while small compared to routine vaccination costs, represent important expenditures to ensure adequate response to potential outbreaks. The uncertainty and sensitivity analyses highlight important uncertainty in the aggregated costs and demonstrates that the discount rate and uncertainty in price and administration cost of IPV drives the expected incremental cost of routine IPV vs. OPV immunization. PMID:17184394

  19. Cost analysis of post-polio certification immunization policies.

    PubMed Central

    Sangrujee, Nalinee; Cáceres, Victor M.; Cochi, Stephen L.

    2004-01-01

    OBJECTIVE: An analysis was conducted to estimate the costs of different potential post-polio certification immunization policies currently under consideration, with the objective of providing this information to policy-makers. METHODS: We analyzed three global policy options: continued use of oral poliovirus vaccine (OPV); OPV cessation with optional inactivated poliovirus vaccine (IPV); and OPV cessation with universal IPV. Assumptions were made on future immunization policy decisions taken by low-, middle-, and high-income countries. We estimated the financial costs of each immunization policy, the number of vaccine-associated paralytic poliomyelitis (VAPP) cases, and the global costs of maintaining an outbreak response capacity. The financial costs of each immunization policy were based on estimates of the cost of polio vaccine, its administration, and coverage projections. The costs of maintaining outbreak response capacity include those associated with developing and maintaining a vaccine stockpile in addition to laboratory and epidemiological surveillance. We used the period 2005-20 as the time frame for the analysis. FINDINGS: OPV cessation with optional IPV, at an estimated cost of US$ 20,412 million, was the least costly option. The global cost of outbreak response capacity was estimated to be US$ 1320 million during 2005-20. The policy option continued use of OPV resulted in the highest number of VAPP cases. OPV cessation with universal IPV had the highest financial costs, but it also had the least number of VAPP cases. Sensitivity analyses showed that global costs were sensitive to assumptions on the cost of the vaccine. Analysis also showed that if the price per dose of IPV was reduced to US$ 0.50 for low-income countries, the cost of OPV cessation with universal IPV would be the same as the costs of continued use of OPV. CONCLUSION: Projections on the vaccine price per dose and future coverage rates were major drivers of the global costs of post-certification polio immunization. The break-even price of switching to IPV compared with continuing with OPV immunizations is US$ 0.50 per dose of IPV. However, this doses not account for the cost of vaccine-derived poliovirus cases resulting from the continued use of OPV. In addition to financial costs, risk assessments related to the re-emergence of polio will be major determinants of policy decisions. PMID:15106295

  20. EFFECTS OF RISING FUEL COSTS ON CONTAINER SHIPPING NETWORKS

    NASA Astrophysics Data System (ADS)

    Shintani, Koichi; Imai, Akio

    Fuel cost increase forces liner shipping companies to bear higher ship operation costs and subsequently a lager total cost. To cope with such a fuel cost increase, they attempt to reduce the ship speed to maintain the low operation costs, even resulting in increase of the transit time. This study examines effects of ship speed reduction on fuel savings as well as profit increase, by using a mathematical model for a container liner service network design with a consideration o f empty container repositioning. Throughout numeric al experiments for the Asia-North America trade, the ship speed reduction is effective in fuel cost savings. Furthermore, it was found that the reduction of ship dwell time at port offset the longer transit time resulting from the cruising speed reduction.

  1. Indiana School Transportation: A Review of Policies, Procedures, and Costs.

    ERIC Educational Resources Information Center

    Sanders, Frank, Jr.

    This detailed report and analysis of school bus transportation in Indiana is divided into the following topics: transportation policies; bus utilization; the bus driver and his terms of employment; bus ownership; insurance, storage, maintenance, and fuel costs; bus ownership and costs; and the transportation director. A strong case is made for…

  2. Autos, tires, aluminum, oil--and cost containment.

    PubMed

    Friedman, E

    1978-09-01

    Faced with massive increases in the costs of the health care benefits they provide for their employees, many large U.S. corporations are becoming increasingly involved in efforts to contain health care costs. Often seeing their efforts as posing an alternative to direct federal government intervention, business leaders are implementing a wide range of programs, including specific arrangements with providers, education of hospital trustees who are also employees, and fitness and preventive medicine programs. PMID:10238290

  3. Eliminating waste and inefficiency can do little to contain costs.

    PubMed

    Schwartz, W B; Mendelson, D N

    1994-01-01

    This study estimates potential savings from eliminating waste and inefficiency in the acute care sector (hospital, physician, and pharmaceutical). Our analysis indicates that in the unlikely event that all potential savings are achieved between 1994 and 2000, the rise in costs would be reduced by about 1.5 percentage points annually. This would slow the real rise in costs from a projected rate of 6.5 percent to 5 percent annually. Covering the uninsured would partially offset these savings and bring the rise in costs to more than 5.5 percent annually. If our estimate of potential efficiency savings is in error by plus or minus 50 percent, the projected rise in costs would be altered by about one percentage point. We conclude that savings from eliminating inefficiency are likely to fall far short of the Clinton administration's cost containment goals. PMID:8188137

  4. Cost-Effectiveness of Fiscal Policies to Prevent Obesity.

    PubMed

    Moodie, Marj; Sheppard, Lauren; Sacks, Gary; Keating, Catherine; Flego, Anna

    2013-01-01

    Cost-effective, sustainable strategies are urgently required to curb the global obesity epidemic. To date, fiscal policies such as taxes and subsidies have been driven largely by imperatives to raise revenue or increase supply, rather than to change population behaviours. This paper reviews the economic evaluation literature around the use of fiscal policies to prevent obesity. The cost-effectiveness literature is limited, and more robust economic evaluation studies are required. However, uncertainty and gaps in the effectiveness evidence base need to be addressed first: more studies are needed that collect 'real-world' empirical data, and larger studies with more robust designs and longer follow-up timeframes are required. Reliability of cross-price elasticity data needs to be investigated, and greater consideration given to moderators of intervention effects and the sustainability of outcomes. Economic evaluations should adopt a societal perspective, incorporate a broader spectrum of economic costs and consider other factors likely to affect the implementation of fiscal measures. The paucity of recent cost-effectiveness studies means that definitive conclusions about the value for money of fiscal policies for obesity prevention cannot yet be drawn. However, as in other public health areas such as alcohol and tobacco, early indications are that population-level fiscal policies are likely to be potentially effective and cost-saving. PMID:23914317

  5. Honoring the Trust: Quality and Cost Containment in Higher Education.

    ERIC Educational Resources Information Center

    Massy, William F.

    This book asserts that improvements in quality and cost containment are required not only for the well-being of individual institutions of higher education, but also to honor the trust placed in academe by society. The book outlines a practical program for improvement. The chapters of part 1, "The Case for Change," are: (1) "The Erosion of Trust";…

  6. Priorities of health policy: cost shifting or population health

    PubMed Central

    Richardson, Jeff RJ

    2005-01-01

    Background This paper is an edited version of an invited paper submitted to the Australian Health Care Summit on 17–19 August 2003. It comments upon the policies which have dominated recent debate and contrasts their importance with the importance of five issues which have received relatively little attention. Methods Policy is usually a response to identified problems and the paper examines the nature and size of the problems which heave led to recent policy initiatives. These are contrasted with the magnitude and potential cost effectiveness policies to address the problems in five areas of comparative neglect. Results It is argued that recent and proposed changes to the financing and delivery of health services in Australia have focused upon issues of relatively minor significance while failing to address adequately major inequities and system deficiencies. Conclusion There is a need for an independent review of the health system with the terms of reference focusing attention upon large system-wide failures. PMID:15679895

  7. Pharmaceutical cost containment and quality care. Conflict or compromise?

    PubMed

    Redwood, H

    1998-01-01

    Existing methods of pharmaceutical cost containment are relatively primitive weapons of expenditure restraint. Their effectiveness is generally limited to short term savings. The conflict between cost containment and quality is epitomised by the 'Drug Budget', which conditions payers to regard pharmaceuticals solely as a cost input without considering the results of their use in terms of integrated health outcomes, crossing the budgetary boundaries between drugs, hospitals, ambulatory and other forms of healthcare. A further problem, also related to the separation of inputs from outcomes, is the contention by healthcare payers that, even if 'expensive' innovative drugs offer Value for Money, budget holders cannot afford the required Money for Value. The limits of affordability are real in poor countries. In rich industrialised nations, the affordability of quality is in essence a political rather than an economic issue. In making choices and determining priorities, elected governments are usually responsive to public opinion, which is coming to regard the issue of quality in healthcare as one of the highest social priorities. Pharmaceutical innovation has much to contribute to quality in healthcare. A compromise between pharmaceutical cost containment and quality is feasible, based on input/outcome considerations, rational drug pricing, and re-engineering decision-making by payers away from the simplistic notion that the cheapest drug budget is necessarily the best. PMID:10186486

  8. Toward strategies for cost containment in surgical patients.

    PubMed Central

    Drucker, W R; Gavett, J W; Kirshner, R; Messick, W J; Ingersoll, G

    1983-01-01

    The University of Rochester, Department of Surgery, in response to an experimental community-wide limit on hospital budgets, studied high-cost general surgical patients as a potential source of leverage for containment of hospital costs. It was found that a small number of patients impact significantly on hospital costs. In 1980, 3935 patients at Strong Memorial Hospital (SMH) had at least one contact with a general surgical patient care or intensive care unit; 261 patients (6.6%) had total 1980 charges of more than $20,000 each. They contributed 32% of the total of both general surgical charges and patient days. A subset of 2021 patients was selected to represent more precisely the general surgical patient. The 85 high-cost patients (4.2%) of this subset were chosen for intensive study. These patients generated a significant and disproportionate per cent of total (2021) general surgical charges (26.8%) and hospital days (27.6%). Average total charges were more than 8 times those of the complementary general surgical subset (1936). Nineteen of the 85 patients (22.3%) died in the hospital and 42 patients (49.4%) were dead within 2 1/2 years. Forty patients (of the 85) were then further identified as "complex", based on multiple, usually unrelated, illnesses and multiple annual admissions. Tending to be elderly with poor prognoses, 60% of them had died by April 1983. The major criterion of complexity was the lack of a well-focused medical problem; the cure for one problem simply relinquished primacy to another. A parallel study of hospital ancillary procedures disclosed a similar high-cost pattern. Of approximately 4000 ancillary procedures, 100 (2.5%) had annual charges of $100,000 or over, accounting for two-thirds of total 1980 ancillary charges. Roughly 20% of a single patient's ordered procedures accounted for 80% of the patient's ancillary charges, thus allowing concentrated study of a relatively small number of charges. Means for cost containment may be applied logically to the high-cost patient and particularly toward the complex patient. The complex patient is especially suited for consideration, since it is postulated that these patients are endemic to all general hospitals and to all clinical services. Strategies to be developed should include: 1) a managerial system in which physicians have an incentive to contain costs, 2) an online data system, 3) an accurate, efficient way to identify prospective high-cost and complex patients and, 4) awareness by physicians, patients, and society that less expensive modes of diagnosis and therapy are an appropriate response to rationed health resources. PMID:6412640

  9. Toward strategies for cost containment in surgical patients.

    PubMed

    Drucker, W R; Gavett, J W; Kirshner, R; Messick, W J; Ingersoll, G

    1983-09-01

    The University of Rochester, Department of Surgery, in response to an experimental community-wide limit on hospital budgets, studied high-cost general surgical patients as a potential source of leverage for containment of hospital costs. It was found that a small number of patients impact significantly on hospital costs. In 1980, 3935 patients at Strong Memorial Hospital (SMH) had at least one contact with a general surgical patient care or intensive care unit; 261 patients (6.6%) had total 1980 charges of more than $20,000 each. They contributed 32% of the total of both general surgical charges and patient days. A subset of 2021 patients was selected to represent more precisely the general surgical patient. The 85 high-cost patients (4.2%) of this subset were chosen for intensive study. These patients generated a significant and disproportionate per cent of total (2021) general surgical charges (26.8%) and hospital days (27.6%). Average total charges were more than 8 times those of the complementary general surgical subset (1936). Nineteen of the 85 patients (22.3%) died in the hospital and 42 patients (49.4%) were dead within 2 1/2 years. Forty patients (of the 85) were then further identified as "complex", based on multiple, usually unrelated, illnesses and multiple annual admissions. Tending to be elderly with poor prognoses, 60% of them had died by April 1983. The major criterion of complexity was the lack of a well-focused medical problem; the cure for one problem simply relinquished primacy to another. A parallel study of hospital ancillary procedures disclosed a similar high-cost pattern. Of approximately 4000 ancillary procedures, 100 (2.5%) had annual charges of $100,000 or over, accounting for two-thirds of total 1980 ancillary charges. Roughly 20% of a single patient's ordered procedures accounted for 80% of the patient's ancillary charges, thus allowing concentrated study of a relatively small number of charges. Means for cost containment may be applied logically to the high-cost patient and particularly toward the complex patient. The complex patient is especially suited for consideration, since it is postulated that these patients are endemic to all general hospitals and to all clinical services. Strategies to be developed should include: 1) a managerial system in which physicians have an incentive to contain costs, 2) an online data system, 3) an accurate, efficient way to identify prospective high-cost and complex patients and, 4) awareness by physicians, patients, and society that less expensive modes of diagnosis and therapy are an appropriate response to rationed health resources. PMID:6412640

  10. 76 FR 60357 - Federal Regulations; OMB Circulars, OFPP Policy Letters, and CASB Cost Accounting Standards...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-29

    ... and 48 CFR Ch. 1 Federal Regulations; OMB Circulars, OFPP Policy Letters, and CASB Cost Accounting... Procurement Policy (OFPP) Policy Letters, and Cost Accounting Standards Board (CASB) Cost Accounting Standards... implementing Executive Order No. 12866 (October 4, 1993, 58 FR 51735). OMB policy guidelines are issued...

  11. Environmental policy, adjustment costs, and behavior of the firm

    SciTech Connect

    Xepapadeas, A.P. )

    1992-11-01

    The effects of environmental policy, in the form of emission charges or emission limits, on the firm's optimal choices of productive and abatement inputs are analyzed. Short-run and long-run impacts on inputs, and the properties of static emission function, are determined through comparative static analysis. Comparative dynamics reveal the properties of the cumulative emission function and the cumulative shadow-cost-of-emission-limits function. 10 refs.

  12. Health care cost containment strategies used in four other high-income countries hold lessons for the United States.

    PubMed

    Stabile, Mark; Thomson, Sarah; Allin, Sara; Boyle, Seán; Busse, Reinhard; Chevreul, Karine; Marchildon, Greg; Mossialos, Elias

    2013-04-01

    Around the world, rising health care costs are claiming a larger share of national budgets. This article reviews strategies developed to contain costs in health systems in Canada, England, France, and Germany in 2000-10. We used a comprehensive analysis of health systems and reforms in each country, compiled by the European Observatory on Health Systems and Policies. These countries rely on a number of budget and price-setting mechanisms to contain health care costs. Our review revealed trends in all four countries toward more use of technology assessments and payment based on diagnosis-related groups and the value of products or services. These policies may result in a more efficient use of health care resources, but we argue that they need to be combined with volume and price controls--measures unlikely to be adopted in the United States--if they are also to meet cost containment goals. PMID:23569043

  13. Are renewables portfolio standards cost-effective emission abatement policy?

    SciTech Connect

    Katerina Dobesova; Jay Apt; Lester B. Lave

    2005-11-15

    Renewables portfolio standards (RPS) could be an important policy instrument for 3P and 4P control. The authors examine the costs of renewable power, accounting for the federal production tax credit, the market value of a renewable credit, and the value of producing electricity without emissions of SO{sub 2}, NOx, mercury, and CO{sub 2}. The focus is on Texas, which has a large RPS and is the largest U.S. electricity producer and one of the largest emitters of pollutants and CO{sub 2}. The private and social costs of wind generation in an RPS is compared with the current cost of fossil generation, accounting for the pollution and CO{sub 2} emissions. It was found that society paid about 5.7 cents/kWh more for wind power, counting the additional generation, transmission, intermittency, and other costs. The higher cost includes credits amounting to 1.1 cents/kWh in reduced SO{sub 2}, NOx, and Hg emissions. These pollution reductions and lower CO{sub 2} emissions could be attained at about the same cost using pulverized coal (PC) or natural gas combined cycle (NGCC) plants with carbon capture and sequestration (CCS); the reductions could be obtained more cheaply with an integrated coal gasification combined cycle (IGCC) plant with CCS. 35 refs., 7 tabs.

  14. Are renewables portfolio standards cost-effective emission abatement policy?

    PubMed

    Dobesova, Katerina; Apt, Jay; Lave, Lester B

    2005-11-15

    Renewables portfolio standards (RPS) could be an important policy instrument for 3P and 4P control. We examine the costs of renewable power, accounting for the federal production tax credit, the market value of a renewable credit, and the value of producing electricity without emissions of SO2, NOx, mercury, and CO2. We focus on Texas, which has a large RPS and is the largest U.S. electricity producer and one of the largest emitters of pollutants and CO2. We estimate the private and social costs of wind generation in an RPS compared with the current cost of fossil generation, accounting for the pollution and CO2 emissions. We find that society paid about 5.7 cent/kWh more for wind power, counting the additional generation, transmission, intermittency, and other costs. The higher cost includes credits amounting to 1.1 cent/kWh in reduced SO2, NOx, and Hg emissions. These pollution reductions and lower CO2 emissions could be attained at about the same cost using pulverized coal (PC) or natural gas combined cycle (NGCC) plants with carbon capture and sequestration (CCS); the reductions could be obtained more cheaply with an integrated coal gasification combined cycle (IGCC) plant with CCS. PMID:16323750

  15. Day care and illness: evidence, cost, and public policy.

    PubMed

    Haskins, R; Kotch, J

    1986-06-01

    Parents, pediatricians, social scientists, and policymakers have become increasingly concerned that infants and children in day care, especially those younger than 3 years of age, are at risk for morbidity associated with several types of acute illness. We have examined the empirical evidence on the impact of day-care attendance on frequency of respiratory illnesses, diarrhea, hepatitis A, meningitis, and cytomegalovirus disease in children, day-care staff, and household contacts. The short- and long-term costs of day-care-associated illnesses were assessed, wherever possible within a benefit-cost framework. Available evidence suggests that children in day care, and sometimes their teachers and household contacts, have higher rates of diarrhea, hepatitis A, meningitis, and possible otitis media than children not in day care. There is only weak or moderate evidence that children and their families are at risk for high rates of respiratory illness (other than otitis media) or cytomegalovirus infection. Taken together, the excess of these illnesses among children in day care may impose moderate net costs on families and on society. Revisions of state regulatory policy regarding health practices in day care and policy initiatives designed to provide parents with more information and authority are recommended to protect the health and development of children in day care. PMID:3012455

  16. 76 FR 70037 - Federal Regulations; OMB Circulars, OFPP Policy Letters, and CASB Cost Accounting Standards...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-10

    ... III 48 CFR Chapter 1 Federal Regulations; OMB Circulars, OFPP Policy Letters, and CASB Cost Accounting... Federal Procurement Policy (OFPP) Policy Letters, and Cost Accounting Standards Board (CASB) Cost.... SUPPLEMENTARY INFORMATION: In a document published in the Federal Register of September 29, 2011 (77 FR...

  17. Cost-effective design of economic instruments in nutrition policy.

    PubMed

    Jensen, Jørgen D; Smed, Sinne

    2007-01-01

    This paper addresses the potential for using economic regulation, e.g. taxes or subsidies, as instruments to combat the increasing problems of inappropriate diets, leading to health problems such as obesity, diabetes 2, cardiovascular diseases etc. in most countries. Such policy measures may be considered as alternatives or supplements to other regulation instruments, including information campaigns, bans or enhancement of technological solutions to the problems of obesity or related diseases. 7 different food tax and subsidy instruments or combinations of instruments are analysed quantitatively. The analyses demonstrate that the average cost-effectiveness with regard to changing the intake of selected nutritional variables can be improved by 10-30 per cent if taxes/subsidies are targeted against these nutrients, compared with targeting selected food categories. Finally, the paper raises a range of issues, which need to be investigated further, before firm conclusions about the suitability of economic instruments in nutrition policy can be drawn. PMID:17408494

  18. A dynamic model for costing disaster mitigation policies.

    PubMed

    Altay, Nezih; Prasad, Sameer; Tata, Jasmine

    2013-07-01

    The optimal level of investment in mitigation strategies is usually difficult to ascertain in the context of disaster planning. This research develops a model to provide such direction by relying on cost of quality literature. This paper begins by introducing a static approach inspired by Joseph M. Juran's cost of quality management model (Juran, 1951) to demonstrate the non-linear trade-offs in disaster management expenditure. Next it presents a dynamic model that includes the impact of dynamic interactions of the changing level of risk, the cost of living, and the learning/investments that may alter over time. It illustrates that there is an optimal point that minimises the total cost of disaster management, and that this optimal point moves as governments learn from experience or as states get richer. It is hoped that the propositions contained herein will help policymakers to plan, evaluate, and justify voluntary disaster mitigation expenditures. PMID:23601023

  19. Managing the cost of emissions for durable, carbon-containing products

    SciTech Connect

    Shirley, Kevin; Marland, Eric; Cantrell, Jenna; Marland, Gregg

    2011-03-01

    We recognize that carbon-containing products do not decay and release CO2 to the atmosphere instantaneously, but release that carbon over extended periods of time. For an initial production of a stock of carbon-containing product, we can treat the release as a probability distribution covering the time over which that release occurs. The probability distribution that models the carbon release predicts the amount of carbon that is released as a function of time. The use of a probability distribution in accounting for the release of carbon to the atmosphere realizes a fundamental shift from the idea that all carbon-containing products contribute to a single pool that decays in proportion to the size of the stock. Viewing the release of carbon as a continuous probabilistic process introduces some theoretical opportunities not available in the former paradigm by taking advantage of other fields where the use of probability distributions has been prevalent for many decades. In particular, theories developed in the life insurance industry can guide the development of pricing and payment structures for dealing with the costs associated with the oxidation and release of carbon. These costs can arise from a number of proposed policies (cap and trade, carbon tax, social cost of carbon, etc), but in the end they all result in there being a cost to releasing carbon to the atmosphere. If there is a cost to the emitter for CO2 emissions, payment for that cost will depend on both when the emissions actually occur and how payment is made. Here we outline some of the pricing and payment structures that are possible which result from analogous theories in the life insurance industry. This development not only provides useful constructs for valuing sequestered carbon, but highlights additional motivations for employing a probability distribution approach to unify accounting methodologies for stocks of carbon containing products.

  20. Evaluation of the Arizona health care cost-containment system

    PubMed Central

    McCall, Nelda; Henton, Douglas; Crane, Michael; Haber, Susan; Freund, Deborah; Wrightson, William

    1985-01-01

    This article evaluates Arizona's alternative to the acute portion of Medicaid, the Arizona Health Care Cost-Containment System (AHCCCS), during its first 18 months of operation from October 1982 through March 1984. It focuses on the program's implementation and describes and evaluates the program's innovative features. The features of the program outlined in the original AHCCCS legislation included: Competitive bidding, prepaid capitation of providers, capitation of the State by the Health Care Financing Administration, assignment of gatekeepers, beneficiary copayment, private administration, inclusion of private and public employees and county financed long-term care. An assessment of implementation during the second 18 months of the program reporting on more recent developments and is now being prepared by SRI International. PMID:10311438

  1. Cost containment through pharmaceutical procurement: a Caribbean case study.

    PubMed

    Huff-Rousselle, M; Burnett, F

    1996-01-01

    This article discusses the potential for health sector cost containment in developing countries through improved pharmaceutical procurement. By describing the specific example of the Eastern Caribbean Drug Service (ECDS), which provides a pooled procurement service to nine ministries of health in the small island nations of the Caribbean, it examines the elements of the procurement operation that allowed ECDS to reduce unit costs for pharmaceuticals by over 50 per cent during its first procurement cycle. The analysis of ECDS considers: (1) political will, institutional alliances, and the creation of a public sector monopsony; (2) pooling demand; (3) restricted international tendering and the pharmaceutical industry; (4) estimating demand and supplier guarantees; (5) reducing variety and increasing volume through standardizing pack sizes, dosage forms and strengths; (6) generic bidding and therapeutic alternative bidding; (7) mode of transport from foreign suppliers; (8) financing mechanisms, including choice of currency, foreign exchange, and terms of payment; (9) market conditions and crafting and enforcing supplier contracts; and, (10) the adjudication process, including consideration of suppliers' past performance, precision requirements in the manufacturing process, number of products awarded to suppliers, and issues of judgment. The authors consider the relevance of this agency's experience to other developing countries by providing a blueprint that can be adopted or modified to suit other situations. PMID:10172681

  2. Detecting nuclear materials smuggling: performance evaluation of container inspection policies.

    PubMed

    Gaukler, Gary M; Li, Chenhua; Ding, Yu; Chirayath, Sunil S

    2012-03-01

    In recent years, the United States, along with many other countries, has significantly increased its detection and defense mechanisms against terrorist attacks. A potential attack with a nuclear weapon, using nuclear materials smuggled into the country, has been identified as a particularly grave threat. The system for detecting illicit nuclear materials that is currently in place at U.S. ports of entry relies heavily on passive radiation detectors and a risk-scoring approach using the automated targeting system (ATS). In this article we analyze this existing inspection system and demonstrate its performance for several smuggling scenarios. We provide evidence that the current inspection system is inherently incapable of reliably detecting sophisticated smuggling attempts that use small quantities of well-shielded nuclear material. To counter the weaknesses of the current ATS-based inspection system, we propose two new inspection systems: the hardness control system (HCS) and the hybrid inspection system (HYB). The HCS uses radiography information to classify incoming containers based on their cargo content into "hard" or "soft" containers, which then go through different inspection treatment. The HYB combines the radiography information with the intelligence information from the ATS. We compare and contrast the relative performance of these two new inspection systems with the existing ATS-based system. Our studies indicate that the HCS and HYB policies outperform the ATS-based policy for a wide range of realistic smuggling scenarios. We also examine the impact of changes in adversary behavior on the new inspection systems and find that they effectively preclude strategic gaming behavior of the adversary. PMID:22043828

  3. Cost containment and quality of care in Japan: is there a trade-off?

    PubMed

    Hashimoto, Hideki; Ikegami, Naoki; Shibuya, Kenji; Izumida, Nobuyuki; Noguchi, Haruko; Yasunaga, Hideo; Miyata, Hiroaki; Acuin, Jose M; Reich, Michael R

    2011-09-24

    Japan's health indices such as life expectancy at birth are among the best in the world. However, at 8·5% the proportion of gross domestic product spent on health is 20th among Organisation for Economic Co-operation and Development countries in 2008 and half as much as that in the USA. Costs have been contained by the nationally uniform fee schedule, in which the global revision rate is set first and item-by-item revisions are then made. Although the structural and process dimensions of quality seem to be poor, the characteristics of the health-care system are primarily attributable to how physicians and hospitals have developed in the country, and not to the cost-containment policy. However, outcomes such as postsurgical mortality rates are as good as those reported for other developed countries. Japan's basic policy has been a combination of tight control of the conditions of payment, but a laissez-faire approach to how services are delivered; this combination has led to a scarcity of professional governance and accountability. In view of the structural problems facing the health-care system, the balance should be shifted towards increased freedom of payment conditions by simplification of reimbursement rules, but tightened control of service delivery by strengthening of regional health planning, both of which should be supported through public monitoring of providers' performance. Japan's experience of good health and low cost suggests that the priority in health policy should initially be improvement of access and prevention of impoverishment from health care, after which efficiency and quality of services should then be pursued. PMID:21885098

  4. Container-based sanitation: assessing costs and effectiveness of excreta management in Cap Haitien, Haiti

    PubMed Central

    Tilmans, Sebastien; Russel, Kory; Sklar, Rachel; Page, Leah; Kramer, Sasha

    2015-01-01

    Container-based sanitation (CBS) – in which wastes are captured in sealable containers that are then transported to treatment facilities – is an alternative sanitation option in urban areas where on-site sanitation and sewerage are infeasible. This paper presents the results of a pilot household CBS service in Cap Haitien, Haiti. We quantify the excreta generated weekly in a dense urban slum,(1) the proportion safely removed via container-based public and household toilets, and the costs associated with these systems. The CBS service yielded an approximately 3.5-fold decrease in the unmanaged share of faeces produced, and nearly eliminated the reported use of open defecation and “flying toilets” among service recipients. The costs of this pilot small-scale service were higher than those of large-scale waterborne sewerage, but economies of scale have the potential to reduce CBS costs over time. The paper concludes with a discussion of planning and policy implications of incorporating CBS into the menu of sanitation options for rapidly growing cities. PMID:26097288

  5. Ship Compliance in Emission Control Areas: Technology Costs and Policy Instruments.

    PubMed

    Carr, Edward W; Corbett, James J

    2015-08-18

    This paper explores whether a Panama Canal Authority pollution tax could be an effective economic instrument to achieve Emission Control Area (ECA)-like reductions in emissions from ships transiting the Panama Canal. This tariff-based policy action, whereby vessels in compliance with International Maritime Organisation (IMO) ECA standards pay a lower transit tariff than noncompliant vessels, could be a feasible alternative to petitioning for a Panamanian ECA through the IMO. A $4.06/container fuel tax could incentivize ECA-compliant emissions reductions for nearly two-thirds of Panama Canal container vessels, mainly through fuel switching; if the vessel(s) also operate in IMO-defined ECAs, exhaust-gas treatment technologies may be cost-effective. The RATES model presented here compares current abatement technologies based on hours of operation within an ECA, computing costs for a container vessel to comply with ECA standards in addition to computing the Canal tax that would reduce emissions in Panama. Retrofitted open-loop scrubbers are cost-effective only for vessels operating within an ECA for more than 4500 h annually. Fuel switching is the least-cost option to industry for vessels that operate mostly outside of ECA regions, whereas vessels operating entirely within an ECA region could reduce compliance cost with exhaust-gas treatment technology (scrubbers). PMID:26258438

  6. Cost Sharing in Higher Education in Kenya: Examining the Undesired Policy Outcomes

    ERIC Educational Resources Information Center

    Ngolovoi, Mary S.

    2010-01-01

    Cost sharing in higher education is a policy that comes from the United States. The policy advocates that costs of higher education should be shared between the government, parents, students and/or donor organizations. Proponents of the policy (such as the World Bank) have over the years been advocating for its implementation in African countries.…

  7. Health Cost Containment, Wellness, and the 1990s.

    ERIC Educational Resources Information Center

    Stasica, Edward R.

    Virtually every employer has it in their power to reduce their employee health care costs by 10-20 percent or more. The solution to the rising health care costs problem is a total health care system. Most cost savings potential will be centered in three areas: control of wasteful and often harmful use of the health care system; provider price…

  8. Cost-containment and the use of reference laboratories.

    PubMed

    Shaw, S T; Miller, J M

    1985-12-01

    Hospital laboratories and hospital-independent reference laboratories will need to change in order to provide comprehensive, medically appropriate, and reasonably priced laboratory services in the cost-containment age we are entering. The change must be economically and technologically innovative and relevant to society's next generation of health care needs. Hospital laboratories and commercial laboratories may become weaker or stronger relative to one another, but our guess is that they will ultimately become more like one another or even may join forces to provide optimal patient care in the future. Until that time comes, hospital laboratories must decide whether to employ reference laboratory services more or less, enter a joint venture with a reference laboratory, or become a reference laboratory. Some of the items that could be considered in arriving at this decision are listed in Table 2. Some items favor hospital laboratories; some favor reference laboratories; some are a toss-up; and some suggest there are advantages in a team approach. For the present, we believe there are many arguments favoring a continuation and possibly even an expansion of hospital laboratory services, but this will likely be most feasible in financially sound and progressive hospitals having forward-looking administrators and imaginative but fiscally minded laboratory directors and managers. If decisions are made to send more tests to reference laboratories, each hospital or user laboratory must seek the best and most cost-effective services available. Various financial, technical, and medical considerations are described that should aid in the evaluation of where to have tests performed. We have provided suggestions on how agreements with reference laboratories can be established in either a formal (contractual) or an informal (verbal) way. Additionally, we have described methods for evaluating (or monitoring) the quality and quantity of services received from a reference laboratory. In general, for any significant agreement with a reputable reference laboratory, little more may be necessary for monitoring purposes than periodic financial and quality assurance audits and follow-up on any clinical complaints regarding test results. With a large contract, the user laboratory is advised to spot check results on submitted blind duplicates of patient samples (to test provider lab precision) and occasionally to split samples between the provider and one or more other reference laboratories (as a first look at possible inaccuracy).(ABSTRACT TRUNCATED AT 400 WORDS) PMID:4085191

  9. 75 FR 26270 - Environmental Planning and Historic Preservation Compliance Costs Policy; Environmental Planning...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-11

    ... SECURITY Federal Emergency Management Agency Environmental Planning and Historic Preservation Compliance Costs Policy; Environmental Planning and Historic Preservation Mitigation Policy AGENCY: Federal... Emergency Management Agency (FEMA) is accepting comments on a draft Environmental Planning and...

  10. European hospital reforms in times of crisis: aligning cost containment needs with plans for structural redesign?

    PubMed

    Clemens, Timo; Michelsen, Kai; Commers, Matt; Garel, Pascal; Dowdeswell, Barrie; Brand, Helmut

    2014-07-01

    Hospitals have become a focal point for health care reform strategies in many European countries during the current financial crisis. It has been called for both, short-term reforms to reduce costs and long-term changes to improve the performance in the long run. On the basis of a literature and document analysis this study analyses how EU member states align short-term and long-term pressures for hospital reforms in times of the financial crisis and assesses the EU's influence on the national reform agenda. The results reveal that there has been an emphasis on cost containment measures rather than embarking on structural redesign of the hospital sector and its position within the broader health care system. The EU influences hospital reform efforts through its enhanced economic framework governance which determines key aspects of the financial context for hospitals in some countries. In addition, the EU health policy agenda which increasingly addresses health system questions stimulates the process of structural hospital reforms by knowledge generation, policy advice and financial incentives. We conclude that successful reforms in such a period would arguably need to address both the organisational and financing sides to hospital care. Moreover, critical to structural reform is a widely held acknowledgement of shortfalls in the current system and belief that new models of hospital care can deliver solutions to overcome these deficits. Advancing the structural redesign of the hospital sector while pressured to contain cost in the short-term is not an easy task and only slowly emerging in Europe. PMID:24703855

  11. Japan's universal long-term care system reform of 2005: containing costs and realizing a vision.

    PubMed

    Tsutsui, Takako; Muramatsu, Naoko

    2007-09-01

    Japan implemented a mandatory social long-term care insurance (LTCI) system in 2000, making long-term care services a universal entitlement for every senior. Although this system has grown rapidly, reflecting its popularity among seniors and their families, it faces several challenges, including skyrocketing costs. This article describes the recent reform initiated by the Japanese government to simultaneously contain costs and realize a long-term vision of creating a community-based, prevention-oriented long-term care system. The reform involves introduction of two major elements: "hotel" and meal charges for nursing home residents and new preventive benefits. They were intended to reduce economic incentives for institutionalization, dampen provider-induced demand, and prevent seniors from being dependent by intervening while their need levels are still low. The ongoing LTCI reform should be critically evaluated against the government's policy intentions as well as its effect on seniors, their families, and society. The story of this reform is instructive for other countries striving to develop coherent, politically acceptable long-term care policies. PMID:17767690

  12. 75 FR 34448 - Proposed CERCLA Administrative Cost Recovery Settlement; Great Lakes Container Corporation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-17

    ... AGENCY Proposed CERCLA Administrative Cost Recovery Settlement; Great Lakes Container Corporation... Lakes Container Corporation Superfund Site, located in Coventry Rhode Island with the settling parties...-1216. Comments should reference the Great Lakes Container Corporation Superfund Site, Coventry,...

  13. Does Prospective Payment Really Contain Nursing Home Costs?

    PubMed Central

    Chen, Li-Wu; Shea, Dennis G

    2002-01-01

    Objective To examine whether nursing homes would behave more efficiently, without compromising their quality of care, under prospective payment. Data Sources Four data sets for 1994: the Skilled Nursing Facility Minimum Data Set, the Online Survey Certification and Reporting System file, the Area Resource File, and the Hospital Wage Indices File. A national sample of 4,635 nursing homes is included in the analysis. Study Design Using a modified hybrid functional form to estimate nursing home costs, we distinguish our study from previous research by controlling for quality differences (related to both care and life) and addressing the issues of output and quality endogeneity, as well as using more recent national data. Factor analysis was used to operationalize quality variables. To address the endogeneity problems, instrumental measures were created for nursing home output and quality variables. Principal Findings Nursing homes in states using prospective payment systems do not have lower costs than their counterpart facilities under retrospective cost-based payment systems, after quality differences among facilities are controlled for and the endogeneity problem of quality variables is addressed. Conclusions The effects of prospective payment on nursing home cost reduction may be through quality cuts, rather than cost efficiency. If nursing home payments under prospective payment systems are not adjusted for quality, nursing homes may respond by cutting their quality levels, rather than controlling costs. Future outcomes research may provide useful insights into the adjustment of quality in the design of prospective payment for nursing home care. PMID:12035993

  14. An analysis of structural incentives in the Arizona Health Care Cost-Containment System

    PubMed Central

    Vogel, Ronald J.

    1984-01-01

    This article analyzes the financial structures of the prevailing public and private health insurance mechanisms. Based on this analysis, it was concluded that the financial structures of health insurance mechanisms are deficient in that they neither produce efficiency in the consumption of health services, nor generate efficiency in the production of health services. On the other hand, closed-end systems of finance, such as the health maintenance organization (HMO) or the new Arizona Health Care Cost-Containment System (AHCCCS), give more promise of achieving such efficiencies. The AHCCCS represents an important innovation in the public financing of health care, and, for policy purposes, should be considered a viable national alternative for the reform of Medicare and Medicaid. PMID:10310943

  15. The flexible budget process--a tool for cost containment.

    PubMed

    Pearson, J R; Romfh, P C; Habib, J M; Frieling, M J

    1985-08-01

    This past year the authors have been using a new tool to examine and monitor their laboratory's expenditures. Called "flexible budgeting," this process has been used to analyze the cost behavior of all operating expenses, establish budget levels for different levels of activity, and monitor activity based on relative cost rather than simply the number of tests performed. The authors' experience has shown that this tool provides much more information than previous procedures. However, better methods need to be developed for monitoring expenditures so that this information can be used effectively. PMID:4025225

  16. 42 CFR 100.2 - Average cost of a health insurance policy.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Average cost of a health insurance policy. 100.2 Section 100.2 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES VACCINE INJURY COMPENSATION § 100.2 Average cost of a health insurance policy. For purposes of...

  17. 42 CFR 100.2 - Average cost of a health insurance policy.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Average cost of a health insurance policy. 100.2 Section 100.2 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES VACCINE INJURY COMPENSATION § 100.2 Average cost of a health insurance policy. For purposes of...

  18. 42 CFR 100.2 - Average cost of a health insurance policy.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Average cost of a health insurance policy. 100.2 Section 100.2 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES VACCINE INJURY COMPENSATION § 100.2 Average cost of a health insurance policy. For purposes of...

  19. 42 CFR 100.2 - Average cost of a health insurance policy.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Average cost of a health insurance policy. 100.2 Section 100.2 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES VACCINE INJURY COMPENSATION § 100.2 Average cost of a health insurance policy. For purposes of...

  20. 42 CFR 100.2 - Average cost of a health insurance policy.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Average cost of a health insurance policy. 100.2 Section 100.2 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES VACCINE INJURY COMPENSATION § 100.2 Average cost of a health insurance policy. For purposes of...

  1. Estimating the Cost of National Class Size Reductions under Different Policy Alternatives.

    ERIC Educational Resources Information Center

    Brewer, Dominic J.; Krop, Cathy; Gill, Brian P.; Reichardt, Robert

    1999-01-01

    Estimates the operational costs of nationwide class-size-reduction programs under various policy alternatives, including the specified class size, flexibility in implementation, and whether the policy is targeted toward at-risk students. Depending on the options, estimated costs range from about $2 billion per year to over $11 billion per year.…

  2. Using the Kaldor-Hicks Tableau Format for Cost-Benefit Analysis and Policy Evaluation

    ERIC Educational Resources Information Center

    Krutilla, Kerry

    2005-01-01

    This note describes the Kaldor-Hicks (KH) tableau format as a framework for distributional accounting in cost-benefit analysis and policy evaluation. The KH tableau format can serve as a heuristic aid for teaching microeconomics-based policy analysis, and offer insight to policy analysts and decisionmakers beyond conventional efficiency analysis.

  3. Cost containment and new priorities in the European community.

    PubMed

    Abel-Smith, B

    1992-01-01

    This article reports on the author's survey of the cost-control measures for health care in 12 European countries during the period from 1983 to 1990. Among these countries the greatest convergence was in the use of the budget as a system of control, reinforced by manpower controls. Budgets were constructed to restrict hospital costs and payments to doctors practicing outside of hospitals. Another strategy was cost sharing for purchase of drugs and, in some cases, for dentistry. Most countries took steps to control expensive medical equipment; others, to restrict entry to medical schools. The European experience demonstrates the technical feasibility of the government's controlling health care costs by regulating supply rather than demand. The key to Europe's success in the use of monopsony power, whereby one purchaser dominates the market. The author contends that regulation works in Europe and questions whether the United States can exert similar control over its coalition of insurers and providers in order to rein in its health care expenses. PMID:1406493

  4. Understanding the cost bases of Space Shuttle pricing policies for commercial and foreign customers

    NASA Technical Reports Server (NTRS)

    Stone, Barbara A.

    1984-01-01

    The principles and underlying cost bases of the 1977 and 1982 Space Shuttle Reimbursement Policies are compared and contrasted. Out-of-pocket cost recovery has been chosen as the base of the price for the 1986-1988 time period. With this cost base, it is NASA's intent to recover the total cost of consumables and the launch and flight operations costs added by commercial and foreign customers over the 1986-1988 time period. Beyond 1988, NASA intends to return to its policy of full cost recovery.

  5. Reliability and cost evaluation of small isolated power systems containing photovoltaic and wind energy

    NASA Astrophysics Data System (ADS)

    Karki, Rajesh

    Renewable energy application in electric power systems is growing rapidly worldwide due to enhanced public concerns for adverse environmental impacts and escalation in energy costs associated with the use of conventional energy sources. Photovoltaics and wind energy sources are being increasingly recognized as cost effective generation sources. A comprehensive evaluation of reliability and cost is required to analyze the actual benefits of utilizing these energy sources. The reliability aspects of utilizing renewable energy sources have largely been ignored in the past due the relatively insignificant contribution of these sources in major power systems, and consequently due to the lack of appropriate techniques. Renewable energy sources have the potential to play a significant role in the electrical energy requirements of small isolated power systems which are primarily supplied by costly diesel fuel. A relatively high renewable energy penetration can significantly reduce the system fuel costs but can also have considerable impact on the system reliability. Small isolated systems routinely plan their generating facilities using deterministic adequacy methods that cannot incorporate the highly erratic behavior of renewable energy sources. The utilization of a single probabilistic risk index has not been generally accepted in small isolated system evaluation despite its utilization in most large power utilities. Deterministic and probabilistic techniques are combined in this thesis using a system well-being approach to provide useful adequacy indices for small isolated systems that include renewable energy. This thesis presents an evaluation model for small isolated systems containing renewable energy sources by integrating simulation models that generate appropriate atmospheric data, evaluate chronological renewable power outputs and combine total available energy and load to provide useful system indices. A software tool SIPSREL+ has been developed which generates risk, well-being and energy based indices to provide realistic cost/reliability measures of utilizing renewable energy. The concepts presented and the examples illustrated in this thesis will help system planners to decide on appropriate installation sites, the types and mix of different energy generating sources, the optimum operating policies, and the optimum generation expansion plans required to meet increasing load demands in small isolated power systems containing photovoltaic and wind energy sources.

  6. Abstracts of State Legislated Hospital Cost-Containment Programs

    PubMed Central

    Esposito, Alfonso; Hupfer, Michael; Mason, Cynthia; Rogler, Diane

    1982-01-01

    This report summarizes State legislated efforts to control rising hospital costs and the status of these efforts in May 1982. The abstract for each of 17 State programs summarizes key legislative features and operating aspects. The States included in this report are: Arizona, California, Connecticut, Florida, Illinois, Maine, Maryland, Massachusetts, Minnesota, New Jersey, New York, Oregon, Rhode Island, Virginia, Washington, West Virginia, and Wisconsin. The abstracts focus on programs requiring the disclosure, review, or legislation of hospital rates and budgets. PMID:10309910

  7. The ABCs of Activity-Based Costing: A Cost Containment and Reallocation Tool.

    ERIC Educational Resources Information Center

    Turk, Frederick J.

    1992-01-01

    This article describes activity-based costing (ABC) and how this tool may help management understand the costs of major activities and identify possible alternatives. Also discussed are the traditional costing systems used by higher education and ways of applying ABC to higher education. (GLR)

  8. Higher Education Cost Drivers, Including Two Hidden Ones with Cost Containment Possibilities.

    ERIC Educational Resources Information Center

    Micceri, Ted

    Identifying higher education cost drivers and working to limit their effects appears to be a necessity if higher education is to retain the support historically allocated by society. Costs occur for three groups: students, institutions, and society. This paper summarizes information about cost drivers in higher education and identifies two that

  9. An Industrial Engineering Approach to Cost Containment of Pharmacy Education

    PubMed Central

    Bottenberg, Michelle; Chase, Marilea; Chesnut, Renae; Clarke, Cheryl; Schott, Kathryn; Torry, Ronald; Welty, Tim

    2015-01-01

    A 2-semester project explored employing teams of fourth-year industrial engineering students to optimize some of our academic management processes. Results included significant cost savings and increases in efficiency, effectiveness, and student and faculty satisfaction. While we did not adopt all of the students’ recommendations, we did learn some important lessons. For example, an initial investment of time in developing a mutually clear understanding of the problems, constraints, and goals maximizes the value of industrial engineering analysis and recommendations. Overall, industrial engineering was a valuable tool for optimizing certain academic management processes. PMID:26839421

  10. An Industrial Engineering Approach to Cost Containment of Pharmacy Education.

    PubMed

    Duncan, Wendy; Bottenberg, Michelle; Chase, Marilea; Chesnut, Renae; Clarke, Cheryl; Schott, Kathryn; Torry, Ronald; Welty, Tim

    2015-11-25

    A 2-semester project explored employing teams of fourth-year industrial engineering students to optimize some of our academic management processes. Results included significant cost savings and increases in efficiency, effectiveness, and student and faculty satisfaction. While we did not adopt all of the students' recommendations, we did learn some important lessons. For example, an initial investment of time in developing a mutually clear understanding of the problems, constraints, and goals maximizes the value of industrial engineering analysis and recommendations. Overall, industrial engineering was a valuable tool for optimizing certain academic management processes. PMID:26839421

  11. The High Cost of Teacher Turnover. Policy Brief

    ERIC Educational Resources Information Center

    National Commission on Teaching and America's Future, 2007

    2007-01-01

    In 2007, the National Commission on Teaching and America's Future (NCTAF) completed an 18-month study of the costs of teacher turnover in five school districts. The selected districts varied in size, location, and demographics enabling exploration of how these variations affected costs. Costs of recruiting, hiring, processing, and training…

  12. Containing the cost of third-molar extractions: a dilemma for health insurance.

    PubMed Central

    Friedman, J W

    1983-01-01

    No known scientific studies support the extraction of third molars (wisdom teeth) to prevent future disease. Yet, third-molar surgery for this purpose has become so common that in at least one major U.S. health insurance plan, the cumulative cost exceeds that for every other kind of major surgery. Many third molars that are developing normally in adolescents are classified as impacted and removed before they erupt, a practice that results in large expenditures for unnecessary surgery. In addition, the difficulty of the extractions is frequently exaggerated, so that patients and insurance plans are overcharged. Third molar surgery is not without risk of iatrogenic injury. Fracture of the jaw, permanent numbness of the lip (paresthesia), and injury to other teeth may occur. This paper presents a mechanism for containing the cost of third-molar surgery by elimination of payment for nonessential extractions and of the related overcharges. Adoption of this policy by administrators of dental insurance plans would save millions of dollars each year, money that could be better used in providing care for more people with real dental disease. PMID:6611824

  13. Cost containment: strategies and responsibilities of the laboratory manager.

    PubMed

    Martin, B G

    1985-12-01

    In these difficult times we must not lose the sense of purpose and the personal drive that makes it possible to achieve excellence. We can be exasperated with reduced funding, burdened with excuses, debilitated with confusion about budgetary cuts, and even be stubborn about alternatives, but we must be serious about excellence and quality. It is natural that during these times we will face those with conflicting views, negative ideas, and erratic long-term goals, but that in itself should rouse us, as professionals, toward the pursuit of quality health care services. With better scheduling of tests and procedure, improved discharge planning, more careful review of the need for patient hospitalization, and a more careful examination of the number, mix, and quality of services furnished during a patient's hospital stay, we, as a health care team, can and will reduce unnecessary utilization of all services. Well-managed laboratories must operate around a return on investment threshold, from which all products, services, and expenditures are ranked. On this basis, management decisions will be made to add to service, reduce service, improve or sustain quality, change technology, or discontinue the business altogether. Given the mandate embodied in the DRG regulations, laboratories have become cost centers. New ideas, new technology, and creative efforts must now be used to improve laboratory productivity while sustaining quality health care services. It is argued philosophically that the DRGs or other major measures to reduce funding adversely affect quality of service. This may be true under the traditional definition of services, but there must be "a new order of things." Today's complex problems indicate that orthodox solutions no longer apply, and in our quest to answer who should pay versus who should receive, and how much is enough, we must ensure quality of all services offered. This new order of doing things could result in far greater savings than has previously been predicted. The patient's length of stay in the hospital has already been reduced. There will continue to be decreases in laboratory utilization and consumption of resources necessary to provide laboratory services. Cost competitiveness coupled with the laboratory's need for increased productivity will further expand savings. To summarize, the laboratory manager in the mid-1980's will have the following goals. To provide quality, cost-efficient, and timely laboratory services. To sustain and nurture the growth of the clinical laboratory profession as dictated by the needs of society and new scientific trends and discoveries.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:4085189

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

    PubMed Central

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

    2011-01-01

    Objectives Growing concern over the costs, environmental impact and safety of tobacco product litter (TPL) has prompted states and cities to undertake a variety of policy initiatives, of which litter abatement fees are part. The present work describes a framework and methodology for calculating TPL costs and abatement fees. Methods Abatement is associated with four categories of costs: (1) mechanical and manual abatement from streets, sidewalks and public places, (2) mechanical and manual abatement from storm water and sewer treatment systems, (3) the costs associated with harm to the ecosystem and harm to industries dependent on clean and healthy ecosystems, and (4) the costs associated with direct harm to human health. The experiences of the City of San Francisco's recently proposed tobacco litter abatement fee serve as a case study. Results City and municipal TPL costs are incurred through manual and mechanical clean-up of surfaces and catchment areas. According to some studies, public litter abatement costs to US cities range from US$3 million to US$16 million. TPL typically comprises between 22% and 36% of all visible litter, implying that total public TPL direct abatement costs range from about US$0.5 million to US$6 million for a city the size of San Francisco. The costs of mitigating the negative externalities of TPL in a city the size of San Francisco can be offset by implementing a fee of approximately US$0.20 per pack. Conclusions Tobacco litter abatement costs to cities can be substantial, even when the costs of potential environmental pollution and tourism effects are excluded. One public policy option to address tobacco litter is levying of fees on cigarettes sold. The methodology described here for calculating TPL costs and abatement fees may be useful to state and local authorities who are considering adoption of this policy initiative. PMID:21504923

  15. Hospital pharmacy decisions, cost containment, and the use of cost-effectiveness analysis.

    PubMed

    Sloan, F A; Whetten-Goldstein, K; Wilson, A

    1997-08-01

    The key hypothesis of the study was that hospital pharmacies under the pressure of managed care would be more likely to adopt process innovations to assure less costly and more cost-effective provision of care. We conducted a survey of 103 hospitals and analyzed secondary data on cost and staffing. Compared to the size of the reduction in length of stay, changes in the way that a day of care is delivered appear to be minor, even in areas with substantial managed care share. The vast majority of hospitals surveyed had implemented some form of therapeutic interchange and generic substitution. Most hospitals used some drug utilization guidelines, but as of mid 1995 these were not yet important management tools for hospital pharmacies. To our knowledge, ours was the first survey to investigate the link between hospital formularies and use of cost-effectiveness analysis. At most cost-effectiveness was a minor tool in pharmaceutical decision making in hospitals at present. We could determine no differences in use of such analyses by managed care market share in the hospital's market share. One impediment to the use of cost-effectiveness studies was the lack of timeliness of studies. Other stated reasons for not using cost-effectiveness analysis more often were: lack of information on hospitalized patients and hence on the potential cost offsets accruing to the hospital: lack of independent sponsorship, and inadequate expertise in economic evaluation. PMID:9226778

  16. Initiatives for Containing the Cost of Higher Education. Stretching the Higher Education Dollar. Special Report 1

    ERIC Educational Resources Information Center

    Massy, William F.

    2013-01-01

    In this article, the author offers a comprehensive reform agenda for policymakers interested in cost containment. Massy lays out a series of initiatives that, working in tandem, can promote the larger goal of compelling colleges to spend money wisely. Among the individual reforms Massy proposes are creating a national database of cost-containment

  17. Critical Issue Bibliography (CRIB) Sheet: Maintaining Financial Health--Tuition Strategies, Cost Containment, and Fundraising.

    ERIC Educational Resources Information Center

    ERIC Clearinghouse on Higher Education, Washington, DC.

    This CRitical Issue Bibliography (CRIB) Sheet lists resources that focus on maintaining the financial health of an institution of higher education. It describes resources in three areas: (1) tuition strategies; (2) cost containment; and (3) fundraising. The focus of the bibliography, however, is on cost containment and efficiency, and it details…

  18. Cost containment strategies by private hospitals: their effectiveness, importance, and use.

    PubMed

    Rutledge, R W; Parsons, S; Bernard, B

    1996-01-01

    This article presents a study that identifies cost issues and strategies in a highly competitive hospital service area. Specifically, the study seeks to determine the most important cost issues that are currently facing hospitals and to examine the effectiveness of various cost containment strategies. Additionally, the study examines the extent of agreement among hospitals regarding the effectiveness of cost containment strategies. The current study focused on all private hospitals in the Baton Rouge service area. A high degree of consensus was found regarding the importance of cost issues in the service area. One of the more significant findings was the strong agreement that physician involvement (in the category of physician use of resources) was the most important cost issue facing hospitals in the Baton Rouge service area. The group of cost containment strategies with the greatest success related to the issue of budgeting and patient accounts. In particular, electronic billing and the use of collection agencies were favored. PMID:8777703

  19. Policies of containment: immigration in the era of AIDS.

    PubMed Central

    Fairchild, A L; Tynan, E A

    1994-01-01

    The US Public Health Service began the medical examination of immigrants at US ports in 1891. By 1924, national origin had become a means to justify broad-based exclusion of immigrants after Congress passed legislation restricting immigration from southern and eastern European countries. This legislation was passed based on the alleged genetic inferiority of southern and eastern Europeans. Since 1987, the United States has prohibited the entrance of immigrants infected with the human immunodeficiency virus (HIV). On the surface, a policy of excluding individuals with an inevitably fatal "communicable disease of public health significance" rests solidly in the tradition of protecting public health. But excluding immigrants with HIV is also a policy that, in practice, resembles the 1924 tradition of selective racial restriction of immigrants from "dangerous nations." Since the early 1980s, the United States has erected barriers against immigrants from particular Caribbean and African nations, whose citizens were thought to pose a threat of infecting the US blood supply with HIV. Images p2012-a p2014-a PMID:7998650

  20. New Center Applies Cost-Benefit Analysis to Education Policies

    ERIC Educational Resources Information Center

    Viadero, Debra

    2008-01-01

    This article describes the Center for Benefit-Cost Studies of Education, at Teachers College, Columbia University. Launched last year by a pair of economists, the center specializes in calculating and comparing the long- and short-term costs--and probable payoffs--of different educational strategies that promise to improve students' lives. Studies…

  1. 75 FR 49508 - Recovery Policy, RP9525.7, Labor Costs-Emergency Work

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-13

    ... updated policy, FEMA proposes that labor costs for firefighters and other responders when activated and... assistance for overtime for firefighters for up to 24 hours per day for the first two weeks after a...

  2. Cost Benefit Analysis of Two Policy Options for Cannabis: Status Quo and Legalisation

    PubMed Central

    Shanahan, Marian; Ritter, Alison

    2014-01-01

    Aims To date there has been limited analysis of the economic costs and benefits associated with cannabis legalisation. This study redresses this gap. A cost benefit analysis of two cannabis policy options the status quo (where cannabis use is illegal) and a legalised–regulated option was conducted. Method A cost benefit analysis was used to value the costs and benefits of the two policies in monetary terms. Costs and benefits of each policy option were classified into five categories (direct intervention costs, costs or cost savings to other agencies, benefits or lost benefits to the individual or the family, other impacts on third parties, and adverse or spill over events). The results are expressed as a net social benefit (NSB). Findings The mean NSB per annum from Monte Carlo simulations (with the 5 and 95 percentiles) for the status quo was $294.6 million AUD ($201.1 to $392.7 million) not substantially different from the $234.2 million AUD ($136.4 to $331.1 million) for the legalised–regulated model which excludes government revenue as a benefit. When government revenue is included, the NSB for legalised–regulated is higher than for status quo. Sensitivity analyses demonstrate the significant impact of educational attainment and wellbeing as drivers for the NSB result. Conclusion Examining the percentiles around the two policy options, there appears to be no difference between the NSB for these two policy options. Economic analyses are essential for good public policy, providing information about the extent to which one policy is substantially economically favourable over another. In cannabis policy, for these two options this does not appear to be the case. PMID:24755942

  3. Funding and Cost Analysis. Policy Paper Series: Document 8.

    ERIC Educational Resources Information Center

    Cobb, H. Brian, Ed.; Larkin, Dave, Ed.

    Five policy papers address methods of funding vocational/special education and relative benefits versus expenditures for different employment training systems for moderately and severely handicapped persons. The first paper critiques the present vocational education funding system for handicapped students. Federal funding mechanisms, state and…

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

    PubMed

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

    2009-01-01

    A public health perspective based on social justice and a population health point of view emphasizes pharmacy policy innovations regarding safety and costs. Such policies that effectively reduce costs include controlling profits, establishing profit targets, extending prescription providers, revising prescription classification schemes, emphasizing generic medications, and establishing formularies. Public education and universal programs may reduce costs, but co-pays and "cost-sharing" do not. Switching medications to over-the-counter (OTC) status, pill splitting, and importing medication from abroad are poor substitutes for authentic public health pharmacy policy. Where policy changes yield savings, public health insists that these savings should be used to increase access and improve population health. In the future, pharmacy policies may emphasize public health accountability more than individual liberty because of potential cost savings to society. Fear of litigation, as an informal mechanism of focusing manufacturer's attention on safety, is inefficient; public health pharmacy policy regarding safety looks toward a more active regulatory role on the part of government. A case study of direct-to-consumer advertising illustrates the complexity of public health pharmacy policy. PMID:19821192

  5. Final Technical Report Power through Policy: "Best Practices" for Cost-Effective Distributed Wind

    SciTech Connect

    Rhoads-Weaver, Heather; Gagne, Matthew; Sahl, Kurt; Orrell, Alice; Banks, Jennifer

    2012-02-28

    Power through Policy: 'Best Practices' for Cost-Effective Distributed Wind is a U.S. Department of Energy (DOE)-funded project to identify distributed wind technology policy best practices and to help policymakers, utilities, advocates, and consumers examine their effectiveness using a pro forma model. Incorporating a customized feed from the Database of State Incentives for Renewables and Efficiency (DSIRE), the Web-based Distributed Wind Policy Comparison Tool (Policy Tool) is designed to assist state, local, and utility officials in understanding the financial impacts of different policy options to help reduce the cost of distributed wind technologies. The project's final products include the Distributed Wind Policy Comparison Tool, found at www.windpolicytool.org, and its accompanying documentation: Distributed Wind Policy Comparison Tool Guidebook: User Instructions, Assumptions, and Case Studies. With only two initial user inputs required, the Policy Tool allows users to adjust and test a wide range of policy-related variables through a user-friendly dashboard interface with slider bars. The Policy Tool is populated with a variety of financial variables, including turbine costs, electricity rates, policies, and financial incentives; economic variables including discount and escalation rates; as well as technical variables that impact electricity production, such as turbine power curves and wind speed. The Policy Tool allows users to change many of the variables, including the policies, to gauge the expected impacts that various policy combinations could have on the cost of energy (COE), net present value (NPV), internal rate of return (IRR), and the simple payback of distributed wind projects ranging in size from 2.4 kilowatts (kW) to 100 kW. The project conducted case studies to demonstrate how the Policy Tool can provide insights into 'what if' scenarios and also allow the current status of incentives to be examined or defended when necessary. The ranking of distributed wind state policy and economic environments summarized in the attached report, based on the Policy Tool's default COE results, highlights favorable market opportunities for distributed wind growth as well as market conditions ripe for improvement. Best practices for distributed wind state policies are identified through an evaluation of their effect on improving the bottom line of project investments. The case studies and state rankings were based on incentives, power curves, and turbine pricing as of 2010, and may not match the current results from the Policy Tool. The Policy Tool can be used to evaluate the ways that a variety of federal and state policies and incentives impact the economics of distributed wind (and subsequently its expected market growth). It also allows policymakers to determine the impact of policy options, addressing market challenges identified in the U.S. DOE's '20% Wind Energy by 2030' report and helping to meet COE targets. In providing a simple and easy-to-use policy comparison tool that estimates financial performance, the Policy Tool and guidebook are expected to enhance market expansion by the small wind industry by increasing and refining the understanding of distributed wind costs, policy best practices, and key market opportunities in all 50 states. This comprehensive overview and customized software to quickly calculate and compare policy scenarios represent a fundamental step in allowing policymakers to see how their decisions impact the bottom line for distributed wind consumers, while estimating the relative advantages of different options available in their policy toolboxes. Interested stakeholders have suggested numerous ways to enhance and expand the initial effort to develop an even more user-friendly Policy Tool and guidebook, including the enhancement and expansion of the current tool, and conducting further analysis. The report and the project's Guidebook include further details on possible next steps. NREL Report No. BK-5500-53127; DOE/GO-102011-3453.

  6. Cost-effectiveness analysis of policy instruments for greenhouse gas emission mitigation in the agricultural sector.

    TOXLINE Toxicology Bibliographic Information

    Bakam I; Balana BB; Matthews R

    2012-12-15

    Market-based policy instruments to reduce greenhouse gas (GHG) emissions are generally considered more appropriate than command and control tools. However, the omission of transaction costs from policy evaluations and decision-making processes may result in inefficiency in public resource allocation and sub-optimal policy choices and outcomes. This paper aims to assess the relative cost-effectiveness of market-based GHG mitigation policy instruments in the agricultural sector by incorporating transaction costs. Assuming that farmers' responses to mitigation policies are economically rationale, an individual-based model is developed to study the relative performances of an emission tax, a nitrogen fertilizer tax, and a carbon trading scheme using farm data from the Scottish farm account survey (FAS) and emissions and transaction cost data from literature metadata survey. Model simulations show that none of the three schemes could be considered the most cost effective in all circumstances. The cost effectiveness depends both on the tax rate and the amount of free permits allocated to farmers. However, the emissions trading scheme appears to outperform both other policies in realistic scenarios.

  7. A Pollution Control Strategy Game: Costs of Control Policies.

    ERIC Educational Resources Information Center

    Bierma, Thomas J.; Walbert, Mark S.

    1987-01-01

    Describes an interactive classroom game designed to enhance student understanding of air pollution control strategies. Discusses the game's focus on the differences in compliance costs that can occur between the three principal control approaches of emission limits, emission permits, and emission taxes. (TW)

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

    PubMed

    Russell, Louise B; Sinha, Anushua

    2016-05-01

    Although the U.S. spends more on medical care than any country in the world, Americans live shorter lives than the citizens of other high-income countries. Many important opportunities to improve this record lie outside the health sector and involve improving the conditions in which Americans live and work: safe design and maintenance of roads, bridges, train tracks, and airports; control of environmental pollutants; occupational safety; healthy buildings; a safe and healthy food supply; safe manufacture of consumer products; a healthy social environment; and others. Faced with the overwhelming array of possibilities, U.S. decision makers need help identifying those that can contribute the most to health. Cost-effectiveness analysis is designed to serve that purpose, but has mainly been used to assess interventions within the health sector. This paper briefly reviews the objective of cost-effectiveness analysis and its methodologic evolution and discusses the issues that arise when it is used to evaluate interventions that fall outside the health sector under three headings: structuring the analysis, quantifying/measuring benefits and costs, and valuing benefits and costs. PMID:27102861

  9. Cost risk benefit analysis to support chemoprophylaxis policy for travellers to malaria endemic countries

    PubMed Central

    2011-01-01

    Background In a number of malaria endemic regions, tourists and travellers face a declining risk of travel associated malaria, in part due to successful malaria control. Many millions of visitors to these regions are recommended, via national and international policy, to use chemoprophylaxis which has a well recognized morbidity profile. To evaluate whether current malaria chemo-prophylactic policy for travellers is cost effective when adjusted for endemic transmission risk and duration of exposure. a framework, based on partial cost-benefit analysis was used Methods Using a three component model combining a probability component, a cost component and a malaria risk component, the study estimated health costs avoided through use of chemoprophylaxis and costs of disease prevention (including adverse events and pre-travel advice for visits to five popular high and low malaria endemic regions) and malaria transmission risk using imported malaria cases and numbers of travellers to malarious countries. By calculating the minimal threshold malaria risk below which the economic costs of chemoprophylaxis are greater than the avoided health costs we were able to identify the point at which chemoprophylaxis would be economically rational. Results The threshold incidence at which malaria chemoprophylaxis policy becomes cost effective for UK travellers is an accumulated risk of 1.13% assuming a given set of cost parameters. The period a travellers need to remain exposed to achieve this accumulated risk varied from 30 to more than 365 days, depending on the regions intensity of malaria transmission. Conclusions The cost-benefit analysis identified that chemoprophylaxis use was not a cost-effective policy for travellers to Thailand or the Amazon region of Brazil, but was cost-effective for travel to West Africa and for those staying longer than 45 days in India and Indonesia. PMID:21586155

  10. Improving air pollution control policy in China--A perspective based on cost-benefit analysis.

    PubMed

    Gao, Jinglei; Yuan, Zengwei; Liu, Xuewei; Xia, Xiaoming; Huang, Xianjin; Dong, Zhanfeng

    2016-02-01

    To mitigate serious air pollution, the State Council of China promulgated the Air Pollution Prevention and Control Action Plan in 2013. To verify the feasibility and validity of industrial energy-saving and emission-reduction policies in the action plan, we conducted a cost-benefit analysis of implementing these policies in 31 provinces for the period of 2013 to 2017. We also completed a scenario analysis in this study to assess the cost-effectiveness of different measures within the energy-saving and the emission-reduction policies individually. The data were derived from field surveys, statistical yearbooks, government documents, and published literatures. The results show that total cost and total benefit are 118.39 and 748.15 billion Yuan, respectively, and the estimated benefit-cost ratio is 6.32 in the S3 scenario. For all the scenarios, these policies are cost-effective and the eastern region has higher satisfactory values. Furthermore, the end-of-pipe scenario has greater emission reduction potential than energy-saving scenario. We also found that gross domestic product and population are significantly correlated with the benefit-cost ratio value through the regression analysis of selected possible influencing factors. The sensitivity analysis demonstrates that benefit-cost ratio value is more sensitive to unit emission-reduction cost, unit subsidy, growth rate of gross domestic product, and discount rate among all the parameters. Compared with other provinces, the benefit-cost ratios of Beijing and Tianjin are more sensitive to changes of unit subsidy than unit emission-reduction cost. These findings may have significant implications for improving China's air pollution prevention policy. PMID:26595398

  11. Initiatives for Containing the Cost of Higher Education. Stretching the Higher Education Dollar. Special Report 1

    ERIC Educational Resources Information Center

    Massy, William F.

    2013-01-01

    In this article, the author offers a comprehensive reform agenda for policymakers interested in cost containment. Massy lays out a series of initiatives that, working in tandem, can promote the larger goal of compelling colleges to spend money wisely. Among the individual reforms Massy proposes are creating a national database of cost-containment…

  12. Risk informed resource allocation policy: safety can save costs.

    PubMed

    Pasman, H J

    2000-01-01

    During economic doldrums, decision making on investments for safety is even more difficult than it already is when funds are abundant. This paper attempts to offer some guidance. After stating the present challenge to prevention of losses in the process industries, the systematic approach of quantified risk assessment is briefly reviewed and improvements in the methodology are mentioned. In addition, attention is given to the use of a risk matrix to survey a plant and to derive a plan of action. Subsequently, the reduction of risk is reviewed. Measures for prevention, protection, and mitigation are discussed. The organization of safety has become at least as important as technical safety of equipment and standards. It is reflected in the introduction of a safety management system. Furthermore, the design process in a pro-active approach is described and the concept of inherent safety is briefly addressed. The concept of Layer of Protection Analysis is explained and also the reason why it is relevant to provide a cost-benefit analysis. Finally, after comments regarding the cost of accidents, the basics of costing and profitability are summarized and a way is suggested to apply this approach to risk-reducing measures. An example is provided on how a selection can be made from a number of alternatives. PMID:10677670

  13. Mitigation Costs and Economic Impacts of Climate Change in a Probabilistic Integrated Assessment of Optimal Policies

    NASA Astrophysics Data System (ADS)

    Drouet, L.; Bosetti, V.; Tavoni, M.

    2013-12-01

    In this study, we use a probabilistic chain methodology in an integrated assessment framework to take into account the uncertainties from the economy and from the climate. First, a random sampling of scenarios is generated covering the range of uncertainties of the socio-economic challenges of mitigation and adaptation and the uncertainty about the delay in the policy action. Then, an economic growth model is used to produce optimal future emission paths in a cost-effectiveness analysis with respect to an extensive range of carbon budgets and to compute the distribution of cost estimates for the mitigation of climate change. A reduced complexity climate model, calibrated from past observation using inverse Bayesian technique, computes probabilistic temperatures projections from the emissions. Finally, The distribution of economic impacts of climate change is produced, by combining the temperatures with impact estimates coming from previous studies. The results show that the distribution of the mitigation costs is right-skewd and that the mitigation costs increase with the delay of policy inaction. In 2050, the economic impacts of climate change are rather positive, but, in 2100, if no stringent policy is applied, the economic impact distribution have a very long tail towards potential high negative impacts. In the Figure, when the two cost distributions are combined, mitigation costs and economic impacts, a stringent policy will lead more likely to a higher loss of GDP than a less stringent policy, however the confidence interval of GDP loss for less stringent policies is much larger. Join distributions of mitigation costs and economic impacts costs per delay of inaction (in rows) and per probability to stay below the 2°C temperature increase (in columns), in 2050 and 2100. The red dot represent the median of the distribution. The y-axis is truncated at -50% of GDP.

  14. Public costs and policy implications of teenage childbearing.

    PubMed

    Burt, M R

    1990-01-01

    Teenage pregnancies end in an increasing number of abortions, a declining number of placements in adoptive homes, and an increasing number of children born to unmarried teens with large public expenditures for welfare and medical care. A study estimated that the public cost of a family started by a 1st birth to a teenager in 1979 would amount to $18,710; and all such families would cost $8.3 billion to taxpayers. Children of teenage parents face poorer infant health, lower academic achievement, greater risk of socioemotional problems, and a greater probability of becoming teen parents themselves. A recent New York City study indicated that 86% of homeless families were female-headed households, 83% received public assistance, and the likelihood of their genesis from a teenage birth was high. Over the past 10-15 years US culture has become more sexualized; as a result 7 million males and 5 million females are sexually active among 26 million young people aged 13-19, and fewer than 9% of them are married according to 1981 data. By 1979, 1/3 of white and 1/2 of black unmarried 16-year old girls had experienced sexual intercourse. Only 1/3 of sexually active teenagers use contraception consistently, and only 1/2 of them used any contraception at 1st intercourse. 20% of teen pregnancies occur within 1 month of 1st intercourse and 50% occur within the 1st 6 months. Fewer than 10% of teenagers receive a comprehensive sex or family life education course in high school. Cost-effective primary prevention activities focus on delay or abstention from sexual activity, or make contraceptives available. Expensive secondary prevention programs influence teenager's decision about whether to abort, carry the pregnancy to term, or place the baby up for adoption; they attempt to prevent various negative consequences of teenage pregnancy, including low birth weight, out-of-wedlock parenting, and educational and employment disadvantages. PMID:12317629

  15. Potential unintended pregnancies averted and cost savings associated with a revised Medicaid sterilization policy

    PubMed Central

    Borrero, Sonya; Zite, Nikki; Potter, Joseph E.; Trussell, James; Smith, Kenneth

    2013-01-01

    Objective Medicaid sterilization policy, which includes a mandatory 30-day waiting period between consent and the sterilization procedure, poses significant logistical barriers for many women who desire publicly-funded sterilization. Our goal was to estimate the number of unintended pregnancies and the associated costs resulting from unfulfilled sterilization requests due to Medicaid policy barriers. Study design We constructed a cost effectiveness model from the health care payer perspective to determine the incremental cost over a 1-year time horizon of the current Medicaid sterilization policy compared to a hypothetical, revised policy in which women who desire a post-partum sterilization would face significantly reduced barriers. Probability estimates for potential outcomes in the model were based on published sources; costs of Medicaid-funded sterilizations and Medicaid-covered births were based on data from the Medicaid Statistical Information System and The Guttmacher Institute, respectively. Results With the implementation of a revised Medicaid sterilization policy, we estimated that the number of fulfilled sterilization requests would increase by 45%, from 53.3% of all women having their sterilization requests fulfilled to 77.5%. Annually, this increase could potentially lead to over 29,000 unintended pregnancies averted and $215 million saved. Conclusion A revised Medicaid sterilization policy could potentially honor women's reproductive decisions, reduce the number of unintended pregnancies, and save a significant amount of public funds. Implication Compared to the current federal Medicaid sterilization policy, a hypothetical, revised policy that reduces logistical barriers for women who desire publicly-funded, post-partum sterilization could potentially avert over 29,000 unintended pregnancies annually and therefore lead to a cost savings of $215 million each year. PMID:24028751

  16. The costs of treating hypertension: what are the long-term realities of cost containment and pharmacoeconomics?

    PubMed

    Elliott, W J

    1996-04-01

    Cost containment is an important force in medicine today, and there is ample reason to believe that it will soon target the No. 1 health problem for which Americans visit physicians--hypertension. The greatly streamlined (and cost-limited) initial evaluation of hypertensive patients suggested by the latest report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure is but one example. Acquisition cost is certainly an important factor in choice of a drug, but it is only one aspect of total cost of care. Limiting pharmacy benefits may produce short-term cost savings but may lead to unanticipated long-term increases in the healthcare budget. Prescribing large numbers of pills or an increased strength to allow pill-splitting and dispensing free medications provided by many pharmaceutical companies are ways some physicians are limiting the cost of antihypertensive drug therapy for patients. More research and sharing of information are necessary before easily generalizable conclusions can be drawn about the long-term pharmacoeconomics of hypertension therapy. PMID:8604411

  17. Decreasing spine implant costs and inter-physician cost variation: the impact of programme of cost containment on implant expenditure in spinal surgery.

    PubMed

    Oren, J; Hutzler, L H; Hunter, T; Errico, T; Zuckerman, J; Bosco, J

    2015-08-01

    The demand for spinal surgery and its costs have both risen over the past decade. In 2008 the aggregate hospital bill for surgical care of all spinal procedures was reported to be $33.9 billion. One key driver of rising costs is spinal implants. In 2011 our institution implemented a cost containment programme for spinal implants which was designed to reduce the prices of individual spinal implants and to reduce the inter-surgeon variation in implant costs. Between February 2012 and January 2013, our spinal surgeons performed 1493 spinal procedures using implants from eight different vendors. By applying market analysis and implant cost data from the previous year, we established references prices for each individual type of spinal implant, regardless of vendor, who were required to meet these unit prices. We found that despite the complexity of spinal surgery and the initial reluctance of vendors to reduce prices, significant savings were made to the medical centre. PMID:26224828

  18. Improving the quality of antimicrobial drug use can result in cost containment.

    PubMed

    Gyssens, I C; Kullberg, B J

    1995-09-22

    Antibiotic policies are implemented to optimize patient care, to limit antimicrobial resistance and to reduce costs. Before improving the use of antimicrobial drugs by monitoring, it is of primary importance to conduct a general utilization review to document problem areas within the hospital and to evaluate quality and costs. Subsequently, limited targets for an intervention can be defined. For the evaluation of quality, established criteria can be used to classify prescriptions into categories of appropriate use. Several classification systems are described in the literature. We have developed a classification method which allows evaluation of each relevant parameter associated with antimicrobial drug use and global (true) cost calculation. Data are processed in a computer program for Apple or Windows. Surgical prophylaxis is a target of choice to analyse at a hospital pharmacy level. Important cost savings can be obtained by implementing well-accepted standards of good antimicrobial prophylaxis. PMID:8574212

  19. COST MINIMIZATION MODEL OF OCEANGOING CARRIERS ON A LARGE-SCALE INTERNATIONAL MARITIME CONTAINER SHIPPING NETWORK CONSIDERING CHARACTERISTICS OF PORTS

    NASA Astrophysics Data System (ADS)

    Shibasaki, Ryuichi; Watanabe, Tomihiro; Ieda, Hitoshi

    This paper deals with a cost minimization problem of oceangoing carriers on a large-scale network of international maritime container shipping industry, in order to measure impact of port policies for each country including Japan. Concretely, the authors develop a model to decide ports to call and size of containership in each route by ocean-going carrier group, with consideration of construction of deeper berths to deal with enlargement of containership, decrease of various port charges per cargo by attracting cargos into one port, and congestion by exceeding aggregation. The developed model is applied to the actual large-scale international maritime container shipping network in Eastern Asia. The performance of the model developed is validated. Also, the sensitivity of the model output is confirmed from the viewpoints of economy and diseconomy of scale included in the model.

  20. How to Calculate the Costs or Savings of Tax Credit Voucher Policies. NEPC Policy Memo

    ERIC Educational Resources Information Center

    Welner, Kevin

    2011-01-01

    In this NEPC Policy Memo, Professor Welner explains that the most honest and conscientious approach to reporting the fiscal impact of tax credit vouchers is to provide a range of outcomes and let the readers--not the legislative analysts themselves--speculate on which is most likely. If a bottom line is demanded, it should be couched in as many…

  1. Consumer cost effectiveness of CO2 mitigation policies in restructured electricity markets

    NASA Astrophysics Data System (ADS)

    Moore, Jared; Apt, Jay

    2014-10-01

    We examine the cost of carbon dioxide mitigation to consumers in restructured USA markets under two policy instruments, a carbon price and a renewable portfolio standard (RPS). To estimate the effect of policies on market clearing prices, we constructed hourly economic dispatch models of the generators in PJM and in ERCOT. We find that the cost effectiveness of policies for consumers is strongly dependent on the price of natural gas and on the characteristics of the generators in the dispatch stack. If gas prices are low (˜4/MMBTU), a technology-agnostic, rational consumer seeking to minimize costs would prefer a carbon price over an RPS in both regions. Expensive gas (˜7/MMBTU) requires a high carbon price to induce fuel switching and this leads to wealth transfers from consumers to low carbon producers. The RPS may be more cost effective for consumers because the added energy supply lowers market clearing prices and reduces CO2 emissions. We find that both policies have consequences in capacity markets and that the RPS can be more cost effective than a carbon price under certain circumstances: continued excess supply of capacity, retention of nuclear generators, and high natural gas prices.

  2. Technological learning and renewable energy costs: implications for U.S. renewable energy policy.

    SciTech Connect

    Erickson, Jon D.; Kobos, Peter Holmes; Drennen, Thomas E.

    2004-09-01

    This paper analyzes the relationship between current renewable energy technology costs and cumulative production, research, development and demonstration expenditures, and other institutional influences. Combining the theoretical framework of 'learning by doing' and developments in 'learning by searching' with the fields of organizational learning and institutional economics offers a complete methodological framework to examine the underlying capital cost trajectory when developing electricity cost estimates used in energy policy planning models. Sensitivities of the learning rates for global wind and solar photovoltaic technologies to changes in the model parameters are tested. The implications of the results indicate that institutional policy instruments play an important role for these technologies to achieve cost reductions and further market adoption.

  3. Cost estimate of high-level radioactive waste containers for the Yucca Mountain Site Characterization Project

    SciTech Connect

    Russell, E.W.; Clarke, W.; Domian, H.A.; Madson, A.A.

    1991-08-01

    This report summarizes the bottoms-up cost estimates for fabrication of high-level radioactive waste disposal containers based on the Site Characterization Plan Conceptual Design (SCP-CD). These estimates were acquired by Babcock and Wilcox (B&S) under sub-contract to Lawrence Livermore National Laboratory (LLNL) for the Yucca Mountain Site Characterization Project (YMP). The estimates were obtained for two leading container candidate materials (Alloy 825 and CDA 715), and from other three vendors who were selected from a list of twenty solicited. Three types of container designs were analyzed that represent containers for spent fuel, and for vitrified high-level waste (HLW). The container internal structures were assumed to be AISI-304 stainless steel in all cases, with an annual production rate of 750 containers. Subjective techniques were used for estimating QA/QC costs based on vendor experience and the specifications derived for the LLNL-YMP Quality Assurance program. In addition, an independent QA/QC analysis is reported which was prepared by Kasier Engineering. Based on the cost estimates developed, LLNL recommends that values of $825K and $62K be used for the 1991 TSLCC for the spent fuel and HLW containers, respectively. These numbers represent the most conservative among the three vendors, and are for the high-nickel anstenitic steel (Alloy 825). 6 refs., 7 figs.

  4. Economically and environmentally informed policy for road resurfacing: tradeoffs between costs and greenhouse gas emissions

    NASA Astrophysics Data System (ADS)

    Reger, Darren; Madanat, Samer; Horvath, Arpad

    2014-10-01

    As road conditions worsen, users experience an increase in fuel consumption and vehicle wear and tear. This increases the costs incurred by the drivers, and also increases the amount of greenhouse gases (GHGs) that vehicles emit. Pavement condition can be improved through rehabilitation activities (resurfacing) to reduce the effects on users, but these activities also have significant cost and GHG emission impacts. The objective of pavement management is to minimize total societal (user and agency) costs. However, the environmental impacts associated with the cost-minimizing policy are not currently accounted for. We show that there exists a range of potentially optimal decisions, known as the Pareto frontier, in which it is not possible to decrease total emissions without increasing total costs and vice versa. This research explores these tradeoffs for a system of pavement segments. For a case study, a network was created from a subset of California’s highways using available traffic data. It was shown that the current resurfacing strategy used by the state’s transportation agency, Caltrans, does not fall on the Pareto frontier, meaning that significant savings in both total costs and total emissions can be achieved by switching to one of the optimal policies. The methods presented in this paper also allow the decision maker to evaluate the impact of other policies, such as reduced vehicle kilometers traveled or better construction standards.

  5. Cost-effectiveness analysis and policy choices: investing in health systems.

    PubMed Central

    Murray, C. J.; Kreuser, J.; Whang, W.

    1994-01-01

    The role of health systems infrastructure in studies of cost-effectiveness analysis and health resource allocation is discussed, and previous health sector cost-effectiveness analyses are cited. Two substantial difficulties concerning the nature of health system costs and the policy choices are presented. First, the issue of health system infrastructure can be addressed by use of computer models such as the Health Resource Allocation Model (HRAM) developed at Harvard, which integrates cost-effectiveness and burden of disease data. It was found that a model which allows for expansion in health infrastructure yields nearly 40% more total DALYs for a hypothetical sub-Saharan African country than a model which neglects infrastructure expansion. Widespread use of cost-effectiveness databases for resource allocations in the health sector will require the cost-effectiveness analyses shift from reporting costs to reporting production functions. Second, three distinct policy questions can be treated using these tools, each necessitating its own inputs and constraints: allocations when given a fixed budget and health infrastructure, or when given resources for marginal expansion, or when given a politically constrained situation of expanding resources. Confusion concerning which question is being addressed must be avoided through development of a consistent and rigorous approach to using cost-effectiveness data for informing resource allocations. PMID:7923545

  6. Marketing Policy and Its Cost in a College of Higher Education.

    ERIC Educational Resources Information Center

    Riley, Eric

    1984-01-01

    Discusses the development of advertising and publicity strategies and policy for student recruitment purposes at a college of education in the United Kingdom between 1972 and 1982. Covers changes in staff attitudes, selection of media, organization of administration, and cost factors. (PGD)

  7. Financing Higher Education in Ethiopia: Analysis of Cost-Sharing Policy and its Implementation

    ERIC Educational Resources Information Center

    Ayalew, Sewale Abate

    2013-01-01

    Cost-sharing as a policy in Ethiopian higher education institutions (HEIs) has been adopted since 2003 to achieve a set of objectives such as supplementing revenue as an alternative non-governmental source, maintaining and enhancing access to higher education, addressing equity in terms of opportunity in higher education and making students…

  8. Human Papillomavirus (HPV) Vaccine Availability, Recommendations, Cost, and Policies Among Health Departments in Seven Appalachian States

    PubMed Central

    Katz, Mira L.; Reiter, Paul L.; Kluhsman, Brenda C.; Kennedy, Stephenie; Dwyer, Sharon; Schoenberg, Nancy; Johnson, Andy; Ely, Gretchen; Roberto, Karen A.; Lengerich, Eugene J.; Brown, Pamela; Paskett, Electra D.; Dignan, Mark

    2009-01-01

    Telephone interviews of health department personnel in six states and review of an immunization database from one state were conducted to assess human papillomavirus (HPV) vaccine availability, recommendations, cost, policies, and educational materials in health departments in seven Appalachian states. Most (99.1%) health departments (n=234) reported receiving patient requests for the HPV vaccine, and only two (1%) health departments reported that they did not provide the vaccine for patients. HPV vaccine supply was reported to not meet demand in 10.5% (24/228) of health departments due to high costs. Level (state, region, county) at which policy about the HPV vaccine was determined, vaccine recommendations, costs, and available educational materials varied among states. This study documented variation in vaccine availability, recommendations, cost, policies, and educational materials in Appalachian health departments that could significantly affect vaccine distribution. Findings highlight the need for more comprehensive and consistent policies that maximize accessibility of the HPV vaccine to women, especially those in underserved areas. PMID:19446191

  9. Environmental tipping points significantly affect the cost-benefit assessment of climate policies.

    PubMed

    Cai, Yongyang; Judd, Kenneth L; Lenton, Timothy M; Lontzek, Thomas S; Narita, Daiju

    2015-04-14

    Most current cost-benefit analyses of climate change policies suggest an optimal global climate policy that is significantly less stringent than the level required to meet the internationally agreed 2 °C target. This is partly because the sum of estimated economic damage of climate change across various sectors, such as energy use and changes in agricultural production, results in only a small economic loss or even a small economic gain in the gross world product under predicted levels of climate change. However, those cost-benefit analyses rarely take account of environmental tipping points leading to abrupt and irreversible impacts on market and nonmarket goods and services, including those provided by the climate and by ecosystems. Here we show that including environmental tipping point impacts in a stochastic dynamic integrated assessment model profoundly alters cost-benefit assessment of global climate policy. The risk of a tipping point, even if it only has nonmarket impacts, could substantially increase the present optimal carbon tax. For example, a risk of only 5% loss in nonmarket goods that occurs with a 5% annual probability at 4 °C increase of the global surface temperature causes an immediate two-thirds increase in optimal carbon tax. If the tipping point also has a 5% impact on market goods, the optimal carbon tax increases by more than a factor of 3. Hence existing cost-benefit assessments of global climate policy may be significantly underestimating the needs for controlling climate change. PMID:25825719

  10. 30 CFR 1218.704 - What is ONRR's policy on interest and administrative costs?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 3 2014-07-01 2014-07-01 false What is ONRR's policy on interest and administrative costs? 1218.704 Section 1218.704 Mineral Resources OFFICE OF NATURAL RESOURCES REVENUE, DEPARTMENT OF THE INTERIOR NATURAL RESOURCES REVENUE COLLECTION OF ROYALTIES, RENTALS, BONUSES, AND OTHER MONIES DUE THE FEDERAL GOVERNMENT Debt...

  11. Laboratory costs and utilization: a framework for analysis and policy design.

    PubMed

    Hardwick, D F; Morrison, J I; Tydeman, J; Cassidy, P A; Chase, W H

    1981-04-01

    A conceptual framework is outlined as the basis for analysis and evaluation of laboratory test-ordering patterns. This framework highlights the input, process, and output phases of the laboratory inquiry system. Data are presented from a contemporary Canadian study to show that the cost of laboratory testing is escalating and represents a sizable proportion of hospital costs. Practical policy interventions intent on reducing the costs in this complex system will require thorough analysis within a conceptual framework such as is outlined here and will require ultimately sophisticated control programs at various levels in the laboratory inquiry system. PMID:7218295

  12. The effect of health payment reforms on cost containment in Taiwan hospitals: the agency theory perspective.

    PubMed

    Chang, Li

    2011-01-01

    This study aims to determine whether the Taiwanese government's implementation of new health care payment reforms (the National Health Insurance with fee-for-service (NHI-FFS) and global budget (NHI-GB)) has resulted in better cost containment. Also, the question arises under the agency theory whether the monitoring system is effective in reducing the risk of information asymmetry. This study uses panel data analysis with fixed effects model to investigate changes in cost containment at Taipei municipal hospitals before and after adopting reforms from 1989 to 2004. The results show that the monitoring system does not reduce information asymmetry to improve cost containment under the NHI-FFS. In addition, after adopting the NHI-GB system, health care costs are controlled based on an improved monitoring system in the policymaker's point of view. This may suggest that the NHI's fee-for-services system actually causes health care resource waste. The GB may solve the problems of controlling health care costs only on the macro side. PMID:22043644

  13. Policy-driven development of cost-effective, risk-based surveillance strategies.

    PubMed

    Reist, M; Jemmi, T; Stärk, K D C

    2012-07-01

    Animal health and residue surveillance verifies the good health status of the animal population, thereby supporting international free trade of animals and animal products. However, active surveillance is costly and time-consuming. The development of cost-effective tools for animal health and food hazard surveillance is therefore a priority for decision-makers in the field of veterinary public health. The assumption of this paper is that outcome-based formulation of standards, legislation leaving room for risk-based approaches and close collaboration and a mutual understanding and exchange between scientists and policy makers are essential for cost-effective surveillance. We illustrate this using the following examples: (i) a risk-based sample size calculation for surveys to substantiate freedom from diseases/infection, (ii) a cost-effective national surveillance system for Bluetongue using scenario tree modelling and (iii) a framework for risk-based residue monitoring. Surveys to substantiate freedom from infectious bovine rhinotracheitis and enzootic bovine leucosis between 2002 and 2009 saved over 6 million € by applying a risk-based sample size calculation approach, and by taking into account prior information from repeated surveys. An open, progressive policy making process stimulates research and science to develop risk-based and cost-efficient survey methodologies. Early involvement of policy makers in scientific developments facilitates implementation of new findings and full exploitation of benefits for producers and consumers. PMID:22265642

  14. 24 CFR 891.670 - Cost containment and modest design standards.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Cost containment and modest design standards. 891.670 Section 891.670 Housing and Urban Development Regulations Relating to Housing and Urban... OF HOUSING AND URBAN DEVELOPMENT (SECTION 8 HOUSING ASSISTANCE PROGRAMS, SECTION 202 DIRECT...

  15. 24 CFR 891.670 - Cost containment and modest design standards.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Cost containment and modest design standards. 891.670 Section 891.670 Housing and Urban Development REGULATIONS RELATING TO HOUSING AND URBAN DEVELOPMENT (CONTINUED) OFFICE OF THE ASSISTANT SECRETARY FOR HOUSING-FEDERAL HOUSING COMMISSIONER, DEPARTMENT OF HOUSING AND URBAN...

  16. 24 CFR 891.670 - Cost containment and modest design standards.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 4 2013-04-01 2013-04-01 false Cost containment and modest design standards. 891.670 Section 891.670 Housing and Urban Development REGULATIONS RELATING TO HOUSING AND URBAN DEVELOPMENT (CONTINUED) OFFICE OF THE ASSISTANT SECRETARY FOR HOUSING-FEDERAL HOUSING COMMISSIONER, DEPARTMENT OF HOUSING AND URBAN...

  17. 24 CFR 891.670 - Cost containment and modest design standards.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 4 2014-04-01 2014-04-01 false Cost containment and modest design standards. 891.670 Section 891.670 Housing and Urban Development REGULATIONS RELATING TO HOUSING AND URBAN DEVELOPMENT (CONTINUED) OFFICE OF THE ASSISTANT SECRETARY FOR HOUSING-FEDERAL HOUSING COMMISSIONER,...

  18. 24 CFR 891.670 - Cost containment and modest design standards.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 4 2012-04-01 2012-04-01 false Cost containment and modest design standards. 891.670 Section 891.670 Housing and Urban Development REGULATIONS RELATING TO HOUSING AND URBAN DEVELOPMENT (CONTINUED) OFFICE OF THE ASSISTANT SECRETARY FOR HOUSING-FEDERAL HOUSING COMMISSIONER,...

  19. Building Housing for the Low-Income Elderly: Cost Containment in the Section 202 Program.

    ERIC Educational Resources Information Center

    Turner, Margery Austin

    1985-01-01

    Assessed cost containment and modest design requirements for the Section 202 Direct Loan Program using projects in five Housing and Urban Development (HUD) field offices. Concluded that project design changes and amenities may be undermining Section 202 as a housing production program. (NRB)

  20. Health cost containment: what it will mean for workers and local economies.

    PubMed Central

    Bishop, C E

    1998-01-01

    After decades of rapid growth, the rate of increase in health services spending appears to be moderating. Although a slowdown in health expenditure growth would release resources for other uses in the economy, concerns have been raised about the effects of a spending slowdown on health workers and regional economies. Based on projections carried out by the Bureau of Labor Statistics during the health reform debate and on state health sector employment data, the author concludes that health workers may experience costly dislocation as health spending growth slows, and some regions may be more affected than others. However, the appropriate response is a general economic policy supporting economic growth and full employment policy with regard to health expenditure growth cannot be held hostage to concerns about employment effects. Images p205-a p212-a PMID:9633864

  1. The low cost of geological assessment for underground CO2 storage: Policy and economic implication

    SciTech Connect

    Friedmann, S. J.; Dooley, James J.; Held, Herman; Ottmar, Edenhofer

    2006-08-31

    The costs for carbon dioxide (CO2) capture and storage (CCS) in geologic formations is estimated to be $6–75/t CO2. In the absence of a mandate to reduce greenhouse gas emissions or some other significant incentive for CCS deployment, this cost effectively limits CCS technology deployment to small niche markets and stymies the potential for further technological development through learning by doing until these disincentives for the free venting of CO2 are in place. By far, the largest current fraction of these costs is capture (including compression and dehydration), commonly estimated at $25–60/t CO2 for power plant applications, followed byCO2 transport and storage, estimated at $0–15/tCO2.Of the storage costs, only a small fraction of the cost will go to accurate geological characterization. These one time costs are probably on the order of $0.1/t CO2 or less as these costs are spread out over the many millions of tons likely to be injected into a field over many decades. Geologic assessments include information central to capacity prediction, risk estimation for the target intervals and development facilities engineering. Since assessment costs are roughly two orders of magnitude smaller than capture costs, and assessment products carry other tangible societal benefits, such as improved accuracy in fossil fuel and ground water reserves estimates, government or joint private–public funding of major assessment initiatives should underpin early policy choices regarding CO2 storage deployment and should serve as a point of entry for policy makers and regulators. Early assessment is also likely to improve the knowledge base upon which the first commercial CCS deployments will rest.

  2. Costs of two alternative Salmonella control policies in Finnish broiler production

    PubMed Central

    Kangas, Susanna; Lyytikäinen, Tapani; Peltola, Jukka; Ranta, Jukka; Maijala, Riitta

    2007-01-01

    Background Costs and benefits of two Salmonella control policies for broiler production were described and compared. The control options were the Zoonosis Directive 92/117/EC and the more intense strategy, the Finnish Salmonella Control Programme (FSCP). Methods The comparison included the Salmonella control costs in primary and secondary production and the direct and indirect losses due to Salmonella infections in humans in 2000. Results The total annual costs of the FSCP were calculated to be 990 400 EUR (0.02 €/kg broiler meat). The average control costs in the broiler production chain were seven times higher with the FSCP than with the Zoonosis Directive alone. However, the public health costs were 33 times higher with the Zoonosis Directive alone. The value of one prevented loss of life per year exceeded the annual control costs of the FSCP. Conclusion Due to significant savings in public health costs compared to costs of FSCP, the FSCP was found to be economically feasible. PMID:18053202

  3. Policy considerations based on a cost analysis of alternative test formats in large scale science assessments

    NASA Astrophysics Data System (ADS)

    Lawrenz, Frances; Huffman, Douglas; Welch, Wayne

    2000-08-01

    This article compares the costs of four assessment formats: multiple choice, open ended, laboratory station, and full investigation. The amount of time spent preparing the devices, developing scoring consistency for the devices, and scoring the devices was tracked as the devices were developed. These times are presented by individual item and by complete device. Times are also compared as if 1,000 students completed each assessment. Finally, the times are converted into cost estimates by assuming a potential hourly wage. The data show that a multiple choice item costs the least, and that it is approximately 80 times as much for an open ended item, 300 times as much for a content station, and 500 times as much for a full investigation item. The very large discrepancies in costs are used as a basis to raise several policy issues related to the inclusion of alternative assessment formats in large scale science achievement testing.

  4. Cost savings associated with 10 years of road safety policies in Catalonia, Spain

    PubMed Central

    Suelves, Josep M; Barbería, Eneko

    2013-01-01

    Abstract Objective To determine whether the road safety policies introduced between 2000 and 2010 in Catalonia, Spain, which aimed primarily to reduce deaths from road traffic collisions by 50% by 2010, were associated with economic benefits to society. Methods A cost analysis was performed from a societal perspective with a 10-year time horizon. It considered the costs of: hospital admissions; ambulance transport; autopsies; specialized health care; police, firefighter and roadside assistance; adapting to disability; and productivity lost due to institutionalization, death or sick leave of the injured or their caregivers; as well as material and administrative costs. Data were obtained from a Catalan hospital registry, the Catalan Traffic Service information system, insurance companies and other sources. All costs were calculated in euros (€) at 2011 values. Findings A substantial reduction in deaths from road traffic collisions was observed between 2000 and 2010. Between 2001 and 2010, with the implementation of new road safety policies, there were 26 063 fewer road traffic collisions with victims than expected, 2909 fewer deaths (57%) and 25 444 fewer hospitalizations. The estimated total cost savings were around €18 000 million. Of these, around 97% resulted from reductions in lost productivity. Of the remaining cost savings, 63% were associated with specialized health care, 15% with adapting to disability and 8.1% with hospital care. Conclusion The road safety policies implemented in Catalonia in recent years were associated with a reduction in the number of deaths and injuries from traffic collisions and with substantial economic benefits to society. PMID:23397348

  5. The Cost of Crime to Society: New Crime-Specific Estimates for Policy and Program Evaluation

    PubMed Central

    French, Michael T.; Fang, Hai

    2010-01-01

    Estimating the cost to society of individual crimes is essential to the economic evaluation of many social programs, such as substance abuse treatment and community policing. A review of the crime-costing literature reveals multiple sources, including published articles and government reports, which collectively represent the alternative approaches for estimating the economic losses associated with criminal activity. Many of these sources are based upon data that are more than ten years old, indicating a need for updated figures. This study presents a comprehensive methodology for calculating the cost of society of various criminal acts. Tangible and intangible losses are estimated using the most current data available. The selected approach, which incorporates both the cost-of-illness and the jury compensation methods, yields cost estimates for more than a dozen major crime categories, including several categories not found in previous studies. Updated crime cost estimates can help government agencies and other organizations execute more prudent policy evaluations, particularly benefit-cost analyses of substance abuse treatment or other interventions that reduce crime. PMID:20071107

  6. Financing Higher Standards in Public Education: The Importance of Accounting for Educational Costs. Policy Brief, No. 10.

    ERIC Educational Resources Information Center

    Duncombe, William; Yinger, John

    This policy brief explains why performance focus and educational cost indexes must go hand in hand, discusses alternative methods for estimating educational cost indexes, and shows how these costs indexes can be incorporated into a performance-based state aid program. A shift to educational performance standards, whether these standards are…

  7. A Cost Effectiveness Analysis of Salt Reduction Policies to Reduce Coronary Heart Disease in Four Eastern Mediterranean Countries

    PubMed Central

    Mason, Helen; Shoaibi, Azza; Ghandour, Rula; O'Flaherty, Martin; Capewell, Simon; Khatib, Rana; Jabr, Samer; Unal, Belgin; Sözmen, Kaan; Arfa, Chokri; Aissi, Wafa; Romdhane, Habiba Ben; Fouad, Fouad; Al-Ali, Radwan; Husseini, Abdullatif

    2014-01-01

    Background Coronary Heart Disease (CHD) is rising in middle income countries. Population based strategies to reduce specific CHD risk factors have an important role to play in reducing overall CHD mortality. Reducing dietary salt consumption is a potentially cost-effective way to reduce CHD events. This paper presents an economic evaluation of population based salt reduction policies in Tunisia, Syria, Palestine and Turkey. Methods and Findings Three policies to reduce dietary salt intake were evaluated: a health promotion campaign, labelling of food packaging and mandatory reformulation of salt content in processed food. These were evaluated separately and in combination. Estimates of the effectiveness of salt reduction on blood pressure were based on a literature review. The reduction in mortality was estimated using the IMPACT CHD model specific to that country. Cumulative population health effects were quantified as life years gained (LYG) over a 10 year time frame. The costs of each policy were estimated using evidence from comparable policies and expert opinion including public sector costs and costs to the food industry. Health care costs associated with CHDs were estimated using standardized unit costs. The total cost of implementing each policy was compared against the current baseline (no policy). All costs were calculated using 2010 PPP exchange rates. In all four countries most policies were cost saving compared with the baseline. The combination of all three policies (reducing salt consumption by 30%) resulted in estimated cost savings of $235,000,000 and 6455 LYG in Tunisia; $39,000,000 and 31674 LYG in Syria; $6,000,000 and 2682 LYG in Palestine and $1,3000,000,000 and 378439 LYG in Turkey. Conclusion Decreasing dietary salt intake will reduce coronary heart disease deaths in the four countries. A comprehensive strategy of health education and food industry actions to label and reduce salt content would save both money and lives. PMID:24409297

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

    PubMed

    Schlatter, Rosane Paixão; Matte, Ursula; Polanczyk, Carisi Anne; Koehler-Santos, Patrícia; Ashton-Prolla, Patricia

    2015-01-01

    This study identifies and describes the operating costs associated with the molecular diagnosis of diseases, such as hereditary cancer. To approximate the costs associated with these tests, data informed by Standard Operating Procedures for various techniques was collected from hospital software and a survey of market prices. Costs were established for four scenarios of capacity utilization to represent the possibility of suboptimal use in research laboratories. Cost description was based on a single site. The results show that only one technique was not impacted by rising costs due to underutilized capacity. Several common techniques were considerably more expensive at 30% capacity, including polymerase chain reaction (180%), microsatellite instability analysis (181%), gene rearrangement analysis by multiplex ligation probe amplification (412%), non-labeled sequencing (173%), and quantitation of nucleic acids (169%). These findings should be relevant for the definition of public policies and suggest that investment of public funds in the establishment of centralized diagnostic research centers would reduce costs to the Public Health System. PMID:26500437

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

    PubMed Central

    Schlatter, Rosane Paixão; Matte, Ursula; Polanczyk, Carisi Anne; Koehler-Santos, Patrícia; Ashton-Prolla, Patricia

    2015-01-01

    This study identifies and describes the operating costs associated with the molecular diagnosis of diseases, such as hereditary cancer. To approximate the costs associated with these tests, data informed by Standard Operating Procedures for various techniques was collected from hospital software and a survey of market prices. Costs were established for four scenarios of capacity utilization to represent the possibility of suboptimal use in research laboratories. Cost description was based on a single site. The results show that only one technique was not impacted by rising costs due to underutilized capacity. Several common techniques were considerably more expensive at 30% capacity, including polymerase chain reaction (180%), microsatellite instability analysis (181%), gene rearrangement analysis by multiplex ligation probe amplification (412%), non-labeled sequencing (173%), and quantitation of nucleic acids (169%). These findings should be relevant for the definition of public policies and suggest that investment of public funds in the establishment of centralized diagnostic research centers would reduce costs to the Public Health System. PMID:26500437

  10. Tritium accident containment within a large fusion enclosure: cost, benefit, and risk considerations

    SciTech Connect

    Sherwood, A.E.

    1983-01-01

    Containment of a tritium accident within a large fusion device building will be difficult and costly. Complete containment is impossible, and with this fact in mind, the global dispersion and health effects of tritium are reviewed. Atmospheric tritium emissions lead to an estimated population dose to the Northern Hemisphere of 5.6 x 10/sup -3/ man-rem/Ci, which may also be interpreted as 1 cancer fatality per MCi. Updating the NRC $1000 per man-rem criterion to 1982 costs gives 9.5 $/y per Ci/y as the unit annual health benefit rate from averting tritium release at a continuous rate. Present worth considerations lead to an estimate of $100 per Ci/y for the maximum capital investment justified per expected curie per year of tritium release averted. A simplified enclosure model is used to explore the trade-off between processing capacity and recycle time with the health cost of residual tritium release included in the analysis.

  11. Cost-comparison of different management policies for tuberculosis patients in Italy. AIPO TB Study Group.

    PubMed Central

    Migliori, G. B.; Ambrosetti, M.; Besozzi, G.; Farris, B.; Nutini, S.; Saini, L.; Casali, L.; Nardini, S.; Bugiani, M.; Neri, M.; Raviglione, M. C.

    1999-01-01

    Although in developing countries the treatment of tuberculosis (TB) cases is among the most cost-effective health interventions, few studies have evaluated the cost-effectiveness of TB control in low-prevalence countries. The aim of the present study was to carry out an economic analysis in Italy that takes into account both the perspective of the resource-allocating authority (i.e. the Ministry of Health) and the broader social perspective, including a cost description based on current outcomes applied to a representative sample of TB patients nationwide (admission and directly observed treatment (DOT) during the initial intensive phase of treatment); a cost-comparison analysis of two alternative programmes: current policy based on available data (scenario 1) and an hypothetical policy oriented more towards outpatient care (scenario 2) (both scenarios included the option of including or not including DOT outside hospital admission, and incentives) were compared in terms of cost per case treated successfully. Indirect costs (such as loss of productivity) were included in considerations of the broader social perspective. The study was designed as a prospective monitoring activity based on the supervised collection of forms from a representative sample of Italian TB units. Individual data were collected and analysed to obtain a complete economic profile of the patients enrolled and to evaluate the effectiveness of the intervention. A separate analysis was done for each scenario to determine the end-point at different levels of cure rate (50-90%). The mean length of treatment was 6.6 months (i.e. patients hospitalized during the intensive phase; length of stay was significantly higher in smear-positive patients and in human immunodeficiency virus (HIV) seropositive patients). Roughly six direct smear and culture examinations were performed during hospital admission and three during ambulatory treatment. The cost of a single bed day was US$186.90, whereas that of a single outpatient visit ranged, according to the different options, from US$2.50 to US$11. Scenario 2 was consistently less costly than scenario 1. The cost per case cured for smear-positive cases was US$16,703 in scenario 1 and US$5946 in scenario 2. The difference in cost between the cheapest option (no DOT) and the more expensive option (DOT, additional staff, incentives) ranged from US$1407 (scenario 1, smear-negative and extrapulmonary cases) to US$1814 (scenario 2, smear-positive cases). The additional cost to society including indirect costs ranged from US$1800 to US$4200. The possible savings at the national level were in the order of US$50 million per year. In conclusion, cost-comparison analysis showed that a relatively minor change in policy can result in significant savings and that the adoption of DOT will represent a relatively modest economic burden, although the real gain in effectiveness resulting from DOT in Italy requires further evaluation. PMID:10427931

  12. The cost of saving a life through cervical cytology screening: implications for health policy.

    PubMed

    Charny, M C; Farrow, S C; Roberts, C J

    1987-06-01

    Through a review of the published literature on routine cervical cytology screening, this paper seeks to establish a likely range for the cost of saving a life through this screening programme as presently organised in England and Wales. The current performance of the programme may be expressed in several ways: a cost of 270,000 pounds to 285,000 pounds per life saved, 40,000 smears and 200 excision biopsies per death averted, or 1000 to 1500 avoidable deaths annually in England and Wales alone. The policy problems are thus of two kinds. First, there is a substantial misallocation of the limited resources available to an insurance based system of health care. Further, the money which is spent on this service does not avoid the mortality and morbidity which could reasonably be expected if the system were performing adequately. It is suggested that substantial improvements in the performance of the programme may well be possible if managers are appointed. Nevertheless a deeper policy issue is raised: to be delivered efficiently, any service based on population rather than individual considerations will require some acceptance by the medical profession of a limit to their traditional view of clinical freedom. The unresolved clash between population and individual considerations which poses such a fundamental challenge for policy making in insurance based health services is particularly well illustrated by the dilemma of publicly funded cervical cytology screening. PMID:10282698

  13. Three Policy Issues in Deciding the Cost of Nursing Home Care: Provincial Differences and How They Influence Elderly Couples' Experiences

    PubMed Central

    Stadnyk, Robin L.

    2009-01-01

    Nursing home care is subsidized in all Canadian provinces, but residents must personally contribute to the cost. This paper explores policy issues that have led to differences in costs of nursing home care among provinces, and how policy and cost differences influence the experiences of married couples when one spouse requires nursing home care. The paper is based on a multiple-case study of three Canadian provinces, each of which had a different system for determining personal contributions to the cost of care. Cross-case analysis of payment systems showed that provinces addressed three main policy issues in determining the cost of care: (a) what costs should be the responsibility of nursing home residents, (b) how subsidies should be determined and (c) how community-dwelling spouses of nursing home residents should be assured of an adequate income. In provinces with policies that resulted in higher care costs to couples and lower amounts of income and assets available to the community-dwelling spouses, study participants described reduced discretionary spending, increased financial concerns and perceptions of system unfairness. This paper discusses the implications of these three policy issues and recent related changes to provincial policies. PMID:20676244

  14. Diabetes in Mexico: cost and management of diabetes and its complications and challenges for health policy

    PubMed Central

    2013-01-01

    Background Mexico has been experiencing some of the most rapid shifts ever recorded in dietary and physical activity patterns leading to obesity. Diabetes mellitus has played a crucial role causing nearly 14% of all deaths. We wanted to make a comprehensive study of the role of diabetes in terms of burden of disease, prevalence, cost of diabetes, cost of complications and health policy. Method We review the quantitative data that provides evidence of the extent to which the Mexican health economy is affected by the disease and its complications. We then discuss the current situation of diabetes in Mexico with experts in the field. Results There was a significant increase in the prevalence of diabetes from 1994 to 2006 with rising direct costs (2006: outpatient USD$ 717,764,787, inpatient USD$ 223,581,099) and indirect costs (2005: USD$ 177,220,390), and rising costs of complications (2010: Retinopathy USD$ 10,323,421; Cardiovascular disease USD$ 12,843,134; Nephropathy USD$ 81,814,501; Neuropathy USD$ 2,760,271; Peripheral vascular disease USD$ 2,042,601). The health policy focused on screening and the creation of self-support groups across the country. Conclusions The increasing diabetes mortality and lack of control among diagnosed patients make quality of treatment a major concern in Mexico. The growing prevalence of childhood and adult obesity and the metabolic syndrome suggest that the situation could be even worse in the coming years. The government has reacted strongly with national actions to address the growing burden posed by diabetes. However our research suggests that the prevalence and mortality of diabetes will continue to rise in the future. PMID:23374611

  15. Evaluation of Arizona Health Care Cost Containment System, 1984-85

    PubMed Central

    McCall, Nelda; Henton, Douglas; Haber, Susan; Paringer, Lynn; Crane, Michael; Wrightson, William; Freund, Deborah

    1987-01-01

    In this article, we describe the evaluation of the Arizona Health Care Cost Containment System (AHCCCS), Arizona's alternative to the acute care portion of Medicaid. We provide an assessment of implementation of the program's innovative features during its second 18 months of operation, from April 1984 through September 1985. Included in the evaluation are assessments of the administration of the program, provider relations, eligibility, enrollment and marketing, information systems, quality assurance and member satisfaction activities, the relationship of the county governments to AHCCCS, the competitive bidding process, and the plans and their financial status. PMID:10312395

  16. PLANNING MODELS FOR URBAN WATER SUPPLY EXPANSION. VOLUME 2. COST ALLOCATION POLICIES FOR REGIONAL WATER SUPPLY SYSTEMS

    EPA Science Inventory

    A three-volume report was developed relative to the modelling of investment strategies for regional water supply planning. Volumes 2 and 3 are successive parts of the research related to the study of cost allocation policies among participants in a regional system. Such policies ...

  17. The moral psychology of rationing among physicians: the role of harm and fairness intuitions in physician objections to cost-effectiveness and cost-containment

    PubMed Central

    2013-01-01

    Introduction Physicians vary in their moral judgments about health care costs. Social intuitionism posits that moral judgments arise from gut instincts, called “moral foundations.” The objective of this study was to determine if “harm” and “fairness” intuitions can explain physicians’ judgments about cost-containment in U.S. health care and using cost-effectiveness data in practice, as well as the relative importance of those intuitions compared to “purity”, “authority” and “ingroup” in cost-related judgments. Methods We mailed an 8-page survey to a random sample of 2000 practicing U.S. physicians. The survey included the MFQ30 and items assessing agreement/disagreement with cost-containment and degree of objection to using cost-effectiveness data to guide care. We used t-tests for pairwise subscale mean comparisons and logistic regression to assess associations with agreement with cost-containment and objection to using cost-effectiveness analysis to guide care. Results 1032 of 1895 physicians (54%) responded. Most (67%) supported cost-containment, while 54% expressed a strong or moderate objection to the use of cost-effectiveness data in clinical decisions. Physicians who strongly objected to the use of cost-effectiveness data had similar scores in all five of the foundations (all p-values > 0.05). Agreement with cost-containment was associated with higher mean “harm” (3.6) and “fairness” (3.5) intuitions compared to “in-group” (2.8), “authority” (3.0), and “purity” (2.4) (p < 0.05). In multivariate models adjusted for age, sex, region, and specialty, both “harm” and “fairness” were significantly associated with judgments about cost-containment (OR = 1.2 [1.0-1.5]; OR = 1.7 [1.4-2.1], respectively) but were not associated with degree of objection to cost-effectiveness (OR = 1.2 [1.0-1.4]; OR = 0.9 [0.7-1.0]). Conclusions Moral intuitions shed light on variation in physician judgments about cost issues in health care. PMID:24010636

  18. Cardiovascular disease and impoverishment averted due to a salt reduction policy in South Africa: an extended cost-effectiveness analysis.

    PubMed

    Watkins, David A; Olson, Zachary D; Verguet, Stéphane; Nugent, Rachel A; Jamison, Dean T

    2016-02-01

    The South African Government recently set targets to reduce cardiovascular disease (CVD) by lowering salt consumption. We conducted an extended cost-effectiveness analysis (ECEA) to model the potential health and economic impacts of this salt policy. We used surveys and epidemiologic studies to estimate reductions in CVD resulting from lower salt intake. We calculated the average out-of-pocket (OOP) cost of CVD care, using facility fee schedules and drug prices. We estimated the reduction in OOP expenditures and government subsidies due to the policy. We estimated public and private sector costs of policy implementation. We estimated financial risk protection (FRP) from the policy as (1) cases of catastrophic health expenditure (CHE) averted or (2) cases of poverty averted. We also performed a sensitivity analysis. We found that the salt policy could reduce CVD deaths by 11%, with similar health gains across income quintiles. The policy could save households US$ 4.06 million (2012) in OOP expenditures (US$ 0.29 per capita) and save the government US$ 51.25 million in healthcare subsidies (US$ 2.52 per capita) each year. The cost to the government would be only US$ 0.01 per capita; hence, the policy would be cost saving. If the private sector food reformulation costs were passed on to consumers, food expenditures would increase by <0.2% across all income quintiles. Preventing CVD could avert 2400 cases of CHE or 2000 cases of poverty yearly. Our results were sensitive to baseline CVD mortality rates and the cost of treatment. We conclude that, in addition to health gains, population salt reduction can have positive economic impacts-substantially reducing OOP expenditures and providing FRP, particularly for the middle class. The policy could also provide large government savings on health care. PMID:25841771

  19. Cardiovascular disease and impoverishment averted due to a salt reduction policy in South Africa: an extended cost-effectiveness analysis

    PubMed Central

    Watkins, David A; Olson, Zachary D; Verguet, Stéphane; Nugent, Rachel A; Jamison, Dean T

    2016-01-01

    The South African Government recently set targets to reduce cardiovascular disease (CVD) by lowering salt consumption. We conducted an extended cost-effectiveness analysis (ECEA) to model the potential health and economic impacts of this salt policy. We used surveys and epidemiologic studies to estimate reductions in CVD resulting from lower salt intake. We calculated the average out-of-pocket (OOP) cost of CVD care, using facility fee schedules and drug prices. We estimated the reduction in OOP expenditures and government subsidies due to the policy. We estimated public and private sector costs of policy implementation. We estimated financial risk protection (FRP) from the policy as (1) cases of catastrophic health expenditure (CHE) averted or (2) cases of poverty averted. We also performed a sensitivity analysis. We found that the salt policy could reduce CVD deaths by 11%, with similar health gains across income quintiles. The policy could save households US$ 4.06 million (2012) in OOP expenditures (US$ 0.29 per capita) and save the government US$ 51.25 million in healthcare subsidies (US$ 2.52 per capita) each year. The cost to the government would be only US$ 0.01 per capita; hence, the policy would be cost saving. If the private sector food reformulation costs were passed on to consumers, food expenditures would increase by <0.2% across all income quintiles. Preventing CVD could avert 2400 cases of CHE or 2000 cases of poverty yearly. Our results were sensitive to baseline CVD mortality rates and the cost of treatment. We conclude that, in addition to health gains, population salt reduction can have positive economic impacts—substantially reducing OOP expenditures and providing FRP, particularly for the middle class. The policy could also provide large government savings on health care. PMID:25841771

  20. Applying cost analyses to drive policy that protects children. Mercury as a case study

    SciTech Connect

    Leonardo Trasande; Clyde Schechter; Karla A. Haynes; Philip J. Landrigan

    2006-09-15

    Exposure in prenatal life to methylmercury (MeHg) has become the topic of intense debate in the United States after the Environmental Protection Agency (EPA) announced a proposal in 2004 to reverse strict controls on emissions of mercury from coal-fired power plants that had been in effect for the preceding 15 years. This proposal failed to incorporate any consideration of the health impacts on children that would result from increased mercury emissions. We assessed the impact on children's health of industrial mercury emissions and found that between 316,588 and 637,233 babies are born with mercury-related losses of cognitive function ranging from 0.2 to 5.13 points. We calculated that decreased economic productivity resulting from diminished intelligence over a lifetime results in an aggregate economic cost in each annual birth cohort of $8.7 billion annually. $1.3 billion of this cost is attributable to mercury emitted from American coal-fired power plants. Downward shifts in intellectual quotient (IQ) are also associated with 1566 excess cases of mental retardation annually. This number accounts for 3.2% of MR cases in the United States. If the lifetime excess cost of a case of MR is $1,248,648 in 2000 dollars, then the cost of these excess cases of MR is $2.0 billion annually. Preliminary data suggest that more stringent mercury policy options would prevent thousands of cases of MR and billions of dollars over the next 25 years.

  1. Modeling spatial segregation and travel cost influences on utilitarian walking: Towards policy intervention

    PubMed Central

    Yang, Yong; Auchincloss, Amy H.; Rodriguez, Daniel A.; Brown, Daniel G.; Riolo, Rick; Diez-Roux, Ana V.

    2015-01-01

    We develop an agent-based model of utilitarian walking and use the model to explore spatial and socioeconomic factors affecting adult utilitarian walking and how travel costs as well as various educational interventions aimed at changing attitudes can alter the prevalence of walking and income differentials in walking. The model is validated against US national data. We contrast realistic and extreme parameter values in our model and test effects of changing these parameters across various segregation and pricing scenarios while allowing for interactions between travel choice and place and for behavioral feedbacks. Results suggest that in addition to income differences in the perceived cost of time, the concentration of mixed land use (differential density of residences and businesses) are important determinants of income differences in walking (high income walk less), whereas safety from crime and income segregation on their own do not have large influences on income differences in walking. We also show the difficulty in altering walking behaviors for higher income groups who are insensitive to price and how adding to the cost of driving could increase the income differential in walking particularly in the context of segregation by income and land use. We show that strategies to decrease positive attitudes towards driving can interact synergistically with shifting cost structures to favor walking in increasing the percent of walking trips. Agent-based models, with their ability to capture dynamic processes and incorporate empirical data, are powerful tools to explore the influence on health behavior from multiple factors and test policy interventions. PMID:25733776

  2. Cost-benefit analysis of the Swiss national policy on reducing micropollutants in treated wastewater.

    PubMed

    Logar, Ivana; Brouwer, Roy; Maurer, Max; Ort, Christoph

    2014-11-01

    Contamination of freshwater with micropollutants (MPs) is a growing concern worldwide. Even at very low concentrations, MPs can have adverse effects on aquatic ecosystems and possibly also on human health. Switzerland is one of the first countries to start implementing a national policy to reduce MPs in the effluents of municipal sewage treatment plants (STPs). This paper estimates the benefits of upgrading STPs based on public's stated preferences. To assess public demand for the reduction of the environmental and health risks of MPs, we conducted a choice experiment in a national online survey. The results indicate that the average willingness to pay per household is CHF 100 (US$ 73) annually for reducing the potential environmental risk of MPs to a low level. These benefits, aggregated over households in the catchment of the STPs to be upgraded, generate a total annual economic value of CHF 155 million (US$ 113 million). This compares with estimated annual costs for upgrading 123 STPs of CHF 133 million (US$ 97 million) or CHF 86 (US$ 63) per household connected to these STPs. Hence, a cost-benefit analysis justifies the investment decision from an economic point of view and supports the implementation of the national policy in the ongoing political discussion. PMID:25251946

  3. Hospital costs of central line-associated bloodstream infections and cost-effectiveness of closed vs. open infusion containers. The case of Intensive Care Units in Italy

    PubMed Central

    2010-01-01

    Objectives The aim was to evaluate direct health care costs of central line-associated bloodstream infections (CLABSI) and to calculate the cost-effectiveness ratio of closed fully collapsible plastic intravenous infusion containers vs. open (glass) infusion containers. Methods A two-year, prospective case-control study was undertaken in four intensive care units in an Italian teaching hospital. Patients with CLABSI (cases) and patients without CLABSI (controls) were matched for admission departments, gender, age, and average severity of illness score. Costs were estimated according to micro-costing approach. In the cost effectiveness analysis, the cost component was assessed as the difference between production costs while effectiveness was measured by CLABSI rate (number of CLABSI per 1000 central line days) associated with the two infusion containers. Results A total of 43 cases of CLABSI were compared with 97 matched controls. The mean age of cases and controls was 62.1 and 66.6 years, respectively (p = 0.143); 56% of the cases and 57% of the controls were females (p = 0.922). The mean length of stay of cases and controls was 17.41 and 8.55 days, respectively (p < 0.001). Overall, the mean total costs of patients with and without CLABSI were € 18,241 and € 9,087, respectively (p < 0.001). On average, the extra cost for drugs was € 843 (p < 0.001), for supplies € 133 (p = 0.116), for lab tests € 171 (p < 0.001), and for specialist visits € 15 (p = 0.019). The mean extra cost for hospital stay (overhead) was € 7,180 (p < 0.001). The closed infusion container was a dominant strategy. It resulted in lower CLABSI rates (3.5 vs. 8.2 CLABSIs per 1000 central line days for closed vs. open infusion container) without any significant difference in total production costs. The higher acquisition cost of the closed infusion container was offset by savings incurred in other phases of production, especially waste management. Conclusions CLABSI results in considerable and significant increase in utilization of hospital resources. Use of innovative technologies such as closed infusion containers can significantly reduce the incidence of healthcare acquired infection without posing additional burden on hospital budgets. PMID:20459753

  4. Cost-effectiveness of Sick Leave Policies for Health Care Workers with Influenza-like Illness, Brazil, 2009

    PubMed Central

    Mota, Nancy Val y Val P.; Lobo, Renata D.; Toscano, Cristiana M.; Pedroso de Lima, Antonio C.; Dias, M. Beatriz Souza; Komagata, Helio

    2011-01-01

    We describe the effect of influenza-like illness (ILI) during the outbreak of pandemic (H1N1) 2009 on health care worker (HCW) absenteeism and compare the effectiveness and cost of 2 sick leave policies for HCWs with suspected influenza. We assessed initial 2-day sick leaves plus reassessment until the HCW was asymptomatic (2-day + reassessment policy), and initial 7-day sick leaves (7-day policy). Sick leaves peaked in August 2009: 3% of the workforce received leave for ILI. Costs during May–October reached R$798,051.87 (≈US $443,362). The 7-day policy led to a higher monthly rate of sick leave days per 100 HCWs than did the 2-day + reassessment policy (8.72 vs. 3.47 days/100 HCWs; p<0.0001) and resulted in higher costs (US $609 vs. US $1,128 per HCW on leave). ILI affected HCW absenteeism. The 7-day policy was more costly and not more effective in preventing transmission to patients than the 2-day + reassessment policy. PMID:21801619

  5. Supply chain management with cost-containment & financial-sustainability in a tertiary care hospital.

    PubMed

    Chandra, Hem; Rinkoo, Arvind Vashishta; Verma, Jitendra Kumar; Verma, Shuchita; Kapoor, Rakesh; Sharma, R K

    2013-01-01

    Financial crunch in the present recession results in the non-availability of the right materials at the right time in large hospitals. However due to insufficient impetus towards systems development, situation remains dismal even when funds are galore. Cost incurred on materials account for approximately one-third of the total recurring expenditures in hospitals. Systems development for effective and efficient materials management is thus tantamount to cost-containment and sustainability. This scientific paper describes an innovative model, Hospital Revolving Fund (HRF), developed at a tertiary care research institute in Asia. The main idea behind inception of HRF was to ensure availability of all supplies in the hospital so that the quality of healthcare delivery was not affected. The model was conceptualized in the background of non-availability of consumables in the hospital leading to patient as well as staff dissatisfaction. Hospital supplies have been divided into two parts, approximately 3250 unit items and 1750 miscellaneous items. This division is based on cost, relative-utility and case-specific utilization. 0.1 Million USD, separated from non-planned budget, was initially used as seed money in 1998. HRF procures supplies from reputed firms on concessional rates (8-25%) and make them available to patients at much lesser rates vis-à-vis market rates, levying minimal maintenance charges. In 2009-10, total annual purchases of 14 Million USD were made. The balance sheet reflected 1.4 Million USD as fixed deposit investment. The minimal maintenance charges levied on the patients along with the interest income were sufficient to pay for all recurring expenses related to HRF. Even after these expenses, HRF boosted of 0.2 Million USD as cash-in-hand in financial year 2009-10. In-depth analysis of 'balance sheet' and 'Income and Expenditure' statement of the fund for last five financial years affirms that HRF is a self-sustainable and viable supply chain mechanism to ensure availability of the right materials at the right time at a reasonable cost. Thus innovations like HRF will prove robust in rendering quality healthcare at an affordable cost. PMID:24010261

  6. Effect of antibiotic order form guiding rational use of expensive drugs on cost containment.

    PubMed

    Sirinavin, S; Suvanakoot, P; Sathapatayavongs, B; Malatham, K

    1998-09-01

    New injectable antimicrobial agents are generally costly and broad-spectrum. Overusage results in unnecessary economic loss and multi-drug resistant organisms. Effective strategies for decreasing costs without compromising patient care are required. This study aimed to evaluate the economic impact of a system using an antimicrobial order form to assist rational usage of expensive antimicrobial agents. The study was performed during 1988-1996 at a 900-bed, tertiary-care, medical school hospital in Bangkok. The target drugs were 3 costly, broad-spectrum antibacterial drugs, namely imipenem, vancomycin, and injectable ciprofloxacin. The restriction of these 3 drugs was started in 1992 and was extended to netilmicin and ceftazidime in 1995. A filled antimicrobial order form (AOF) was required by pharmacists before dispensing the drugs. The AOF guided the physicians to give explicit information about anatomic diagnosis, etiologic diagnosis, and suspected antimicrobial resistance patterns of the organisms. It also contained information about indications of the restricted drugs. The filled forms were audited daily during working days by the chairman of The Hospital Antibiotic Committee. Feedback was given to the prescribers by infectious disease specialists at least twice a week. The strategy was endorsed by the executive committee of the hospital. Impact of AOF without endorsement, audit and feedback, was evaluated in 1996. The expenditures of the drugs were adjusted to the average admitted patient-days per fiscal year of the study period. The system with endorsement was well accepted and could be maintained for 4 years. The adjusted expenditures per year of the 3 restricted antibiotics were 1.41-1.87 million baht less (22-29%) in 1992-1994 than the pre-intervention year 1991. The cost reduction of imipenem and injectable ciprofloxacin could also be maintained for 1995 but not vancomycin for which use increased. The costs of these 3 restricted drugs increased very sharply (69%) in 1996 when there was loss of endorsement and capacity to perform auditing and feed back by infectious disease specialists. The system did not work with ceftazidime which was commonly used for febrile neutropenia and nosocomial infections. PMID:10437971

  7. 32 CFR 643.22 - Policy-Public safety: Requirement for early identification of lands containing dangerous materials.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 4 2010-07-01 2010-07-01 true Policy-Public safety: Requirement for early identification of lands containing dangerous materials. 643.22 Section 643.22 National Defense Department of...—Public safety: Requirement for early identification of lands containing dangerous materials. (a) DA...

  8. 32 CFR 643.22 - Policy-Public safety: Requirement for early identification of lands containing dangerous materials.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 4 2011-07-01 2011-07-01 false Policy-Public safety: Requirement for early identification of lands containing dangerous materials. 643.22 Section 643.22 National Defense Department of...—Public safety: Requirement for early identification of lands containing dangerous materials. (a) DA...

  9. What managed-care doctors can do to contain costs. Do we really need Uncle Sam's help?

    PubMed

    Clanton, C W

    1994-02-15

    Why does the government need to be involved in cost containment in the healthcare industry? Can't physicians improve efficiency and see more patients without federal rules, regulations, and limits? Dr Clanton shares some ideas about increasing efficiency in managed-care operations, describing ways that physicians and administrators can decrease the cost of healthcare delivery. PMID:7906876

  10. Beyond Business as Usual: A Framework and Options for Improving Quality and Containing Costs in California Higher Education.

    ERIC Educational Resources Information Center

    Knutsen, Kirk L.

    This monograph summarizes the current thinking in the national literature on the subject of cost-containment and productivity in higher education and applies findings to higher education in California. It presents a framework for characterizing the major factors driving higher education costs, outlines potentially promising areas in identifying…

  11. Weighing the Costs and Benefits of Renewables Portfolio Standards:A Comparative Analysis of State-Level Policy Impact Projections

    SciTech Connect

    Chen, Cliff; Wiser, Ryan; Bolinger, Mark

    2007-01-16

    State renewables portfolio standards (RPS) have emerged as one of the most important policy drivers of renewable energy capacity expansion in the U.S. Collectively, these policies now apply to roughly 40% of U.S. electricity load, and may have substantial impacts on electricity markets, ratepayers, and local economies. As RPS policies have been proposed or adopted in an increasing number of states, a growing number of studies have attempted to quantify the potential impacts of these policies, focusing primarily on projecting cost impacts, but sometimes also estimating macroeconomic and environmental effects. This report synthesizes and analyzes the results and methodologies of 28 distinct state or utility-level RPS cost impact analyses completed since 1998. Together, these studies model proposed or adopted RPS policies in 18 different states. We highlight the key findings of these studies on the costs and benefits of RPS policies, examine the sensitivity of projected costs to model assumptions, assess the attributes of different modeling approaches, and suggest possible areas of improvement for future RPS analysis.

  12. Applying cost analyses to drive policy that protects children: mercury as a case study.

    PubMed

    Trasande, Leonardo; Schechter, Clyde; Haynes, Karla A; Landrigan, Philip J

    2006-09-01

    Exposure in prenatal life to methylmercury (MeHg) has become the topic of intense debate in the United States after the Environmental Protection Agency (EPA) announced a proposal in 2004 to reverse strict controls on emissions of mercury from coal-fired power plants that had been in effect for the preceding 15 years. This proposal failed to incorporate any consideration of the health impacts on children that would result from increased mercury emissions. We assessed the impact on children's health of industrial mercury emissions and found that between 316,588 and 637,233 babies are born with mercury-related losses of cognitive function ranging from 0.2 to 5.13 points. We calculated that decreased economic productivity resulting from diminished intelligence over a lifetime results in an aggregate economic cost in each annual birth cohort of $8.7 billion annually (range: $0.7-$13.9 billion, 2000 dollars). $1.3 billion (range: $51 million-$2.0 billion) of this cost is attributable to mercury emitted from American coal-fired power plants. Downward shifts in intellectual quotient (IQ) are also associated with 1566 (range: 115-2675) excess cases of mental retardation (MR defined as IQ < 70) annually. This number accounts for 3.2% (range: 0.2-5.4%) of MR cases in the United States. If the lifetime excess cost of a case of MR (excluding individual productivity losses) is $1,248,648 in 2000 dollars, then the cost of these excess cases of MR is $2.0 billion annually (range: $143 million-$3.3 billion). Preliminary data suggest that more stringent mercury policy options would prevent thousands of cases of MR and billions of dollars over the next 25 years. PMID:17119266

  13. Between Too Little and Too Late: Political Opportunity Costs in Climate Policy Analysis

    NASA Astrophysics Data System (ADS)

    Gilligan, J. M.; Vandenbergh, M. P.

    2014-12-01

    Discussion of climate policy has focused almost exclusively on comprehensive regulatory instruments to price emissions with tradeable permits or emissions taxes. More recently, a number of proposals have been advanced to abandon comprehensive emissions pricing in favor of focusing exclusively on clean-energy innovation. Neither approach adequately accounts for the combination of timing and scale. Advocates of emissions pricing are persuasive that this is the most likely way to reduce emissions sufficiently to stabilize greenhouse gas (GHG) concentrations at desirable levels. However, as innovation advocates point out, the political climate is inhospitable to such sweeping regulations and it is unlikely that comprehensive carbon pricing can be enacted and implemented in the next decade. However, clean-energy innovation by itself is a high-stakes gamble that may fail to reduce emissions sufficiently to stabilize GHG concentrations, and may reduce support for the kind of comprehensive pricing measures that could stabilize GHG concentrations.We propose that analysis of climate policies take account of the opportunity costs associated with the process of enacting a proposed policy: If one measure is much more controversial than another, how does the difference in time necessary to persuade the public and legislators to adopt them affect their ultimate impact? As General Patton is reputed to have said, "A good solution applied with vigor now is better than a perfect solution applied ten minutes later." Similarly, it is important to consider whether adopting one measure would build or erode support for complementary ones. As an example, we consider the largely neglected role of nonregulatory measures, such as private governance and household-level behavior change, as examples of actions that could buy time by producing rapid, although modest, impacts without eroding support for more comprehensive measures later on.

  14. [Consequences of the judicialization of health policies: the cost of medicines for mucopolysaccharidosis].

    PubMed

    Diniz, Debora; Medeiros, Marcelo; Schwartz, Ida Vanessa D

    2012-03-01

    This study analyzes expenditures backed by court rulings to ensure the public provision of medicines for treatment of mucopolysaccharidosis (MPS), a rare disease that requires high-cost drugs not covered by the Brazilian government's policy for pharmaceutical care and which have disputed clinical efficacy. The methodology included a review of files from 196 court rulings ordering the Brazilian Ministry of Health to provide the medicines, in addition to Ministry of Health administrative records. According to the analysis, the "judicialization" of the health system subjected the Brazilian government to a monopoly in the distribution of medicines and consequently the loss of its capacity to manage drug purchases. The study also indicates that the imposition of immediate, individualized purchases prevents obtaining economies of scale with planned procurement of larger amounts of the medication, besides causing logistic difficulties in controlling the amounts consumed and stored. In conclusion, litigation results from the lack of a clear policy in the health system for rare diseases in general, thereby leading to excessive expenditures for MPS treatment. PMID:22415180

  15. Minimum specific cost control of technological processes realized in a living objects-containing microenvironment.

    PubMed

    Amelkin, Alexander A; Blagoveschenskaya, Margarita M; Lobanov, Yury V; Amelkin, Anatoly K

    2003-01-01

    The purpose of the present work is to work out an approach for the development of software and the choice of hardware structures when designing subsystems for automatic control of technological processes realized in living objects containing limited space (microenvironment). The subsystems for automatic control of the microenvironment (SACME) under development use the Devices for Air Prophylactic Treatment, Aeroionization, and Purification (DAPTAP) as execution units for increasing the level of safety and quality of agricultural raw material and foodstuffs, for reducing the losses of agricultural produce during storage and cultivation, as well as for intensifying the processes of activation of agricultural produce and industrial microorganisms. A set of interconnected SACMEs works within the framework of a general microenvironmental system (MES). In this research, the population of baker's yeast is chosen as a basic object of control under the industrial fed-batch cultivation in a bubbling bioreactor. This project is an example of a minimum cost automation approach. The microenvironment optimal control problem for baker's yeast cultivation is reduced from a profit maximum to the maximization of overall yield by the reason that the material flow-oriented specific cost correlates closely with the reciprocal value of the overall yield. Implementation of the project partially solves a local sustainability problem and supports a balance of microeconomical, microecological and microsocial systems within a technological subsystem realized in a microenvironment maintaining an optimal value of economical criterion (e.g. minimum material, flow-oriented specific cost) and ensuring: (a) economical growth (profit increase, raw material saving); (b) high security, safety and quality of agricultural raw material during storage process and of food produce during a technological process; elimination of the contact of gaseous harmful substances with a subproduct during various technological stages; (c) improvement of labour conditions for industrial personnel from an ecological point of view (positive effect of air aeroionization and purification on human organism promoting strengthened health and an increase in life duration, pulverent and gaseous chemical and biological impurity removal). An alternative aspect of a controlled living microenvironment forming is considered. PMID:12635958

  16. Diabetes in Argentina: cost and management of diabetes and its complications and challenges for health policy

    PubMed Central

    2013-01-01

    Background Diabetes is an expensive disease in Argentina as well as worldwide, and its prevalence is continuously rising affecting the quality of life of people with the disease and their life expectancy. It also imposes a heavy burden to the national health care budget and on the economy in the form of productivity losses. Aims To review and discuss a) the reported evidence on diabetes prevalence, the degree of control, the cost of care and outcomes, b) available strategies to decrease the health and economic disease burden, and c) how the disease fits in the Argentinian health care system and policy. Finally, to propose evidence-based policy options to reduce the burden of diabetes, both from an epidemiological as well as an economic perspective, on the Argentinian society. The evidence presented is expected to help the local authorities to develop and implement effective diabetes care programmes. Methodology A comprehensive literature review was performed using databases such as MEDLINE, EMBASE and LILACS (Latin American and Caribbean Health Sciences). Literature published from 1980 to 2011 was included. This information was complemented with grey literature, including data from national and provincial official sources, personal communications and contacts with health authorities and diabetes experts in Argentina. Results Overall diabetes prevalence increased from 8.4% in 2005 to 9.6% 2009 at national level. In 2009, diabetes was the seventh leading cause of death with a mortality rate of 19.2 per 100,000 inhabitants, and it accounted for 1,328,802 DALYs lost in the adult population, mainly affecting women aged over fifty. The per capita hospitalisation cost for people with diabetes was significantly higher than for people without the disease, US$ 1,628 vs. US$ 833 in 2004. Evidence shows that implementation of combined educative interventions improved quality of care and outcomes, decreased treatment costs and optimised the use of economic resources. Conclusions Based on the evidence reviewed, we believe that the implementation of structured health care programmes including diabetes education at every level, could improve quality of care as well as its clinical, metabolic and economic outcomes. If implemented across the country, these programmes could decrease the disease burden and optimise the use of human and economic resources. PMID:24168330

  17. Forecasting coronary heart disease incidence, mortality, and cost: the Coronary Heart Disease Policy Model.

    PubMed Central

    Weinstein, M C; Coxson, P G; Williams, L W; Pass, T M; Stason, W B; Goldman, L

    1987-01-01

    A computer simulation model was developed to project the future mortality, morbidity, and cost of coronary heart disease (CHD) in the United States population. The model contains a demographic-epidemiologic (DE) submodel, which stimulates the distribution of coronary risk factors and the conditional incidence of CHD in a demographically evolving population; a "bridge" submodel, which determines the outcome of the initial CHD event; and a disease history (DH) submodel, which simulates subsequent events in persons with a previous CHD event. The user of the model may simulate the effects of interventions, either preventive (i.e., risk factor modification) or therapeutic, upon mortality, morbidity, and cost for up to a 30-year period. If there were no future changes in risk factors or the efficacy of therapies after 1980, baseline projections indicate that the aging of the population, and especially the maturation of the post-World War II baby-boom generation, would increase CHD prevalence and annual incidence, mortality, and costs by about 40-50 per cent by the year 2010. Unprecedented reductions in risk factors would be required to offset these demographic effects on the absolute incidence of CHD. The specific forecasts could be inaccurate, however, as a consequence of erroneous assumptions or misestimated baseline data, and the model awaits validation based on actual future data. PMID:3661794

  18. Cost Containment in Higher Education: Issues and Recommendations. ASHE-ERIC Higher Education Report, Volume 28, Number 5. Jossey-Bass Higher and Adult Education Series.

    ERIC Educational Resources Information Center

    Brown, Walter A.; Gamber, Cayo

    This book provides an overview of strategies colleges and universities can use to help contain costs. It also describes a range of strategies that have been used to contain costs and refine budgeting systems in an era of low returns on investment and greater competition. The volume synthesizes research on internal cost containment strategies…

  19. The financial implications of endovascular aneurysm repair in the cost containment era

    PubMed Central

    Stone, David H.; Horvath, Alexander J.; Goodney, Philip P.; Rzucidlo, Eva M.; Nolan, Brian W.; Walsh, Daniel B.; Zwolak, Robert M.; Powell, Richard J.

    2014-01-01

    Objective Endovascular aneurysm repair (EVAR) is associated with significant direct device costs. Such costs place EVAR at odds with efforts to constrain healthcare expenditures. This study examines the procedure-associated costs and operating margins associated with EVAR at a tertiary care academic medical center. Methods All infrarenal EVARs performed from April 2011 to March 2012 were identified (n = 127). Among this cohort, 49 patients met standard commercial instruction for use guidelines, were treated using a single manufacturer device, and billed to Medicare diagnosis-related group (DRG) 238. Of these 49 patients, net technical operating margins (technical revenue minus technical cost) were calculated in conjunction with the hospital finance department. EVAR implant costs were determined for each procedure. DRG 238-associated costs and length of stay were benchmarked against other academic medical centers using University Health System Consortium 2012 data. Results Among the studied EVAR cohort (age 75, 82% male, mean length of stay, 1.7 days), mean technical costs totaled $31,672. Graft implants accounted for 52% of the allocated technical costs. Institutional overhead was 17% ($5495) of total technical costs. Net mean total technical EVAR-associated operating margins were $4015 per procedure. Our institutional costs and length of stay, when benchmarked against comparable centers, remained in the lowest quartile nationally using University Health System Consortium costs for DRG 238. Stent graft price did not correlate with total EVAR. market share. Conclusions EVAR is currently associated with significant negative operating margins among Medicare beneficiaries. Currently, device costs account for over 50% of EVAR-associated technical costs and did not impact EVAR market share, reflecting an unawareness of cost differential among surgeons. These data indicate that EVAR must undergo dramatic care delivery redesign for this practice to remain sustainable. PMID:24139984

  20. A Review of Recent RTO Benefit-Cost Studies: Toward MoreComprehensive Assessments of FERC Electricity RestructuringPolicies

    SciTech Connect

    Eto, Joseph H.; Lesieutre, Bernard C.

    2005-12-01

    During the past three years, government and private organizations have issued more than a dozen studies of the benefits and costs of Regional Transmission Organizations (RTOs). Most of these studies have focused on benefits that can be readily estimated using traditional production-cost simulation techniques, which compare the cost of centralized dispatch under an RTO to dispatch in the absence of an RTO, and on costs associated with RTO start-up and operation. Taken as a whole, it is difficult to draw definitive conclusions from these studies because they have not examined potentially much larger benefits (and costs) resulting from the impacts of RTOs on reliability management, generation and transmission investment and operation, and wholesale electricity market operation. This report: (1) Describes the history of benefit-cost analysis of FERC electricity restructuring policies; (2)Reviews current practice by analyzing 11 RTO benefit-cost studies that were published between 2002 and 2004 and makes recommendations to improve the documentation of data and methods and the presentation of findings in future studies that focus primarily on estimating short-run economic impacts; and (3) Reviews important impacts of FERC policies that have been overlooked or incompletely treated by recent RTO benefit-cost studies and the challenges to crafting more comprehensive assessments of these impacts based on actual performance, including impacts on reliability management, generation and transmission investment and operation, and wholesale electricity market operation.

  1. "It's the economy, stupid": strategies for improved cost containment in cancer treatment.

    PubMed

    Sleijfer, S

    2014-04-01

    The advent of numerous novel antitumor compounds has improved the prognosis of many cancer patients but has also substantially increased the costs of cancer care and put more pressure on health-care budgets. This situation increasingly raises questions such as the extent to which these drugs offer value sufficient to justify their cost and how to accommodate the increasing costs of cancer care. Here I look at the various aspects that affect cancer care economics and offer potential solutions. PMID:24646487

  2. Policy recommendations and cost implications for a more sustainable framework for European human biomonitoring surveys.

    PubMed

    Joas, Anke; Knudsen, Lisbeth E; Kolossa-Gehring, Marike; Sepai, Ovnair; Casteleyn, Ludwine; Schoeters, Greet; Angerer, Jürgen; Castaño, Argelia; Aerts, Dominique; Biot, Pierre; Horvat, Milena; Bloemen, Louis; Reis, M Fátima; Lupsa, Ioana-Rodica; Katsonouri, Andromachi; Cerna, Milena; Berglund, Marika; Crettaz, Pierre; Rudnai, Peter; Halzlova, Katarina; Mulcahy, Maurice; Gutleb, Arno C; Fischer, Marc E; Becher, Georg; Fréry, Nadine; Jensen, Genon; Van Vliet, Lisette; Koch, Holger M; Den Hond, Elly; Fiddicke, Ulrike; Esteban, Marta; Exley, Karen; Schwedler, Gerda; Seiwert, Margarete; Ligocka, Danuta; Hohenblum, Philipp; Kyrtopoulos, Soterios; Botsivali, Maria; DeFelip, Elena; Guillou, Claude; Reniero, Fabiano; Grazuleviciene, Regina; Veidebaum, Toomas; Mørck, Thit A; Nielsen, Jeanette K S; Jensen, Janne F; Rivas, Teresa C; Sanchez, Jinny; Koppen, Gudrun; Smolders, Roel; Kozepesy, Szilvia; Hadjipanayis, Adamos; Krskova, Andrea; Mannion, Rory; Jakubowski, Marek; Fucic, J Aleksandra; Pereira-Miguel, Jose; Gurzau, Anca E; Jajcaj, Michal; Mazej, Darja; Tratnik, Janja Snoj; Lehmann, Andrea; Larsson, Kristin; Dumez, Birgit; Joas, Reinhard

    2015-08-01

    The potential of Human Biomonitoring (HBM) in exposure characterisation and risk assessment is well established in the scientific HBM community and regulatory arena by many publications. The European Environment and Health Strategy as well as the Environment and Health Action Plan 2004-2010 of the European Commission recognised the value of HBM and the relevance and importance of coordination of HBM programmes in Europe. Based on existing and planned HBM projects and programmes of work and capabilities in Europe the Seventh Framework Programme (FP 7) funded COPHES (COnsortium to Perform Human Biomonitoring on a European Scale) to advance and improve comparability of HBM data across Europe. The pilot study protocol was tested in 17 European countries in the DEMOCOPHES feasibility study (DEMOnstration of a study to COordinate and Perform Human biomonitoring on a European Scale) cofunded (50%) under the LIFE+ programme of the European Commission. The potential of HBM in supporting and evaluating policy making (including e.g. REACH) and in awareness raising on environmental health, should significantly advance the process towards a fully operational, continuous, sustainable and scientifically based EU HBM programme. From a number of stakeholder activities during the past 10 years and the national engagement, a framework for sustainable HBM structure in Europe is recommended involving national institutions within environment, health and food as well as European institutions such as ECHA, EEA, and EFSA. An economic frame with shared cost implications for national and European institutions is suggested benefitting from the capacity building set up by COPHES/DEMOCOPHES. PMID:25526891

  3. Costs and Benefits Associated with the MRSA Search and Destroy Policy in a Hospital in the Region Kennemerland, The Netherlands

    PubMed Central

    Souverein, Dennis; Houtman, Patricia; Euser, Sjoerd M.; Herpers, Bjorn L.; Kluytmans, Jan; Den Boer, Jeroen W.

    2016-01-01

    Objective The objective of this study was to analyze the costs and benefits of the MRSA Search and Destroy (S&D) policy between 2008 and 2013 in the Kennemer Gasthuis, a 400 bed teaching hospital in the region Kennemerland, the Netherlands. Methods A patient registration database was used to retrospectively calculate costs, including screening, isolation, follow-up, contact tracing, cleaning, treatment, deployment of extra healthcare workers, salary for an infection control practitioner (ICP) and service of isolation rooms. The estimated benefits (costs and lives when no MRSA S&D was applied) were based on a varying MRSA prevalence rate (up to 50%). Results When no MRSA S&D policy was applied, the additional costs and deaths due to MRSA bacteraemia were estimated to be € 1,388,907 and 33 respectively (at a MRSA prevalence rate of 50%). Currently, the total costs were estimated to be € 290,672 (€ 48,445 annually) and a MRSA prevalence rate of 17.3% was considered as break-even point. Between 2008 and 2013, a total of 576 high risk patients were screened for MRSA carriage, of whom 19 (3.3%) were found to be MRSA positive. Forty-nine patients (72.1%) were found unexpectedly. Conclusions Application of the MRSA S&D policy saves lives and money, although the high rate of unexpected MRSA cases is alarming. PMID:26849655

  4. Cost and Price Increases in Higher Education: Evidence of a Cost Disease on Higher Education Costs and Tuition Prices and the Implications for Higher Education Policy

    ERIC Educational Resources Information Center

    Trombella, Jerry

    2011-01-01

    As concern over rapidly rising college costs and tuition sticker prices have increased, a variety of research has been conducted to determine potential causes. Most of this research has focused on factors unique to higher education. In contrast, cost disease theory attempts to create a comparative context to explain cost increases in higher

  5. Cost and Price Increases in Higher Education: Evidence of a Cost Disease on Higher Education Costs and Tuition Prices and the Implications for Higher Education Policy

    ERIC Educational Resources Information Center

    Trombella, Jerry

    2011-01-01

    As concern over rapidly rising college costs and tuition sticker prices have increased, a variety of research has been conducted to determine potential causes. Most of this research has focused on factors unique to higher education. In contrast, cost disease theory attempts to create a comparative context to explain cost increases in higher…

  6. Field Studies and Educational Administration and Policy: The Fit, the Challenge, the Benefits, and Costs.

    ERIC Educational Resources Information Center

    Marshall, Catherine

    1985-01-01

    Reviews the contributions of field studies conducted in the areas of educational administration and policy, including organizational processes, education politics, and leadership and decision making. Suggests new directions in educational policy that field research could explore. (GC)

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

    PubMed Central

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

    2014-01-01

    Background: Shifting to active modes of transport in the trip to work can achieve substantial co-benefits for health, social equity, and climate change mitigation. Previous integrated modeling of transport scenarios has assumed active transport mode share and has been unable to incorporate acknowledged system feedbacks. Objectives: We compared the effects of policies to increase bicycle commuting in a car-dominated city and explored the role of participatory modeling to support transport planning in the face of complexity. Methods: We used system dynamics modeling (SDM) to compare realistic policies, incorporating feedback effects, nonlinear relationships, and time delays between variables. We developed a system dynamics model of commuter bicycling through interviews and workshops with policy, community, and academic stakeholders. We incorporated best available evidence to simulate five policy scenarios over the next 40 years in Auckland, New Zealand. Injury, physical activity, fuel costs, air pollution, and carbon emissions outcomes were simulated. Results: Using the simulation model, we demonstrated the kinds of policies that would likely be needed to change a historical pattern of decline in cycling into a pattern of growth that would meet policy goals. Our model projections suggest that transforming urban roads over the next 40 years, using best practice physical separation on main roads and bicycle-friendly speed reduction on local streets, would yield benefits 10–25 times greater than costs. Conclusions: To our knowledge, this is the first integrated simulation model of future specific bicycling policies. Our projections provide practical evidence that may be used by health and transport policy makers to optimize the benefits of transport bicycling while minimizing negative consequences in a cost-effective manner. The modeling process enhanced understanding by a range of stakeholders of cycling as a complex system. Participatory SDM can be a helpful method for integrating health and environmental outcomes in transport and urban planning. Citation: Macmillan A, Connor J, Witten K, Kearns R, Rees D, Woodward A. 2014. The societal costs and benefits of commuter bicycling: simulating the effects of specific policies using system dynamics modeling. Environ Health Perspect 122:335–344; http://dx.doi.org/10.1289/ehp.1307250 PMID:24496244

  8. Multifunctional polymer composites containing inorganic nanoparticles and novel low-cost carbonaceous fillers

    NASA Astrophysics Data System (ADS)

    Wu, Hongchao

    Advanced polymer nanocomposites/composites containing inorganic nanoparticles and novel carbonaceous fillers were processed and evaluated for the multifunctional purposes. To prepare the high performance conformal coating materials for microelectronic industries, epoxy resin was incorporated with zirconium tungstate (ZrW 2O8) nanoparticles synthesized from hydrothermal reaction to alleviate the significant thermal expansion behavior. Three types of ZrW 2O8 at different loading levels were selected to study their effect of physical (morphology, particle size, surface area, etc.) and thermal (thermal expansivity) properties on the rheological, thermo-mechanical, dynamic-mechanical, and dielectric properties of epoxy resin. Epoxy resin incorporated by Type-1 ZrW2O8 exhibited the overall excellent performance. Hexagonal boron nitride (h-BN) nanoplatelets were non-covalently encapsulated by a versatile and mussel-adhesive protein polydopamine through the strong pi-pi* interaction. The high-temperature thermoset bisphenol E cyanate ester (BECy) reinforced with homogenously dispersed h-BN at different volume fractions and functionalities were processed to investigate their effect on thermo-mechanical, dynamic-mechanical, dielectric properties and thermal conductivity. Different theoretical and empirical models were also successfully applied for the prediction of CTE, thermal conductivity and dielectric constant of h-BN/BECy nanocomposites. On the basis of the improvement in dimensional stability, the enhancement in storage modulus in both glassy and rubbery regions, associated with the increment in thermal conductivity without deterioration of thermal stability, glassy transition temperature and dielectric properties, pristine h-BN/BECy nanocomposites exhibited the prospective application in microelectronic packaging industry. Polydopamine functionalized h-BN significantly increased the dielectric constant of cyanate ester at lower frequency region. Asphaltene, a carbonaceous by-product of crude oil extraction, was studied as a novel and low-cost additives in polymer matrices. Two kinds of asphaltene were extracted and investigated using different analytical techniques for the comparison of their elemental composition, molecular structure, and morphology. One asphaltene underwent the successful molecular functionalization via two silane coupling agents prior to the preparation of epoxy composites. Another asphaltene was incorporated into poly(styrene-butadiene-styrene) copolymers (SBS) for the fabrication of hybrid composites using melt compounding technique. Based on it intrinsic rigid molecular structure, the reinforcement effect of asphaltene was recognized to be more pronounced in a softer matrix (SBS) than the rigid one (epoxy).

  9. Hospital cost-containment strategies that earn the respect of rating agencies.

    PubMed

    Dopoulos, Jason

    2016-01-01

    To confirm that hospitals have the necessary structures and strategies in place to reduce costs and secure future market share, credit rating agencies analyze a variety of quantitative and qualitative criteria, including: Salaries and benefits, bad debt, age of plant and depreciation, and other line items that may point to inefficiencies in a hospital's expense structure. Cost-benefit analyses, strategic plans, and leadership qualities that show the long-term value of expense cuts, capital investments, and mergers and acquisitions. Cost-effective and clinically appropriate shifts in a hospital's outpatient-to-inpatient ratio. Liquidity and market share. PMID:26863833

  10. Policy expectations and reality of telemedicine - a critical analysis of health care outcomes, costs and acceptance for congestive heart failure.

    PubMed

    Achelrod, Dmitrij

    2014-05-01

    A critical review of evidence was carried out to discover whether the actual performance of telemedicine fulfils the expectations of German policy-makers. The analysis was conducted using the example of telemedicine for congestive heart failure (CHF). It was based on both German and international evidence. The PubMed, MEDLINE, Google Scholar and Cochrane Library databases were searched, as well as public sources from the German Federal Ministry of Health. Forty-five studies reporting patient outcomes, costs or acceptance of telemedicine for CHF were included in the review, of which 28 were interventional. The policy expectations of telemedicine generally are: high technology acceptance and improved patient outcomes at lower costs. However, in the field of CHF, policy-makers underestimate the complexity of telemedicine and the technology has not yet lived up to its expectations. Although some studies show improvements in all-cause mortality and CHF-related hospitalisations, there is excessive study heterogeneity and vagueness in the areas of costs and acceptance. Methodological insufficiencies as well as the scarcity of evidence in the German context do not allow definite conclusions to be drawn. Policy-makers and other stakeholders should increase their efforts to consolidate isolated telemedicine projects, establish guidelines for clinical treatment procedures and economic evaluations, and define industry/technical device standards to enhance the comparability of interventions. Imposing the use of telemedicine on patients and physicians is not likely to be fruitful. A successful adaptation requires an analysis of needs and continuous education on both sides. PMID:24803273

  11. Public policy and private interests: why transmission planning and cost-allocation methods continue to stifle renewable energy policy goals

    SciTech Connect

    Puga, J. Nicolas; Lesser, Jonathan A.

    2009-12-15

    It has been almost 10 years since FERC Order 2000 created regional transmission organizations and independent system operators in order to establish competitive power markets and to stimulate the development of new transmission. Now, the dominant behavior of the incumbent transmission owners, expressed through their RTO and ISO transmission expansion planning processes, is at loggerheads with public policies aimed at developing renewable energy resources. (author)

  12. Revisiting sub-Saharan African countries' drug problems: health, social, economic costs, and drug control policy.

    PubMed

    Affinnih, Yahya H

    2002-02-01

    This article takes an international perspective on the drug problem in sub-Saharan Africa. This analysis borrows ideas from physical and economic geography as a heuristic device to conceptualize the global narcoscapes in which drug trafficking occurs. Both the legitimate and the illegal drug trade operate within the same global capitalist system and draw on the same technological innovations and business processes. Central to the paper's argument is evidence that sub-Saharan African countries are now integrated into the political economy of drug consumption due to the spill-over effect. These countries are now minor markets for "hard drugs" as the result of the activities of organizations and individual traffickers that use Africa as a staging point in their trade with Europe and the United States. As a result, sub-Saharan African countries have drug consumption problems that were essentially absent prior to 1980, along with associated health, social, and economic costs. The emerging drug problem has forced African countries to develop their own drug control policy. The sub-Saharan African countries mentioned below vary to some extent in the level of drug use and misuse problems: Burundi, Comoros, Djibouti, Eritrea, Ethiopia, Kenya, Madagascar, Malawi, Mauritius, Mozambique, Reunion, Rwanda, Seychelles, Somalia, Tanzania, Uganda, Zambia, Angola, Cameroon, Central African Republic, Chad, Congo, Congo (Zaire), Equatorial Guinea, Gabon, Sao Tome and Principe, Botswana, Lesotho, Namibia, South Africa, Swaziland, Benin, Burkina Faso, Cape Verde, Cote d'Ivoire, Gambia, Ghana, Guinea, Guinea Bissau, Liberia, Mali, Mauritania, Niger, Nigeria, Senegal, Sierra Leone, and Togo. As part of this effort, African countries are assessing the health, social, and economic costs of drug-use-related problems to pinpoint methods which are both effective and inexpensive, since their budgets for social programs are severely constrained. Many have progressed to the point of adopting anti-drug laws or legislation, or of establishing a drug control agency. They are also cooperating regionally to coordinate drug control measures and working with the Organization of African Unity (OAU). In addition, almost all the sub-Saharan African countries are signatories to all United Nations drug conventions. Since the drug problem in Africa has international origins, it will take concerted international cooperation and coordinated effort to combat the "social cancer" of drugs. PMID:11913904

  13. The cost-effectiveness of policies for the safe and appropriate use of injection in healthcare settings.

    PubMed Central

    Dziekan, Gerald; Chisholm, Daniel; Johns, Benjamin; Rovira, Juan; Hutin, Yvan J. F.

    2003-01-01

    OBJECTIVE: Poor injection practices transmit potentially life-threatening pathogens. We modelled the cost-effectiveness of policies for the safe and appropriate use of injections in ten epidemiological subregions of the world in terms of cost per disability-adjusted life year (DALY) averted. METHODS: The incidence of injection-associated hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infections was modelled for a year 2000 cohort over a 30-year time horizon. The consequences of a "do nothing" scenario were compared with a set of hypothetical scenarios that incorporated the health gains of effective interventions. Resources needed to implement effective interventions were costed for each subregion and expressed in international dollars (I dollars). FINDINGS: Worldwide, the reuse of injection equipment in the year 2000 accounted for 32%, 40%, and 5% of new HBV, HCV and HIV infections, respectively, leading to a burden of 9.18 million DALYs between 2000 and 2030. Interventions implemented in the year 2000 for the safe (provision of single-use syringes, assumed effectiveness 95%) and appropriate (patients-providers interactional group discussions, assumed effectiveness 30%) use of injections could reduce the burden of injection-associated infections by as much as 96.5% (8.86 million DALYs) for an average yearly cost of 905 million I dollars (average cost per DALY averted, 102; range by region, 14-2293). Attributable fractions and the number of syringes and needles required represented the key sources of uncertainty. CONCLUSION: In all subregions studied, each DALY averted through policies for the safe and appropriate use of injections costs considerably less than one year of average per capita income, which makes such policies a sound investment for health care. PMID:12764494

  14. Restructuring Higher Education: Cost Containment and Productivity Enhancement Efforts of North American Colleges and Universities.

    ERIC Educational Resources Information Center

    Primary Research Group, Inc., New York, NY.

    This report addresses issues in the efforts of colleges and universities to reduce costs. First, some key findings are identified, including the rapid increase in tuition since 1981; decreases in academic library expenditures; increases in cooperative arrangements; use of more adjunct faculty; and increased privatization of services. Individual…

  15. The new era of payment reform, spending targets, and cost containment in Massachusetts: early lessons for the nation.

    PubMed

    Mechanic, Robert E; Altman, Stuart H; McDonough, John E

    2012-10-01

    As its 2012 session drew to a close, the Massachusetts legislature passed a much-anticipated cost control bill. The bill sets annual state spending targets, encourages the formation of accountable care organizations, and establishes an independent commission to oversee health care system performance. It is Massachusetts's third law to address health spending since the state's landmark health insurance coverage reforms in 2006. The 2012 legislation is a notable step beyond other recent cost control efforts. Although it lacks strong mechanisms to enforce the new spending goals, it creates a framework for increased regulation if spending trends fail to moderate. Massachusetts's experience provides several lessons for state and federal policy makers. First, implementing near-universal coverage, as is planned under the Affordable Care Act for 2014, will increase pressure on government to begin controlling overall health care spending. Second, introduction of cost control measures takes time: Massachusetts enacted a series of incremental but increasingly strong laws over the past six years that have gradually increased its ability to influence health spending. Finally, the effectiveness of new cost control laws will depend on changes in providers' and insurers' behavior; in Massachusetts, private market activity has had a complementary impact on the pace of health system change. PMID:22993207

  16. Labor Market Policy: A Comparative View on the Costs and Benefits of Labor Market Flexibility

    ERIC Educational Resources Information Center

    Kahn, Lawrence M.

    2012-01-01

    I review theories and evidence on wage-setting institutions and labor market policies in an international comparative context. These include collective bargaining, minimum wages, employment protection laws, unemployment insurance (UI), mandated parental leave, and active labor market policies (ALMPs). Since it is unlikely that an unregulated…

  17. Labor Market Policy: A Comparative View on the Costs and Benefits of Labor Market Flexibility

    ERIC Educational Resources Information Center

    Kahn, Lawrence M.

    2012-01-01

    I review theories and evidence on wage-setting institutions and labor market policies in an international comparative context. These include collective bargaining, minimum wages, employment protection laws, unemployment insurance (UI), mandated parental leave, and active labor market policies (ALMPs). Since it is unlikely that an unregulated

  18. Impacts of the Universal Primary Education Policy on Educational Attainment and Private Costs in Rural Uganda

    ERIC Educational Resources Information Center

    Nishimura, Mikiko; Yamano, Takashi; Sasaoka, Yuichi

    2008-01-01

    While some governments in Sub-Saharan Africa have abolished tuition to achieve universal primary education (UPE), few studies have examined the impacts of the UPE policy beyond school enrolment. This study estimates the impact of the UPE policy in Uganda on overall primary education attainments by using data including 940 rural households. We find…

  19. Response to: The Development of a Cost of Education Index: Some Empirical Estimates and Policy Issues.

    ERIC Educational Resources Information Center

    Matthews, Kenneth M.; Brown, Carvin L.

    1980-01-01

    Argues that a cost of education index presented in the winter 1980 issue may create inequities in the treatment of both taxpayers and pupils, mainly because of its evaluation of teacher salary costs. (IRT)

  20. Costs and benefits of an enhanced reduction policy of particulate matter exhaust emissions from road traffic in Flanders

    NASA Astrophysics Data System (ADS)

    Schrooten, Liesbeth; De Vlieger, Ina; Lefebre, Filip; Torfs, Rudi

    We demonstrate that accelerated policies beyond the steady improvement of technologies and the fleet turnover are not always justified by assumptions about health benefits. Between the years 2000 and 2010, particulate matter (PM) exhaust emissions from traffic in Flanders, a region of Belgium, will be reduced by about 44% without taking any extra reduction measures (baseline scenario). The PM emissions from road traffic were calculated using the MIMOSA model. Furthermore, we explored a range of options to increase attempts to reduce PM exhaust emission from traffic in 2010. When installing particle filters on heavy-duty trucks and buses, introducing biodiesel and diesel/hybrid cars, as well as slowing down the increase of private diesel cars, only an extra reduction of about 8% PM can be achieved in Flanders. The costs to achieve this small reduction are very high. To justify these costs, benefits for public health have been calculated and expressed in external costs. We demonstrate that only an enhanced effort to retrofit trucks and buses with particle filters has a net benefit. We have used Monte Carlo techniques to test the validity of this conclusion. It is concluded that a local or national policy that goes beyond European policies is not always beneficial and that additional measures should be assessed carefully.

  1. Space projects: Astrophysics facility program contains cost and technical risks. Report to Congressional Requesters

    NASA Astrophysics Data System (ADS)

    Warren, David R.

    1994-01-01

    NASA is developing the Advanced X-ray Astrophysics Facility (AXAF) to be one of the mainstays of this nation's space science program during the next decade. It is to be used to investigate important questions such as the age and origin of the universe. The status of the 1992 redesigned AXAF program is reviewed to assess the reasonableness of NASA's estimate of program costs and to determine the extent to which the redesign will provide scientific returns comparable to the original program. It is recognized that a recent congressional direction may affect a portion of this program, but the cost and technical impacts of that decision are uncertain at this time. However, the results of the work in other segments of the program are still relevant.

  2. High performance, low cost, self-contained, multipurpose PC based ground systems

    NASA Technical Reports Server (NTRS)

    Forman, Michael; Nickum, William; Troendly, Gregory

    1993-01-01

    The use of embedded processors greatly enhances the capabilities of personal computers when used for telemetry processing and command control center functions. Parallel architectures based on the use of transputers are shown to be very versatile and reusable, and the synergism between the PC and the embedded processor with transputers results in single unit, low cost workstations of 20 less than MIPS less than or equal to 1000.

  3. Low cost site built fiberglass water containers for thermal mass and small scale aquaculture

    SciTech Connect

    Shepard, M.

    1981-01-01

    A step by step method of constructing water storage tubes from commonly available fiberglass glazings is outlined. Drawing on experience gained in making tubes for the NMSEA demonstration greenhouse aquaculture program, sufficient information is presented to enable the layperson to build his or her own water containers, from a few gallons to hundreds of gallons in capacity.

  4. Cost containment for treating hypertension in African Americans: impact of a combined ACE inhibitor-calcium channel blocker.

    PubMed Central

    Kountz, D. S.

    1997-01-01

    The use of calcium channel blockers (CCBs) and angiotensin-converting enzyme (ACE) inhibitors has increased dramatically over the last 10 years and now accounts for 60% to 70% of all new antihypertensive prescriptions. Even though these two classes are efficacious, they are costly. Combined ACE inhibitor/CCB therapy (amlodipine-benazepril) was introduced in 1995. An analysis was done to assess the potential financial impact of substituting this agent for patients being treated with on ACE inhibitor/CCB combination. A pharmaceutical profile review of prescriptions during October 1995 was performed on 219 randomly selected patients enrolled in a Medicaid managed care program. Eighty-four profiles were analyzed; 24% of patients were on a combination ACE inhibitor/CCB regimen with an average monthly cost of $135. If the single agent amlodipine-benazepril with an average monthly cost of $45 (all strengths) was substituted, the savings would be considerable: $1080 per patient per year and $1,080,000 annualized for the calculated number of hypertensives on combination therapy in our network of 15,000 patients. Therapeutic substitution is one method of achieving cost containment in managed care. The cost differential between separately prescribed CCBs and ACE inhibitors and amlodipine-benazepril is significant. Compliance also should be enhanced as the patient would need to take only one pill daily. Once a patient has been maintained on a stable dose of a CCB/ACE inhibitor, substitution with amlodipine-benazepril should be considered. PMID:9220694

  5. Water supply development and tariffs in Tanzania: From free water policy towards cost recovery

    NASA Astrophysics Data System (ADS)

    Mashauri, Damas A.; Katko, Tapio S.

    1993-01-01

    The article describes the historical development of water tariff policy in Tanzania from the colonial times to present. After gaining independence, the country introduced “free” water policy in its rural areas. Criticism against this policy was expressed already in the 1970s, but it was not until the late 1980s that change became unavoidable. All the while urban water tariffs continued to decline in real terms. In rural and periurban areas of Tanzania consumers often have to pay substantial amounts of money for water to resellers and vendors since the public utilities are unable to provide operative service. Besides, only a part of the water bills are actually collected. Now that the free water supply policy has been officially abandoned, the development of water tariffs and the institutions in general are a great challenge for the country.

  6. Natural Iraqi palygorskite clay as low cost adsorbent for the treatment of dye containing industrial wastewater.

    PubMed

    Nassir Taha, Dakhil; Sadi Samaka, Isra'a

    2012-01-01

    In this study, natural Iraqi low- cost locally available clay (palygorskite) was studied for its potential use as an adsorbent for removal Congo red from aqueous solutions. Batch type experiments were conducted to study the effect of contact time, initial pH of the dye solution, initial dye concentration, adsorbent dosage, and particle size of adsorbent on adsorption capacity of Congo red. The adsorption occurred very fast initially and attains equilibrium within 60 min. When the effect of pH of solution dye on the yield adsorption has been carried in a range of 2-10, the adsorption obtained was nearly the same with very slightly effect of pH and it was reported that above 49.07 mg/g of Cong red by palygorskite clay occurred in the pH range 2 to 10. It was observed that the removal of Congo red increase with increasing initial dye concentration and adsorbent dose, but, adsorption capacity decrease with increasing adsorbent dose. The adsorption capacity increase with decreasing particle size of adsorbent. The equilibrium adsorption data were interpreted using Langmuir and Freundlich isotherm models. The obtained results revealed that the equilibrium data closely followed both models, but the Langmuir isotherm fitted the data better. The maximum adsorption capacity was found to be 99 mg/g at ambient temperature. Results indicate that Iraqi palygorskite clay could be employed as a low cost alternative to commercial activated carbon in wastewater treatment for the removal of colour and dyes. PMID:23196874

  7. Cost-effective containment of unmagnetized argon plasma using a magnetic bucket and a helicon source

    NASA Astrophysics Data System (ADS)

    Henriquez, Miguel; Siddiqui, M. Umair; Scime, Earl

    2015-11-01

    We demonstrate highly-ionized and unmagnetized plasma production in the low-power Compact HElicon for Waves and Instabilities Experiment (CHEWIE) at West Virginia University. To achieve this, the argon helicon is injected plasma into a multidipole-confined expansion chamber. Using Langmuir probes and optical emission spectroscopy, we calculate ionization fractions in the unmagnetized volume as a function of input power and fill pressures. Finally, we investigate the ionization efficiency power scaling to determine if helicons are cost-efficient plasma sources for larger highly-ionized, unmagnetized plasma experiments. This work is supported by US National Science Foundation grant number PHY-1360278 and Miguel Henriquez was supported by West Virginia University.

  8. Cost-Effectiveness and Educational Policy. Yearbook of the American Education Finance Association, 2002.

    ERIC Educational Resources Information Center

    Levin, Henry M., Ed.; McEwan, Patrick J., Ed.

    This collection of papers provides decision-makers with tools to improve resource allocation. The two primary tools, or modes, are cost-effective analysis and cost-benefit analysis, which researchers in education have devised and refined. This volume has three main goals, all intended to help decision-makers construct a useful research program:…

  9. Price-Cost Ratios in Higher Education: Subsidy Structure and Policy Implications

    ERIC Educational Resources Information Center

    Xie, Yan

    2010-01-01

    The diversity of US institutions of higher education is manifested in many ways. This study looks at that diversity from the economic perspective by studying the subsidy structure through the distribution of institutional price-cost ratio (PCR), defined as the sum of net tuition price divided by total supplier cost and equals to one minus…

  10. Cost savings associated with landfilling wastes containing very low levels of uranium

    SciTech Connect

    Boggs, C.J.; Shaddoan, W.T.

    1996-03-01

    The Paducah Gaseous Diffusion Plant (PGDP) has operated captive landfills (both residential and construction/demolition debris) in accordance with the Commonwealth of Kentucky regulations since the early 1980s. Typical waste streams allowed in these landfills include nonhazardous industrial and municipal solid waste (such as paper, plastic, cardboard, cafeteria waste, clothing, wood, asbestos, fly ash, metals, and construction debris). In July 1992, the U.S. Environmental Protection Agency issued new requirements for the disposal of sanitary wastes in a {open_quotes}contained landfill.{close_quotes} These requirements were promulgated in the 401 Kentucky Administrative Record Chapters 47 and 48 that became effective 30 June 1995. The requirements for a new contained landfill include a synthetic liner made of high-density polyethylene in addition to the traditional 1-meter (3-foot) clay liner and a leachate collection system. A new landfill at Paducah would accept waste streams similar to those that have been accepted in the past. The permit for the previously existing landfills did not include radioactivity limits; instead, these levels were administratively controlled. Typically, if radioactivity was detected above background levels, the waste was classified as low-level waste (LLW), which would be sent off-site for disposal.

  11. A cost-effective method for detoxification of sludge containing lead.

    PubMed

    Banerjee, K; Blumenschein, C D

    2003-01-01

    The industrial wastewater treatment plant discussed in this paper generates sludge containing heavy metals, including lead. Occasionally, the concentration of lead in the Toxic Characteristics Leaching Procedure (TCLP) extract from the sludge exceeded the U.S. Environmental Protection Agency (EPA) regulatory limit of 5 mg/l and resulted in the solid waste exhibiting the characteristic of toxicity. The technical and economic feasibility of a process for conditioning the lead-containing sludge was investigated. The results revealed that the lead-laden sludge could be made non-hazardous by chemical conditioning. The lead reduction efficiency of triple super phosphate (TSP) is higher than that of either calcium carbonate or magnesium hydroxide. The laboratory and pilot-scale tests indicated that the conditioning system consistently reduced the lead in the TCLP extract below the regulatory limit of 5 mg/l. The economic feasibility evaluation demonstrated that more than 450,000 US dollars could be saved annually by conditioning the sludge with TSP and disposing it as a non-hazardous material in a landfill. The results obtained from the laboratory as well as from the pilot-scale operation are described and discussed in this paper. PMID:12926695

  12. Utility planning using least-cost principles and the role of externalities - staff report on a Keystone policy dialogue

    SciTech Connect

    1996-05-01

    For over two years, The Keystone Center facilitated a two-phase dialogue on Utility Planning Using Least-Cost Principles and, in the second phase, on the role of Externalities. The intent of this report is to assist policy-makers faced with decisions about changes to traditional utility regulation and planning. This report is not a consensus document, rather it is staff written summary of two years of discussion on the issues. As a concept, least-cost planning has been discussed since the 1970`s and many states have implemented such programs since the mid-1980`s. Yet, the actual goals and objectives of least-cost planning remain a source of controversy between affected interest groups. Some industry observers believe that least-cost planning can help reconcile the often conflicting demands between increased capacity requirements and concerns about the external costs of power production. In traditional utility regulation practices, capital investments are rewarded and revenue is a direct function of sales. However, a number state public utility commissions have altered their practices to allow for returns on investments in more efficient end-use equipment (also known as ratebasing conservation) and adjusting revenues to account for sales lost due to utility conservation programs. Other states are planning these types of changes. Still others are observing the impacts of the changes before they commit.

  13. Development and evaluation of die and container materials. Low cost silicon solar array project

    NASA Technical Reports Server (NTRS)

    Wills, R. R.; Niesx, D. E.

    1979-01-01

    Specific compositions of high purity silicon aluminum oxynitride (Sialon) and silicon beryllium oxynitride (Sibeon) solid solutions were shown to be promising refractory materials for handling and manipulating solar grade silicon into silicon ribbon. Evaulation of the interaction of these materials in contact with molten silicon indicated that solid solutions based upon beta-Si3N4 were more stable than those based on Si2N2O. Sibeon was more resistant to molten silicon attack than Sialon. Both materials should preferably be used in an inert atmosphere rather than under vacuum conditions because removal of oxygen from the silicon melt occurs as SiO enhances the dissolution of aluminum and beryllium. The wetting angles of these materials were low enough for these materials to be considered as both die and container materials.

  14. Survey of consumer attitudes and awareness of the metric conversion of distilled spirits containers: A policy and planning evaluation

    NASA Astrophysics Data System (ADS)

    Simpson, J. A.; Barsby, S. L.

    1981-12-01

    The survey was conducted as part of a policy and planning evaluation study. The overall study was an examination of a completed private sector conversion to the metric system, in the light of the US Metric Board's planning guidelines and procedures. The conversion of distilled spirits containers took place prior to the establishment of the USMB. The study's objective was to use the completed version to determine if the guidelines and related procedures were adequate to help the conversion process. If they were not, the study was designed to provide suggestions for improvement.

  15. Use of Generics—A Critical Cost Containment Measure for All Healthcare Professionals in Europe?

    PubMed Central

    Godman, Brian; Shrank, William; Wettermark, Bjorn; Andersen, Morten; Bishop, Iain; Burkhardt, Thomas; Garuolienè, Kristina; Kalaba, Marija; Laius, Ott; Joppi, Roberta; Sermet, Catherine; Schwabe, Ulrich; Teixeira, Inês; Tulunay, F. Cankat; Wendykowska, Kamila; Zara, Corinne; Gustafsson, Lars L.

    2010-01-01

    Pharmaceutical expenditures in ambulatory care rose rapidly in Europe in the 1990s and early 2000s. This was typically faster than other components of healthcare spending, leading to reforms to moderate future growth. A number of these centered on generic medicines with measures to lower reimbursed prices as well as enhance their prescribing and dispensing. The principal objective of this paper is to review additional measures that some European countries can adopt to further reduce reimbursed prices for generics. Secondly, potential approaches to address concerns with generics when they arise to maximize savings. Measures to enhance the prescribing of generics will also briefly be discussed. A narrative review of the extensive number of publications and associated references from the co-authors was conducted supplemented with known internal or web-based articles. In addition, health authority and health insurance databases, principally from 2001 to 2007, were analyzed to assess the impact of the various measures on price reductions for generic omeprazole and generic simvastatin vs. pre-patent loss prices, as well as overall efficiency in Proton Pump Inhibitor (PPI) and statin prescribing. The various initiatives generally resulted in considerable lowering of the prices of generics as well as specifically for generic omeprazole and generic simvastatin vs. pre-patent loss prices. At one stage in the UK, generic simvastatin was just 2% of the originator price. These measures also led to increased efficiency for PPI and statin prescribing with reimbursed expenditure for the PPIs and statins either falling or increasing at appreciably lower rates than increases in utilization. A number of strategies have also been introduced to address patient and physician concerns with generics to maximize savings. In conclusion, whilst recent reforms have been successful, European countries must continue learning from each other to fund increased volumes and new innovative drugs as resource pressures grow. Policies regarding generics and their subsequent impact on reimbursement and utilization of single sourced products will continue to play a key role to release valuable resources. However, there must continue to be strategies to address concerns with generics when they exist.

  16. Bearing the Cost: An Examination of the Gendered Impacts of Water Policy Reform in Malawi

    ERIC Educational Resources Information Center

    Marra, Simona

    2008-01-01

    Water insecurity is one of the most pressing issues currently faced by Malawi. The consequences of these issues are borne significantly by women, who are most directly involved with water provision and use, particularly at the household level. Since the mid-1990s, Malawi has undertaken a process of water policy reform. Reflective of international

  17. Bearing the Cost: An Examination of the Gendered Impacts of Water Policy Reform in Malawi

    ERIC Educational Resources Information Center

    Marra, Simona

    2008-01-01

    Water insecurity is one of the most pressing issues currently faced by Malawi. The consequences of these issues are borne significantly by women, who are most directly involved with water provision and use, particularly at the household level. Since the mid-1990s, Malawi has undertaken a process of water policy reform. Reflective of international…

  18. Keeping Teachers on the Job Costs Less than Advertised. Policy Memorandum #168

    ERIC Educational Resources Information Center

    Bivens, Josh

    2010-01-01

    A misplaced obsession with the size of federal budget deficits remains the single biggest obstacle to enacting new measures to create jobs on a scale commensurate with the crisis in the American labor market. Even assuming that budget scoring rules can't be changed, at the very least policy makers should be aware of the true impact a given piece…

  19. 78 FR 17300 - Reform of Federal Policies Relating to Grants and Cooperative Agreements; Cost Principles and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-21

    ...; ] OFFICE OF MANAGEMENT AND BUDGET 2 CFR Chapters I and II Reform of Federal Policies Relating to Grants and...: Executive Office of the President, Office of Management and Budget (OMB). ACTION: Extension of comment period; proposed guidance. SUMMARY: The Office of Management and Budget is extending the comment...

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    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-26

    ... Federal Register on February 28, 2012, at 77 FR 11178. The original comment period was scheduled to end on... OF MANAGEMENT AND BUDGET 2 CFR Chapters I and II Reform of Federal Policies Relating to Grants and...: Executive Office of the President, Office of Management and Budget (OMB). ACTION: Advance notice of...

  1. [Labeling of food containing genetically modified organisms: international policies and Brazilian legislation].

    PubMed

    Costa, Thadeu Estevam Moreira Maramaldo; Marin, Victor Augustus

    2011-08-01

    The increase in surface area planted with genetically modified crops, with the subsequent transfer of such crops into the general environment for commercial trade, has raised questions about the safety of these products. The introduction of the Cartagena Protocol on Biosafety has led to the need to produce information and ensure training in this area for the implementation of policies on biosafety and for decision-making on the part of governments at the national, regional and international level. This article presents two main standpoints regarding the labeling of GM products (one adopted by the United States and the other by the European Union), as well as the position adopted by Brazil and its current legislation on labeling and commercial release of genetically modified (GM) products. PMID:21860957

  2. A study of metric conversion of distilled spirits containers: A policy and planning evaluation on findings and lessons learned

    NASA Astrophysics Data System (ADS)

    Simpson, J. A.; Barsby, S. L.

    1981-10-01

    This report is the Task 4 report and final product for "A Study of Metric Conversion of Distilled Spirits Containers: A Policy and Planning Evaluation,' performed by Applied Concepts Corporation for the United States Metric Board (USMB). This report summarizes the results for the entire project, which entailed: conducting a detailed case study of the distilled spirits conversion; developing and analyzing a set of hypothetical scenarios regarding the circumstances of the conversion and USMB's possible role in it; assessing the completeness and clarity of USMB's planning guidelines; conducting a survey of consumer awareness of and attitudes toward the conversion; and analyzing the implications of the findings from all the above for USMB policy. The report presents a brief overview of the major findings from the case study, regarding the actual events, issues, and impacts of the distilled spirits conversion. It traces the impacts of possible USMB intervention strategies under several alternative scenarios, in the context of the distilled spirits conversion. The study assesses the planning guidelines and analyzes the implications for USMB policy and presents a concise summary of findings and "lessons learned' over the course of this project. Consumer survey results are attached in an Appendix.

  3. What School Administrators Should Know about Inclusion and Its Costs.

    ERIC Educational Resources Information Center

    Pruslow, John T.

    2003-01-01

    Examines cost-effectiveness of school inclusion for special-needs students. Includes cost analysis of instructional personnel, impact on general education spending, transportation, and school space. Draws policy implications. (Contains 34 references.) (PKP)

  4. Policies to clean up toxic industrial contaminated sites of Gela and Priolo: a cost-benefit analysis.

    TOXLINE Toxicology Bibliographic Information

    Guerriero C; Bianchi F; Cairns J; Cori L

    2011-01-01

    BACKGROUND: Cost-benefit analysis is a transparent tool to inform policy makers about the potential effect of regulatory interventions, nevertheless its use to evaluate clean-up interventions in polluted industrial sites is limited. The two industrial areas of Gela and Priolo in Italy were declared "at high risk of environmental crisis" in 1990. Since then little has been done to clean the polluted sites and reduce the health outcomes attributable to pollution exposure. This study, aims to quantify the monetary benefits resulting from clean-up interventions in the contaminated sites of Gela and Priolo.METHODS: A damage function approach was used to estimate the number of health outcomes attributable to industrial pollution exposure. Extensive one way analyses and probabilistic analyses were conducted to investigate the sensitivity of results to different model assumptions.RESULTS: It has been estimated that, on average, 47 cases of premature death, 281 cases of cancer and 2,702 cases of non-cancer hospital admission could be avoided each year by removing environmental exposure in these two areas. Assuming a 20 year cessation lag and a 4% discount rate we calculate that the potential monetary benefit of removing industrial pollution is €3,592 million in Priolo and €6,639 million in Gela.CONCLUSIONS: Given the annual number of health outcomes attributable to pollution exposure the effective clean-up of Gela and Priolo should be prioritised. This study suggests that clean-up policies costing up to €6,639 million in Gela and €3,592 million in Priolo would be cost beneficial. These two amounts are notably higher than the funds allocated thus far to clean up the two sites, €127.4 million in Gela and €774.5 million in Priolo, implying that further economic investments - even considerable ones - could still prove cost beneficial.

  5. Policies to clean up toxic industrial contaminated sites of Gela and Priolo: a cost-benefit analysis

    PubMed Central

    2011-01-01

    Background Cost-benefit analysis is a transparent tool to inform policy makers about the potential effect of regulatory interventions, nevertheless its use to evaluate clean-up interventions in polluted industrial sites is limited. The two industrial areas of Gela and Priolo in Italy were declared "at high risk of environmental crisis" in 1990. Since then little has been done to clean the polluted sites and reduce the health outcomes attributable to pollution exposure. This study, aims to quantify the monetary benefits resulting from clean-up interventions in the contaminated sites of Gela and Priolo. Methods A damage function approach was used to estimate the number of health outcomes attributable to industrial pollution exposure. Extensive one way analyses and probabilistic analyses were conducted to investigate the sensitivity of results to different model assumptions. Results It has been estimated that, on average, 47 cases of premature death, 281 cases of cancer and 2,702 cases of non-cancer hospital admission could be avoided each year by removing environmental exposure in these two areas. Assuming a 20 year cessation lag and a 4% discount rate we calculate that the potential monetary benefit of removing industrial pollution is €3,592 million in Priolo and €6,639 million in Gela. Conclusions Given the annual number of health outcomes attributable to pollution exposure the effective clean-up of Gela and Priolo should be prioritised. This study suggests that clean-up policies costing up to €6,639 million in Gela and €3,592 million in Priolo would be cost beneficial. These two amounts are notably higher than the funds allocated thus far to clean up the two sites, €127.4 million in Gela and €774.5 million in Priolo, implying that further economic investments - even considerable ones - could still prove cost beneficial. PMID:21797993

  6. Monitoring Conformance and Containment for Geological Carbon Storage: Can Technology Meet Policy and Public Requirements?

    NASA Astrophysics Data System (ADS)

    Lawton, D. C.; Osadetz, K.

    2014-12-01

    The Province of Alberta, Canada identified carbon capture and storage (CCS) as a key element of its 2008 Climate Change strategy. The target is a reduction in CO2 emissions of 139 Mt/year by 2050. To encourage uptake of CCS by industry, the province has provided partial funding to two demonstration scale projects, namely the Quest Project by Shell and partners (CCS), and the Alberta Carbon Trunk Line Project (pipeline and CO2-EOR). Important to commercial scale implementation of CCS will be the requirement to prove conformance and containment of the CO2 plume injected during the lifetime of the CCS project. This will be a challenge for monitoring programs. The Containment and Monitoring Institute (CaMI) is developing a Field Research Station (FRS) to calibrate various monitoring technologies for CO2 detection thresholds at relatively shallow depths. The objective being assessed with the FRS is sensitivity for early detection of loss of containment from a deeper CO2 storage project. In this project, two injection wells will be drilled to sandstone reservoir targets at depths of 300 m and 700 m. Up to four observation wells will be drilled with monitoring instruments installed. Time-lapse surface and borehole monitoring surveys will be undertaken to evaluate the movement and fate of the CO2 plume. These will include seismic, microseismic, cross well, electrical resistivity, electromagnetic, gravity, geodetic and geomechanical surveys. Initial baseline seismic data from the FRS will presented.

  7. Draft environmental assessment: Swisher County site, Texas. Nuclear Waste Policy Act (Section 112). [Contains Glossary

    SciTech Connect

    Not Available

    1984-12-01

    In February 1983, the US Department of Energy (DOE) identified a location in Swisher County, Texas, as one of nine potentially acceptable sites for a mined geologic repository for spent nuclear fuel and high-level radioactive waste. The potentially acceptable site was subsequently narrowed to an area of 9 square miles. To determine their suitability, the Swisher site and the eight other potentially acceptable sites have been evaluated in accordance with the DOE's General Guidelines for the Recommendation of Sites for Nuclear Waste Repositories. These evaluations are reported in this draft environmental assessment (EA), which is being issued for public review and comment. The DOE findings and determinations that are based on these evaluations are preliminary and subject to public review and comment. A final EA will be prepared after considering the comments received. On the basis of the evaluations contained in this draft EA, the DOE has found that the Swisher site is not disqualified under the guidelines. The site is contained in the Permian Basin, which is one of five distinct geohydrologic settings considered for the first repository. This setting contains one other potentially acceptable site - the Deaf Smith site. Although the Swisher site appears to be suitable for site characterization, the DOE has concluded that the Deaf Smith site is the preferred site in the Permian Basin and is proposing to nominate the Deaf Smith site rather than the Swisher site as one of the five sites suitable for characterization.

  8. Wasteful waste-reducing policies? The impact of waste reduction policy instruments on collection and processing costs of municipal solid waste.

    PubMed

    De Jaeger, Simon; Eyckmans, Johan; Rogge, Nicky; Van Puyenbroeck, Tom

    2011-07-01

    We study the impact of some local policies aimed at municipal solid waste (MSW) reduction on the cost efficiency of MSW collection and disposal. We explicitly account for differences between municipalities in background conditions by using a bootstrapped version of the Data Envelopment Analysis methodology in combination with a matching technique. Using data on 299 municipalities in Flanders, Belgium, for the year 2003, our results indicate that municipalities that are member of a waste collection joint venture, or that subscribe to a voluntary agreement to reduce MSW at the highest ambition level, collect and process MSW more efficiently than other municipalities. Weekly instead of two-weekly waste collection, or using a weight-based pricing system appears to have no impact on efficiency. Our results show that aiming at MSW reduction does not lead to lower efficiency of public service provision, even on the contrary. PMID:21429732

  9. R&D policy, agency costs and innovation in personalized medicine.

    PubMed

    Yin, Wesley

    2009-09-01

    The Orphan Drug Act (ODA) was designed to spur the development of drugs for rare diseases. In principle, its design also incentivizes pharmaceutical firms to develop drugs for "rare" subdivisions of more prevalent diseases. I find that in response to this incentive, firms develop drugs for ODA-qualifying subdivisions of non-rare diseases. The impact in these tailored drug markets represents half of the total R&D response to the ODA. I also find that 10-percent of the innovation in subdivided disease drugs induced by the ODA would have been conducted without the policy. While modest in size, this inefficiency suggests that agency problems should be considered when designing innovation policy. PMID:19671480

  10. A study of metric conversion of distilled spirits containers: A policy and planning evaluation

    NASA Astrophysics Data System (ADS)

    Simpson, J. A.

    1981-08-01

    The report establishes the historical baseline regarding events that occurred, the reasons for the events, their impacts, and the lessons learned from the conversion. The report consists of eight chapters and an appendix: (1) an overview of the distilled spirits industry, (2) an analysis of the motivation phase of the conversion, (3) an analysis of the planning phase, (4) a description and analysis of the events of the implementation phase, (5) an analysis of the costs and savings resulting from the conversion, (6) an analysis of the impact of the conversion on prices of distilled spirits, (7) an analysis of the impacts on consumption, profitability, industry structure, and size, product and brand preferences, (8) a summary of the findings and conclusions from the assessment of the process, and (9) (the appendix) a detailed chronology of events.

  11. [Drug utilization and pharmaceutical cost-containment in germany-perspectives 1 year after enactment of the GMG].

    PubMed

    Schlander, Michael

    2005-06-15

    After 3 decades of health care cost containment in Germany, enactment of the most recent reform (Health Insurance Modernization Act, GMG) marks a watershed insofar as, apparently, the potential has been largely exhausted for further savings in pharmaceutical spending. Yet the new drugs segment maintains its role as a growth driver, owing to the continuing shift from older to new, and frequently more expensive, products. This observation holds true even after introducing phase 2 reference pricing, covering so-called me too products. Health economic analyses would be required to better differentiate pharmaceutical products based on their incremental cost-effectiveness ratio. However, the opportunity was missed with the GMG to introduce formal health-economic evaluations and thus overcome the counterproductive silo mentality associated with traditional German component management. International experience from Australia, Canada, and the United Kingdom suggests that economic evaluations, while informing rational reimbursement decisions, may in fact contribute to increasing pharmaceutical expenditures. Further tightening of pharmaceutical component management in Germany may result in increasing inefficiencies due to underuse of effective products; furthermore, it appears conceivable that ("second order") dynamic inefficiencies and, hence, social costs might be the consequence of reduced pharmaceutical research and development expenditures. PMID:15968483

  12. A retrospective investigation of energy efficiency standards: policies may have accelerated long term declines in appliance costs

    NASA Astrophysics Data System (ADS)

    Van Buskirk, R. D.; Kantner, C. L. S.; Gerke, B. F.; Chu, S.

    2014-11-01

    We perform a retrospective investigation of multi-decade trends in price and life-cycle cost (LCC) for home appliances in periods with and without energy efficiency (EE) standards and labeling polices. In contrast to the classical picture of the impact of efficiency standards, the introduction and updating of appliance standards is not associated with a long-term increase in purchase price; rather, quality-adjusted prices undergo a continued or accelerated long-term decline. In addition, long term trends in appliance LCCs—which include operating costs—consistently show an accelerated long term decline with EE policies. We also show that the incremental price of efficiency improvements has declined faster than the baseline product price for selected products. These observations are inconsistent with a view of EE standards that supposes a perfectly competitive market with static supply costs. These results suggest that EE policies may be associated with other forces at play, such as innovation and learning-by-doing in appliance production and design, that can affect long term trends in quality-adjusted prices and LCCs.

  13. The Costs of Online Learning. Creating Sound Policy for Digital Learning: A Working Paper Series from the Thomas B. Fordham Institute

    ERIC Educational Resources Information Center

    Battaglino, Tamara Butler; Haldeman, Matt; Laurans, Eleanor

    2012-01-01

    The latest installment of the Fordham Institute's "Creating Sound Policy for Digital Learning" series investigates one of the more controversial aspects of digital learning: How much does it cost? In this paper, the Parthenon Group uses interviews with more than fifty vendors and online-schooling experts to estimate today's average per-pupil cost

  14. Comparing the cost-effectiveness of water conservation policies in a depleting aquifer:A dynamic analysis of the Kansas High Plains

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This research analyzes two groundwater conservation policies in the Kansas High Plains located within the Ogallala aquifer: 1) cost-share assistance to increase irrigation efficiency; and 2) incentive payments to convert irrigated crop production to dryland crop production. To compare the cost-effec...

  15. An integrated assessment of two decades of air pollution policy making in Spain: Impacts, costs and improvements.

    PubMed

    Vedrenne, Michel; Borge, Rafael; Lumbreras, Julio; Conlan, Beth; Rodríguez, María Encarnación; de Andrés, Juan Manuel; de la Paz, David; Pérez, Javier; Narros, Adolfo

    2015-09-15

    This paper analyses the effects of policy making for air pollution abatement in Spain between 2000 and 2020 under an integrated assessment approach with the AERIS model for number of pollutants (NOx/NO2, PM10/PM2.5, O3, SO2, NH3 and VOC). The analysis of the effects of air pollution focused on different aspects: compliance with the European limit values of Directive 2008/50/EC for NO2 and PM10 for the Spanish air quality management areas; the evaluation of impacts caused by the deposition of atmospheric sulphur and nitrogen on ecosystems; the exceedance of critical levels of NO2 and SO2 in forest areas; the analysis of O3-induced crop damage for grapes, maize, potato, rice, tobacco, tomato, watermelon and wheat; health impacts caused by human exposure to O3 and PM2.5; and costs on society due to crop losses (O3), disability-related absence of work staff and damage to buildings and public property due to soot-related soiling (PM2.5). In general, air quality policy making has delivered improvements in air quality levels throughout Spain and has mitigated the severity of the impacts on ecosystems, health and vegetation in 2020 as target year. The findings of this work constitute an appropriate diagnosis for identifying improvement potentials for further mitigation for policy makers and stakeholders in Spain. PMID:25965050

  16. Wrestling Rising Costs with Innovation. Policy Matters. Volume 4, Number 1, January 2007

    ERIC Educational Resources Information Center

    Markowitz, Melissa

    2007-01-01

    While tuition costs are likely the most talked about topic in higher education, focusing on the institutional finance is equally important. The growing expenses associated with educating students is often a catalyst for rising tuition and fees, and they play a large role as educators plan for the future of their institutions. Although higher…

  17. Measuring (and Managing) the Invisible Costs of Postsecondary Attrition. Policy Brief

    ERIC Educational Resources Information Center

    Wellman, Jane; Johnson, Nate; Steele, Patricia

    2012-01-01

    The collision between funding realities and the paramount goal of increasing educational attainment has brought new attention to ways to reduce postsecondary attrition and get more students who enroll in college to complete a degree or credential. Reductions in attrition are both educationally effective and cost effective. Students reach…

  18. They Spend What? The Real Cost of Public Schools. Policy Analysis. No. 662

    ERIC Educational Resources Information Center

    Schaeffer, Adam

    2010-01-01

    Although public schools are usually the biggest item in state and local budgets, spending figures provided by public school officials and reported in the media often leave out major costs of education and thus understate what is actually spent. To document the phenomenon, this paper reviews district budgets and state records for the nation's five…

  19. Costs and Policy Options for Federal Student Loan Programs. A CBO Study

    ERIC Educational Resources Information Center

    Lucas, Deborah; Moore, Damien

    2010-01-01

    The Department of Education oversees various programs to help students pay for the costs of postsecondary education. This Congressional Budget Office (CBO) study focuses on the two largest student loan programs created under the authority of the Higher Education Act of 1965 (as amended): (1) The Federal Family Education Loan (FFEL) program, which…

  20. The Cost Structure of Higher Education: Implications for Governmental Policy in Steady State.

    ERIC Educational Resources Information Center

    Lyell, Edward H.

    The historical pattern of resource allocation in American higher education as exemplified by public colleges in Colorado was examined. The reliance upon average cost information in making resource allocation decisions was critiqued for the special problems that arise from student enrollment decline or steady state. A model of resource allocation…

  1. Increasing Fuel Costs Hit Hard: Districts Change Policies to Offset Rising Prices

    ERIC Educational Resources Information Center

    Ash, Katie

    2008-01-01

    This article reports that with fuel prices soaring nationwide, reaching more than $4 for each gallon of gas or diesel, school districts are struggling to supplement transportation-budget shortfalls and find ways to offset the increasing costs as a new school year approaches. Now districts--most of whose buses run on diesel fuel--are scrambling to

  2. The Evidence on Universal Preschool: Are Benefits Worth the Cost? Policy Analysis. Number 760

    ERIC Educational Resources Information Center

    Armor, David J.

    2014-01-01

    Calls for universal preschool programs have become commonplace, reinforced by President Obama's call for "high-quality preschool for all" in 2013. Any program that could cost state and federal taxpayers $50 billion per year warrants a closer look at the evidence on its effectiveness. This report reviews the major evaluations of preschool…

  3. Increasing Fuel Costs Hit Hard: Districts Change Policies to Offset Rising Prices

    ERIC Educational Resources Information Center

    Ash, Katie

    2008-01-01

    This article reports that with fuel prices soaring nationwide, reaching more than $4 for each gallon of gas or diesel, school districts are struggling to supplement transportation-budget shortfalls and find ways to offset the increasing costs as a new school year approaches. Now districts--most of whose buses run on diesel fuel--are scrambling to…

  4. Weighing the Costs and Benefits of State Renewables Portfolio Standards in the United States: A Comparative Analysis of State-Level Policy Impact Projections

    SciTech Connect

    Chen, Cliff; Wiser, Ryan; Mills, Andrew; Bolinger, Mark

    2008-01-07

    State renewables portfolio standards (RPS) have emerged as one of the most important policy drivers of renewable energy capacity expansion in the U.S. As RPS policies have been proposed or adopted in an increasing number of states, a growing number of studies have attempted to quantify the potential impacts of these policies, focusing primarily on cost impacts, but sometimes also estimating macroeconomic, risk reduction, and environmental effects. This article synthesizes and analyzes the results and methodologies of 31 distinct state or utility-level RPS cost-impact analyses completed since 1998. Together, these studies model proposed or adopted RPS policies in 20 different states. We highlight the key findings of these studies on the projected costs of state RPS policies, examine the sensitivity of projected costs to model assumptions, evaluate the reasonableness of key input assumptions, and suggest possible areas of improvement for future RPS analyses. We conclude that while there is considerable uncertainty in the study results, the majority of the studies project modest cost impacts. Seventy percent of the state RPS cost studies project retail electricity rate increases of no greater than one percent. Nonetheless, there is considerable room for improving the analytic methods, and therefore accuracy, of these estimates.

  5. The French nuclear power plant reactor building containment contributions of prestressing and concrete performances in reliability improvements and cost savings

    SciTech Connect

    Rouelle, P.; Roy, F.

    1998-12-31

    The Electricite de France`s N4 CHOOZ B nuclear power plant, two units of the world`s largest PWR model (1450 Mwe each), has earned the Electric Power International`s 1997 Powerplant Award. This lead NPP for EDF`s N4 series has been improved notably in terms of civil works. The presentation will focus on the Reactor Building`s inner containment wall which is one of the main civil structures on a technical and safety point of view. In order to take into account the necessary evolution of the concrete technical specification such as compressive strength low creep and shrinkage, the HSC/HPC has been used on the last N4 Civaux 2 NPP. As a result of the use of this type of professional concrete, the containment withstands an higher internal pressure related to severe accident and ensures higher level of leak-tightness, thus improving the overall safety of the NPP. On that occasion, a new type of prestressing has been tested locally through 55 C 15 S tendons using a new C 1500 FE Jack. These updated civil works techniques shall allow EDF to ensure a Reactor Containment lifespan for more than 50 years. The gains in terms of reliability and cost saving of these improved techniques will be developed hereafter.

  6. [Health inequalities and cost-effectiveness: what do important health policy actors say about this potential conflict situation?].

    PubMed

    Hofmann, M; Mielck, A

    2015-02-01

    The German statutory health-care system is based on the principle of solidarity and thus it is committed to the objective of 'equal chances'. From an economic perspective it is also important to emphasise that scarcity of resources continuously pushes the services towards cost control and towards increasing cost-effect-iveness. There could be conflicts between the 2 objectives 'equal chances' and 'cost-effectiveness', of course, for example if measures for increasing cost-effectiveness lead to increased financial burdens of the insured. To date it has not been studied if and how this potential conflict is discussed in Germany.In a first step we searched for German publications discussing this potential conflict focusing on 3 major public health journals (Das Gesundheitswesen, Bundesgesundheitsblatt, Ethik in der Medizin) and on the internet portal "gerechte-gesundheit.de". For the main part of the paper, we looked for publications from 4 major health policy actors (Bundesärztekammer, Zentrale Ethikkommission bei der Bundesärztekammer, Deutscher Ethikrat, Sachverständigenrat zur Begutachtung der Entwicklung im Gesundheitswesen). All papers published since the year 2000 were included in the system-atic qualitative analysis.The analyses show that the potential conflict between 'equal chances' and 'cost-effectiveness' is rarely discussed in any detail, at most in an implicit way. It would be important, though, to have an explicit discussion, supported by scientifically based analyses and recommendations. One step towards this objective could be, for example, a closer cooperation between social-epidemiologists and health--economists. PMID:24918869

  7. Draft environmental assessment: Deaf Smith County site, Texas. Nuclear Waste Policy Act (Section 112). [Contains Glossary

    SciTech Connect

    Not Available

    1984-12-01

    In February 1983, the US Department of Energy identified a location in Deaf Smith County, Texas, as one of nine potentially acceptable sites for a mined geologic repository for spent nuclear fuel and high-level radioactive waste. The potentially acceptable site was subsequently narrowed to an area of 9 square miles. To determine their suitability, the Deaf Smith site and the eight other potentially acceptable sites have been evaluated in accordance with the DOE's General Guidelines for the Recommendation of Sites for Nuclear Waste Repositories. These evaluations are reported in this draft environmental assessment, which is being issued for public review and comment. The DOE findings and determinations that are based on these evaluations are preliminary and subject to public review and comment. A final EA will be prepared after considering the comments received. On the basis of the evaluations reported in this draft EA, the DOE has found that the Deaf Smith site is not disqualified under the guidelines. The site is in the Permian Basin, which is one of five distinct geohydrologic settings considered for the first repository. This setting contains one other potentially acceptable site - the Swisher site. Although the Swisher site appears to be suitable for site characterization, DOE has concluded that the Deaf Smith site is the preferred site. The DOE finds that the site is suitable for site characterization because the evidence does not support a conclusion that the site will not be able to meet each of the qualifying conditions specified in the guidelines. On the basis of these findings, the DOE is proposing to nominate the Deaf Smith site as one of five sites suitable for characterization. Having compared the Deaf Smith site with the other four sites proposed for nomination, the DOE has determined that the Deaf Smith site is one of the three preferred sites for recommendation to the President as candidates for characterization.

  8. Chemical gel barriers as low-cost alternative to containment and in situ cleanup of hazardous wastes to protect groundwater

    SciTech Connect

    1997-01-01

    Chemical gel barriers are being considered as a low-cost alternative for containment and in situ cleanup of hazardous wastes to protect groundwater. Most of the available gels in petroleum application are non-reactive and relative impermeable, providing a physical barriers for all fluids and contaminants. However, other potential systems can be envisioned. These systems could include gels that are chemically reactive and impermeable such that most phase are captured by the barriers but the contaminants could diffuse through the barriers. Another system that is chemically reactive and permeable could have potential applications in selectivity capturing contaminants while allowing water to pass through the barriers. This study focused on chemically reactive and permeable gel barriers. The gels used in experiment are DuPont LUDOX SM colloidal silica gel and Pfizer FLOPAAM 1330S hydrolyzed polyacrylamide (HPAM) gel.

  9. The Hidden Costs of a Free Caesarean Section Policy in West Africa (Kayes Region, Mali).

    PubMed

    Ravit, Marion; Philibert, Aline; Tourigny, Caroline; Traore, Mamadou; Coulibaly, Aliou; Dumont, Alexandre; Fournier, Pierre

    2015-08-01

    The fee exemption policy for EmONC in Mali aims to lower the financial barrier to care. The objective of the study was to evaluate the direct and indirect expenses associated with caesarean interventions performed in EmONC and the factors associated with these expenses. Data sampling followed the case control approach used in the large project (deceased and near-miss women). Our sample consisted of a total of 190 women who underwent caesarean interventions. Data were collected from the health workers and with a social approach by administering questionnaires to the persons who accompanied the woman. Household socioeconomic status was assessed using a wealth index constructed with a principal component analysis. The factors significantly associated with expenses were determined using multivariate linear regression analyses. Women in the Kayes region spent on average 77,017 FCFA (163 USD) for a caesarean episode in EmONC, of which 70 % was for treatment. Despite the caesarean fee exemption, 91 % of the women still paid for their treatment. The largest treatment-related direct expenses were for prescriptions, transfusion, antibiotics, and antihypertensive medication. Near-misses, women who presented a hemorrhage or an infection, and/or women living in rural areas spent significantly more than the others. Although abolishing fees of EmONC in Mali plays an important role in reducing maternal death by increasing access to caesarean sections, this paper shows that the fee policy did not benefit to all women. There are still barriers to EmONC access for women of the lowest socio-economic group. These included direct expenses for drugs prescription, treatment and indirect expenses for transport and food. PMID:25874875

  10. Cost Containment Through Risk-Sharing by Primary Care Physicians: A History of the Development of United Healthcare

    PubMed Central

    Moore, Stephen H.; Martin, Diane P.; Richardson, William C.; Riedel, Donald C.

    1980-01-01

    A new type of Independent practice association has been organized to encourage primary care physicians in private practice to become coordinators and financial managers for their patients' medical care. Each patient chooses one internist, family or general physician, or pediatrician and must be referred by that physician for all specialized care. The primary care physician authorizes payment from his/her own account for hospital and referral care provided to patients. He or she shares any deficit or surplus remaining at the end of the year. This is a background paper detailing the history of development and specific features contained in this new concept of putting the physician in charge and “at risk” for the costs of medical care to his/her patients. The plan has been operating in northern California, Washington, and Utah and has 40,000 members and 750 participating physicians. This historical background paper is part of a large project—State Employees' Insurance Benefits Utilization Study (SEIBUS) being done by the University of Washington School of Public Health to evaluate use and costs of medical care under this innovative plan. PMID:10309220

  11. Cost, Price and Public Policy: Peering into the Higher Education Black Box. New Agenda Series[TM], Volume 1, Number 3.

    ERIC Educational Resources Information Center

    Stringer, William L.; Cunningham, Alisa F.

    This report contains a conceptual framework for analyzing costs and prices by evaluating the higher education production function and the determinants of both prices and costs. The framework can be used to strengthen understanding of costs and prices within individual institutions and to inform macro level investments at state and national levels.…

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

    PubMed

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

    2011-07-01

    Ongoing care for chronic conditions is best provided by interprofessional teams. There are challenges in achieving this where teams cross organisational boundaries. This article explores the influence of organisational factors on collaboration between private and public sector primary and community health services involved in diabetes care. It involved a case study using qualitative methods. Forty-five participants from 20 organisations were purposively recruited. Data were collected through semi-structured interviews and from content analysis of documents. Thematic analysis was used employing a two-level coding system and cross case comparisons. The patterns of collaborative patient care were influenced by a combination of factors relating to the benefits and costs of collaboration and the influence of support mechanisms. Benefits lay in achieving common or complementary health or organisational goals. Costs were incurred in bridging differences in organisational size, structure, complexity and culture. Collaboration was easier between private sector organisations than between private and public sectors. Financial incentives were not sufficient to overcome organisational barriers. To achieve more coordinated primary and community health care structural changes are also needed to better align funding mechanisms, priorities and accountabilities of the different organisations. PMID:21554068

  13. How state and federal policies as well as advances in genome science contribute to the high cost of cancer drugs.

    PubMed

    Ramsey, Scott D

    2015-04-01

    During a time when cancer drug prices are increasing at an unprecedented rate, a debate has emerged as to whether these drugs continue to provide good value. In this article I argue that this debate is irrelevant because under today's highly distorted market, prices will not be set with value considerations in mind. As an alternative, I suggest considering the "value" of three policy changes—Medicare's "average sales price plus 6 percent" payment program, laws that require insurance coverage of all new cancer drugs, and the Affordable Care Act—that are fueling manufacturers' willingness to set higher prices. More important than these issues, however, is the revolution that is occurring in molecular biology and its impact on scientists' ability to detect changes in the cancer genome. The lowered cost of discovery is driving more competitors into the market, which under distorted pricing paradoxically encourages drug makers to charge ever higher prices for their products. PMID:25847638

  14. Risk-cost-benefit analysis of atrazine in drinking water from agricultural activities and policy implications

    NASA Astrophysics Data System (ADS)

    Tesfamichael, Aklilu A.; Caplan, Arthur J.; Kaluarachchi, Jagath J.

    2005-05-01

    This study provides an improved methodology for investigating the trade-offs between the health risks and economic benefits of using atrazine in the agricultural sector by incorporating public attitude to pesticide management in the analysis. Regression models are developed to predict finished water atrazine concentration in high-risk community water supplies in the United States. The predicted finished water atrazine concentrations are then used in a health risk assessment. The computed health risks are compared with the total economic surplus in the U.S. corn market for different atrazine application rates using estimated demand and supply functions developed in this work. Analysis of different scenarios with consumer price premiums for chemical-free and reduced-chemical corn indicate that if the society is willing to pay a price premium, risks can be reduced without a large reduction in the total economic surplus and net benefits may be higher. The results also show that this methodology provides an improved scientific framework for future decision making and policy evaluation in pesticide management.

  15. Potential of trans fats policies to reduce socioeconomic inequalities in mortality from coronary heart disease in England: cost effectiveness modelling study

    PubMed Central

    Pearson-Stuttard, Jonathan; Hooton, William; Diggle, Peter; Capewell, Simon; O’Flaherty, Martin

    2015-01-01

    Objectives To determine health and equity benefits and cost effectiveness of policies to reduce or eliminate trans fatty acids from processed foods, compared with consumption remaining at most recent levels in England. Design Epidemiological modelling study. Setting Data from National Diet and Nutrition Survey, Low Income Diet and Nutrition Survey, Office of National Statistics, and health economic data from other published studies Participants Adults aged ≥25, stratified by fifths of socioeconomic circumstance. Interventions Total ban on trans fatty acids in processed foods; improved labelling of trans fatty acids; bans on trans fatty acids in restaurants and takeaways. Main outcome measures Deaths from coronary heart disease prevented or postponed; life years gained; quality adjusted life years gained. Policy costs to government and industry; policy savings from reductions in direct healthcare, informal care, and productivity loss. Results A total ban on trans fatty acids in processed foods might prevent or postpone about 7200 deaths (2.6%) from coronary heart disease from 2015-20 and reduce inequality in mortality from coronary heart disease by about 3000 deaths (15%). Policies to improve labelling or simply remove trans fatty acids from restaurants/fast food could save between 1800 (0.7%) and 3500 (1.3%) deaths from coronary heart disease and reduce inequalities by 600 (3%) to 1500 (7%) deaths, thus making them at best half as effective. A total ban would have the greatest net cost savings of about £265m (€361m, $415m) excluding reformulation costs, or £64m if substantial reformulation costs are incurred outside the normal cycle. Conclusions A regulatory policy to eliminate trans fatty acids from processed foods in England would be the most effective and equitable policy option. Intermediate policies would also be beneficial. Simply continuing to rely on industry to voluntary reformulate products, however, could have negative health and economic outcomes. PMID:26374614

  16. Do interventions to increase income improve the health of the poor in developed economies and are such policies cost effective?

    PubMed

    Ludbrook, Anne; Porter, Kathy

    2004-01-01

    Health policy has shifted towards placing a greater emphasis on the role of lifestyle and life circumstances in improving health. The factors that are associated with poor health status are known, but the comparative effectiveness of specific policy interventions in improving health and reducing inequalities in health is unclear. For example, there is little evidence that specific policies aimed at providing income support or poverty eradication have any measurable impact on health. Two previous reviews have addressed the evidence in this area but in a fairly restrictive way. One considered only randomised trials and the other excluded non-cash benefits. This article builds on the previous reviews in three ways: a broader scope of study designs and types of intervention is considered; more recent literature is reviewed; and it considers the extent to which an economic evaluation framework has been applied. A systematic search of electronic databases was carried out for literature published since 1980 and in the English language. Each study was appraised in terms of its relevance to the question of interest, and the quality of the study design was appraised in terms of its capacity to provide robust answers. Few studies were found with health outcomes as their main focus. Most of the studies that used secondary data sources or survey data were of poor quality. Where economic evaluations were reported, these tended to be restricted to financial assessments. Different types of interventions were evaluated. In studies of cash benefits, there was limited evidence that they had a positive effect on some health domains, mainly psychosocial. Studies in welfare-to-work interventions produced mixed results in terms of impact on either income or health; there was no consistent relationship between income gains and health improvements. Five welfare-to-work studies included 'benefit-cost analysis', but these were essentially financial assessments. Studies of benefits in kind did not meet the quality criteria for inclusion in this article. Overall, we found no evidence of the potential cost effectiveness of income support or anti-poverty initiatives in improving health, nor is there a strong effectiveness literature on which to build such analysis. However, the hypothesis that increased income may improve health cannot be said to have been properly tested. Studies generally analyse the incremental effect of changes to the welfare system and do not estimate the health effects of current provisions. The production function for good health is complex. Increasing income may be a necessary, but not a sufficient, condition for the creation of better health in those with low incomes. PMID:15702949

  17. Health Care Cost Containment: Are America's Aged Protected? Hearing before the Select Committee on Aging. House of Representatives, Ninety-Ninth Congress, First Session.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. House Select Committee on Aging.

    This document contains testimony and prepared statements from the Congressional hearing examining the impact on the elderly of the federal health care cost containment measure. Correspondence between the Select Committee on Aging and the Department of Health and Human Services, concerning the government restrictions' harmful effects on the

  18. Estimating the Costs in Lost Power of Alternative Snake-Columbia Basin Management Policies

    NASA Astrophysics Data System (ADS)

    Hanson, R. J.; Millham, C. B.

    1981-10-01

    This work, in part, describes a 51 dam, 56 time period long-range simulation model of the hydropower system in the Snake-Columbia basin, including projects on those two rivers and on major tributaries thereof. The model is then applied to study a series of alternative basin management scenarios, and the consequences in lost power of these scenarios are evaluated economically. With 56 time periods and 51 projects (some having as many as five data sets), computational efficiency in a restricted computing environment is important. Efficiency in this model was achieved via use of `French Curve' cubic spline data fits, together with fast pointers to carefully defined data structures. In addition, care was taken to couch the model in a setting making it accessible to use by nonprogramers, in a quasiconversational mode. Some technical detail on the implementation of the model is included in the paper. Mention is also made of another model developed during this effort, called PASO (Peaking Alternatives System Operation), a heuristic look ahead model now operational and available to interested users. Discussion of the validation procedures for both models is involved. The `firm power' capability of the hydropower system in the Pacific Northwest is that maximal (monthly or biweekly) energy production which the system could produce during a 44½-month `critical period' of extremely low historical flows. In years of higher, more normal flows, the hydropower system can generate power substantially in excess of the firm capability. This `secondary' power ebbs and flows annually as a function of many things, and it therefore seemed most relevant to focus studies of alternative basin management schemes on firm power production. Accordingly, the work assumed the historical flows of the period July 1, 1928-June 30, 1932, a period of time including the critical period. The model and flow data was applied to the series of alternative basin management schemes, each selected for its environmental and/or political interest. The impact of each management scheme was then evaluated in terms of lost or foregone power against a `base regulation' in which the objective was to generate as much power as possible over the critical period. Lost power was conservatively evaluated at 35 mills per lost kilowatt-hour for baseload, with much higher costs possible for lost peaking.

  19. NanoCOT: Low-Cost Nanostructured Electrode Containing Carbon, Oxygen, and Titanium for Efficient Oxygen Evolution Reaction.

    PubMed

    Shan, Zhichao; Archana, Panikar Sathyaseelan; Shen, Gang; Gupta, Arunava; Bakker, Martin G; Pan, Shanlin

    2015-09-23

    Developing high-efficiency, durable, and low-cost catalysts based on earth-abundant elements for the oxygen evolution reaction (OER) is essential for renewable energy conversion and energy storage devices. In this study, we report a highly active nanostructured electrode, NanoCOT, which contains carbon, oxygen, and titanium, for efficient OER in alkaline solution. The NanoCOT electrode is synthesized from carbon transformation of TiO2 in an atmosphere of methane, hydrogen, and nitrogen at a high temperature. The NanoCOT exhibits enhanced OER catalytic activity in alkaline solution, providing a current density of 1.33 mA/cm(2) at an overpotential of 0.42 V. This OER current density of a NanoCOT electrode is about 4 times higher than an oxidized Ir electrode and 15 times higher than a Pt electrode because of its nanostructured high surface area and favorable OER kinetics. The enhanced catalytic activity of NanoCOT is attributed to the presence of a continuous energy band of the titanium oxide electrode with predominantly reduced defect states of Ti (e.g., Ti(1+), Ti(2+), and Ti(3+)) formed by chemical reduction with hydrogen and carbon. The OER performance of NanoCOT can also be further enhanced by decreasing its overpotential by 150 mV at a current density of 1.0 mA/cm(2) after coating its surface electrophoretically with 2.0 nm IrOx nanoparticles. PMID:26340536

  20. Secondary Schools in a County in Kenya Seem to Be Taking Advantages of the Cost Sharing Policy: Understanding Its Practice and Implications

    ERIC Educational Resources Information Center

    Makori, Andrew; Chepchieng, Gideon; Misoi, Pauline; Kiplagat, Rotich

    2015-01-01

    The study set out to research on parents' views regarding the practice of cost sharing policy in secondary schools in Kenya in relation to form one entry items requirement and fee payment. This article reports on its findings. The study adopted a quantitative survey and employed a questionnaire (both closed and open-ended) to collect data. The…

  1. Rigorous Program Evaluations on a Budget: How Low-Cost Randomized Controlled Trials Are Possible in Many Areas of Social Policy

    ERIC Educational Resources Information Center

    Coalition for Evidence-Based Policy, 2012

    2012-01-01

    The increasing ability of social policy researchers to conduct randomized controlled trials (RCTs) at low cost could revolutionize the field of performance-based government. RCTs are widely judged to be the most credible method of evaluating whether a social program is effective, overcoming the demonstrated inability of other, more common methods…

  2. Greenhouse effect and coastal wetland policy: How Americans could abandon an area the size of Massachusetts at minimum cost

    NASA Astrophysics Data System (ADS)

    Titus, James G.

    1991-01-01

    Climatologists generally expect an anthropogenic global warming that could raise sea level 30-150 cm in the next century and more thereafter. One of the impacts would be the loss of coastal wetlands. Although the inundation of adjacent dryland would enable new wetlands to form, much of this land is or will soon be developed. If developed areas are protected, wetlands will be squeezed between an advancing sea and the land being protected, which has already happened in China and the Netherlands, where people have built dikes for centuries. Unlike those countries, the United States has enough land to accommodate the landward migration of wetlands; but governments lack the funds to purchase all the coastal lowlands that might be inundated and the legal authority to prohibit their development. We propose a third approach: allowing property owners to use coastal lowlands today as they choose, but setting up a legal mechanism to ensure that the land is abandoned if and when sea level rises enough to inundate it. Although compensation may be required, this approach would cost less than 1% as much as purchasing the land, and would be (1) economically efficient by enabling real estate markets to incorporate expectations of future sea level rise; (2) constitutional by compensating property owners; and (3) politically feasible by pleasing people who care about the long-term fate of the coastal environment without disturbing people who either are unconcerned about the distant future or do not believe sea level will rise. This article demonstrates that it would be irrational to delay policy formulation until sea level rise projections are more precise. The cost will be small if we act now but great if we wait, and sea level is already rising along most coasts. The US government should develop a strategy in the next three years.

  3. Health-related external cost assessment in Europe: methodological developments from ExternE to the 2013 Clean Air Policy Package.

    PubMed

    van der Kamp, Jonathan; Bachmann, Till M

    2015-03-01

    "Getting the prices right" through internalizing external costs is a guiding principle of environmental policy making, one recent example being the EU Clean Air Policy Package released at the end of 2013. It is supported by impact assessments, including monetary valuation of environmental and health damages. For over 20 years, related methodologies have been developed in Europe in the Externalities of Energy (ExternE) project series and follow-up activities. In this study, we aim at analyzing the main methodological developments over time from the 1990s until today with a focus on classical air pollution-induced human health damage costs. An up-to-date assessment including the latest European recommendations is also applied. Using a case from the energy sector, we identify major influencing parameters: differences in exposure modeling and related data lead to variations in damage costs of up to 21%; concerning risk assessment and monetary valuation, differences in assessing long-term exposure mortality risks together with assumptions on particle toxicity explain most of the observed changes in damage costs. These still debated influencing parameters deserve particular attention when damage costs are used to support environmental policy making. PMID:25664763

  4. Cost assessment of the movement restriction policy in France during the 2006 bluetongue virus episode (BTV-8).

    PubMed

    Tago, Damian; Hammitt, James K; Thomas, Alban; Raboisson, Didier

    2014-12-01

    This study aims at evaluating the costs of the movement restriction policy (MRP) during the 2006 BTV-8 epidemic in France for the producers of 6-9 month old Charolais beef weaned calves (BWC), an important sector that was severely affected by the restrictions imposed. This study estimates the change in the number of BWC sold that was due to the movement restrictions, and evaluates the economic effect of the MRP. The change in BWC sold by producers located inside the restriction zone (RZ) was analyzed for 2006 by using a multivariate matching approach to control for any internal validity threat. The economic evaluation of the MRP was based on several scenarios that describe farms' capacity constraints, feeding prices, and the animal's selling price. Results show that the average farmer experienced a 21% decrease in animals sold due to the MRP. The economic evaluation of the MRP shows a potential gain during the movement standstill period in the case of no capacity constraint faced by the farm and food self-sufficiency. This gain remains limited and close to zero in case of a low selling price and when animals are held until they no longer fit the BWC market so that they cannot be sold as an intermediate product. Capacity constraints represent a tremendous challenge to farmers facing movement restrictions and the fattening profit becomes negative under such conditions. The timing and length of the movement standstill period significantly affect the profitability of the strategy employed by the farmer: for a 5.5 month-long standstill period with 3.5 months of cold weather, farmers with capacity constraints have stronger incentives to leave their animals outside during the whole period and face higher mortality and morbidity rates than paying for a boarding facility for the cold months. This is not necessarily true for a shorter standstill period. Strategies are also sensitive to the feed costs and to the food self-sufficiency of the farm. Altogether, the present work shows the farmer's vulnerability to animal movement restrictions and quantifies the costs of the standstill. These results should assist decision-makers who seek to calculate adequate subsidies/aid or to efficiently allocate resources to prevent future outbreaks. PMID:25458706

  5. Commercial Insurance vs Community-Based Health Plans: Time for a Policy Option With Clinical Emphasis to Address the Cost Spiral

    ERIC Educational Resources Information Center

    Amundson, Bruce

    2005-01-01

    The nation continues its ceaseless struggle with the spiraling cost of health care. Previous efforts (regulation, competition, voluntary action) have included almost every strategy except clinical. Insurers have largely failed in their cost-containment efforts. There is a strong emerging body of literature that demonstrates the relationship…

  6. Public College and University Procurement: A Survey of the State Regulatory Environment, Institutional Procurement Practices and Efforts toward Cost Containment

    ERIC Educational Resources Information Center

    American Association of State Colleges and Universities, 2010

    2010-01-01

    This study contends that one area rich for reform and cost-saving opportunities is college and university procurement--the billions of dollars public institutions spend annually to purchase goods and services. While considerable cost savings may be realized in the reform of current procurement practices, these practices are largely shaped by state…

  7. The Reduction of Faculty Reassigned Time as a Community College Cost Containment Initiative: A Case Study of the Maricopa County Community College District.

    ERIC Educational Resources Information Center

    Petrowsky, Michael C.

    This paper argues that community colleges can contain costs by reducing faculty reassigned time, defined as a conscious or deliberate management action, either discretionary or mandated, that releases full-time faculty from teaching duties in order to perform other tasks. According to the paper, standard financial accounting systems have a…

  8. US-Japan energy policy dialogue. [Contains a list of attendees, agenda, report summaries, and a financial report

    SciTech Connect

    Guertin, Donald L.; Davis, W. Kenneth; Ikuta, Toyoaki

    1993-03-16

    The Atlantic Council has cooperated in an ongoing dialogue on energy policy issues with key Japanese organizations for the past twelve years. These Japanese organizations are the Committee for Energy Policy Promotion (CEPP) and the Institute of Energy Economics (IEE). The members of CEPP are major energy supplier and user companies. The IEE conducts sophisticated research and prepares policy papers on a range of international and Japanese energy issues. This energy dialogue is the only long-term US-Japan dialogue which engages CEPP/IEE members. Over the past twelve years the US-Japan energy dialogue has met seventeen times, with alternating meetings held in Tokyo, Hawaii, and Washington, DC. While the dialogue is a private sector activity, US and Japanese government officials are kept informed on the program and are invited to participate in the meetings in Washington and Tokyo. Major benefits of this activity have included: Establishment of close working relationships among Japanese and US private sector energy institutions and experts; exchange of papers on energy issues among participants and on a selected basis to others in the private and governmental sectors; facilitation of separate US-Japanese work on policy issues - for example a joint US-Japan cooperative policy paper on global climate change published in 1991, some government representatives participated in a May 1991 meeting on this subject. Encouragement of Japanese participation in separate Atlantic Council programs on US energy policy imperatives (1990); technology cooperation with developing countries in the field of energy supply and use for sustainable development (1992); creation of a World Energy Efficiency Association (1993); and a US-Japan-Newly Independent States project on NIS energy policy (1992--1994).

  9. An assessment of electric vehicles: technology, infrastructure requirements, greenhouse-gas emissions, petroleum use, material use, lifetime cost, consumer acceptance and policy initiatives.

    PubMed

    Delucchi, M A; Yang, C; Burke, A F; Ogden, J M; Kurani, K; Kessler, J; Sperling, D

    2014-01-13

    Concerns about climate change, urban air pollution and dependence on unstable and expensive supplies of foreign oil have led policy-makers and researchers to investigate alternatives to conventional petroleum-fuelled internal-combustion-engine vehicles in transportation. Because vehicles that get some or all of their power from an electric drivetrain can have low or even zero emissions of greenhouse gases (GHGs) and urban air pollutants, and can consume little or no petroleum, there is considerable interest in developing and evaluating advanced electric vehicles (EVs), including pure battery-electric vehicles, plug-in hybrid electric vehicles and hydrogen fuel-cell electric vehicles. To help researchers and policy-makers assess the potential of EVs to mitigate climate change and reduce petroleum use, this paper discusses the technology of EVs, the infrastructure needed for their development, impacts on emissions of GHGs, petroleum use, materials use, lifetime costs, consumer acceptance and policy considerations. PMID:24298079

  10. Containing health care costs--a critical test of the public-private joint venture in health.

    PubMed

    Derzon, R A

    1980-05-01

    As the federal government shifted from its traditional roles in health to the payment for personal health care, the relationship between public and private sectors has deteriorated. Today federal and state revenue funds and trusts are the largest purchasers of services from a predominantly private health system. This financing or "gap-filling" role is essential; so too is the purchaser's concern for the costs and prices it must meet. The cost per person for personal health care in 1980 is expected to average $950, triple for the aged. Hospital costs vary considerably and inexplicably among states; California residents, for example, spend 50 percent more per year for hospital care than do state of Washington residents. The failure of each sector to understand the other is potentially damaging to the parties and to patients. First, and most important, differences can and must be moderated through definite changes in the attitudes of the protagonists. PMID:6770551

  11. An Introduction to Benefit-Cost Analysis for Evaluating Public Expenditure Alternatives. Learning Packages in the Policy Sciences, PS-22.

    ERIC Educational Resources Information Center

    LaPlante, Josephine M.; Durham, Taylor R.

    A revised edition of PS-14, "An Introduction to Benefit-Cost Analysis for Evaluating Public Programs," presents concepts and techniques of benefit-cost analysis as tools that can be used to assist in deciding between alternatives. The goals of the new edition include teaching students to think about the possible benefits and costs of each…

  12. Health Care Cost Containment: Dilemmas and Solutions. Midwest Alliance in Nursing Fall Workshop (Dearborn, Michigan, September 1983).

    ERIC Educational Resources Information Center

    Minckley, Barbara B., Ed.; Walters, Mary Dale, Ed.

    Focusing on various issues related to rapidly rising health care costs, and the dilemmas these pose for health care professionals these proceedings include the following papers: (1) "A Federal Perspective: Nursing under Prospective Payment," by Carolyne K. Davis; (2) "Providers' Panel: Facing the Issues," by Connie Curran, Jeptha Dalston, David…

  13. The impact of cost recovery and sharing system on water policy implementation and human right to water: a case of Ileje, Tanzania.

    PubMed

    Kibassa, Deusdedit

    2011-01-01

    In Tanzania, the National Water Policy (NAWAPO) of 2002 clearly stipulates that access to water supply and sanitation is a right for every Tanzanian and that cost recovery is the foundation of sustainable service delivery. To meet these demands, water authorities have introduced cost recovery and a water sharing system. The overall objective of this study was to assess the impact of cost recovery and the sharing system on water policy implementation and human rights to water in four villages in the Ileje district. The specific objectives were: (1) to assess the impact of cost recovery and the sharing system on the availability of water to the poor, (2) to assess user willingness to pay for the services provided, (3) to assess community understanding on the issue of water as a human right, (4) to analyse the implications of the results in relation to policies on human rights to water and the effectiveness of the implementation of the national water policy at the grassroots, and (5) to establish the guidelines for water pricing in rural areas. Questionnaires at water demand, water supply, ability and willingness to pay and revenue collection were the basis for data collection. While 36.7% of the population in the district had water supply coverage, more than 73,077 people of the total population of 115,996 still lacked access to clean and safe water and sanitation services in the Ileje district. The country's rural water supply coverage is 49%. Seventy-nine percent of the interviewees in all four villages said that water availability in litres per household per day had decreased mainly due to high water pricing which did not consider the income of villagers. On the other hand, more than 85% of the villagers were not satisfied with the amount they were paying because the services were still poor. On the issue of human rights to water, more than 92% of the villagers know about their right to water and want it exercised by the government. In all four villages, more than 78% of the interviewees are willing to payforwater provided that the tariffs are affordable. Water policy implementation continues slowly: regardless of the fact that more than five years have passed since policy inception, 60% of the villagers in Itumba still have no water services at all. The study shows that government fulfilment of human rights to water has a long way to go, especially in rural areas where people cannot afford to pay for water and some of the villages still depend on water from wells and seasonal rivers. PMID:22049743

  14. ''When Cost Measures Contradict''

    SciTech Connect

    Montgomery, W. D.; Smith, A. E.; Biggar, S. L.; Bernstein, P. M.

    2003-05-09

    When regulators put forward new economic or regulatory policies, there is a need to compare the costs and benefits of these new policies to existing policies and other alternatives to determine which policy is most cost-effective. For command and control policies, it is quite difficult to compute costs, but for more market-based policies, economists have had a great deal of success employing general equilibrium models to assess a policy's costs. Not all cost measures, however, arrive at the same ranking. Furthermore, cost measures can produce contradictory results for a specific policy. These problems make it difficult for a policy-maker to determine the best policy. For a cost measures to be of value, one would like to be confident of two things. First one wants to be sure whether the policy is a winner or loser. Second, one wants to be confident that a measure produces the correct policy ranking. That is, one wants to have confidence in a policy measure's ability to correctly rank policies from most beneficial to most harmful. This paper analyzes empirically these two properties of different costs measures as they pertain to assessing the costs of the carbon abatement policies, especially the Kyoto Protocol, under alternative assumptions about implementation.

  15. Relative cost-effectiveness of using an extensively hydrolyzed casein formula containing the probiotic Lactobacillus rhamnosus GG in managing infants with cow’s milk allergy in Spain

    PubMed Central

    Guest, Julian F; Weidlich, Diana; Mascuñan Díaz, J Ignacio; Díaz, Juan J; Ojeda, Pedro Manuel; Ferrer-González, J Pablo; Gil, David; Onrubia, Isabel; Rincón Victor, Pedro

    2015-01-01

    Objective To estimate the cost-effectiveness of using an extensively hydrolyzed casein formula containing the probiotic Lactobacillus rhamnosus GG (eHCF + LGG; Nutramigen LGG) as a first-line management for cow’s milk allergy compared with eHCF alone, and amino acid formulae in Spain, from the perspective of the Spanish National Health Service (SNS). Methods Decision modeling was used to estimate the probability of immunoglobulin E (IgE)-mediated and non–IgE-mediated allergic infants developing tolerance to cow’s milk by 18 months. The models also estimated the SNS cost (at 2012/2013 prices) of managing infants over 18 months after starting a formula as well as the relative cost-effectiveness of each of the formulae. Results The probability of developing tolerance to cow’s milk by 18 months was higher among infants with either IgE-mediated or non–IgE-mediated allergy who were fed eHCF + LGG compared with those fed one of the other formulae. The total health care cost of initially feeding infants with eHCF + LGG was less than that of feeding infants with one of the other formulae. Hence, eHCF + LGG affords the greatest value for money to the SNS for managing both IgE-mediated and non–IgE-mediated cow’s milk allergy. Conclusion Using eHCF + LGG instead of eHCF alone or amino acid formulae for first-line management of newly-diagnosed infants with cow’s milk allergy affords a cost-effective use of publicly funded resources because it improves outcome for less cost. A randomized controlled study showing faster tolerance development in children receiving a probiotic-containing formula is required before this conclusion can be confirmed. PMID:26648744

  16. Cost-Effectiveness Analysis and Educational Policy--Profusion, Confusion, Promise. Research and Development Memorandum No. 41.

    ERIC Educational Resources Information Center

    Levin, Henry M.

    This paper applies cost-effectiveness analytic techniques to decisions on teacher recruitment and retention. The data are derived from the U.S. Office of Education's Survey of Equal Opportunity for the school year 1965-66. Evidence relating teacher characteristics to student achievement is combined with data on the costs of obtaining teachers with…

  17. Costs associated with implementation of a strict policy for controlling spread of highly resistant microorganisms in France

    PubMed Central

    Birgand, Gabriel; Leroy, Christophe; Nerome, Simone; Luong Nguyen, Liem Binh; Lolom, Isabelle; Armand-Lefevre, Laurence; Ciotti, Céline; Lecorre, Bertrand; Marcade, Géraldine; Fihman, Vincent; Nicolas-Chanoine, Marie-Hélène; Pelat, Camille; Perozziello, Anne; Fantin, Bruno; Yazdanpanah, Yazdan; Ricard, Jean-Damien; Lucet, Jean-Christophe

    2016-01-01

    Objective To assess costs associated with implementation of a strict ‘search and isolate’ strategy for controlling highly drug-resistant organisms (HDRO). Design Review of data from 2-year prospective surveillance (01/2012 to 12/2013) of HDRO. Setting Three university hospitals located in northern Paris. Methods Episodes were defined as single cases or outbreaks of glycopeptide-resistant enterococci (GRE) or carbapenemase-producing Enterobacteriacae (CPE) colonisation. Costs were related to staff reinforcement, costs of screening cultures, contact precautions and interruption of new admissions. Univariate analysis, along with simple and multiple linear regression analyses, was conducted to determine variables associated with cost of HDRO management. Results Overall, 41 consecutive episodes were included, 28 single cases and 13 outbreaks. The cost (mean±SD) associated with management of a single case identified within and/or 48 h after admission was €4443±11 552 and €11 445±15 743, respectively (p<0.01). In an outbreak, the total cost varied from €14 864 ±17 734 for an episode with one secondary case (€7432±8867 per case) to €136 525 ±151 231 (€12 845±5129 per case) when more than one secondary case occurred. In episodes of single cases, contact precautions and microbiological analyses represented 51% and 30% of overall cost, respectively. In outbreaks, cost related to interruption of new admissions represented 77–94% of total costs, and had the greatest financial impact (R2=0.98, p<0.01). Conclusions In HDRO episodes occurring at three university hospitals, interruption of new admissions constituted the most costly measure in an outbreak situation. PMID:26826145

  18. Relative cost-effectiveness of an extensively hydrolyzed casein formula containing the probiotic Lactobacillus rhamnosus GG in managing infants with cow’s milk allergy in Italy

    PubMed Central

    Guest, Julian F; Panca, Monica; Ovcinnikova, Olga; Nocerino, Rita

    2015-01-01

    Objective To estimate the cost-effectiveness of using an extensively hydrolyzed casein formula (eHCF) containing the probiotic Lactobacillus rhamnosus GG, (eHCF + LGG; Nutramigen LGG) as first-line management for cow’s milk allergy (CMA) compared with eHCF alone, soy-based formulae (SBF), hydrolyzed rice formulae (HRF), and amino acid formulae (AAF) in Italy, from the perspective of the Italian National Health Service (INHS) and parents. Methods Decision modeling was used to estimate the probability of infants developing tolerance to cow’s milk by 18 months, based on an observational study dataset. The model also estimated the cost (at 2012/2013 prices) of health care resource use funded by the INHS and formulae paid for by parents over 18 months after starting a formula, as well as the relative cost-effectiveness of each of the formulae. Results The probability of developing tolerance to cow’s milk by 18 months was higher among infants with either IgE-mediated or non-IgE-mediated allergy who were fed eHCF + LGG compared to those fed one of the other formulae. The total health care cost of initially feeding infants with eHCF + LGG was less than that of feeding infants with one of the other formulae. Hence, eHCF + LGG affords the greatest value for money to both the INHS and parents of infants with either IgE-mediated or non-IgE-mediated CMA. Conclusion Using eHCF + LGG instead of eHCF, SBF, HRF, or an AAF for first-line management of newly diagnosed infants with CMA in Italy affords a cost-effective use of publicly funded resources, and is cost-effective from the parents’ perspective, since it improves outcome for less cost. A randomized controlled study showing faster tolerance development in children receiving a probiotic-containing formula is required before this conclusion can be confirmed. PMID:26089692

  19. Save a Penny, Lose a School: The Real Cost of Deferred Maintenance. Policy Brief Series on Rural Education.

    ERIC Educational Resources Information Center

    Lawrence, Barbara Kent

    Deferring maintenance in small rural schools creates poor conditions that can affect the health and safety of everyone who uses the facility, damage the morale of students and teachers, impair their ability to teach and learn, and threaten the facility itself. Numerous recommendations for policy changes that affect maintenance are presented. A…

  20. Diabetes in Algeria and challenges for health policy: a literature review of prevalence, cost, management and outcomes of diabetes and its complications

    PubMed Central

    2014-01-01

    Background Diabetes has become an increasingly prevalent and severe public health issue in Algeria. This article investigates the prevalence, the cost and the management of this disease. Its first objective is to better understand the burden (both from an epidemiological and economic perspective) and management of diabetes. The second objective is to understand the health policy strategy adopted by Algeria in order to respond to the disease. Methods We conducted a literature review of prevalence, costs, management and outcomes of diabetes and its complications. This was complemented by data compilations and results of expert consultations. Results The epidemiology of diabetes is continually evolving and is becoming more problematic. The national evidence suggests that the prevalence of diabetes in Algeria has increased from 6.8% in 1990 to 12.29% in 2005, but is quite higher among certain groups and areas of the country. This disease affects all population groups, especially 35–70 year olds, who constitute a large segment of the working population. There are very few estimates of the cost of diabetes. These include a 1998 study on the total cost of type 1 diabetes (USD 11.6 million, which, inflated to 2013 value, totals to USD 16.6 million), a study on the cost of complications in 2010 (at 2013 value, ranging from USD 141 for first-year treatment of peripheral vascular disease to USD 30,441 for first-year cost of renal transplantation) and the 2013 IDF estimates of total cost of type 1 and type 2 diabetes (USD 513 million). Conclusions As the prevalence of diabetes continues to increase, the financial burden will increasingly weigh heavily on social security resources and the government budget. Future priorities must focus on empowering general practitioners in treating type 2 diabetes, improving screening of diabetes and its complications, tackling the growing obesity epidemic, strengthening health information systems and implementing the national diabetes prevention and control plan. PMID:24564974

  1. Spallation Neutron Source high-power Rf transmitter design for high availablility, ease of installation and cost containment

    SciTech Connect

    Bradley, J. T. , III; Rees, D. E.; Hardek, T. W.; Lynch, M. T.; Roybal, W. T.; Tallerico, P. J.

    2003-01-01

    The availability goals and installation schedule for the Spallation Neutron Source (SNS) have driven the availability and installation of the SNS linac's high-power RF systems. This paper discusses how the high-power RF systems' availability and installation goals have been addressed in the RF transmitter design and procurement. Design features that allow R1; component failures to be quickly diagnosed and repaired are also presented. Special attention has been given lo interlocks, PLC fault logging and real-time interfaces to thc accelerator's Experimental Physics and Industrial Control System (EPICS) archive system. The availability and cost motivations for the use of different RF transmitter designs in the normalconducting and super-conducting sections of the linac are reviewed. Factory iicceptance tests used to insure fully functional equipment and thereby reduce the time spent on installation and cotnmissioning of the RF transmitters are discussed. Transmitter installation experience and klystron conditioning experience is used to show how these design features have helped and will continue to help the SNS linac to meet its availability and schedule goals.

  2. Engineering and environmental properties of thermally treated mixtures containing MSWI fly ash and low-cost additives.

    PubMed

    Polettini, A; Pomi, R; Trinci, L; Muntoni, A; Lo Mastro, S

    2004-09-01

    An experimental work was carried out to investigate the feasibility of application of a sintering process to mixtures composed of Municipal Solid Waste Incinerator (MSWI) fly ash and low-cost additives (waste from feldspar production and cullet). The proportions of the three constituents were varied to adjust the mixture compositions to within the optimal range for sintering. The material was compacted in cylindrical specimens and treated at 1100 and 1150 degrees C for 30 and 60 min. Engineering and environmental characteristics including weight loss, dimensional changes, density, open porosity, mechanical strength, chemical stability and leaching behavior were determined for the treated material, allowing the relationship between the degree of sintering and both mixture composition and treatment conditions to be singled out. Mineralogical analyses detected the presence of neo-formation minerals from the pyroxene group. Estimation of the extent of metal loss from the samples indicated that the potential for volatilization of species of Pb, Cd and Zn is still a matter of major concern when dealing with thermal treatment of incinerator ash. PMID:15268956

  3. PPD-QALY-an index for cost-effectiveness in orthopedics: providing essential information to both physicians and health care policy makers for appropriate allocation of medical resources.

    PubMed

    Dougherty, Christopher P; Howard, Timothy

    2013-09-01

    Because of the increasing health care costs and the need for proper allocation of resources, it is important to ensure the best use of health benefits for sick and injured people of the population. An index or indicator is needed to help us quantify what is being spent so that comparisons with other options can be implemented. Cost-effective analysis seems to be well suited to provide this essential information to health care policy makers and those charged with distributing disability funds so that the proper allocation of resources can be achieved. There is currently no such index to show whether the benefits paid out are the most cost-effective. By comparing the quality-adjusted life year (QALY) of a treatment method to the disability an individual would experience, on the basis of lost wages as measure of disability, we provide decision makers more information for the basis of cost allocation in health care. To accomplish this, we describe a new term, the PPD-QALY (permanent partial disability-quality of life year). This term was developed to establish an index to which musculoskeletal care can be compared, to evaluate the cost-effectiveness of a treatment on the basis of the monetary value of the disability. This term serves to standardize the monetary value of an injury. Cost-effective analysis in arthroscopic surgery may prove to be a valuable asset in this role and to provide decision makers the information needed to determine the societal benefit from new arthroscopic procedures as they are developed and implemented. PMID:23924750

  4. Why do women pay more than they should? A mixed methods study of the implementation gap in a policy to subsidize the costs of deliveries in Burkina Faso.

    PubMed

    Ridde, Valéry; Kouanda, Seni; Yameogo, Maurice; Kadio, Kadidiatou; Bado, Aristide

    2013-02-01

    In 2007, Burkina Faso launched a public policy to subsidize 80% of the cost of normal deliveries. Although women are required to pay only the remaining 20%, i.e., 900F CFA (1.4 Euros), some qualitative evidence suggests they actually pay more. The aim of this study is to test and then (if confirmed) to understand the hypothesis that the amounts paid by women are more than the official fee, i.e., their 20% portion. A mixed method sequential explanatory design giving equal priority to both quantitative (n=883) and qualitative (n=50) methods was used in a rural health district of Ouargaye. Half (50%, median) of the women reported paying more than the official fee for a delivery. Health workers questioned the methodology of the study and the veracity of the women's reports. The three most plausible explanations for this payment disparity are: (i) the payments were for products used that were not part of the delivery kit covered by the official fee; (ii) the implementers had difficulty in understanding the policy; and (iii) there was improper conduct on the part of some health workers. Institutional design and organizational practices, as well as weak rule enforcement and organizational capacity, need to be considered more carefully to avoid an implementation gap in this public policy. PMID:23123308

  5. The Costs of Implementing Federally Mandated Social Programs at Colleges and Universities. Policy Analysis Service Special Report.

    ERIC Educational Resources Information Center

    Van Alstyne, Carol; Coldren, Sharon L.

    Federally mandated social programs that apply to colleges and universities because they are treated as business entities are covered in this report. These programs have contributed to the continually increasing operating costs of colleges and universities over the last decade. This study aims at providing quantified examples of these cost…

  6. Pursuing cost containment in a pluralistic payer environment: from the aftermath of Clinton's failure at health care reform to the Balanced Budget Act of 1997.

    PubMed

    Mayes, Rick; Hurley, Robert E

    2006-07-01

    Following a decade in which Medicare operated as the leading 'change agent' within the US health care system, the private sector rose to the fore in the mid 1990s. The failure of President Clinton's attempt at comprehensive, public sector-led reform left managed care as the solution for cost control. And for a period it worked, largely because managed care organizations were able to both squeeze payments to selective networks of medical providers and significantly reduce inpatient hospital stays. There was a lot of 'fat' in the nation's convoluted health care system that could be (and was) eliminated through competitive negotiations between medical providers and insurers, employers, or managed care organizations. One of our primary arguments in this article is that managed care operated partly as a systematic suppression of price discrimination or differential pricing (often referred to as 'cost shifting'), as managed care organizations qua purchasing agents prevented hospitals and physicians from summarily raising prices to private payers to meet their financial requirements. Over time, however, managed care fell victim to inflated expectations, its own initial success, and larger fiscal forces. During this same period, Republicans and Democrats struggled to reach a consensus over the future direction of Medicare. Their disagreements contributed to the impasse over budget policy in 1995 and the infamous partial federal government shutdown. After President Clinton's reelection in 1996, partisan disagreements over Medicare dissipated. And, in 1997, Congress and the president passed the Balanced Budget Act of 1997, which emerged as a massive piece of patchwork legislation that sought to balance the federal budget, rein in Medicare spending, and increase the number of the programme's beneficiaries in private health plans. PMID:18634695

  7. Titrating versus targeting home care services to frail elderly clients: an application of agency theory and cost-benefit analysis to home care policy.

    PubMed

    Weissert, William; Chernew, Michael; Hirth, Richard

    2003-02-01

    The article summarizes the shortcomings of current home care targeting policy, provides a conceptual framework for understanding the sources of its problems, and proposes an alternative resource allocation method. Methods required for different aspects of the study included synthesis of the published literature, regression analysis of risk predictors, and comparison of actual resource allocations with simulated budgets. Problems of imperfect agency ranging from unclear goals and inappropriate incentives to lack of information about the marginal effectiveness of home care could be mitigated with an improved budgeting method that combines client selection and resource allocation. No program can produce its best outcome performance when its goals are unclear and its technology is unstandardized. Titration of care would reallocate resources to maximize marginal benefit for marginal cost. PMID:12611411

  8. Access, Cost and Quality: Tensions in the Development of Primary Education in Kenya

    ERIC Educational Resources Information Center

    Somerset, Anthony

    2011-01-01

    Throughout Kenya's history, tensions between two goals have characterised the educational policy debate: first, the expansion of access; second, the containment of costs. During the colonial period, cost-containment predominated, leading to severe restrictions on access and massive unmet social demand. Then, during post-Independence years,…

  9. The cost effectiveness of a policy to store carbon in Australian agricultural soils to abate greenhouse gas emissions

    NASA Astrophysics Data System (ADS)

    White, Robert E.; Davidson, Brian

    2015-07-01

    Data for cropping and pastoral enterprises in south eastern Australia were used in a cost-effectiveness analysis to assess the feasibility of abating greenhouse gas (GHG) emissions through storing soil carbon (C) as soil organic matter under the Australian government's Carbon Farming Initiative. We used the C credit value for 2013-14 of 24.15 per tonne of CO2- equivalent (CO2-e) and a C storage rate of 0.5 tonne C/hectare/year for conversion of cropland to pasture. Given that a change of enterprise is driven primarily by farmer returns, we found that none of the changes were feasible at current prices, with the exception of wheat to cattle or sheep in an irrigated system, and dryland cotton to cattle or sheep. Given that our model scenario assumed the most favourable economic factors, it is unlikely that increased soil C storage through a change from cropping to pasture can make a significant contribution to abating Australia's CO2 emissions. However, of greater concern to society is the methane emissions from grazing cattle or sheep, which would negate any gain in soil C under pasture, except for a switch from dryland cropping to sheep.

  10. The Impact of Policy and Institutional Environment on Costs and Benefits of Sustainable Agricultural Land Uses: The Case of the Chittagong Hill Tracts, Bangladesh

    NASA Astrophysics Data System (ADS)

    Rasul, Golam; Thapa, Gopal B.

    2007-08-01

    As in other mountain regions of Asia, agricultural lands in the Chittagong Hill Tracts (CHT) of Bangladesh are undergoing degradation due primarily to environmentally incompatible land-use systems such as shifting cultivation ( jhum) and annual cash crops. The suitable land-use systems such as agroforestry and timber tree plantation provide benefit to the society at large, but they might not provide attractive economic benefits to farmers, eventually constraining a wide-scale adoption of such land-use systems. Therefore, it is essential to evaluate agricultural land-use systems from both societal and private perspectives in the pursuit of promoting particularly environmentally sustainable systems. This article evaluated five major land-use systems being practiced in CHT, namely jhum, annual cash crops, horticulture, agroforestry, and timber plantation. The results of the financial analysis revealed the annual cash crops as the most attractive land use and jhum as the least attractive of the five land-use systems considered under the study. Horticulture, timber plantation, and agroforestry, considered to be suitable land-use systems particularly for mountainous areas, held the middle ground between these two systems. Annual cash crops provided the highest financial return at the cost of a very high rate of soil erosion. When the societal cost of soil erosion is considered, annual cash crops appear to be the most costly land-use system, followed by jhum and horticulture. Although financially less attractive compared to annual cash crops and horticulture, agroforestry and timber plantation are the socially most beneficial land-use systems. Findings of the alternative policy analyses indicate that there is a good prospect for making environmentally sustainable land-use systems, such as agroforestry and timber plantation, attractive for the farmers by eliminating existing legal and institutional barriers, combined with the provision of necessary support services and facilities.

  11. GME: at what cost?

    PubMed

    Young, David W

    2003-11-01

    Current computing methods impede determining the real cost of graduate medical education. However, a more accurate estimate could be obtained if policy makers would allow for the application of basic cost-accounting principles, including consideration of department-level costs, unbundling of joint costs, and other factors. PMID:14626704

  12. Estimating the Potential Health Impact and Costs of Implementing a Local Policy for Food Procurement to Reduce the Consumption of Sodium in the County of Los Angeles

    PubMed Central

    Kuo, Tony; Dunet, Diane; Schmidt, Steven M.; Simon, Paul A.; Fielding, Jonathan E.

    2011-01-01

    Objectives. We examined approaches to reduce sodium content of food served in settings operated or funded by the government of the County of Los Angeles, California. Methods. We adapted health impact assessment methods to mathematically simulate various levels of reduction in the sodium content of food served by the County of Los Angeles and to estimate the reductions’ potential impacts on mean systolic blood pressure (SBP) among food-service customers. We used data provided by county government food-service vendors to generate these simulations. Results. Our analysis predicted that if the postulated sodium-reduction strategies were implemented, adults would consume, on average, 233 fewer milligrams of sodium each day. This would correspond to an average decrease of 0.71 millimeters of mercury in SBP among adult hypertensives, 388 fewer cases of uncontrolled hypertension in the study population, and an annual decrease of $629 724 in direct health care costs. Conclusions. Our findings suggest that a food-procurement policy can contribute to positive health and economic effects at the local level. Our approach may serve as an example of sodium-reduction analysis for other jurisdictions to follow. PMID:21680933

  13. Looking Back, Going Forward: The Carnegie Commission Tuition Policy. The New Millennium Project on Higher Education Costs, Pricing, and Productivity Working Paper.

    ERIC Educational Resources Information Center

    Wellman, Jane V.

    In thinking about the design of public policy for higher education finance, it may be instructive to look back at the evolution of finance policy and how it has worked over the last three decades of U.S. higher education. The vehicle for this exploration is the tuition policy framework developed by the Carnegie Commission on Higher Education…

  14. Water Use in Enhanced Geothermal Systems (EGS): Geology of U.S. Stimulation Projects, Water Costs, and Alternative Water Use Policies

    DOE Data Explorer

    Schroeder, Jenna N.

    2014-12-16

    According to the Energy Information Administration (EIA) of the U.S. Department of Energy (DOE), geothermal energy generation in the United States is projected to more than triple by 2040 (EIA 2013). This addition, which translates to more than 5 GW of generation capacity, is anticipated because of technological advances and an increase in available sources through the continued development of enhanced geothermal systems (EGSs) and low-temperature resources (EIA 2013). Studies have shown that air emissions, water consumption, and land use for geothermal electricity generation have less of an impact than traditional fossil fuel?based electricity generation; however, the long-term sustainability of geothermal power plants can be affected by insufficient replacement of aboveground or belowground operational fluid losses resulting from normal operations (Schroeder et al. 2014). Thus, access to water is therefore critical for increased deployment of EGS technologies and, therefore, growth of the geothermal sector. This paper examines water issues relating to EGS development from a variety of perspectives. It starts by exploring the relationship between EGS site geology, stimulation protocols, and below ground water loss, which is one of the largest drivers of water consumption for EGS projects. It then examines the relative costs of different potential traditional and alternative water sources for EGS. Finally it summarizes specific state policies relevant to the use of alternative water sources for EGS, and finally explores the relationship between EGS site geology, stimulation protocols, and below ground water loss, which is one of the largest drivers of water consumption for EGS projects.

  15. An open, parallel, randomized, comparative, multicenter study to evaluate the cost-effectiveness, performance, tolerance, and safety of a silver-containing soft silicone foam dressing (intervention) vs silver sulfadiazine cream.

    PubMed

    Silverstein, Paul; Heimbach, David; Meites, Herbert; Latenser, Barbara; Mozingo, David; Mullins, Fred; Garner, Warren; Turkowski, Joseph; Shupp, Jeffrey; Glat, Paul; Purdue, Gary

    2011-01-01

    An open, parallel, randomized, comparative, multicenter study was implemented to evaluate the cost-effectiveness, performance, tolerance, and safety of a silver-containing soft silicone foam dressing (Mepilex Ag) vs silver sulfadiazine cream (control) in the treatment of partial-thickness thermal burns. Individuals aged 5 years and older with partial-thickness thermal burns (2.5-20% BSA) were randomized into two groups and treated with the trial products for 21 days or until healed, whichever occurred first. Data were obtained and analyzed on cost (direct and indirect), healing rates, pain, comfort, ease of product use, and adverse events. A total of 101 subjects were recruited. There were no significant differences in burn area profiles within the groups. The cost of dressing-related analgesia was lower in the intervention group (P = .03) as was the cost of background analgesia (P = .07). The mean total cost of treatment was $309 vs $513 in the control (P < .001). The average cost-effectiveness per treatment regime was $381 lower in the intervention product, producing an incremental cost-effectiveness ratio of $1688 in favor of the soft silicone foam dressing. Mean healing rates were 71.7 vs 60.8% at final visit, and the number of dressing changes were 2.2 vs 12.4 in the treatment and control groups, respectively. Subjects reported significantly less pain at application (P = .02) and during wear (P = .048) of the Mepilex Ag dressing in the acute stages of wound healing. Clinicians reported the intervention dressing was significantly easier to use (P = .03) and flexible (P = .04). Both treatments were well tolerated; however, the total incidence of adverse events was higher in the control group. The silver-containing soft silicone foam dressing was as effective in the treatment of patients as the standard care (silver sulfadiazine). In addition, the group of patients treated with the soft silicone foam dressing demonstrated decreased pain and lower costs associated with treatment. PMID:21979855

  16. Markets and childhood obesity policy.

    PubMed

    Cawley, John

    2006-01-01

    In examining the childhood obesity epidemic from the perspective of economics, John Cawley looks at both possible causes and possible policy solutions that work through markets. The operation of markets, says Cawley, has contributed to the recent increase in childhood overweight in three main ways. First, the real price of food fell. In particular, energy-dense foods, such as those containing fats and sugars, became relatively cheaper than less energy-dense foods, such as fresh fruits and vegetables. Second, rising wages increased the "opportunity costs" of food preparation for college graduates, encouraging them to spend less time preparing meals. Third, technological changes created incentives to use prepackaged food rather than to prepare foods. Several economic rationales justify government intervention in markets to address these problems. First, because free markets generally under-provide information, the government may intervene to provide consumers with nutrition information they need. Second, because society bears the soaring costs of obesity, the government may intervene to lower the costs to taxpayers. Third, because children are not what economists call "rational consumers"--they cannot evaluate information critically and weigh the future consequences of their actions-the government may step in to help them make better choices. The government can easily disseminate information to consumers directly, but formulating policies to address the other two rationales is more difficult. In the absence of ideal policies to combat obesity, the government must turn to "second-best" policies. For example, it could protect children from advertisements for "junk food." It could implement taxes and subsidies that discourage the consumption of unhealthful foods or encourage physical activity. It could require schools to remove vending machines for soda and candy. From the economic perspective, policymakers should evaluate these options on the basis of cost-effectiveness studies. Researchers, however, have as yet undertaken few such studies of obesity-related policy options. Such analyses, once available, will help policymakers achieve the greatest benefit from a fixed budget. PMID:16532659

  17. Have All the Costs of Closing a School Been Considered?

    ERIC Educational Resources Information Center

    Lytton, Michael

    2011-01-01

    Many schools around the world are struggling in the face of reduced funding and fluctuating enrolments. Often, the solution to this unhappy equation is quite simply to shut down facilities. But when all the costs of closing a school are considered--financial, material and human--implementing this policy calls for caution. (Contains 3 footnotes.)

  18. [Healthy pharmaceutical policy].

    PubMed

    Gonzlez Pier, Eduardo

    2008-01-01

    Today, the pharmaceutical industry is experiencing a profound transition. Globalization and technological advancement represent the principal pressures for change in the market, where it is increasingly more difficult for this type of industry to efficiently recoup the growing cost of innovation. Mexico needs to analyze the policy implications of these change factors and promote, in the pharmaceutical market, policies that maximize health gains on invested resources. Pharmaceutical policy offers a rare example for a complementary approach between a sound health policy and an efficient economic policy; that is, a "healthy pharmaceutical policy." PMID:19082260

  19. The Growing Costs and Burden of Family Caregiving of Older Adults: A Review of Paid Sick Leave and Family Leave Policies.

    PubMed

    Chen, Mei-Lan

    2016-06-01

    Many family caregivers of older adults suffer from a high burden of care and struggle with the balance of jobs and caregiving tasks. However, the United States is the only developed country without paid sick leave policies for all workers and their families. The purpose of this article is to review the federal Family and Medical Leave Act (FMLA) and empirical studies about paid sick policy, propose policy recommendations, and provide a starting point for future research. The result has shown that the FMLA only applies to certain employees and the provided leave is unpaid under the act. Working women, Latinos, low-wage workers, and less-educated employees are less likely to access paid sick leave and family leave. Obviously, social injustice exists in the FMLA and paid sick leave policies. This article proposes that the Family and Medical Leave Act coverage should be expanded to protect all workers, especially for primary family caregivers of older adults, regardless of family relationships. Also, paid sick and family leave laws should be passed, and requirements to contribute to a family-friendly workplace added to relieve the growing burden of family caregiving of older adults. Policy recommendations including the exemplar of the San Francisco Paid Sick Leave Ordinance, and suggestions for more comprehensive policies are proposed for federal, state, or/and city legislation. PMID:25335873

  20. The differential impact of low-carbon technologies on climate change mitigation cost under a range of socioeconomic and climate policy scenarios.

    SciTech Connect

    Barron, Robert W.; McJeon, Haewon C.

    2015-05-01

    This paper considers the effect of several key parameters of low carbon energy technologies on the cost of abatement. A methodology for determining the minimum level of performance required for a parameter to have a statistically significant impact on CO2 abatement cost is developed and used to evaluate the impact of eight key parameters of low carbon energy supply technologies on the cost of CO2 abatement. The capital cost of nuclear technology is found to have the greatest impact of the parameters studied. The cost of biomass and CCS technologies also have impacts, while their efficiencies have little, if any. Sensitivity analysis of the results with respect to population, GDP, and CO2 emission constraint show that the minimum performance level and impact of nuclear technologies is consistent across the socioeconomic scenarios studied, while the other technology parameters show different performance under higher population, lower GDP scenarios. Solar technology was found to have a small impact, and then only at very low costs. These results indicate that the cost of nuclear is the single most important driver of abatement cost, and that trading efficiency for cost may make biomass and CCS technologies more competitive.

  1. 48 CFR 9904.417 - Cost of money as an element of the cost of capital assets under construction.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.417...

  2. From heterogeneity to harmonization? Recent trends in European health policy.

    PubMed

    Gerlinger, Thomas; Urban, Hans-Jürgen

    2007-01-01

    In the European Union (EU), health policy and the institutional reform of health systems have been treated primarily as national affairs, and health care systems within the EU thus differ considerably. However, the health policy field is undergoing a dynamic process of Europeanization. This process is stimulated by the orientation towards a more competitive economy, recently inaugurated and known as the Lisbon Strategy, while the regulatory requirements of the European Economic and Monetary Union are stimulating the Europeanization of health policy. In addition, the so-called open method of coordination, representing a new mode of regulation within the European multi-level system, is applied increasingly to the health policy area. Diverse trends are thus emerging. While the Lisbon Strategy goes along with a strategic upgrading of health policy more generally, health policy is increasingly used to strengthen economic competitiveness. Pressure on Member States is expected to increase to contain costs and promote market-based health care provision. PMID:17625641

  3. Operating Policies and Procedures of Computer Data-Base Systems.

    ERIC Educational Resources Information Center

    Anderson, David O.

    Speaking on the operating policies and procedures of computer data bases containing information on students, the author divides his remarks into three parts: content decisions, data base security, and user access. He offers nine recommended practices that should increase the data base's usefulness to the user community: (1) the cost of developing…

  4. University Research: Policies for the Reimbursement of Indirect Costs Need to Be Updated. Report to Congressional Committees. GAO-10-937

    ERIC Educational Resources Information Center

    Needham, John K.

    2010-01-01

    In fiscal year 2007, the majority of the Department of Defense's (DOD) basic research obligations were provided to higher education institutions. DOD reimburses these institutions for both direct and indirect costs for research. Two federal agencies, DOD and the Department of Health and Human Services (HHS), negotiate indirect cost rates used to…

  5. The Cost-Effectiveness of Baccalaureate Programs at Two-Year Public Colleges: A Policy Option to Support the Virginia Higher Education Opportunity Act of 2011

    ERIC Educational Resources Information Center

    Davis, Christopher Scott

    2012-01-01

    The unanimous passing of the Virginia Higher Education Opportunity Act of 2011 highlights the need to create a cost-effective pathway to baccalaureate degree growth. Using an exploratory case study design, this study compared the cost-effectiveness of two baccalaureate degree programs offered by institutions in the State University System of…

  6. Blurred edges to population policies.

    PubMed

    David, H P

    1992-05-01

    Fertility is now below replacement level in most European countries, especially the industrialized ones. In the last 20 years, several countries have developed or improved pronatalist programs containing incentives that are designed to motivate couples to have a 2nd and especially a 3rd child, to maintain a stable population. The WHO Sexuality and Family Planning Unit called a short consultation on this subject last October. What actually constitutes a pronatalist population program and the connections between public policies and private reproductive behavior were not very clear. Nor is it easy to assess the longer--term demographic effects of pronatalist policies or what influences their effectiveness. The outcome usually reflects the country's history, cultural and religious traditions, changes in lifestyle, and the value given to the family and children. Incentives are defined as monetary or nonmonetary inducements to voluntary reproductive behavior that conforms to specified population policies. They may be small or large, in cash or kind, parity-specific or income-linked, immediate or developed, one-time or incremental, or any combination of these. Disincentives are negative sanctions that are either incurred or thought likely as a result of violating the policy. But both incentives and disincentives are difficult to define. Pronatalist policies designed to encourage early marriage and larger families, thereby raising the future total fertility rate should not be confused with traditional social welfare policies designed simply to ease the burden of childbearing. Some policies have both demographic and social welfare aims. Strong pronatalist policies may be linked with restrictions on contraceptive availability and legal abortion. Moreover, other public policies affecting social security, education, employment, housing, regional planning and the emancipation of women may unintentionally influence demographic behavior. Population policies are the product of politics. Often written in ambiguous language and intended to affect society as a whole, they still depend for their outcome on microlevel changes in a couple's perceptions of the costs and benefits of having children. In theory, they can be carried out in many ways but in practice such policies are severely limited by administrative, political, technological, economic, and ethical constraints. One difficulty is that governments is rarely enunciate precise goals. Their approach may range from noninterference in private reproductive behavior to total coercion using controls ranging from traditional cultural influences to imposition of fertility regulations. In some countries, fertility rates have increased briefly (in terms of period rates) following introduction of pronatalist policies. However, it is not clear how the rates were influenced, particularly in the case of parities 1, 2, and 3. A forthcoming report will describe experiences in Bulgaria, France, Germany, Sweden, and Norway. PMID:12222234

  7. Camping impact management at Isle Royale National Park: an evaluation of visitor activity containment policies from the perspective of social conditions

    USGS Publications Warehouse

    Farrell, T.A.; Marion, J.L.

    2000-01-01

    A survey of backcountry and wilderness campsites at Isle Royale National Park reveals that the park?s policies for managing visitor impacts have been remarkably effective in limiting the areal extent of camping-related disturbance. However, the dense spatial arrangement of designated campsites within backcountry campgrounds has also contributed to problems with visitor crowding and conflict. Only 9% of the sites had no other sites visible, while 22% had three or more other sites visible. Mean intersite distance was only 76 feet, and 34% of the sites are within 50 feet of another site. Visitor education programs and selected relocation of sites could reduce these social problems.

  8. Chiropractic Health Care: A National Study of Cost of Education, Service Utilization, Number of Practicing Doctors of Chiropractic, and Other Key Policy Issues. Volumes I-II.

    ERIC Educational Resources Information Center

    von Kuster, Thomas, Jr.

    Results from the first federally sponsored study of the chiropractic health care profession are presented, and a broad range of facts and issues of concern to policy-makers, the profession, and the public are described. The two-year project included three national surveys of: service providers (doctors of chiropractic in practice more than two…

  9. The Policy of Choice: Expanding Student Options in Higher Education. The New Millennium Project on Higher Education Costs, Pricing, and Productivity.

    ERIC Educational Resources Information Center

    Cunningham, Alisa Federico

    This report discusses what college choice means and how it works. Exploring in some detail the various definitions of choice, the report reveals what is known about the factors that influence students decisions, and the current status of choice. The analysis focuses on choice in relation to federal need-based financial aid policy. Higher education…

  10. Study program to develop and evaluate die and container materials for the growth of silicon ribbons. [for development of low cost solar cells

    NASA Technical Reports Server (NTRS)

    Addington, L. A.; Ownby, P. D.; Yu, B. B.; Barsoum, M. W.; Romero, H. V.; Zealer, B. G.

    1979-01-01

    The development and evaluation of proprietary coatings of pure silicon carbide, silicon nitride, and aluminum nitride on less pure hot pressed substrates of the respective ceramic materials, is described. Silicon sessile drop experiments were performed on coated test specimens under controlled oxygen partial pressure. Prior to testing, X-ray diffraction and SEM characterization was performed. The reaction interfaces were characterized after testing with optical and scanning electron microscopy and Auger electron spectroscopy. Increasing the oxygen partial pressure was found to increase the molten silicon contact angle, apparently because adsorbed oxygen lowers the solid-vapor interfacial free energy. It was also found that adsorbed oxygen increased the degree of attack of molten silicon upon the chemical vapor deposited coatings. Cost projections show that reasonably priced, coated, molten silicon resistant refractory material shapes are obtainable.

  11. Immobilization of heavy metals contained in incinerator fly ash by application of soluble phosphate--treatment and disposal cost reduction by combined use of high specific surface area lime

    SciTech Connect

    Uchida, Toshihito; Itoh, Ichiro; Harada, Koji

    1996-12-31

    In Japan, the lime injection rate to municipal waste incinerator flue gas has had a tendency to increase in recent years. This trend is due to the need to comply with the stringent air pollution control regulation, to neutralize and remove more acid gas contained in the flue gas, together with utilization of fabric filter (FF) units to efficiently remove particulate and other hazardous materials. Evaluation results of combined application of High Specific Surface Area Lime and soluble phosphate as heavy metals immobilizing agent for fly ash intermediate treatment can help to reduce output of incinerator fly ash amount and total fly ash treatment and disposal costs. High Specific Surface Area Lime injection rate to achieve same outlet HCL concentration will be reduced to about 1/2 of the conventional lime injection rate. As the residual lime content in the fly ash is reduced, the treatment costs by soluble phosphate can be remarkably reduced.

  12. Prepared for the future? Evaluating the costs and benefits of voluntary work for natural disaster management under a changing climate - data on recent flood events, stakeholder needs and policy applications

    NASA Astrophysics Data System (ADS)

    Pfurtscheller, Clemens; Brucker, Anja; Seebauer, Sebastian

    2014-05-01

    Voluntary emergency and relief services, such as fire brigades or rescue organisations, form the backbone of disaster management in most of European countries. In Austria, disaster management relies on the cooperation between governmental and non-governmental institutions: When a disaster occurs, the volunteer organizations act as auxiliaries to the responsible disaster management authority. The assessment of costs and benefits of these emergency services is a crucial component of risk and disaster management strategies, since public means are getting scarcer and these costs can reach critical levels for low-income municipalities. As extreme events and emergency operations are likely to increase due to climate change, the efficient allocation of public budgets for risk and disaster management becomes more important. Hence, both, the costs and the benefits must be known, but voluntary and professional work is hardly documented and assessed comprehensively. Whereas the costs of emergency services can be calculated using market values and an analysis of public and institutional budgets, the benefits of voluntary efforts cannot be assessed easily. We present empirical data on costs of voluntary and professional emergency services during the floods of 2002, 2005 and 2013 in Austria and Germany on different scales, obtained from public authorities, fire brigades and by means of public surveys. From these results, we derive a calculation framework and data requirements for assessing costs of emergency services. To consider the different stakeholders needs of administration, emergency institutions and voluntary members, we carried out workshops, first to identify future challenges in voluntary work for disaster management instigated by climate change and second, to develop approaches how the voluntary system can be uphold when facing increasing adverse impacts of natural hazards. The empirical results as well as the workshop outcome shall be translated into policy recommendations and research needs to derive strategies for strengthening resilience at the local and regional level and to design appropriate incentives.

  13. Teachers in Developing Countries: Improving Effectiveness and Managing Costs. Economic Development Institute Seminar Background Papers (Washington, D.C., April 1987). EDI Seminar Series.

    ERIC Educational Resources Information Center

    Farrell, Joseph P., Ed.; Oliveira, Joao B., Ed.

    This volume discusses the major options decisionmakers face when they are dealing with teacher career and remuneration policies. The document deals with a central question: how can remuneration and managerial policies help improve teacher effectiveness? The book is divided into three parts containing 15 papers. The first part, "The Cost and…

  14. Multilayer-strategy to enhance optimal safety of the blood supply: The role of pathogen inactivation for optimizing recipient safety and helping health care cost containment: Moderator views.

    PubMed

    Seghatchian, Jerard

    2015-04-01

    This brief paper is based on the Coimbra 'conference presentation by the moderator', prior to the two main lectures on pathogen reduction treatment [PRT] of plasma. Being an educationist and teacher in core and having a great interest to simplify the message convey to conference' participants and readers I decided to maintain the slide format of the presentation. To highlight most effectively the role played by pathogen reduction to supplement the multilayer-strategy already in place, emphasizes were placed by going back to basic focusing on: where we were, where we are now and where we are going!. The unresolved problems of viral safety of blood components and criteria of universal acceptability of PRT are highlighted so is the need for further DDR strategies both in incremental and innovative ways. Finally the issue of who would benefit from implementation of PRT is described based on published data and also providing some visionary foresights for the long term benefits of PRT in both optimizing the safety of blood supply and helping at least in health care containment. I hope this new approach will be useful to readers, providing at least some conceptual and technical supports in understanding the role of PRT in optimizing the safety of blood supply. PMID:25748230

  15. Policy opportunities

    NASA Technical Reports Server (NTRS)

    Mccray, Richard; Ostriker, Jeremiah P.; Acton, Loren W.; Bahcall, Neta A.; Bless, Robert C.; Brown, Robert A.; Burbidge, Geoffrey; Burke, Bernard F.; Clark, George W.; Cordova, France A.

    1991-01-01

    Recommendations are given regarding National Science Foundation (NSF) astronomy programs and the NASA Space Astrophysics program. The role of ground based astronomy is reviewed. The role of National Optical Astronomy Observatories (NOAO) in ground-based night-time astronomical research is discussed. An enhanced Explored Program, costs and management of small and moderate space programs, the role of astrophysics within NASA's space exploration initiative, suborbital and airborne astronomical research, the problems of the Hubble Space Telescope, and astronomy education are discussed. Also covered are policy issues related to the role of science advisory committees, international cooperation and competition, archiving and distribution of astronomical data, and multi-wavelength observations of variable sources.

  16. The Benefits and Costs of Good Child Care: The Economic Rationale for Public Investment in Young Children. A Policy Study. Monograph No. 1.

    ERIC Educational Resources Information Center

    Cleveland, Gordon; Krashinsky, Michael

    This report details an assessment of the economic impact of a major investment of public money in good quality child care for Canadian children 2 to 5 years of age. Chapter 1 provides an extended discussion of the background and techniques of economic analysis used to make judgments about the economic benefits and costs of child care. Chapter 2

  17. Costing Distance Education and Open Learning in Sub-Saharan Africa: Working Group on Distance Education and Open Learning-- A Survey of Policy and Practice. Final Report

    ERIC Educational Resources Information Center

    Commonwealth of Learning, 2004

    2004-01-01

    Ideological arguments are made for open learning, economic ones for distance education. If it can produce similar results to those of conventional education at a lower cost, then distance education has a powerful appeal. With increasing demand for access to educational opportunities at all levels, and often decreasing budgets in real terms for…

  18. Collision Course: Rising College Costs Threaten America's Future and Require Shared Solutions--A Policy Brief from Lumina Foundation for Education

    ERIC Educational Resources Information Center

    Dickeson, Robert C.

    2004-01-01

    One of the most critical issues affecting higher education access today is the rising cost of going to college. Symptoms of the trend include dramatic increases in tuition and fees, reduced state higher education budgets, declines in the purchasing power of student grant aid, increasing student debt burdens and heightened demand for institutional…

  19. Evaluating Public Per-Student Subsidies to Low-Cost Private Schools: Regression-Discontinuity Evidence from Pakistan. Policy Research Working Paper 5638

    ERIC Educational Resources Information Center

    Barrera-Osorio, Felipe; Raju, Dhushyanth

    2011-01-01

    This study estimates the causal effects of a public per-student subsidy program targeted at low-cost private schools in Pakistan on student enrollment and schooling inputs. Program entry is ultimately conditional on achieving a minimum stipulated student pass rate (cutoff) in a standardized academic test. This mechanism for treatment assignment…

  20. Developing a holistic strategy for integrated waste management within municipal planning: Challenges, policies, solutions and perspectives for Hellenic municipalities in the zero-waste, low-cost direction

    SciTech Connect

    Zotos, G.; Karagiannidis, A.; Zampetoglou, S.; Malamakis, A. Antonopoulos, I.-S.; Kontogianni, S.; Tchobanoglous, G.

    2009-05-15

    The present position paper addresses contemporary waste management options, weaknesses and opportunities faced by Hellenic local authorities. It focuses on state-of-the-art, tested as well as innovative, environmental management tools on a municipal scale and identifies a range of different collaboration schemes between local authorities and related service providers. Currently, a policy implementation gap is still experienced among Hellenic local authorities; it appears that administration at the local level is inadequate to manage and implement many of the general policies proposed; identify, collect, monitor and assess relevant data; and safeguard efficient and effective implementation of MSWM practices in the framework of integrated environmental management as well. This shortfall is partly due to the decentralisation of waste management issues to local authorities without a parallel substantial budgetary and capacity support, thus resulting in local activity remaining often disoriented and isolated from national strategies, therefore yielding significant planning and implementation problems and delays against pressing issues at hand as well as loss or poor use of available funds. This paper develops a systemic approach for MSWM at both the household and the non-household level, summarizes state-of-the-art available tools and compiles a set of guidelines for developing waste management master plans at the municipal level. It aims to provide a framework in the MSWM field for municipalities in Greece as well as other countries facing similar problems under often comparable socioeconomic settings.

  1. Current policies regarding smoking in the workplace.

    PubMed

    Walsh, D C; McDougall, V

    1988-01-01

    This paper briefly reviews the evolution of worksite smoking policies and programs, beginning with the goals and objectives from which they have sprung. Workplace smoking deterrents are shown to involve three different types of strategies: 1) legalistic approaches use policies and rules to restrict or foreclose smoking on the job; 2) economic strategies create incentives and disincentives, often through the employee health benefit plan; and 3) educational programs seek to motivate smokers to quit and to supply them with information and skill that may facilitate that process. The three types of intervention are combined in a broad public health approach that some companies are now developing. Research is needed on the efficacy of a range of possible approaches and attention should be paid to the ethical and policy issues of tensions and contradictions between health goals and cost containment. PMID:3278604

  2. Vaccine development costs: a review.

    PubMed

    Waye, Arianna; Jacobs, Philip; Schryvers, Anthony B

    2013-12-01

    The cost of drug development is commonly cited between US$800 and US$1.8 billion. A similar statistic for vaccines is yet to be estimated, and it is unclear whether the cost of vaccines is similar to drug development. Financial and regulatory policy significantly impacts the extent and cost of pharmaceutical development, and as such it is important that governments should be informed about the costs of developing vaccines. The purpose of this paper is to review the concept of drug and vaccine R&D costs, to review the associated literature and to relate these findings to the area of vaccine industry's financial and regulatory policy. PMID:24160863

  3. Cross-sectional study of morbidity, morbidity-associated factors and cost of treatment in Ngaoundere, Cameroon, with implications for health policy in developing countries and development assistance policy

    PubMed Central

    Holtedahl, Knut; Hurum, Harald

    2002-01-01

    Background In a population-based epidemiological study in Ngaoundere, Cameroon, we studied cross-sectional child morbidity and the cost of necessary investigation and treatment. Methods Three teams of two to three health workers visited haphazardly selected households in all major housing quarters. We asked permission to enter for a health survey. Children with cough, fever or weight loss as well as sick adults were offered free-of-charge local hospital examination and treatment. Results From 177 households with 1777 persons, 51 (2.9%) persons were referred. Thirty-five of them had an undiagnosed disease threatening individual health and in many cases also public health. Seven were hospitalised, including three adults with tuberculosis. Malnutrition was diagnosed in nine small children. Four patients had AIDS, seven had malaria. Average total cost for ambulant patients was 15 USD, for hospitalised patients 110 USD. In the households, almost half of the women 16–50 years of age had no schooling. Two per cent of women and nine per cent of men were daily smokers. Coughing children were more likely than non-coughing children to live in a household with at least one smoker (OR = 3.58, 95% CI 1.72 to 7.46), and they generally lived in more poor households (P = 0.018). Twelve of 16 children with weight loss were referred from households with a high poverty score. Conclusions Adult smoking and poverty affect children's health. The cost of hospitalisation or long-lasting therapy is beyond the means of most ordinary families. Diseases with severe consequences for public health, like tuberculosis, AIDS and malaria should have national programs with free, decentralised examination and treatment. Access to generic drugs is important. A major educational effort is needed to improve public health. PMID:11955291

  4. 44 CFR 206.228 - Allowable costs.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Allowable costs. General policies for determining allowable costs are established in 44 CFR 13.22. Exceptions to those policies as allowed in 44 CFR 13.4 and 13.6 are explained below. (a) Eligible direct... costs for major disasters and emergencies will be paid in accordance with 44 CFR part 207. (b)...

  5. 44 CFR 206.228 - Allowable costs.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Allowable costs. General policies for determining allowable costs are established in 44 CFR 13.22. Exceptions to those policies as allowed in 44 CFR 13.4 and 13.6 are explained below. (a) Eligible direct... costs for major disasters and emergencies will be paid in accordance with 44 CFR part 207. (b)...

  6. 44 CFR 206.228 - Allowable costs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Allowable costs. General policies for determining allowable costs are established in 44 CFR 13.22. Exceptions to those policies as allowed in 44 CFR 13.4 and 13.6 are explained below. (a) Eligible direct... costs for major disasters and emergencies will be paid in accordance with 44 CFR part 207. (b)...

  7. Cut the Costs on Workman's Comp.

    ERIC Educational Resources Information Center

    Robinson, Leland L.

    1996-01-01

    The ultimate cost of workers compensation is made up of loss costs (the amounts paid to injured employees to compensate for lost wages and medical bills) and administrative costs. This article concentrates on potential savings in loss costs, highlighting indemnity and medical cost drivers, the need for effective policy communication to employees,…

  8. Cost containment: the Middle East. Saudi Arabia.

    PubMed

    Chang, R W

    1994-08-01

    The 1970s and early 1980s saw the phenomenal growth and development of healthcare services in Saudi Arabia. This growth was unique in that it took place in a country that lacked basic infrastructure and trained personnel, but had recently acquired great wealth. Developments that took hundreds of years to occur in other countries took only 20 yrs to attain in Saudi Arabia. This growth posed unique challenges and required novel solutions. Recently, the country has had to cope with a drastic decrease in oil revenue, as well as cutbacks in healthcare funding. Now that the basic foundations of a national healthcare service have been constructed, it remains to be seen whether gains can be consolidated and steady progress made as more and more Saudi nationals take over and run their own public and private healthcare services. PMID:8087599

  9. 48 CFR 1235.003 - Policy.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... CONTRACTING RESEARCH AND DEVELOPMENT CONTRACTING 1235.003 Policy. (b) Cost sharing. DOT cost sharing policies shall be in accordance with (FAR) 48 CFR 16.303, (FAR) 48 CFR 42.707(a), and Operating Administration... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Policy. 1235.003...

  10. A longitudinal cohort study of the relationship between Thimerosal-containing hepatitis B vaccination and specific delays in development in the United States: Assessment of attributable risk and lifetime care costs.

    PubMed

    Geier, David A; Kern, Janet K; Hooker, Brian S; King, Paul G; Sykes, Lisa K; Geier, Mark R

    2016-06-01

    Epidemiological evidence suggests a link between mercury (Hg) exposure from Thimerosal-containing vaccines and specific delays in development. A hypothesis-testing longitudinal cohort study (n=49,835) using medical records in the Vaccine Safety Datalink (VSD) was undertaken to evaluate the relationship between exposure to Hg from Thimerosal-containing hepatitis B vaccines (T-HBVs) administered at specific intervals in the first 6months of life and specific delays in development [International Classification of Disease, 9th revision (ICD-9): 315.xx] among children born between 1991 and 1994 and continuously enrolled from birth for at least 5.81years. Infants receiving increased Hg doses from T-HBVs administered within the first month, the first 2months, and the first 6months of life were significantly more likely to be diagnosed with specific delays in development than infants receiving no Hg doses from T-HBVs. During the decade in which T-HBVs were routinely recommended and administered to US infants (1991-2001), an estimated 0.5-1million additional US children were diagnosed with specific delays in development as a consequence of 25μg or 37.5μg organic Hg from T-HBVs administered within the first 6months of life. The resulting lifetime costs to the United States may exceed $1 trillion. PMID:26166425

  11. Adverse drug events resulting from use of drugs with sulphonamide-containing anti-malarials and artemisinin-based ingredients: findings on incidence and household costs from three districts with routine demographic surveillance systems in rural Tanzania

    PubMed Central

    2013-01-01

    Background Anti-malarial regimens containing sulphonamide or artemisinin ingredients are widely used in malaria-endemic countries. However, evidence of the incidence of adverse drug reactions (ADR) to these drugs is limited, especially in Africa, and there is a complete absence of information on the economic burden such ADR place on patients. This study aimed to document ADR incidence and associated household costs in three high malaria transmission districts in rural Tanzania covered by demographic surveillance systems. Methods Active and passive surveillance methods were used to identify ADR from sulphadoxine-pyrimethamine (SP) and artemisinin (AS) use. ADR were identified by trained clinicians at health facilities (passive surveillance) and through cross-sectional household surveys (active surveillance). Potential cases were followed up at home, where a complete history and physical examination was undertaken, and household cost data collected. Patients were classified as having ‘possible’ or ‘probable’ ADR by a physician. Results A total of 95 suspected ADR were identified during a two-year period, of which 79 were traced, and 67 reported use of SP and/or AS prior to ADR onset. Thirty-four cases were classified as ‘probable’ and 33 as ‘possible’ ADRs. Most (53) cases were associated with SP monotherapy, 13 with the AS/SP combination (available in one of the two areas only), and one with AS monotherapy. Annual ADR incidence per 100,000 exposures was estimated based on ‘probable’ ADR only at 5.6 for AS/SP in combination, and 25.0 and 11.6 for SP monotherapy. Median ADR treatment costs per episode ranged from US$2.23 for those making a single provider visit to US$146.93 for patients with four visits. Seventy-three per cent of patients used out-of-pocket funds or sold part of their farm harvests to pay for treatment, and 19% borrowed money. Conclusion Both passive and active surveillance methods proved feasible methods for anti-malarial ADR surveillance, with active surveillance being an important complement to facility-based surveillance, given the widespread practice of self-medication. Household costs associated with ADR treatment were high and potentially catastrophic. Efforts should be made to both improve pharmacovigilance across Africa and to identify strategies to reduce the economic burden endured by households suffering from ADR. PMID:23844934

  12. 42 CFR 50.503 - Policy.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... this policy, the Secretary has established, in 45 CFR part 19, a procedure for determining the Maximum... 42 Public Health 1 2010-10-01 2010-10-01 false Policy. 50.503 Section 50.503 Public Health PUBLIC... Allowable Cost for Drugs § 50.503 Policy. It is the policy of the Secretary that program funds which...

  13. Financing Child Care. A Public Policy Report from the Ewing Marion Kauffman Foundation. Winter 2002.

    ERIC Educational Resources Information Center

    Ewing Marion Kauffman Foundation, Kansas City, MO.

    This public policy report focuses on financing child care in the United States. The report contains brief articles on the following topics: (1) child care wages in comparison to other positions; (2) benefits to businesses when employees have high-quality child care; (3) resources for funding early education systems; (4) comparison of the cost of…

  14. Covering the costs of care in neonatal intensive care units.

    PubMed

    Imershein, A W; Turner, C; Wells, J G; Pearman, A

    1992-01-01

    The continued rise of health care costs, despite private and governmental control efforts, has sustained cost containment as a central issue for health care researchers and policy makers. In keeping with these concerns, the Florida Health Care Cost Containment Board conducted a study of neonatal intensive care units (NICUs) in Florida to ascertain the costs, charges, and net revenues associated with NICU services in individual hospitals, to document cost shifting and cross-subsidization as a means of financing NICU care for indigent populations, and to assess the fiscal impact of NICUs in state-sponsored vs non-state-sponsored Regional Perinatal Intensive Care Center hospitals providing NICU care. Hospitals in the state-sponsored program reported a loss of approximately $16.5 million in contrast to the non-state-sponsored hospitals, which reported a gain of $1 million. Payment being generated by private-pay patients amounted to almost 60% of total revenues but constituted less than one third of the costs in state-sponsored hospitals, indicating a high level of cost shifting. Government support of state-sponsored NICUs, while substantial, has been insufficient; increasing constraints on this funding source would likely worsen the deficit and increase the necessity of cost shifting. PMID:1728023

  15. 24 CFR 700.115 - Program costs.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... recognized as expenditures in compliance with OMB Cost Policies, i.e., OMB Circular A-87, 24 CFR 85.36, and..., dishwashers, trash compactors or sinks); (ii) Administrative costs that represent a non-proportional share...

  16. 7 CFR 1944.254 - Program costs.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... recognized as expenditures in compliance with OMB Cost Policies, i.e., OMB Circular A-87, 24 CFR 85.36, and..., dishwashers, trash compactors or sinks); (ii) Administrative costs that represent a non-proportional share...

  17. Agriculture Policy Is Health Policy

    PubMed Central

    Jackson, Richard J.; Minjares, Ray; Naumoff, Kyra S.; Shrimali, Bina Patel; Martin, Lisa K.

    2009-01-01

    The Farm Bill is meant to supplement and secure farm incomes, ensure a stable food supply, and support the American farm economy. Over time, however, it has evolved into a system that creates substantial health impacts, both directly and indirectly. By generating more profit for food producers and less for family farmers; by effectively subsidizing the production of lower-cost fats, sugars, and oils that intensify the health-destroying obesity epidemic; by amplifying environmentally destructive agricultural practices that impact air, water, and other resources, the Farm Bill influences the health of Americans more than is immediately apparent. In this article, we outline three major public health issues influenced by American farm policy. These are (1) rising obesity; (2) food safety; and (3) environmental health impacts, especially exposure to toxic substances and pesticides. PMID:23144677

  18. Technology and international climate policy

    SciTech Connect

    Clarke, Leon; Calvin, Kate; Edmonds, James A.; Kyle, Page; Wise, Marshall

    2009-05-01

    Both the nature of international climate policy architectures and the development and diffusion of new energy technologies could dramatically influence future costs of reducing global emissions of greenhouse gases. This paper explores the implications of interactions between technology availability and performance and international policy architectures for technology choice and the social cost of limiting atmospheric CO2 concentrations to 500 ppm by the year 2095. Key issues explored in the paper include the role of bioenergy production with CO2 capture and storage (CCS), overshoot concentration pathways, and the sensitivity of mitigation costs to policy and technology.

  19. Restoration advisory board (RAB) policy implementation

    SciTech Connect

    Ross, J.

    1994-12-31

    Public involvement is an integral part of the Air Force Installation Restoration Program (IRP). The IRP focuses on assessing and remediating environmental contamination caused by past waste management practices at Air Force installations. Since the IRP is concerned with toxic or hazardous waste, people feel personally involved in the process particularly if they live near a contaminated site. Public involvement in the IRP is required by the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) as amended by the Superfund Amendments and Reauthorization Act (SARA), the National Contingency Plan (NCP), and Air Force policy and guidance. Air Combat Command (ACC) is committed to a public involvement program that encourages mutual two-way communication. ACC seeks to partner with and incorporate inputs from all stakeholders in order to efficiently and cost effectively implement the IRP. IRP stakeholders include Air Force personnel, local citizens, local and state governments, the Environmental Protection Agency (EPA), and other Federal agencies. ACC policy is to incorporate community involvement, participation, consultation, and advice into the IRP at each installation. This paper contains an overview of the ACC policy, an evaluation of how the RAB policy differs from previous public involvement efforts, and an overview of ACC experiences with RAB policy implementation.

  20. 44 CFR 204.63 - Allowable costs.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ....63 Allowable costs. 44 CFR 13.22 establishes general policies for determining allowable costs. (a) We will reimburse direct costs for the administration of a fire management assistance grant under 44 CFR... 44 Emergency Management and Assistance 1 2014-10-01 2014-10-01 false Allowable costs....

  1. 44 CFR 79.8 - Allowable costs.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 44 Emergency Management and Assistance 1 2012-10-01 2011-10-01 true Allowable costs. 79.8 Section... Allowable costs. (a) General. General policies for determining allowable costs are addressed in §§ 13.4, 13.6, and 13.22 of this chapter. Allowable costs are explained in this paragraph. (1)...

  2. 44 CFR 79.8 - Allowable costs.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 44 Emergency Management and Assistance 1 2014-10-01 2014-10-01 false Allowable costs. 79.8 Section... Allowable costs. (a) General. General policies for determining allowable costs are addressed in §§ 13.4, 13.6, and 13.22 of this chapter. Allowable costs are explained in this paragraph. (1)...

  3. 44 CFR 204.63 - Allowable costs.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ....63 Allowable costs. 44 CFR 13.22 establishes general policies for determining allowable costs. (a) We will reimburse direct costs for the administration of a fire management assistance grant under 44 CFR... 44 Emergency Management and Assistance 1 2012-10-01 2011-10-01 true Allowable costs....

  4. 44 CFR 204.63 - Allowable costs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ....63 Allowable costs. 44 CFR 13.22 establishes general policies for determining allowable costs. (a) We will reimburse direct costs for the administration of a fire management assistance grant under 44 CFR... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Allowable costs....

  5. 44 CFR 204.63 - Allowable costs.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ....63 Allowable costs. 44 CFR 13.22 establishes general policies for determining allowable costs. (a) We will reimburse direct costs for the administration of a fire management assistance grant under 44 CFR... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Allowable costs....

  6. Health Expenditure Concentration and Characteristics of High-Cost Enrollees in CHIP.

    PubMed

    Sen, Bisakha; Blackburn, Justin; Aswani, Monica S; Morrisey, Michael A; Becker, David J; Kilgore, Meredith L; Caldwell, Cathy; Sellers, Chris; Menachemi, Nir

    2016-01-01

    Devising effective cost-containment strategies in public insurance programs requires understanding the distribution of health care spending and characteristics of high-cost enrollees. The aim was to characterize high-cost enrollees in a state's public insurance program and determine whether expenditure inequality changes over time, or with changes in cost-sharing policies or program eligibility. We use 1999-2011 claims and enrollment data from the Alabama Children's Health Insurance Program, ALL Kids. All children enrolled in ALL Kids were included in our study, including multiple years of enrollment (N = 1,031,600 enrollee-months). We examine the distribution of costs over time, whether this distribution changes after increases in cost sharing and expanded eligibility, patient characteristics that predict high-cost status, and examine health services used by high-cost children to identify what is preventable. The top 10% (1%) of enrollees account for about 65.5% (24.7%) of total program costs. Inpatient and outpatient costs are the largest components of costs incurred by high-cost utilizers. Non-urgent emergency department costs are a relatively small portion. Average expenditure increases over time, particularly after expanded eligibility, and the share of costs incurred by the top 10% and 1% increases slightly. Multivariable logistic regression results indicate that infants and older teens, Caucasian children, and those with chronic conditions are more likely to be high-cost utilizers. Increased cost sharing does not reduce cost concentration or average expenditure among high-cost utilizers. These findings suggest that identifying and targeting potentially preventable costs among high-cost utilizers are called for to help reduce costs in public insurance programs. PMID:27166411

  7. Costing mental health services.

    PubMed

    Knapp, M; Beecham, J

    1990-11-01

    In this paper four principal topics are addressed: (a) the policy and political contexts in which demands arise for cost information; (b) the nature and phasing of those demands; (c) the basic rules of empirical costs research for meeting those demands; and (d) concomitant implications for the design, execution and interpretation of their research. Mental health care policy or practice changes which ignore costs, or which embody cost information without obeying or recognizing the four basic rules, can only be of dubious validity, or can only be used to answer a limited range of questions. But, as the illustrative studies show, it need not be an horrendous, or ideologically compromising or scientifically complex task to add a cost dimension to the evaluation of mental health services. There are enough examples in the literature of bad costs research to demonstrate that it is not as simple as some people think, but there are also enough examples of good research to encourage further attempts. PMID:2126630

  8. The Costs and Benefits of Compliance with Renewable Portfolio Standards: Reviewing Experience to Date

    SciTech Connect

    Heeter, Jenny; Barbose, Galen; Bird, Lori; Weaver, Samantha; Flores, Francisco; Kuskova-Burns, Ksenia; Wiser, Ryan

    2014-03-12

    More than half of U.S. states have renewable portfolio standards (RPS) in place and have collectively deployed approximately 46,000 MW of new renewable energy capacity through year-end 2012. Most of these policies have five or more years of implementation experience, enabling an assessment of their costs and benefits. Understanding RPS benefits and costs is essential for policymakers evaluating existing RPS policies, assessing the need for modifications, and considering new policies. A key aspect of this study is the comprehensive review of existing RPS cost and benefit estimates, in addition to an examination of the variety of methods used to calculate such estimates. Based on available data and estimates reported by utilities and regulators, this study summarizes RPS costs to date. The study considers how those costs may evolve going forward, given scheduled increases in RPS targets and cost containment mechanisms incorporated into existing policies. The report also summarizes RPS benefits estimates, based on published studies for individual states, and discusses key methodological considerations.

  9. Educational Costs.

    ERIC Educational Resources Information Center

    Arnold, Robert

    Problems in educational cost accounting and a new cost accounting approach are described in this paper. The limitations of the individualized cost (student units) approach and the comparative cost approach (in the form of fund-function-object) are illustrated. A new strategy, an activity-based system of accounting, is advocated. Borrowed from…

  10. 44 CFR 206.228 - Allowable costs.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Allowable costs. General policies for determining allowable costs are established in 44 CFR 13.22. Exceptions to those policies as allowed in 44 CFR 13.4 and 13.6 are explained below. (a) Eligible direct... accordance with 44 CFR part 207. (b)...

  11. 44 CFR 206.228 - Allowable costs.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Allowable costs. General policies for determining allowable costs are established in 44 CFR 13.22. Exceptions to those policies as allowed in 44 CFR 13.4 and 13.6 are explained below. (a) Eligible direct... accordance with 44 CFR part 207. (b)...

  12. STS pricing policy

    NASA Technical Reports Server (NTRS)

    Lee, C. M.; Stone, B.

    1982-01-01

    In 1977 NASA published Shuttle Reimbursement Policies for Civil U.S. Government, DOD and Commercial and Foreign Users. These policies were based on the principle of total cost recovery over a period of time with a fixed flat price for initial period to time to enhance transition. This fixed period was to be followed with annual adjustments thereafter, NASA is establishing a new price for 1986 and beyond. In order to recover costs, that price must be higher than the initial fixed price through FY 1985. NASA intends to remain competitive. Competitive posture includes not only price, but other factors such as assured launch, reliability, and unique services. NASA's pricing policy considers all these factors.

  13. 49 CFR 10.3 - Policy.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 1 2012-10-01 2012-10-01 false Policy. 10.3 Section 10.3 Transportation Office of... Applicability and Policy § 10.3 Policy. It is the policy of the Department of Transportation to comply with the letter and the spirit of the Privacy Act (the Act). Therefore, personal data contained in each system...

  14. 49 CFR 10.3 - Policy.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 1 2011-10-01 2011-10-01 false Policy. 10.3 Section 10.3 Transportation Office of... Applicability and Policy § 10.3 Policy. It is the policy of the Department of Transportation to comply with the letter and the spirit of the Privacy Act (the Act). Therefore, personal data contained in each system...

  15. 49 CFR 10.3 - Policy.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 1 2014-10-01 2014-10-01 false Policy. 10.3 Section 10.3 Transportation Office of... Applicability and Policy § 10.3 Policy. It is the policy of the Department of Transportation to comply with the letter and the spirit of the Privacy Act (the Act). Therefore, personal data contained in each system...

  16. 49 CFR 10.3 - Policy.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 1 2013-10-01 2013-10-01 false Policy. 10.3 Section 10.3 Transportation Office of... Applicability and Policy § 10.3 Policy. It is the policy of the Department of Transportation to comply with the letter and the spirit of the Privacy Act (the Act). Therefore, personal data contained in each system...

  17. Recent Contributions to the Urban Policy Debate.

    ERIC Educational Resources Information Center

    Morrison, Peter A.; And Others

    This report contains the text of five briefings on research in Rand's Urban Policy Analysis program. "Brief History of Rand's Urban Policy Analysis Program," by Barbara R. Williams, discusses the changing Federal role in urban policy, problems encountered in Rand's attempt during the early 1970s to examine the central policy problems of cities at…

  18. Costs of groundwater contamination

    SciTech Connect

    O'Neil, W.B.; Raucher, R.S. )

    1990-01-01

    Two factors determine the cost of groundwater contamination: (1) the ways in which water was being used or was expected to be used in the future and (2) the physical characteristics of the setting that constrain the responses available to regain lost uses or to prevent related damages to human health and the environment. Most contamination incidents can be managed at a low enough cost that uses will not be foreclosed. It is important to take into account the following when considering costs: (1) natural cleansing through recharge and dilution can take many years; (2) it is difficult and costly to identify the exact area and expected path of a contamination plume; and (3) treatment or replacement of contaminated water often may represent the cost-effective strategy for managing the event. The costs of contamination include adverse health effects, containment and remediation, treatment and replacement costs. In comparing the costs and benefits of prevention programs with those of remediation, replacement or treatment, it is essential to adjust the cost/benefit numbers by the probability of their actual occurrence. Better forecasts of water demand are needed to predict more accurately the scarcity of new supply and the associated cost of replacement. This research should include estimates of the price elasticity of water demand and the possible effect on demand of more rational cost-based pricing structures. Research and development of techniques for in situ remediation should be encouraged.

  19. Cost goals

    NASA Technical Reports Server (NTRS)

    Hoag, J.

    1981-01-01

    Cost goal activities for the point focusing parabolic dish program are reported. Cost goals involve three tasks: (1) determination of the value of the dish systems to potential users; (2) the cost targets of the dish system are set out; (3) the value side and cost side are integrated to provide information concerning the potential size of the market for parabolic dishes. The latter two activities are emphasized.

  20. The Shuttle Cost and Price model

    NASA Technical Reports Server (NTRS)

    Leary, Katherine; Stone, Barbara

    1983-01-01

    The Shuttle Cost and Price (SCP) model was developed as a tool to assist in evaluating major aspects of Shuttle operations that have direct and indirect economic consequences. It incorporates the major aspects of NASA Pricing Policy and corresponds to the NASA definition of STS operating costs. An overview of the SCP model is presented and the cost model portion of SCP is described in detail. Selected recent applications of the SCP model to NASA Pricing Policy issues are presented.

  1. Construction Costs.

    ERIC Educational Resources Information Center

    Georgia State Dept. of Education, Atlanta. Facilities Services Unit.

    With the increasing pace of school construction, knowing how much a school should cost can facilitate effective new-school planning. To help with this process, this document provides new-construction costs as figured for the State of Georgia. The estimates include costs per square foot for elementary schools, middle schools, and high schools, as…

  2. Tracking Costs

    ERIC Educational Resources Information Center

    Erickson, Paul W.

    2010-01-01

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

  3. Tracking Costs

    ERIC Educational Resources Information Center

    Erickson, Paul W.

    2010-01-01

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

  4. 48 CFR 9904.412 - Cost accounting standard for composition and measurement of pension cost.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 7 2012-10-01 2012-10-01 false Cost accounting standard... Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.412...

  5. 48 CFR 9904.401 - Cost accounting standard-consistency in estimating, accumulating and reporting costs.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 7 2012-10-01 2012-10-01 false Cost accounting standard... Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.401...

  6. 48 CFR 9904.401 - Cost accounting standard-consistency in estimating, accumulating and reporting costs.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 7 2014-10-01 2014-10-01 false Cost accounting standard... Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.401...

  7. 48 CFR 9904.412 - Cost accounting standard for composition and measurement of pension cost.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 7 2014-10-01 2014-10-01 false Cost accounting standard... Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.412...

  8. 48 CFR 9904.411 - Cost accounting standard-accounting for acquisition costs of material.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Cost accounting standard... System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.411...

  9. 48 CFR 9904.401 - Cost accounting standard-consistency in estimating, accumulating and reporting costs.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 7 2013-10-01 2012-10-01 true Cost accounting standard... Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.401...

  10. 48 CFR 9904.401 - Cost accounting standard-consistency in estimating, accumulating and reporting costs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  11. 48 CFR 9904.412 - Cost accounting standard for composition and measurement of pension cost.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 7 2013-10-01 2012-10-01 true Cost accounting standard... Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.412...

  12. 48 CFR 9904.411 - Cost accounting standard-accounting for acquisition costs of material.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 7 2013-10-01 2012-10-01 true Cost accounting standard... System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.411...

  13. 48 CFR 9904.411 - Cost accounting standard-accounting for acquisition costs of material.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 7 2012-10-01 2012-10-01 false Cost accounting standard... System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.411...

  14. 48 CFR 9904.411 - Cost accounting standard-accounting for acquisition costs of material.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 7 2014-10-01 2014-10-01 false Cost accounting standard... System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.411...

  15. 48 CFR 9904.412 - Cost accounting standard for composition and measurement of pension cost.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Cost accounting standard... Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.412...

  16. Environmental Technology Verification Program (ETV) Policy Compendium

    EPA Science Inventory

    The Policy Compendium summarizes operational decisions made to date by participants in the U.S. Environmental Protection Agency's (EPA's) Environmental Technology Verification Program (ETV) to encourage consistency among the ETV centers. The policies contained herein evolved fro...

  17. Policy Problematization

    ERIC Educational Resources Information Center

    Webb, P. Taylor

    2014-01-01

    This article places Michel Foucault's concept of "problematization" in relation to educational policy research. My goal is to examine a key assumption of policy related to "solving problems" through such technologies. I discuss the potential problematization has to alter conceptions of policy research; and, through this…

  18. Policy Problematization

    ERIC Educational Resources Information Center

    Webb, P. Taylor

    2014-01-01

    This article places Michel Foucault's concept of "problematization" in relation to educational policy research. My goal is to examine a key assumption of policy related to "solving problems" through such technologies. I discuss the potential problematization has to alter conceptions of policy research; and, through this

  19. 33 CFR 277.6 - Basic policies.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... interests desire improvements or modifications in the new bridge design for reasons other than that required... WATER RESOURCES POLICIES AND AUTHORITIES: NAVIGATION POLICY: COST APPORTIONMENT OF BRIDGE ALTERATIONS... costs of bridge alterations recommended by reporting officers in the interest of navigation...

  20. 33 CFR 277.6 - Basic policies.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... interests desire improvements or modifications in the new bridge design for reasons other than that required... WATER RESOURCES POLICIES AND AUTHORITIES: NAVIGATION POLICY: COST APPORTIONMENT OF BRIDGE ALTERATIONS... costs of bridge alterations recommended by reporting officers in the interest of navigation...

  1. 33 CFR 277.6 - Basic policies.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... interests desire improvements or modifications in the new bridge design for reasons other than that required... WATER RESOURCES POLICIES AND AUTHORITIES: NAVIGATION POLICY: COST APPORTIONMENT OF BRIDGE ALTERATIONS... costs of bridge alterations recommended by reporting officers in the interest of navigation...

  2. 33 CFR 277.6 - Basic policies.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... interests desire improvements or modifications in the new bridge design for reasons other than that required... WATER RESOURCES POLICIES AND AUTHORITIES: NAVIGATION POLICY: COST APPORTIONMENT OF BRIDGE ALTERATIONS... costs of bridge alterations recommended by reporting officers in the interest of navigation...

  3. 33 CFR 277.6 - Basic policies.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... interests desire improvements or modifications in the new bridge design for reasons other than that required... WATER RESOURCES POLICIES AND AUTHORITIES: NAVIGATION POLICY: COST APPORTIONMENT OF BRIDGE ALTERATIONS... costs of bridge alterations recommended by reporting officers in the interest of navigation...

  4. 48 CFR 1516.303-72 - Policy.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Policy. 1516.303-72 Section 1516.303-72 Federal Acquisition Regulations System ENVIRONMENTAL PROTECTION AGENCY CONTRACTING METHODS AND CONTRACT TYPES TYPES OF CONTRACTS Cost-Reimbursement Contracts 1516.303-72 Policy. (a) The Agency shall use cost-sharing contracts where...

  5. 7 CFR 1709.202 Policy. - [Reserved

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 11 2011-01-01 2011-01-01 false 1709.202 Policy. Section 1709.202 Policy. Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE ASSISTANCE TO HIGH ENERGY COST COMMUNITIES Bulk Fuel Revolving Fund Grant Program § 1709.202 Policy....

  6. 7 CFR 1709.2 Policy. - [Reserved

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 11 2012-01-01 2012-01-01 false 1709.2 Policy. Section 1709.2 Policy. Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE ASSISTANCE TO HIGH ENERGY COST COMMUNITIES General Requirements § 1709.2 Policy....

  7. 7 CFR 1709.202 Policy. - [Reserved

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 11 2012-01-01 2012-01-01 false 1709.202 Policy. Section 1709.202 Policy. Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE ASSISTANCE TO HIGH ENERGY COST COMMUNITIES Bulk Fuel Revolving Fund Grant Program § 1709.202 Policy....

  8. 7 CFR 1709.202 Policy. - [Reserved

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 11 2010-01-01 2010-01-01 false 1709.202 Policy. Section 1709.202 Policy. Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE ASSISTANCE TO HIGH ENERGY COST COMMUNITIES Bulk Fuel Revolving Fund Grant Program § 1709.202 Policy....

  9. 7 CFR 1709.2 Policy. - [Reserved

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 11 2011-01-01 2011-01-01 false 1709.2 Policy. Section 1709.2 Policy. Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE ASSISTANCE TO HIGH ENERGY COST COMMUNITIES General Requirements § 1709.2 Policy....

  10. 7 CFR 1709.2 Policy. - [Reserved

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 11 2010-01-01 2010-01-01 false 1709.2 Policy. Section 1709.2 Policy. Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE ASSISTANCE TO HIGH ENERGY COST COMMUNITIES General Requirements § 1709.2 Policy....

  11. 48 CFR 951.101 - Policy.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Policy. 951.101 Section... GOVERNMENT SOURCES BY CONTRACTORS Contractor Use of Government Supply Sources 951.101 Policy. (a) It is Department of Energy (DOE) policy that contractors performing under cost-reimbursement contracts should...

  12. A review of existing models and methods to estimate employment effects of pollution control policies

    SciTech Connect

    Darwin, R.F.; Nesse, R.J.

    1988-02-01

    The purpose of this paper is to provide information about existing models and methods used to estimate coal mining employment impacts of pollution control policies. The EPA is currently assessing the consequences of various alternative policies to reduce air pollution. One important potential consequence of these policies is that coal mining employment may decline or shift from low-sulfur to high-sulfur coal producing regions. The EPA requires models that can estimate the magnitude and cost of these employment changes at the local level. This paper contains descriptions and evaluations of three models and methods currently used to estimate the size and cost of coal mining employment changes. The first model reviewed is the Coal and Electric Utilities Model (CEUM), a well established, general purpose model that has been used by the EPA and other groups to simulate air pollution control policies. The second model reviewed is the Advanced Utility Simulation Model (AUSM), which was developed for the EPA specifically to analyze the impacts of air pollution control policies. Finally, the methodology used by Arthur D. Little, Inc. to estimate the costs of alternative air pollution control policies for the Consolidated Coal Company is discussed. These descriptions and evaluations are based on information obtained from published reports and from draft documentation of the models provided by the EPA. 12 refs., 1 fig.

  13. Dataset Lifecycle Policy

    NASA Technical Reports Server (NTRS)

    Armstrong, Edward; Tauer, Eric

    2013-01-01

    The presentation focused on describing a new dataset lifecycle policy that the NASA Physical Oceanography DAAC (PO.DAAC) has implemented for its new and current datasets to foster improved stewardship and consistency across its archive. The overarching goal is to implement this dataset lifecycle policy for all new GHRSST GDS2 datasets and bridge the mission statements from the GHRSST Project Office and PO.DAAC to provide the best quality SST data in a cost-effective, efficient manner, preserving its integrity so that it will be available and usable to a wide audience.

  14. Sharps container

    NASA Technical Reports Server (NTRS)

    Lee, Angelene M. (Inventor)

    1992-01-01

    This invention relates to a system for use in disposing of potentially hazardous items and more particularly a Sharps receptacle for used hypodermic needles and the like. A Sharps container is constructed from lightweight alodined nonmagnetic metal material with a cup member having an elongated tapered shape and length greater than its transverse dimensions. A magnet in the cup member provides for metal retention in the container. A nonmagnetic lid member has an opening and spring biased closure flap member. The flap member is constructed from stainless steel. A Velcro patch on the container permits selective attachment at desired locations.

  15. Cardiology and cost control: the ethical challenge for the new millennium.

    PubMed

    Mattke, S

    2000-08-01

    Government interventions in the health care sector threaten the traditional role of physicians, since they are increasingly forced to consider the cost of medical care when making decisions on behalf of their patients. To prepare themselves for this ethical challenge and to actively participate in the debate about cost containment, physicians need to understand how health economists and politicians view the problem of rising medical costs. This review summarizes some essential facts and findings of the health economics literature that provide the rationale for different approaches to cost containment. The effects of rapidly growing health care cost on the economy are discussed, and improvement of medical technology is identified as the driving force behind this growth. The different policy instruments, which can be employed for cost containment, are explained against this background with an emphasis on Managed Care and global budgets. The outlined concepts are finally discussed in the context of the current debate about the proposed cost containment legislation in Germany. PMID:11013969

  16. Addiction, ethics and public policy.

    PubMed

    West, R

    1997-09-01

    Addiction affects the lives of all of human kind, either directly or indirectly. The cost to individuals and societies is immense and tackling the problem is as much one for policy makers as clinicians, counsellors and scientists. Ethical issues permeate much of the work of all these groups. The issue of what is right and wrong, morally defensible or morally unacceptable arises at both an individual and societal level. This special issue contains 21 commissioned articles from leading figures in addiction research. To set the scene for these in-depth analyses, this article reports the results of an expert panel survey on addiction, ethics and public policy. A total of 199 people from 24 countries identified as first authors of research papers abstracted in Addiction Abstracts in 1994 and 1995 completed a postal questionnaire asking their views on a range of issues. They were asked to state their position on the issue and to identify what they considered to be the most important factors in the decision. Among the findings of interest were: a majority believed that possession of cannabis should be legal but that possession of 'hard drugs' should be illegal. An overwhelming majority believed that tobacco advertising should be banned, that smoking should be prohibited in public buildings and offices and that the legal age for tobacco sales should be 18 or more. A majority believed that researchers should not accept backing from tobacco companies; opinion on accepting backing from the alcohol industry was more evenly divided. An overwhelming majority believed that drug addicts should be able to attend treatment centres on demand and that some form of methadone maintenance should be available to addicts who want it. The survey should prove a useful resource when debating the issues in policy and research arenas. PMID:9374001

  17. 33 CFR 239.8 - Cost sharing.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Cost sharing. 239.8 Section 239.8... RESOURCES POLICIES AND AUTHORITIES: FEDERAL PARTICIPATION IN COVERED FLOOD CONTROL CHANNELS § 239.8 Cost... to provide additional cost sharing to reflect special local benefits or betterments. Such...

  18. 45 CFR 63.22 - Cost sharing.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Cost sharing. 63.22 Section 63.22 Public Welfare... THE ASSISTANT SECRETARY FOR PLANNING AND EVALUATION Financial Provisions § 63.22 Cost sharing. Policy... amount equal to as much as the entire cost of the project....

  19. 44 CFR 208.33 - Allowable costs.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    .... Consistent with Office of Management and Budget (OMB) Circulars A-21, A-87, A-102 and A-110 (2 CFR part 215... 44 Emergency Management and Assistance 1 2012-10-01 2011-10-01 true Allowable costs. 208.33... Agreements § 208.33 Allowable costs. (a) Cost neutrality. DHS policy is that an Alert or Activation should...

  20. 44 CFR 208.33 - Allowable costs.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    .... Consistent with Office of Management and Budget (OMB) Circulars A-21, A-87, A-102 and A-110 (2 CFR part 215... 44 Emergency Management and Assistance 1 2014-10-01 2014-10-01 false Allowable costs. 208.33... Agreements § 208.33 Allowable costs. (a) Cost neutrality. DHS policy is that an Alert or Activation should...

  1. 45 CFR 63.22 - Cost sharing.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Cost sharing. 63.22 Section 63.22 Public Welfare... THE ASSISTANT SECRETARY FOR PLANNING AND EVALUATION Financial Provisions § 63.22 Cost sharing. Policy... amount equal to as much as the entire cost of the project....

  2. 44 CFR 208.33 - Allowable costs.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    .... Consistent with Office of Management and Budget (OMB) Circulars A-21, A-87, A-102 and A-110 (2 CFR part 215... Agreements 208.33 Allowable costs. (a) Cost neutrality. DHS policy is that an Alert or Activation should be as cost neutral as possible to Sponsoring Agencies and Participating Agencies. To make an Alert...

  3. 7 CFR 1944.254 - Program costs.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... recognized as expenditures in compliance with OMB Cost Policies, i.e., OMB Circular A-87, 24 CFR 85.36, and... 7 Agriculture 13 2012-01-01 2012-01-01 false Program costs. 1944.254 Section 1944.254 Agriculture... REGULATIONS (CONTINUED) HOUSING Congregate Housing Services Program § 1944.254 Program costs. (a)...

  4. Toward a Record Retention Policy

    ERIC Educational Resources Information Center

    Vaughan, Jason

    2007-01-01

    An academic library working group was charged in 2005 to create a records retention schedule and policy applicable to records containing personally identifiable information of library patrons. This group conducted a survey and extensive research, culminating in an adopted library records retention schedule and policy implemented in 2006.

  5. NASA policy on pricing shuttle launch services

    NASA Technical Reports Server (NTRS)

    Smith, J. M.

    1977-01-01

    The paper explains the rationale behind key elements of the pricing policy for STS, the major features of the non-government user policy, and some of the stimulating features of the policy which will open space to a wide range of new users. Attention is given to such major policy features as payment schedule, cost and standard services, the two phase pricing structure, optional services, shared flights, cancellation and postponement, and earnest money.

  6. 48 CFR 9904.417 - Cost of money as an element of the cost of capital assets under construction.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.417 Cost... 48 Federal Acquisition Regulations System 7 2012-10-01 2012-10-01 false Cost of money as...

  7. 48 CFR 9904.417 - Cost of money as an element of the cost of capital assets under construction.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.417 Cost... 48 Federal Acquisition Regulations System 7 2013-10-01 2012-10-01 true Cost of money as an...

  8. 48 CFR 9904.417 - Cost of money as an element of the cost of capital assets under construction.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.417 Cost... 48 Federal Acquisition Regulations System 7 2014-10-01 2014-10-01 false Cost of money as...

  9. Preventing the importation of illicit nuclear materials in shipping containers.

    PubMed

    Wein, Lawrence M; Wilkins, Alex H; Baveja, Manas; Flynn, Stephen E

    2006-10-01

    We develop a mathematical model to find the optimal inspection strategy for detecting a nuclear weapon (or nuclear material to make a weapon) from being smuggled into the United States in a shipping container, subject to constraints of port congestion and an overall budget. We consider an 11-layer security system consisting of shipper certification, container seals, and a targeting software system, followed by passive (neutron and gamma), active (gamma radiography), and manual testing at overseas and domestic ports. Currently implemented policies achieve a low detection probability, and improved security requires passive and active testing of trusted containers and manually opening containers that cannot be penetrated by radiography. The annual cost of achieving a high detection probability of a plutonium weapon using existing equipment in traditional ways is roughly several billion dollars if testing is done domestically, and is approximately five times higher if testing is performed overseas. Our results suggest that employing high-energy x-ray radiography and elongating the passive neutron tests at overseas ports may provide significant cost savings, and several developing technologies, radiation sensors inside containers and tamper-resistant electronic seals, should be pursued aggressively. Further effort is critically needed to develop a practical neutron interrogation scheme that reliably detects moderately shielded, highly enriched uranium. PMID:17054538

  10. Prescription drugs in nursing homes: managing costs and quality in a complex environment.

    PubMed

    Mendelson, Dan; Ramchand, Rajeev; Abramson, Richard; Tumlinson, Anne

    2002-11-12

    This brief provides a description of prescription drug use in nursing homes and a summary of current policy issues in this area. The brief first profiles the nursing home pharmaceutical market, outlining the major trends in demographics and drug utilization, the supply chain by which drugs go from manufacturers to pharmacies to nursing home residents, and the alternative arrangements by which prescription drugs in nursing homes are financed. The brief then provides a synopsis of current policy issues, focusing in turn on cost containment and quality improvement initiatives. PMID:12463231

  11. Collapsing Containers.

    ERIC Educational Resources Information Center

    Brown, Justina L.; Battino, Rubin

    1994-01-01

    Describes variations on atmospheric pressure demonstrations and some systematic studies. Demonstrations use steam, generated either externally or internally to the container, to sweep out residual air. Preferred vessels collapsed slowly. Demonstrations use plastic milk jugs set in layers of aluminum foil, pop bottles immersed in 4-L beakers

  12. Collapsing Containers.

    ERIC Educational Resources Information Center

    Brown, Justina L.; Battino, Rubin

    1994-01-01

    Describes variations on atmospheric pressure demonstrations and some systematic studies. Demonstrations use steam, generated either externally or internally to the container, to sweep out residual air. Preferred vessels collapsed slowly. Demonstrations use plastic milk jugs set in layers of aluminum foil, pop bottles immersed in 4-L beakers…

  13. CONTAINMENT TECHNOLOGIES

    EPA Science Inventory

    Hazardous waste containment's primary objective is to isolate wastes deemed as hazardous from man and environmental systems of air, soil, and water. Hazardous wastes differ from other waste classifications due to their increased potential to cause human health effects or environ...

  14. Critical Policy Sociology: Historiography, Archaeology and Genealogy as Methods of Policy Analysis.

    ERIC Educational Resources Information Center

    Gale, Trevor

    2001-01-01

    Examines the essential characteristics of three approaches to conducting critical policy sociology of higher education: Historiography, archaeology, and genealogy. Draws on Australian higher education policy research to illustrate the use of these three methods. (Contains 65 references.) (PKP)

  15. Curbing Workers' Comp Costs.

    ERIC Educational Resources Information Center

    Deeb, William S.

    1998-01-01

    An actuarial study revealed that Pasadena Schools had an unfunded worker's compensation liability of over $10 million and 400 open claims. Advised to implement strong cost-containment measures (an early return-to-work program) and equally strong accountability measures (strict performance guides and safe work practices), the district achieved…

  16. Distributed Wind Policy Comparison Tool

    SciTech Connect

    2011-12-01

    Power through Policy: 'Best Practices' for Cost-Effective Distributed Wind is a U.S. Department of Energy (DOE)-funded project to identify distributed wind technology policy best practices and to help policymakers, utilities, advocates, and consumers examine their effectiveness using a pro forma model. Incorporating a customized feed from the Database of State Incentives for Renewables and Efficiency (DSIRE), the Web-based Distributed Wind Policy Comparison Tool (Policy Tool) is designed to assist state, local, and utility officials in understanding the financial impacts of different policy options to help reduce the cost of distributed wind technologies. The Policy Tool can be used to evaluate the ways that a variety of federal and state policies and incentives impact the economics of distributed wind (and subsequently its expected market growth). It also allows policymakers to determine the impact of policy options, addressing market challenges identified in the U.S. DOE’s '20% Wind Energy by 2030' report and helping to meet COE targets.

  17. Affirmative Action: Psychological Data and the Policy Debates.

    ERIC Educational Resources Information Center

    Crosby, Faye J.; Iyer, Aarti; Clayton, Susan; Downing, Roberta A.

    2003-01-01

    Uses psychological research to examine affirmative action policy, noting that many studies indicate that affirmative action as a policy has more benefits than costs. Discusses issues of merit, asserting that affirmative action policy conforms to the American ideal of fairness and is a necessary policy. Suggests that affirmative action is superior…

  18. [Public policy analysis].

    PubMed

    Subirats, J

    2001-01-01

    This article presents to public health professionals concepts and perspectives from political science relevant for creating a healthier public policy. Currently, there is no uniform vision of what constitutes public interest and the decisions of public administrations tend to be based on compromise. In public debate, what is paramount is the capacity to persuade. From the perspective of public policy analysis, the crucial issue is definition: the final decision depends on the definition of the problem that has emerged triumphant in the public debate among competing actors with different definitions of the problem. From a policy analysis perspective, the problems entering the agenda of public administration does not necessarily correspond to their severity, as competing actors try to impose their point of view. Because of its historical evolution, the Spanish political system has specific traits. The relatively weak democratic tradition tends to make the decision process less visibles, with strong technocratic elements and weaker social articulation. Both the juridical tradition and liberal rhetoric portray lobbying as contrary to public interest, when in fact it is constantly performed by powerful vested interest groups, through both personal contacts and economic connections. Regulatory policies, with concentrated costs and diffuse benefits, seem to be moving from Spain to the European Union. To promote healthier public policies, the development of civil society initiatives and the building of coalitions will play an increasingly greater role in the future. PMID:11423032

  19. 48 CFR 2823.403 - Policy.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... For Products Containing Recovered Materials (CPG) (40 CFR part 247). The recommended minimum recovered... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Policy. 2823.403 Section....403 Policy. It is the policy of DOJ that its contracting activities and contractors that procure...

  20. 48 CFR 1601.301 - Policy.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Policy. 1601.301 Section... Regulation (FEHBAR) 1601.301 Policy. (a) Procedures, contract clauses, and other aspects of the acquisition... policies and procedures contained in this regulation as implemented and supplemented from time to time;...

  1. 32 CFR 231.2 - Policy.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Policy. The policy pertaining to financial institutions operating on DoD installations is contained in DoD Directive 1000.11 (32 CFR part 230) and in § 231.4. ... 32 National Defense 2 2010-07-01 2010-07-01 false Policy. 231.2 Section 231.2 National...

  2. 48 CFR 2101.301 - Policy.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Policy. 2101.301 Section... Acquisition Regulations 2101.301 Policy. (a) Procedures, contract clauses, and other aspects of the... the policies and procedures contained in this chapter as implemented and supplemented from time...

  3. Reagan's Foreign Policy: An Assessment (I) Introduction.

    ERIC Educational Resources Information Center

    Johnston, Whittle

    1990-01-01

    Examines the relationship between former U.S. President Ronald Reagan's foreign policy and those of his predecessors. Focuses on the differences between Reagan's policies and those of former U.S. President Jimmy Carter. Analyzes Reagan's policies of containment, human rights, and arms control. Discusses criticisms launched against Reagan's…

  4. The Relationship of Inquiry to Public Policy.

    ERIC Educational Resources Information Center

    Sailor, Wayne; Stowe, Matthew

    2003-01-01

    This article examines the nature of inquiry and how it has evolved in American culture. Issues of "evidence" are examined, both for inquiry and for its application in public policy. It considers the role of policy in inquiry and the implications of altering the traditional relationship of policy to inquiry. (Contains references.) (CR)

  5. 48 CFR 2804.470-1 - Policy.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 6 2012-10-01 2012-10-01 false Policy. 2804.470-1 Section... Safeguarding Classified Information Within Industry 2804.470-1 Policy. It is the policy of the Department of... sensitive information contain, as appropriate, requirements for appropriate personnel security screening...

  6. 48 CFR 1601.301 - Policy.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 6 2014-10-01 2014-10-01 false Policy. 1601.301 Section... Regulation (FEHBAR) 1601.301 Policy. (a) Procedures, contract clauses, and other aspects of the acquisition... policies and procedures contained in this regulation as implemented and supplemented from time to time;...

  7. 48 CFR 2101.301 - Policy.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 6 2014-10-01 2014-10-01 false Policy. 2101.301 Section... Acquisition Regulations 2101.301 Policy. (a) Procedures, contract clauses, and other aspects of the... the policies and procedures contained in this chapter as implemented and supplemented from time...

  8. 48 CFR 2823.403 - Policy.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... For Products Containing Recovered Materials (CPG) (40 CFR part 247). The recommended minimum recovered... 48 Federal Acquisition Regulations System 6 2014-10-01 2014-10-01 false Policy. 2823.403 Section....403 Policy. It is the policy of DOJ that its contracting activities and contractors that procure...

  9. 48 CFR 1301.301 - Policy.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Policy. 1301.301 Section... ACQUISITION REGULATIONS SYSTEM Agency Acquisition Regulations 1301.301 Policy. (a) The designee authorized to... operating guidance and procedures are contained in the CAM and other policy guidance documents issued by...

  10. 48 CFR 9904.414 - Cost accounting standard-cost of money as an element of the cost of facilities capital.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  11. 48 CFR 9904.414 - Cost accounting standard-cost of money as an element of the cost of facilities capital.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 7 2012-10-01 2012-10-01 false Cost accounting standard... Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST...

  12. 48 CFR 9904.414 - Cost accounting standard-cost of money as an element of the cost of facilities capital.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 7 2014-10-01 2014-10-01 false Cost accounting standard... Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST...

  13. 48 CFR 9904.414 - Cost accounting standard-cost of money as an element of the cost of facilities capital.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 7 2013-10-01 2012-10-01 true Cost accounting standard... Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST...

  14. Predictable Unpredictability: the Problem with Basing Medicare Policy on Long-Term Financial Forecasting.

    PubMed

    Glied, Sherry; Zaylor, Abigail

    2015-07-01

    The authors assess how Medicare financing and projections of future costs have changed since 2000. They also assess the impact of legislative reforms on the sources and levels of financing and compare cost forecasts made at different times. Although the aging U.S. population and rising health care costs are expected to increase the share of gross domestic product devoted to Medicare, changes made in the program over the past decade have helped stabilize Medicare's financial outlook--even as benefits have been expanded. Long-term forecasting uncertainty should make policymakers and beneficiaries wary of dramatic changes to the program in the near term that are intended to alter its long-term forecast: the range of error associated with cost forecasts rises as the forecast window lengthens. Instead, policymakers should focus on the immediate policy window, taking steps to reduce the current burden of Medicare costs by containing spending today. PMID:26219117

  15. The unhealthy state of health policy research.

    PubMed

    Majumdar, Sumit R; Soumerai, Stephen B

    2009-01-01

    Health policies often represent large-scale natural experiments with poorly understood risks and benefits. Unfortunately, researchers often stray from the core principles of study design required to provide valid evidence. The result is that policymakers and the public do not always know what to believe. We illustrate the problem in several fields, including pay-for-performance, cost sharing, and health information technology policies. We suggest a few ways to improve health policy research so that evidence can inform policy more often. The way forward should include more credible data for those making the hard trade-offs between cost and quality of care. PMID:19671571

  16. Commentary on NTIS Document Costs

    ERIC Educational Resources Information Center

    Richardson, Robert J.

    1973-01-01

    The author believes it would be appropriate to review the current National Technical Information Service (NTIS) pricing policy in terms of its rationale, legality, and the possibility of mitigating or reversing the demonstrated pattern of repeated cost increases. (Author/SJ)

  17. AIDS costs in Trinidad and Tobago.

    PubMed

    Henry, R; Newton, E

    1994-01-01

    In 1983, there were only eight registered cases of AIDS in Trinidad and Tobago, all among male homosexuals and bisexuals. By the beginning of 1992, however, Trinidad and Tobago was ranked 17th worldwide among 164 countries for which AIDS-case data had been collected in terms of the number of reported cases of AIDS per 100,000 population. Moreover, by 1992, of the 175 new cases reported for which risk factors could be established, 77.1% were from among the heterosexual population, with 10.3% of cases with known risk factors being in the pediatric category. 143 people had died of AIDS in the country by the end of November 1993. IV drug use has not been much of a problem in Trinidad and Tobago. The prospective costs of HIV and AIDS depend upon the course taken by the epidemic over the next few years, but it has already, in terms of the human capital approach, made an impact upon national GDP. The authors developed projections of AIDS incidence for Trinidad and Tobago through the year 2020 based upon assumptions of plausible patterns of HIV prevalence. The AIDS Projection Model and DemProj, a demographic projection model used mainly to generate estimates of the age distribution of AIDS incidence, were employed. Even the most conservative of projections suggests that the number of cases will rise by a factor of 4-5 by the year 2000. It is hoped that a better appreciation of the full costs of AIDS will help in the development of policies designed to contain the spread of the disease and ensure that the level of societal investment necessary is undertaken to save upon prospective private and social costs. Sections describe unfolding scenarios, estimates of social monetary costs, hospitalization costs, foregone earnings, and prevention programs. PMID:12346421

  18. Transition-cost recovery and trueup mechanisms

    SciTech Connect

    Hirst, E.; Hadley, S.

    1998-03-01

    Designing a workable and policy-responsive cost-recovery and trueup mechanism may be the key unresolved issue related to the transition costs (TCs) facing US electric utilities. This report first discusses the general issues associated with the design and implementation of such mechanisms. It then presents the results of quantitative analyses that show how seven mechanisms perform against six public-policy objectives.

  19. Costs of pain in rheumatology.

    PubMed

    Marsico, A; Atzeni, F; Piroddi, A; Cazzola, M; Stisi, S; Sarzi-Puttini, P

    2014-01-01

    Chronic pain has been identified as an important issue related to various rheumatic diseases. At the time of a major government spending review, it is appropriate to discuss the pain characterising rheumatic diseases and its related costs. It is clearly essential for healthcare authorities to rationalise their policies on the basis of the increasing expectations of the users of healthcare services while simultaneously balancing their books. There are few published studies concerning the costs of pain of any kind, and the same is true of the costs of the chronic pain associated with diseases such as rheumatoid arthritis, osteoarthritis, and fibromyalgia. PMID:24938203

  20. Preemptive public policy for genomics.

    PubMed

    Carlson, Rick J

    2008-02-01

    To many, genomics is merely exploitable technology for the leviathan of biotechnology. This is both shallow and short sighted. Genomics is applied knowledge based on profound and evolving science about how living things develop, how healthy or sick we are, and what our future will be like. In health care, genomics technologies are disruptive yet potentially cost-effective because they enable primary prevention, the antidote to runaway costs and declining productivity. The challenges to integration are great, however, and many bioethical and social-policy implications are alarming. Because it is poorly understood today, we must debate genomics vigorously if we are to act wisely. Public policy must lead. PMID:18252856

  1. Opportunity Cost of Distance Education

    ERIC Educational Resources Information Center

    Turkoglu, Recep

    2004-01-01

    In this study, opportunity cost (OC) of distance education (DE) has been examined. In addition, factors which affect OC of DE have been investigated. (Contains 1 table.) [Abstract modified to meet ERIC guidelines.

  2. Cost-shifting under cost reimbursement and prospective payment.

    PubMed

    Foster, R W

    1985-09-01

    Cost-shifting is seen as a three-way phenomenon involving hospital interests as well as those of government and private patients. Without economies of scale, private patients are indifferent to government policies unless underpayment leads to hospital bankruptcy. In the presence of economies of scale, private patients benefit from reductions in government payment under either cost reimbursement or prospective payment. Their interest in a shift to prospective payment depends upon the hospital's location on its cost curve. Hospitals benefit from increases in payment rates in all cases, but benefit from a shift to prospective payment only if operating in a region of declining average costs. The conventional view of cost-shifting is inconsistent with profit maximization and may be inappropriate for many voluntary hospitals as well. PMID:10300555

  3. Costing blood products and services.

    PubMed

    Wallace, E L

    1991-05-01

    At present, blood centers and transfusion services have limited alternatives for offsetting the ever-rising costs of health care inputs. In the face of current revenue constraints, cost reduction or cost containment through efficiency improvements or service reduction is the principal available means. Such methods ought to be pursued vigorously by blood bankers with the aid of well-designed costing and other physical measurements systems. Experience indicates, however, that blood bankers, in their attempts to reduce or contain costs, are likely to place undue reliance on cost accounting systems as the means of capturing sought-for benefits. Management must learn enough about methods of costing to judge directly the uses and limitations of the information produced. Such understanding begins with recognition that all costs and cost comparisons should be specific to the purpose for which they are developed. No costing procedure is capable of producing measures generally applicable to all management decisions. A measure relevant to a planning decision is unlikely to be appropriate for performance evaluation. Useful comparisons among sets of organizations of costs, or of measures of physical inputs and outputs, require assurance that the methods of measurement employed are the same and that the sets of organizations from which the measures are drawn are reasonably comparable. PMID:2020991

  4. Handbook for estimating fabrication costs

    NASA Technical Reports Server (NTRS)

    Freeman, L. M.

    1978-01-01

    Guide helps design engineers determine total cost of fabricating electronic equipment. It contains tables of "factors" for determining costs associated with fabrication. "Standards" section includes estimations of time required for procedures ranging from machining, to wiring, to printed-circuit board fabrication.

  5. Health care costs in end-of-life and palliative care: the quest for ethical reform.

    PubMed

    Jennings, Bruce; Morrissey, Mary Beth

    2011-01-01

    Health reform in the United States must address both access to medical services and universal insurance coverage, as well as health care cost containment. Uncontrolled health care costs will undermine improvements in access and coverage in the long-run, and will also be detrimental to other important social programs and goals. Accordingly, the authors offer an ethical perspective on health care cost control in the context of end-of-life and palliative care, an area considered by many to be a principal candidate for cost containment. However, the policy and ethical challenges may be more difficult in end-of-life care than in other areas of medicine. Here we discuss barriers to developing high quality, cost effective, and beneficial end-of-life care, and barriers to maintaining a system of decision making that respects the wishes and values of dying patients, their families, and caregivers. The authors also consider improvements in present policy and practice-such as increased timely access and referral to hospice and palliative care; improved organizational incentives and cultural attitudes to reduce the use of ineffective treatments; and improved communication among health professionals, patients, and families in the end-of-life care planning and decision-making process. PMID:22150176

  6. Costing climate change

    NASA Astrophysics Data System (ADS)

    Reay, David S.

    2002-12-01

    Debate over how, when, and even whether man-made greenhouse-gas emissions should be controlled has grown in intensity even faster than the levels of greenhouse gas in our atmosphere. Many argue that the costs involved in reducing emissions outweigh the potential economic damage of human-induced climate change. Here, existing cost-benefit analyses of greenhouse-gas reduction policies are examined, with a view to establishing whether any such global reductions are currently worthwhile. Potential for, and cost of, cutting our own individual greenhouse-gas emissions is then assessed. I find that many abatement strategies are able to deliver significant emission reductions at little or no net cost. Additionally, I find that there is huge potential for individuals to simultaneously cut their own greenhouse-gas emissions and save money. I conclude that cuts in global greenhouse-gas emissions, such as those of the Kyoto Protocol, cannot be justifiably dismissed as posing too large an economic burden.

  7. Assessment of the costs, risks and benefits of selected integrated policy options to adapt to flood and drought in the water and agricultural sectors of the Warta River Basin

    NASA Astrophysics Data System (ADS)

    Sendzimir, Jan; Dubel, Anna; Linnerooth-Bayer, Joanne; Damurski, Jakub; Schroeter, Dagmar

    2014-05-01

    Historically large reservoirs have been the dominant strategy to counter flood and drought risk in Europe. However, a number of smaller-scale approaches have emerged as alternative strategies. To compare the cost effectiveness of reservoirs and these alternatives, we calculated the Investment & maintenance costs in terms of (euros) /m3 water stored or annual runoff reduced for five different strategies: large reservoirs (1.68 euros), large on-farm ponds (5.88 euros), small on-farm ponds (558.00 euros), shelterbelts (6.86 euros), switching to conservation tillage (-9.20 euros). The most cost effective measure for reducing runoff is switching to conservation tillage practices because this switch reduces machinery and labor costs in addition to reducing water runoff. Although shelterbelts that reduce annual runoff cannot be directly compared to ponds and reservoirs that store water, our estimates show that they likely compare favorably as a natural water retention measure, especially when taking account of their co-benefits in terms of erosion control, biodiversity and pollination. Another useful result is our demonstration of the economies of scale among reservoirs and ponds for storing water. Small ponds are two orders of magnitude more costly to construct and maintain as a flood and drought prevention measure than large reservoirs. Here, again, there are large co-benefits that should be factored into the cost-benefit equation, including especially the value of small ponds in promoting corridors for migration. This analysis shows the importance of carrying out more extensive cost-benefit estimates across on-farm and off-farm measures for tackling drought and flood risk in the context of a changing climate. While concrete recommendations for supporting water retention measures will depend on a more detailed investigation of their costs and benefits, this research highlights the potential of natural water retention measures as a complement to conventional investments in large reservoirs.

  8. 48 CFR 9904.416 - Accounting for insurance costs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Accounting for insurance costs. 9904.416 Section 9904.416 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST...

  9. 25 CFR 700.81 - Monthly housing cost.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false Monthly housing cost. 700.81 Section 700.81 Indians THE... Policies and Instructions Definitions § 700.81 Monthly housing cost. (a) General. The term monthly housing...) Computation of monthly housing cost for replacement dwelling. A person's monthly housing cost for...

  10. 25 CFR 700.81 - Monthly housing cost.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 2 2011-04-01 2011-04-01 false Monthly housing cost. 700.81 Section 700.81 Indians THE... Policies and Instructions Definitions § 700.81 Monthly housing cost. (a) General. The term monthly housing...) Computation of monthly housing cost for replacement dwelling. A person's monthly housing cost for...

  11. Cost Control

    ERIC Educational Resources Information Center

    Foreman, Phillip

    2009-01-01

    Education administrators involved in construction initiatives unanimously agree that when it comes to change orders, less is more. Change orders have a negative rippling effect of driving up building costs and producing expensive project delays that often interfere with school operations and schedules. Some change orders are initiated by schools…

  12. 48 CFR 9904.410 - Allocation of business unit general and administrative expenses to final cost objectives.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

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

  13. 48 CFR 925.7002 - Policy.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... ACQUISITION Acquisition of Nuclear Hot Cell Services 925.7002 Policy. In selecting offer(s) for award of contracts for nuclear hot cell services, costs related to the decommissioning of nuclear facilities...

  14. 48 CFR 925.7002 - Policy.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... ACQUISITION Acquisition of Nuclear Hot Cell Services 925.7002 Policy. In selecting offer(s) for award of contracts for nuclear hot cell services, costs related to the decommissioning of nuclear facilities...

  15. 48 CFR 335.070-1 - Policy.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... CONTRACTING RESEARCH AND DEVELOPMENT CONTRACTING 335.070-1 Policy. (a) Contracting activities shall encourage... of background knowledge in future contracts. Cost-sharing is intended to serve the mutual...

  16. 48 CFR 1034.201 - Policy.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... life cycle investment costs; and (5) Level of risk. ... CONTRACTING MAJOR SYSTEM ACQUISITION Earned Value Management System 1034.201 Policy. (a) (1) An Earned Value Management System (EVMS) is required for major acquisitions for development/modernization/enhancement...

  17. 48 CFR 1034.201 - Policy.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... life cycle investment costs; and (5) Level of risk. ... CONTRACTING MAJOR SYSTEM ACQUISITION Earned Value Management System 1034.201 Policy. (a) (1) An Earned Value Management System (EVMS) is required for major acquisitions for development/modernization/enhancement...

  18. 48 CFR 925.7002 - Policy.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... ACQUISITION Acquisition of Nuclear Hot Cell Services 925.7002 Policy. In selecting offer(s) for award of contracts for nuclear hot cell services, costs related to the decommissioning of nuclear facilities...

  19. 48 CFR 925.7002 - Policy.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... ACQUISITION Acquisition of Nuclear Hot Cell Services 925.7002 Policy. In selecting offer(s) for award of contracts for nuclear hot cell services, costs related to the decommissioning of nuclear facilities...

  20. 48 CFR 925.7002 - Policy.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... ACQUISITION Acquisition of Nuclear Hot Cell Services 925.7002 Policy. In selecting offer(s) for award of contracts for nuclear hot cell services, costs related to the decommissioning of nuclear facilities...

  1. 48 CFR 9904.402 - Cost accounting standard-consistency in allocating costs incurred for the same purpose.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 7 2012-10-01 2012-10-01 false Cost accounting standard... Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.402...

  2. 48 CFR 9904.402 - Cost accounting standard-consistency in allocating costs incurred for the same purpose.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 7 2014-10-01 2014-10-01 false Cost accounting standard... Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.402...

  3. 48 CFR 9904.402 - Cost accounting standard-consistency in allocating costs incurred for the same purpose.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 7 2013-10-01 2012-10-01 true Cost accounting standard... Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.402...

  4. 48 CFR 9904.402 - Cost accounting standard-consistency in allocating costs incurred for the same purpose.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  5. Three essays on monetary policy responses to oil price shocks

    NASA Astrophysics Data System (ADS)

    Plante, Michael

    This dissertation contains three chapters which explore the question of how monetary policy should respond to changes in the price of oil. Each chapter explores the question from the perspective of a different economic environment. The first chapter examines welfare maximizing optimal monetary policy in a closed economy New Keynesian model that is extended to include household and firm demand for oil products, sticky wages, and capital accumulation. When households and firms demand oil products a natural difference arises between the Consumer Price Index (CPI), the core CPI, and the GDP deflator. I show that when nominal wages are flexible then the optimal policy places a heavy emphasis on stabilizing the inflation rate of the core CPI. If aggregate nominal wages are sticky then the central bank should focus on stabilizing some combination of core inflation and nominal wage inflation. Under no case examined is it optimal to stabilize either GDP deflator or CPI inflation. The second chapter examines monetary policy responses to oil price shocks in a small open economy with traded and non-traded goods. Oil and labor are used to produce the traded and non-traded goods and prices are sticky in the non-traded sector. I show analytically that the ratio of the oil and labor cost shares in the traded and non-traded sectors is crucial for determining the dynamic behavior of many macroeconomic variables after a rise in the price of oil. A policy of fixed exchange rates can produce higher or lower inflation in the non-traded sector depending upon the ratio. Likewise, a policy that stabilizes the inflation rate of prices in the non-traded sector can cause the nominal exchange rate to appreciate or depreciate. For the proper calibration, a policy that stabilizes core inflation produces results very close to the one that stabilizes non-traded inflation. Analytical results show that the fixed exchange rate always produces a unique solution. The policy of stabilizing non-traded inflation produces a unique solution so long as the nominal interest rate is raised more than one for one with increases in non-traded inflation. A policy of stabilizing core inflation, however, produces a unique solution only if the response is greater than one for one and less then one divided by one minus the share of the non-traded good in the CPI. In the third chapter I consider monetary and fiscal policy responses to oil price shocks in a low income oil importing country. The model used in this chapter differs from the model in the second chapter in that there is currency substitution, household demand for oil products, and a potential subsidy on the purchase of oil products by households. I examine the dynamic properties and the welfare implications of a set of inflation targeting policies and a group of policies that subsidize the price of oil and finance the subsidy through a combination of raising lump sum taxes and printing money. The dynamic properties of the inflation targeting policies are similar in many regards to those in the second chapter as the key assumptions driving the results are the same in the two models. For the policies which subsidize the price of oil I show that both the choice to have the subsidy and how to finance it matter a great deal for the behavior of the macroeconomic variables. In terms of welfare, for most calibrations there are only minor differences between the inflation targeting polices, the policy with a subsidy funded by lump sum taxes, and the baseline policy with no subsidy. The policy with a subsidy financed by the inflation tax generally causes significant welfare losses compared to the policy with no pass through.

  6. Balancing policy objectives in long-term care.

    PubMed Central

    Christianson, J B

    1978-01-01

    The public policy objectives in long-term care--quality, availability, and cost containment--are promoted by different groups with conflicting but legitimate interests. The problem faced by the policymaker is to balance the economic and political consequences for patients, providers, and public funding agencies, and he often does this by partial achievement or selective nonachievement of the policy goals. A multidimensional objective function is described that permits calculation of the optimum extent to which conflicting goals can be achieved. The model allows simulation of the effects, on several simultaneous measures, of an administered change in some or all of the measures. The example given illustrates the complexity of the policymaker's problem and suggests a rational approach to dealing with it. PMID:418028

  7. The Rising Cost of Private Higher Education.

    ERIC Educational Resources Information Center

    Suttle, J. Lloyd

    1983-01-01

    The informational and analytical bases by which Yale University sets tuition levels and long-term pricing policies are illustrated. The rising cost of private higher education is discussed, considering historical trends, inflation, the institution's financial condition, comparative costs from other schools, and effect on enrollment. (MSE)

  8. 7 CFR 1944.254 - Program costs.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... recognized as expenditures in compliance with OMB Cost Policies, i.e., OMB Circular A-87, 24 CFR 85.36, and... and equipment, and costs associated with self evaluation or assessment (not to exceed one percent of... to administering medication, purchase of medical supplies, equipment and medications,...

  9. 24 CFR 700.115 - Program costs.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... recognized as expenditures in compliance with OMB Cost Policies, i.e., OMB Circular A-87, 24 CFR 85.36, and... and equipment, and costs associated with self evaluation or assessment (not to exceed one percent of... to administering medication, purchase of medical supplies, equipment and medications,...

  10. Reliability and cost analysis methods

    NASA Technical Reports Server (NTRS)

    Suich, Ronald C.

    1991-01-01

    In the design phase of a system, how does a design engineer or manager choose between a subsystem with .990 reliability and a more costly subsystem with .995 reliability? When is the increased cost justified? High reliability is not necessarily an end in itself but may be desirable in order to reduce the expected cost due to subsystem failure. However, this may not be the wisest use of funds since the expected cost due to subsystem failure is not the only cost involved. The subsystem itself may be very costly. We should not consider either the cost of the subsystem or the expected cost due to subsystem failure separately but should minimize the total of the two costs, i.e., the total of the cost of the subsystem plus the expected cost due to subsystem failure. This final report discusses the Combined Analysis of Reliability, Redundancy, and Cost (CARRAC) methods which were developed under Grant Number NAG 3-1100 from the NASA Lewis Research Center. CARRAC methods and a CARRAC computer program employ five models which can be used to cover a wide range of problems. The models contain an option which can include repair of failed modules.

  11. Health promotion in nursing and cost-effectiveness.

    PubMed

    Jadelhack, Raja

    2012-01-01

    Close examination of the different healthcare systems and the present economic crisis worldwide suggests that all health organizations should re-evaluate the concept of health promotion and its relationship to cost-effectiveness. When choosing the most efficient and cost-effective system, each nation's healthcare system must seriously start to implement strategies for the change. Health professions, including nursing, must change their vision of education both in academic and practice settings, to focus on health promotion and illness prevention. The key principle underlying this paper is to illustrate the importance of health promotion and cost-effectiveness being adopted by all health organizations worldwide, as well as to observe the experiences of selected counties in developing a health policy related to education in primary healthcare. The paper will include a plan adopted by the General Nursing Directorate (GND) in the Kingdom of Saudi Arabia (SA), which contains a health promotion policy for the nursing administrations in all governmental primary healthcare centers in Saudi Arabia. PMID:22924205

  12. Policy Overview and Options for Maximizing the Role of Policy in Geothermal Electricity Development

    SciTech Connect

    Doris, E.; Kreycik, C.; Young, K.

    2009-09-01

    Geothermal electricity production capacity has grown over time because of multiple factors, including its renewable, baseload, and domestic attributes; volatile and high prices for competing technologies; and policy intervention. Overarching federal policies, namely the Public Utilities Regulatory Policies Act (PURPA), provided certainty to project investors in the 1980s, leading to a boom in geothermal development. In addition to market expansion through PURPA, research and development policies provided an investment of public dollars toward developing technologies and reducing costs over time to increase the market competitiveness of geothermal electricity. Together, these efforts are cited as the primary policy drivers for the currently installed capacity. Informing policy decisions depends on the combined impacts of policies at the federal and state level on geothermal development. Identifying high-impact suites of policies for different contexts, and the government levels best equipped to implement them, would provide a wealth of information to both policy makers and project developers.

  13. Standard cost elements for technology programs

    NASA Technical Reports Server (NTRS)

    Christensen, Carisa B.; Wagenfuehrer, Carl

    1992-01-01

    The suitable structure for an effective and accurate cost estimate for general purposes is discussed in the context of a NASA technology program. Cost elements are defined for research, management, and facility-construction portions of technology programs. Attention is given to the mechanisms for insuring the viability of spending programs, and the need for program managers is established for effecting timely fund disbursement. Formal, structures, and intuitive techniques are discussed for cost-estimate development, and cost-estimate defensibility can be improved with increased documentation. NASA policies for cash management are examined to demonstrate the importance of the ability to obligate funds and the ability to cost contracted funds. The NASA approach to consistent cost justification is set forth with a list of standard cost-element definitions. The cost elements reflect the three primary concerns of cost estimates: the identification of major assumptions, the specification of secondary analytic assumptions, and the status of program factors.

  14. Globalisation and social policy.

    PubMed

    Langmore, J

    2001-01-01

    This paper discusses six major themes: that economic and social issues are closely interdependent and that the appropriate stance is to work on both together, simultaneously; that though the threats from globalisation have been exaggerated, there can be substantial costs as well as considerable benefits; that constraints on national policy are significant but are less severe than is commonly considered; that the vitality-the vigour-of national and international political processes must be increased to cope effectively with the changes which are underway; that the private sector, unions and civil society have crucial roles in the provision of services and in advocating socially responsible values, standards and policies; and that one of the most effective means of addressing the erosion of national autonomy from globalisation is for countries to cooperate in setting and implementing shared objectives and international standards and establishing more global public goods. PMID:12219761

  15. An analysis of congressional health policy voting in the 1970s.

    PubMed

    Mueller, K J

    1986-01-01

    This paper analyzes nine health policy votes in the U.S. House of Representatives. The votes all occurred between 1973 and 1980 and include such issues as health planning, health maintenance organizations, cost containment, and professional standards review organizations. The objective of this analysis is to examine the independent contribution of variables indigenous to health issues while controlling for party identification and ideology. The influence of health providers, measured by the effect of the number of state medical association members in each state, is significant in the findings. The state and local share of Medicaid expenses is also significant in explaining several votes. Contributions from political action committees were not important until 1979, when the rising costs of campaigns gave them more influence, and when our measures of their influence improved. By the time Congress voted in 1979 on hospital cost containment legislation, the PAC variable surpassed even the AMA variable in importance. PMID:3088091

  16. Population policy.

    PubMed

    1987-03-01

    Participants in the Seminar on Population Policies for Top-level Policy Makers and Program Managers, meeting in Thailand during January 1987, examined the challenges now facing them regarding the implementation of fertility regulation programs in their respective countries -- Bangladesh, China, India, Indonesia, Malaysia, Nepal, Pakistan, the Philippines, the Republic of Korea, and Thailand. This Seminar was organized to coincide with the completion of an Economic and Social Commission for Asia and the Pacific (ESCAP) study investigating the impact and efficiency of family planning programs in the region. Country studies were reviewed at the Seminar along with policy issues about the status of women, incentive and disincentive programs, and socioeconomic factors affecting fertility. In Bangladesh the government recognizes population growth as its top priority problem related to the socioeconomic development of the country and is working to promote a reorientation strategy from the previous clinic-oriented to a multidimensional family welfare program. China's family planning program seeks to postpone marraige, space the births of children between 3-5 years, and promote the 1-child family. Its goal is to reduce the rate of natural increase from 12/1000 in 1978 to 5/1000 by 1985 and 0 by 2000. India's 7th Five-Year-Plan (1986-90) calls for establishing a 2-child family norm by 2000. In Indonesia the government's population policy includes reducing the rate of population growth, achieving a redistribution of the population, adjusting economic factors, and creating prosperous families. The government of Indonesia reversed its policy to reduce the population growth rate in 1984 and announced its goal of achieving a population of 70 million by 2100 in order to support mass consumption industries. It has created an income tax deduction system favoring large families and maternity benefits for women who have up to 5 children as incentives. Nepal's official policy is to decrease fertility, control international migration, and modify the spatial distribution of the population. To reduce its population growth rate, Pakistan has adopted a multi-sectoral, multidimensional approach to family planning. The policy of the government of the Philippines is to bring the population growth rate in line with the availability of natural resources and employment opportunities. In its 5-year plan covering 1982-86, the government of the Republic of Korea emphasized social development, attempting to more fully integrate population and development policies and programs within relevant sectors. To reduce its population growth rate to 1.3% by 1992, the government of Thailand is expanding the reach of its family planning program. PMID:12341036

  17. 48 CFR 2129.170 - Policy.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Policy. 2129.170 Section 2129.170 Federal Acquisition Regulations System OFFICE OF PERSONNEL MANAGEMENT, FEDERAL EMPLOYEES GROUP... Policy. (a) OPM shall consider taxes as a FEGLI Program cost under 2131.205-41. (b) For purposes of...

  18. American Students' Perceptions of American Foreign Policy.

    ERIC Educational Resources Information Center

    Barger, Robert N.

    The perception of typical U.S. college students toward the Reagan administration's foreign policy is that it is based on the principle that Communism must be stopped at any cost. Students' beliefs are defined according to their reactions to specific U.S. foreign policy initiatives. Three areas have aroused considerable campus reaction and…

  19. 23 CFR 668.105 - Policy.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... more cost effective as described in 23 CFR 635.204. Emergency repair work may be accomplished by the... 23 Highways 1 2010-04-01 2010-04-01 false Policy. 668.105 Section 668.105 Highways FEDERAL HIGHWAY... Procedures for Federal-Aid Highways § 668.105 Policy. (a) The Emergency Relief (ER) program is intended...

  20. 2 CFR 230.15 - Policy.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 2 Grants and Agreements 1 2010-01-01 2010-01-01 false Policy. 230.15 Section 230.15 Grants and Agreements OFFICE OF MANAGEMENT AND BUDGET CIRCULARS AND GUIDANCE Reserved COST PRINCIPLES FOR NON-PROFIT ORGANIZATIONS (OMB CIRCULAR A-122) § 230.15 Policy. The principles are designed to provide that the...

  1. 48 CFR 48.102 - Policies.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... VALUE ENGINEERING Policies and Procedures 48.102 Policies. (a) As required by Section 36 of the Office... cost-effective value engineering procedures and processes. Agencies shall provide contractors a... engineering provisions in appropriate supply, service, architect-engineer and construction contracts...

  2. 43 CFR 12.710 - Policy.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 43 Public Lands: Interior 1 2013-10-01 2013-10-01 false Policy. 12.710 Section 12.710 Public Lands: Interior Office of the Secretary of the Interior ADMINISTRATIVE AND AUDIT REQUIREMENTS AND COST PRINCIPLES... § 12.710 Policy. (a) In the case of any equipment or product that may be authorized to be...

  3. 48 CFR 1516.303-72 - Policy.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 6 2014-10-01 2014-10-01 false Policy. 1516.303-72 Section 1516.303-72 Federal Acquisition Regulations System ENVIRONMENTAL PROTECTION AGENCY CONTRACTING METHODS AND CONTRACT TYPES TYPES OF CONTRACTS Cost-Reimbursement Contracts 1516.303-72 Policy. (a)...

  4. 2 CFR 225.20 - Policy.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 2 Grants and Agreements 1 2010-01-01 2010-01-01 false Policy. 225.20 Section 225.20 Grants and Agreements OFFICE OF MANAGEMENT AND BUDGET CIRCULARS AND GUIDANCE Reserved COST PRINCIPLES FOR STATE, LOCAL, AND INDIAN TRIBAL GOVERNMENTS (OMB CIRCULAR A-87) § 225.20 Policy. This part establishes...

  5. Monitoring the Impact of Education Policies.

    ERIC Educational Resources Information Center

    Johnstone, James N.

    Monitoring the impact of education policy is a critical component of planning. Without an effective monitoring system, the achievements of policies cannot be evaluated nor can the cost-effectiveness of various strategies be estimated. Monitoring requires the establishment of good data bases that are served by good (computerized) data collection…

  6. 48 CFR 48.102 - Policies.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... VALUE ENGINEERING Policies and Procedures 48.102 Policies. (a) As required by Section 36 of the Office... cost-effective value engineering procedures and processes. Agencies shall provide contractors a... engineering provisions in appropriate supply, service, architect-engineer and construction contracts...

  7. Economic aspects of addiction policy.

    PubMed

    Maynard, A

    1986-05-01

    One definition of policy or government action in the Oxford English Dictionary is "craftiness" i.e. cunning or deceit. Such qualities have to be employed by governments because of the potential vote-losing effects of radical addiction policies. Health promotion, in relation to addictive substances such as alcohol and tobacco in particular, involves a trade-off between the costs of such policies, especially to industry (which seeks regulation to protect itself from competitors), and the benefits--improvements in the quality and length of life. Measures of such benefits (quality-adjusted life-years or QALYs) are available now to use in the evaluation of competing health promotion policies to determine their efficiency at the margin. Analysis of the market for tobacco indicates that consumption has been falling generally in the UK except among teenagers who appear to be the target of the industry's advertising and sponsorship efforts. This fall in consumption appears to be explained by health promotion rather than the active use of fiscal instruments of control. The recognition of the health effects of passive smoking and the impact of advertising and sponsorship, especially on the young, are policy areas requiring careful review and the evaluation of the costs and benefits of competing policies.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:10318048

  8. Policy implications of greenhouse warming

    NASA Astrophysics Data System (ADS)

    Coppock, Rob

    1992-03-01

    A study panel of the National Academy of Sciences, National Academy of Engineering, and Institute of Medicine recently issued the report Policy Implications of Greenhouse Warming. That report examined relevant scientific knowldeg and evidence about the potential of greenhouse warming, and assayed actions that could slow the onset of warming (mitigation policies) or help human and natural systems of plants and animals adapt to climatic changes (adaptation policies). The panel found that, even given the considerable uncertainties knowledge of the relevant phenomena, greenhouse warming poses a threat sufficient to merit prompt action. People in this country could probably adapt to the changes likely to accompany greenhouse warming. The costs, however, could be substantial. Investment in mitigation acts as insurance protection against the great uncertainties and the possibility of dramatic surprises. The panel found mitigation options that could reduce U.S. emissions by an estimated 10 to 40 percent at modest cost.

  9. Public policy and pharmaceutical innovation.

    PubMed

    Grabowski, H G

    1982-09-01

    Historically, new drug introductions have played a central role in medical progress and the availability of cost-effective therapies. Nevertheless, public policy toward pharmaceuticals has been characterized in recent times by increasingly stringent regulatory controls, shorter effective patent terms, and increased encouragement of generic product usage. This has had an adverse effect on the incentives and capabilities of firms to undertake new drug research and development activity. The industry has experienced sharply rising research and development costs, declining annual new drug introductions, and fewer independent sources of drug development. This paper considers the effects of government regulatory policies on the pharmaceutical innovation process from several related perspectives. It also examines the merits of current public policy proposals designed to stimulate drug innovation including patent restoration and various regulatory reform measures. PMID:10309721

  10. Policy Driven Development: Flexible Policy Insertion for Large Scale Systems

    PubMed Central

    Demchak, Barry; Krüger, Ingolf

    2014-01-01

    The success of a software system depends critically on how well it reflects and adapts to stakeholder requirements. Traditional development methods often frustrate stakeholders by creating long latencies between requirement articulation and system deployment, especially in large scale systems. One source of latency is the maintenance of policy decisions encoded directly into system workflows at development time, including those involving access control and feature set selection. We created the Policy Driven Development (PDD) methodology to address these development latencies by enabling the flexible injection of decision points into existing workflows at runtime, thus enabling policy composition that integrates requirements furnished by multiple, oblivious stakeholder groups. Using PDD, we designed and implemented a production cyberinfrastructure that demonstrates policy and workflow injection that quickly implements stakeholder requirements, including features not contemplated in the original system design. PDD provides a path to quickly and cost effectively evolve such applications over a long lifetime. PMID:25383258

  11. Three air quality policy case studies: Evaluating mass balance closure and the federal reference method for PM2.5, impacts of light duty diesel vehicles for GHG emissions control, and fleet hybridization as a cost-effective carbon dioxide reduction approach

    NASA Astrophysics Data System (ADS)

    Rees, Sarah L.

    This dissertation examines several policy issues in air quality regarding fine particulate matter (PM2.5) and greenhouse gas (GHG) emissions. First, mass balance closure for the Federal Reference Method (FRM) for measuring PM2.5 is examined using extensive data available from the Pittsburgh Air Quality Study (PAQS). Evaluating the data from PAQS for different measurement techniques provides insight as to the measurement artifacts associated with the FRM, which is the legal definition of PM2.5. This insight is in turn helpful in evaluating effective control technologies to attain PM 2.5 regulatory standards. The second policy issue evaluated is that of light duty diesel vehicles, and whether they provide the reductions in GHG emissions promised. If so, whether they produce corresponding adverse air quality impacts, and how significant these are. Finally, the current trend of purchasing hybrid vehicles for government fleet use is examined using real time data from the Washington State Department of Ecology (Ecology). Evaluating these data allows for a determination as to whether the fuel savings and GHG emission reductions achieved from the widespread use of hybrids in the fleet are worth the additional capital cost from the purchase of hybrids, and whether there are other strategies that could achieve similar reductions without incurring such capital costs.

  12. Academic Policy.

    ERIC Educational Resources Information Center

    Chicago City Colleges, IL.

    This statement outlines the academic policies of the City Colleges of Chicago. Part I outlines the Institution's academic standards, covering: (1) student class attendance; (2) the grading system; (3) mid-term grades; (4) the use of non-grade designations; i.e., administrative initiated withdrawal, auditor, no-show withdrawal, incomplete, and…

  13. Proposed reliability cost model

    NASA Technical Reports Server (NTRS)

    Delionback, L. M.

    1973-01-01

    The research investigations which were involved in the study include: cost analysis/allocation, reliability and product assurance, forecasting methodology, systems analysis, and model-building. This is a classic example of an interdisciplinary problem, since the model-building requirements include the need for understanding and communication between technical disciplines on one hand, and the financial/accounting skill categories on the other. The systems approach is utilized within this context to establish a clearer and more objective relationship between reliability assurance and the subcategories (or subelements) that provide, or reenforce, the reliability assurance for a system. Subcategories are further subdivided as illustrated by a tree diagram. The reliability assurance elements can be seen to be potential alternative strategies, or approaches, depending on the specific goals/objectives of the trade studies. The scope was limited to the establishment of a proposed reliability cost-model format. The model format/approach is dependent upon the use of a series of subsystem-oriented CER's and sometimes possible CTR's, in devising a suitable cost-effective policy.

  14. Drug Prohibition in the United States: Costs, Consequences, and Alternatives

    NASA Astrophysics Data System (ADS)

    Nadelmann, Ethan A.

    1989-09-01

    ``Drug legalization'' increasingly merits serious consideration as both an analytical model and a policy option for addressing the ``drug problem.'' Criminal justice approaches to the drug problem have proven limited in their capacity to curtail drug abuse. They also have proven increasingly costly and counterproductive. Drug legalization policies that are wisely implemented can minimize the risks of legalization, dramatically reduce the costs of current policies, and directly address the problems of drug abuse.

  15. Cost-Effectiveness and Cost-Reduction in United States Colleges and Universities.

    ERIC Educational Resources Information Center

    Miller, Richard I.; Miller, Peggy M.

    1991-01-01

    The relationship in college administration between cost effectiveness/cost reduction and planning, management, and evaluation is explored, and approaches to cost accounting and financial ratio analysis are discussed. It is concluded that it is important to emphasize institutional mission and people rather than cost containment and productivity.…

  16. Federal water policy: a progress report

    SciTech Connect

    Not Available

    1990-01-01

    The Federal Water Policy (FWP) is a statement of the federal government's philosophy and goals for the nation's freshwater resources and of the proposed ways of achieving them. This document provides background information on the FWP and the process followed by the Interdepartmental Committee on Water in developing this report. A complete review of achievment under the 5 strategies (water pricing, science leadership, integrated planning, legislation and public awareness) which support the FWP follows, ending in a presentation of new directions to better support the Policy. The report also contains a detailed review of the various policy statements enunciated under the 25 policy concerns contained in the FWP.

  17. Role of State Policy in Renewable Energy Development

    SciTech Connect

    Doris, E.; Busche, S.; Hockett, S.; McLaren, J.

    2009-07-01

    State policies can support renewable energy development by driving markets, providing certainty in the investment market, and incorporating the external benefits of the technologies into cost/benefit calculations. Using statistical analyses and policy design best practices, this paper quantifies the impact of state-level policies on renewable energy development in order to better understand the role of policy on development and inform policy makers on the policy mechanisms that provide maximum benefit. The results include the identification of connections between state policies and renewable energy development, as well as a discussion placing state policy efforts in context with other factors that influence the development of renewable energy (e.g. federal policy, resource availability, technology cost, public acceptance).

  18. Renewable Energy Cost Modeling. A Toolkit for Establishing Cost-Based Incentives in the United States

    SciTech Connect

    Gifford, Jason S.; Grace, Robert C.; Rickerson, Wilson H.

    2011-05-01

    This report serves as a resource for policymakers who wish to learn more about levelized cost of energy (LCOE) calculations, including cost-based incentives. The report identifies key renewable energy cost modeling options, highlights the policy implications of choosing one approach over the other, and presents recommendations on the optimal characteristics of a model to calculate rates for cost-based incentives, FITs, or similar policies. These recommendations shaped the design of NREL's Cost of Renewable Energy Spreadsheet Tool (CREST), which is used by state policymakers, regulators, utilities, developers, and other stakeholders to assist with analyses of policy and renewable energy incentive payment structures. Authored by Jason S. Gifford and Robert C. Grace of Sustainable Energy Advantage LLC and Wilson H. Rickerson of Meister Consultants Group, Inc.

  19. The role of multi-target policy instruments in agri-environmental policy mixes.

    PubMed

    Schader, Christian; Lampkin, Nicholas; Muller, Adrian; Stolze, Matthias

    2014-12-01

    The Tinbergen Rule has been used to criticise multi-target policy instruments for being inefficient. The aim of this paper is to clarify the role of multi-target policy instruments using the case of agri-environmental policy. Employing an analytical linear optimisation model, this paper demonstrates that there is no general contradiction between multi-target policy instruments and the Tinbergen Rule, if multi-target policy instruments are embedded in a policy-mix with a sufficient number of targeted instruments. We show that the relation between cost-effectiveness of the instruments, related to all policy targets, is the key determinant for an economically sound choice of policy instruments. If economies of scope with respect to achieving policy targets are realised, a higher cost-effectiveness of multi-target policy instruments can be achieved. Using the example of organic farming support policy, we discuss several reasons why economies of scope could be realised by multi-target agri-environmental policy instruments. PMID:25038517

  20. Laboratory cost control and financial management software.

    PubMed

    Mayer, M

    1998-02-01

    Economical constraints within the health care system advocate the introduction of tighter control of costs in clinical laboratories. Detailed cost information forms the basis for cost control and financial management. Based on the cost information, proper decisions regarding priorities, procedure choices, personnel policies and investments can be made. This presentation outlines some principles of cost analysis, describes common limitations of cost analysis, and exemplifies use of software to achieve optimized cost control. One commercially available cost analysis software, LabCost, is described in some detail. In addition to provision of cost information, LabCost also serves as a general management tool for resource handling, accounting, inventory management and billing. The application of LabCost in the selection process of a new high throughput analyzer for a large clinical chemistry service is taken as an example for decisions that can be assisted by cost evaluation. It is concluded that laboratory management that wisely utilizes cost analysis to support the decision-making process will undoubtedly have a clear advantage over those laboratories that fail to employ cost considerations to guide their actions. PMID:9541753